Ottoman medicine is a combination of many structures from Ottoman conquests of the Middle East, European and African lands. It is an amalgamation of the complex social, cultural, political and religious identities of many people and as such comprises many medicinal treatments and cures. The Ottoman Empire played a very crucial role in the origins of and history of Ottoman medicine, because it absorbed vast quantities of medical knowledge along the Silk Road, as well other parts of the empire. Hence, according to Miri Shefer- Mossensohn, Ottoman medicine was a superstructure comprising ‘smaller building blocks of medical ideas and practises’. [1]

Shefer- Mossensohn claims that there were three building blocks or traditions upon which Ottoman medicine was based, namely Folkloristic, Prophetic and Mechanistic medicine.[2]

According to Shefer- Mossensohn “ The Ottomans inherited shamanistic medical traditions from central Asia that Turkish tribes immigrating to the Middle East and Asia Minor brought with them.”[3] This folkloristic popular medicine incorporated age-old practises and rituals into the Ottoman medicine systems, such as seers, who it was thought were able to see into the near future and use divine inspiration, magic, and ritual as medicine practices.

Popular medicine was an oral tradition of medicine “from below”.[4] It comprised of popular stories based on medical folklore, which were passed down from forefathers to their children and had “no religious, judicial or scientific authority.”[5]

Prophetic or religious medicine in the Ottoman Empire was based on teachings and sayings of the prophet Muhammad that were incorporated into the Ottoman medicine system, as Muhammad ‘had healing powers attributed to him’. [6]. According to Shefer- Mossensohn “suffering was celebrated as a religious virtue” [7] . It was thought that suffering was purifying and as such it was desirable; hence the prophetic saying “A believer will suffer no illness without God expiating his sins”[8] Prophetic medicine was based on the written word from the Koran and the prophet Muhammad . As such, Prophetic medicine was not theologically neutral.

 

The Mechanistic medicine of the ottoman medicine was based on the humoralism inherited from ancient Greece. The Greeks used the knowledge and understanding of the importance of the system of the four humours as well as the ‘physical and philosophical points of the body and mind. Evliya celebi talks about the relevance of mechanistic medicine with the body and the religion as to how it is connected through variations of transmission between the two “Science is two, the science of bodies, and the science of religions”[9] This Muslim humoralism had a unique literature of writing. It was written by various scholars and translated from Greek texts and used in the Ottoman field of medicine.

 

Unlike Prophetic medicine, Muslim humoralism was theologically neutral because it was transmitted and written over time. Furthermore, there was no race or gender issue. As this was not a subjective matter, the idea of working to find a ‘cure’ for a patient was more important in the Ottoman world of medicine. In medieval Europe –critics called it pagan or atheist, but according to modern scholars it was rational and secular. [10]

Despite the differences between the 3 traditions and the belief that people did on the whole stick with one system of ideas, Shefer-Mossensohn claims that, “in reality both healers and patients fused medical ideas and practices” albeit sometimes unintentionally. She also claims that patients crossed from one tradition to another in the hunt for the most effective/useful treatment.[11] Therefore, there was an overlap in medical knowledge and technology, as can be seen in the following three examples: phlebotomy, Physical examination for diagnosis and pluralism.

Phlebotomy was an important practice within Ottoman medicine because of the blood letting and the changes that could consequently follow. This involved the bleeding of the veins, since it was felt that the removal of bad blood cells was necessary as this is what was causing the patient to feel a lot of pain and the bleeding would subsequently release the pain/pressure. [12] This was a very important tradition within the Middle East, and was vital to Islamic and Ottoman medicine to try an balance the humors because an imbalance of humors was thought to cause old age.[13]

There were various ways for the Ottoman physicians to examine and diagnose illnesses and the practices of morality, modesty, contentedness, fidelity and hopefulness were very important. For cures they tended to use various ointments to check the pressure of the pulses and veins as well as checking patients’ breathing. However, the diagnosis of physicians was very systematic and was dependent on ‘what would work, what wouldn’t work’. This basic principle made sure that physicians’ results in their work were highly effective. [14] Additionally the ottoman examination demonstrated how they utilised every little detail description whether it come from the patients themselves or other colleagues of physicians, it was vital before they could come up with a conclusion for illness and cure.[15] “Most important of the early Ottoman medical scholars was the chief doctor of Amasya public hospital, Sabuncuoglu Serefeddin, whose study of surgery, Cerrahname-i Ilhan (1465), based on his own medical experience, was the most original ottoman medical work of its time.”[16]

 

Ottoman pluralism was important to the practice of medicine because of its rationality of the thought process of cures and treatments and the fact that it took different social factors and class into consideration. According to Shefer-Mossensohn, physicians had a code of morality, which played an important part in giving the best treatment of the highest standard for both the higher and lower classes in society. [17] In other words, whatever the diagnosis physicians lived by a code of doing whatever was best for the patient without putting a financial burden upon them.[18] Imarets and hospitals also performed the important function of supplying and helping out the poor for supplements and cures for diseases. Furthermore, hospitals played a vital role in society because they took in the ‘poor’ and looked after the ‘sick’.[19] For example, there was another type of fiscal payment for the physicians, namely quantities of “food were a mode of payment” the ottoman physicians and the ottoman prescribed depending on the amount of herbs and medication.[20]

 

However, the clinical reality of pluralism meant that social and economic factors did affect the numerous treatments that were available to the Ottoman peoples. Class and economic factors had an effect on access to medicines and treatments because of the structure of Ottoman society. Means of finance played an integral part to access. Ottoman upper class bureaucrats could afford the best and most extravagant medicine and herbs, such as Opium, ointment, precious gems to ease pain, and other various rare metals.[21] Because of this it affected which ill patients could access the available medicine, cures and treatments.

 

Because the Ottoman Empire was so vast it covered different climate zones, each of which had its unique health issues and medical problems. However, each climate zone also had its own ‘flora and fauna from which medication and treatments were prepared. [22]

The link between food and health was well established in the Ottoman Empire. This emphasis on the importance of food and health was a vital factor in Ottoman society and Ottoman medicine because of food shortages, and crop failures which brought with them the risk of malnutrition and hunger.[23] A balanced and varied diet was recommended for good health. Meat was considered a basic dietary requirement, however:

“the example of meat illustrates that the great variety of foodstuffs one was supposed to consume in a balanced diet in order to stay healthy or to combat illness was available for daily consumption only to the Ottoman elite”[24]

Another reason that the food diet was very important was because of ‘health regime and the therapeutic ‘ side of healing and preventing illness by having regular healthy and clean food. [25] This was another factor which contributed to the creation of Imarets and other stationary places, such as ‘vakfiye’ or ‘vakif’. These were important institutions put in place to help out the poor of the Ottoman Empire to make sure they were not hungry and they had basic needs of treatment.[26] Despite this, as has been mentioned above for many poor people the reality of the situation was that “the less wealthy people mostly lived on much cheaper foodstuffs, like green vegetables, beans and lentils” [27] this was not their reality, due to economic constraints and as Shefer-Mossensohn points out, “If the doctor ordered the patient to consume meat, could the patient follow that order?” [28]

 

The Ottoman Empire also believed in cleanliness and the importance of bathhouses or hammams because of the ‘medical healing properties’ of water. Water was an important factor in medical practice in the empire as cleanliness meant less risk of diseases developing and this was something the Ottoman Empire believed in as it tied in with the notion of preventing illnesses from happening. As such, there were many special cleaning hospitals or mosques where the less privileged were able to go. [29]

 

The ottoman medicine treatments cover various types

It should also be noted that music played a important part in the process of treating certain mental problems in the Ottoman Empire, as it was thought to ease the soul and cause better long term effects.

Nature was also taken into consideration when treating mental contemplation.[30] Another point to mention is the gardens situated within hospitals, which have been described as a ‘world within a world’. These too were regarded as another function of the treatment in healing the sick within the Ottoman empire. Evliya Celebi describes the importance of the garden and hospitals in ottoman practice when he described the patients within:

Each one roars and sleeps like a lion in his lair. Some fix their eyes on the pool and fountain and repeat words like a begging derwish. And some doze in the rose garden, grape orchards and fruit orchards and sing with the unmelodious voices of the mad.[31]

Thus, the importance of the hospital and the “healing garden” was an important part of the ottoman society and its medicine.

Ottoman physicians used a range of relief remedies for pains especially herbs to cure pains such as those experienced by the famous ottoman sultans, such as Sultan Suleiman who was prescribed opium ointment, which was important for the easing of his leg pains.

In sum, there were many methods for curing illnesses which have been discussed, such as: the humeral system and blooding letting; the mental curing through the use of music which was perceived to be a long term solution; cleansing by water was another treatment which played a important part in the prevention as well as the curing of diseases and the promotion of longevity.[32]

Ottoman medicine grew rapidly during the 15th century. The Ottoman Empire imported much of its knowledge from regions in central Asia and “Medicine also developed rapidly in the fifteenth century, again under the impetus of scholars imported from Central Asia.”[33] Stanford J.Shaw, talks about the importance of the transmission of knowledge and that scholars have been studying medical works from the works of Arabs and Persia’s. He claims that it is these practices which transformed the Ottoman medical practices and how even in the late 15th century the importance of knowledge from various scholars work could not be underestimated.[34]

 

[1] Shefer-Mossensohn Miri, Ottoman Medicine Healing Institutions 1500-1700, (Albany: State University of New York Press, 2009)p.22

[2] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’ p.22

[3] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’ p.23

[4] Shefer-Mossensohn Miri, Ottoman Medicine Healing Institutions 1500-1700, (Albany: State University of New York Press, 2009)p.23

[5] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’p23

[6] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’p.24

[7] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’p.25

[8]Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’p.25

[9] Robert Dankoff, Eviliya Celebi in Bitlis The relevant section of the Seyahanname edited with translation, commentary and introduction (Leiden:E.J.Brill,1990).pp.93

[10] Shefer-Mossensohn Miri, Ottoman Medicine Healing Institutions 1500-1700, (Albany: State University of New York Press, 2009)p.25

[11] Shefer-Mossensohn Miri, ‘Ottoman Medicine Healing Institutions 1500-1700’p.26

[12] Stanford J. Shaw, History of the Ottoman Empire and Modern Turkey: Volume 1, Empire of the Gazis , The Rise and Decline of the Ottoman Empire 1280-1808 (Cambridge: Cambridge University Press, 1976)p.143

[13] Sara Scalenghe , Disability in The Ottoman Arab World 1500-1800 (New York: Cambridge University Press,2014).pp.27

[14] Shefer-Mossensohn Miri, An Ottoman Observer of central European Surgery, Vesalius, XIV, 1,4-7, (2008).p.5

[16] Stanford J. Shaw, History of the Ottoman Empire and Modern Turkey: Volume 1, Empire of the Gazis , The Rise and Decline of the Ottoman Empire 1280-1808 (Cambridge: Cambridge University Press, 1976)p.143

[17] Stanford J. Shaw, ‘History of the Ottoman Empire and Modern Turkey: Volume 1’ p.143

[18]Miri Shefe- Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175. P.157

[19] Miri Shefe- Mossensohn, ‘Health as social agent in Ottoman patronage and authorityp’.157

[20] Miri Shefe- Mossensohn, ‘Health as social agent in Ottoman patronage and authorityp’p.156

[21] Miri Shefer-Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175. P.155

[22] Shefer-Mossensohn Miri, Ottoman Medicine Healing Institutions 1500-1700, (Albany: State University of New York Press, 2009)p.23

[23]Shefer-Mossensohn Miri, Ottoman Medicine Healing Institutions 1500-1700,.p30

[24] Miri Shefer-Mossensohn, , Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175, p.153

[25] Miri Shefer-Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175, pp.151

[26] Miri Shefer Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007): 147-175 .p.157

[27]Miri Shefer Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175, p.155

[28]Miri Shefer Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175.155

[29] Bruinessen, Van Martin and Boeschoten, Hendrik, Evliya Celebi in Diyarbekir The Relevant Section of the Seyahtname Edited With Translation, Commentary and Introduction, (Leiden: E.J.Brill,1988)p.147

[30] Miri Shefer Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007):147-175162

[31]Miri Shefer Mossensohn, Health as social agent in Ottoman patronage and authority, New Perspective on Turkey, no37 (2007): 147-175. p164

[32] Bruinessen, Van Martin and Boeschoten, Hendrik, Evliya Celebi in Diyarbekir The Relevant Section of the Seyahtname Edited With Translation, Commentary and Introduction, (Leiden: E.J.Brill,1988)p.147

[33] Stanford J. Shaw, History of the Ottoman Empire and Modern Turkey: Volume 1, Empire of the Gazis , The Rise and Decline of the Ottoman Empire 1280-1808 (Cambridge: Cambridge University Press, 1976)p.143

[34]Stanford J. Shaw, ‘History of the Ottoman Empire and Modern Turkey: Volume 1’p.143

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