The International Qajar Studies Association (IQSA) is holding its 2016 conference in Vienna, on August 8-9, on the topic of “Doctors and the Medicinal Arts in Qajar Iran”. It’s the occasion for us to talk about Tinco Lycklama’s observations on health during his stays in Persia in 1866 and 1867.
Dr. Johan Schlimmer, Dr. Conrad Fagergrin, Dr. Joseph Dickson, Dr. James Baker, Dr. Heward… Not surprisingly, Tinco Lycklama met many physicians during his stays in Persia in 1866 and 1867 – as he seems to have suffered almost permanently from one or another illness. Wherever he went, he obviously met with foreigners who had settled in Persia. And, foreign physicians were everywhere. Qajar Persia relied on these foreign doctors to modernize the practice of medecine throughout the country.
“In the eyes of the Persians, all Europeans are somehow physicians”
Tinco’s observation comes from an anecdote when visiting the town of Izad Khast (written ‘Yezdegast’ by Tinco) – on the road from Isfahan to Chiraz. A local notable was seriously suffering from what appeared to be a bullet wound. Tinco had no knowledge of surgery and there was nothing he could do. But, he shared some bandages, for which the poor man’s family was already extremely grateful.
In another passage in his books, Tinco also reflects, quite unfavourably, on the state of medecine in Persia: “It is purely empirical, devoid of any notion about the human organism. This total ignorance of the anatomy makes one wonder about the state of surgical practice in Persia which is obviously working according to the most basic principles and interventions.”
Was Tinco biased? He seems to have suffered all his life from weak health. In fact, his health was one of his main motives for moving from his native Beetsterzwaag (NL) to Cannes (F), shortly after spending more than three years in the Orient. When reading his books, one sometimes gets the impression that Tinco may have been a hypocondriac as he always seems to worry about getting sick.
Almost dead in Kirva
In all fairness, let’s keep in mind that Tinco traveled through hostile landscapes and climates. As colonel Andreini noted during an episode in Kirva, Tinco was often suffering from “traveler’s fever”, caused by fatigue and inappropriate food. Nothing that a solid dose of quinine, a diet, and some good rest could not solve.
Colonel Andreini was not a physician but – as an Italian military man (at the service of the Qajar court) – he had traveled a lot and had solid experience with foreign climates. He also liked to refer to the learnings of another Dutchman, the 18th century physician Herman Boerhave, still a reference for European travelers.
At Kirva, the local Persian physicians had concluded that Tinco was probably dying. They suspected cholera, and Tinco almost believed them. He feared that he would succomb to the same fate as the famous French 17th traveler Jean Thévenot, who also died at Kirva in 1667. But, after reaching Qasbin and with the help of colonel Andreini, Tinco survived.
At Qasbin, Tinco was joined by Mirza Cheikh Djellal, a young and trustworthy Persian physician dispatched by the French minister in Tehran Jacques-Adolphe Cousseau, comte de Massignac (1815-1879). The usual French physician at the legation in the capital, Dr. Joseph Tholozan was unavailable, but sending this Persian physician “could do no harm”.
The foreign doctors in Persia
Mirza Cheikh Djellal had had the privilege of studying at the Faculté de médecine in Paris – probably as one of the first students sent by the pioneering polytechnical school in Tehran – the Dar al-Fonun. However, Tinco observes that the young doctor had obviously “not understood much of modern science, in which his cult of tradition only saw a series of dangerous innovations“.
Tinco had arrived in Persia in the early days of what the Qajar court of Naser al-Din Shah considered to be the necessary modernization of the country. Medicine was one of the Shah’s priorities and became a major section at the Dar al-Fonun, which started operating in 1851.
But, the foreign legations in Persia still relied heavily on their own physicians to deal with the health problems of foreign personnel. In turn, these foreign doctors were critical in helping Persia with the modernization of medical practices.
At the highest levels of the Qajar court, it was understood that the health of the royals was better served by foreign doctors. Ernest Cloquet (1818-1855) was the doctor of the French legation and became the personal physician to Naser al-Din Shah. Upon his death in 1855, he was replaced by the Bohemian doctor Jakob Eduard Polack, who had previously been the first teacher in medecine at the Dar al-Fonun. The Dutch physician Johann Schlimmer replaced Polack in 1860 at the polytechnic, and in the same year the French doctor Joseph Tholozan (1820-1897) takes Polack’s place as the physician to the Shah.
Tholozan remained in this position until shortly before his death. He accompanied the Shah on each of his three trips to Europe (1873, 1878 and 1889), and may be considered as instrumental in organizing the first efficient medical infrastructure to combat the spread of infectuous diseases in the country.
But, also beyond the royal court and beyond Tehran, Persians seemed to turn to foreigners to provide health care. For instance, in 1867, when Tinco travels through the little town of Sadatabad (named “Seadet Abad” by Tinco) he notices that there were no foreigners amongst the population except for one Armenian and twelve jews. These few foreigners were all pharmacists and physicians (though not of good quality – says Tinco).
In 1866, when Tinco arrived in Teheran, Dr. Joseph Tholozan was the only French physician in town. Surprisingly, Tinco never mentions Tholozan in his writings, even though we know from the message from French minister de Massignac to Tinco that Tholozan was in the capital. Then again, besides a few noteworthy exceptions, Tinco Lycklama is very sparse with his comments on the people he met at Tehran.
But, Tinco tells us a lot about the other doctors he acquainted. At the British legation, for instance, he met with the English physician Dr. Joseph Dickson, who kept his position for almost 40 years (1848-1887). More than simply being doctors, people like Dickson played an important diplomatic role as they easily gained the confidence of their patients at the Qajar court. Another Englishman whom Tinco acquainted was Dr. James Baker, who later wrote an authoritative report for the House of Commons about the sanitary situation in Persia (“A few remarks on the most prevalent Diseases and the Climate of the North of Persia”, 1886).
As we saw earlier, the Dutch Dr. Johann Schlimmer (1819-1881) became the head of medecine at the Dar al-Fonun in 1860. In 1861, he was also responsible for training students at the new state hospital in Tehran, and he was one of the few who actually wrote textbooks for the benefit of medical students. A few years later, the Shah transferred Schlimmer to Fars, where he was appointed as personal physician to the province’s governor, Massoud Mirza Zell-e Soltan (1850-1919), a son of the Shah. During his time at Isfahan, Tinco actually stays at the home of Dr. Schlimmer and his Armenian wife.
In Chiraz, Tinco meets with Dr. Conrad Fagergrin (1818-1879) – a Swede from Stockholm. Again, Tinco suffers from a heavy headache, but it was easily solved after the doctor practiced a bleeding. Dr. Fagergrin had arrived in Persia twenty-five years earlier, and was sent by the Shah to Chiraz to handle a big epidemic in the province. He stayed on to become the chief physician of Chiraz. He and his French wife and family where the only Europeans in town – so they were most happy to welcome Tinco in their home.
Tinco’s travel through Persia in 1867 ended at the harbour city of Bender Bushir, where he embarked on a steamer that would take him over the Persian Gulf to Iraq – an Ottoman territory at that time. But, Bender Bushir might well have become his last resting place – were it not for the good care of Dr. Heward, an Armenian doctor. Indeed, feeling unwell, Tinco was quickly diagnosed with symptoms of typhoid fever, probably caused by drinking from the same water jar as his servant Ali Beg. Dr. Heward prescribed big doses of quinine and some herbal concoctions, and Tinco was fine within a couple of hours. The poor Ali Beg, however, died a few days later.
Quinine, diet, rest, and tea
The quality of the food was never the issue for Tinco’s ills in Persia. In fact, he states that the food served was very wholesome (but perhaps he may have indulged too much, at times). It is more likely that the hot climate was a major factor, especially for someone who grew up in Frisia. If Tinco’s health was not the best, he certainly did not make it any better by traveling cold mountain passes and sweltering deserts on horseback. Also, from several observation in his books, we understand that travelers had to be very careful about the water they were drinking.
What we do learn from Tinco’s writings is that quinine was essential – and he made sure that he always had an ample supply of that. Combined with solid rest and a reasonable diet it usually fixed the problems. And, Tinco tells us also: “I drank a lot of tea which, throughout my travels, has been my universal panacea, excellent in health, and even better so when ill.”