The Paracelsian Influence on Ottoman Medicine in the Seventeenth and Eighteenth Centuries II
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4. Medical practice in the light of the Parcelsian influence
Considering the mass of the Ottoman "Tibb-i Jadîd" manuscripts, medical philosophy occupies a small part, when compared with the content of each book, and it has an introductory character. Almost all of the books consist nearly drug compositions obtained by technical methods. It is seen that, in time, Paracelsus' philosophy came to be neglected and only the useful drug compositions remained. This fact proves that Ottoman doctors pay more attention to practice than philosophy.
In the old medical literature, not only magic and sorcery was omitted, but Tibb-i Jadîd literature of alchemy, astrology and mysticism was criticized, too. Omer b. Sinan indicated that chemistry was not his discovery, but he brought strange ideas along with a new technique:
"Paracelsus found some medical methods in the old way and introduced new terminology and strange expressions. He thinks that he himself founded this science, which is not true. But, he invented terms and strange phrases; and the methods of medical art described by him are the product of his own philosophy" .
Some medical historians  try to explain the main reason why the Ottoman medicine was mostly influenced by Paracelsus and his followers, with the fact that, this school was mystical and in harmony with the Islamic way of thought. We do not agree with this assumption. Because, Paracelsusian school favours superstition and magic, so contradicts Islam. For this reason, Paracelsus' theory was introduced shortly, as a transfer of new compositions was mainly emphasized. Then, why did his new kind of information and techniques of preparing drugs and new current influenced the Ottoman world so deeply? As we also understand from medical literature that, medical, as well as commercial and diplomatic relations between the Ottoman world and the west, especially Italy, took an important place, during this period . Many European (French) doctors and their therapies are mentioned in manuscripts. We know that during this period, many doctors came from the west, and especially Venice, to work in Istanbul, served in the Palace and naturally some of them acted as spies . European (French) and above all physicians from Venice, came to Empire and while practicing must have affected their colleague.
Naturally, another important factor for adopting the new medicine was the interest in new drugs and the hope of finding new treatment for incurable illnesses.
We come across very clear and definite descriptions recorded in "Tibb-i Jadîd" manuscripts. For instance, completely technical methods are described, as in the following:
"Distil in a copper still, then distil it in ("hamam-i mâriyye": Bain Marie) " and keep it; Distil it in a double boiler on heated sand (nar-i reml); keep it for twenty days on a double boiler, put it in a pot and heat it on strong fire (nâr-i shedîd for about five hours; sublimate in a long necked distillation apparatus (tavîtu'l-unk)  for eight hours; evaporate the moisture in curved necked distillation apparatus (mâilu'r-rakabe)  on light fire" .
The prevailing use of drug compositions in "Tibb-i Jadîd" manuscripts, reminds the Acrabadins of the old medicine. But, the main difference between them is that, in the new medical books, the way to obtain its raw material is described for each composition. Another important difference is that, while inorganic material was generally used externally and less often in the old medicine, in the new medicine it was used more frequently and was administered orally.
We can consider this period as the beginning of medical chemistry and chemotherapy. The doctor, who served as a pharmacologist in the past, came to undertake the role of chemist, as well; and for this reason, these physicians were called chemist doctors, "hukemâ-i kimyaiyyûn". In other words, the old kind of doctor made only different kinds of medical compositions when needed; the doctor of the new school was expected to produce the raw material of the drug, too. In fact, the usage of inorganic material in medicine and techniques such as distillation, heating, cooking and Bain Marie was known and practiced for a long time . Indeed, the techniques described in the books of "Tibb-i Jadîd" are also very simple. Thus the innovation was the concept of "chemist doctor" and the usage of inorganic material more effectively and in higher doses.
When we study "Tibb-i Jadîd" medical literature, we see that medical compositions, believed to be prepared by Paracelsus, were dominantly herbal medical compositions and even drugs solely from herbal saps existed. For instance, the composition of the mastic solution prescribed for gastric troubles contain only mastic ("sakiz": Cummi mastix), nutmeg ("kucuk Hindistan cevizi": Semen Myristicae), clove ("karanfil": Flos Caryophylt), cinnamon ("tarcin": Cortex Cinnamoni) and misk apple ("misk elmasi") . But no inorganic matter was added. We can give more examples on this matter . Herbs were sometimes used for oxidation, as well .
Paracelsus' search for a specific drug for every illness, led him to study the effective matter of every material. While in the old medicine, mixtures were made of drugs, Paracelsus tried to analyse and isolate effective elements in them. We know that Paracelsus did not approve poly pharmacy; because one drug neutralized the other. However, very extensive drug mixtures are prescribed in the literature of the new medicine (Tibb-i Jadîd), just as in the old. For instance, a medicine for infectious diseases is composed of 26 drugs . It is very seldom that a medicine composed of two drugs is prescribed. But, in the former, that is the new medicine drugs are included in the prescriptions after treatment with several pharmacological techniques.
Another remarkable point is that the writers of the new medicine didn't favour the Paracelsusian theories on the etiology of disease. According to the old medicine, illnesses occurred as a result of the imbalance of humours, due to their shortage or excess. While the old physicians looked for the cause of illness in the human body, on the contrary, Paracelsus considered them to be due to external factors, minerals, atmosphere, "poisons" originating from stars, etc. In this way, a special foreign agent gets in the body and dominates it . The Ottoman doctors didn't favour this etiology of illness very much. Moreover, strange to say, methods such as sweating, getting one vomited, administrating purgatives, bleeding and enema in order to cure the sick by purging bad humours out of the body, is not recorded in the "Tibb-i Jadîd" manuscripts.
The properties of drugs, such as being cold or warm, are no longer mentioned. In the old medicine contrasts in therapy, that is cold medicine for the illnesses of the hot nature, was prevailed, while Paracelsus favoured the therapy by means of similarities, such as homeopathic principles . Paracelsus' interest in the likenesses and the theory of "signatures" , oriented him to a tendency of this sort.
Another important point is that, foreign terminology wasn't quoted in the text. Both the names of plants and minerals, and the name of illnesses are same as those used in the old medicine. The treatment of "mal-i hulya" , "sevda" , "sudde" , "tesennuc"  "gashy"  and "hafakan"  were again treated with the preparations of the new medicine . Even "dense phlegm" (galîz balgam) and "feverish humours" (yakici hiltlar) were prescribed.
5. Evaluation of the Parcelsian Influence
Did all the Ottoman doctors favour the Paracelsusian medicine? No. All the writers on the modern medicine record the disputes between the followers of the new and old medicine. Medical historians of the west record similar controversies amongst the European doctors" .
It is also pointed out that, because their poison is very strong, minerals should be carefully used. The importance of removing the poison of minerals is also emphasized. According to the followers of the new medicine, the variety of the drugs of the old medicine is many, but they're not effective enough. The number of ingredients of the drugs in the new medicine was few, but they were very effective and pleasantly flavoured and consequently not disliked by the patient.
However, writers of the new medicine point out that the medicine of Paracelsus was not intelligible enough, for in translation from one language into another, some words sounded meaningless and in addition the medicine of Paracelsus was full of symbols. Gevrekzâde says, "I also translated the new medicine, but I had comment on the difficult parts" . Gevrekzâde notes that some people didn't believe in curing by means of minerals and they said that these caused death because of their poisonousness. But, according to Gevrekzâde, they dare say these, because they are ignorant of the said science.
Gevrekzâde both praises and warns those, who administer the new medicine:
"With this art of chemistry, minerals are softened and its poison is turned into antidote, by analyzing and purifying. They become drugs for several illnesses, with their strong influence. But the effects of minerals, "which is very strong on human beings, is unlike to the effects of plants, so it's not right for everyone to try them to administer. It isn't proper to receive these drugs from anyone .
We find these discussions of the old and the new medicine in the other medical manuscripts, too. Thus, during the reign of Sultan Ahmed III (1703-1730), a decree was issued to prevent some ignorant doctors from practicing the new medicine (1704). The decree began as the following:
"Some charlatan European (Frenk) doctors left the school of the old medicine, and administering some drugs under the name of the new medicine, gave harm to some patients; Mehmed, the convert, and his partner, a European (Frenk) doctor, who had started an office at Adrianople, were expelled from the city" .
Certainly, this edict did not put an end to writing on the new medicine. We conclude from medical manuscripts that more care was taken in this method.
How long did the effect of the new medicine continue on the Ottoman medicine? When we study the dates of the copies on the modern medicine, we conclude that this trend continued until the end of the 18th century. We see that, later translations were made from other western physicians and the philosophy of the new chemical medicine (Tibb-i Jadîd-i Kimyâî) left its place to the new concepts.
- Adivar, Adnan: Osmanli Turklerinde Ilim. Istanbul 1971.
- Akinci, Sirri: "Bir mezar tasi: Hekimbasi Sâlih Efendi". Hayat Tarih Mecmuasi, No: 12, 1968. pp. 26-30.
- Altindal, Aytunc: "Paracelsus". Surec, 1 (3), 1980, pp. 52-61.
- Aygun, Sureyya Tahsin: "Tabiat ve tip alimi mutefekkir Paracelsus unvani ile taninan Bombastus Theoprastus'un 400. yildonumu (1493-1541)". Turk Veteriner Hekimligi Dergisi, 11 (8), 1941, pp. 36-37.
- Baytop. Turhan: Turk Eczacilik Tarihi. Istanbul, 1985.
- Baylav, Nasit: Turk Eczacilik Tarihi Istanbul, 1968.
- Debus, Allen G.: Mysticism and the Rise of Modern Science.
- Eren, Saffet: "Hekimbasi Sâlih Efendi hakkinda, 1231-1312 (1816-1895)." Turk Tip Tarihi Arkivi, No: 6, sayi: 21-22, 1943, pp. 9-23.
- Garrison, F.H.: An Introduction to the History of Medicine. Philadelphia, 1929.
- Gunergun, Feza: Osmanli Yukselis Devrinde (14-17. yy.) Kullanilan Anorganik ilaclar ve Elde Edilis Metodlari. Istanbul, 1984.
- Holmyard, E.J.: Alchemy. Great Britain, 1968, Penguin Books Ltd.
- Ihsanoglu, Ekmeleddin (Ed.) Catalogue of Islamic Medical Manuscripts (in Arabic, Turkish & Persian) in the Libraries of Turkey. By Sesen, R.; Akpinar, C.; Izgi, Cevat, published by Research Centre For Islamic History, Art and Culture (IRCICA), Istanbul 1984.
- Kaiser, Ernst; Paracelsus. Hamburg, 1984.
- Kolta, Kemal Sabri. "Hekimbasi Sâlih b. Nasrullah b. Sellum'un gorusune gore Paracelsus". Turk-Alman Tibbî iliskileri Sempozyum Bildirileri 18-19 Ekim 1976, Istanbul, 1981.
- Kurdoglu. Veli Behcet: Sâir Tabibler. Istanbul. 1967.
- Maskar, Uveis: "Theophrastus Bombastus Paracelsus". Istanbul Seririyati, No: 24, Istanbul, 1942, pp. 91-92.
- Mehmed Tahir (Bursali): Osmanli Muellifleri. 3. vol., Istanbul, 1975.
- Multhauf, Robert: "The Significance of Distillation in Renaissance Medical Chemistry". Bulletin of the History of Medicine, No: 30, Baltimore, 1956, pp. 329-346.
- Pagel, Walter: "Paracelsus Theophrastus Phillipus Aureoulus Bombastus von Hohenheim". Dictionary of Scientific Biography, vol. X, Editor in chief: C. C. Gillispie, New York 1974.
- Rola, Stainislas Klossowski de: The Secret Art of Alchemy. London, 1973., Thames and Hudson Ltd.
- Ronan, Colin A.: Science Its History Development among the World's Cultures. New York 1982.
- Sherlock, T. P.: "The Chemical Work of Paracelsus". Being the Journal of the Society for the Study of Alchemy and Early Chemistry, Ambix, vol. Ill, No: 1-2, May 1948, pp. 33-63.
- Sigerist, Henry E.: On the History of Medicine. New York, 1960.
- Sehsuvaroglu, Bedi N.: Eczacilik Tarihi Dersleri. Istanbul, 1970.
- Sehsuvaroglu, Bedi N.: Turk Tip Tarihi. Bursa, 1984.
- Uzluk, F.N.: Genel Tip Tarihi I. Ankara, 1958.
- Uzluk.F.N.: "Bursali Tabip Mevlevi Omer Sifai Dede". Dirim, Tom: 25, No: 5, 1950, pp. 170-175.
- Unver, Suheyl: "Italya ile Turkiye arasinda tarihte tibbi munasebetler hakkinda". I.U. Tip Fakultesi Mecmuasi, vol. 18, sayi: 2, 1955.
- Zekert, Otto (Festschrift fur): Die ganze Welt ein Apotheken. Osterreichs, 1965.
7. Medical manuscripts
- Gevrekzâde Hafiz Hasan: Murshîd al-Alibbâ fî Tarcamati Ispagorya. Istanbul University Library. T. Y. 7085; Cerrahpasa Medical History Department Library. No: 161.
- Gevrekzâde Hafiz Hasan: Tarcama-i Tibb al-Jadîd al-Kimyâî li Baraklisus. Cerrahpasa Medical History Department Library. No: 668.
- Hasan Davut: Gâyetu'l-Muterakkî fî Tadbîri Kull al-Marazî. Istanbul University Library. T. Y. 7135.
- Kasîr al-Nâf': Cerrahpasa Medical History Department Library. No: 434.
- Omer b. Sinan el-Iznîkî: Kitâb-i Kunûz-i Hayâtu'l-lnsan Kavânîn-i Atibbâ-i Feylesofân. Istanbul University Library. T. Y. 7140.
- Omer b. Sinan el-lznîkî: Sifâ al-Muminîn (Al-Tibb-i Kimyâî). Istanbul University Library. T.Y. 7083.
- Omer Sifai: Jawhar al-Farîd fi't-Tibb al-Jadîd. Cerrahpasa Medical History Department Library. No: 195/1.
- Omer Sifai: Minhâcu's-Sifâî fî Tibb al-Kimyâî. Istanbul University Library. No: 7072.
- Omer Sifâî: Tibb-i Jadîd al-Kimyâî. Istanbul University Library. T.Y. 7103.
- Sâlih b. Nasrullah: Fî hâzâ Kitâbu't-Tibb al-Jadîd el-Kimyâvî allajî Ihtirâ'a-i Baraklisus. Suleymaniye Library. Ayasofya section. No: 367/1; Hafid Efendi section. No: 269/1.
- Sâlih b. Nasrullah: Nuzhet al-Abdân fî Tarcamai Gâyat al-Itkân. Cerrahpasa Medical History Department. No: 539, 544; Fatih Millet Library. Tib Section, No: 328.
 Omer b. Sinan: Tibb-i Kimyâî. fol: 5b.
 A. G. Debus: op. cit., pp. 57-88.
 See: Suheyl Unver: "Italya ile Turkiye Arasinda Tarihte Tibbi Munasebetler Hakkinda". I. U. Tip Fakultesi Mecmuasi, vol. 18, No: 2, 1955.
 See: Hammer: Histoire de L ‘Empire Ottoman, vol. XVI, pp. 171-172.
 See: Nil San: "18. ve 19. Asirda kimyager hekimlerin kullandiklari aletler". Tip Tarihi Arastirmalari, No: 1, Istanbul, 1986, p. 53.
 See: Nil San: op. cit., p. 56.
 See: Nil San: op. cit., p. 62.
 Kasîr al-Naf': fols.: 23b-185b; 189a-192b.
 See: Robert Multhauf: "The Significance of distillation in Renaissance Medical Chemistry". Bulletin of the History of Medicine, No: 30, 1956, pp. 329-246.
 Kasîr al-Naf': fols.: 23b.
 Kasîr al-Naf': Mau'l-Mâ-i hulya (Medicinal liquid for "mal-i hulya") I. book, fols.: 29a; Iksîr-i zehebu'l-kadîr (Gold elixir tonic) I. book, fols.: 49a, e.t.c.
 Kasîr al-Naf': Macun al-zumrud (Emeraldpaste), Cevâris-i kibrit (Sulphur). III. book, fols.: 225b.
 Kasîr al-Naf': I. book, fol: 23b.
 Kasîr al-Naf': fols.: 4b, 6a.
 See: A.G. Debus: op. cit., p. 54.
 The theory of signatures: The conviction that every plant had a sign given by the Creator. The shape of the plant, its similarity to an organ, its colour and sometimes smell give a clue about how and where it should be used. For example, "Kirlangic otu" (Chelidonium maius) is used to treat hepatitis, as it had a yellow latex; "boyaci koku" (Rubia tinctorum), is used for helping menstruation, as it contains a red latex; "bean " was used to treat renal diseases, for it was in the shape of a kidney; "ginseng" (Panax ginseng) was used as an aphrodisiac, for it looked like human hip.
 "Mâl-i hulyâ": A mental illness, the symptoms of which were believed to be fear, obsession, and sadness. (See: Nil Sari: Mal-i Hulya ve Tedâvisi, Istanbul, 1982, Assoc. Professorship thesis.)
 "Sevdâ" Black bile; mental illnesses and other diseases due to the increase of black bile, one of the four elements believed to exist in the body.
 "Stidde": Blockage of the vessels, canals or cavities in the body, because of various reasons.
 "Tesennuc": Muscle spasm; convulsion.
 "Gasy": Fainting.
 "Hafakan": An illness accompanied with tachycardia, pessimism and anxiety.
 Kasîr al-Naf': fols.: 23b, 192b; Omer Sifai: Tibb-i Jadîd-i Kimyâî No: 7103; Omer b. Sinan: Kitâb-i Kunûz-i Hayat al-lnsan Kavânîn-i Atibbâ-i Feylesofân. No: 7083, fols.: 5a; Gevrekzâde Hafiz Hasan, Mursid al-Alibbâ fî Tarcamati Ispagorya. No: 161/1, fols.: 6b.
 A. G.Debus: op. cit., p. 54.
 Gevrekzâde Hafiz Hasan: op. cit., fols.: 4b.
 Gevrekzâde Hafiz Hasan: Ibid, fols.: 6 a-b.
 See: Ahmet Refik: Onikinci Asirda Istanbul Hayati. 1100-1200. Istanbul, 1930, p. 37.
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