Evolution of Attitudes Towards Human Experimentation in Ottoman Turkish Medicine -II
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16. Utilizing the new discoveries
From the mid 19th century on, the acquiring of the new information was speeded up and was added to the Ottoman medicine in a short time. For example, in the 1847-8 activity report of the Royal Medical School, it is recorded that, the Ottomans started to use chloroform in operations and taught of it in the courses of the medical school only one year after Simpson's use of chloroform in operation in 1847. After Pasteur's first application of rabies vaccine in 1885, Sultan Abdülhamid II sent a team of three scholars to Paris for utilizing the new finding through direct observation and study in the institution it was being practiced. The rabies vaccine was prepared in the internal medicine department of the Medical School in early 1887, and later the physician Hüseyin Remzi, a member of the team, published a book on rabbies vaccine in 1889. Two years after the discovery of Roentgen in 1895, Esat Feyzi and Rifat Osman used the X-ray machine for the first time to define the spots of the bullet in the wounded during the Greek-Turkish war, which was recorded in the Turkish history of medicine as a remarkable event .
17. Physicians in search for new knowledge: Contribution to the science of medicine
Figure 11: Dr. Esad Feyzi and the X- ray machine. (Röntgen Su'a'ati ve Tatbikat-i Tibbiye ve Cerrahiyesi. Istanbul University Medical School, Medical History Department collection).
When the practice of the European and the old medicine based on the humoral theory together ended, the necessity for acquiring both the old and the new medical knowledge came to an end, too. Thus, the tradition of priority of being a sage then being merely a medical practitioner came to an end as well.
Physicians born during the late Ottoman period had medical education at the Ottoman medical school; went to a European medical centre for training and research, later lived and died as citizens of the Republic of Turkey, founded in 1923. Several of them contributed to medicine, introduced one or more innovations and started a foundation. These physicians and their work symbolize the peak of the efforts of the Ottoman intellectuals in westernization in the field of medicine. The role of positivism on their attitudes and activities is reflected in their laboratory and clinical researches and practices.
These physicians who, were not satisfied with the practice of the new medicine only, started activities and research for the acquisition of new knowledge, the basis of development in science. Ottoman Turkish physicians of the late 19th century, who contributed to the world medicine realized some of their innovations in European countries where intellectuals of science existed. For instance, Celal Muhtar (Özden) functioned in doctor Roux's and doctor Metchnikoff s laboratories in Paris (1890); AMI Muhtar (Özden) studied in professor Mayor's laboratory of experiment and treatment in Geneva (1907); and Hasan Resad (Sigindim) worked in Hamburg with professor Arning (1913), contributing to medicine respectively. Researcher physicians such as Akil Muhtar, who founded a research laboratory in Turkey, succeeded to introduce science to their homeland, creating a tendency for research, so continued to contribute to science in Turkey. For instance, Akil Muhtar came to be a European man of science and tested the effects of drugs on patients in the clinic, a part of the Pharmacodynamics Laboratory. Akil Muhtar was a positivist, joining those who interpreted the evolution of ethics as a result of the evolution of the organism. His book named "Morals from the Point of View of Science' has a strong reflection of positivism. Furthermore, for Akil Muhtar, an operation aiming to prove a reality through scientific methods might be a justification for omitting some moral rules. For example, when he functioned as a pathologist at the Haseki Hospital, he was able to say to one of his students about a patient, "in case the women dies let me know of it, so that we can practice a post mortem examination" for the purpose of describing autopsy by demonstration; and afterwards, in order to be able to practice autopsy, he could say that she was "a suspect of the probability of being poisoned".
18. From past to present
Believing "the concept of justice to be the basis of the existence of being", the Ottoman Turkish physician was responsible for establishing the balance and harmony in the universe, nature and man. While the will to be a wise physician was expressed in hospitals' trust of deeds, medical manuscripts and literary work, the principle of not to harm the patient, avoiding practices that may imbalance the body were the most important values that hindered the development of the medical science through questioning the current knowledge and experimenting. While a professional high ethics observing patients' consent and the medical ethics requiring the priority of not being harmful to the patients was to be considered by the Ottoman physician, Europeans contributed to the science of the world through their experiments that started the way for science by means of what they learned during operations in nature, aiming to utilize/overcome nature in which they were often successful.
Physicians of the Turkish Republic have been learning and practicing contemporary scientific medicine since 1923, the foundation of the State. Researcher physicians have been carrying out experimentations and contributing to the development of medicine. However, have the 20th and 21st centuries' Turkish regulations provided sufficient patient protection? In 1928, law on medical practice was passed, and consent was required before medical intervention. In 1960, a regulation on the principles of medical deontology was put into force and physicians were permitted to try new methods of treatment in case of an incurable disease, though not to cause the patient get worse. Many other Turkish laws and regulations related with medical ethics can be cited.
I would like to relate an anecdote that reflects the sensitiveness of an affectionate Turkish researcher in a period (1973) when research ethics committees did not exist. A PhD student, an intimate friend of mine complained in sorrow: "I scrape palate tissue from patients for experimentation. Patients thank and pray me. They say "God bless you". They assume that it is a part of their treatment. I feel so disgusting." Educated as a medical scientist, she was following her teachers' attitude towards positive science. However she was worried about not telling the truth to the patients she was to harm, though she was not taught in any other way to act.
A turning point was the regulation on drug experimentation, passed in 1993; and hence a research ethics committee's permission has been required. Recently, related new regulations have been discussed in detail. Developments in medicine will require new laws to be passed in the future. However, we should keep in mind that, the scientific medical world will always be in need of virtuous physicians and researchers, no less then it was needed in the past.
19. Notes and references
Figure 12: Prof. Dr. Cemil Topuzlu, the founder of modern surgery in Turkey (Cerrahpasa Medical School, Medical History Museum collection.)
[1.] S. Kadioglu: "Nâbi'nin Hayriyye'sinin Mebhâs-i Lâzime-i Hikmet ü Tib Bölümü: Sair Gözüyle On Yedinci Yüzyil Osmanli Tibbina Elestirisel Bir Bakis". International Congress on Learning and Education in the Ottoman World. Istanbul, 12-14 Nisan 1999. See also M. Kaplan: Hayriyye-i Nabi (Inceleme-Metin). Ankara 1995.
The following phrases are included in the trust of deeds of Fatih, Haseki, Manisa, Süleymaniye and Atik Valide hospitals, respectively: "Two physicians superior in their knowledge of medicine and treatment methods; those who know all the laws of medicine and philosophy and comprehend by experience all the related issues in detail; physicians cognizant of all the medical and philosophical issues through experience; physicians who have acquired all details of medicine and philosophy (hikmet), having filled their minds with knowledge of wisdom shall be employed." See N. Sari: "Osmanli Darüssifalarina Tayin Edilecek Görevlilerde Aranan Nitelikler", Yeni Tip Tarihi Arastirmalari I, Istanbul 1995, pp. 11-54; p. 18; N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, Istanbul 1977, p. 70 for the requisite of the physician to be a scholar (learned wise man, âlim).
[2.] G. A. Russel: "Physicians at The Ottoman Court", Medical History, A Quarterly Journal Devoted to the History of Medicine and Related Sciences, vol. 34, no. 3, July 1990, pp. 243-267; p. 267. For some publications describing and explaining the question and sources of knowledge in Ottoman medicine and the philosophy (hikmet)/philosopher-physician (hakîm) concepts, see N. Keklik: Türk-Islam Felsefesi Açisindan Felsefenin Ilkeleri. Ankara 1996, "Istanbul University Faculty of Literature Publication no. 3484", pp. 2-14; M. Türker-Küyel: "Türklerde Felsefe Gelenegi". Türk Yurdu. vol. 44, no. 390, Nisan 1991, pp. 5, 11, 12; S. Ural: Bilim Tarihi. Istanbul 1998, "Kirkambar Publication no. 27"; E. Kâhya: "Anadolu Selçuklularinda Bilim", Erdem, vol. 5/13, no. 13, Ocak 1989, pp. 63-79 (see: pp. 65-68 on the relation between man and cosmos, the question of existence; and mathematics being regarded as a bridge between the world of senses and the one perceived through mind/intellect in the Turkish-Moslem community is discussed); M. T. Türker-Küyel: "Felsefenin Tarifinde ve Tarihinde Bir Kaynak Olarak Farabi (Al-Farabi As a Source of the History of Philosophy and of Its Definition." Erdem, vol. 6, no. 18, 1992, pp. 725-735; I. Yakit: Ihvan-i Safa Felsefesinde Bilgi Problemi. Istanbul 1985, "Akademik Kitaplar Series 40"; I. Özel ve ark.: Bilgi, Bilim ve Islam. "ISAV Tartismali Ilmi Toplantilar Series 5", Istanbul 1992; Yesim Isil (Ülman): "XIX. Yüzyil Sonunda Ali Sedad Bey'in Kavaid-i Tahavvülât Fî Harekâti'z-Zerrat Adli Kitabinda Ilmi Zihniyet Meselesi Hakkinda. Tip Tarihi Arastirmalari 3, Istanbul, 1989, pp. 108-115 for the question of scientific approach amongst Ottoman-Turkish intellectuals in late 19th century. Also see: N. Öner: Tanzimattan Sonra Türkiye'de Ilim ve Mantik Anlayisi, Ankara 1967, Ankara Üniversitesi Ilahiyat Fakültesi Publication; and I. Özel: Bilgi, Bilim ve Islam I: ISAV Tartismali Ilmî Toplantilar Dizisi 5, Istanbul 1992.
[3.]. Ottoman medicine was based on the theory of four elements (anasir-i erbaa) and four temperaments (mizac). The four elements did not simply mean fire, water, earth and air; and the four qualities, heat, dryness, moisture and coldness were not evaluated simply as perceived in nature, because all the other elements and qualities were considered to be included in this theory. The four humors (ahlat-i erbaa), i.e. blood, phlegm, yellow bile, and black bile, were believed to be found in the body, in correspondence to the four elements in nature, were supposed to have different qualities. The composition of the four humors was considered to form the character, that is the temperament of a person; consequently everyone has an individual character, for the composition of the four humors is particular to each person. There might be imbalance in the proportion of the humors, consequently some people are phlegmatic, others are melancholic, choleric or sanguine. See N. Sari: "Bilim Dogu'ya Göç Ediyor: Islam Dünyasi". Cerrahpasa Medical School Medical History Department 1995-96 lecture notes, pp. 1-2.
As Ottoman medicine was based on the theory of four elements and humors, consequently it was always emphasized strongly in the trust of deeds of hospitals; and physicians were required to be "skilful in diagnosing people's temperaments and dispositions"; "one who knows the characteristics of temperaments"; "a master in improving temperaments and informed of the effects of humors' qualities and the nature of food and syrups"; to have "full comprehension of temperaments'characteristics"; and to be one who "knows the characteristics of human nature". See N. Sari: "Osmanli Darüssifalarina Tayin Edilecek Görevlilerde Aranan Nitelikler", Yeni Tip Tarihi Arastirmalari I, Istanbul 1995, pp. 11-54. See: pp. 1618.
[4.] R. H. Uzel: "Kanuni Süleyman Zamaninda Bir Tibbi Müsavere: Kaysunîzâde ve Hamonoglu". Türk Tip Tarihi Arkivi, vol. 4, no. 15, 1940, pp. 103-105. E. Ihsanoglu: Büyük Cihad'dan Frenk Fodulluguna, p. 102.
[5.] See Abbas Vesim Efendi b. Abdurrahman b. Abdullah: Düstûrü'l Vesim fi' t-Tibbi'l-Cedid ve'l-Kadim Ragip Pasa Library, no. 947, f. 508a for the idea that obtaining information by reading books written in the past is beneficial. Also see Mukbilzâde Mü'min: Miftâhü'n Nur ve Hazâinü' s Sürûr. Süleymaniye/Hamidiye Library, no. 1034/4, f. 93a. ; Emir Çelebi: Enmüzecü't tib. Süleymaniye/Fatih Library, no. 3530, f. 263a; and Abbas Vesim, f. 507 b for the necessity to be informed by the authorities. See N. Sari: Türk Tip Tarihinde Hindiba Türleri, Etkileri ve Günümüz Arastiricilarina Öneriler, (The Drug Hindiba)" Yeni Tip Tarihi Arastirmalari 4, Istanbul 1998, pp. 11-54 (pp. 12-13, 15-16, 38, 40, 46, 48); N. Akdeniz (Sari): "Osmanlilarda Hekim ve Deontolojisi", op.cit., pp. 72, 127, 138; E. Kâhyanotes: "Generally previous medical works were copied or comments were made to classical works of medicine in the 18th century too" (see Kâhya E.: "On Dokuzuncu Yüzyilin Ilk Yarisinda Osmanli Imparatorlugunda Tip Egitimi ve Kalburüstü Hekimlerimiz". Erdem, Eylül 1985, vol. I, no. 3, pp. 685-6; p. 687).
[6.] . See Abbas Vesim Efendi b. Abdurrahman b. Abdullah: Düstûrü'l Vesim fi' t-Tibbi'l-Cedid ve'l-Kadim. Ragip Pasa Library, no. 947, ff. 509 b, 500a - 501a, 505a, for the importance of reaching information by means of observation in hospitals. See Emir Çelebi: Enmüzecü't tib. Süleymaniye/Fatih Library, no. 3530, f. 263a; and Abbas Vesim, f. 508a, for the idea that obtaining information by reading books written in the past is beneficial. See N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op.cit., pp. 72, 127, 138.
[7.] S. Ural.: Bilim Tarihi. Istanbul 1998, Kirkambar Publication no. 27, pp. 152, 153, 213-214, 225, 245; H. Z. Ülken: Bilim Felsefesi. Istanbul, 1983, "Ülken Publication no. 3."; C. Yildirim: Bilim Felsefesi. Istanbul 1979, "Remzi Kitabevi Publication, Büyük Fikir Kitaplari Series 35"; R. S. Westfall: Modern Bilimin Olusumu The Construction of Modern Science (translated by I. H. Duru), Ankara 1987, V. Publication; G. A. Russell: Introduction To The Seventeenth Century: The Age of 'Arabick'. "The 'Arabick' Interest of the Natural Philosophers in Seventeenth-Century" England. Edit. G. A. Russell. E. J. Brill, Leiden 1994, p. 6; E. Kâhyanotes, "Generally previous medical works were copied or comments were made to classical works of medicine in the 18th century too." See "On Dokuzuncu Yüzyilin Ilk Yarisinda Osmanli Imparatorlugunda Tip Egitimi ve Kalburüstü Hekimlerimiz", op.cit., pp. 685-6; S. Ural: op.cit., p. 216. For Roger Bacon's (1220-1292) reaction to authorities, see pp. 150-152, 214; E. Z. Karal: Osmanli Tarihinde Türk Dili Sorunu (Tarih Açisindan Bir Açiklama) Bilim Kültür ve Ögretim Dili Olarak Türkçe. Ankara, 1978, "Türk Tarih Kurumu Publication, XXIII Series, no. 1", pp. 7-96. See p. 40.
[8.] For the advice to physicians not to use drugs he/she does not know, see foot note 35; also see: N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op.cit., pp. 113-114. For the qualifications expected to be employed as a lecturer (müderris) according to the trust of deed of Süleymaniye Medical Madrasa, see K. Kürkçüoglu: Süleymaniye Vakfiyesi. Ankara 1962, Vakiflar Umum Müdürlügü publication, p. 86. On the qualifications expected to be employed as a physician, see: N. Sari: "Osmanli Darüssifalarina Tayin Edilecek Görevlilerde Aranan Nitelikler", op.cit., pp. 17, 18.
[9.] . M. Kaplan: Hayriyye-i Nabi (Inceleme-Metin), Ankara 1995.
[10.]. R. M. Veatch: Case Studies In Medical Ethics. 1976, Harvard University Press, pp. 2021.
[11.]. For the necessity of treatment appropriate to the temperament of the patient, not disturbing his/her nature, see N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, pp. 112-113, 114, 159; and N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, pp. 113-114. See Ibn-i Serif (15th century): Yâdigâr, f. 59 b.; Hayrullah Efendi (1820-1869): Makâlat-i Tibbiye, pp. 145 ff. For the importance paid to man created as the most glorious being and the essense of the universe, see N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, pp. 20, 22, 27-32.
Nabi expresses his anxiety and advices for operating on the human body carefully:
"Drugs must be used carefully and after research
Should not spoil the temperament because of ignorance
Shall be a guide of hygiene for the sick
Should not spoil the temperament because of ignorance" (M. Kaplan: Hayriyye-i Nabi (Inceleme-Metin). Ankara 1995).
For the Islamic rules related with the legal responsibility of the physician, see: A. Udeh (trans. R. Özcan - A. Safak): "Et-Tesriü'I-Cinâiyyü'l-Islâmî Mukarinen Bi'l Kanuni'l-Vaz'i." Mukayeseli Islâm Hukuku ve Beseri Hukuk (Notlar Ilaveli ve Türk Ceza Kanunu ile Karsilastirmali). vol. 2, Ankara 1990", Rehber publication no. 11, Temel Eserler series 1, p. 123. See Ö. N. Bilmen: Hukuki Islamiyye ve Istilahati Fikhiyye Kamusu. Istanbul, Bilmen publication, vol. 3, p. 113; vol. 7, p. 272; and H. Günenç: Günümüz Meselelerinde Fetvalar, vol. 1, Istanbul 1983, Ilim publication, vol. 138.
[12.]. N. Sari: "Türk Tip Tarihinde Hindiba Türleri, Etkileri ve Günümüz Arastiricilarina Öneriler", op. cit., pp. 12-13, 15-16, 38, 40, 46, 48. In the introduction of his Edviye-i Müfrede, the first medical manuscript in Turkish, Ishak bin Murad noted: "I compiled the materia medica current in neighboring districts/provinces and those known in Turkish."; however, he described under the title willow his discovery of a new medicine (f. 23b), explaining that he "prescribed it many times and that it was unknown in medicine." Although in Ottoman manuscripts we frequently come across drug treatments said to be tried, we rarely find one described as a discovery. See M. Canpolat: XIV Yüzyilda Yazilmis Degerli Bir Tip Eseri Edviye-i Müfrede, Türkoloji Dergisi. vol. V, no. 1, 1973, pp. 25-26. See:pp. 21-22.
It was not unusual that health practitioners recorded their secret knowledge and experiences as a keepsake for their son or apprentice, so as not to be forgotten. As an example of such work written down not to be copied, see Dervis Mehmed's(1764/5-1840) treatise on prescriptions of ointments. There are phrases in this manuscript about keeping drug prescriptions as secret. See f. 8a8b, 10b-11a, 19a. See N. Sari-R. Tug: "Enderun-i Hümayun Kilâr-i Hassa Baskullukçusu Dervis Mehmed'in (1764/5-1840) Dühn Terkiplerine Ait Risalesi". IV.Türk Eczacilik Tarihi Toplantisi (4-5 Haziran l998) Bildirileri (Edt: E. Dölen). Marmara University publication no. 657, Eczacilik Fakültesi Yayin no.15. 2000: 238-297.) In the anonymous book "Kitabü'l Mecmuatü'l Mücerrabat" (probably of the 18th century) on chemistry and alchemy, it is noted that some specially secret knowledge was intended to be hidden from "incompetent people". See N. Sari-Y. Okutan: "Kimya Ilmine Ait Kitâbü'l Mecmuatü'l Mücerrebât'a Kisa Bir Bakis". IV. Türk Eczacilik Tarihi Toplantisi Bildirileri (4-5 Haziran l998, Istanbul). Marmara University publication no. 657, Eczacilik Fakültesi Yayin no.15. 2000: 261-276).
For a general look at the 19th century Ottoman medicine, see E. Kâhya: Ondokuzuncu Yüzyilda Osmanli Imparatorlugunda Tip Egitimi ve Türk Hekimleri. Ankara 1997, "Atatürk Kültür Merkezi Baskanligi Publication, Türk Kültüründen Görüntüler Series: 34"; and A. Adivar: "Osmanli Türklerinde Ilim". Istanbul, 1943; A. Adivar: Osmanlilarda Türklerinde Ilim. 4th publication. A. Kazancigil, S. Tekeli (Ed.), Istanbul 1982, Remzi Kitabevi. See: p. 172; Düstürü'l Vesim fi Tibbü' l-Cedîd ve' l-Kadîm. Ragip Pasa Library, no. 947.
[13.]. E. Ihsanoglu: Büyük Cihad'dan Frenk Fodulluguna. p.102. See R. H. Uzel: Kanuni Süleyman Zamaninda Bir Tibbi Müsavere: Kaysunîzâde ve Hamonoglu. Türk Tip Tarihi Arkivi, vol. 4, no. 15, 1940, pp. 103-105. As stated in the trust of deeds of hospitals, physicians were required to "work hard for treating patients using the proper medicine described in well known medical books; be skilful in preparing drugs and being informed of whether or not a syrup or paste would be appropriate for the temperament of the patient; be a master about the harmful and beneficial effects of drugs and highly informed of the harms and benefits of medical plants; be skilful in preparing drugs and understanding the proper and adverse effects of pastes and syrups on patients; be highly experienced in preparing drugs, informed of patients' temperaments and the appropriateness of drugs for them, hence competent both in theory and practice, knowing the principles of preparing drugs and skilled in preparing liquids and pastes". See N. Sari: Osmanli Darüssifalarina Tayin Edilecek Görevlilerde Aranan Nitelikler, op.cit., pp. 18-19. See N. Akdeniz (Sari) : Osmanlilarda Hekim ve Deontolojisi, op.cit., p. 112 for prescribing the medicine proper for the temperament.
Nabi, the poet, describes the importance of knowing pharmacology for the physician of the 17th century:
"God has created drugs and plant roots (rhizomes)
As means of healing diseases and suffering
Must know the nature of drugs and plant roots
Must know the way to treat the affected organ of the human body."
[14.]. N. Sari: "Türk Tip Tarihinde Hindiba Türleri, Etkileri ve Günümüz Arastiricilarina Öneriler (The Drug "Hindiba")" Yeni Tip Tarihi Arastirmalari 4, Istanbul 1998, pp. 11-54. Professor Ali Haydar Bayat noted that Muhammed Ibn-i Mahmud Sirvanî's various observations in his work "Mürsîd" on eye diseases are contributions to medicine, of which two examples are below: "Ibn Sina notes in his Canon: "if the right eye is ulcerated, the patient should lie on the left side and vice versa. I say that, if you know that the ulcerous inflammation is not ophthalmia wherever or which ever eye it is diagnosed, it is better for the patient to lie with his/her face down on a high pillow, so that the humor inside would run out, not harming the layers of the eye." (f.13la). "In Hawi it is stated that, how ever you treat cataract it can not be cured if a scar continues to exist there. I, Muhammed Ibn-i Mahmud-i Sirvâni assume that the cloudy cornea can be cured, if it is not ulcerous; but the cataract beneath the cornea (lens) can not be cured completely, who ever and how long he/she tries to cure " (f.14la) (Manisa Il Halk Library, Old Books Section, no. l840)
[15.]. Sari, N. : "Ethical Aspects of Ottoman Surgical Practice." Türkiye Klinikleri Tip Etigi Dergisi, Nisan 2000; 8 (1): 9 -14.
[16.]. A. Bardakoglu: Islam Hukukunda Doktor ve Diger Saglik Personelinin Hukuki Mesuliyeti. Kayseri Üniversitesi Gevher Nesibe Bilim Haftasi ve Tip Günleri, 11-13 Mart 1982, pp. 527-530; A. Udeh (trans. R. Özcan-A. Safak): "Et-Tesriü'I-Cinâiyyü'l-Islâmî Mukarinen Bi'l Kanuni'lVaz'i. Mukayeseli Islâm Hukuku ve Beseri Hukuk (Notlar Ilaveli ve Türk Ceza Kanunu ile Karsilastirmali). Vol. 2, Ankara 1990", Rehber publication no. 11, Temel Eserler series 1, p. 124; C. C. Güzel, H. Yetkin: Gaziantep Ser' i Mahkeme Sicillerinden Örnekler (Cilt 81141/Milâdî 1729-1825). Gaziantep, 1970, "Gaziantep Kültür Dernegi Yayini, no. 55", p. 80 (Gaziantep defteri, vol. 122, pp. 72, 15 Saban 1178/8.02.1765).
[17.]. O. S. Uludag: Osmanli Sarayinin Yabanci Hekimleri, Yeni Türk, vol. 4, no. 38, Subat 1936, pp. 189-194; F. N. Uzluk: Fatih Sultan Mehmed Zehirlendi mi Eceli ile mi Öldü? Ankara Üniversitesi Tip Fakültesi publication, no. 150. Specially see pp. 22, 23, 25, 32, 38, 44, 46, 48, 52; N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op.cit., pp. 154-164; G. A. Russell: Physicians At The Ottoman Court. op. cit., p. 248; E. Kâhya: On Dokuzuncu Yüzyilda Osmanli Imparatorlugu'nda Tip Egitimi ve Türk Hekimleri. Ankara 1997, Kültür Merkezi Baskanligi publication, Türk Kültüründen Görüntüler Series, p. 2; A. Adivar, op.cit., p. 178; E. Kâhya: "On Dokuzuncu Yüzyilin Ilk Yarisinda Osmanli Imparatorlugunda Tip Egitimi ve Kalburüstü Hekimlerimiz",op. cit., see p. 688; and H. Sahillioglu: "1700 Yilinda Istanbul'da Muayenehane Açma Izni Olan Tabib ve Cerrahlar", Türk Dünyasi Tarih Dergisi, no. 136, Nisan 1998, pp. 10-14; p.12.
[18.] N. Sari - M.B. Zülfikar: "The Paracelsusian Influence on Ottoman Medicine in the Seventeenth and Eighteenth Centuries". Transfer of Modern Science and Technology to the Muslim World; Proceedings of the International Symposium on Modern Science and the Muslim World (Istanbul, 2-4 September 1987) Istanbul 1992, pp. 157-179; N. Sari, B. Zülfikar, M. Yildirim: "Gevrekzâde Hafiz Hasan ve 'Zübdetü'l-Kuhliyye-fi Tesrihi'l-Basariyye." III. Türk Tip Tarihi Kongresi (Istanbul, 20 -22 Eylül l993) Kongreye Sunulan Bildiriler. Türk Tarih Kurumu Basimevi. Ankara, 1999: 250 -256 (Levha: 14 -23); A. Adivar, op.cit., p. 101: "According to Paracelsus, as diseases are the result of the increase or decrease of chemicals that provide the chemical composition of the body, patients could be treated either by supplementing or by releasing elements of this chemical composition." See also E. Atabek: "Hollandali Hekim H. Boerhaave'in Aphorisma'larinin Türk Tip Tarihindeki Yeri". Tip Tarihi Arastirmalari History of Medicine Studies. vol 1, Istanbul 1986, pp. 25-44; pp. 28-30; and Kâhya E.: "Tanzimatta Eski ve Yeni Tip", 150. Yilinda Tanzimat. H. D. Yildiz (Ed.), Ankara, 1992, See: p. 292.
[19.] Gevrekzâde Hafiz Hasan Efendi: Risalei Zübdetü' i Kuhliyye fi Tesrihi' i Basariyye. Topkapi Palace Library/ Hazine, no. 571. See foreword.
[20.]. Garrison F. H.: An Introduction to the History of Medicine with Medical Chronology, Suggestions for Study and Bibliographic Data, Philadelphia, 1929, Saunders Company.
[21.] The Italian physicians Valli and Pezzoni and their assistants were officially authorized to practice safely and freely in Bolu, Bursa, Iznik, Izmir, Ankara, Nigde, Konya, Kayseri and other provinces. Though undated it's probably an early 19th century document. See B.O.A., Cevdet Sihhiye 484 and R. Murphey: pp. 265-267. (David Porter:"Constantinople and Its Environs in a Series of Letters (1831-1834)". I, New York: Harper and Brothers. 1835, p. 271).
[22.]B. O. A.: Cevdet Sihhiye, no. 304; N. Sari: "Osmanlilarda Tiphanenin Kurulusuna Kadar Tip Egitimi". Türk Dünyasi Arastirmalari, no. 22, Subat 1983, pp. 152-182; p. 162; O. Ergin: Istanbul Tip Mektepleri Enstitüleri ve Cemiyetleri. Istanbul 1940, "Istanbul Üniversitesi Tib Tarihi Enstitüsü, no. 17", p. 2; Düstur, Tertip I. vol. 2, pp. 814-6
[23.] N.Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op.cit., pp. 149-150; O. Ergin: Türkiye Maarif Tarihi. vol. 2, Istanbul 1940, pp. 364-5; and E. K. Unat-M. Samasti: Mekteb-i Tibbiye-i Mülkiye. Istanbul 1990, Istanbul University Cerrahpasa Medical School publication, pp. 8-9.
[24.]. A. I. Gencer: "Istanbul Tersanesinde Açilan Ilk Tip Mektebi." Tip Fakültesi Mecmuasi, vol. 41, 1978, pp. 732-747. See: pp. 736, 742; BOA, Maliyeden Müdevver defter, no. 8886, p. 341.
[25.] O. Ergin: op. cit., pp. 2, 4; N. Sari: Osmanlilarda Tiphanenin Kurulusuna Kadar Tip Egitimi, op.cit, p. 162; See BOA Cevdet Sihhiye 304; E. Z. Karal: Osmanli Tarihinde Türk Dili Sorunu (Tarih Açisindan Bir Açiklama) Bilim Kültür ve Ögretim Dili Olarak Türkçe. Ankara, 1978, "Türk Tarih Kurumu Publication, XXIII series, no. 1", pp. 7-96. See: p. 35; A. Adivar: op. cit., p. 191; A. Altintas: "Tiphane-i Amire'ye Adim Adim", Tarih ve Toplum, Vol. 29, no. 171, Mart 1998, pp. 132-137; 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.
[26.] Hayrullah Efendi: Makalât-i Tibbiye. Matbaa-i Amire, Istanbul 1259. See: p. 145.
[27.]. Osman Hayri Mürsid b. Halil Tarsusî: Kenzû' s-Sihhatü'l Ebdaniyye Eser-i Mürsid-i Osmaniyye, Istanbul 1298/ 1881, Matbaa-i Osmaniye. See p. 167. (Cerrahpasa Medical School, Medical History Department Library, no. 45); also see N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op. cit., p. 136; Salih b. Nasrullah: Gâyetü'l-Itkân fi Tedbîr-i Bedeni' l Insân. (Translated by Mustafa ebu'I-Feyz et tabibü'1-evvel-i Bimaristan-i Sultan Ahmed Han. 1141/1728-9. Nüzhetü' l Ebdân fi Tercüme-i Gâyetü'l Itkân. Istanbul 1303/1886. (Cerrahpasa Medical School, Medical History Department Library, no. 906); "Amongst the medical books published several times in the 19th century are popular books of humoral medical practice widely used in the previous centuries. One of the best examples is Davud el-Antâkî's works." See E. Kâhya: "Tanzimatta Eski ve Yeni Tip", op. cit., p. 291
[28.]. Düstur Tertip I. vol. 2, pp. 814-6; N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, op.cit., pp. 149-150.
[29.]. O. Ergin: Türkiye Maarif Tarihi. vol. 2, Istanbul 1940, pp. 364-5; E. K. Unat-M. Samasti: Mekteb-i Tibbiye-i Mülkiye. Istanbul 1990, Istanbul University Cerrahpasa Medical School publication, pp. 8-9.
[30.]. 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.
We learn from the 1847-48 activity report of the medical school Mekteb-i Tibbiye that chloroform was used in surgery and medical training in the Ottoman Empire after a short time following Simpson's use of chloroform in an operation in 1847. See Y. i. Ülman: "Mekteb-i Tibbiye-i Adliye-i Sahane'de Kloroformun Ilk Kez Kullanilmasi." Tarih ve Toplum, vol. 23, no. 138, Haziran 1995, pp. 24-26; Y. I. Ülman: Journal de Constantinople'a Göre Mekteb-i Tibbiye-i Adliye-i Sahane'nin Galatasaray Dönemi, Istanbul University Health Sciences Institute, unpublished MSc thesis, Istanbul 1994, pp. 75-76, 77, 78; Z. M. Tunçman: "Büyük Pasteur'ün Kuduz Asisi Bulusu Hakkinda." Istanbul Seririyati, yil: XXVII, no. 12, 1945, pp. 6-10; pp. 8-9; S. Ünver: "Ölümünün 50'inci Yilinda Doktor Hüseyin Remzi'nin, Üstadi Pastör'ün Kuduz Üzerine Çalismalari Hakkinda Hatiralari." Tibbiyeliler Bayrami, 14 Mart 1947, Istanbul 1947, Tib Talebe Cemiyeti publication, no. 12, pp. 6-12; and N. Sari: "Tarihte Radyoloji- Türk Tarihinde Röntgen Öncüleri". 1987 lecture notes, pp. 4-5.
[31.] Akil Muhtar studied the effects of drugs on animals in the pharmacodynamics laboratory he founded; and he enabled the observation of drugs' effects on patients in the clinic (Tedavi Klinigi) he started as a section of the pharmacodynamics laboratory. His scientific approach was trasferred to his student Prof. Dr. Alaaddin Akcasu, who also contributed highly to medicine. The above mentioned researchers' innovations are most remarkable in the history of Turkey in respect to the fact that scientific inventions in a field follow one another and scientific information is transmitted from one period to the next, that is, science is a kind of knowledge that develops continuously. Similar examples can be given from recent history of Turkish dermatology, hematology and rheumatology. See N. Sari - Z. Özaydin: "Mekteb-i Tibbiye Mezunu Türk Hekimlerinin Buluslari", 1998 lecture notes. See A. Muhtar (Özden): Ilim Bakimindan Ahlak. 3rd issue, Istanbul 1950; and N. Taskiran: Haseki'nin Kitabi. Istanbul 1972, pp. 317-318.
[32.] For the necessity of treatment appropriate to the temperament of the patient, not disturbing his/her nature, see N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, pp. 112-113, 114, 159. On the importance paid to man created as the most glorious being and the essense of the universe, see N. Akdeniz (Sari): Osmanlilarda Hekim ve Deontolojisi, pp. 20, 22, 27-32; and R. M. Veatch : Case Studies In Medical Ethics. 1976, Harvard University Press, pp. 2021.
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by: Professor Nil Sari, Fri 27 August, 2010