One of the most important consequences of the institutionalization of Unani medicine was the systematization of Unani knowledge and the establishment of regulations for the recognition of its professionals at different levels. These new forms of knowledge transmission and authority have not eroded older ways completely. As a consequence, various and sometimes conflicting forms of medical authority, legitimation, and practice coexist in contemporary Unani medicine. This chapter discusses the problem of state legitimation versus professional recognition by peers and patients, scrutinizing forms of knowledge creation and transmission as well as the limitations of state regulation. Apart from analysing the influence of these processes on the enactments of Unani and the looping effects emerging from them that shape what Unani is today, I discuss multiplicity as inherently characteristic of Unani medicine, arguing that it persists in spite of efforts of standardization.

Creation and Transmission of Medical Knowledge

Becoming a Hakim

Before the spreading of formal teaching institutions, Unani medical education was commonly imparted through an ustād-shāgird (‘master-pupil’) apprenticeship system that remained greatly unchanged (Liebeskind 1996: 39). Practitioners trained mostly in informal settings like homes (Metcalf 1985: 4; Kutumbiah 1962, cit. in Jefffery 1988: 46). Also, training in institutionalized settings was most probably imparted in madrasas, such as during Akbar's reign (1556-1605) (Speziale 2012b: 160), and there are indications that this was the case in Punjab in the late nineteenth century, too (Attewell 2005: 389). Basic medical training in madrasas did not only target hakims-to-be, but also religious and other scholars (ibid.). Although the textbooks, mostly in Arabic and Persian, constituted an important part of medical training (Attewell 2005: 390), practice itself had a dominant role, both as clinical training or bed-side instruction (Jaggi 1977: 26; Liebeskind 1996: 40). Students learned how to examine patients and how to diagnose and treat through practice (ibid.). Also, the preparation of drugs was a constitutive part of their learning and an important aspect of the family practice (ibid.; Speziale 2010b: 177f.). Part of this medical knowledge was not in the books. In order to become a Unani practitioner, apprenticeship with a practicing hakim remained necessary, and physician-families offered more sustainable forms of knowledge transmission than hospitals (Speziale 2012b: 161).