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Agnes Loeffler

Allopathy goes Native. Traditional Versus Modern Medicine in Iran. London - New York, Tauris Academic Studies, 2007,  211 p. + xi.

Compte-rendu réalisé par Anna Vanzan

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1Medical anthropological research in Iran is a – so far – little explored field, though the seminal works by Byron Good and Mary-Jo Del Vecchio Good already opened the path to investigation several years ago. Therefore, we should welcome Agnes Loeffler’s book which attempts to describe “the cultural paradigms from which Iranian allopathic practice emerges” (p. 175). However, the book is so full of bias, prejudices and misrepresentation not only of Iranian allopathic systems, but also of Iranians in general, that one cannot but wonder about the scope of such an essay.

2In her introduction, Loeffler states that one of the main conclusions of her research, is that, in Iran, “allopaths may draw upon native conceptualization of health to guide their actions” (p. 14). Indeed, the main focus of her investigation seems to be that Iranian doctors, though trained as allopaths, rely heavily on folk medicine, which verges on magic and superstition. Although her field work has been carried out at the University of Shiraz Medical School (globally known as one of the best in the Middle East area), the author describes the setting of her research as one in which the level of both the students and the faculty is very low, mainly due to political reasons (“faculty appointments at universities and admissions have expanded beyond academic merit alone”, p. 34). Besides, the author adds that she had to become fluent in Persian because despite “their claims to the contrary, physicians and students trained or being trained at the University of Shiraz Medical School do not speak English well” (p. 29). However, even the ones who may use English for professional communication are moved by mean aims, such as “to maintain a monopoly over medical knowledge. If patients found out what drugs to take for that condition, they would not feel the need to consult physicians anymore.” (p. 142).

3While the book is presented as an ethnographic portrait of how allopathy and unani medicine would intersect in everyday medical practice in Iran, it rather turns out to be an accusation against both lay people and physicians. Iranians are represented as deeply affected by superstitious beliefs, such as that in the Evil Eye, or relying on supernatural characters such as the Imams and God. But even the allopathic physicians are described as superstitious and illogical, always prone to back their patients’ irrational convictions when “allopathic treatment rationales […] are frankly contradictory to native logics” (p. 95). Here we bring just two of the many examples:

4An internist said about two skin lesions on the palm of a patient’s hand, “Don’t be upset about them because they are ugly: they are good against the Evil Eye.” (p. 90).

5Menstrual cramps occur only in virgins, doctors told me. The uterus has to contract in order to get the menstrual blood across the semi porous hymen. Both the build-up of blood behind the hymen and the contractions cause pain. Taking pills to still the cramps reduces the ability of the uterus to clear out the blood, so “dirt” accumulates, and anyway, the ultimate therapy is marriage (sexual intercourse), so why bother with pills? (p. 95).

6The whole text is based on an “Orientalist” (in accordance with Edward Said’s theory and criticism) approach and bias. For example, according to the author, Iranian physicians “reveal a tacit expectation that medicine be a lucrative business” (p. 116). Although the author admits that this may be the case of physicians elsewhere, she blames Iranian doctors in particular because their “deep seated economic pragmatism [..] takes priority over ethical considerations” (ibid.). On the other hand, with a sentence which seems to spring out of the 19th century Orientalistic novel, Hajji Baba of Isfahan, the author asserts: “the basis of financial success in Iran is said to be zerangī, shrewdness or cleverness. The trait of zerangī is greatly admired in Iran, but it does not have purely positive association. Zerangī is the ability to act on an advantage without being held back by consideration of the fairness of the transaction. […] In Iran successful physicians are said to be “making zerangī” (p. 129).

7When not accused of being incompetent and hungry for money, Iranian doctors, who “spend minimal time with their patients” (p. 151), are blamed for using religion in order to avoid their patients’ complaints in case of failure: “They deflect doubts about their competence by invoking God’s will and by associating God’s Wisdom with their own” (p. 162).

8What is also disturbing is the fact that the author never directly quotes her sources of information; she just mentions “a gynaecologist”, “a surgeon”, “an older university professor”, or “a woman”, without ever giving a name. Though due to obvious reasons of privacy, the total absence not only of names but also of any contextualization of the people interviewed makes the theoretical frame of this research vague and ambiguous.

9What is overt and shocking is the general disdain the author shows towards Iranians, who are once again cast as superstitious, false, cynical, money oriented, and Westernstruck (“In Iran, the importance of a ‘foreign’ (ārejī) connection is all-pervasive.” (p. 146.).

10We cannot but wait and hope for future research on allopathic medicine in Iran which could focus the problem in a more impartial and unprejudiced way.

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Anna Vanzan. Agnes Loeffler, « Allopathy goes Native. Traditional Versus Modern Medicine in Iran. London - New York, Tauris Academic Studies, 2007,  211 p. + xi. », Abstracta Iranica [En ligne], Volume 30 | 2010, document 242, mis en ligne le 08 avril 2010, consulté le 20 août 2019. URL : http://journals.openedition.org/abstractairanica/37979

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