Health and treatment are important issues in the social history of Iran that have received less attention in traditional and political historiography. Since the court historians of the Afshar and Zand eras mainly dealt with political and military events, knowledge of the medical situation, public health, and how society and the government faced epidemics can be reconstructed, above all, through primary historical sources and European travelogues. This research, using a descriptive-analytical method and relying on library resources, seeks to explain the reasons for the inefficiency of the health and treatment system and examine how society and the government faced epidemics in the Afshar and Zand eras. The research findings show that the weakness of the health system in this period was not simply due to the limitations of medical knowledge, but rather stemmed from the interaction of three fundamental factors: the dominance of fatalistic beliefs in society, the lack of policy-making and sustainable health institutions by the government, and the disconnect between existing medical knowledge and the executive structure of the government. A comparative study of historical sources and travelogues also shows that although some physicians and new treatment methods were known in Iran, due to the lack of institutional support and cultural resistance, these capacities did not have a significant impact on improving public health. The innovation of this research lies in the simultaneous analysis of the interaction of social beliefs, government structure, and medical knowledge in explaining the causes of the persistence of health crises in the Afshar and Zand eras, and it attempts to present a clearer picture of the neglected dimensions of Iranian social history.