The Ulama and Public Health in Imperial Russia and the Kazakh Steppe

There has been surprisingly little published that generalizes on the role of the ulama in implementing state public health policies in Russia and the Kazakh Steppe. Students of modernism who have emphasized the role of jadids in introducing “modernity” to Muslim communities have had little to say regarding medical science in 19^th century Russia. In the 19^th and early 20^th centuries the ulama developed a keen interest in broadening their understanding of medical science beyond the traditional texts and knowledge of ‘ilm-i tibb. This brief post is aimed at illuminating the role of the ulama in popularizing state-sponsored public health initiatives in Russia and the Kazakh steppe and encouraging Muslims to seek treatments using medical techniques that originated outside the Muslim world. Muslim medicine has been described as “eclectic,” making use of observation-based medical science, folk medicine, and magical remedies. But in Central Eurasia medical science in particular was for a long time the realm of the ulama. As such, it was one of many sciences a legal scholar could specialize in. The main authoritative text for Muslim medicine in Central Eurasia was the writing of Ibn Sina devoted to the science of tibb, which European doctors consulted in Latin translations well into the 18^th century.  The practitioners of this sort of medicine were known as a tabibs. In Central Asia today this term signifies a folk healer as opposed to a medical doctor. However, in the Volga-Ural region the term tabib kept its original meaning, and today still signifies a medical doctor, showing the link in Russia between ‘ilm-i tibb and international medical science that developed in the 19^th century.

The origins of the alliance between the ulama and the public health authorities in imperial Russia dates to the 1830s, when Russia was struck by its first major cholera epidemic. In 1831 the Russian authorities in St. Petersburg issued a royal decree demanding that Muslim subjects be admitted into Russian medical schools to be trained as doctors. This decree was to be carried out by the Governor of Orenburg, Count Sukhtelen, who turned to the ulama for help in implementing it. Sukhtelen turned to the Orenburg Mufti, ‘Abd as-Salam b. ‘Abd ar-Rahim, fearing there might be resistance on the part of the Muslims.

The Mufti, himself a tabib and specialist on herbal medicine, issued his fatwa, which called on Muslims to heed the decree and supply the young men to be trained in Russian medical institutes. In it he cited a number of Islamic scholarly works that praised the science of medicine as one that was useful for Muslims, but also necessary for salvation. These included Ghazali’s Ihya, the Tatarkhaniya, and the Bustan al’-Arifin.

The fatwa is perhaps our earliest Islamic document on the public health alliance that developed in the 19^th century between the ulama and the Russian state. Both the decree and the fatwa reveal some important evidence on how Muslims perceived their relationship to “Russian medicine,” as it is somewhat inaccurately called (doctors from Russia included many Poles, Germans, and Jews who were trained in Central and Western Europe; moreover, Russian peasants had no greater access to this sort of medicine than Muslims did). For the Russian authorities, the issue concerning the cholera epidemic was that at the outset Muslims had concealed the illness from the authorities, which had resulted in its spread and additional mortality. Clearly, the authorities needed better information on public health in Muslim communities, and the presence of Muslim doctors was an obvious solution. In 1830 a council of doctors in Orenburg had recommended printing in Tatar and Russian pamphlets that described the system of cholera and other infectious diseases, and methods to combat them. Priests and mullahs were to read these pamphlets to their communities.

The fatwa also suggests that it might be mistaken to assume that Muslims in the 1830s sensed a difference between “Russian medicine” and Muslim medicine. While there is evidence that in the 19^th century some Muslims were skeptical toward non-Muslim doctors, many members the ulama clearly saw medical science as universal, one that Muslims should gain access to if they could benefit from it. Indeed, the mufti clearly defined obtaining medical knowledge as a religious obligation. While some Muslims feared non-Muslim doctors, others viewed medical consultations with non-Muslim physicians to be a source of prestige. James Pickett has shown this to have been the case for 19^th century Bukhara, and the ethnographer and medical doctor Karl Fuks treated the Tatar merchant elite in Kazan in the first half of the 19^th century (Fuks was also involved in combatting cholera in Kazan Province in 1830).

In one of his letters from the 1830s (published in Riza ad-Din b. Fakhr ad-Din’s Asar), mufti ‘Abd as-Salam explained the reasons for Muslims’ initial resistance to the decree. The common people and ulama in Cheliabinsk, Verkhneural’sk and Troitsk districts in Orenburg province had resisted the decree and refused to send their young men to become medical students. The local communities wrote their akhunds, explaining that they feared forced Christianization, presumably of the students. Nevertheless, ‘Abd as-Salam, who as a scholar was drawn to the ‘ilm-i tibb and wrote medical treatises quickly extinguished this resistance by arguing that Muslims were obligated to study medicine where they had an opportunity. Later, the Tsar rewarded him for his efforts with a gold medal.

The Mufti ‘Abd al-Wahid b. Sulayman continued the Muftiate’s interventions in public health. In 1847 he issued a series of fatwas ordering imams to verify that before officiating a wedding couples possessed medical certificates establishing that they were free of infectious diseases. He issued another fatwa instructing imams and akhunds to verify that Muslims were following the instructions of public health officials during epizootics.

By the second half of the 19^th century the number of Tatar and Bashkir graduates of Russian medical schools, particular Kazan University, had grown considerably. Many of these physicians were also members of the ulama, which enabled them to compose medical treatises in Tatar and Kazakh that included the knowledge they had acquired in Russian medical schools.

Following the large-scale cholera epidemic of 1892, by which time researchers in France and Germany had isolated the cholera bacillus and had a much clearer understanding of how to diagnose, treat, and halt the spread of the illness, the Russian authorities embarked on a full-scale public health initiative that included publishing up-to-date medical information in non-Russian languages. Missionaries and public health authorities in the 1890’s and in the first decade of the 20^th century published numerous pamphlets in Finno-Ugric and Turkic languages for Christian communities, and in Tatar and Kazakh for Muslims. At this time, we also see treatises written specifically by the ulama, where madrasa instruction is announced as a source of the authors’ authority.

One author who possessed both medical credentials and an imam’s license was Fasih ad-Din b. Muhyi ad-Din al-Apaqi, who in 1899 published a work in “easy-to-understand” Tatar entitled Tibb kitabi. The work was a catalog of illnesses and their treatment, including herbal remedies and other treatments associated with Ibn Sina, but clearly Fasih ad-Din’s concept of tibb embraced medicine more generally, since on the title page he cites as the authority for the medical information the editorial support and supervision of physicians from the Kazan Provincial hospital, named as professors. We also learn from the title page that the project was funded in 1896 by the Kazan provincial zemstvo.