Method and approach

At the beginning of the nineteenth century, Louis Frank, a French doctor practicing in Tunis, found that he had to stay on good terms with the Muslim chief of physicians to practice European medicine without difficulties. At the end of the century, Hamda b. Kilani, a Muslim doctor and son of the former chief of physicians of Tunis, found that he had to be classed as médecin toléré (a second-class medical status) by the French medical authority to practice Arabic medicine at all. Why the change in power?

The answer emerges in the long struggle between Arabic and European medicine that accelerated with European economic expansion. The intricacies of the medical confrontation are best seen through the history of the major epidemics that struck the people of Tunisia between 1780 and 1900. The epidemics threatened the lives of vast numbers of people and called forth responses from all levels of society: ordinary people, medical personnel, religious authorities, and the political and commercial elite. The process of medical change revealed by the epidemics can only be studied meaningfully against the political, social, and economic realities of the times.

In Tunisia, the shift from Arabic to European medicine was a fundamental part of the colonial experience. The suspicion of the Muslim elite that European science contained superior sources of knowledge and therefore of temporal power led them to reconsider long-held medical concepts and to undertake a reform program with both enthusiasm and misgiving.