Van – Popular Medicine

Author:  Adom H. Boudjikanian, 21/05/20 (Last modified 21/05/20) - Translator: Simon Beugekian

An overview of Van and its geographic position

The people of Van were master craftsmen. Among their specialties were jewelry, blacksmithing, embroidery, and the weaving of rugs. Those who lived in the mountainous plains of Hayots Tsor raised cattle, engaged in farming in the water-rich flatlands, and grew orchards and vineyards. The abundance of fruit trees in the province inspired the name of one of the principal suburbs of the city of Van – Aykesdan [Land of Orchards].

Although we were unable to find incontrovertible evidence of this, we can assume that people whose diet mostly consists of agricultural crops, like the diet of the Armenians of Van, generally enjoy better health.

When we examine the map of the historic province of Van-Vasbouragan, we immediately notice that the area was home to various ethnic groups. This diversity brought with it various positive and negative consequences. The area’s history is one of constant political upheaval and successive military invasions. All of this played a role in the shaping of local culture. The people of Van were engaged in a constant exchange of knowledge with outsiders, and this knowledge was adapted to local conditions [1]. It is highly likely that the people of Van translated and improved upon Greek, Arabic, Persian, Assyrian, and other historical medical texts. For example, they were acquainted with Ghazar Amtetsi’s work on veterinary medicine, Pjshgaran Vasn Tsyo yév Choro yév gam Ishou [Medical Manual on Horses, Mules, and Donkeys], translated in 1696 (Ghazar Amtetsi was based at the Hoghats Monastery, southwest of Lake Van) [2].

The Armenian mystical poet and monk, Saint Krikor Naregatsi (Gregory of Narek; 951-1003), author of the Book of Lamentations (The Nareg), studied and lived at the Naregavank Monastery of Van [3]. Later in this article we will return to the Nareg and its importance to the area’s medical practices.

The area of Vasbouragan included many cities and villages. Although primary sources on the area’s medical practices are few, we were able to find information on a number of specific localities, namely Van, Akhlat, Aralez, Ardzge, Ardjesh, Pergri, Ourants, Kharzit, and Khizan.

The city of Van (on the southeastern shore of Lake Van) is located at a latitude of 38°38’ N and a longitude of 42°49’ E, at an altitude of 1,708 meters (5,603 feet) above sea level [4]. Lake Van (covering an area of 3,755 square kilometers) has seismic origins. Its waters are fed by several rivers, but due to its high rate of evaporation, the lake has a high percentage of mineral salts [5]. According to Sengiz Alper, Lake Van’s waters have a salinity of 11.9 percent, which is about three times higher than seawater. The water has a composition of 11 percent sodium chloride and sodium carbonate and 0.65 percent magnesium sulfate and magnesium chloride [6]. We wonder if the people of Van enjoyed the medical benefits of swimming in the waters of the lake. As a volcanically active area, Van was also home to many hot springs, including the Djoulamerg.

General overview of environmental conditions in Van

Beginning in the second half of the 19th century, several textile factories operated in the city of Van. Shoemaking had also experienced a period of growth, and mechanical engineering was gaining a foothold, thanks to the importation of machines from the United States and Europe. At the start of the 20th century, about 1,500 people worked in the city’s textile factories [7]. Like Harput/Kharpert, Van was home to a whole class of residents whose health status, specifically the prevalence of occupational diseases among them, was impossible to ascertain with the sources that we have. It must be noted that living and working in close proximity is conducive to the transmission of communicable diseases. We must also not forget that the putrid effluent of the city’s tanneries polluted the area’s springs, streams, and both the irrigation and drinking water obtained from artesian wells.

Homes: Our sources indicate that the people of Van lived in one- or two-story homes, generally with balconies. The more prosperous citizens of the city lived in two- or three-story homes, also with balconies [8]. Based on this, we can deduce that a certain percentage of well-to-do Van residents lived in spacious, airy homes, which would preclude the spread of communicable diseases. There remains the question: what were the living conditions of the rest of the population of the city, the majority? And what about those who lived in the villages and countryside?

General overview of public health conditions in Van

-An article entitled Diseases in the Villages, published in the January 26, 1913 edition of the Van-Dosb weekly newspaper (year A, number 1), argues that public health conditions in the countryside of Van were not enviable. The correspondent, writing under the pseudonym “Yergnakar,” visited an unidentified village in the area, where he met with sick individuals. One of the patients was a woman who had been beaten up by her “man,” resulting in a miscarriage and the loss of a large amount of blood. The enfeebled woman had been wrapped in rags and made to lie in a putrid corner of the barn, with other women sitting nearby and pelting her with advice. One of these “well-meaning” attendants told a story of how an acquaintance of hers had sustained the same injuries and had succumbed to them. Others urged the injured woman to make pledges and promises to whichever saints would come to mind, Krikor Naregatsi chief among them. One woman, more practical than the others, suggested reciting the Nareg (Naregatsi’s Book of Lamentations).

The same article also describes the case of a young father whose cheeks had turned scarlet from fever, and who was lying on a tonir, exhausted and delirious. The correspondent had discovered that the man had traveled to the village from the city, and on the way, had drunk brandy to keep warm, had waded into a river despite the cold, and had then traveled on to the village on foot. In the absence of any medical assistance, the man later died. Most of the villagers did not travel to the city to obtain medical treatment, or resorted to this measure too late, when they were already on the verge of death [9].

The article concluded: “In the villages, diseases and resultant deaths occur mostly from the fall until the spring. The usual causes are falling asleep inside the watermills, catching cold, the moist and fetid air of the barns, and the immediate transition from the frugal life of the summer in the open air to the stagnant indoor atmosphere in the winter. Winters are also the holiday season, when feasts and weddings are common. This results in quick transitions from hot to cold and cold to hot, amplified by the effects of excess alcohol consumption.” [10] To save the villagers from this deplorable state of health, the correspondent suggested the dispatching to the countryside, by the government authorities, of itinerant doctors and chemists. He also proposed the organizing of medical lectures delivered in a language that the villagers could understand, and the expanding of the number of itinerant doctors and chemists during epidemics [11]. Hampartsoum Yeramian, in his book, also writes that the Armenians of Van had a habit of holding lavish feasts during the winters [12].

-Another article in the Van-Dosb weekly newspaper, appearing in the May 25, 1913 issue, anonymously pilloried the authorities for the slow progress of the reforms they had launched in the field of public health. We learn from the article that in the Alur village of the Timar district, in a period of two weeks, an outbreak of gouloulou (whooping cough) had claimed the lives of 20 children, and was continuing to kill another three to four per day. The author noted that the most basic medical treatments were unavailable in the village [13].

It is instructive to examine the case of Hampartsoum Yeramian, a resident of Van, who contracted smallpox/variola as a child. The smallpox vaccine was discovered in 1798 by British doctor Edward Jenner, who tested it on eight-year-old James Phipps [14]. But according to Feza Günnergun, smallpox was still claiming lives across the Ottoman Empire in the second half of the 19th century. Until 1847, the Ottoman Empire’s smallpox vaccination program was based on Jenner’s discoveries. But a short time later, the public health authorities reverted to a medieval style of inoculation, which they adopted from methods used in Central Asia in the 17th century. As a result, those who were inoculated fell sick instead of gaining immunity. Some people began refusing to be inoculated, and the central health authorities were not capable of forcing them to undergo the procedure [15]. Hampartsoum Yeramian’s mother refused to allow him to be inoculated, but as a result, the child contracted smallpox and almost entirely lost his vision. He was sent to Germany where he was examined by a specialist, but treatment was unsuccessful. It is safe to say that in the Ottoman Empire, smallpox was a true blight, as there was no effective vaccine that protected against it [16].

Popular medicine in Van

As we have already noted, it was impossible to find primary sources on popular medicine as practiced across Van. But articles published by Houshamadyan on popular medicine as practiced in other areas of Ottoman Armenia (Dersim, Ourfa, Kayseri/Gesaria, and Harput/Kharpert) show that medical practices did not differ greatly within individual provinces. For the preparation of this article, we mostly used Serine Avakian’s work on medical practices in the district of Ardjag in Vasbouragan. We believe that this information can be applied more widely to the entire province of Van.

The district of Ardjag was located east of the city of Van. It was home to a salt-water lake. The district’s principal settlement was Ardjag (present day Erchek/Erçek), but it also included about 30 other villages [17].

The distance between the district of Ardjag and the city of Van was only 30-35 kilometers. Therefore, it is probable that there was an exchange of medical knowledge between the two localities over the centuries. These medical practices were also probably widespread across the other cities and villages on the shores of Lake Van.

Faith-based healing

Popular faith-based medical practices included prayers, pilgrimages (or the visiting of holy sites), and the belief in miracles and the intervention of supernatural forces.

Superstitions

Part of Van’s local folklore was the legend of the Armenian king Ara the Beautiful and the Assyrian queen Shamiram. When Ara the Beautiful was killed on the battlefield, his corpse was carried to the pagan temple in the city of Lezk and offered to the mythological creatures called haralez hounds. These hounds licked Ara’s wounds, bringing him back to life. In later years, the Holy All-Savior Church was built at the site of the same temple [18].

Seroun Yeghishian remembers that two weeks after Easter, the Armenians of Van celebrated the Lezk festival. The festivities included a game of chance that was reminiscent of the games held during the celebrations of Hampartsoum (Feast of Ascension). Yeghishian also remembers the Mheri Tour, or Mher’s Door, dug into the mountain of the city of Van, and of the “voices that came” from the Zemzem cave, right behind this door. Two saints were thought to be buried there. A tree also grew at the site, at whose roots flowed a spring with miraculous properties. Its waters had healed the facial scars of Yeghishian’s brother. People came from as far as distant Kharpert to simply dip a towel into this water and wash their wounds with it [19].

According to Serine Avakian, almost the entire population of Ardjag believed in the existence of demons. People resorted to various means to protect themselves from them, including the cutting of crosses into the dough of the bread they baked and intoning Isous Chyisdos [Jesus Christ] in their unique local dialect. They even made the sign of the cross over their lips when yawning, lest demons enter their open mouths. The expression “A demon has got into his belly” probably originated from this belief.

It was commonly believed that demons were particularly dangerous to newborns and their mothers. In Ardjag, demons were believed to live in the ruins outside of the village, specifically in the gorge known as Keazna. But when a woman gave birth, the “Mother of Demons” came to the village, disguised as a person, fox, or wolf, and headed for the house where the birth occurred. It then entered the house in the shape of a cat, then become a fly or a strand of hair, entered the mother’s womb, snatched out her liver, and killed her.

To protect against these demons, birthing mothers were never left alone in the days preceding childbirth, and constantly paced around the house while holding a hooked skewer or the metallic oar used to take bread out of the tonir.

After childbirth, women were not allowed to drink cold water. They were fed oiled, roasted, hairless cereals. It’s unclear if demons avoided women fed on this diet, but it probably promoted maternal lactation. Eight days after birth, the infant was baptized, and the mother was deemed to be immune from demons. However, just to be safe, she continued crossing herself constantly and reciting Isous Chriydos for some time [20].

The evil eye was known locally as nyat. When we express praise for something or admiration for a person (or domestic animal, in the case of the people of Van), we use certain phrases and expressions. The Armenians of Ardjag believed that such expressions of approval could bring harm to the person or animal involved, especially if they came from someone who had a habit of “casting the evil eye.” It was also said that children were particularly susceptible to such hexes. But people had ways of protecting themselves. There were two methods of defense, each of with its own nuances.

In the first case, if the person casting the evil eye was well-intentioned, he was asked to take back the nyat from the child. He would approach the child, soothe her, spit on her, take a strip of her clothing and a clump of her hair, burn the fabric and hair immediately, and have the child inhale the smoke.

However, if the person casting the evil eye was not a trustworthy individual, a very different strategy was employed. A few strands of the offending party’s hair would be obtained by subterfuge, as well as strips of her clothing or chips off her door. These items were all burned, and the child made to inhale the smoke. Another way to counter the evil eye was to exactly retrace the offending party’s footsteps, or to take dirt from where she had trodden and mix it with the child’s bath water.

As we can see, even in instances of preventive medicine, the Armenians of Van resorted to their fate and beliefs. But we can also see that the health of their children was of a matter of great concern. In cases where children contracted infectious disease, some adults avoided looking at them, lest, “God forbid,” they cast the evil eye on the child and made the situation worse [21].

Families had their guardian spirits, called tovlat/tolvat/dovlat. The external appearance of this spirit would vary according to the circumstances of the household. It was said to live in storerooms. It could appear as a non-venomous snake, another animal, or even a human being. The spirit could be displeased with the family if it did not treat its domestic animals well, or if it built a new house and abandoned the old. For this reason, when people built a new house, they left a lamp burning in the old, until one of them saw a dream that could be interpreted as the family’s guardian spirit settling down in the new house [22].

Another benevolent household spirit was the goutrat. It had the appearance of a modest and young bride or a blushing maiden. She lived in the tonir, the storeroom, or behind the flour jug. She looked over newborn babies and performed some of the more difficult household chores while the family were absent. Kind housekeepers, after baking bread in their tonirs, would leave a loaf on the wall for their invisible helper as compensation. Moreover, Goutrat was used as a female given name in the Van area [23].

To gain divine protection against misfortune and illness, the people of Van pledged to God that they would provide good, healthy lavash bread to their family and relations. Bread was customarily baked at midnight, and before dawn had broken, the head of the household would toss a few loaves off the roof and call out: “Artntsek taja khatsn-i , Asbadz entouneli ani!” (“Wake up, it’s fresh bread! May God accept it!”) There was also the madagh [offering], prepared in the morning and distributed in its own stew, again accompanied with many calls and chants. The person doing the chanting was customarily not allowed to partake in the bread or meat [24].

Christian beliefs in popular medicine

The Nareg

It is no surprise that the people of Van, who lived in Krikor Naregatsi’s native land, resorted to the Nareg prayer book for healing, like Armenians all over the Ottoman Empire. They recited appropriate excerpts depending on the patient’s ailment in anticipation of divine intervention. Krikor Naregatsi’s Book of Lamentations consists of 95 prayers, some of which target specific health conditions [25].

Aside from their faith in the Nareg, the Armenians of Van, like Armenians across the Ottoman Empire, had their own local, traditional, religious beliefs related to health. Some of these are detailed below.

‘Nareg – Book of prayers [Book of Lamentations] – Written by St Gregory of Nareg’, Istanbul, 1782 (Source: Staatsbibliothek, Berlin)

Holy Sites

The ruins of the Asbardzin (Asdvadzadzin; Holy Virgin) Monastery

This site was located two kilometers outside of Ardjag. To the right of the altar was a crypt in which a piece of the Holy Virgin’s belt was buried. The crypt also bore an inscription in Armenian. A pond of frigid water near the monastery, called Kaytoun Geol, was said to have miraculous properties. Locals believed that those suffering from malaria or scabies would be healed by bathing in it. The waters of the pond also irrigated the monastery’s fields. In mid-August, on the Feast of the Holy Virgin, this site was visited by hosts of not only Armenian pilgrims, but also Assyrians, Kurds, and Yezidis. The pilgrimage lasted three days, stretching from the Saturday before the holiday into the following Monday, when the animals offered by the pilgrims as sacrifices were slaughtered [26].

The Bible of the Vanits King (The Bible of the King of the Monastery)

This Bible, written on red parchment, was kept in a house near a cemetery, in a wooden box, in the supply room adjacent to the home’s tonir. An elderly man kept the key to the box, which was passed down to the oldest son of each generation of the family. Women were not allowed to touch this “powerful and miraculous” book [27].

Left and Right: Silver cover of a Bible made in Van. Mesrob Mashdots Repository of Manuscripts (Madenataran), Yerevan.
Center: Silver cover of a Bible made in Khizan. Mesrob Mashdots Repository of Manuscripts (Madenataran), Yerevan.
(Source: Osep Tokat, 
Armenian Master Silversmiths, Tigran Mets Printing House, Yerevan, 2005).

The ruins of the Saint Sarkis hill

Legend held that that one day, while gathering marshmallow roots on the flanks of this wide and peaked hill, women found copper trays buried in the ground. This led to the conclusion that the hill had once been the site of an ancient habitation. The local Armenians soon began treating the ruins as a holy site, and legends circulated that strange lights emanated from them [28].

Toukh Manoug

This was the name given to a small hill near the lake of Ardjag. At the summit of the hill were the ruins of a stone structure, without any engraved crosses. It is thought that the ruins were those of a pagan temple, and it is unclear how they had become associated with Christian saints. Pilgrims would light lamps and place them on ledges in the ruins, in the belief that by doing so, they absorbed the ruins’ holy light. They also believed that if they performed this action, the saints who inhabited the ruins would heal their eczema, chest wounds, and earaches. Pilgrims would then grab a handful of dirt from the holy site and sprinkle it on their ailing body parts. Additionally, the ruins were thought to have the power to turn nightmares into pleasant dreams. Visitors came to Toukh Manoug from all over the province [29].

Pazoum Khacher (Many Crosses)

Ardjag was also home to a holy site known as Pazoum Khacher, located in the Keozar and Pos neighborhoods. These ruins were reminiscent of Toukh Manoug and also had ledges where believers could place their lighted lamps. However, the ruins at this site bore engraved crosses. Pilgrims would visit the ruins early on Sunday mornings, and pray to God, but this was not a site where they prayed for healing. According to local lore, the minstrel Nahabed Kouchag, in his youth, saw a dream while in the section of the ruins in the Pos neighborhood, after which he was able to insert a nail into the stones of the ruins with his fists alone. This dream was said to have been the inspiration behind his artistic career [30].

Various medical conditions and ailments

Here, we present a list of common medical conditions and ailments, and the various treatment methods used by the people of Van, including herbs, folk medicine, diets, etc.

Conditions of the eye

Eye hekims (eye doctors): In Ardjag, conditions of the eyes were more prevalent among women, as they spent more time working in dust and smoke. Hekims (eye doctors) were elderly women, and the profession was the preserve of specific families, handed down from one generation to the next. There were four astringent actives solutions on the list of ointments used by Ardjag hekims, one of which, copper sulfate, has proven antiseptic properties. Avakian remembers the dark-colored keashmig, whose flat, yellow seeds were roasted by the hekims, then ground into powder. There was also the rasout, a red powder; and the gray sivday. One could obtain rasout or sivday from Hekim Srpig, who lived in the city of Van. We were unable to identify keashmig, rasout, and sivday.

These powders were applied to the eyes using a thin implement made of bone called the deghdir (tegh-tnogh [medication applier]?). The deghdir could be purchased from the craftsmen of Van. In cases of patients presenting with symptoms of an eye condition called tan-tana, the hekim would directly rub crystals of copper sulfate onto the eyelid or underneath it. Tan-tana was probably what we now know as trachoma (see the next paragraph) [31].

Achkashop (eye pain) or khsdoug (intense eye pain) (trachoma): This condition was prevalent among children between the ages of three and six, and especially during the hot and dry months of the summer. Trachoma is caused by the bacterium Chlamydia trachomatis, transmitted by mosquito bites or human interactions. In local parlance, it was said that patients had “madwort growing in their eyes.” Trachoma causes watering of the eyes, severe pain, and damage to the conjunctiva and eyelids. Its symptoms include the presence of a pus-like liquid, which itself can transmit the illness. Avakian writes that to alleviate the pain of khsdoug, the locals dripped urine obtained from girls between the ages of one and seven, or the “milk of a mother nursing a girl,” into the eyes. These three additional options existed to treat this condition:

  1. Heating a clay pot in the tonir (perhaps to disinfect it), then mixing the white of an egg with white shir (possibly grape molasses obtained from white grapes) in it. The egg white would split into two. The warm liquid of the egg would be dripped into the eye, and the coagulated paste would be applied to the eyelid.
  2. Or, only the egg yolk was used, which was again mixed with shir. The resulting mixture was dripped into the eye three times per day.
  3. If these two methods of treatment failed, there was a third option that used shir. It was mixed with the dried buds of clovers, and the mixture was heated in the tonir. It was then ground into a powder and mixed with powdered sugar. The mixture was squirted onto the eyelids in the evenings, after previously coating the eyelids with butter. It was said that this treatment would yield positive results after four applications.

Avakian writes that untreated “trakhoma” caused “hair to grow” in the eyes, under the eyelids. In such cases, the hekims would either use small tweezers to remove these hairs or use a warm, tar-like poultice and a small needle to stick these hairs back to the lids [32]. We now know that in cases of trachoma, hairs do not grow on the lids, but rather, the eyelids turn inward, resulting in the eyelashes damaging the eye. In modern medicine, trachoma is treated with antibiotics, including azithromycin, doxycycline, and tetracycline [33].

Toz: If a person’s vision was affected by a head injury, they were immediately given a mixture of oil and honey to drink. Additionally, for eight consecutive days, their head was washed with water heated over a flame [34].

There was no cure for eye damage caused by smallpox.

There is some data in modern scientific literature indicating that urine and mother’s milk have antibacterial properties [35].

Khavgor or havgoroutyun (night blindness): Those who suffered from this condition lost the ability to see from dusk to dawn. This condition was prevalent among those who worked in the sun, such as farmers. Treatment consisted of the following: the patient was bathed, then wrapped in cloth from head to foot. While still wrapped, he was given boiled liver to eat and “liver water” to drink. He also inhaled the vapors of the liver as it boiled alongside water, with his eyes open. Results were expected after several sessions [36]. Liver contains vitamin A, which improves vision, especially night vision. The humidity of the vapor may have alleviated the dryness of the pupils and healed minute wounds in it.

Treatments of various types of pains and injuries

Earaches

In newborns, drops of their mother’s milk were dripped into the ear. In adults, earaches were thought to be caused by “head colds.” The treatment was to place heated bags of salt on the ears, or to insert a stalk of the onion plant, dipped in oil, into the ear. This last treatment may have been effective because the oil may have dissolved the onion’s naturally occurring antibacterial components, then allowed these chemicals to penetrate the bloodstream through the membranes. Similar results can be obtained by using warm poultices applied through cloth to the affected ear [37].

Toothaches

Like in other Armenian-populated provinces of the Ottoman Empire, Armenians in Van alleviated oral or dental pain by inhaling tobacco smoke into their mouths. There were, however, other treatments. A piece of cotton would be dipped in brandy, then stuffed into the rotten tooth. This would anesthetize the nerves. Then, salt water would be sprinkled onto the tooth, further alleviating pain and easing infections. White shir (probably grape molasses) could also be stuffed into the tooth, or roasted walnuts could be applied to it. If none of these measures succeeded, the tooth would have to be extracted. In Ardjag, the extraction was performed by the village jamhar (bell-ringer). In all instances of toothaches, heated bags of salt would be placed into the mouth. Patients would also inhale the smoke of a plant called khappoug, alongside tobacco smoke [38]. The khappoug is a plant from the beet family. Nicotine, the main active chemical in tobacco, has well-established analgesic properties [39].

Bone trauma

In cases of dislocated bones, the sendjek/sendjekh (bonesetter) would immerse the affected area in warm water, carefully massage it, and then manipulate the bones back into their proper positions. Then the affected area would be immobilized by wrapping it with warm cloth, and would be left wrapped for two to three days. In cases of broken bones, the sendjekh, helped by a strong assistant, would again manipulate the bones back into position and wrap the affected area with clean cloth infused with raw egg yolk and a binding agent (gum Arabic?). In order to immobilize the injury effectively, bonesetters used wooden splints. The method of wrapping would differ according to the area of the body affected (leg, ankle, hand, etc.). The bonesetter would also advise the patient to eat khash, as it was rich in gelatin, and to drink wine [40].

Mey mekhan headaches (headaches affecting one side of the head, possibly migraines)

This condition was prevalent among adults, mostly women. The people of Van believed that the pain was caused by coldness in the blood and by psychological trauma. They also believed that the condition had no effective treatment. One way to alleviate the pain was called shough zarnel. It involved striking the temple repeatedly and lightly with the tip of a sock-knitting needle previously heated on a flame. This would result in minute burns on the patient’s skin. They would then wrap the affected area in a dressing infused with brandy and a solution of ginger, which heated the skin. The following day, a mixture of powdered frankincense, black pepper, ginger, white gum (probably a gummy resin obtained from trees), and egg yolk was applied to a cloth, which was then wrapped around the forehead and allowed to come loose without intervention. The basis of this treatment was to make the patient “forget” about the headache by inducing more tolerable stimuli, such as those caused by small burns of the skin or the heat emanating from the various components of the ointment. This approach, called counter-irritance, is still used in modern medicine. Avakian notes that the people of Ardjag obtained ginger (dak-godj) from merchants in the city of Van [41].

Djndjkhoug (Chnchkhvadzk, bruising/contusions)

These injuries are caused by powerful blows or significant amounts of pressure, without any attendant bleeding. They are injuries of the soft tissues. In other words, the damage is to the deeper layers of the skin and/or to the muscles beneath them. The symptoms include blue discoloration and the swelling of the affected area. According to our source, the people of Ardjag treated bruises using khmtourdz, meaning that they wrapped the injury with cloth, after having treated the cloth with ashes from a tonir mixed with salt water [42].

Kham arnel

When, as a result of muscle pain, an individual lost the ability to move or walk, the condition was called kham arnel (catching kham). It occurred when someone engaged in heavy manual labor after keeping their muscles immobilized for a lengthy period of time. According to Avakian, the people of Ardjag resorted to salt water to treat this condition. In cases of mild pain, the affected area was massaged with salt water. In cases of more severe pain, a special type of lavash bread was used, which was made using two handfuls of flour and two handfuls of salt, alongside the yeast. The dough was rolled open with a pin, then tossed in boiling water, removed, and wrapped around the affected area. The following morning, the dough was removed, and the affected area was washed with salt water and child’s urine [43].

Mayasoul (toutk) (hemorrhoids)

Hemorrhoids are caused by the expansion of the veins in the anus, often as a result of constipation. This causes pain, tenesmus, and itching. The condition is often accompanied by a desire to empty the bowels, even when they are already empty. Sometimes, symptoms including bloody stools. The treatments used by the people of Ardjag are outlined below.

Those affected by hemorrhoids avoided spicy foods and kept their backside warm by leaning it against the warm edge of a tonir. They also applied the juice of a plant called tarouch (“bitter”) to their backsides. We were unable to ascertain the exact nature of tarouch. But we do know of the plant called tarinch, which is also bitter, and is the Picris altissima, not too different from chicory (Cichorium intybus family). This plant was known in the local dialect as hindbey. There may have been some confusion regarding the name of the plant, especially as there are six different sub-types of chicory.

Avakian also talks about a treatment method that used the flower mayasoul. Specifically, the flower, either fresh or dried, “… Was boiled, then drunk while hot. The patient also sat in and on top of the pot in which the water was boiled” [44]. Notably, Cichorium intybus has been used in popular medicine in various areas of the world (Italy, Bosnia, Bulgaria, Iran, Turkey, etc.), and has well-documented medicinal properties, including anti-inflammatory, antispasmodic, analgesic, wound-healing, and anti-hemorrhoid properties [45].

Madnashourt (madnashounch) (paronychia)

This condition was characterized by the reddening of the skin around the fingernails, accompanied by pain, infection, the sensation of warmth, and discoloration. “The affected finger was continually dipped into boiling milk, or in the absence of milk, boiling water, until the skin of the finger began to burn and whitened, and the sharp pain eased.” If this treatment failed, the wound was wrapped with dough containing sugar and oil, so that the wound would open and the pus would drain. Then, once this happened, a poultice consisting of olive oil, roasted onions, and cabbage leaves or yezan lezou [bugloss] was applied to the finger [46].

Paronychia is the result of infection with the Staphylococcus aureous bacterium and some of its derivatives. In modern medicine, the condition is treated with antibiotics, as well as the cutting open of the boil in order to drain the pus [47]. Sugar, onion, and cabbage have antibiotic properties. According to Andew Chevallier, the wet shells of the seeds of bugloss (Plantago species) can be used as cataplasm to disinfect boils and abscesses of the fingers [48].

Aghkyatsav (diarrhea, most probably dysentery)

Dysentery was rare in the Van area, and the usual methods of treatment were generally successful. The illness results in diarrhea, accompanied by characteristic abdominal contractions, abdominal pain, and blood in the stool. The locals were convinced that the illness was caused by coldness in the blood. Thus, they wrapped the patients’ abdomens with warm cloth, and a piece of felt, boiled in animal fat, was placed on their backside. The patient was fed grape molasses mixed with yogurt, flour-based dishes, and was made to drink water boiled with pomegranate rind [49].

Dysentery is caused by the Shigella bacteria. We know that yogurt contains probiotics, which can often fight infections. The starch in flour can thicken the stool and alleviate diarrhea. As for the pomegranate, alongside other health benefits, it contains compounds that have antibacterial, antifungal, and antiviral properties [50].

Various illnesses, including contagious diseases

Jaundice

In the local dialect, jaundice-hepatitis was called teghnouten. The condition is characterized by yellow discoloration of the skin, pupil, and urine, as well as discoloration of the feces. Jaundice occurs when, for various reasons, the body’s bilirubin (a naturally occurring chemical compound produced by old red blood cells) remains in the bloodstream (hyperbilirubinemia), instead of being evacuated from the body via the bladder. This may happen for several reasons, such as obstructions that interfere with the functioning of the liver, the Epstein-Barr virus, or hepatitis [51].

a) Childhood jaundice: The child was bathed with govou shdoug (fermented yogurt), wrapped in the leaves of a plant called grnzi taf, and left to sweat. We were not able to identify grnzi taf, but perspiration has the ability to alleviate fever. Some bathed the child with willow leaves, then wrapped him in the large leaves of the same tree. Others placed embers in the child’s bath water, after which they hooked the child’s feet behind her neck. This treatment had to be performed “before the break of dawn.”

It is well-known that willow leaves contain acetylsalicylic acid (better known as aspirin), an analgesic and antipyretic. This chemical would easily be absorbed through the child’s warm skin. However, it must be noted that aspirin can result in negative side effects in children, including Reye’s syndrome, a potentially fatal neurological/brain condition.

b) Adult jaundice: The people of Ardjag believed that adults could come down with jaundice upon receiving bad news, as a result of the shock. It was believed that shock could block the exit of the bladder, preventing yellow urine from being expelled. The accumulation of urine would ultimately find its way to the bloodstream and spread across the body. This was believed to cause the discoloration of various parts of the body. According to Avakian, treatment consisted of startling the patient, for example by slapping him, which would hopefully re-open the blocked exit of the bladder. Generally, it took months to recover from jaundice. For the duration of the condition, the patient was proscribed from eating meat or lard, was instructed to eat very little vegetable oil and eggs, and to eat plenty of fruits, vegetables, and sweets [52].

Togh (the shakes, malaria)

Ardjag and Khoragonis (a nearby village), being humid areas, were home to a large number of swamps during the hot and humid season. This resulted in the propagation of the specific type of mosquito that transmits the togh. The female of this species, through its bites, infuses the victim’s blood with single-celled plasmodium organisms, which then infect the red blood cells. These organisms complete their life cycles inside the victims’ bodies, causing various symptoms as they proceed through the different stages of their life-cycle. These symptoms include fever, head/body aches, excessive perspiration, delirium, loss of appetite, and strong spasms [53].

Avakian writes that given the summer weather in Ardjag and Khoragonis, these two villages were always the hardest hit by togh in the province.

Patients were given a mixture of water and kinakina powder to drink, or were given the same plant’s tree bark to gnaw on. Kinakina could be found at the only apothecary in the city of Van [54]. It is a tree native to South America (Cinchona species), which, in the 1630s, Jesuit missionaries introduced in Spain. They had noticed that the indigenous people of South America used the plant to fight off malaria and high fever. Kinakina was used as a treatment for malaria for approximately 190 years before, in 1820, the French pharmacists Pelletier and Caventou discovered that the bark of the tree contained quinine, which can kill the plasmodium parasite that causes malaria [55].

Respiratory conditions

Khontsav/harpoukh (the common cold of viral origin): The people of Ardjag knew that this illness was infectious, but they did not take any preventive measures against it. To treat the illness, they simply inhaled the vapor/smoke of onions, garlic, and blue rags that they burned. They wrapped their underwear around their heads, noses, and mouths at night [56].

Shora (flu/influenza): This illness was characterized by persistent high fever, coughs, tremors, headaches, general fatigue, and joint pain. Influenza is caused by the Influenza A or B virus. Avakian writes, “… If the flu entered a home, it infected everyone in it.” This is understandable, as families in the Ardjag area lived in close proximity. The first method of treatment was to induce sweating in the patient. To do this, the locals used the boiled roots of a plant called havloudjan. Unfortunately, we could not identify this plant. Shora was also treated by feeding the patient a mixture of onions and incense, or the ashes of a quince. Patients also drank an infusion of marshmallow plant. The patient’s palate and throat were massaged internally, using the fingers wrapped in cloth. The goal was to remove the “rind” that formed on the palate and throat. To alleviate fever, the patient’s temples, palms, and feet were rubbed with warm brandy [57].

Sateldjam/sateldjan (pneumonia): The symptoms of pneumonia include difficulty breathing, tremors, high fever, and loss of consciousness. The local treatment was to induce sweating by various means. For example, cow manure was lit in the tonir. Then, as soon as the fire went out, the patient was stripped and lowered into the tonir pit, resting his feet on the still-smoldering manure and leaning his back/side against the warm wall. With the patient in this position, the tonir was covered with a blanket, with only a small opening to allow air to circulate. Once the patient reported that he had sweated sufficiently, he was brought out. His caretakers would wrap him with dry cloth and a dry blanket, and would lay him down near the tonir, in order to induce another round of perspiration. If these treatment methods were not possible, the patient was put in bed, and a pot of boiled water, with a wooden lid and wrapped in cloth, was placed in the bed beside him. The patient would rest his feet against the pot and would be covered with a blanket.

If the patient did not recover within three weeks, people resorted to another method – they would take the skin of a large, newly-slaughtered sheep, and would sprinkle it with a mixture of spices that produced heat. The skin would then be tied securely to the patient’s body. The patient would be left in this state for two hours, sweating profusely and suffering in delirium. This “medical” coat would then be removed. The patient’s body would be entirely red and raw, and very sensitive. He would then be dressed in soft cotton clothing [58].

Brdoudj Agergel (esophagus blockage)

If the people of Ardjag experienced pain while swallowing, they attributed it to their esophagus being blocked by food. To treat it, upon waking up, and while their stomachs were still empty, those who suffered from a blockage would fill their mouth with water and swing from a tree branch while holding the water in their mouths. Their feet had to stay at least two meters above the ground. They had to swing, jump down, and swallow the water just as they jumped and while they were still in the air. If, after this treatment, the esophagus remained blocked, the locals said that the food had “made its own nest,” and waited for it to slowly make its way down the throat of its own accord [59].

Pediatric Conditions

Smallpox (Variola)

The people of Ardjag believed that vaccinations were crucial to combat smallpox. However, with some respectable exceptions, most of them used only traditional methods to treat it. Among these methods, Avakian mentions refraining from bathing infected children; keeping them in their beds; and refraining from using light in their rooms, so that the glare of the light would not shine into their eyes. Children suffering from smallpox were fed sweets, raisins, and nabat sugar (Crystallized sugar). Meat, lard, and other oils were strictly prohibited. These methods were naturally powerless in stopping the advance of the illness, or in preventing the blindness that often resulted. When a child in a village came down with smallpox, the illness quickly spread to other children [60].

Scarlet Fever

Our source states that this “was an inevitable disease of childhood.” Treatment was similar to the treatments for smallpox, but in this case, the child was wrapped in red cloth, and was made to drink donkey’s milk at least once.

More children died in Ardjag of scarlet fever than of smallpox. Symptoms of this condition include a sore throat, fever, and red bumps on the skin. The disease is caused by the bacterium Streptococcus A. Given the crowded households of the area and the daily interaction with neighbors, the infection spread rapidly among children between the ages of 5 and 15. Scarlet fever can cause complications that affect the heart, lungs, and kidneys. Avakian mentions that during the Genocide of 1915, cases of scarlet fever skyrocketed among Ardjag Armenians who had been deported [61]. As for the use of donkey’s milk to treat the condition, Joe Schwartz writes that donkey’s milk is closest, in terms of its chemical makeup, to human milk. We know that a mother’s milk plays an important role in the development of immunity among children, and also contains various anti-bacterial substances [62].

Diphtheria

The infectious bacterium that causes diphtheria is the Corynebacterium diphtariae. The following treatment was used by the people of Ardjag: the child’s swollen neck would be squeezed with the fingers, and she would be given donkey’s milk to drink (see the above paragraph regarding the composition of donkey milk). The child’s body would also be rubbed with kerosene. According to our source, these actions would yield positive results only in mild cases of the disease. Diphtheria caused widespread devastation across the Armenian countryside [63].

Khoroza (whooping cough, blue cough, pertussis)

This disease is caused by the bacterium Bordetella pertussis. The child would begin “rasping”, and as Avakian writes, make the sounds of a rooster. The family would call on the church bell-ringer. Until the bell-ringer’s arrival, the child’s forehead would be treated with a mixture of crushed onions and salt, then wrapped. Upon his arrival, the bell-ringer would remove the dressing, use a razor to make a cut on the child’s head, then, after wiping off the coagulated blood, would rub the cut with brandy. The Armenians of Ardjag were convinced that this treatment would restore the child’s normal breathing [64].

Dzarav kashel (cutting off the thirst)

This condition was prevalent among infants from the age of eight months to one year. The symptoms were intense thirst and the constant desire to drink water, leading to the loss of weight and appetite. According to Avakian, this occurred because at some point, the mother must have forgotten to give the child water, and thus had failed to “cut off” the latter’s thirst. As a result, the infant nursed an intense desire for water. Experienced mothers (mothers of twins) would “cut off” the child’s thirst using the following method: they would lay the child down, with her feet held higher than her head, and would massage her hip bone and squeeze the lower abdomen. If the child’s stomach was heard rumbling, it meant that the treatment had succeeded. However, more often than not, this treatment resulted in negative results. Avakian writes that young mothers did not place much faith in this treatment method [65]. The symptoms described by Avakian lead us to suspect that this condition was none other than pediatric type 1 diabetes (T1D), although pediatric diabetes is much more prevalent between the ages of five and nine [66]. We do not know why Avakian categorized this condition as a communicable disease.

The use of medicinal plants in popular medicine

As Avakian states, “Like all their near-eastern compatriots, the people of Ardjag used a host of medicinal plants to treat medical conditions and passed the knowledge down to successive generations.” [67]

However, Avakian’s use of the local Van dialect in his work proved to be a serious obstacle as we tried to analyze the use of medicinal plants in Van, especially as the author often provides no identifying details regarding the various flora he mentions.

In this section, we separately present the plants discussed in Avakian’s book and their medicinal uses. However, we must emphasize that we are not fully satisfied with the information provided here, as the complex chemical makeup of these plants can result in complicated pharmacological effects.

Yezan Lezou (Anchusa officinalis, bugloss)

The hekims of Ardjag mixed the seeds of this plant with buffalo milk and boiled the mixture. The resulting paste was rubbed onto cloth, which was then tied around unopened boils. This would result in the boil popping and the pus draining. The leaves and seeds of this plant were also boiled with water and drunk in cases of stomach ailments [68]. According to another source, yezan lezou was also known as tortig or bakhrayi aganch. It was used to treat gastrointestinal ulcers, hemorrhoids, conditions of the liver and spleen, neck swelling, infected wounds, tumors, and arrhythmia. The plant contains saponins, other microelements, and microbicides. Its roots also contain red dyes [69].

Choban Doshagi

Most probably, this was Capsella bursa-pastoris or shepherd’s pouch. Avakian writes that village surgeons would use the dried and crushed leaves of this plant to ensure that wounds closed quickly [70]. According to Chevallier, the plant can be an effective treatment for bleeding and infections [71].

Khapepoug-Barbat

Avakian describes this plant as a light-colored, trumpet-shaped flower, with spherical seed capsules. As the flower dried up, it pushed out the seeds [72]. This description matches that of the highly toxic/deadly Datura stramonium, which can have devastating effects on those who ingest it. For this reason, it was called barbat or berbat, which translates into “terrible” in Turkish. In English, Datura stramonium is known as Jimsonweed and angel’s trumpet [73]. According to Chevallier, ingesting a certain dose of this plant can induce hallucinations. In ancient times, it was used to treat lunacy. It contains chemicals of the tropane class, which can be absorbed across the skin and can alleviate joint pain and neuralgia [74]. Avakian writes that in cases of toothaches (navazil), the people of Van would roll the seeds of this plant in paper and smoke them like a cigarette, holding the smoke in their mouths.

Garmir Avel (Red Broom)

Identifying this plant proved to be particularly challenging. Kapigian writes: “Approximately 15 different plants were known as avel, namely gabouyd [blue] avelchout aveltsakhavelshghig avel, etc. They were all used to make brooms” [75]. Avakian writes that “During childbirth, if a mother’s contractions ceased instead of intensifying, the midwife would conclude that she was cold and burn garmir avel. The mother would then squat over the fire” [76]. Clearly, the woman in labor would be warmed by this treatment, but would this be enough to stimulate further contractions? We know one plant that has uterotropic qualities, and that’s Cytisus scoparius, or the common broom, whose complex chemical composition gives it the ability to accelerate contractions of the womb. Such contractions facilitate birth, as they push the fetus out. In Turkish the red broom could well be kızıl süpürge bitkisi, or Calluna vulgaris (the common heather). We learn from Chevallier that this plant has several therapeutic properties. It may act as an antiseptic agent and fight off bladder and urinary tract infections; act as a diuretic; or act as an anti-lithiatic and assist in the expulsion of stones from the kidney or gall bladder. However, Chevallier’s work does not list any uterotropic properties for Calluna vulgaris. [77]

Abrem-Chabrem or Yeritsoug

This was Anthemis tinctoria (golden marguerite). According to Avakian, in cases of toothaches or infections of the gum, an infusion of this flower was boiled, and the mouth was held open over the boiling water [78]. Giustino Orlando and his colleagues have extensively studied the chemical and pharmaceutical properties of the Anthemis species. This particular plant is used widely as an antiseptic, anti-inflammatory, analgesic, and cosmetic. The essential oils that it contains have well-documented healing properties [79].

Sources emphasize that among other medicinal uses, Anthemis is effective against toothaches. We can surmise that the vapors of the above-mentioned infusion were rich in vaporized essential oils, and were thus effective in treating the toothaches of the people of Ardjag.

Deghd (Doughd)

This was the marshmallow plant, Althaea officinalis, also known as khatmi. Avakian gives a very concise overview of its medicinal uses. He only mentions that during the winter, people used the dried flowers of this plant to make a tea, which they then gave to the sick. Additionally, Avakian writes that the roots of the flower were used as a soap to wash the head [80].

We will not delve into the chemical and medicinal properties of the marshmallow. However, it is notable that Amirtovlat of Amasia (1420-1495), the celebrated physician, prescribed the use of khatmi to treat scabies, baldness, hair dandruff, and other conditions [81].

Conclusion

The reports from 1913 in the pages of the Van-Dosb weekly newspaper make it clear that public health in the area of Van was in a parlous state. In fact, we wonder how many of the city’s doctors ever visited patients in the countryside.

Due to the dearth of primary sources on the subject, it was not possible to provide a comprehensive overview of popular medicine as practiced across the province of Van/Vasbouragan. But other articles written on four other regions of historic Ottoman Armenia (Dersim, Ourfa, Kayseri/Gesaria, and Harput/Kharpert) show that medicinal practices within provinces were notably similar. Thus, we can conclude that our findings concerning the village of Ardjag of Vasbouragan can be extrapolated and applied to the entire province.

The Armenians of Van were notable for their ingenuity and boldness in the medical arena, going as far as performing eye surgery. The villagers also showed the commendable ability to adapt to their circumstances and use whatever means were available to treat complex medical conditions. We listed treatment methods for 15 different ailments and medicinal uses for five different plants. The people of Van had even developed different methods for treating jaundice in adults and in children. We must note that linguistic difficulties (namely the use of the Van dialect and widespread use of Eastern Armenian by our sources) sometimes made it impossible to identify some specific medical conditions or plants.

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  • [31] Ibid., pp. 74-75.
  • [32] Ibid., page 75.
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  • [37] Ibid., page 76.
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  • [59] Ibid., page 80.
  • [60] Ibid.
  • [61] Ibid., page 81.
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