Ottoman Medical Practice and The Medical Science - V
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11. Orientation Towards New Knowledge and the Language Problem
In the 19th century when it became inevitable for the Ottoman physician to follow the innovations in European medicine, the language problem arose again for those who had been expected to learn the former medical system based on the humoral theory, observe its philosophical rules and learn Arabic in order to utilize the knowledge of those learned in the field and not to endanger the life of the patient,. By taking an approach that avoided interventions that might harm the patient's nature, the Ottoman physician was able only to follow the innovations taking place in the field of medicine in foreign countries. Yet, to utilize knowledge obtained in Europe, it was necessary to read and understand the books compiled in European countries. So, in order to import the new knowledge, Ottoman physicians had either to learn a European language, translate medical books into Turkish; or else they had to travel to a European country or invite European physicians to Turkey. It was difficult for the madrasa trained Ottoman physicians of the Court and hospitals, to follow the developing science in European languages. As Abbas Vesim clearly stated in the 18th century, "Moslem physicians were not able to learn the European physicians' experiences, because books composed in Europe were in languages which Muslim scholars were ignorant of ." On the other hand, non-Muslims had learned European languages.
Figure 11: Sânizâde Atâullah Efendi: Miratü'l Ebdan fî Tesrih-i Azâü'l-insân. Istanbul Darü't-tibaatü'l Amire, 1235 H (1820), illustration 22.
The Ottoman rulers, who were aware of the harm done by some European physicians, planned in 1805 that the new medical school for the Greek Ottoman citizens, would use the European medical system,. From the related documents, we conclude that this school was not only permitted to be founded by Greek citizens as a political privilege, but it was also the result of trying to solve an important problem. "As correspondence with the physicians of European hospitals and problems such as operations and experimenting on patients and anatomical practices were not convenient to be carried out in the medical madrasas in Istanbul", the Greek subjects were appointed to start a new medical school. These sources prove that members of the medical madrasa were not able to exchange information with their European colleagues because they did not know European languages; neither could they experiment on patients, nor dissect dead bodies, because they continued to observe the former principles of medicine .
In 1806 when a medical school was planned near the Navy Hospital (Tersane-i Amire - Ispitalya) for educating physicians and surgeons to be employed at the shipyard and the navy, the Ottomans once again came across the problem of foreign languages. Books in Turkish about the new medicine founded in Europe were extremely few, as it was recorded in the Navy Medical School's regulation (dated 1807) about medical and surgical sciences etc.: "Although medical instruction in European countries is carried out by means of their own native languages, as the majority of the (Ottoman) students employed in pharmacies had learned Italian, they would easily have Italian medical and pharmacological books, so instruction of medicine and surgery is decided to be started first in Italian and later in French, step by step." The most interesting statement was that "translating medical books from Italian would be a waste of time" . Such ineffective efforts to solve the problems, not considering the future results, resulted in them being more difficult to solve.
Mustafa Behçet Efendi (1774-1834), the head physician of Sultan Mahmud II and the founder of the Tibhane-i Amire regarded as the beginning of today's modern medical schools in Turkey, wrote in his report dated 1826: "Although it is clear that medical treatment must be carried out in accordance with the rules of medicine, most of the Muslim physicians in Istanbul practice observing old medicine (based on the humoral theory), they are ignorant of the new medicine, while a physician to be worthy of being a member of the profession must utilize both the former and the new (European) medicine together on the patients treated. Good physicians are needed for treating the sick soldiers properly. However, Muslim physicians continue to practice the old medicine; they are ignorant of the new medicine. But, a good physician must cure his patients utilizing the information of both the former and the new medicine. That is, the necessity for treatment in accordance with the rules of medicine is obvious as everybody knows, yet the rules of medicine have changed. Furthermore, it is necessary to learn a foreign language for the education of science and skill in accordance with the new medicine" .
In early 19th century, the transfer of knowledge from European languages came to be current, just as previously it had been necessary to utilize the Arabic and Persian books to practice medicine and use the knowledge properly. Moreover, Ottoman physicians were ignorant of the information translated. Once again the problem was correctly perceived: language was the basis of education and training. The best and the shortest solution should have been to prepare a new curriculum utilizing translations from foreign languages, but who should undertake the duty of translating? So, from the start of the Tibhâne-i Amire medical school, teaching a European language (Italian and French) became an inevitable part of the medical education; and in 1839 the language of instruction in medical education was French. European physicians who did not know Turkish were appointed as scholars and lectured in the medical school . However, years of medical education increased and in the course of time teaching French came to be an aim instead of a means. As it is noted in the reports of performance of the medical school Mekteb-i Tibbiye-i Sahane, the period of education increased and only 8-10 students were graduated in a year. In the meantime, the number of non-Muslim graduates, who had learned a European language, increased. In 1865, only one of 24 lecturers of the medical school was a Turk named Ahmed Efendi. The teachers of the medical school who asserted the insufficiency of the Turkish medical language cited madrasas (schools where education was performed in Arabic), as an example of the lack of need to use the formal language Turkish in the medical school. They offered education in French, noting, "Everything is Arabic in madrasas, except the students, who are known not to be Arabs" . During the period of education in French there were so few graduates that no physician was found to employ in the army during the the cholera epidemic in 1865. The small number of graduates did not change until the foundation of the Civilian School of Medicine (Mülkî Tibbiye) where instruction was in Turkish. "The insufficient number of medical students educated" was clearly expressed as the reason for founding a civilian school of medicine in 1866 . Salih Efendi, the president of the school of medicine Mekteb-i Tibbiye-i Sahane, presented a bill for solution in which he offered to simplify the education of a useful science of this kind by translating the science of medicine comprehensively into Ottoman Turkish.; The report of the Supreme Parliament (Meclis-i Vâlâ) indicated that instruction in French (the necessity to learn French before starting medical education and the use of French while studying medicine) was the cause for prolonging medical education. However, many medical students could be educated in a shorter time by instruction in Turkish, consequently ending the need to use a foreign language in medical education .
Starting medical education in French in 1839 delayed the development of medical literature in Turkish for forty years. The French textbooks used in the school of medicine postponed the translation of innovations into Turkish. The fact that only a small number of Turkish medical books were published during the period of education in French, is proof of this .
During the process for restarting the use of Turkish in education and instruction in 1866-67, the problem was once more comprehended: "language is the only means of teaching and educating". In practice, however, they were mistaken. Aiming to translate medical books into Turkish, the Ottoman Society of Medicine (Cemiyet-i Tibbiye-i Osmaniyye) founded in 1867, compiled the medical dictionary Lugat-i Tibbiye in 1874, which was to be the essence of the new medical knowledge. In its forward it was noted that, "Members of our Society had to find new terminology which were not included in the said books, though existing in Nisten's Dictionary. We did the same as the Europeans who brought together the two words describing the meaning of what was newly discovered. But we have preferred Arabic and Persian to the Latin and Greek, as their words resemble the Ottoman dialect. And we have introduced some of the words used in all the European languages, not translating, but as they are"; but, Turkish was never mentioned in the statement. The new Ottoman medical terms quoted for describing the new concepts in the dictionary were prepared in Arabic and Persian words and phrases . Nobody thought of developing a Turkish medical terminology and compiling a Turkish medical dictionary. The medical terms in the above mentioned dictionary compiled with great effort during the Ottoman period had been used in the Medical School of the University of Damascus and became the basis of contemporary Arabic medical terminology. Nothing remains of these terms developed by our ancestors in either Turkish medical education or in todays' Turkish medical literaturev .
The Ottoman physician's concept of justice, that is observing the medical principles of the day in medical practice, prevented the idea of the probability of existence of any other reality. Ottoman physicians, practitioners of the humoral medical theory, never aimed to develop new theories and operate the human body aiming new findings in this respect; and even they avoided practicing new treatments and methods, fearing the danger of harming the patient. Ottoman physicians approved the current medical principles; and aiming to treat patients in the best way, tried to accentuate these utilizing their experiences, so continued to describe their observations and experiences in accordance with the humoral theory. Ottoman physicians who needed to acquire professional information for medical practice did not include scientific researches in the program of the medical school Mekteb-i Tibbiye where modern medicine was taught.
Figure 12: Akil Muhtar Özden experimenting on a rabbit, an oil painting by Feyhaman Duran dated 1932. Source: Cerrahpasa Medical School Medical History Museum collection.
Europeans also had continued translating the works of Hippocrates and Ibn Sina and observing the principles of the humoral theory in treating patients until the mid 19th century . To start practicing innovations immediately contradicts medical ethics, as a man's health and frequently their life may be endangered. Practicing new medical findings in clinics, that is reflecting medical science in clinical practice did not happen immediately in Europe, either. For instance, 16th, 17th and 18th centuries' innovations in basic sciences, such as anatomy, physiology, physics and chemistry began to be used in medical practice many years, even centuries later . Only in the second half of the 19 century were innovations in basic medical sciences used extensively in medical practice soon after their discovery.
Maybe the most important difference between European and Ottoman intellectuals and scholars was the existence of intellectuals questioning the current knowledge base, changing the knowledge base as a result and continuing this type of scholarship through the generations by interaction between teachers and students. New knowledge could only be reached by questioning those believed to be right. This is the process, by which current knowledge is replaced by the new. Curiosity starts science. However, only after having read and acquired the current knowledge may one start doubting and questioning; as a result, the way to new knowledge will be found. Europeans passed through a period of translation of the best known scholastic works. They used ancient Greek and Latin literature which are the basis of the European languages, as well as translations from Arabic. The invention of print and the importance paid to native languages helped the spread of information. Turkish is not of the same linguistic origin as either Arabic and Persian or European languages. Even during the periods of inclination to the use of Turkish, both foreign words introduced to Turkish and the use of foreign language structure caused difficulty in understanding and comprehending.
Ottoman physicians tried to explain their observation of patients and treatment, that is their clinical experiences according to the humoral theory. However European physicians tried to reach new facts and explain their findings. This attempt necessitated experiments on patients, which might be harmful. For example, when Jenner expressed his hesitation of smallpox vaccination to his teacher John Hunter, he advised him "Don't think, try, but be accurate" . So, although smallpox variolation had been in use for centuries by the Ottoman people, Ottoman physicians had never thought of experimenting with it on humans. But, Lady Montagu, wife of the British ambassador, who perceived the advantage of this interesting practice, managed to get the information transferred to England . The European scientific attitude which inclined man towards satisfying his curiosity when transfusing blood from a dog to a man in the 17th century, continued to contribute greatly to medical science by dangerous experiments on humans by German physicians and even by haphazard experiments by American physicians in 1960-70s .
On the other hand, Ottomans were much more advanced then Europeans with respect to patients' rights. While Europe progressed in positive science, the Ottoman physician used to obtain his patient's consent before treatment or operation, in the presence of the judge (qadi) and witnesses. Believing "the concept of justice to be the basis of the existence of being", the Ottoman physician felt himself responsible for preserving the balance and harmony between the universe-nature-man and people . While the will to be a wise physician was expressed in hospitals' trust deeds, medical manuscripts and literary work, the principle of not harming the patient and avoiding practices that might imbalance the body were important values that hindered the development of medical science through the questioning of current knowledge and experimentation. The Ottomans who had been governing a society consisting of various peoples of different nations speaking different languages, were not able to continue using the literary Turkish that had been developed during the period of the Anatolian Seljuk States and used Arabic as the common literature of science. They later failed to translate enough European medical knowledge into Turkish and were too late in starting printing, Consequently the Ottomans failed to spread knowledge all over the country . In addition, bureaucracy based on the concept of justice was sometimes misused. All these reasons described concisely in this paper prevented the development of medicine in an Ottoman society which had created a rich, mighty and great civilization. While a high standard of professional ethics in observing patients' consent and a code of medical ethics requiring the priority of not doing harm to the patient was expected of an Ottoman physician, Europeans contributed to world science through their experiments. This paved the way for science by means of what they learned during operations in nature, aiming to utilize and overcome nature, in which they were often successful.
Figure 13: A student of the Military School of Medicine. (In: Mahmud Sevket Pasa, Teskilât-i Kiyâfet-i Askeriye, vol. 3, illustration 59, Istanbul, 1325/1919.)
In studying contribution to science, the aim of the Ottoman physicians was to transfer knowledge through original or translated texts during the period of the school of medicine Mekteb-i Tibbiye and the university Darü'l fünun, where current European knowledge was translated or compiled, however the function of research and developing science was not observed. Except for a few late 19th and early 20th century scholars, Ottoman intellectuals failed to realise the importance of acquiring knowledge through research in order to develop a scientific way of thinking, yet they aimed to spread the current science in the society . Although the attitude, tendencies and values regarding the science of medicine in modern Turkey have been imported from Europe, the desired level of knowledge as a contribution to the science of medicine could not be reached; and instruction and education together with students oriented to questioning and researching could not be practiced in general. Professor Malche, who was invited to Turkey from Geneva by Atatürk for the university reform in 1933 had assumed that, "the duty of a university was not to administer existent knowledge, but create scientific understanding."
Resit Galip MD, the Minister of Health of the period had said: "The main function of a university is to instruct a science not aiming any benefit, rather then attempting practical solutions." That is right, professional training ought to be provided at medical schools, however a university is not a technical school, or only a school for acquiring professional knowledge. The aim of a university ought to be to get the new books and periodicals known, to carry out new researches, note facts, criticize current knowledge, create new knowledge and communicate it; and probably the most important of all is to develop a scientific attitude. The main aim of the university reform in 1933 was to administer the results obtained by scholars' scientific researches depending on their creative thoughts to students by means of education and to people by means of publication and press, that is, education and publication should follow science based on research .
Professor Hirsh, who spoke on the university concept and its development in Turkey at Istanbul University in 1979, stated that:
"The main criterion of the university concept had turned from doctrine to teaching and in educating students practical aims were observed, consequently, the university concept was turned to be a school for providing professional knowledge, while scientific researches and studies remained theoretical; and as a result, the idea that science played a secondary role in actual life overcame Atatürk's aphorism, "The best enlightener and leader in life is science". Hirch also said that, "Instead of enriching the treasure of science by means of scientific research, the new tendency was observing the instruction and publication of the current knowledge; and an education aiming to teach and publish existing knowledge was used as a criterion, however a scientific institution could be respected only by its contribution to science " .
The prestige and ability of development in a country is parallel to its contribution to science, too. However, human rights should not be ignored.
Notes and References
 For a general look at the 19th century Ottoman medicine, see E. Kâhya: Ondokuzuncu Yüzyilda Osmanli Imparatorlugunda Tip Egitimi ve Türk Hekimleri. "Atatürk Kültür Merkezi Baskanligi, Türk Kültüründen Görüntüler, seri 34", Ankara 1997.
- A. Adivar: op.cit, p. 172; See Düstürü'l Vesim fi Tibbü' l-Cedîd ve' l-Kadîm, Ragip Pasa Library, no. 947.
 O. Ergin: op.cit, p. 2.
- N. Sari: Osmanlilarda Tiphanenin Kurulusuna Kadar Tip Egitimi, op.cit, p. 162; See BOA Cevdet Sihhiye 304.
- E. Z. Karal: op.cit, p. 35.
- A. Adivar: op.cit, p. 191.
 A. I. Gencer: op.cit., pp. 736, 742; BOA, Maliyeden Müdevver defter, no. 8886, p. 341.
 O. Ergin: op.cit, p. 4.
- A. Altintas: "Tiphane-i Amire'ye Adim Adim", op.cit, p. 135.
- Mustafa Behçet Efendi, who was a pioneer of European medical education, translated Antonio Caldani's Fisiologicae from Italian to Turkish ten years after its publication, a short period for the day." See E. Kâhya: Tanzimatta Eski ve Yeni Tip, op.cit, p. 292.
 O. Ergin: op.cit, pp. 12, 14.
- A. Altintas: Dr. Karl Ambrose Bernard'in Mekteb-i Tibbiye'nin Kurucusu Oldugu Meselesi. Tarih ve Toplum, vol. 24, no. 143, Kasim 1995, pp. 36-45.
- "The specialists who were invited from abroad with great difficulties and expenses were not beneficial enough for Turkish students in Turkey; at least they were not as beneficial as they were expected to be. One of the major reasons for this is that they did not know Turkish. Students could not benefit enough from the specialists who did not know Turkish." See E. Kâhya: Osmanlilarda Bilim, p. 505.
 For the 1841-1842 academic year's activity report see Topkapi Palace Archive, no. 879.
- In her PhD thesis Y. I. Ülman discusses the results of medical education in French, giving the following statistics:
- 1842- 1843 academic year's activity report: 7 years of education (3 years high school (idadi), 4 years study on medicine and surgery); 341 students in the 7th grade. Only 16 students graduated (see pp. 36-38).
- 1843- 1844 academic year's activity report: 7 years of education (3 years high school, 4 years study on medicine and pharmacology). Only 9 students graduated (see pp. 46-48).
- 1845-1846 academic year's activity report: 10 years of education (5 years high school, 5 years study on medicine); 125 students admitted to the school; total number of students: 400. Only 6 students graduated (see pp. 60-62);
- 1847-1848 academic year's activity report: 10 years of education (1 year preparatory class, 4 years high school, 6 years study on medicine and surgery). There were 220 students in the first class and 14 in the 10th class. Only 8 students graduated (see pp. 68-70). See Y. I. Ülman: Journal de Constantinople' a Göre Mekteb-i Tibbiye-i Adliye-i Sahane'nin Galatasaray Dönemi. Istanbul University Health Sciences Institute, unpublished PhD thesis, advisor N. Yildirim, Istanbul 1994, pp. 75-78).
- Also see Y. I. Ülman: "Mekteb-i Tibbiye-i Adliye-i Sahane'nin 1846-1847 Ögretim Yili Faaliyet Raporu". Yeni Tip Tarihi Arastirmalari, no. 4, 1998, pp. 117-148. See p. 146.
- The low number of graduates did not change until the Civilian Medical School (Mülkî Tibbiye) was started: The numbers of graduates were 18 in the 1860-1861 academic year; 11 in 1861-1862; 8 in 1862-1863; 4 in 1863-1864, 14 in 1864-1865, and 18 in l865-l866. See Riza Tahsin: Tip Fakültesi Tarihi (Mir'at-i Mekteb-i Tibbiye). 2 vol., A. Kazancigil (Ed.), Özel Yay., Istanbul 1991. (See: Kism-i sani, 1277-1282 neset eden etibba, pp. 101-110.)
- For the numbers of students, lecturers (muallim) and assistants (muavin) of the Medical School Mekteb-i Tibbiye after starting medical education in Turkish, see Y. Ö. Sirin: Osmanli Salnamelerinde 1867' den 1908 Tarihine Kadar Tip Egitimi. Istanbul 1999, Istanbul University, Medical History and Ethics Department, unpublished MSc thesis, advisor M. Deger, pp. 22-96, 123-126.
- A. Altintas: " Mülki Tibbiye'nin Kurulusu," Tarih ve Toplum, no. 184; Nisan 1999, pp. 12-18.
- O. S. Uludag: Tanzimat ve Hekimlik. 100 üncü Yildönümü Münasebetiyle Tanzimat I. Maarif, Istanbul 1940, pp. 967-977. For those who took the side of medical education in French see p. 974.
- E. K. Unat: "Osmanli Imparatorlugunda Fransizca Tip Ögretimi ve Etkileri." VIII. Türk Tarih Kongresi, vol. II., 1981, pp. 1291-1298. Benefits of medical education in Turkish are mentioned in this article as:
- The first medical dictionary Lugât-i Tibbiye was published in 1873.
- Medical newspapers and periodicals were published in Turkish.
- Publications useful for public health were issued.
- A great number of medical books were published in Turkish.
- While the number of Turkish and Muslim lecturers in the Military Medical School Mekteb-i Tibbiye was no more th an 1 or 2, 13 years after education began to be carried on in Turkish, the total of Turkish and/or Muslim lecturers in the School had risen to 60%.
- The number of Turkish and Muslim students increased rapidly.E. K. Unat states in the same article that the influence of education in French continued for a long time:
- Prescriptions in French could not be prevented for a long period.
- Medical consultations were in French for a long time.
- Lectures, minutes and the periodical of the Royal Society of Medicine (Cemiyet-i Tibbiye-i Sahane) continued to be in French.
- The superiority of non-Muslim people employed at the offices of medical and health institutions continued for many years.
- Those who were entrusted for spreading French culture to the Ottoman subjects supported one another.
- According to the Civil Administration Regulation (Idare-i Mülkiye Nizamnamesi) issued in 1869, the Administration of Civil Medicine (Nezaret-i Tibbiye-i Mülkiye) was started as an office of the Ministry of Home Affairs and the Society of Civil Medicine (Cemiyet-i Tibbiye-i Mülkiye) was connected to it. The Administration chose and appointed the health personnel such as physicians, pharmacists and midwives for employment in municipalities; approved or disallowed the promotion and transfer of these employees; was authorized to permit those educated abroad as a physician, pharmacist, dentist or midwife to practice in Turkey; and answered the questions and requirements of courts about health problems. The official language of the Administration was French. Turkish began to be used only after 1892. These institutions favored the minorities. In 1900, 50% of the municipal physicians were not Turks. In 1919, only 20% of the owners of the pharmacies in Istanbul were Turks.
- Rich and influential non-Muslim and non-Turkish physicians supported their nations in several ways.
 O. Ergin: op.cit., pp. 364-5;
- E. K. Unat, M. Samasti: Mekteb-i Tibbiye-i Mülkiye (Sivil Tip Mektebi) 1867¬1909. "Istanbul University, Cerrahpasa Medical School, no. 155", Istanbul 1990, pp. 8-9.
The fact that the number of graduates of the Military Medical School was too small is emphasized in the letter and the law proposed (lâyiha) by Salih Efendi for the foundation of a civilian medical school, sent to the Grand Vizier's office (Sadaret): "Miktar-i asâkir-i sahaneye nisbetle aded-i etibba ekall-i kalil ve belki ancak nisfinin iradesine kâfi olabilir derecelerde olup..." (BOA. Irade Meclis-i Mahsus, no. 1363, Belge no. 1)
The incompetence of foreign physicians was asserted in the official report of the Supreme Parliament (Meclis-i Vâlâ mazbatasi) and the decree record (irade tezkiresi): "Physicians to be employed were indispensably chosen amongst foreigners, but if we investigate the degree of their mastery and skill in medical practice, we see that most are not endowed the skill to protect the well-being of people ..." (BOA Irade Meclis-i Mahsus no. l363, Belge no. 2 ve 3).
- See A. Altintas: "Mülki Tibbiye'nin Kurulusu" Tarih ve Toplum, no. 184, Nisan 1999, pp. 12-18.
 E. K. Unat, M. Samasti: Mekteb-i Tibbiye-i Mülkiye (Sivil Tip Mektebi) 1867¬1909, op.cit., pp. 3-10.
- N. Sari: "Cemiyet-i Tibbiyye-i Osmaniyye ve Tip Dilinin Türkçelesmesi Akimi". Osmanli Ilmi ve Mesleki Cemiyetleri I. Milli Türk Bilim Tarihi Sempozyumu, (Istanbul 3-5 Nisan 1987), Istanbul 1987, Istanbul Üniversitesi Edebiyat Fakültesi ve Islam, Tarih, Sanat ve Kültür Arastirma Merkezi, pp. 121-142.
- Altintas: "Mülki Tibbiye'nin Kurulusu". Tarih ve Toplum. no. 184, Nisan 1999, pp. 15-17;
- See: BOA Irade Meclis-i Mahsus, no. 1363, Belge no. 3. Irade Tezkiresi, 1. Ocak 1867; Irade Meclis-i Vâlâ, no. 25500, Belge no. 2 ve 3; Irade Tezkiresi, 2 Mart 1867; Padisah Iradesi, 3 Mart 1867.
 S. Ünver: "Osmanli Tababeti ve Tanzimat Hakkinda Yeni Notlar", op.cit., p. 941.
- E. K. Unat: "Osmanli Imparatorlugunda Fransizca Tip Ögretimi ve Etkileri", op.cit. See foot note 139.
- A. Altintas: "Mülki Tibbiye'nin Kurulusu", op.cit., pp. 16-17.
- G. Dinç notes the number of Turkish Medical books printed as 33 during 1817-1855, 25 during 1856-1870 and 173 during 1871-1890, that is after medical education was started in Turkish the number of printed medical books increased rapidly. We are informed of the first printed books in Turkish on auscultation and percussion from this study. The first book in Turkish dealing with percussion invented by Auenbrugger was published as a monography 80 years after it was introduced to the medical community; Laennec's stethoscope was deseribed in Turkish in a monography published 70 years after its invention. See: Paul Nmayerden Abdülhakim Hikmet: Muhtasar Kar' ve Isga. Istanbul Nisan Berberyan Matbaasi, 1303/1886). See G. Dinç: "Saglik Bilimleri Alaninda 1928'e Kadar Basilmis Eski Türkçe Eserler Üzerine Bir Degerlendirme Denemesi." Bernard published Precis de Percussion et d'auscultation in 1843 when he was in Istanbul. Osman Saip Efendi described percussion and auscultation in Turkish for the first time in his Ahkâmü' l Emrâz (1852) See S. Ünver: Osmanli Tababeti ve Tanzimat Hakkinda Yeni Notlar, op.cit., p. 937; Uzluk: "Istanbul Tibbiyesi Için Avrupa'dan Getirilen Ilk Hekim." Dirim, no. 6, 1937.
- For the invention of percussion and auscultation/stethoscope, see Garrison: op.cit., pp. 352-353; 411-412. (Auenbrugger (1722-1809): lnventum Novum (1761); Corvisart intoduced it in 1808. Laennec (1781-1826): Traite' de l' auscultation mediate (published in 1819 and 1826).
 Lugat-i Tibbiyye. Mekteb-i Tibbiyye-i Sahane Matbaasi, Istanbul 1290; see foreword (mukaddime). Lugat-i Tib, Istanbul 1318/1901; see foreword (mukaddime).
- N. Sari: "Cemiyet-i Tibbiyye-i Osmaniyye ve Tip Dilinin Türkçelesmesi Akimi", op.cit., pp.131-134.
- H. Hatemi-Y. Ülman: Bir Bilim Dili Mücadelesi ve Tanzimat. Istanbul 1989, pp. 27-29.
- E. Z. Karal: "Osmanli Tarihinde Türk Dili Sorunu (Tarih Açisindan Bir Açiklama) ". For the work and efforts to clear Turkish from foreign terminology, see Bilim Kültür ve Ögretim Dili Olarak Türkçe, op.cit. p. 30.
 Dr. Shehade, a professor of dermatology of the Damascus Medical School, pointed to the dictionary Lugât-i Tibbiye which he saw in my office and expressed his thankfulness to Ottoman physicians and acknowledged Syrian physicians' debt to the dictionary for the medical terms they used in medical education in Arabic.
- Lugât-i Tibbiye was the main source of the campaign for using Arabic in medical education led by the lecturers of the Medical School of the Damascus University founded by the Ottoman Empire and called the Damascus Medical School (1903-1918). See Ihsanoglu: Osmanli Devletine 19. yy.'da Bilimin Girisi ve Bilim-Din Iliskisi Hakkinda Bir Degerlendirme Denemesi, op.cit., p. 85.
- B. Al-Kateb: Review of the History of the Teaching of Medicine in Arabic, op.cit., pp: 601, 603.
Kateb argues that medical literature and education in the native language is the main factor that influences the development in medicine: "Europeans reached the Greek heritage from Arabs through the Sicilian and Andalucian schools and the translations into Latin. However, when Renaissance began, specially after European authors began to write in their native languages, education and instruction were no longer under the monopoly of a particular class. Native languages functioned as an important means of spreading knowledge in all of the social classes which was a step that marked the beginning of the revolution in science of the European Renaissance."
"The above mentioned view suggests the idea that the development of a civilization in a society depends on the literature written in the native language of the people. When the language of education in a country is different from its peoples' language, that country will be hardly civilized and underdeveloped. This was a problem of the Romans who could not utilize enough the Greek civilization because of the language handicap and the Ottoman Turks who could not benefit from the Arabic literature of the Islamic civilization through translations into Turkish." (p. 598)
"Science cannot be developed in a country unless current knowledge is spread to its people as much as possible by means of their native language" (p.599)
"Education at the Damascus Medical School (Arab Medical Institute) started in Arabic quite easily during 1918-1919. Aiming for the translation of current scientific terminology into Turkish, Ottomans had made use of Arabic terms. There were some Arab lecturers employed at the Istanbul University who in translating a term from a foreign language such as French, German, English or Latin, used Arabic terms when they could not find the Turkish equivalents. Thus, it was easy for the lecturers of the Damascus Medical School to use most of the medical terms in Ottoman Turkish by turning them back into their original Arabic forms." (p. 601)."
 H. E. Sigerist: A History of Medicine, vol. I, 1987, Historical Library, Yale Medical Library, no. 27, pp. 3-4.
 N. Sari: "Bati'da Yeniden Dogus: Rönesans", op.cit., pp. 3-7, 9, 15-16.
 F. H. Garrison: op.cit., p. 372.
 S. Ünver: Türkiye' de Çiçek Asisi ve Tarihi. Istanbul 1948, pp. 19-23.
 Z. Özaydin: "Insan Üzerinde Etige Aykiri Deneyler ve Etik Kodlar". Sendrom, yil 9, no.10, Ekim 1997, pp. 102-107.
 M. Türker-Küyel: "Türklerde Felsefe Gelenegi", Türk Yurdu, vol. 44, no. 390, Nisan 1991, p. 5; S. Ural: op.cit., pp. 195, 197, 198, 199, 202; R. R. Faden, T. L. Beauchamp: A History and Theory of Informed Consent. Oxford 1986, Oxford University Press, pp. 53-86.
 For the first published Turkish book on medicine see footnote 40. See also E. Kâhya: Tanzimatta Eski ve Yeni Tip, op.cit, p. 291: "Although printing presses were more widespread in the Ottoman Empire during the 19th century compared with the previous century, most of the medical books of the period were still manuscripts. This was true specially during the first half of the 19th century."
 "The aim of starting the Ottoman Society of Science (Cemiyet-Ilmiye-i Osmaniye) in 1861; the publication of the first Turkish scientific journal (Mecmua-i Fünun); and the foundation of the Ottoman University (Osmanli Üniversitesi) first in 1863, then in 1870 was to introduce modern sciences to a great number of people. According to the first item of its foundation regulation, the aim of the Ottoman Society of Science was to enlighten people through translations and compilations of modern scientific literature. This shows that the Ottoman intellectuals led by Münif Pasha did not pay the necessary importance to scientific research and they could not perceive the real function of research yet. It is not possible to say for certain that these enterprises played a different role than the previous ones in the formation of a scientific approach amongst Turkish intellectuals." See E. Ihsanoglu: Osmanli Devletine 19. yy.'da Bilimin Girisi ve Bilim-Din Iliskisi Hakkinda Bir Degerlendirme Denemesi", op.cit., p. 87.
 "German professors appointed to the Istanbul University started teaching in German and Turkish assistants translated their lectures into Turkish simultaneously. Later, some of the German lecturers learned Turkish and lectured in Turkish according to the agreement with the Istanbul University administration. However, some of them were not able to learn Turkish, an Ural-Altai language entirely different from European languages. The relation and consequence between having learned Turkish well and success in teaching calls attention" H. Widmann: Atatürk Üniversite Reformu, A. Kazancigil - S. Bozkurt (translators), Istanbul Üniversitesi Cerrahpasa Tip Fakültesi, Atatürk'ün 100. Dogum Yilini Kutlama Yayini Özel Seri 3, Istanbul 1981, pp. 29, 188-189. See also B. Al-Kateb, op.cit, p. 600.
 E. E. Hirsch: "Üniversite" Kavrami ve Türkiye'deki Gelisimi. Fakülteler Matbaasi, Istanbul 1979. Lecture on the occasion of the ceremony held on 22nd May 1979 when the honorary doctorate was granted by Istanbul University, Faculty of Law.
*Head of the Medical History and Ethics Department of Cerrahpasa Medical School, Istanbul University.
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by: Prof. Dr. Nil Sari, Wed 08 July, 2009