The Medical Organization at the Ottoman Court

The Ottoman imperial Palace was quite different from Western palaces and courts, for it was not only the residence of the Ottoman Sultans and their royal household, but also served to various other functions as well. In addition to being the seat of the imperial reign, it comprised schools and hospitals, and was a centre of trade, arts and crafts. With its about 10,000 inhabitants and 400 years of service, the Ottoman Palace was the centre of the health organization of the Empire. The following surveys the medical organization at the Ottoman court by focussing on the Topkapi Palace, founded by Sultan Mehmed the Conqueror in 1476.

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Nil Sari* and Ali Haydar Bayat**

Table of contents
1. Hospitals
2. Palace Health Personnel
3. The Chief Physician
4. Bibliography

***

Note of the editor

This article was first published in Studies in History of Medicine & Science, vol. XVI, No. 1-2, New Series (1999/00), pp. 31-51. We are grateful to Professor Nil Sari for allowing republication. The readers may note that the equivalents of Turkish letters c, ç, g, h, h, s. in English are j, ch (tch), gh, kh (sometime), sh respectively. The author's Turkish orthography is kept unaltered. For Arabic terms Arabic orthography is used (the editor of the original article).

The Ottoman imperial palace was quite different from Western palaces, for it was not only the residence of the Ottoman Sultans and their royal household, but served for various other functions as well. That is, in addition to being the seat of the Sultan's imperial reign, it comprised schools and hospitals, and it was also a centre of trade, arts and crafts. In addition, with its about 10,000 inhabitants and 400 years of service, the Palace was also the centre of the health organization of the Empire [1]. Though the other Ottoman palaces, such as the one in Edirne [2], were similarly organized, we take as a model in the following study the practices at the Topkapi Palace. This Palace was founded by Sultan Mehmed the Conqueror in 1476, and during its long history it was the classic centre of the Ottoman palace organization and the court health personnel structure. Our survey will provide an overall picture of the activities of the institutionalization of health at the Ottoman Court.

1. Hospitals

Writers note several hospitals and pharmacies in the Topkapi Palace, though the most known of all was an infirmary (timarhâne)* for the royal pages, also called the palace of the invalids (saray-i bîmârân) in archival sources [3]. Founded in the 15th century, it burned down in 1856. In the representations from the 17th to the 19th century, the infirmary is depicted at the right side of the Imperial Gate as a group of buildings around an inner courtyard. In a miniature comprised in a 16th century chronicle called Hunernâme, the hospital is described as the chamber of patients (hastalar odasi). The miniature depicts the chief eunuch of the infirmary and a hand cart used for carrying sick pages [4].

There was another hospital for the members of the imperial guards, who were called also gardeners (bostanci), for they also grew vegetables to be consumed in and outside the Palace. It was located along the Marmara shore of the Palace, since the corps guarded the shores and waters of the Bosphorus. Melling's engraving depicts an early 19th century view of the hospital [5].

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Figure 1: A detail figure of Divrigi Dar al-Shifa's gate. Ord. Prof. Dr. A. Süheyl Unver Nakishanesi Yorumuyla Divrigi Ulucami ve Sifahanesi Tas Bezemeleri, VIII. Turk Tip Tarihi Kongresi 16-18 Haziran 2004 Sivas-Divrigi (ed. Nil Sari, G. Mesara, N. Colpan), Istanbul 2004, p. 7.

An infirmary for the residents of the harem was founded in late 16th century; before it, the sick members of the harem were treated in the Old Palace. Built at the farthest end of the harem, it was a two-floored hospital. There were dormitories on each floor, and rooms were assigned to female officials, servants and the pharmacy. It had a kitchen, a bath, a cistern, a laundry house and water closets [6].

According to archival sources, such as the pay registers of 1798-99, there was a paid female health team in the Old Palace. Its existence proves that there was a health organization for the members of the harem too. Besides, male physicians and surgeons were employed at the harem [7].

2. Palace Health Personnel

The Topkapi Palace was surrounded by an outer wall with towers. It consisted of an inner or private section, called enderûn, and an outer section, called bîrûn. The medical professionals were part of the outer section. As a learned class (‘ulamâ), the physicians were members of the community of court physicians (jamâ'at-i ‘atibbâ'-i khâssa); surgeons and oculists were members of their own crafts community (jama'at-i jarrahân-i khâssa; jama'ât-i kahhâlân-i khâssa) [8]. There were also other court health professionals, such as the bone setter (chikikji) [9] and the medicated taffy maker (ma'jûnî) [10], etc. The most reliable information about the health personnel is found in the palace archival documents.

Court physicians appear in the pay registers of the Ottoman Imperial Treasury for palace officials called daftar-i jama'at-i mushâhir-i khurân (including one or two surgeons). According to the registers, the number of Muslim physicians employed in the court changed from 11 to 36 from year to year [11].

Of the physicians, surgeons and oculists who came to Istanbul from far away countries, such as Egypt and Iran, the famous ones were invited to the Palace when needed [12]. Also, mostly Jews and a few Christians from Europe (frenk) were employed in the court. Being a Jew or a Christian was not an obstacle in treating Muslim patients. Jewish refugees from abroad, mainly originating from the Iberian peninsula, were eagerly received by the Ottoman rulers. There were even several separate lists of the community consisting of a great number of Jewish physicians attached to the court, called jama'at-i atibbâ'-i Yahûdiyân in the treasury registers. At the beginning of the 17th century, their number attained 63 physicians. Actually, the aim of inviting or appointing physicians to the Palace was to treat the Sultan and family or the court personnel, not to contribute to the progress of medicine [13].

Ottoman archival documents show that the physicians, besides being employed in the Old and New Palaces, were appointed to the Galata Sarayi palace school, Edirne and Bursa Palaces, as well as other official state institutions. Physicians were also appointed to the military corps and fortresses when needed [14]. Palace physicians sometimes undertook two offices together, for example in the court as well as at a hospital or at the Suleymâniye Medical School [15].

Figure 2: The treatment of broken legs by a Muslim surgeon miniature in Sharaf al-Din Sabuncuoglu's book Jarrahiyat al-Hâniyya.

Some of the Ottoman physicians employed at the Palace were transferred from a hospital, such as the Fâtih or Bâyezid Hospital, or from the Suleymâniye Medical School. The wages for the offices were also distributed among these institutions. Many of them were qualified as mainland, meaning the one who has passed all the levels of the madrasa education [16]. There are several archival documents showing that faculty members of the Suleymâniye Medical School, that is instructors (mudarris), assistants (mu'id), disciples/apprentices (shâgird) and graduates/scholars (dânishmand) were appointed as Palace physicians from time to time and vice versa [17]. According to the trust of deed, the Suleymâniye Medical School students were to be Muslims [18]. Still others came from medical families, or following medical training as an assistant to a known physician [19]. The process of appointment of the physicians to the Palace shows that the dawshirme tradition was not observed here [20].

The Palace physicians received high wages [21]. As a part of the wages of those Palace physicians who died, retired or resigned were distributed amongst physicians of hospitals and the faculty members of the Suleymâniye Medical School, such as assistants, we can conclude that the budget of the Palace treasury was distributed not only amongst health personnel of the Palace, but also among the medical school and hospitals' personnel all over the country. The Palace treasury supported the payment of the salaries of the hospitals' personnel and the restoration of the hospitals [22]. The Palace was therefore the centre of the health organisation, and the health institutions outside the Palace were in a sense extension of this court organisation.

A great number of surgeons were employed by the Palace in related offices. The division of the military and civil service of surgeons and oculists was determined by the needs of the day. The distribution of members for service was determined by the requirements of the outer and inner sections of the Palace; and also by the need during war and peace. In addition to a great number of surgeons employed at the different places within the Topkapi Palace itself, such as the Enderûn and Harem, surgeons and oculists were mainly employed in the army and fewer numbers of them were employed in Edirne and Bursa Palaces as well as in the Galata Sarayi Palace school and fortresses, such as Rumeli Hisari, etc [23].

The Palace Craftsmen's Organization (ahl-i hirfa) employed surgeons and oculists as members, and they were included in the registers for Palace craftsmen called daftar-i mavâjib-i jama'at-i ahl-i hirfa, as it was considered an art practised with hand [24]. This Organization was a kind of training institution connected to the Palace, that is the state, where members of the craftsmen's society consisted of masters (ustâdân) and apprentices (shâgirdân) who were employed in different offices, positions and provinces. The number of surgeons and oculists of the organisation changed from time to time; and the greatest number was 113 at the end of the 16th century, as far as we know. This remarkable number of surgeons was due to the fact that their service was not limited to the Topkapi Palace. Lists clearly show that master surgeons and their apprentices who were members of the organization having been appointed to different places were quite mobile; meanwhile apprentices were trained in different circles and improved their art, besides practising [25].

Figure 3: The office of the chief physician of the Ottoman State: Bash Lala Kulesi (chief tutor tower) in the Topkapi Palace. (© Salim Aydüz).

In the oldest extant salary register of surgeons and oculists, dated 1526, out of 50 recruited members we find only 11 who were converted Christian boys, recorded as dawshirme youth [26]. The explanations given in this document are detailed. For example, even the dawshirme and the non-dawshirme janissary are noted. In the following treasury registers only the birth places of some are given, such as Cyprus, Istanbul, Bosnia etc.; or their ethnic origins, such as Albanian, Georgian, etc. Still later, in registers of the 17th and 18th centuries, out of about 90 to 100 names, we come across one or two of Christian origin called Dhimmî, or a newly converted Muslim, called Muslim-i now, rarely a European noted as frenk, and actual names were mentioned again and again for many years [27]. In short, from the second half of the 16th to the end of the 18th century, in the treasury registers dawshirmes are not mentioned. Therefore, the idea that the dawshirme system, depending on a selection largely based on physiognomy provided the court surgeons, cannot be generalized [28]. However, this does not mean that all non-dawshirme were of Turkish origin; for here we are trying to describe the system of starting service of a surgeon at the Court.

In appointments to offices inside and outside the Palace, the progress and prestige of the individual health personnel played an important role. The conditions in the appointment or promotion to an office were quoted as talented (musta'id), efficient (ahl), deserved (mustahiq), able (muqtadir), skilled (hâdhiq), perfect (kâmil) and sincere (sâdîq) [29]. There exist archival documents referring to anatomy courses in order to attend the Suleymâniye Medical School, which was a condition for the choice of surgeons' appointment to the Palace [30], though, sometimes individual sport by an effective official played a part in the choice.

The Palace health personnel's salary that showed their progress varied in accordance with their seniority, efficiency and the degree of responsibility. The promotion of physicians, surgeons and oculists also depended on having been initiated and trained in the profession from the beginning onward, that is those who came from a medical family or trained by a master before having been employed by the State. That important condition was expressed in pay registers as "the one who has come as experienced in the art", called san'ât birle, meaning skilled. Such personnel built quite a large group. For example during the years 1525-26 out of 50 surgeons, 19 were recorded as such. Being gifted, called qâbiliyyet birle, that is the talented ones, were also noted, although the number of the gifted quoted was only three, which reflects the proportion of the gifted in the general population, as it always is [31]. The main aim of this bureaucracy was to satisfy the health needs of the Palace and the army, and was not to contribute to the progress of medicine.

Figure 4: A pavilion corner of Topkapi Palace (photo taken by Salim Aydüz).

There was also a head surgeon of the Palace (sarây-i humâyûn jerrâhbashisi; sar-jarrâhîn-i khâssa) and one of the army (ordu-yu humâyûn jerrâhbashisi) [32] and a head oculist (kehhâlbashi, sar-kahhâl) [33], each of whom was responsible for the personnel of their field of practice. Each Janissary corps (ojak) had its responsible chief surgeon too [34].

3. The Chief Physician

Physicians, surgeons and oculists were superintended by the chief physician of the court (sar-atibbâ-i khâssa). The chief physician ranked as a superior official, with a high income through his salary, grants and awards [35].

The Sultan himself used to select and appoint the head physician, that is he was appointed directly by the Sultan's decree [36]. For the appointment, an initiation ceremony took place, in which the chief physician was dressed in a fur coat [37]. Although the position of the chief physician was not an appointment to an office granted through reference or advice, but directly by the decree of the Sultan, yet the Sultan was not able to get to know every professional and so he was in need of recommendation. Since there were no regular rules for the promotion, some managed to influence the Sultan and get their acquaintances appointed. We can quote the dismissal of Emir Chelebi (d. 1638) and appointment of Zaynal ‘Âbidîn bin Khâlil (d. 1647) instead. The promotion of Yenibahcheli Mehmed (d.1723), Halebî Mustafa and Nu'mânzâde Mustafa Mesud (d. 1820) are other examples [38]. However, there was no head physician transferred and appointed to the court directly from provinces; for, the one who was to be selected as a head physician had to be well known in the capital in order to have a chance to be the private physician of the Sultan, since the chief physician's most critical responsibility was the Sultan's health. For instance, Sâlih bin Nasrullâh, having acquired fame as the head physician of the Fâtih hospital and having been later employed as a Palace physician; and Emir Chelebi, after having started an office at Unkapani and having been well known, was appointed to a financial office; both were later nominated as Palace chief physicians (the former in 1629, the latter in 1656) [39].

The preparation of drugs to be administered to the Sultan and the royal patients were made by an apothecary in the residence of the Royal Tutor, a two-floored tower, while the chief physician supervised [40]. The chief physician accompanied the Sultan during wartime, though when the Sultan stayed at the Palace during war, the chief physician of the army (ardu-yu humâyûm hekimbashisi) undertook the supervision of the health services of the army [41].

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Figure 5: Chief physician of Ottoman court. The illustration is published by kind permission of Nil Sari and Ulker Erke. Source: 38th International Congress on History of Medicine, Turkish Medical History Through Miniature Pictures Exhibition (Drawn by U. Erke, Organizer and Editor Nil Sari), Istanbul 2002. © Nil Sari and Ulker Erke.

The chief physician had to be a Muslim and all Ottoman chief physicians were either born Muslims or converted Muslims. From 1500 to 1850, that is during 350 years, 40 head physicians were employed by the Ottoman State. As some of them were employed more than once, 58 appointments were made to the chief physician's seat. Of these, 31 chief physicians were considered to be Turks, while four were converted Christians: Isâ from Chios (d. 1649); Sâlih bin Nasrullâh Halebî, a Christian Arab from Aleppo (d. 1670); Nûh from Crete (d. 1707): Ismâ'il Pâshâ from Chios (d. 1880); two Jews who embraced Islam: Hayâtizâde Mustafa Feyzî (d. 1692), Halebî Mustafa (d. after 1757); and three were Arab Muslims: Qaysûnî Badruddin from Jerusalem (d. 1562), Qosonî Muhammad from Cairo (d. 1569), Sayyid Yûsuf Maghribî from North Africa (d. after 1695) [42].

Some historians have noted a tradition according to which the instructor (mudarris) of Suleymâniye Medical School was expected to be so highly efficient as to be selected for the position of the chief physician, though as far as we know there are only few examples of an appointment hierarchy between the Suleymâniye Medical School instructors and chief physicians [43]. We know that, the Palace chief physicians Uskuplu Shemseddîn (d. 1596) and Gevrekzâde Hâfiz Hasan (d. 1801) were employed at the Suleymâniye Medical School. Omer (d. 1724), Hayâtizâde Mehmed Emîn (d. 1747) and Kâtibzâde Mehmed Refî (d. 1769) were employed at normal madrasa [44].

Since the position was regarded as administrative, there was no requirement for formal medical education in order to be appointed to the position of the chief physician.

As far as we know only few individuals, for example Nuh, Nu'mânzâde Mustafa, Mes'ud, Ahmed, Najib (d. 1850) and Ismâ'il Pâshâ, were officially educated medical doctors according to some sources, though these too are doubtful [45].

After the first three chief physicians, Mehmed Muhyiddin (d. 1504), Haji Hekim (d. 1507) and Ahi Chelebi. (d. 1524), and the last ones, Ahmed Nejib and Isma'il Pasha, the appointees were generally madrasa graduates. Except those listed above, they had medical training as an apprentice under a master, they were brought up in a medical family, or self-educated in the field of medicine, as we learn from Shaqâyiqs and their supplements, the biographical works of their times [46]. Having been educated in a madrasa during their office as judges (qâdî) or scholars (ulamâ), some of them, who were also interested in medicine, studied classical works, and being self-trained, were trained as a disciple of a master, or coming from a medical family, they had won popularity also in the medical field.

A 17th century document clearly shows that the shortest route leading to the chief physician's post was to be a qâdî. The fact that most of the chief physicians were promoted from the post of the qâdî is the proof of this process [47]. However, since most of them were given classical madrasa education and that chief physicians were generally from the class of scholars, it does not necessarily mean that this was a general rule. For example, Ahî Chelebi, ‘Isâ, Nuh, Halebî, Mustafa, Mustafa Mes'ud, Isma'il Pasha were not madrasa graduates [48]. In the above-mentioned archival document, the Sheikhu'I-Islâm respectfully reminds the Sultan of an old tradition, referring to the grant of land (arpaliq) to the chief physician, and recommends Ahmed Efendizâde for the office of the chief physician. The Sheikhu'l-Islâm, also recalling that the Sultan's father (Suleyman II: 1687-91) had appointed a mudarris, Hayâtizâde Kebîrî Mustafa as the chief physician, advised that Ahmed Efendizâde, who had been transferred to the Suleymâniye Madrasa, was going to be a qâdî the following year according to the scholars' rule (tarîq), and that he might be appointed as the chief physician, if the Sultan (Ahmed II: 1691-95) so willed.

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Figure 6: Photography of the physician and historian Shânizâde Mehmed Ataullah Efendi(1771-1826). History of the Ottoman State, society and civilization, ed. By E. Ihsanoglu, Istanbul: IRCICA, 2002, no. 161.

Although this document clearly shows that the shortest route to the chief physician's post was to be first a qâdî, yet the above-mentioned advice by the Sheikhu'l-Islâm was not followed, because there is no record of Ahmed Efendizâde‘s appointment as chief physician. Evidently there was no such general rule to that effect and the appointment depended purely on the Sultan's will. Instead, the chief physicians of Sultan Ahmed II were Tablî Hasan, Seyyid Yûsuf and the head astrologer Arabzâde Mehmed [49]. When the Sultan was deposed or executed, the chief physician retained his post, because he was not considered to be responsible for it. When the new Sultan ascended the throne, the chief physician could be dismissed or stay in office [50].

The head physician was in the rank of the minister of health and had several administrative duties. He had the authority to propose the appointment, promotion, transfer, and dismissal of health personnel in all palaces, hospitals, and the medical School (Suleymâniye Tib Madrasa) [51]. He played an important role in making the decisions about independent health medical practice, such as permission for starting a private practice (dukkân) [52]. Although we do not have an example of a bill submitted by a head physician to the state (Divân-cabinet), we do have documents concerned with the head physician's suggestions for supervising the health personnel, and protecting the masses against quacks, the unqualified and the inefficient. From time to time, when public complaints increased, he supervised and tested the health personnel by means of an examination, either by himself or by his subordinates. For instance, a decree was issued in 1573 on the request of the head physician Gharsuddînzâde Muhyiddîn, who belonged to a medical family and was a madrasa-trained scholar, that he was to examine physicians, surgeons and oculists himself and those who successed in the test were to be given a certificate, whereas quacks were also to be punished. On the same date, it was also decreed that those who practised therapy were to be examined in their field by the specialists of their fields, the head physician (hekimbashi), the head oculist (Kehhâlbashi) and the head surgeon (jarrahbashi). Further, the decrees were applicable to both Ottoman and non-Ottoman health personnel as well. It means that a sort of official standardization was attempted in the health practice from time to time; though, as far as we know, those edicts were issued for Istanbul and the district around it [53].

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Figure 7: The Justice Tower at theTopkapi Palace in Istanbul (photo taken by Salim Aydüz).

Besides, the head physician was also regarded as the authority to be referred to for the solution of the problems of medical professionals. As an example, we may quote a document regarding the conflict between two physicians, who displaced each other at the Yildirim Bâyezid Hospital in Bursa. The first physician of the hospital was accused and dismissed as being inefficient and instead another physician was appointed; but, when the judge (qâdî) was changed, the dismissed physician complained and accused the one who had replaced him. Consequently, both were called to Istanbul to be examined by the head physician [54].

A similar role was played by the chief physician in a case when a Palace physician, who was formerly a mudarris of the medical school, complained to the chief physician of his replacement from his former office. That means that the head office in charge of the health services of the state, when required, also acted as a judge or rather the final authority for solving the problems amongst the health personnel [55], though it was impossible for the chief physician to deal with all health problems in an empire spread over a wide territory. We must always keep in mind the great role played by the canonical courts where all kinds of judicial problems, including those related with health were dealt with [56].

As the head employee in the field of medicine, the Palace chief physician was also expected to play a leading role in matters related to medical education, and it was the chief physician Mustafa Behchet who was a pioneer in the foundation of the modern medical school Tibhâne-i Âmire by Sultan Mahmûd II, on 14 March 1827, the date celebrated every year in Turkey by physicians as the medical anniversary [57].

Figure 8: Chief Physician Salih Efendi's seaside residence. Anonymous photo.

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  • Uzuncarsili, I.H. (1945): Osmanli Devletinin Saray Teskilati, Turk Tarih Kurumu, Ankara.
  • Uzuncarsili, I.H. (1965): Osmanli Devletinin ‘Ilmiye Teskilati, Turk Tarih Kurumu, Ankara.
  • Uzuncarsili, I.H. (1975): Osmanli Tarihi, vol. 2, Turk Tarih Kurumu, Ankara.
  • Uzuncarsili, I.H. (1984): Osmanli Devleti Teskilatindan Kapukulu Ocaklari I, Turk Tarih Kurumu, Ankara.
  • Uzuncarsili, I.H. (1986): Osmanli Sarayi'nda Ehl-i Hiref (Sanatkârlar) Defterleti, Turk Tarih Belgeleri Dergisi (Ankara), vol. 11, No. 15, pp. 23-76.

Footnotes

[1] Uzuncarsili (1945); Necipoglu (1985), p. 260.

[2] Rifat Osman (Ed. Unver) (1989), pp. 92-94.

[3] Miller (1941), pp. 48-53; Terzioglu (1983), pp. 18-24; Fisher (1985), pp. 17, 48, 76.

[4] Seyyid Lokman: Hunernâme, Topkapi Palace Museum Library/Hazine Kitapligi, No. 1523, vol.. 1 (1584 H.), f. 15.

[5] See Necipoglu (1985), p. 260; Kumbaracilar (1949), p. 59; Kumbaracilar (1948), pp. 44-47.

[6] Goksoy (1987), pp. 30-35.

[7] Sari (1996-97), pp. 16-19; 31, 38; BOA, Ibnul Emîn Sihhiye 44; Cevdet Saray 8852; Cevdet Sihhiye 4152; Meric (1955), pp. 27-113; see p. 53.

[8] Uzuncarsili (1945) chapter titled ‘Ulemâ' Sinifina Mensub Saray Me'murlari, pp. 364-365; Meric (1955), pp. 37-113; Meric (1958), pp. 266-293; Uzuncarsili (1943), pp. 13-30.

[9] Chikikji: BOA, Cevdet Sihhiye 77, 94, 1117.

[10] Ma'junî: BOA, Cevdet Sihhiye: 68, 833, 1185; Cevdet Saray: 8181; Cevdet Evqâf: 31551; Tabîb-i Rûhâni-i Khâssa: Uzuncarsili (1945), p. 368.

[11] Orkun (1935), pp. 182,197; Kumbaracizade (1933), pp. 33-34; Uzuncarsili (1945), pp. 364-365; Hammer (1986), p. 231; Sahillioglu (1998), p. 10; BOA, Kamil Kepeci Kucuk Ruznâme 3399.

[12] Sari (1996-1997), pp. 18-19; BOA, Cevdet Saray 6797; Muhimme register 4, no. 582, 583, p. 55; Kurdoglu (1967), p.81; Nev'izâde Ataî (ed. Ozcan) (1989), pp. 196-197; Bayat (1998), pp. 27-39.

[13] Kumbaracizâde (1933), p. 34; Uzuncarsili (1945), p. 365; BOA, Kamil Kepeci Kucuk Ruznâme, register 1; date: 1013/1604; Galante (1938), pp. 79-117; Taskiran (1975), pp. 105, 109; Heyd (trans. F.N. Uzluk) (1970), pp. 306-327; Uludag (1936), pp. 190-194; Hammer (1986), p. 231.

[14] Examples of documents referring to the various offices of palace physicians: Old Palace (Saray-i Atîq): BOA, Cevdet Saray 5886; Galata Sarayi: Cevdet Sihhiye 167, 302, 579, 691; Isfendiyaroglu (1952), pp. 110-113. Fortresses: Ibnul Emîn Sihhiye 155; physician of the Janissary corps: Cevdet Sihhiye 533. Janissary medical corps consisted of physicians and surgeons. See Meric (1955), p. 35; Meric (1958); Uzuncarsili (1984), p. 405; Sari (1996-97), pp. 19, 31, 38; BOA, Ibnul Emîn Sihhiye 44; Cevdet Saray 8852; Cevdet Sihhiye 4152.

[15] Examples of physicians appointed to two offices at the same time: See: BOA, Cevdet Sihhiye 632, 633, 1083, 1084, 1085; Ibnul Emîn Sihhiye 99.

[16] BOA, Kamil Kepeci Kucuk Ruznâme 3399; Uzuncarsili (1945), pp. 364-365; (Kâmil Kepeci Ruznâme, register no. 1, date: 1604-1605).

[17] Akdeniz (Sari) (1977); Sari (1983), pp. 152-182. Examples of physicians and their salaries transferred from the Suleymâniye Medical School to the Palace and vice versa: BOA, Ibnul Emîn Sihhiye, 82; Cevdet Sihhiye 124, 632, 699, 704, 1084, 1107, 1116, 1190, 1363; Maârif Cevdet 1516.

[18] Kurkcuoglu (1962), p. 33.

[19] Kumbaracizade (1933), pp. 32-34; BOA, Kamil Kepeci Kucuk Ruznâme 3399; Cevdet Sihhiye 946; Uzuncarsili (1945), pp. 364-365.

[20] Russell (1990), pp. 254, 266. See notes 13, 14, 15, 16 and 17 above.

[21] Balkan (1979), pp. 300, 305-306, 348-349.

[22] Examples of the salary distribution of the palace physicians, who died, retired or resigned: BOA: Cevdet Sihhiye: 633, 699, and 1400. See note 17 above.

[23] Meric (1955) and (1958). Examples of appointments of surgeons as members of the Craftsmen's Organisation (ahl-i hirfa tâbi jarrah): BOA, Cevdet Sihhiye 399, 949. Examples of surgeons employed at the palaces (Saray-i Humâyûn, Harem, Saray-i ‘Atîq, Galata Sarayi): BOA, Cevdet Sihhiye 87, 171, 940, 1208, Cevdet Saray 6152. Also see Meric (1955); Isfendiyaroglu (1952). Examples of surgeons employed at the military corpses (Yeniceri Ojaghi, Agha Qapisi, Bostanji Ojaghi., Bostâni Tufenkchileri Ojaghi etc.): BOA, Cevdet Sihhiye 26, 76, 80, 148, 302, 679, and 816. Examples of the appointments of surgeons to fortresses: BOA, Cevdet Sihhiye 39, 56, 163; Ibnul Emîn Sihhiye 35. Privy garden surgeon: Meric (1955), pp. 75, 92.

[24] Meric (1958), pp. 266-293; Uzuncarsili (1984), pp. 368-369, 401, 405-406; Uzuncarsili (1986), pp. 23-76; Kal'a (1995), p. 424.

[25] Meric (1955) and (1958).

[26] Topkapi Palace Archive: D. 9706 (932/1526); Meric (1955), pp. 38-40; Meric (1958); Uzuncarsili (1984), pp. 368-369, 401, 405-406; Uzuncarsili (1986), pp. 25, 61-64; Russell (1990), p. 254.

[27] Meric (1958), p. 276; Meric (1955), pp. 85, 88, 90. The same names occur several times.

[28] Russell (1990), p. 256.

[29] BOA, Ibnul Emîn Sihhiye 82, 99/1; Cevdet Sihhiye 632, 759, 1118; Muhimme register 4, no. 582, 583, p. 55.

[30] BOA, Cevdet Sihhiye, 759; Uzuncarsili (1984), pp. 368-369, 401, 405-400.

[31] Meric (1955) and (1958); Russell (1990), pp. 254; 266-267; BOA, Cevdet Sihhiye 1188, 1225; Muhimme register, vol. 4, No. 586, p. 55; Oliver (1942), pp. 19-20.

[32] See: BOA, Cevdet ‘Askeriyye 25700; Cevdet Sihhiye 46, 87, 336, 399, 452, 467, 759, 874, 909, 942, 970, 974, 1124, 1165; Ibnul Emîn Sihhiye: 143.

[33] Examples of the documents related with chief oculists: BOA, Cevdet Maârif 4988; Cevdet Sihhiye 847; Ibnul Emîn Sihhiye 32, 142, 172, 188.

[34] Examples of the documents related with the chief surgeons of the Janissary corpses (Yenicheri Ojaghi, Tophane Ojaghi etc.): BOA, Cevdet Sihhiye, 50, 76, and 679.

[35] BOA, Cevdet Sihhiye 661, 753; Cevdet Tîmâr 8041; Cevdet Saray 7072.

[36] Uzuncarsili (1945), pp. 71, 205, 364-368. The Palace Reception Registries (Defter-i Yevmiye-i Oda-i Tesrîfât 677 mukerrer); and the Topkapi Palace archive document registered under number E 668 are proofs of the appointment of the head physician by the Sultan.

[37] BOA, Cevdet Sihhiye 529; 1247; Uzuncarsili (1945), pp. 365-366.

[38] Bayat (1999).

[39] Nev'izâde Ata'î (ed. Ozcan, A.) (1989), pp. 196-197; Russell (1990), p. 255.

[40] Tayyarzâde Ahmed Atâ: Tarih-i Atâ, vol.. 1, Istanbul (1292), pp. 193-194; Kumbaracizade (1933), p. 8; Kumbaracilar (1949), pp. 114-118.

[41] Examples of the documents related with the chief physician of the army: BOA, Cevdet Sihhiye: 34, 79, 172, 257, 626, 691, 705, 730, 908, 909, 917, 1127, 1227; Cevdet ‘Askerî 16608. There were also chief physicians of the Janissary corps: BOA, Cevdet Sihhiye 24.

[42] Bayat (1999); For Nûh, see: Hammer (1985), p. 130; Seyhî Mehmed (ed. Ozcan, A.) (1989), vol.. II-III, p. 292

[43] Topkapi Palace Archive: No. E 668; Uzuncarsili (1965), p. 35. See Selânikî Tarihi, f. 361; Uzuncarsili (1945), p. 364.

[44] Uzuncarsili (1945), p. 364; Bayat (1999).

[45] Taskiran (1974), pp. 369-376; Bayat (1999).

[46] Ahî Chelebi learned medicine from his father and later from Kutbeddin and Altunizâde; Sinaneddin Yûsuf from the chief physician Muhyiddin; Gharsuddinzâde from his father Sheikh Ahmed, a physician; Mûsâ from his father Sucaeddin Ilyas and the palace physician Ishâq Chelebi and his son Mûsâ also from his father; Mehmed ‘Arif, from Vâsif Efendi, an instructor (mudarris) of the Suleymâniye Medical School; Mehmed Emîn, from his father the chief physician Arabzâde Mehmed; Hâfiz Ghayrullah, from Mehmed Sa'id; Gevrekzâde from his father, a physician; Mehmed Sâdiq from Kambur Abbas Vesim, a known physician etc. See Bayat (1999).

[47] Topkapi Palace Archive, No. E 668; Sari (1983); Bayat (1999).

[48] Bayat (1999); Seyhî Mehmed (ed. Ozcan) (1989), vol.. IV, pp. 557-559, especially see p. 558.

[49] Topkapi Palace Archive, No. E 668. For the list of the Ottoman chief physicians, see Bayat (1997).

[50] Uzuncarsili (1945), p. 367.

[51] Examples of proposals by the chief physician for appointments, promotions and salary distributions of physicians and surgeons to palaces: BOA, Cevdet Sihhiye 10, 43, 47, 66, 67, 171, 704; Cevdet Maârif 1516; appointment of chief oculist: BOA, Cevdet Sihhiye 847. Examples of proposals by the Chief physician for appointments, promotions, and dismissals of physicians and surgeons to hospitals: BOA, Cevdet Sihhiye 1, 44, 569. Examples of proposals by the chief physician for appointments or salary distributions to the Suleymâniye Medical School: BOA, Cevdet Sihhiye 632, 663, 1283.

[52] Examples of permission for opening a private practice (dukkân): BOA, Cevdet, Sihhiye 68, 1228; Ibnul Emîn Sihhiye 87.

[53] Edict dated 1573 during die chief physician Gharsuddinzâde Muhyiddin's office. See: Refik (1984), pp. 93-94; edict dated 1592 during the chief physician Yûsuf Sinan's office. See: Daglioglu (1939), pp. 41-42; edict dated 1730 during the chief physician Hayâlizâde Mustafa Feyzî II's office. See: Refik (1930), pp. 106-107. Edict dated 1768 during the chief physician Kâtibzâde Mehmed Refî's office. See: Refik (1930), pp. 214-215; Uzuncarsili (1975), p. 601; Uzuncarsili (1945), p. 364; BOA, Muhimme register 2, pp. 140, 203; Muhimme register 4, p.28; Muhimme register 23, edict 92, 106, pp. 22, 45. Yet, according to the documents we have so far reached, the control of health personnel by means of an examination by the head physician was not true of distant provinces far away from Istanbul. Decrees were issued for Istanbul and the districts in the neighbourhood, such as Bursa, not distant from Istanbul to reach.

[54] BOA, Cevdet, Sihhiye 132; Sari: "Hekimbasi", Turkiye Diyanet Vakfi Islam Ansiklopedisi, (1997).

[55] BOA, Ibnul Emîn Sihhiye 82.

[56] Bayat (1992), pp. 9-21.

[57] Altintas (1998), pp. 4-9 (132-137).

*Professor Ph. D., Istanbul University Cerrahpasa Medicine Faculty, Department of Deontology and History of Medicine.

**Professor, Ege University, Medicine Faculty, Department of Deontology and History of Medicine.

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