Washington University in St. Louis Washington University Open Scholarship All Theses and Dissertations (ETDs) Spring 4-22-2014 Making Healthy Minds and Bodies in Syria and Lebanon, 1899 - 1961 Beverly A. Tsacoyianis Washington University in St. Louis Follow this and additional works at: https://openscholarship.wustl.edu/etd Recommended Citation Tsacoyianis, Beverly A., "Making Healthy Minds and Bodies in Syria and Lebanon, 1899 - 1961" (2014). All Theses and Dissertations (ETDs). 1265. https://openscholarship.wustl.edu/etd/1265 This Dissertation is brought to you for free and open access by Washington University Open Scholarship. It has been accepted for inclusion in All Theses and Dissertations (ETDs) by an authorized administrator of Washington University Open Scholarship. For more information, please contact [email protected]. WASHINGTON UNIVERSITY IN ST. LOUIS Department of History Dissertation Examination Committee: Nancy Reynolds, Chair Timothy Parsons, co-chair Nancy Berg Ahmet Karamustafa Hillel Kieval Making Healthy Minds and Bodies in Syria and Lebanon, 1899 – 1961 by Beverly Ann Tsacoyianis A dissertation presented to the Graduate School of Arts and Sciences of Washington University in partial fulfillment of the requirements for the degree of Doctor of Philosophy May 2014 St. Louis, Missouri © 2014, Beverly Ann Tsacoyianis Table of Contents List of Abbreviations......................................................................................................................iii Acknowledgments .........................................................................................................................iv Chapter 1 – History, Healing, and its Limits...................................................................................1 Chapter 2 – The Origins of Syrian Medical Institutions................................................................36 Chapter 3 – Vernacular Healing in Greater Syria .........................................................................78 Chapter 4 – Medical Missionaries and Asfuriyeh, 1899-1960.....................................................112 Chapter 5 – Mental Illness and Ibn Sina Hospital, 1922-1961....................................................153 Chapter 6 – Conclusion: Making Healthy Bodies in Syria and Lebanon ...................................214 Bibliography................................................................................................................................239 Appendix .....................................................................................................................................259 ii Note on Transliteration I follow a simplified version of the system used in the International Journal of Middle East Studies. Except for the ʿayn (ʿ) and hamza (ʾ) I omit case endings and diacritical marks in the body of the text, but retain them in the footnotes and bibliography. For words in English and French sources I retain their spelling where appropriate (for example, the mental hospital in Lebanon known as Asfuriyeh) and for names of authors who published in English and French, I write their names as these authors spelled them. Where authors published in Arabic, I use the transliterated spelling as they are listed in library catalogs. List of Abbreviations AUB – American University of Beirut BNA – British National Archives ECT – electro-convulsive therapy EST – electro-shock therapy IFPO – Institut français du Proche-Orient ISHR – Ibn Sina Hospital Record LH – Lebanon Hospital for Nervous and Mental Disorders at Asfuriyeh MAE – Ministère des Affaires Étrangères (Ministry of Foreign Affairs), France SHD – Service Historique de la Défense SPC – Syrian Protestant College (renamed AUB in 1921) iii Acknowledgments This research was made possible with funding from the Fulbright-Hays Doctoral Dissertation Research Abroad award administered by the United States Department of Education, the Chancellor's Graduate Fellowship Award and the International and Area Studies pre-dissertation travel grant from Washington University in St. Louis, and the P.E.O. Scholar award administered by P.E.O., an international Philanthropic Educational Organization for women's education that helped finance the completion of my dissertation. I would especially like to thank the women of P.E.O. chapter GG in Alton, IL for nominating me for the award and for providing continued emotional support throughout the last two years of writing. In the United States, I am thankful for the unfailing support of my dissertation committee, especially my main advisors Nancy Reynolds and Timothy Parsons, and to other historians both on and outside my committee (Ahmet Karamustafa, Hillel Kieval, and Jonathan Sadowsky) who stayed in contact with me and gave advice and encouragement even while we worked from campuses hundreds of miles apart. I am also grateful for the input of Nancy Berg, who showed me the exciting directions interdisciplinary work could take when informing medical and social history research with approaches in comparative literature and film studies. My gratitude also goes to Sara Scalenghe and Kristina Richardson for encouraging this project in panel presentations at the annual meetings of the Middle East Studies Association and the American Historical Association, and to Dr. David Satin at Harvard Medical School for allowing me to present in the colloquium series in the History of Medicine and Psychiatry in December 2013. In France and the United Kingdom, I am indebted to the staff of the government archives in Nantes, Paris, and Kew Gardens. I am especially thankful to the archivists and military iv officers of the Val-de-Grâce Psychiatric Hospital and of the Service Historique de la Défense at the château de Vincennes, and to archivist Debbie Usher at the Middle East Centre Archives of St. Antony's College, Oxford University. In Syria, while withholding names of many to protect friends and colleagues in the current civil war, I would like to thank the staff and scholars affiliated with the Institut Français du Proche-Orient (IFPO) in Damascus, civil servants in the Syrian Ministry of Culture and Syrian Ministry of Health who approved my research access to government hospital records, and the current and former staff of Ibn Sina Mental Hospital, especially Dr. ʿAbdul-Massih Khalaf and Dr. Mahmood Naddaf, for their generosity, time, research, and friendship as I collected my data in 2009 and 2010. I have fond memories of good people, compassionate doctors, and remarkable places in Syria that I hold close to my heart. I pray for a quick and peaceful resolution to the conflict, and for effective and culturally meaningful healing systems to care for all victims of physical, mental, and emotional trauma. I owe a very special debt of gratitude to family and friends, particularly my father Robert and my mother Sylvia Levine (née Reyes) for believing in me and supporting my journey as I became the first woman in our family to earn a post-graduate degree in the United States, and my patient and loving husband Matt for carrying me through all those times I was unable to cope with the various challenges on my own. v Chapter 1 – History, Healing, and its Limits Introduction Health shaped the modern citizens and states of Syria and Lebanon. Community practices and institutions during the late Ottoman Empire, the French colonial project, and the early post- colonial Syrian state point to a medical and social history that does not have neat categories separating biomedical from folk practices and foreign from local. Scientific knowledge is produced in culturally specific ways, and doctors in cross-cultural spaces had to adapt to local customs and beliefs to effect real change in health-seeking behavior. Just as medical and scientific knowledge change over time, so too are local health practices informed by change and variance in religious and cultural practices. Since healing systems (whether folk or psychiatric) are not static categories, researchers must be careful to contextualize mental health treatment in its particular time and space. Scholars cannot fully comprehend the significance of psychiatric history to the development of the modern Syrian and Lebanese states without considering both the political and cultural contexts of natural and super-natural understandings of mental illness. Existing scholarship on health in Greater Syria has largely focused on either biomedical or vernacular frameworks, but rarely on the spaces of interaction between the two. This study of Greater Syria challenges the binary nature of research that separates foreign from local spaces of knowledge and practice. Instead, Ottoman and French legacies (in creating medical schools, hospitals, and public health legislation) shaped the medical landscape in ways that marginalized vernacular forms of healing but failed to effect a paradigm shift in local perceptions of the causes of mental illness. This dissertation argues that class and cultural worldviews played a greater role in the 1 consumption and production of healing practices in early and mid-twentieth century Syria than did ethnicity, gender, or religion, while sectarian concerns as well as class and cultural worldviews affected health-seeking behavior in Lebanon in the same period. Medical elites and other socio-economic classes in Greater Syria had widely divergent ideas about the causes of and treatments for normal and abnormal minds. These ideas contributed to understandings about the role of the state