Remedy in a Bottle: Mutatabbibs and the Regulation of Medicine Production in the Late Ottoman Empire

Modern medical institutions became important components of the reform movement known as Tanzimat in the late Ottoman Empire. Ottoman authorities sought to compete with their European counterparts not only on the field of battle but also through medical and scientific knowledge production. The Ottomans’ efforts to reform medical practices were also driven by their desire to form a governable society that was healthy and productive. Thus, they implemented aggressive regulations to set hierarchies within the medical practice by criminalizing non-licensed medical practitioners, who were called mutatabbibs — “the pretenders,” or charlatans — who did not comply with the official modern medical methods taught at the Imperial School of Medicine in Istanbul. However, even as Ottoman authorities sought to establish modern medicine as a field of power and governance, their institutional capacity as well as evolving medical knowledge was stretched to the limit by brutal outbreaks of cholera, plague, syphilis, and leprosy over the course of the nineteenth century. In this historical context, to quote Barry Smith, “desperate illnesses beget secret remedies.” The mutatabbibs, including former local practitioners, lay healers, and midwives who had become illegal overnight due to new regulations, emerged as both dangerous and necessary agents of late-Ottoman medical treatment. This paper discusses how outbreaks of diseases with unknown or uncertain treatments blurred the boundaries between modern, traditional, and Islamic medicine. In these contexts, medicine was shaped by the everyday needs of ordinary people as well as the rulings of political authorities. By laying bare the relations of cooperation, conflict, and contingency that shaped the circulation and transmission of medical knowledge and practice between Ottoman medical authorities and mutatabbibs, this paper demonstrates how medical knowledge and practice became a central domain of contestation among different claimants to both healing and modernity in the late Ottoman context.