while traditional medicine continues to flourish in the popular sector, t raditional health care specialists constantly fear suppression of their practice. There remain in Maragheh sellers of herbal medicine (ca. 3), traditional orthopedists (ca. 6 of wide reputation), neighborhood midwives (perhaps 25), and women in each neighborhood who specialize in cupping (perhaps 50 or more). Few of these persons are high specialists in the old tradition, but all are steeped in the popularized version of the high t radition and many are highly skilled technically. While all mullahs (clerics) have a 'medical' role through their interpretation of ritual purity in terms of hygiene, the only religious specialists in curing are the writers of curative prayers (du'a nevis). Many seyyids or mullahs write an occasional prayer, but perhaps ten have city-wide reputations in Maragheh. Du 'a nevis practice a form of divination, using four strung die ( ram!), an astrolobe , the Qur'an, or a system of assigning numbers to the letters of one's name. In some parts of t he count ry these men are highly trained, some having been apprentices in India, and use divination to practice a kind of folk psychiat ry
(Fischer 1973:288).
The prayer-writers in Maragheh play a less conscious 'psychiatric' role, b ut in treating problems believed to respond to curative prayers - infertility , some forms of madness, and illness caused by evil eye, fright , or intentional magic - they become involved in the emotional and interpersonal crises of their clients.
Three high t raditions of medicine - Galenic-Islamic, sacred , and cosmo politan - provide the underlying structure for the medical theories and therapeutic forms of bot h the health care specialists and lay persons in Iran . Classical humoral medicine, continuous through the Greeks, Arabs, and Persians, provides the basic structure for popular physiology , images of illness, and therapy.4 In simple terms, illness is conceived as arising from an excess or deficiency of the humors or the basic qualities (hot-cold, wet-dry), and therapy is directed at restoring the equilibrium characteristic of an individual's nature (tabe'e). Sacred medicine is grounded in the cosmology of the Qur'an and the Tradition (Hadith) (Nasr 1968), from which are drawn the images of jinns (spirits) and evil eye as agents of disease, and the logic of healing through the power of the sacred words, the breath or touch of holy men, or the manipulation of impurit y. Sacred medicine is also based on the Hermetic tradition of astrology , alchemy, letter magic, and divination (Nasr 1967). Both of these sources provide the basis for popular notions of illness caused by spirit ual invasion or interpersonal harm and for the therapy of the prayer-writers.
The three high traditions of medicine provide the basic explanatory models and theories of disease causation and cure that make up popular medical culture in Maragheh today. 5 While including ideas and therapies elaborated in several different high theoretical traditions, popular medicine integrates these
into a distinctive system of health care. This includes a popularly shared ethnophysiology, several 'folk illnesses' only partially recognized in the high traditions, a 'hierarchy of resort' for seeking care (Schwartz 1969), and forms of home care which vary from bed rest and diet to brief curing rites undertaken at home or in the neighborhood.
The popular system of medical care is above all medicine of the lay population and medicine of the home. It provides a language, passed on from generation to generation, in which people voice their experience of disease. And it provides a set of ideas, cognitive models, expectations, and norms that guide the responses to disease by a patient and by those persons in the patient's home, family and neighborhood who care for him. In this way the popular system of medicine socially and meaningfully constructs the experience of disease and the care of the ill.
A careful examination of popular medicine immediately poses a dilemma for understanding. On the one hand it appears to be made up of bits and pieces of ideas and therapeutic practices drawn from diverse sources, from medical traditions elaborated at a great remove - historically, geographically, cultur ally - from its present context in Maragheh. As in all complex societies, popular medicine in Iran includes a collection of ideas and practices, idiosyncratic and contradictory beliefs, mistaken metaphors (Percy 1975:64), and therapies followed cook-book style. It appears as a 'bricolage', a collection of elements "retained on -the principle that 'they may always come in handy' " (Levi-Strauss 1966:18), a set of tools for constructing responses to disease. On the other hand this diverse collection seems somehow to be coherent and woven intimately into the structured fabric of social life behind the high courtyard walls and within the neighborhoods and the shops of Maragheh.
Popular medicine in many complex societies seems deeply integrated into the social life and symbolic structures of the community. From the products of diverse historical periods and high theoretical traditions, popular medicine constructs illness configurations which articulate conflicts and stresses peculiar to that community, and often provides therapies which reinforce integration and conservative values of the community. Currier (1966) describes how the hot-cold dichotomy, developed in ancient Greece and elaborated by Islamic science, provides a basic structuring principle of Mestizo culture and social interaction. Hildred Geertz shows how latah, a psychological disorder existing
with similar symptomatology in several Asian societies, seems to be "tailor-made for Javanese" (1968:98). The same could be demonst rated for elements of popular medicine in Maragheh: the idiom of hot and cold, the humors (blood , dirty blood, bile), the extended meanings of the heart and liver, the use of the ritually polluted ( najes ) in curing, or folk illnesses caused by fright or the evil eye, each seem specially suited to Iranian social life.
Medical language, whatever its source, acquires meaning specific to a particular social and cultural context and in t urn integrates illness and cure deeply into that context. How does this occur, and what does it imply for our analysis of the meaning of medical language, for a theory of the relationship between language and disease? The description of 'heart distress' in Iran will allow us to address this issue in more detail.