In the United States, medicine is a clinical matter. Tightly regulated by the prescription pad, pills are dispensed from behind the pharmacy counter, a crisp, cordoned-off section of our “drugstores”––which carry everything from beach umbrellas to batteries to paperbacks to business envelopes.
Pharmacies in the Arab world work a bit differently. For one thing, they are more common. In Cairo, as in many other Arab cities, it sometimes feels as though there is a pharmacy on every street corner. They are sometimes named after great classical Islamicate medical authorities, like Ibn Sina or al-Kindi, and sometimes after the presiding pharmacist. The latter trend reflects the pharmacist’s position in society; in much of the Arabic speaking world, the local pharmacist is a commonly consulted source of medical advice. Pharmacies dispense “over the counter” many drugs that in the United States would require a doctor’s appointment and a written prescription.
In a few key respects, pharmacies in Egypt and other Arab countries are much more like their European, rather than American, counterparts.
First, they are just pharmacies––not convenience stores that happen to have a pharmacy counter. Second, and more importantly, Egyptian pharmacies, like European ones, feature an array of distinctly non-pharmaceutical items. Unlike American drugstores, the non-medicinal products that Egyptian pharmacies carry are restricted to products related to caring for the body, such as makeup, skin creams, hair products, and deodorant (the most interesting pharmacies in Cairo, like my favorite ones in Paris, are always the ones with the best cosmetics).
It was not until I started digging into the legacy of pharmacies in Islamic history that I began to wonder whether this juxtaposition of beauty products and pharmaceuticals was more than just a merchandising choice, or an accident in the way European medicine was introduced into Arab societies. The broader framework of Islamicate understandings of the body, and the ways discourses about beauty, medicine, cooking, and sex are interwoven throughout the historical literature, pointed to another possibility: that the persistent pairing of cosmetics and medicine reflected a more meaningful connection between seemingly different ways of caring for the self.
For answers to these questions, I turned to the space of the attar, the still-present “traditional” or herbal pharmacist whose existence hints at the roots of this connection not only in history, but also in space, embedded within an urban fabric that simultaneously includes to this day both attarin and pharmacists.
Beauty, Health, and Taste: Taking Stock of Pharmacy Shelves
The word attar (plural: attarin) can be translated in a number of different ways, including druggist, apothecary, perfumist, spice vendor, or pharmacist. The multivalence of the word corresponds to the wide range of functions that the attar typically enacts; it is also reflected in the array of products he carries. Stop by the attar today, and you can find homemade beauty treatments, spices for cooking, incense and perfumes, herbal medical remedies, and, most likely, items necessary for making amulets.
As different as these products may seem from a typical pharmaceutical inventory, the pharmacy and the attar share, a few key commonalities even today. One, as mentioned above, is the juxtaposition of beauty and pharmacy products. But on an even more basic level, the two institutions share strikingly similar approaches to visual merchandising. In both the traditional-looking shops of the attarin and the pharmacies of upscale Zamalek, products are arranged in dazzling visual displays that favor color and aesthetics above categorization.
In Arabic, the linguistic root of the word attar connotes perfuming and aromatics in addition to drugs, hinting at another layer of the institution: its appeal to all of the senses. Not only does it unite the visual and tactile (with its beauty products and beautiful displays) with the gustatory (through spices and various other culinary items), it encompasses the olfactory as well.
In this way, the social space of the attar’s shop is tightly linked to a conception of the body that is rooted in Islamicate medical theories. These theories, the product of translation movements and imperial expansions that incorporated the best of Greek, Persian, Indian, and other medical traditions, took all of the senses into account when determining what factors impacted a person’s health. According to this holistic understanding of the body, diet, environment, and even the clothing a person wore were as important to physical and mental wellness as medicine itself.
Thus, the attar’s shop endures not only as an institution that unites items relevant to all the senses; it also indicates a link between the purely sensory or surface aesthetic, on the one hand, and medical, and even ethical, understandings of the workings of the body, on the other.
Modern Apothecaries and Traditional Pharmacies
By no means am I suggesting that these connections between beauty and health, outside and inside, sensual and medical, are stable, unchanging relationships reaching back into the medieval era. Nor am I claiming that the attar as a space, figure, or institution has not changed since its origins in the classical Islamic world. Such arguments would obviously be reductionist and inaccurate.
Today’s attar is in fact as much a product of “modernity” as its pharmaceutical counterpart. But the attar’s profession, with its curious if tenuous parallels in modern pharmacy, does offer a useful framework for thinking about change and continuity over time. Attarin have told me that women (who, they say, make up the vast majority of their customer base) still come to them asking for contraceptives, even though emergency contraception is available at pharmacies. Sometimes women are seeking herbal or traditional remedies, but sometimes they are also interested in modern pharmaceutical pills. Many of today’s Egyptian pharmacies carry herbal teas alongside their pills and bottles, and pharmacists have told me that apart from their formal training, one of the foundations of their profession is learning to read and deal with people. This is something they learn on the job, through observation––just like attarin.
Certainly the attar and the pharmacist are not the only professions that work on an apprenticeship model, but observing these kinds of parallels play out in the neighborhoods of today’s Cairo offers a picture of the attar as something integrated within and in conversation with “modern” medical practices, rather than as a dusty alternative or predecessor to them.
Thinking in these terms is an invitation to push back against conceptions of Egyptian or Middle Eastern history in terms of “before and after” the introduction of modern discourses like medicine and pharmacy into the region. Khaled Fahmy is one historian who has demonstrated how the arrival of modern medical and legal practices to Egypt was not a straightforward story of “Western” discourses displacing “Islamic” ones, but instead a process that became a part of existing social dynamics within nineteenth-century Egyptian society. This is clear in the simple fact that the modern pharmacy, while resembling in some respects the attar’s shop, has in no way replaced it.
Some of the practices of the attar seem to be stable and enduring––today’s attarin still sell animal hides with Qur’anic verses written in saffron dye as amulets to guard against hasad, or the evil eye, as well as dried safflower and other spices for use in pickling; both practices are documented in historical and literary texts dating from the Mamluk era. Other attarin have morphed considerably: while they have always imported spices and incense from distant locales via semi global trade networks, attarin are now likely to carry industrially manufactured incense from China alongside, or instead of, more traditional forms. Today, some attarin study modern botany and agricultural sciences to augment their traditional training.
While it is common to think of older, folkloric traditions as locally rooted practices, situated in opposition to newer developments reflecting more “global” institutions and discourses, the history of the attar is closer to a narrative of shifting and evolving transnational networks, and not a line that follows a straightforward trajectory of local institutions that gradually become globalized. Modern pharmacy, too, has significant historical roots in Egypt; the was founded in Cairo in 1824. But to read the pharmacy’s prominence in Egyptian society as a straightforward example of the introduction of “Western” or “modern” medicine would be an oversimplification.
A comparative consideration of pharmacists and attarin can help us rethink boundaries clumsily constructed by categories like local and imported, traditional and modern, folk and scientific. In deconstructing these categories, we can also begin to reconsider teleological narratives that portray the “modern” as a steady and inevitable march forward, and the “reactionary” narratives that tend to accompany them. As in Cairo’s street corner pharmacies and the attar’s alley in Khan al-Khalili, the boundaries between the “traditional” and the “modern” are much more fluid than we may realize.