Famous Figures of the Modern Turkish Medical School
The shift in medical practice and learning from the Ottoman tradition, rooted in Islamic medicine, to the modern medicine, learned and practiced along western standard, is an important moment of the transformation that occured in Turkey and in the rest of the Muslim world since the middle of the 19th century. In this article, a set of PPT poster files endeavours to set light on this radical shift in scientific ideas and medical practice, through the glances on the lifes and works of eight famous late Ottoman and early Turkish physicians who had outstanding contributions in medicine. The posters were prepared by the students of the post graduate Medical History Course Workshop at Cerrahpasa Medical School, Medical Ethics and History Department at Istanbul University. They were presented in the 39th International Congress on the History of Medicine (September, 5-10, 2004), in Bari (Italy): Eight physicians study, Megaposter by Nil Sari, Esin Karlidag, Ibrahim Topçu, Elif Vatanoglu, Emrah Kurt, Ferda Gündogdu, Necla Kinik, Zeynep Belbez and Ahmet Ataman (see the list of posters in the congress program at http://www.bium.univ-paris5.fr/ishm/Final%20Program%20Bari.pdf).
The eight physicians whose biography and medical work were surveyed included: Esat Isik Pasa (1865-1936), Celal Muhtar Özden (1865-1947), Akil Muhtar Özden (1877-1949), Besim Ömer Akalin (1885-1940), Hasan Resat Sigindim (1884-1971), Hulusi Behçet (1889-1948), Ihsan Sükrü Aksel (1899-1987) and Münir Ahmet Sarpyener ( 1902-1982).
The work of this group of physicians allows a characterization of elements and, hence, provide a general view of the medical science of the period. All of the eight physicians were born during the late Ottoman period; they had medical education in an Ottoman medical school; then they went to a European medical center for training and research, and they all returned to Turkey, where they held official positions in the network of medical care, medicine teaching and medical research. Each of them was an eminent physician, who contributed to medicine by introducing one or more innovations or starting a foundation in different fields of medicine, such as ophthalmology, pharmacology, internal medicine, obstetrics, pediatrics, hematology, dermatology, neurology and orthopedics. These physicians and their work symbolize the peak of the efforts of the Ottoman intellectuals in modernising the field of medicine through the introduction of new discoveries, instruments, theories, and practices.
We must note also that most of them played political and social roles in their country, and contributed to the creation of professional organisations with a clear social and charitable dimension (Red Crecent, medical socities, etc.) In some cases, they participated to establish organs of the academic scene in Turkish modern medicine, such as the creation of institutions, chairs, and journals.
Hereinafter we present short summaries about the eight physicians and their works.
1. Akil Muhtar Özden (1877-1946)
| ||Figure 1: Akil Muhtar Özden (1877-1946).|
Between 1896 and 1902, he was educated at the Medical School of Geneve, then he worked at the L'Institut Pasteur in Paris and prepared a doctoral thesis on ‘‘Long Lasting Cerebrospinal Meningitis'. He carried out researches on ‘‘chloralose' and ‘‘opium alkaloids', which he carried out at Dr. Mayor's experimental therapy laboratory, and were published in French. In 1909 he was appointed to the Civil Medical School of Istanbul as a lecturer and embarked on a long career of medicine teaching (1908-1944).
In 1926 he found the exact effect period for digitaline; and proved that 20 drops of oral digitaline started to be effective in 1-1.5 hours, with its maximum effect seen in 3.5 hours. This was an important discovery at that time because till then it was thought that it took as long as 12-24 hours for digitaline to be effective. This experiment came to be known as the Usskof experiment, for he made use of the Usskof device in order to trace the radial pulse rhythm and amplitude.
| ||Figure 2: The colorimeter designed by Akil Muhtar for the Santonin Experiment to measure the detoxifying function of the liver.|
2. Besim Ömer Akalin (1862-1940)
He was the founder of modern obstetrics and gynecology in Turkey. He contributed greatly in establishing the first obstetrics clinic and the first midwifery school in Turkey affiliated with the Medical School of Istanbul.
In his medical research, Besim Ömer Akalin published on preventive medicine and public health issues (mouth hygiene, smoking, alcoholism, spas, sea baths, first aid etc.) His article on tuberculosis was the first to be published as a booklet for the campaign against tuberculosis. In an age when even the medical examination of women was not tolerated well by the public, he tried to establish scientific methods in modern obstetrics.
| ||Figure 3: Besim Ömer Akalin (1862-1940).|
He also designed courses for uneducated midwifes and thus made possible a remarkable decrease in the mortality of puerperal fever. Among his other social activities linked to medical care, he contributed to the reorganization of the Turkish Red Crescent Society and had a leading role in founding the Society for the Protection and Care of Children, occupied the office of president of the Ottoman Society of Fight Against Tuberculosis, and one of the founders of the Turkish History of Medicine Society.
3. Celal Muhtar Özden (1865-1947)
In another medical field, that of dermatology, mention was made of Celal Muhtar Özden (1865-1947), who is famous for having promoted the Turkish Red Crescent. Indeed, he was General Inspector of the Turkish Red Crescent (1913-1925). He was distinguished by his simple and practical approach in his clinical education of medical students. The following phrase which he insistently repeated to his students during bedside visits, well demonstrate the importance he gave to clinical observation and practice:
| ||Figure 4: Two books by Celal Muhtar Özden.|
4. Esad Isik Pasa (1865-1936)
After his studies of ophthalmology in Paris School of Medicine, Esad Isik he was appointed as an associate professor of ophthalmology at the Istanbul University Medical School (1894) and then at the Military Medical School in Istanbul (1899). He established the first private ophthalmology clinic in Turkey, where he employed students from the senior classes of the medical school as his assistants and trained them. He crowned this professional career by being Minister of Health in 1912.
Joining concave and convex mirrors in 1903, he modified the original ophthalmoscope invented by the German physicist Helmholtz in 1851. This new ophthalmoscope was used widely throughout the world and was known as the Essad Ophtalmoscope.
5. Hasan Resat Sigindim (1884-1971)
The specialist of hematology Hasan Resat Sigindim graduated from the Civil Medical School in Istanbul in 1905. He continued his medical studies in Germany and in 1913, after his return to Turkey, was appointed as the director at Damascus and Beirut Medical Schools. In the period 1916-1933, he served as the Director of Internal Medicine Department and lectured on Physiology at the Istanbul University Medical School. Later on, between 1941 and1963, he served as a dermatologist at various hospitals in Istanbul.
An important mark in the career of Dr. Resat Sigindim is the discovery of Monocytic Leukemia. In 1913, while he was working at the Sankt George Hospital of Hamburg he observed that the blood samples from a patient diagnosed as acute myeloid leukemia had a very peculiar microscopic appearance. This was an uncommon form of leukemia where the predominating cells were monocytes. He published his findings together with Dr. Schilling in a famous article: Über eine neue Leukämie durch echte Übergangsformen (Splenozytenleukämie) und ihre Bedeutung für die Selbstständigkeit diser Zellen. For long years this type of leukemia came to be known as the Schilling type monocytic leukemia, or simply Schilling's leukemia. Later, with the new classification of leukemias, this name was changed to M5- monocytic leukemia.
6. Hulusi Behçet (1889-1948)
The best way to describe the medical contribution of Hulusi Behçet is that he is the doctor whose name was given to a disease. After his graduation in 1910 from the Istanbul University, Medical School, he worked at the Gülhane Dermatology Clinic as an assistant to Esref Rusen, Talat Çamli and the bacteriologist Resat Riza. During the war (1914-1918), he was appointed as a dermatologist to the Military Hospitals in Thrace. Later on, he had an academic stay at the Charité Hospital's Dermatology and Syphilology clinic in Berlin, before he returned to Turkey where he occupied, beginning in 1923, the functions of director of the Hasköy Venereal Disease Hospital, dermatologist at the Gureba Hospital and in 1933 professor and head of the Dermatology and Syphilology Clinic of Istanbul University Medical School. Almost three decades after his death, and in honour of his memory, the Turkish Scientific and Technical Research Organization (TUBITAK) was established in 1975 and awarded in the name of Hulusi Behçet.
| ||Figure 5: Turkish stamp depicting Hulusi Behçet.|
With careful observations from 1929 onward, he found out that various symptoms of the skin, the eye and the internal organs attributed to different diseases were actually the different manifestations of a specific disease. During the International Dermatology Congress assembled at Geneve on September 13th, 1947, Hulusi Behçet's thesis about various cases with evidences of mouth and genital ulcers and infection of the eyes was acknowledged as a new disease of viral origin. Also, on the proposal of Dr. Miescher, a dermatology professor of the Zurich Medical School, the disease was named "MORBUS BEHÇET" (Behçet's Disease).
7. Ihsan Sükrü Aksel (1899-1987)
He was Turkey's first Neuropathologist. After his medical studies and graduating from the Istanbul University Medical School, marked by the influence exerted upon him by the clinical demonstrations, specially the treatment of hysteria with psychotherapy, by Mazhar Osman, the eminent professor of psychiatry, he was certified as a Psychiatrist and Neurologist in 1922 and some time later he established the first neuropathology department and laboratories at the Toptasi and Bakirköy Mental Hospitals.
Medical work: He developed Mann's Method for marking the Negri particles, used in the diagnosis of rabies. With Aksel's method it became much simpler and reliable to depict these particles in the brains of infected animals; author of 260 articles; and wrote the chapter on rabies in the world famous pathology textbook of Henke-Lubarsch. He knew world fame and received many international awards. In 1971 he was honoured by the International Federation of Psychiatry as "one of the 16 most prominent psychiatrists of the world".
8. Münir Ahmet Sarpyener (1902-1982)
Dr. Sarpyener was a surgeon and he excelled in the diagnosis and surgical correction of canal stenosis. He graduated from the Istanbul University Medical School in 1923 and worked at Gülhane Clinical Practice Hospital and Haydarpasa Military Hospital. In 1927, he was a resident at the Pediatric Surgery and Orthopedics Department of the Lyon Medical School in France, before he returned to Turkey to work in several military hospitals and he was appointed as professor to the Pediatric and Orthopedic Surgery Clinic of Hamidiye Etfal, the Childrens' Hospital. From 1958, he became the director of the Pediatric Surgery and Orthopedics Department of Istanbul University Medical School.
His doctorate thesis (1934) was on spina bifida. Following his studies on cadavers and examinations on his patients and their X-rays, he described in 1944 a specific congenital malformation, which he proposed to treat by surgery expanding the spinal canal. He showed that this malformation, thereafter known as "canal stenosis", was a congenital stricture of the spinal canal, constricting the nerves, causing paresias, walking disorders, paresthesias, urinary and fecal incontinence, paralysis and inward bending of the feet.
| ||Figure 6: Issue of Acta Ortapedica Turcica (vol.8-n° 1, 1974).|
Sarpyener was also the first to establish that canal stenosis might also be encountered in the adult population. With this contribution, many patients who had been misdiagnosed, or many cases which were thought to be untreatable till then, could successfully be diagnosed and treated. He published the journal Acta Ortapedica Turcica and was one of the founders of the Turkish Orthopedics and Traumatology Society, and the Turkish Sports Medicine Society. He wrote 6 books and more than 200 articles, 25 of which were in foreign languages.
Akkan, A. 1992. "Dr. Besim Ömer Pasa (Akalin)", Mimar Sinan (Istanbul), vol. 84: pp. 15-20.
Atici, E., Oncel, O. 2006. "The Place in the History of Medicine of Prof. Dr. Hasan Resat Sigindim (1884-1971), the Discoverer of the Acute Monocytical Leukemia", 40th Congress of the International Society for the Histrory of Medicine (Budapest, August 2006), online at: http://www.ishm2006.hu/scientific/abstract.php?ID=39.
Barlas, U. 2001. "Ord. Prof. Dr. Akil Muhtar Ozden (1877-1949): His Life and his Scientific Contributions" (in Turkish), Tip Tarihi Arastirmalari vol. 10: pp. 207-20. Abstract online at: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12173611&dopt=AbstractPlus.
Esat Isik, Hasan 1965. "Discours de Son Excellence Monsieur Hasan Esat Isik, Ministre des Affaires Etrangères de Turquie, Prononcé au Cours du Débat Général de la XXème Session de l'Assemblee Générale des Nations-Unies", Milletlerarasi Münasebetler Türk Yilligi (Ankara) vol. 6: pp. 199-211.
Naderi, Sait et al. 2007. "Dr. Ahmet Munir Sarpyener: Pioneer in Definition of Congenital Spinal Stenosis", Spine (Philadelphia), vol. 32, no. 5: p. 606.
[On Ihsan Sükrü Aksel (2007)]. "Ihsan Sükrü Aksel (Istanbul)" (in Turkish), online at: http://www.kenthaber.com/Arsiv/IzBirakanlar/Istanbul/IzBirakan_1792.aspx.
Piller, G.J. 2001. "Leukemia: A Brief Historical Review from Ancient Times to 1950". British Journal of Haematology 112(2): 282-292.
Sehsuvaroglu, B.N. 1948. Türk hekimleri biyografisi (Biography of Turkish physicians). Archives of Prof. Dr. Bedii N. Sehsuvaroglu, Istanbul University Faculty of Medicine Department of History of Medicine and Deontology Library.
Ünver, A. Süheyl, "Dr. Akif Muhtar Özden", Istanbul Üniversitesi Tip Fakültesi Mecmuasi, Istanbul 12 (2), 1949, 102-121.
In the following we present the set of nine posters on the contribution of eight late Ottoman and early Turkish physicians:
Esat Isik Pasa
Celal Muhtar Özden
Akil Muhtar Özden
Besim Ömer Akalin
Hasan Resat Sigindim
Ihsan Sükrü Aksel
Münir Ahmet Sarpyener
by: FSTC Limited, Tue 23 October, 2007