MEDICAL EDUCATION AND RELATED INSTITUTIONS IN ISTANBUL

THE BYZANTINE PERIOD

There is no clear information regarding how doctors attained occupational knowledge during the early period of the Byzantine Empire. It is believed that before medical training had been institutionalized in hospitals in the late Byzantine period, doctors had been trained as apprentices and benefitted from the medical textbooks that existed at that time. These books were generally simple descriptions of remedies, medicines and a compilation of traditional cures. In most cases, the medical profession was passed down from father to son.

During the period prior to the reign of Emperor Justinian (527-565), physicians were exempt from paying taxes, and the government paid their salaries. Thus, they did not charge students or the poor. However, when Emperor Justinian accused medical schools in other cities of paganism and ordered their closure, Constantinople became the focal point of medical training. As a result of differences in religious views, in the eighth century Leon III closed the academy in Constantinople (725). During the reign of Michael III (842-867), a new school for medical training was opened in Constantinople. The Byzantine physicians, who had been familiar with Islamic medicine since the tent century, in particular studied the works of Ibn Sina (Avicenna). In the twelfth century, medicine was taught next to the fountain in the courtyard of the Church of Holy Apostles, which was located on the site of Fatih Mosque today. Here, physicians and their students held discussions and debates.

From the twelfth century, medical training was provided in hospitals. One of the most reputable hospitals in Constantinople where medical training was given was the Pantocrator Hospital. In 1136, in addition to the Pantocrator Monastery, known as Hristos Pantokrator or “Christ the Almighty, Emperor John II Komnenos opened a library and a hospital. In the Typicon (monastery records) the Byzantine hospital was described in detail. The monastery, which included a church, formed by combining three chapels, and two charitable institutions, also included a xenon/nosokomio (hospital), gerokomeion (a home for the elderly) and a medical library. One of the famous doctors responsible for medical training in the Pantokrator Hospital spent the entire day teaching the sons of doctors who were affiliated with the hospital. It was an ancient custom for the medical occupation to be passed down from father to son. This doctor, who not only trained medical students, but also the young doctors who were interns and assistants, received the highest salary. The period in which the doctor responsible for medical training in the hospital taught the students was known as the kronia. After receiving medical training, medical students would be subjected to an examination by the emperor’s physician, a mentor known as the actuarios/aktourios. Successful candidates earned the right to practice medicine. As there were no physicians in the monasteries in Medieval Europe, it was important for the young doctors or doctors accompanied by students to make visits to the patients in the hospital. The main church of the Pantokrator Monastery in the Zeyrek district of Istanbul, today known as the Zeyrek Mosque, still exists, but the hospital is no longer standing. During the Latin occupation of Constantinople there was a hiatus in medical education (1204). When the Byzantines regained control of the city, medical education, which was not classified as an independent branch of science, as well as philosophical education became revived next to the monastery.

1- Süleymaniye Medical School (Madrasa)

THE OTTOMAN PERIOD

It is believed that before the establishment of the Fatih Darüşşifa (hospital), which began operating in 1470, medical training was conducted as a form of apprenticeship. Physicians who were trained in Bursa and Edirne, or in medical centers in Egypt, Syria, Iran and Iraq before coming to Istanbul, contributed to medical training in the city. After the Fatih Darüşşifa started to operate, the cities of Bursa and Edirne began to diminish in terms of importance in medical training. In time, Istanbul became the most significant center for medical education in the Ottoman Empire. It was even possible to find medical books in the libraries of the madrasas. Until the first quarter of the nineteenth century, medical training was given in Istanbul in Topkapı Palace, Fatih Darüşşifa and in the grounds of the Süleymaniye Tıp Medresesi (Süleymaniye Medical School). The Fatih Darüşşifa and Süleymaniye Tıp Medresesi were the main institutions that trained physicians for the palaces (Topkapı Palace / Saray-ı Cedid, Old Palace in Beyazıt, Edirne Palace and Galata Palace) and the military. Topkapı Palace was directly involved in medical training, having authority over the services provided both inside and outside the palace, and also within Istanbul and the provinces.

Medical Education in the Fatih Darüşşifa

We learn from archival records that students were trained in the usta-çırak (master-apprentice) method in the hospitals. Although it is not recorded in the waqfiyas (endowment deeds), student doctors, known as tabip şakirdi (the equivalent of residents today) were trained by the physicians in the hospitals.

The Fatih Darüşşifa, which was also referred to as darü’t-tıb (medical college), and in which a dersiam (professor) taught students, was a medical training center. In 1591, the official who inspected those working in the Darüşşifa and the work they were performing earned a salary of 2 akçe per diem. The tabip şakirdi, who were assigned as trainee physicians in the Darüşşifa, were similar to resident students and worked as assistants to the physician. Living quarters in the Darüşşifa were allocated for those who were being trained by physicians in the usta-çırak method at the bedsides of patients. It is recorded in an archival document, dated to 1591, that there were seven tabip şakirdis. These trainee physicians formed a group known as the cemaat-ı şakirdan-ı etıbba (trainee physicians), and each earned a daily salary of 5 akçes. These were graded as first or second grade. When the şakirds had completed their training, they would be appointed as second or third grade physicians in other hospitals, or assigned as physicians or assistant physicians within the palaces. For example, when a first-grade şakird in the Fatih Darüşşifa became an usta (master), he would be appointed to a vacant position for a second physician at the Sultan Beyazıt Darüşşifa in Edirne or in the Haseki Darüşşifa, or as third physician at the Süleymaniye Darüşşifa, or as a palace physician.

Süleymaniye Medical School

The medical school, built by Sultan Süleyman within the Süleymaniye Complex between 1553 and 1559, was the first and only medical school built during the Ottoman period. The medical school, described in the endowment deed of the complex as ilm-i tıp için bina olunan medrese-i tayyibe (the pleasant madrasa constructed for medical science), was also known as the Darü’t-tıb (medical school). The entrance to the madrasa, adjacent to the first and second madrasas schools, standing in the same row as the Süleymaniye Darüşşifa, was opposite to the Süleymaniye Mosque. The structure, which is clearly very different from other madrasas, consists of two floors on the Tiryakiler Market side, with two side wings that contained rooms with stoves and windows. Today, only parts of the medical school remain.

An alternative form of medical training to that of the usta-çırak method began in the medical school and the darüşşifa. The construction of the medical school and the darüşşifa opposite to one another, in terms of conducting theoretical medicine alongside practical medicine, was a novel approach that surpassed all other medical practices of the time. This was the first time in history that a hospital and medical school had been built side by side. This allowed the darüşşifa and the medical school to act as a teaching hospital. The pharmaceutical storage unit (darü’l-akakir or daruhane), which became the main pharmacy in Istanbul, was located on the corner where the narrow street between the medical school and the darüşşifa and the Tiryaki Çarşısı road met. The resident medical students benefitted from the complex’s soup kitchen, living quarters, baths and pharmacy.

2- The register dated March 4, 1594 about the employees of Süleymaniye Medical  School (Madrasa) and Hospital (BOA, MAD, no. 2056, p. 26)

According to the waqfiya of the Süleymaniye Complex, in which significant information regarding the teaching-training personnel is provided, a müderris (professor), a muid (assistant instructor), eight danişmend (students who had completed their education in the madrasa and were studying medicine), a noktacı (inspector), a bevvab (security guard) and a ferraş (cleaner) were appointed to the Süleymaniye Medical School. When the hekimbaşı (chief physician) normally presented the müderris (professor) of the Süleymaniye Medical School as someone who is “knowledgeable, honorable individual competent in delivering medical lectures, reliable and worthy in every aspect.” It was also a condition that only those who were sufficiently qualified to become a candidate for the position of hekimbaşı be appointed as professors at the medical school.

Physicians, who graduated from the Süleymaniye Medical School, a center for medical training, were employed in the military, palaces and hospitals, both in Istanbul and the provinces. With the establishment of the Süleymaniye Medical School, the demand for foreign doctors gradually decreased. The Süleymaniye Darüşşifa was the highest-ranking hospital in the Seljuk and Ottoman periods. Physicians from the hospitals and palaces were all connected in the chain of medical training. When one of the first-grade medical students had completed his clinical training in the Fatih Darüşşifa, and was appointed as a second or third physician in a hospital or as the physician of a palace. The danişmend in the queue, who had graduated from the Süleymaniye madrasa and had waiting for an assignment would be appointed to vacated position or to the position of şakird (trainee physician) in their own institution, if this position was vacant. Thus, the students who were given positions would move among the various institution that provided medical services.

From the time of its establishment until the nineteenth century, the Süleymaniye Medical School continued to become the focal point of social, medical and scientific life in Istanbul. Although medical education continued in the medical school in the middle of the nineteenth century, the Mekteb-i Tıbbiye (medical college) that opened in 1827 and provided teaching in European medicine became the new center for medical training. In the Second Constitutional Period that began in 1908, the Süleymaniye Medical School and other madrasas in Istanbul were placed under the administration of the Darü’l-hilafeti’l-aliyye Medresesi. Between 1946 and 2007, after the restoration of the building, which over time had become non-functional and had fallen into disuse, it was used as the Süleymaniye Maternity and Infant Hospital. The madrasa building is currently connected to the Süleymaniye Library.

Training of Surgeons (Cerrah) and Ophthalmologists (Kehhal) in the Palace

Surgeons and ophthalmologists were trained as part of the organization of ehl-i hiref (craftsmen) in the palace. They were trained as apprentices (çıraks) and received both practical and theoretical education. Among these groups, in addition to the specialist surgeons and ophthalmologists, there were also students, known as şakird. The şakird who proved to be competent in a particular field were ranked as ustad. Occasionally, surgeons and ophthalmologists from these groups were assigned to military posts.

3- The names and daily wages of surgeons and medical schools (Topkapı Palace  Museum Archive, D. 9706)

At the end of the sixteenth century, the number of this group of surgeons and ophthalmologists reached 113. In the mevacib (salary) registers, dated between the sixteenth and eighteenth centuries, in addition to the names of the ustas (masters) and çıraks in these groups, their birth places were sometimes included; for example, İstanbuli (from Istanbul), Kıbrisi (from Cyprus) or Bosnavi (from Bosnia). Among the names of 90–100 surgeons, attributes such as zimmi (non-Muslim), Muslim-i nev (Muslim convert) or Frenk (European) are included, helping us to understand that both Muslims and non-Muslims were accepted by this teaching institution.

4- Chief Physician Gevrekzade Hasan Efendi’s drawings of eyes in Zubdat al-Kuhliyya (Topkapı Palace Museum Archive, H. 571 fol. 22b-23a)

Some Jewish physicians, particularly those who had sought refuge in the Ottoman state upon being driven from Spain during the Inquisition, were employed in the palace. Indeed, at the beginning of the seventeenth century, the number of Jewish physicians working in the palace was as high as 63. However, there has been no study that indicates the interest of Jewish physicians, who were resident in Istanbul, in training others.

Medical Training in Clinics

Qualified physicians, surgeons and ophthalmologists who practiced private medicine trained doctors in clinics known as a dükkan (shop) or in private teaching institutions. Many famous physicians were trained by qualified doctors. For example, it is recorded that in the sixteenth and seventeenth centuries, the specialists Nidai and Siyahi Larendevi, became qualified after receiving private training from an usta physician. Famous physicians all had dükkans in Istanbul. For example, Emir Çelebi opened a workshop close to Balkapanı and Abbas Vesim opened one in Sultan Selim Bazaar in Fatih. According to the records of appointments for the positions of palace physicians, many surgeons came from families, famous for their surgeon sons, were trained by a specialist surgeon, or received qualifications in medicine from one of the famous physicians. According to Evliya Çelebi’s records, in the seventeenth century, there were 1,000 medical practitioners who had dükkans in Istanbul; the number of surgeons who had their own practice in the city was 700. The figures for travelling physicians, that is, physicians not owning a dükkan, were relatively higher. When this is compared with the numbers of physicians in the palaces and hospitals, it is possible to assume that a large number of private doctors, with or without a dükkan, were trained through the usta-çırak system.

The Involvement of Chief Physicians (Hekimbaşı) in Medical Education

The hekimbaşıs, who had authority similar to that of the present-day minister of health, resided in the place known as the hekimbaşı odası (chief physician’s chamber). Hekimbaşıs were also responsible for matters regarding medical training. Thus, any issues related to medical training, were directed from Istanbul. Until 1836, there was no stipulation in the law that hekimbaşıs be officially trained in medicine. They were chosen from among scholars. After completing the regular madrasa education, many hekimbaşıs were trained as apprentices, or they came from a family of physicians, or they taught themselves the art of medicine. The number of hekimbaşıs who had been trained in the Süleymaniye Medical School was small. The office of the chief physician was an administrative, political and judicial position.

Even though the darüşşifas in Istanbul and the provinces, and the Süleymaniye medical school were run in accordance with the regulations of their waqfiyas, they were still under the supervision of the hekimbaşıs. The assignment and dismissal of şakirds in the palace, the darüşşifas and the medical school were mostly carried out in accordance with proposals made by the hekimbaşı. The majority of the doctors appointed to the palace were assigned as palace physicians from among the müderris, muid, şakird or danişmend from the darüşşifas or Süleymaniye Medical School. In fact, many of the palace physicians had completed all the levels of madrasa education, and had been awarded the title mevlana.

Unqualified individuals who worked as doctors, surgeons, ophthalmologists and herbalists, giving incorrect diagnoses and treatments, and those against whom complaints were filed were subjected to an examination to test their ability, knowledge and skills. Those found competent were granted a certificate authorizing them to practice as doctors. However, the incompetent ones who practiced medicine improperly, or who had not learned the profession from a qualified physician were banned from practicing medicine. Examinations aimed at preventing those who had come from abroad from practicing medicine and thus harming the people. Particularly after the eighteenth century, these examinations were implemented to control and restrict European physicians who practiced the medicine of Paracelsus, known as tıbb-ı cedid (new medicine).

5- The gravestone of Chief eye doctor Müstekimzade Mehmed Said Efendi

6- Treatment of a patient with back deformation and hump by cauterization (Sabuncuoğlu, Jarrahiyyat al-Haniya)

In 1700, only 6 of the 25 physicians and 28 surgeons who had passed the examination and were granted permission to practice medicine and open private workshops were Muslims; the others were all non-Muslims. Among them, we can see foreigners who came from countries such as France, Holland, Italy and Spain. In 1704, under the ruling “As some so-called physicians from among the Europeans have deviated from the methods of physicians of the past and use certain medications in the name of new medicine which causes harm to those they treat…the individuals from this group who have somehow opened dükkans here should be banned from the medical profession…,” European doctors who randomly practiced this new form of medicine were banned from treating patients. Complaints about European physicians who were guilty of malpractice, or insufficient medical knowledge and skills can be found not only in official documents, but also articles written by contemporary physicians. However, the curriculum studied in the Süleymaniye Medical School in the nineteenth century, one that was dominated by European science, proved to be inadequate. During the era of Selim III (1789-1807), when Mustafa Behçet Efendi was chief physician, new medical schools were opened in Istanbul in 1805/1806 and in 1827 to modernize medical education. Hekimbaşıs were assigned to the administration of Tıphane-i Amire (Imperial School of Medicine) in 1827 and to the Tıbbiye-i Şahane (Military School of Medicine) in 1839. In 1840, control of exams for the medical staff of the hekimbaşı was transferred to the Meclis-i Tıbbiye (Council for Medical Affairs) formed in the Mekteb-i Tıbbiye (school of medicine) in Galatasaray. Thus, with the abolishment of the post of hekimbaşı in 1850, both his duties in the Meclis-i Tıbbiye and his involvement in medical training and education came to an end.

The Tersane-i Amire Tabibhanesi (The Medical School of the Imperial Shipyard)

The Nizam-i Cedid (New Order) program was concerned with the modernization of state institutions. The Marine Law Regulation, which came into force as part of this program, organized health services for the employees of the Tersane-i Amire (Imperial Shipyard) in Kasımpaşa and the navy (1805). According to this regulation, the individuals who were appointed as chief physician and chief surgeon of the Imperial Navy were to have assistants and students. In the Tersane, a wooden hospital was built close to the great dock, known as the Taşkızak. This hospital was the foundation for the modern Naval Hospital. In the hospital physicians and surgeons were trained in the usta-çırak method to serve the Tersane and the navy. In 1805 there were just 7 students. In 1806, it was ordered that a tabibhane (medical school) be constructed next to the Tersane-i Amire Hospital, which was known as ispitalya. This medical school was expected to spread the medical profession throughout the Ottoman region.

After a proposal that concerned the allocation of physicians and surgeons to ships at times of military campaigns, and ensuring that people who were not usta or qualified not be appointed, and that these medical personnel be selected from among Ottoman subjects and the Muslim community, a nizamname (regulation) dated 25 Shawwal 1221 (5 January 1807) brought an order to the “medical and surgical sciences and other matters” of the Tersane Tıphanesi.

Turkish medical books, concerned with the developments of modern medicine in Europe, were very few. Medical education was provided in the respective languages of every state in Europe. However, as the majority of the students in Turkey worked in the Istanbul pharmacies, and were therefore familiar with Italian, and as Italian medical and pharmacology books were easy to obtain, the decision was made for education in medicine and surgery to initially be given in Italian, later to be changed gradually into French. The Ottomans gave priority to Italy in trade and political relations, in relations that were aimed towards education and the exchange of information. It is interesting that the first translations were mainly from Italian texts, even from texts that had been translated from other languages into Italian.

7- Chief Physician (Topkapı Palace Museum Archive, no. 3690)

All the pharmacy supplies and equipment provided for each ship when leaving on campaign were the responsibility of the medical students. Upon returning to Istanbul, the remaining supplies were to be handed back to the teachers. The Tabibhane was in operation in 1807; however, its situation in later years is unknown. It is believed that as a result of the revolt against the Nizam-i Cedid, there was an interruption in education at the school. It came to an end with the abolishment of the naval ministry. Both the hospital and school buildings were totally destroyed in the Kasımpaşa fire of 1822.

The Kuruçeşme Greek Medical School

In keeping with the practice of modern medicine and military health services in the nineteenth century, qualified physicians were in demand in hospitals. In 1805, when Mustafa Behçet Efendi was the chief physician, the establishment of a Greek Hospital showed the importance of the modern medical education. The demand to open a medical school for Greek citizens was justified by saying “although physicians have studied in some of the most famous medical schools in Europe, we have learned through experience that the physicians who came to Turkey from Europe made many mistakes in a number of respects. Therefore, it is believed that medicine should be learned and practiced locally.” This is an indication of the realization that studying medicine in Europe was by no means sufficient for being a good physician. The Ottoman administration, which did not discriminate between its citizens, authorized the establishment of the new medical school in Kuruçeşme by members of the Greek community. In this school, European medicine was to be taught. It can be clearly understood from the records that authorization for the construction of the school was not granted to the Greeks purely as a political gesture, but rather as a solution to a major contemporary problem. Because the members of the Süleymaniye Medical School were not familiar with foreign languages, a requirement for learning modern medicine, they were unable to communicate with their European colleagues. In modern medicine, it was necessary to practice and experiment on patients and to perform post-mortem examinations. The medical madrasa, which taught the old methods and codes of medicine, was not sufficiently prepared or equipped to teach European medicine.

8- The list of medical books loaned to Chief Physician Molla Kasım and Chief   Physician İsa Çelebi from internal treasury at the beginning of October 1580 (Topkapı Palace Museum Archive, D. 8228)

9- The gravestone of Chief Physician Nuh Efendi

The building which had been constructed in Kuruçeşme for the teaching of the “sciences of geometry and miscellaneous education” was allocated to the medical school. Dimitrasko Meroz (Demetrious Mourouzi) was appointed as the head of the school. We have no information regarding the operation of this school, which allegedly began as a hospital. It is believed that the school was closed following the execution of Dimitrasko Meroz in 1812 as a traitor to the state.

Tıphane-i Amire /Darü-t-Tıbb-ı Amire (The Imperial Medical School)

The Tıphane-i Amire or Daru’t-Tıbb-ı Amire, an institution that is considered to have marked the start of modern medical faculties, was officially established on 14 March, 1827. It was established during Mahmud II’s reign on the proposal of the chief physician, Mustafa Behçet Efendi. The main purpose of the establishment of a modern medical school in which education was modeled on European medical education was to train physicians and surgeons to serve the Ottoman army in accordance with new medical regulations. The second objective was to dispose of certain European quacks who claimed to be familiar with modern medicine, but who in fact caused harm to medicine, and to prevent the assignment of non-Muslim physicians to the military. Only Muslim students were accepted into the medical school. Textbooks were imported from Paris for the Tıphane-i Amire, and lessons were given in Turkish, Arabic, Italian and French. Some non-Muslim Ottoman physicians educated in Italy (Pisa) and France began to teach at the school. New developments in medicine were avidly followed in the medical school, and the importance given to the exchange of information through publications enabled modern medicine to spread rapidly among the Ottoman physicians and medical staff. Modern medical education, which began in Istanbul, also encouraged the establishment of other modern health institutions.

Cerrahhane-i Mamure (School of Surgery)

According to the Kanunname-i Hümayun (Imperial Law Code) of 1827, it was necessary that each military battalion have a surgeon. However, this law was not enforced. In an attempt to train surgeons quickly, an individual class for surgery (şakirdan-ı cerrahin) was opened in the Tulumbacıbaşı Mansion, thus separating the education of surgeons and physicians. It was decided that twenty surgeons would be chosen and trained from among the surgeons in Istanbul. When necessary, these trained surgeons would be assigned to divisions of the Asakir-i Mansure (Ottoman army). A lecturer educated in Europe was appointed to the surgery class.

The premises of the Tulumbacıbaşı Mansion, which was used to train and teach surgeons and physicians, were inadequate to teach these two groups separately. Thus, the hospital known as the Hastalar Odası/Bostancılar Hastanesi close to the Topkapı Palace, in a region known as Değirmenkapı, was transformed into a school. Education began in this hospital, now known as the Cerrahhane-i Mamure (School of Surgery) in 1832. In 1833, the surgery class of the Tıphane-i Amire also joined this new school. A French surgeon was assigned to the Cerrahhane-i Mamure as an administrator and lecturer. During this period, as in Europe, the education of surgeons and physicians was conducted separately.

Mekteb-i Tıbbiye-i Adliye-i Şahane (Imperial Faculty of Medicine)

When the Tulumbacıbaşı Mansion was sold in 1837, the Tıphane-i Amire moved to the Otlukçu Barracks in Sarayburnu. When the building became inadequate, on proposal of the chief physician (1837), the sultan was informed that the Tıphane-i Amire required a new building. As the building of the Enderun Ağaları School, located on the site of today’s Galatasaray High School, had many of the necessary sections, it was decided that the building should be repaired and renovated. When the construction work was completed in 1838, the Tıphane-i Amire and the Cerrahhane-i Mamure moved to the new building and became merged. Teaching and training in the school were restructured. Since this date, the school became known as the Mekteb-i Tıbb-ı Cedid (New School of Medicine), Mekteb-i Cedid-i Amire (New Imperial School) or Mekteb-i Cedid-i Ulum-i Tıbbiye (New School of Medical Sciences). On May 14, 1839, following Mahmud II’s visit to the school, the school was renamed the Mekteb-i Tıbbiye-i Adliye-i Şahane der Asitane-i Aliyye (Imperial Faculty of Medicine in Istanbul) in respect of the sultan’s title Adli. However, due to its location, the Europeans referred to the medical school as the Ecole de Medecine de Galata-Serai. Because the journey to school every day made the education of the students more difficult, the school provided accommodation for students, with a dormitory and dining area for 300 students. In 1841, the school, which had originally only accepted Muslim students, accepted students from various non-Muslim communities. These made up a third of the total student body. The students who registered at the school were selected by their own communities. The first Jewish students were registered at the school in the 1846–1847 academic year.

Education at the school was given in French. Karl Ambros Bernard, who was invited from Vienna, was appointed the headmaster at the school in the autumn of 1839 and as the chief professor in 1840. He continued to serve in this office until his death in 1844. The curriculum of the Mekteb-i Tıbbiye-i Adliye-i Şahane was restructured to be similar to that of the Josephinum Military Medical-Surgical Academy. It was decided that both students studying medicine and surgery would receive the same lessons for the first three years. In accordance with changes made in the academic year of 1842–1843, preparatory classes (classes elementaires et préparatoires) were added to the medicine classes. In the academic year of 1845–1846, the duration of the program was increased from seven to ten years. In addition to physicians, other healthcare members were also trained at the school. The objective of opening the two-year pharmacy class, the three-year surgery class, which trained assistant surgeons, the midwifery class, which provided practical training for midwifes in Istanbul, and the opening of the health official class in 1846 was to meet the growing demand for medical staff.

10- The gravestone of Tokadi Hoca Mustafa Efendi, the translator of Kanun, who   translated Avicenna’s al-Kanun fi al-Tibb into Turkish for the first time during the  Ottoman period

11- Mustafa Behcet’s book titled <em>Risala al-Firangi</em> (Millet Library, Ali Emiri, Tıp, no. 221 fol. 1b-2a)

The Mekteb-i Tıbbiye-i Adliye-i Şahane was designed to introduce improvements in medical training and clinical practices. In 1841, permission was granted for students at the Mekteb-i Tıbbiye-i Adliye-i Şahane to carry out anatomy lessons and examinations on corpses of prisoners brought to the Çürüklük graveyard between Kasımpaşa and Tepebaşı. Five years later, the bodies of male and female slaves who died in the slave market were sent to the school. New medical reforms and developments in the world were brought to the school and adopted immediately. For example chloroform, introduced as an anesthetic in 1847, was used in the same year in experiments and surgery at the school.

At the Mekteb-i Tıbbiye-i Adliye-i Şahane, great importance was given to hands-on practical clinic training. Professors and their students at the school provided healthcare to the Istanbul public. In 1841, in the muayenehane-i umumi (public polyclinic), students observed and assisted physicians. Patients, Muslim and non-Muslim, male and female were examined free of charge and drugs were issued from the school pharmacy. Following the treatment of patients in houses rented close to the school, poor patients were also examined and treated in many of the pharmacies that opened in central districts—the pharmacies known as nöbet mahalleri. The polyclinics of the Mekteb-i Tıbbiye-i Adliye-i Şahane were the initiation for teaching hospitals. The pharmacies, known as ispençiyar odası, opened in various districts of Istanbul, for example, Beyazıt, Eyüp, Üsküdar, Salıpazarı and Topkapı. These served the Istanbul public day and night. Physicians from the medical school also treated and monitored patients in the Davutpaşa, Kuleli, Maltepe, Haydarpaşa and Gülhane military hospitals. In order to enhance their knowledge and learn more about hospital services, graduates from the Mekteb-i Tıbbiye were obliged to practice medicine for a year under the orders of the chief physician in one of Istanbul’s military hospitals.

The Mekteb-i Tıbbiye was the most important institution reflecting modernization in the Ottoman State. The sultan, state officials, foreign scientists and state representatives visited the school and attended graduation ceremonies, which were open to the public. Additionally, the sultan and his guests were able to put questions to candidate physicians who had completed their thesis defense. Graduates from the medical school had an education equivalent to the education of those who had graduated from European schools. On the orders of Sultan Abdülmecit, four of the new graduates from the Mekteb-i Tıbbiye-i Adliye-i Şahane entered an exam at the Vienna Medical Faculty, and passed with flying colors in 1848. In the eyes of the Europeans, the new graduates’ great achievement in Vienna was classified as an indication of the reforms made by the Ottomans. After the Mekteb-i Tıbbiye-i Adliye-i Şahane had been classified as being equal to the medical faculties in Europe, graduates who obtained diplomas from foreign countries and wanted to work in Turkey were to sit a colloquium exam from 1848 on. The diplomas of successful students were certified by the Mekteb-i Tıbbiye .

The Mekteb-i Tıbbiye-i Şahane in Galatasaray, a symbol of the Westernization process in the Ottoman Empire for Europe, was totally destroyed in a fire that broke out in Beyoğlu on October 11, 1848. The natural history, zoology, anatomy and bandage museums, the pharmacy, library and botanic gardens all were destroyed in this fire. The Mekteb-i Tıbbiye-i Şahane and its surgery and pharmacy classes moved to the Humbarahane Barracks in Halıcıoğlu. This building had been used as the Mühendishane-i Berri-i Hümayun (Imperial School of Military Engineering), and was called the Humbarahane Tıbbiyesi. In 1848, the first medical journal, Vekayi-i Tıbbiye and the French Journal Gazette Medicale de Constantinople were published and printed with the collaboration of the professors and students in the school’s printers. In addition to Turkish and foreign articles on medical science, the journal also provided health advice for the public. In 1857, the first administrative regulation for the Mekteb-i Tıbbiye was put into force as the Mekteb-i Tıbbiye-i Şahane’nin İdare-i Dahiliyesine Dair Kanunname (Law for Administration of the Imperial School of Medicine). Under this legislation, the Meclis-i Tıbbiye (Medical Council) was responsible for organizing and supervising the curriculum and exams. With the issuance of Tababet-i Belediye İcrasına Dair Nizamname (the Regulation Concerning the Municipal Practice of Medicine) in 1861, in order to practice medicine or midwifery within the Ottoman state, foreign physicians were obliged to register their diplomas with the Mekteb-i Tıbbiye-i Şahane and sit an exam.

12- The painting of Mekteb-i Tıbbiye-i Adliye-i Şahane by Süheyl Ünver

With the outbreak of cholera in Istanbul in 1865 the Humbarhane Barracks were transformed into a hospital. The medical preparatory class was moved to the Kırmızı Barracks in Topkapı, while the Mekteb-i Tıbbiye was relocated in the Gergeroğlu Mansion in Hasköy. In 1866, when the epidemic had come to an end, the school was transferred to Taşkışla in Demirkapı, Sirkeci. The Büyük Ayasofya Vakfı, opposite the Bab-i Hümayun Barracks, was transformed into a clinic/surgery where male and female patients were examined and treated separately. In accordance with the Umur-ı Sıhhiye-i Askeriye Nizamnamesi (Regulation for the Affairs of the Military Health) (1869), graduates were posted to military hospitals as senior officers. In 1870, in an attempt to provide better education and comply with the regulations, the Haydarpaşa Military Hospital was converted into a teaching hospital, and called the Haydarpaşa Tatbikat-ı Tıbbiye-i Askeriye Mektebi (Haydarpaşa School for Practical Military Medicine). During the same period (from 1869), new graduates, both Muslim and non-Muslim, were sent to Europe, mainly to Paris and Vienna, to receive education in medicine. In 1869, the administration of the Nezaret-i Umur-ı Tıbbiye-i Mülkiye ve Sıhhiye-i Umumiye (Ministry of Civilian Medical and General Health Affairs), established in 1869 in accordance with the İdare-i Tıbbiye-i Mülkiye Nizamnamesi (Regulation for the Administration of Civilian Medicine), was affiliated with the administration of the Mekteb-i Tıbbiye-i Şahane. The administration was to consult the commander-in-chief concerning issues regarding the Mekteb-i Tıbbiye-i Şahane, or the Home Office and Governor’s Office concerning civilian matters.

13- Sultan Mahmud II in Mekteb-i Tıbbiye (Süheyl Ünver)

The Demirkapı Barracks were not suitable, in terms of space or location, for expansion, or the development of the Mekteb-i Tıbbiye-i Şahane. In 1873, the school, which had been relocated in the Galatasaray building in Beyoğlu known as the Mekteb-i Sultani, returned to Demirkapı, and the preparatory class was transferred to Kuleli. During this period, the name of the school was recorded on the students’ diplomas as Mekteb-i Tıbbiye Şahane / Ecole Imperiale de Medecine-Faculte de Medicine de Constantinople.

Mekteb-i Tıbbiye-i Mulkiye-i Şahane (Imperial School of Civil Medicine)

When the military was forced to employ foreign physicians during the Crimean War (1853-1856), it was clear that the numbers of physicians was insufficient and more physicians needed to be trained in medical education in the Turkish language. In the special class opened in 1857, known as the mümtaz sınıf (select class), intelligent students from the medical school were selected. The students’ language abilities in Turkish, Arabic and Persian began to develop. In 1866, in an edict and official report made by the Meclis-i Vala (Sublime Council), the justification for establishing the Mekteb-i Tıbbiye-i Mulkiye-i Şahane (Imperial School of Civil Medicine) was that the public were forced to use European physicians at that time; however, the skills and ability of these physicians was generally insufficient to protect public health. This once again emphasized the inadequacy of the physicians who had come to Turkey from Europe. Thus, in 1866, when listing the reasons for establishing the Mekteb-i Tıbbiye-i Mulkiye-i Şahane, the “shortage of students trained in this art” is clearly emphasized. When necessary, foreign physicians were occasionally appointed to the military administration. In the provinces doctors were few, and foreign doctors who treated the civilians were not sufficiently experienced. In view of this, it was decided to train “district physicians” at the Mekteb-i Tıbbiye-i Mulkiye-i Şahane to serve in the provinces.

As it proved difficult to switch education at the Mekteb-i Tıbbiye-i Adliye-i Şahane, where a majority of the teachers were foreign, into Turkish, in 1866 the Mekteb-i Tıbbiye-i Mülkiye-i Şahane / Ecole Imperiale Civile de Medecine was opened, and in 1867 medicine began to be taught in Turkish in a separate class at the Mekteb-i Tıbbiye-i Adliye-i Şahane. The first director of this school was Kırımlı Aziz Bey, one of the students of the mümtaz sınıf. The education at the Mekteb-i Tıbbiye-i Mülkiye-i Şahane was also under the control of the military medical school and was administered by a director from this school. Teachers generally taught in both schools. Clinical training was provided at the Gureba Hospital. In an attempt to increase interest in the Mekteb-i Tıbbiye-i Mülkiye-i Şahane, students who came from the provinces were granted exemption from military service and doctorate exams. However, it was compulsory for graduates to serve as physicians within the state for five years. Following the success of medical education in Turkish, in 1870 instruction began in Turkish from the first class of the Imperial School of Medicine, which trained physicians for the military. During the last quarter of the nineteenth century, translations of Western medical works, often from carefully selected texts, were made; this introduced important contemporary developments into Ottoman medicine.

14- Mekteb-i Tıbbiye-i Adliye-i Şahane in Haydarpaşa (Istanbul Metropolitan Municipality, Atatürk Library)

In 1870, when interest in the school increased, an extra year was added to the five-year course. Doctorate exams were made compulsory. The addition of the preparatory class increased education to seven years. As the numbers of students increased, the Mekteb-i Tıbbiye-i Mülkiye-i Şahane and its clinics moved to a new building that had been constructed in the grounds of the building previously used as a hospital in Ahırkapı (1874). In 1879, the administration of the Mekteb-i Tıbbiye-i Mülkiye-i Şahane was affiliated with the Ministry of Education. However, the school’s curriculum remained under control of the administration of the Imperial Medical School. In 1880, the Mekteb-i Tıbbiye-i Mülkiye-i Şahane published a journal called Vekayi-i Tıbbiye. Due to the inadequacy of the school’s clinic, in 1881 students began a one-year training course at the Bezmialem Gureba Hospital. As animal diseases became increasingly damaging to the national economy, in 1888 a veterinary class was opened in the Mekteb-i Tıbbiye-i Mülkiye-i Şahane where Pasteur’s methods of vaccination and veterinary medicine were taught.

When the numbers of students at the Mekteb-i Tıbbiye-i Mülkiye-i Şahane continued to increase, reaching as many as five hundred, the site at Ahırkapı proved inadequate for the increasing demand. During Abdülhamid II’s reign, (1892), the Menemenli Mustafa Pasha Mansion on Kadırga Square was purchased, and pavilions were constructed in the mansion’s grounds to house the clinics. The Mekteb-i Tıbbiye-i Mülkiye-i Şahane continued to operate in this building from 1893 until it moved to Haydarpaşa.

Graduates were sent to various provinces as government physicians. Over a period of time, claiming that the compulsory physician posts in rural areas were only for those who came from the provinces, graduates from Istanbul refused to work at the allocated posts. Consequently, a decree was issued in 1893 stating that students from Istanbul who were accepted at the school were to sign a document stating that they agreed to work as a physician in the provinces after graduation, and that the diplomas of those who did not comply with this agreement would be repealed. In time, when non-Muslims attending the school were in the majority and Muslims students in minority, lessons in Islamic law and practices were added to the curriculum (1898). Under a student directive issued in 1900, students who failed to pass a written French exam had to take French lessons.

Haydarpaşa Tatbikat-ı Tıbbiye-i Askeriye Mektebi (Haydarpaşa School for Military Practical Medicine)/ Haydarpaşa Hastanesi Ameliyat Mektebi (Haydarpaşa Hospital Surgery School)

In accordance with the Umur-u Sıhhiye-i Askeriye Nizamnamesi (Regulation for the Affairs of military health), issued in 1869, in order to ensure that graduates of the medical school received practical training, in 1870 the Haydarpaşa Military Hospital was transformed into a teaching hospital and was given the name Haydarpaşa Tatbikat-ı Tıbbiye-i Askeriye Mektebi. Under the same regulation, the ranks given to graduates of the medical school according to their grades were converted into military ranks. Therefore, the medical school, a civilian school that had trained physicians for the military, was transformed into a military medical school. Physicians and surgeons who graduated were awarded the ranks of captain, while pharmacy graduates were ranked as first lieutenants; both types of graduates were sent to the Haydarpaşa Military Hospital and following two years of practical training sat an exam. Those who achieved a certificate of competency were posted to battalions and hospitals. Clinical training was divided into four branches: internal medicine, surgery, ophthalmology and dermatology. In 1872, selected physicians who had completed their training and received a diploma were sent to Vienna or Paris to study for a postgraduate degree. During Abdülhamid II’s reign, the relations between the Ottoman State and Germany improved. In 1889, graduates were sent to Berlin to study for a postgraduate degree. After the Gülhane Seririyat Hastanesi ve Tatbikat Mektebi was opened in 1898, practical training in the Haydarpaşa Hospital came to an end.

Haydarpaşa Hastanesi Cerrah Dershanesi (Haydarpaşa Hospital School of Surgery)

In 1870, before education started to be given in Turkish, those who were unsuccessful in French at the Imperial School of Medicine were transferred to the pharmacy and surgery classes. Following the introduction of Turkish education, there was also a decrease in enrollments in the pharmacy and surgery classes, resulting in a shortage of surgeons at a time when there was a huge demand for surgeons in the military. In 1873, a school known as Cerrah Dershanesi (school of surgery) opened. According to the school’s regulations, salaried students were to be trained in Haydarpaşa Hospital for three years (later increased to four years), serve in other hospitals and remain on-call at all times. They were only allowed to go home once a week. Surgeons who were not included in the military had no right to reject the posts they were assigned after graduation.

Specialization in Medical Education, Pharmacy, and Elementary School for Military Training in the Kasımpaşa Naval Hospital

From 1882, specialization branches were opened in the Bahriye Merkez Hastanesi (Naval Central Hospital), located in the Sakızağacı district of Kasımpaşa. Clinics were divided into surgery, ophthalmology, dermatology and syphilitic disease clinics. A bacteriology laboratory was also opened. As from 1885, military physicians who graduated from the Mekteb-Tıbbiye and who wanted to serve in the navy had to sit an exam and train at the naval hospital for two years. They would only be accepted into the navy after completing this training. In order to train assistant pharmacists and surgeons the Eczacı ve Tımarcı Sıbyan Mektebi (Elementary School of Pharmacy and Military training) was opened in 1897. In 1917, a medical training course was opened in an attempt to meet the demand for health personnel during the wartime. Physicians of the hospital were sent to America from 1955 to receive underwater and diving training. In 1957 the Deniz Sıhhıye Astsubay Okulu (Naval Officers’ Medical School) and Yardımcı Hemşire Kursları (Assistant Nurse Courses) were opened in the hospital. Today the hospital still functions as the Kasımpaşa Military Hospital.

Gülhane Tatbikat Mektebi ve Seririyat Hastanesi (Gülhane Clinical Teaching Hospital and School of Medical Practice)

Abdülhamid II wanted medical teaching to be given at the highest standards. Dr. Robert Rieder, who was invited to Turkey from Germany to reform the medical school in 1898, was appointed as the mekatib-i tıbbiye-i şahane müfettişi ve seririyat-ı hariciye ve dahiliye muallimi (inspector of the medical school and professor of surgery and internal medicine). When Dr. Rieder, who ran the medical school, suggested the establishment of a new teaching hospital, the building of the Gülhane Military High School, which still stands today in Gülhane Park, underwent repairs and renovation, and was transformed into a hospital with a 150-bed capacity. On December 30, 1898, after the opening of the Gülhane Tatbikat Mektebi ve Seririyat Hastanesi, graduates from the Mekteb-i Tıbbiye were trained here to develop their experience and skills. In 1899, Dr. Rieder was appointed as the head of the Gülhane Seririyat Mektebi, a teaching school for the School of Medicine. He claimed that in order to be successful in surgical operations it was necessary to perform autopsies on corpses at the Gülhane Tatbikat Mektebi as was done at medical schools in Germany. For physicians to gain skills and be successful in operating on patients, it was necessary to train them by carrying out surgery on unclaimed corpses who died in the Gureba Hospital and public prisons. In order to verify the diagnosis of a patient, it was essential that autopsies be carried out on corpses. In the Gülhane Hospital, training was based on bedside practice. Soldiers received training for nursing care. In addition, nuns who came from Germany worked as nurses in the hospital until 1932.

15- The 1910 graduates of Medical School (<em>Şehbal</em>)

Successful students from the first graduates of Gülhane were sent to Germany. Süleyman Numan, Ziya Nuri, Asaf Derviş, Kerim Sebati and Eşref Ruşen Begs, who were sent to Germany in 1894, were appointed as lecturers in the Gülhane Hospital upon their return. In later years, some of the students who had completed their training were sent to Germany to study in a specialized field in order to increase their knowledge and experience.

Taking advantage of the new developments that came with the reforms of the Second Constitutional Period, Dr. Julius Weiting (Pasha), the director of Gülhane at that period, applied to the War Ministry and had the Gülhane Tatbikat Mektebi ve Seririyat Hastanesi transformed into an independent medical school. During the Balkan War and World War I, the school served as a military hospital and became better known as the Gülhane Tababet-i Askeriye ve Tatbikat Mektebi. In 1912, at a time when the cause of typhus was still unknown, Reşad Rıza (1877-1941) prepared a vaccination against the typhus parasite. During the World War I, a significant number of physicians and assistants were sent to the battlefront. When the French occupied the building in Gülhane in 1918, the institution continued to operate from the Gümüşsuyu Military Hospital, returning to Gülhane in 1923. The school, which moved to the Cebeci District Hospital in Ankara in 1941 due to inadequate space and facilities, was renamed the Gülhane Askeri Tıp Akademisi – GATA (Gülhane Military Medical Academy) in 1947. In 1980, the Gülhane Military Medical Faculty and the Gülhane Teaching Hospital were separated. GATA’s second teaching hospital began operating in Istanbul in 1985 in the Haydarpaşa Military Hospital as the Gülhane Askeri Tıp Akademisi Haydarpaşa Eğitim Hastanesi (Gülhane Military Medical Academy’s Haydarpaşa Teaching Hospital).

The Mekteb-i Tıbbiye-i Şahane Moves to Haydarpaşa

The students of the Military Medical School who were sent to study in Europe began to acquire political views. On their return to Turkey, they participated in political activities and formed an opposition against Abdülhamid II’s regime. The founders of the İttihat ve Terakki Cemiyeti (Committee of Union and Progress), who in time became influential in the affairs of the Ottoman State, were in fact students from the medical school. A short while after Abdülhamid came to the throne, when the Kanun-i Esasi (Ottoman Constitution) was suspended and the Meclis-i Mebusan (Parliament) was dissolved, opposition within the military medical school increased. Sultan Abdülhamid II wanted to eliminate this movement; he had the Mekteb-i Tıbbiye-i Şahane, which was affiliated with the Bab-ı Seraskeri (Office of the Commander-in-chief), transferred to the Umum Mekatib-i Askeriye-i Şahane Nezareti (the Directorate of all Administrative Offices). All military schools were combined under a single directorship in 1892. Zeki Pasha, the commander of Tophane, was appointed as the director. In addition to the unrest caused by the medical school students, due to the inadequacy of the Mekteb-i Tıbbiye-i Şahane buildings and grounds in Demirkapı, the issue of moving to Haydarpaşa, a location still undeveloped at that time, came onto the agenda. In 1895, it was decided that a new building would be constructed to house the Haydarpaşa Military Medical School. This would be constructed on a large plot of land adjacent to the Haydarpaşa Military Hospital. The plans for the building of the new medical school were designed and prepared by a committee consisting of the architects Alexandre Valluary and Raimonde D’Aranco, and military engineers. On February 14, 1898, Prof. Dr. Robert Rieder was invited from Germany to supervise the construction and improve education in the Mekteb-i Tıbbiye-i Şahane. In the same year, he was appointed as director and professor at the school. Although the construction, which began in 1895, was completed in 1900, because the furnishings and equipment were incomplete, the opening of the new building of the Mekteb-i Tıbbiye-i Şahane and the start of education at the school only began in 1903. Any shortcomings were to be resolved at a later date.

16- The staff of Medical school in 1910: “Those standing in the first row from right to left Assistant Doctor Fikret Tahir Bey, Doctor Mahmud Ata Bey, Doctor Adnan Bey,
    Doctor Hikmet Bey, Assistant Doctor Burhan Bey, Assistant Doctor Yahya Bey. Those sitting on the left from right Assistant Doctor Emin Bey, Assistant Doctor İpokrat? Bey.
    Those standing in the back from right Assistant Doctor İshak Efendi, Assistant Doctor Sabri Bey, Assistant Doctor Ruber Efendi, Assistant Doctor Ali Mazhar Bey, Assistant
    Doctor Fuad Bey, Assistant Doctor Tevfik Bey, Assistant Doctor Sufugli? Bey, Assistant Doctor Hazım Bey.” (Şehbal))

17- The building which used to be School of Pharmacy and Dental School and currently is part of Beyazıt State Library

The Haydarpaşa Mekteb-i Tıbbiye-i Şahane, with its spacious rooms (classrooms, lecture halls and theatres, laboratories, dormitories, dining room, service buildings, kitchen, storerooms, laundry and baths), modern clinics (clinical hospital), the most modern medical equipment and supplies, substantial library and competent teaching staff achieved the standards of leading medical schools in Europe.

Construction of the medical school and clinics aroused the matter of developing the surrounding areas. The wide road known as Tıbbiye Avenue, which passed between the medical school and the clinics, was set out in accordance with the foundations of the two buildings. The roads around the Haydarpaşa Port, Üsküdar, Karacaahment and Selimiye were all renovated, taking the conditions of the patients into consideration.

Even today, the building of the Mekteb-i Tıbbiye-i Şahane built by Sultan Abdülhamid II in Haydarpaşa adds an elegant splendor to the skyline of Üsküdar. At the present time, the medical school is being used by Marmara University, while the clinical buildings of the teaching hospital are used by the Numune Hospital.

The Faculty of Medicine of the Darülfünun-ı Osmani (Ottoman University)

On July 24, 1908, following the declaration of the Second Constitutional Period, it was suggested by a joint commission that as there was no need for two separate medical schools in Istanbul the schools should be combined. However, it was understood that if this was done, many of the professors from the teaching staff would have to be dismissed. Professors and assistants at the Mekteb-i Tıbbiye-i Şahane came together in an attempt to improve the school and eliminate any shortcomings, making an appeal to the Ministry of War. However, the Mekteb-i Tıbbiye-i Mülkiye became a part of the the Darülfünun-ı Şahane in 1900 in accordance with the Darüfünun Nizamnamesi (Regulation for the University). However, upon the application of the professors of the school, the minister of education brought the two civilian schools—the Mekteb-i Tıbbiye-i Mülkiye and the Şam Mekteb-i Tıbbiye-i Mülkiyesi, which had opened in 1903—under the control of the ministry of education. On October 24, 1908, the Mekteb-i Tıbbiye-i Mülkiye officially became a branch of the Darülfünun-ı Osmani, and became known as the Darülfünun Medical Faculty. Eventually, in 1909, when the minister of finance transferred the funds for the military medical school to the medical faculty, the military school was joined to the Darülfünun Medical Faculty; they were officially merged as the Darülfünün-ı Osmani Faculty of Medicine. Although some of the professors from the military and civilian medical schools were assigned to the medical faculty, many remained unemployed. During this period, the school building in Haydarpaşa, its laboratories and clinics were completed and equipped to the highest standards, equivalent to European medical schools. Both military and civilian students were accepted at the medical faculty and attended classes together. However, a separate directive was issued for military students, similar to that in operation at the Lyon Military Medical School in France. A separate military medical school administration was established within the faculty.

Intern military medical students were affiliated to the military medical school administration. When the military and civilian medical schools had been combined under the Darülfünun to form a medical faculty, the pharmacy classes from both schools were also combined, thus establishing the Darülfünun-ı Osmani Tıp Fakültesi Eczacı ve Dişçi ve Kabile (Ebelik) Hastabakıcı Mektepleri (The Faculty of Medicine’s Schools of Pharmacy, Dentistry, Midwifery and Nursing). Instruction began in the building of the Tıbbiye-i Mülkiye in Kadırga, which had become vacant with the move to Haydarpaşa. In 1909 a new practice was implemented. The medical students were sent to Hamidiye Etfal Hospital to be trained in pediatric diseases and graduates were sent to work for a year, without pay, at the Haseki Hospital for Woman and the Etfal and Gureba Hospitals to develop their clinic practice.

18- Istanbul University Medical School

Instructors and students from the medical faculty were involved in the political disturbances and campaigns of that period. The students of the Askeri Tıbbiye attempted to form a union, but were unable to do this on their own. As a result, on July 3, 1911 the Türk Ocağı (Turkish Hearth) was formed. Members of the medical faculty provided medical and social assistance during the Turkish-Italian War, the Balkan Wars, World War I and the War of Turkish Independence. In addition to treating the wounded in battles, the professors of the faculty, who were the leading administrators of the Osmanlı Hilal-i Ahmer Cemiyeti (Ottoman Association of Red Crescent), were also at the forefront in providing social services to immigrants and to the poor. Professors at the Darülfünun who were administrators of the Red Crescent not only formed and managed the association, but were also pioneers in establishing connections with the state, the palace, the military and other health and social institutions, and local and foreign media and international institutes. They represented the society at meetings abroad. Professors from the medical faculty played important roles in bringing together Ottoman intellectuals and the public via the Red Crescent, the oldest non-governmental organization in the Ottoman period.

At the beginning of the Balkan Wars, Besim Ömer Bey, the head professor of the Darülfünun’s Seririyat-ı Viladiye (Maternity Clinic) and deputy chief of the Red Crescent transformed the maternity clinic into a hundred-bed hospital known as the Hilal-i Ahmer Hospital. This hospital opened on October 23, 1912. Due to the high numbers of injured who came to Istanbul during the Balkan Wars, the Darülfünun-ı Osmani was temporarily closed and on October 31, 1912 the Red Crescent Society transformed the Darülfünun building into a hospital (Darülfünun Hospital), giving support by deploying personnel to the hospital. The Sirkeci Sevk-i Zuafa ve Mecruhin Komisyonu (Sirkeci Commission for Dispatching the Ill and Wounded) sent prisoners of war and wounded soldiers to the medical faculty and Darülfünun hospitals. Some of the leading professors who served in the Ottoman Red Crescent Society, as well as students, nurses and employees from the medical school remained in Istanbul, while others served in various Red Crescent Societies and hospitals in the Anatolian region or remote provinces. During World War I, many of the professors, assistants and clinical chiefs, some nurses and employees of the medical faculty and a large number of higher grade students from the faculty of medicine were deployed to the military units and provided medical services to the military. At the end of 1914, the faculty of medicine hospital was transformed into the Tıp Fakültesi Askeri İhtiyat / Yedek Asker Hastanesi (Medical Faculty Hospital for Military Reserves). It provided services as the Mecruhin / Yaralılar Hastanesi (Hospital for the Wounded). As many of the students from the medical faculty, including students from the schools of pharmacy and dentistry, were drafted into the army as sergeants and non-commissioned sergeants, being assigned to the military and Red Crescent hospitals by the Ministry of War, classes at the medical faculty were suspended in 1915. A large number of medical students died during combat or due to epidemics.

During World War I, between 1913 and 1915, nursing courses were given to women in Istanbul under the auspices of the Red Crescent Society at the Darülfünun conference hall; these were led by Professor Dr. Besim Ömer. The Medical Faculty, in cooperation with the Red Crescent Society, contributed greatly to training women as nurses, thus enabling them to take their place in the professional community. In 1916, under war conditions the Istanbul Darülfünun Tıp Fakültesi Mecmuası was the first journal to be published. Today, the journal continues to be published as the İstanbul Üniversitesi Tıp Fakültesi Mecmuası (Journal of Istanbul University’s Faculty of Medicine).

Students who survived the war returned to the school. Students who had been drafted into the army were excused and granted the right to retake exams. As a result of the events that occurred in the Ottoman Darülfünun following the invasion of Istanbul by the allied states, instruction in the school was suspended for some time. During the truce period, the English accused professors Süleyman Numan and Esat Işık Pasha from the Darülfünun of war crimes and exiled them to Malta. Certain professorships and classes were abolished and many personnel and professors were dismissed. In 1920, four physicians from the French Occupation Army were appointed as professors at the medical faculty. Between 1919 and 1920, the invading forces reduced the numbers of students enrolled at the military medical school to twenty. The British occupied the medical faculty building in Haydarpaşa (February 3, 1919). Teachers and students from the Darülfünun medical faculty joined the War of Independence against the occupational forces, who were imposing a number of restrictions on the students. The students of the Medical Faculty, who organized demonstrations against the invading forces in Istanbul and their oppression, began celebrating Doctors/Medical Day on March 14.

In 1922, after long arguments, with the support of Besim Ömer Pasha, the chief official of the Darülfünun, the medical faculty began to accept female students.

The Department of Medicine in Istanbul College for Women

The medical school that was planned to be established within the Istanbul (American) College for Girls was opened as the Department of Medicine, Constantinople College for Women during the time of truce in 1920. The school’s curriculum was planned based on education offered at Columbia University, College of Physicians and Surgeons in New York. A building was constructed for the medical school on the grounds of the college’s campus and was called Bingham Hall. The following year Turkish students were enrolled at the school. Initially, instruction began with nineteen Russian and Bulgarian students. Although this was the first medical school to accept female students in Turkey, when the Istanbul Darülfünun medical faculty began to accept female students in 1922, some students transferred here. When the Tevhid-i Tedrisat Kanunu (Law for the Unity of Education) came into force in 1924, medical education was abolished by the schools’ board of trustees. At the present time, the school building is used as a dormitory for male students from Robert College.

THE REPUBLICAN ERA

İstanbul Darülfünunu Tıp Fakültesi (Istanbul University Faculty of Medicine)

When Ankara became the capital of the Republican government, the Ministry of War in Istanbul was abolished. On October 15, 1923, the building was allocated to the Darülfünün (Istanbul University). In 1926, the pharmacy and dentistry schools that were affiliated with the Faculty of Medicine moved from Menemenli Mustafa Pasha Mansion in Kadırga to the former gendarme command post in Beyazıt. The Republican government reserved a majority of the university’s funds for the Faculty of Medicine. Great importance was given to the relationship between the Darülfünun and European universities. Exchange visits were organized abroad for both students and teachers, and a budget was reserved for attending congresses and university conventions abroad. Incentives were provided for scientific research, for example, funds were allocated for study trips, the publication of scientific studies and purchasing books for the library.

On September 4, 1924, amendments were added to the Istanbul University regulations, and changes were made to education and teaching at the Faculty of Medicine. Education at the faculty was reduced from five to four years. Regulations were introduced regarding the enrollment of students at the Faculty of Medicine. Students were to enter individual PCN (physics, chemistry, natural sciences) exams, both theoretical and practical, as part of physics, chemistry and biology (animal and botanic) classes at the faculty of science. Research centers and institutes affiliated with the Faculty of Medicine were set up. In 1924 the Türkiye Antropoloji Tetkikat Merkezi (Center for Anthropological Research) was opened in the Faculty of Medicine. From 1925, the Journal of Turkish Anthropology / Revue Turque d’Anthropologie was published in Turkish and French. A cancer institute was established in 1927 by developing the cancer department that had been set up in the pathology anatomy laboratory in 1925 by Dr. Hamdi Suat (Aknar), professor in pathologic anatomy. Finally, the Physiology Institute was formed in collaboration with Kemal Cenap (Berksoy) (1931).

The location of the Faculty of Medicine on the Anatolian side of Istanbul had been a topic of dispute since the Ottoman period. The question of moving the school from Haydarpaşa back to the European side continued to be discussed. Supporters of the move pointed out that Haydarpaşa was a long way from the city center, that the majority of professors of the Faculty of Medicine lived on the European side and that due to the distance of the faculty building the teachers would be unable to attend classes on a regular basis and patients were unable to go to the hospital. Finally, the the Faculty of Medicine hospital was inadequate in terms of patients and clinical training in a variety of diseases. According to those who opposed the move, they stated that although it would be more beneficial for the faculties to be in the vicinity of the university in Beyazıt, it would be difficult to find a location adequate to house the Faculty of Medicine, and to transport the laboratory, clinic equipment and supplies undamaged. They argued that there were many physicians that could provide clinical training in Istanbul city hospitals. At the end of 1924, the Faculty of Medicine’s two senior classes were sent for training to the Gureba, Cerrahpaşa and Haseki Hospitals, but if training in the Faculty of Medicine was to be held on both the European and Anatolian sides of the city this would be difficult for the students. Irreconcilable differences occurred between the now unwelcome professors at the Faculty of Medicine and the physicians of the city hospitals. On the decision of the TBMM (Turkish Parliament), the Faculty of Medicine returned to Haydarpaşa in 1925. In 1930, once again the issue of moving the Faculty of Medicine to the European side of Istanbul came onto the agenda. Believing that the Darülfünun would not be able to make internal reforms, the decision was made to invite a professor from Europe. Professor Malche, who was invited to Turkey to reorganize the university, stated that there were skilled, competent and hardworking doctors at the Faculty of Medicine, that their skills were extremely good, and that the faculty produced good doctors. However, he also said that students were not treating an adequate variation of patients in the Haydarpaşa Hospital and suggested that students should benefit from the city hospitals by moving them to the European side of Istanbul. Dr. Reşit Galib, the minister of education, also supported the move of the Faculty of Medicine. In the academic year of 1932–1933, the senior class students of the Faculty of Medicine completed their internship in hospitals on the European side of the city.

Istanbul University Faculty of Medicine

During the first years of the Republic, the Darülfünun was heavily criticized. There were claims that the majority of the teachers were not publishing enough, did not attend international activities in science and worked in various other positions outside the university, thus not working a full day. Many of the teachers at the Darülfünun when the Republic was established were individuals who had been educated and trained abroad. Since 1924, after passing an exam, students were sent to Europe on a regular basis, and the students who completed their studies were employed at the university upon their return. However, when those who studied abroad returned to Turkey, there were arguments that because these physicians worked like civil servants they were not very successful. Albert Malche, Professor of Pedagogy at Geneva University in Switzerland, was assigned as a consultant to reorganize the Darülfünun. On September 19, 1932, like Dr. Reşit Galib, the minister of education, Malche also supported having fewer lecturers and providing better conditions for those who continued to work at the university. In the legislation, dated to March 13, 1933, the reorganization and reforms which had come into effect led to the closure of the Darülfünun. On May 3, 1933, in keeping with Law No. 2252 regarding the Istanbul Darülfünunu’nun İlgasına ve Maarif Vekaleti’nce Yeni Bir Üniversite Kurulmasına Dair Kanun (Law Regarding the Abolition of the Istanbul Darülfünun and the Establishment of a New University by the Ministry of Education), the Istanbul Darülfünun was closed. On August 1, the minister of education was appointed to establish a new university that was to be known as Istanbul University. In conjunction with this law, the Darülfünun and its institutions, codes and regulations were also abolished; the entire teaching staff was suspended from their duties. The reform committee, which was to decide whether or not professors and teachers were to be appointed as members of staff at the university, made this decision according to the instructors’ academic qualifications; it was formed under the chairmanship of Professor Malche, the consultant of Reforms.

With the support of Dr. Reşit Galib, the Faculty of Medicine moved to the European side of Istanbul in 1933. The Faculty of Medicine in the Istanbul Darülfünun, which moved from Haydarpaşa to the building, which had formerly housed the ministry of war, was now called the Istanbul University Faculty of Medicine. There was a considerable distance between the former ministry of war and the Bekirağa Barracks, which had been allocated to the Faculty of Medicine, and the ministry of health, municipality and waqf hospitals that were to be used for clinical training. The students continuously travelled between the main building in Beyazıt and the Şişli Etfal, Vakıf Gureba, Haseki Nisa, Cerrahpaşa and Bakırköy Emraz-ı Akliye hospitals.

The empty building of the Faculty of Medicine was handed over to Haydarpaşa High School, and its clinics were given to the Numune Hospital. Repercussions of the move were extremely severe. The Faculty of Medicine, which constituted a single body with its large laboratories, dissection rooms, anatomy, physiology and surgical theatres, museums, print shop and clinics, was dispersed. A majority of the equipment and furnishing of the Faculty of Medicine and its clinics in Haydarpaşa, which was established with immense effort and a large budget, was abandoned due to lack of space and damage. Various fixtures and plumbing, installed with great care and at a high cost, were torn out and thrown away in the renovation of the building so that it could house the Haydarpaşa High School. Due to lack of space in the Numune Hospital, which had replaced the clinics of the Faculty of Medicine, the building lost many of its historical features. The Cemil Pasha lecture room in the External Disease Clinic was demolished. The majority of the portable fixtures and fittings from the building were not preserved. The Faculty of Medicine, which had school and clinics located over a vast area in Haydarpaşa, were distributed among many hospitals in various districts on the European side of Istanbul and clinical training was provided in different hospitals. However, the Faculty of Medicine became totally dependent on the hospitals. Eventually, the basic and clinical medical training was separated. After the distribution of the Faculty of Medicine to various hospitals on the European side of Istanbul, it took many years and unnecessary expense to reassemble and reequip all the clinics of the Faculty of Medicine.

During the same period, the National Socialist Party, which came to power in Germany (1933), began to suspend scientists of Jewish descent from the universities. The foundations to appoint the professors who had been dismissed from German universities to Istanbul University were prepared, and the government invited the German scientists who were in conflict with the regime. German professors classified as refugees were appointed as heads of most of the newly reformed clinics and institutes. Among the refugees there were also scientists of Austrian, Czech and Hungarian descent. Some of these refugees went to the United States after a short stay in Turkey, while others returned to their country after the war. A few of the scientists, such as Erich Frank and Siegfried Oberndorfer, learnt Turkish and remained in Turkey for the remainder of their lives. Erich Frank made huge contributions to medicine in the treatment of diabetes and hypertonia, Friedrich Dessauer in the field of radiology and Rudolf Nissen in chest surgery.

From 1950 onwards, some of the clinics began to come together in the hospitals, which were relatively close to one another. The land tracts where the buildings of the Faculty of Medicine in Çapa were purchased from the directorate of waqfs in 1966 and became the property of Istanbul University. By dividing the personnel and locations of the Istanbul University medical faculty in 1967, these continued to operate as two separate faculties, one with the clinics in Cerrahpaşa Hospital, known as Cerrahpaşa Faculty of Medicine and the other with the clinics in Çapa, known as Istanbul Faculty of Medicine.

Istanbul University contributed to the establishment of Ege University’s Faculty of Medicine in Izmir in 1955, the Uludağ University’s Faculty of Medicine in Bursa in 1970 and the Trakya University’s Faculty of Medicine in Edirne in 1974.

Medical Schools in Istanbul

  1. Istanbul University: Istanbul Faculty of Medicine (1827 Çapa-Fatih)
  2. Istanbul Cerrahpaşa University Faculty of Medicine (1867 Cerrahpaşa-Fatih)
  3. Marmara University Faculty of Medicine (1883 Üsküdar)
  4. Koç University Faculty of Medicine (1993 Sarıyer)
  5. Yeditepe University Faculty of Medicine (1996 Bostancı)
  6. Maltepe University Faculty of Medicine (1997 Maltepe)
  7. Demiroğlu Bilim University Faculty of Medicine (2006 Şişli)
  8. Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine (2007 Maltepe)
  9. Medipol University Faculty of Medicine (2009 Fatih)
  10. Istanbul Medeniyet University Faculty of Medicine (2010 Göztepe-Kadıköy)
  11. Bezm-i Alem Vakıf University Faculty of Medicine (2010 Fatih)
  12. Istanbul Yeni Yüzyıl University Faculty of Medicine (2010 Zeytinburnu)
  13. Altınbaş University Faculty of Medicine (2013 Bakırköy)
  14. Istanbul Okan University Faculty of Medicine (2013 Tuzla)
  15. Bahçeşehir University Faculty of Medicine (2013 Kadıköy)
  16. Biruni University Faculty of Medicine (2014 Zeytinburnu)
  17. Haliç University Faculty of Medicine (2014 Beyoğlu)
  18. İstinye University Faculty of Medicine (2015 Zeytinburnu)
  19. Istanbul Aydın University Faculty of Medicine (2015 Küçük Çekmece)
  20. Beykent University Faculty of Medicine (2017 Büyük Çekmece)
  21. Sağlık Bilimleri University Faculty of Medicine (2018 Üsküdar)

BIBLIOGRAPHY

Bayat, Ali Haydar, Osmanlı Devletinde Hekimbaşılık Kurumu ve Hekimbaşılar, Ankara: Atatürk Kültür Merkezi Yayınları, 1999.

Besim Ömer [Akalın], “Mekteb-i Tıbbiye-i Mülkiye-i Şahane”, Nevsâl-i Âfiyet, 1316 (1900), vol. 2, p. 125.

Dölen, Emre, Türkiye Üniversite Tarihi, Istanbul: İstanbul Bilgi Üniversitesi Yayınları, 2010, vol. 2-4.

Ergin, Osman, İstanbul Tıp Mektepleri, Enstitüleri ve Cemiyetleri, Istanbul: İstanbul Üniversitesi Yayınları, 1940.

Eyice, Semavi, “Bizans Devrinde İstanbul’da Tababet, Hekimler ve Sağlık Tesisleri”, İstanbul Üniversitesi Tıp Fakültesi Mecmuası, vol. 21, no. 3 (1958), pp. 657-691.

Galip Ata, İstanbul Darülfünûnu Tıp Fakültesi, Istanbul: Yeni Matbaa, 1341 (1925).

Manizade, Derviş, 65 Yıllık Cerrahpaşa Hastanesi, Istanbul: Matematik Araştırma Enstitüsü Baskı Atölyesi, 1976.

Meriç, Rıfkı Melul, “Osmanlı Tabâbeti Tarihine Ait Vesikalar I, Cerrâhlar-Kehhâller”, Tarih Vesikaları, 1955, vol. 1, no. 1 (16), pp. 27-113; 1958, vol. 1, no. 2 (17), pp. 266-293.

Rıza Tahsin, Mir’ât-ı Mekteb-i Tıbbiye, II vol., Istanbul: Kader Matbaası, 1328/1912.

Sarı, Nil, “Mekteb-i Tıbbiye (1827-1909)”, Kuruluşundan Günümüze Cerrahpaşa Tıp Fakültesi (1827-1967-2007), ed. Nil Sarı, Zuhal Özaydın and Burhan Akgün, Istanbul: Nobel Tıp kitabevleri, 2009, pp. 7-28.

Sarı, Nil, “Osmanlı Darüşşifalarına Tayin Edilecek Görevlilerde Aranan Nitelikler”, Yeni Tıp Tarihi Araştırmaları, no. 1 (1995), pp. 11-54.

Sarı, Nil, “Osmanlılarda Tıphane’nin Kuruluşuna Kadar Tıp Eğitimi”, Türk Dünyası Araştırmaları, no. 22 (1983), pp. 152-182.

Unat, Ekrem Kadri ve Mustafa Samastı, Mekteb-i Tıbbiye-i Mülkiye (Sivil Tıp Mektebi 1867-1909), Istanbul: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, 1990.

Yıldırım, Nuran, İstanbul’un Sağlık Tarihi, Istanbul: İstanbul Üniversitesi and İstanbul 2010 Avrupa Kültür Başkenti Ajansı, 2010.


This article was translated from Turkish version of History of Istanbul with some editions to be published in a digitalized form in 2019.

SUBTITLES