Thursday, June 7, 2007

Medical History

Educating Ottoman Doctors


The Kayseri Hospital (Gevher Nesibe Sultan Shifahâna). Drawn by Suheyl Unver
This short article is taken from the full article which is available here as a PDF file


This article was first published in the Turkish review History of Medicine Studies (Editors, Nil Sari-Husrev Hatemi), Istanbul 1988, pp. 40-64. We are grateful to Nil Sari, author of the article for allowing publication.

The Ottomans had a special concept of medicine and methods of medical training. Besides the "tabîb" whom we can call a specialist of internal diseases, there were several other specialists such as the surgeon, ophthalmologist, orthopaedist, syrup preparer, herbalist etc… all dealing with public health and trained in different ways.


The physician held the highest position in the class focusing on health and he was usually educated at a madrasa and dâr al-shifa (hospital). But, since the documents studied so far do not give full and satisfactory information, there is a great gap of knowledge about the education at the "madrasa" and "dâr al-shifa". It is certain that in the Ottoman Hospitals, as well as in Seljuk Hospitals of Kayseri (1205-6) which has a double "madrasa plan" and Sivas, the physician was trained both theoretically and practically.


The young man who entered a trade in order to learn an art or a craft, serving under the supervision of a master or foreman was called "cirak" or "Shaqird". One who wanted to be a physician was called "tâlib" and the name of the student physician was "Shaqirdi tabîb." The "Sakird" attended clinical cases at the hospital and acquired theoretical learning in medical science at the madrasa and by reading medical manuscripts in the library of the "madrasa."
Ottomans carried on the good tradition, building new hospitals, in addition to the old ones of the Seljuks. One of these was the Bursa Hospital (1399), a part of the Sultan Yildirim complex where physicians were trained at the "dâr al-tib" (school of medicine). There was a schoolroom in the hospital and a teacher who was a physician. It was the first hospital built by the Ottomans. It is also noted that in the Fatih Hospital (1470) in Istanbul, there was a teacher; called "darsiâm" and medical students called "tabîb shaqirdi". In Edirne (Adrianople) at the Bâyezid II Hospital (1484) it is noted that there was a medical school called "madrasa-i atibba". As a continuation of the Islamic tradition, just as in the Seljuk period and the Ottoman period, theoretical and practical medical sciences were taught in the hospitals. Until the mid nineteenth century, physicians were trained at hospitals that also served as medical schools.



Gevher Nesibe Sultan (d. circa 1204)


A separate medical school was founded at the "Suleymaniye Complex" (1556-7) where medicine was taught as an independent field of study. The medical students had their courses in applied medicine at the hospital near the "madrasa". Suleymaniye medical school is described in the "Waqfiya," as "a supreme and honourable school built for the science of medicine..."


Graduation from classical madrasa was required in order to be qualified for enrolment to the medical school to specialize. The physician who had already studied Islamic jurisprudence, divinity, philosophy, and literature had by then learned Arabic and Persian as well. Physicians educated at hospital were always required to have "madrasa" education as well as medical learning. In addition to learning Islamic divinity, they were expected to acquire knowledge of all sciences. Having received a certificate according to the textbooks he had studied in the class, he continued in the class of another professor (mudarris). And when he had received the last certificate he became a "mudarris", or a "qâdî" (qâdî-judge of the Islamic canon; governor of a district) As a result many physicians could chose to work in various fields, as a "mudarris", a "qâdî", an "imam" and "kazasker"-(Chief military judge)-.


The Ottoman scholars used to attend the madrasas in Syria, Egypt and Iran. For instance the Hajji Pasa (1424), obeying the fashion of the day, studied at a madrasa in Egypt and after a while he developed an interest in medicine. He became a physician and in time he was promoted to the post of head-physician of Kalavun Hospital.


There was a close relation between the medical service in the palace and in the hospitals. Just as the physicians of Suleymaniye were appointed as palace physicians, there were also palace physicians who were transferred to a hospital. And there were even physicians working as palace physicians who at the same time served at Fatih and Suleymaniye Hospitals.
Yildirim Dâr al-shifa in Bursa, built in 1399 by Yildirim Bayezid (1389-1402). A view of the lecture hall



The chief physician (Hekimbasi) was not only in charge of the health affairs of the state but was also closely interested in medical education. From a document in Topkapi Palace Archive, we find a list of the books to be used by the head-physician. In a record at the back of this document, it is noted that these books were given to the head physician Molla Kasim in 1575 who, on his retirement, delivered them over to Isa Celebi who replaced him in 1580. We can conclude from these documents that head physicians were closely interested in medical education.


The organization of artisans in the palace was an important institute of education. Surgeons and ophthalmologists were educated at hospitals or learned medicine at a shop, working as an apprentice with a master. There were also families that carried on the medical profession as a family tradition, the younger learning it from their elders in from within the family. There was, however, an organization in the palace which also trained surgeons and ophthalmologists who were regarded as craftsmen. This organisation of artisans in the palace was an important institute of education. It was named "hâssa ehl-i hiref" and selected and educated those sufficiently talented to fulfil these roles.


There was another form of education besides the madrasa, the hospital, and the palace. It was also possible to be trained by a qualified physician in his office or in a special class by the master-apprentice method and get a certificate for practicing medicine. In this case, little research has been made regarding the relation between the craftsmen's guild (ahî teskilati) and the physicians, surgeons and ophthalmologists who practiced independently.
Many experienced physicians trained students in private courses, even in their private classrooms. Especially at the end of the seventeenth century and in the eighteenth century, with the deterioration of the "madrasas" and the appearance of ignorant ones amongst real scholars, there was an increase of the practice of private education outside hospitals.


Another important item for the history of medical education is that decrees were issued from time to time as a result of the appearance of quacks requiring physicians, surgeons, ophthalmologists and herbalists to be examined and those found efficient were to be given a certificate but those who failed were forbidden to practice. It was decreed that those who practiced therapy were to be examined in their field by the head-physician of the day and those who were successful were given a certificate sealed by the head-physician which enabled them to practice. Those who had not studied medical science with a great master and the ignorant who practiced medicine without learning the medical art from skilful physicians were forbidden from practice and punished.


More extensive research needs to be made in Ottoman history of medicine and the conclusions to be arrived at are sure to shed light on our problems today and enable us to understand them better. This will be possible, however, by the classification, study, and publication of all the documents and manuscripts relating to the field that exist in archives and libraries.


by: Prof. Nil Sari, Fri 02 September, 2005

1 comment:

sample said...

Thanks for some great history lessons!


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