Medicine in Practice: European Influences on the Ottoman Medical Habitat

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Ebru Boyar Middle East Technical University, Ankara [email protected]

Abstract

This article considers the transfer of medical knowledge from Europe to the Ottoman empire and argues that what was significant in such transfer was medical practice rather than textual transfer, that the Ottomans were open to adopting medical knowledge from the non-Islamic world, the deciding factor being not the origin but the successful nature of the treatment, and that if there was a border which medical knowledge did not traverse, it was one created by everyday custom not by any Muslim/Christian divide or rejection of knowledge from outside.

Keywords

Ottoman medicine – syphilis – plague – Paracelsus – Galenic medicine – transfer of knowledge – Jewish physicians

Traditionally Ottoman medicine has tended to be defined as Islamic by scholars in the field,1 who have also argued that ‘true’ European influence can only be found from the seventeenth century onwards. Bedi Şehsuvaroğlu, who

1 Uludağ, Osman Şevki, Osmanlılar Devrinde Türk Hekimliği, ed. Esin Kahya (Ankara: Türk Tarih Kurumu Basımevi, 2010), pp. 115 and 119; Adıvar, Abdülhak Adnan, Osmanlı Türklerinde İlim (Istanbul: Maarif Matbaası, 1943), passim; Şehsuvaroğlu, Bedi N., “Anadolu Türklerinde Eczacılık Öğretimine Bir Bakış ve İstanbul Eczacılık Fakültesi”, İstanbul Üniversitesi Eczacılık Fakültesi Mecmuası, 1/1 (1965), p. 91; Ağırakça, Ahmet, “Osmanlı Tıbbının Kaynakları”, in Osmanlılarda Sağlık i, ed. Coşkun Yılmaz and Necdet Yılmaz (Istanbul: Esen Ofset, 2006), p. 151.

214 Boyar has published much on this subject, has argued that Ottoman medicine was a continuation of Seljuk medicine, which he described as “Islamic, oriental and scholastic”, and that Ottoman medicine only “came into true contact with the West” in the seventeenth century. According to Şehsuvaroğlu, in the period before the seventeenth century, Ottoman medical relations with Europe were limited and were only possible thanks to doctors coming from Europe to Anatolia. With the increase of knowledge of languages including Latin, French and Italian among Ottoman doctors in the seventeenth century, con- tacts with Europe took on a “more definite character” beginning initially with the exchange of medicines and then expanding with the translation of medical works.2 Other scholars have followed Şehsuvaroğlu, Nil Sarı, for example, claiming that Ottoman medicine was until the seventeenth century “charac- teristically Islamic”.3 For Esin Kahya and Ayşegül D. Erdemir, the seventeenth century was in medicine, as in other branches of science, “the period in which western influences began to appear for the first time”.4 One of the factors which led scholars such as Şehsuvaroğlu to regard Ot- toman medicine as practically sealed off from European influence before the seventeenth century was that very few medical texts were found in translation from the earlier period and that works written by Ottomans themselves relied on either classical Greek or classical Islamic texts.5 Among these few works, the earliest known translation of a European text into Ottoman was a Greek and Syriac source acquired during the conquest of Venetian Modon by the Ottomans in 1500 and translated by Cerrah İbrahim ibn Abdullah. According to Nuran Yıldırım, this was not a simple translation of an ancient text, for İbrahim ibn Abdullah added material from various works by Ottoman physicians as well as elements of his own medical experience to the copy found in Modon

2 Şehsuvaroğlu, Bedi N., Anadolu’da Dokuz Asırlık Türk Tıp Tarihi. Turkish History of Medicine in Anatolia for Nine Centuries. Histoire de la médecine des Turcs d’Anatolie (Istanbul: İsmail Akgün Matbaası, 1957), pp. 37–8. See also Şehsuvaroğlu, Bedi N., “Osmanlı Tababetinde Garplılaşma Cereyanları”, Tıp Fakültesi Mecmuası, 19/2 (1956), 168–92. Şehsuvaroğlu and his colleagues, repeated similar arguments almost 30 years later, Şehsuvaroğlu, Bedi N., Ayşegül Erdemir Demirhan and Gönül Cantay Güreşsever, Türk Tıp Tarihi (Bursa: n.p., 1984), p. 91. 3 Sarı, Nil, “A look through the international medical relations of Turkic peoples in history, with emphasis on the Ottoman-European relations”, Türkiye Klinikleri. Tıp Tarihi, 1/2 (2001), p. 82. 4 Kahya, Esin and Ayşegül D. Erdemir, Bilimin Işığında Osmanlıdan Cumhuriyete Tıp ve Sağlık Kurumları (Ankara: Türkiye Diyanet Vakfı Yayınları, 2000), p. 173. 5 Ağırakça, “Osmanlı Tıbbının Kaynakları”, p. 159.

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Medicine in Practice 215 to produce a new text.6 This text, then, became the first work in Turkish to give information on syphilis7 and injuries caused by firearms,8 areas which in fact European physicians had only just started to produce medical texts on. Apart from Cerrah İbrahim ibn Abdullah’s work, Ekmeleddin İhsanoğlu and Ramazan Şeşen referred to the works of Abdüsselam el-Muhtedi el-Muhammedi (Hoca İliya el-Yahudi), Musa ibn Hamun (Moses Hamon), İbn Cani (Şaban ibn İshak el-İsraili) and Mahfi-i Gilani as showing European influence but argued that “the influence in these works was not particularly important from the point of view of medicine”.9 Behind Şehsuvaroğlu’s and others’ acceptance of the seventeenth century as the beginning of ‘true’ medical contact with the West was the clear use of western sources by the palace Head Physician, a Christian convert, Salih ibn Nasrullah (d. 1669–70), known also as Ibn Sallum in his works.10 In particular his Tıbb-ı Cedid al Kimyai,11 written in Arabic, was heavily based on the works of the Protestant Swiss German physician Paracelsus (1493–1541) who challenged Galenic theory, claiming that “he could learn more medicine by travelling and observing than from any library, and that the books of Hippocrates and Galen should be burned”,12 and “introduced a new medical understanding,

6 Yıldırım, Nuran, “Türkçe Cerrahnâmeler (15. Yüzyıl)”, in 14. Yüzyıldan Cumhuriyet’e Hastalıklar, Hastaneler, Kurumlar. Sağlık Tarihi Yazıları – 1 (Istanbul: Tarih Vakfı Yurt Yayınları, 2014), pp. 25–6. 7 Adıvar, Osmanlı Türklerinde İlim, p. 47. According to Yıldırım, Cerrah İbrahim ibn Abdullah did not simply translate the text but added parts to it on syphilis based on his knowledge and his practical experience. Yıldırım, Nuran, “Alâ’im-i Cerrâhîn’de Frengi”, 14. Yüzyıldan Cumhuriyet’e Hastalıklar, Hastaneler, Kurumlar. Sağlık Tarihi Yazıları – 1 (Istanbul: Tarih Vakfı Yurt Yayınları, 2014), pp. 50–3. 8 Ağırakça, “Osmanlı Tıbbının Kaynakları”, p. 156; Yıldırım, “Türkçe Cerrahnâmeler (15. Yüzyıl)”, p. 28. 9 İhsanoğlu, Ekmeleddin and Ramazan Şeşen, “Osmanlı Tıbbī Bilimler Literatürü Tarihine Giriş”, in Osmanlı Tıbbi Bilimler Literatürü Tarihi (History of the Literature of Medical Sci- ences during the Ottoman Period), ed. Ekmeleddin İhsanoğlu, Ramazan Şeşen, M. Serdar Bekar, Gülcan Gündüz and Veysel Bulut (Istanbul: ircica, 2008), vol. I, p. lxxxix. 10 For further information about him, see Miri Shefer-Mossensohn, “An Ottoman physician and his social and intellectual milieu: the case of Salih bin Nasrallah Ibn Sallum”, Studia Islamica, 1 (2010), 133–58. 11 Şehsuvaroğlu, Bedi N., Eczacılık Tarihi Dersleri (Istanbul: Hüsnütabiat Matbaası, 1970), p. 296; later in the eighteenth century, this book was translated from Arabic into Turkish by various physicians. Şehsuvaroğlu, Erdemir Demirhan and Cantay Güreşsever, Türk Tıp Tarihi, pp. 99–100. 12 French, Roger, Medicine before Science. The Business of Medicine from the Middle Ages to the Enlightenment (Cambridge: Cambridge University Press, 2003), p. 148.

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216 Boyar based on chemical principles”.13 Paracelsus, however, did not change medical understanding in Europe in this period and his new approach to medicine was not universally accepted.14 Among the ardent critics of the Paracelsian understanding was Giovanni Tommaso Minadoi, who, shortly after his graduation from the University of Padua, went to Aleppo to serve as a physician attached to the Venetian consulate for two periods between 1578–1587, and there ob- tained both European acquaintances and local Ottoman connections. This access to Ottoman sources and his diplomatic missions on behalf of Venice enabled him to publish his famous Historia della guerra fra Turchi et Persiani (History of the War between Turks and Persians) in 1587.15 He later became a lecturer in practical medicine at the University of Padua where he wrote medical texts reflecting “his habitual opposition to innovation in medical teaching”, mainly the Paracelsian ideas.16 Paracelsus, nevertheless, eased the way for further challenges to the Galenic theory from the seventeenth century onwards. Tıbb-ı Cedid (The New Medi- cine), in particular, became very popular in the eighteenth century among some Ottoman physicians who made extensive use of the works of Paracelsus and his followers in their medical texts.17 Through the translations and use of various medical texts from European languages, the eighteenth century further prepared the theoretical ground for the adoption of western medicine in the following century.18 It was for this reason, according to the eminent medical historian, A. Süheyl Ünver, that the eighteenth century was the period when the

13 Sarı, Nil and Bedizel Zülfikar, “The Paracelsusian influence on Ottoman medicine in the seventeenth and eighteenth centuries”, in Transfer of Modern Science and Technology to the Muslim World, ed. Ekmeleddin İhsanoğlu (Istanbul: ircica, 1992), p. 157. 14 French, Medicine before Science, pp. 148–9. 15 The first edition was published in Rome in 1587 and its second revised edition in Venice in 1588. 16 Siraisi, Nancy G., History, Medicine and the Traditions of Renaissance Learning (Ann Arbor: University of Michigan Press, 2010), p. 254. 17 Sarı and Zülfikar, “The Paracelsusian influence on Ottoman medicine in the seventeenth and eighteenth centuries”, pp. 158–60. For a survey of Ottoman texts on ‘The New Medi- cine’, see Dinar, Talat, “Tıbb-ı Cedid Yazmaları Üzerine Bazı Tespitler”, Turkish Studies, 7/4 (2012), 1541–6. 18 Aydüz, Salim, “On Sekizinci Yüzyıl Osmanlı Tıbbında Değişim: Doğu Tıbbından Batı Tıbbına Geçiş Üzerine Bir Deneme”, in 38. Uluslararası Tıp Tarihi Kongresi Bildiri Kitabı. Proceedings of the 38th International Congress on the History of Medicine. Acte du 38éme congrès international d’histoire de la médecine, ed. Nil Sarı, Ali Haydar Bayat, Yeşim Ülman and Mary Işın (Ankara: Türk Tarih Kurumu, 2005), p. 1035.

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Medicine in Practice 217 influence of western knowledge finally took root.19 For Osman Şevki Uludağ, who was considered the first medical historian of the Turkish Republic,20 the second half of the eighteenth century was the real turning point in Ottoman engagement with European medicine. Although there had been “new move- ments” in European medicine since the sixteenth century, “Ottoman Turkey lived inside its own shell. It did not have contact with Europe. It did not see the new developments there, it had no knowledge of the medical revolution”.21 For some, however, the full shift in Ottoman medicine towards European medicine did not occur in the Ottoman empire until the nineteenth century. While, like many other scholars, Arslan Terzioğlu, too, accepts the seventeenth century as a turning point in Ottoman medical thinking, the “westernization” of Ottoman medicine having begun in the second half of the century with “the translating of famous European medical works into Turkish and Arabic by palace physicians in Istanbul and doctors of Ottoman paşas in Belgrade”,22 he em- phasizes that real ‘westernization’ of Ottoman medicine was achieved only at the beginning of the nineteenth century with the establishment of a modern medical school, the first naval training hospital, Spitalya, which was opened in 1805, and then the Tıbhane/Tabibhane in 1806 for the teaching of theoretical medicine and surgery, which was modelled on the Austrian military medical academy, Josephinum, opened in Vienna in 1785.23 The establishment of this European-modelled medical institution coincided with the official ac- knowledgement of the insufficiency of medical education in Istanbul, mainly in Süleymaniye Tıp Medresesi (Süleymaniye Medical School), where formal

19 Ünver, A. Süheyl, Tıb Tarihi. Tarihten Önceki Zamandan İslâm Tababetine ve İslâm Taba- betinden xx inci Asra Kadar (Istanbul: İstanbul Üniversitesi, 1943), p. 171. 20 Yıldırım, Nuran, “Osmanlı Türklerinde İlim Üzerinden O. Şevki Uludağ-Fuat Köprülü Tartışması ve O. Şevki Uludağ’dan A. Adnan Adıvar’a Eleştiriler”, Osmanlı Bilimi Araştırmaları, 8/2 (2007), p. 92. 21 Uludağ, Osmanlılar Devrinde Türk Hekimliği, p. 119. 22 Terzioğlu, Arslan, “Tersane-i Âmire’deki Tabibhane’den Gülhane’ye Türk Tıbbının Batılılaşması”, in Türk Tıbbının Batılılaşması. Gülhane’nin 90. Kuruluş Yıldönümü Anısına 11–15 Mart 1988’de Ankara ve İstanbul’da Yapılan Simpozyuma Sunulan Bildiriler/ Verwestli- chung der türkischen Medizin. Berichte des Symposions anlässlich des 90. Gründungjahres der Militärmedizinischen Akademie Gülhane vom 11.-15. März 1988 in Ankara und İstanbul, ed. Arslan Terzioğlu and Erwin Lucius (Istanbul: Arkeoloji ve Sanat Yayınları, 1993), p. 24 and Terzioğlu, Arslan, “İstanbul Tıp Fakültesi Tarihçesi”, İstanbul Tıp Fakültesi Mecmuası, Supplementum 2, 63/2 (2000), pp. 1–2. 23 Terzioğlu, “Tersane-i Âmire’deki Tabibhane’den Gülhane’ye Türk Tıbbının Batılılaşması”, pp. 24–5.

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218 Boyar

traditional medical education was given.24 According to Yıldırım, both the existing darüşşifas (hospitals) as well as Süleymaniye Tıp Medresesi, “were hardly able to follow the developments of European medicine”.25 This medrese, nevertheless, continued to function well into the 1830s.26 Although accepting the mid-fifteenth century as the beginning of European influence on Ottoman medicine, Aydın M. Sayılı takes 1827 as a turning point. “European influences on Turkish medicine”, he wrote, “began as early as the time of the Turkish conquest of Istanbul. In the 16th and 17th centuries some physicians were already quoting from European texts and to a greater extent during the 18th and 19th centuries. In the year 1827, the Medical School of Istanbul [Tıbhane-i Amire] was opened. With this we see a marked European influence coming in”.27 The Ottoman state in fact officially adopted European medicine with the establishment of Tıbhane-i Amire in 1827 and Cerrahhane-i Mamure in 1832, turning these two establishments into a totally modern military medical school, Mekteb-i Tıbbiye-i Adliye-i Şahane which was opened in 1839.28 Looking at texts as the most important medium of transfer of knowledge29 or focusing on the formal and complete adoption of western medical institutions

24 boa, Cevdet Sıhhiye Tasnifi nr. 304 quoted in Zorlu, Tuncay, “Süleymaniye Tıp Medresesi- ii”, Osmanlı Bilim Araştırmaları, 1/4 (2002), p. 77. 25 Yıldırım, Nuran, “Le rôle de médecins turcs dans la transmission du savoir”, in Médecins et ingénieurs ottomans à l’âge des nationalismes, ed. Méropi Anastassiadou-Dumont (Paris: Maisonneuve et Larose: Beyoğlu, İstanbul: Institut français d’études anatoliennes, 2003), p. 127. 26 Zorlu, “Süleymaniye Tıp Medresesi-ii”, pp. 77–8. 27 Sayılı, Aydın M., “Turkish medicine”, Isis, 26/2 (1937), pp. 413–14. 28 Terzioğlu, “Tersane-i Âmire’deki Tabibhane’den Gülhane’ye Türk Tıbbının Batılılaşması”, p. 27; Günergun, Feza and Şeref Etker, “Waqf endowments and the emergence of modern charitable hospitals in the Ottoman empire: the case of Zeynep-Kamil Hospital in Istanbul”, in The Development of Modern Medicine in Non-Western Countries, ed. Hormoz Ebrahimnejad (London and New York: Routledge, 2009), p. 87; Yıldırım, “Le rôle de méde- cins turcs dans la transmission du savoir”, p. 128; Yıldırım, Nuran, “Tıp Eğitimimizin Tari- hsel Sürecinde Eğitim Modellerine Bakış (1827–1933)”, in Türkiye’de Üniversite Anlayışının Gelişimi (1861–1961), ed. Aras, Namık Kemal, Emre Dölen and Osman Bahadır (Ankara: Türkiye Bilimler Akademisi, 2007), pp. 237–47. Even according to Bedi N. Şehsuvaroğlu, Ayşegül Erdemir Demirhan and Gönül Cantay Güreşsever, in medicine the “movement of westernisation, or more correctly modernisation, was only to come to an end at the end of the nineteenth or even the beginning of the twentieth century”, in Türk Tıp Tarihi, p. 91. 29 For the great importance attached to language and texts in the transfer of European medical knowledge, see Sarı, Nil, “Osmanlı Hekimliği ve Tıp Bilimi”, Yeni Tıp Tarihi Araştırmaları, ed. Nil Sarı, vol. 5 (1999), pp. 27–36. For A. Süheyl Ünver, the Jewish physicians did not

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Medicine in Practice 219 in order to understand European influence on Ottoman medicine, however, limits our understanding of the nature of the relationship between the Otto- man world and Europe. Following Harun Küçük’s argument that “European knowledge did not serve as a replacement but rather as an addition to existing scientific practices”,30 one must therefore look at practice in order to understand the impact of European medical knowledge. As Miri Shefer-Mossensohn has observed, “Ottoman medicine was a blend of customs, ideas, and realities aiming to solve a constant human problem ˗ illness and death”.31 Pragmatism thus lay behind Ottoman medicine’s amalga- mation of practices and ideas from ancient Greek medicine, from folklore and from medicine practiced in the Islamic world.32 As Nil Sarı and Bedizel Zülfikar have noted, “Ottoman doctors were more interested in practice than in theories, philosophy and mysticism”.33 While the translation of medical texts or the use of European sources in original medical texts can be used to show the transfer of medical knowledge, they were by no means the only signifiers dem- onstrating this and in order to understand the spread of medical knowledge it is important to look at practice, and not just at written texts. Roger French’s argument that “manual practice was taught by example and experience and accordingly left fewer records”34 should be valid too for Ottoman medical experience. It should also be noted that most medicine in the Ottoman empire was practiced outside the established formal medical structure where traditional healers, private physicians, surgeons and oculists as well as European or European-trained doctors, who were not employed in the state sector, provided their medical services. It is practice, thus, rather than the written word which elucidates the relations between Ottomans and Europeans in this field and the transfer of medical knowledge from Europe should be looked at as part

contribute to the development of Ottoman medicine as they “did not work for the development of medicine in Ottoman times since they did not create or translate scientific work”, Tıb Tarihi, p. 162. 30 Küçük, B. Harun, “Science studies and early modern Ottoman science”, International Jour- nal of Middle East Studies, 47 (2015), p. 586. 31 Shefer-Mossensohn, Miri, Ottoman Medicine. Healing and Medical Institutions 1500–1700 (Albany, ny: suny Press, 2009), p. 15. 32 Murphey, Rhoads, “Ottoman medicine and transculturalism from the sixteenth through the eighteenth century”, Bulletin of the History of Medicine, 66/3 (1992), p. 396; Shefer- Mossensohn, Ottoman Medicine. Healing and Medical Institutions 1500–1700, p. 21. 33 Sarı and Zülfikar, “The Paracelsusian influence on Ottoman medicine in the seventeenth and eighteenth centuries”, p. 159. Sarı repeated this view elsewhere, too. Sarı, “Osmanlı Hekimliği ve Tıp Bilimi”, p. 13. 34 French, Medicine before Science, p. 153.

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220 Boyar of an ongoing process rather than being imprisoned in a specific time frame, particularly considering that it was only in the middle of the eighteenth century that a specific paradigm of European medicine was established.

European Medical Knowledge in Ottoman Lands

A considerable number of early modern European texts about the Ottomans stressed the difference between Europe and the Ottoman empire. This atti- tude inevitably affected the European approach to Ottoman medicine. For instance, the early seventeenth-century Venetian ambassador Ottaviano Bon disparagingly claimed that “according to the knowledge and custom of the Turks” medicine prescribed was “but only some kind of loosening and refresh- ing Sherbit, for they seldom use any other physick; nor do I hold their skill sufficient to prepare medicines for every malady”.35 This allegation was based on a stereotypical representation rather than the realities of Ottoman medical life. Sonya Brentjes underlines the fact that “Western European public opin- ion, including its diverse scholarly communities, for two more centuries [from the seventeenth century onwards] continued to consider the Ottomans as a dynasty lending no support to the sciences and the people they ruled as likewise disinterested”.36 However, especially in the case of medicine, Ottoman interest in scientific developments was by no means lacking, as long as such developments met the need to cure diseases or to prevent their spread within the empire. This interest was very evident in the Ottoman approach to plague. Contrary to the general European trope exemplified by Theodore Spandounes, writing at the beginning of the sixteenth century for a western audience, who claimed that “The plague is very common in these parts; but the Turks take no pre- cautions against contagion because they firmly believe in the inescapability of destiny, for good or ill”,37 the Ottomans did adopt the practice of fleeing from plague-ridden areas. The famous religious scholar İdris-i Bidlisi (d. 1520) wrote

35 Bon, Ottaviano, The Sultan’s Seraglio. An Intimate Portrait of Life at the Ottoman Court (From the Seventeenth-Century Edition of John Withers), introduced and annotated by Godfrey Goodwin (London: Saqi Books, 1996), p. 89. 36 Brentjes, Sonya, “Early modern western European travellers in the Middle East and their reports about the sciences”, in Brentjes, Sonya, Travellers from Europe in the Ottoman and Safavid Empires, 16th–17th Centuries. Seeking, Transforming, Discarding Knowledge (Surrey and Burlington: Ashgate Variorum, 2010), v, p. 380. 37 Spandounes, Theodore, On the Origin of Ottoman Emperors, trans. and ed. Donald M. Nicol (Cambridge: Cambridge University Press, 1997), p. 131.

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Medicine in Practice 221 a treatise after 1511 about the necessity and benefits of escaping from plague38 and other scholars after him, Kemalpaşazade Şemseddin Ahmed (d. 1534) and Taşköprüzade Ahmed Efendi (d. 1561), too, allowed for such an escape in their treaties on plague.39 The famous sixteenth-century şeyhülislam Ebussuud Efendi (d. 1574) formulated this in religious terms: “it is permissible with in- tention and faith to take refuge from an evil in the goodness of God”.40 Loren- zo Bernardo, the Venetian bailo between 1585 and 1587, reported that during his period in office, the şeyhülislam had left Istanbul for fear of the plague. Bernardo commented that the idea that death was decreed and that one could not thus save oneself from danger was no longer the case among the Ottomans “because experience has taught them the opposite”.41 Those who stayed behind were most likely those who could not afford to leave or could be forced to stay.42 The English clergyman John Covel, who was in Edirne when the city was struck by a plague, noted in his diaries which cover the period 1670 to 1679 how the plague stereotype about Turks did not reflect the truth:

The best sort of people fled to other places, as the Turkes likewise themselves did from Adrianople to their houses here, for that same is a story that they are not afraid of the plague, because their fortunes are wrote in their forehead; for all fled, but such as were poor, or had offices about Court, and could not get away.43

38 İhsanoğlu, Ekmeleddin, Ramazan Şeşen, M. Serdar Bekar, Gülcan Gündüz and Veysel Bulut (eds.), Osmanlı Tıbbi Bilimler Literatürü Tarihi (History of the Literature of Medical Sciences during the Ottoman Period) (Istanbul: ircica, 2008), vol. 1, p. 101. 39 Varlık, Nükhet, Plague and Empire in the Early Modern Mediterranean World. The Otto- man Experience, 1347–1600 (Cambridge and New York: Cambridge University Press, 2015), pp. 243–5. 40 Düzdağ, M. Ertuğrul (ed.), Şeyhülislâm Ebussuûd Efendi Fetvaları Işığında 16. Asır Türk Hayatı (Istanbul: Enderun Kitabevi, 1983), no. 913, p. 182. 41 “1590 Lorenzo Bernardo nobilhomo relazione”, in Relazioni di ambasciatori veneti al sen- ato, volume xıv Costantinopoli relazioni inedite (1512–1789), ed. Maria Pia Pedani-Fabris (Padoa: Bottega d’Erasmo, 1996), pp. 367–8. 42 Varlık, Nükhet, “Plague, conflict, and negotiation: the Jewish broadcloth weavers of Salonica and the Ottoman central administration in the late sixteenth century”, Jewish History, 28 (2014), p. 277; Varlık, Plague and Empire, pp. 245–6; Boyar, Ebru and Kate Fleet, A Social History of Ottoman Istanbul (Cambridge: Cambridge University Press, 2010), p. 76. 43 Bent, J. Theodore (ed.), Early Voyages and Travels in the Levant. i. The Diary of Mas- ter Thomas Dallam, 1599–1600. ii. Extracts from the Diaries of Dr. John Covel, 1670–1679 (London: Printed for the Hakluyt Society, 1893), p. 244.

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According to the Florentine Benedetto Dei’s account from 1469, fleeing from plague was something the Ottomans were taught by the Florentines in Istanbul in the 1460s.44 There is, however, no proof, apart from Dei’s remark, that this was in fact the case. Doukas noted that Mehmed ii was already in the habit of escaping from plague in 1455. Trying to meet the sultan, Doukas had to pursue him through Thrace for he was “moving about from place to place because of the bubonic plague…On learning that the ruler was sojourning in Philippopo- lis, we made our way there. We missed the ruler by two days. In order to escape the dreadful disease which had also reached that city, he marched toward the regions of Sofia…”.45 This was not the only occasion on which Mehmed sought to escape from plague.46 It is clear that the Ottomans were aware of the European practices concerning plague and, as Nükhet Varlık recently demon- strated, that the Ottoman state altered its approach to plague in the sixteenth century.47 This Ottoman openness to the medical knowledge coming from Europe became particularly obvious when they were faced with the new disease of syphilis. The Ottomans looked for a cure to the source of the illness, that is to Europe. Although the dominance of the Columbian Theory on the origins of syphilis has been strongly challenged,48 the Ottomans first became aware of such a disease49 shortly after it was recorded as a distinct disease in Europe after the first recorded epidemic outbreak in 1495. The novelty of syphilis for the Ottomans was acknowledged by the eighteenth-century Ottoman physician,

44 Dei, Benedetto, La Cronica dall’anno 1400 all’anno 1500, ed. Roberto Barducci (Florence: F. Papafava, 1984), p. 167. 45 Doukas, Decline and Fall of Byzantium to the Ottoman Turks, annotated and trans. Harry J. Magoulis (Detroit: Wayne State University Press, 1975), p. 251. 46 Lowry, Heath W., “Pushing the stone uphill: The impact of bubonic plague on Ottoman urban society in the fifteenth and sixteenth centuries”, Osmanlı Araştırmaları/The Journal of Ottoman Studies, 23 (2003), p. 103. 47 Varlık, Nükhet, “From “Bête Noire” to “le Mal de Constantinople”: plagues, medicine and the early modern Ottoman state”, Journal of World History, 24/4 (2013), 741–70; Varlık, Plague and Empire, pp. 248–91. 48 See for example, Anteric, Ivana, Zeljana Basic, Katarina Vilovic, Kresimir Kolic and Simun Andjelinovi, “Which theory for the origin of syphilis is true?”, Sexual Medicine History, 11 (2014), 3112–18. 49 Syphilis, before being standardized as “frengi” in the late Ottoman vernacular, had many names such as “veba-ül Efrenci” (plague of Franks); “maraz-ı İspanya” (Spanish disease); “maraz-ı Hindi” (Indian disease); “daü’l Efrenç” (sickness/disease of Franks); “cüzzam-ı cinaiye” (murderous leprosy); “maraz-ü şeytan” (devil’s disease); “marazü’l-halik” (disease of the perished); “marazü’l-hacale” (disease of shame); “illet-ü zani” (adulterer’s malady). Uludağ, Osmanlılar Devrinde Türk Hekimliği, p. 137.

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Ömer Şifai (d. 1742) who claimed that “because it is a new disease which is recent and venomous and which has newly appeared, it is not written about in the books of the physicians of the past”.50 The first available medical account about this disease in Turkish is found in the work of Cerrah İbrahim ibn Abdul- lah referred to earlier. The section on syphilis not only gave information about the source of the disease and its typology but also included various remedies to be used for its treatment and the way to concoct them.51 As Europe was seen as the source of syphilis in the Islamic world, ʿAbd al-Karim ibn Muʾmin travelled from Morocco to France in search of a cure for syphilis, finding no difficulty seeking this medical knowledge from a French Jewish doctor for “the science of medicine was mushtarak – common to all peoples”.52 This commonness of knowledge was very evident in the widespread use of mercury for the treatment of syphilis by Ottoman physicians. Girolamo Fracastro (d. 1553), “the father of ‘syphilis’”,53 suggested the use of mercury, which was traditionally used for skin diseases, and guaiac, which was extracted from evergreen trees of South America and the West Indies, against syphilis, and Ottoman physicians, too, made great use of mercury for syphilis treatment. The head physician of Süleyman i, Kaysunizade Bedreddin Muhammed (d. 1568) suggested the use of ointments, incenses and pills made of mercury for the treatment of syphilis, and, as Fracastro instructed his patients, Kaysunizade Bedreddin Muhammed, too, instructed them to use this medicine together with sweating. Sure of the healing effect of mercury, Kaysunizade Bedred- din Muhammed reassured those who used this ingredient: “So many times I tested it / I saw no fault in it. / Experience is proof of truth and relief. / Go and use it, don’t be suspicious”.54 Although according to the medical historian Lois N. Magner, “four hundred years of mercury therapy for syphilis have been summed up as probably the most colossal hoax in the history of medicine”,55 the Ottoman physicians, like most of their European counterparts,56 continued to instruct their patients to use mercury for the treatment of the disease.

50 Quoted in Uludağ, Osmanlılar Devrinde Türk Hekimliği, p. 131. 51 Yıldırım, “Alâ’im-i Cerrâhîn’de Frengi”, pp. 46–50. 52 Matar, Nabil, Europe Through Arab Eyes 1578–1727 (New York: Columbia University Press, 2009), p. 25. 53 Quétel, Claude, History of Syphilis, trans. Judith Braddock and Brian Pike (Cambridge: Pol- ity Press, 1990), p. 52. 54 Uludağ, Osmanlılar Devrinde Türk Hekimliği, pp. 138–9, and quotation from p. 139. 55 Magner, Lois N., “7. Medicine and the Renaissance”, in History of Medicine (New York and Basel, 1992), p. 180. 56 Magner noted that there was not a consensus among European physicians about the benefits of painful mercury treatment and mercury was mostly used by the poor while guaiac was for the rich. Magner, “7. Medicine and the Renaissance”, pp. 179–80.

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The sixteenth-century physician, Nidai Mehmed Çelebi el-Ankaravi (d. c. 1567), who served under Selim ii, proposed the use of mercury57 and Davud ibn Umar al-Antaki, active in Cairo in the same period, suggested the use of an ointment made up of mercury.58 But it was only in the last quarter of the seventeenth century that Fracastro’s thesis on syphilis became part of the textual transfer of knowledge. The head physician and Jewish convert Hayatizade Mustafa Feyzi (d. 1692; his name before his conversion was Moses ben Raphael Abravanel),59 made use of Fracastro’s pioneering 1530 work on syphilis (Syphilis sive morbus gallicus…), and other European sources for his treatise on syphilis, “Risale-i Maraz-ı Efrenç” (The Treatise on the Disease of the Franks) included in Resail el-Müşfiye li-Emraz el-Müşkile (Treatises of Cures for Difficult Diseases), also known as Hamse-i Hayatizade (The Quintet of Hayatizade). Hayatizade Mus- tafa Feyzi, according to his own account, wrote these treatises to give clear and concise information about the diseases and their treatments in order to fill a gap in Ottoman medical literature upon the order of Mehmed iv who wanted him to write a book in Turkish on these diseases.60 The greatest motivator in the search for medical knowledge was the need to know how to cure a disease, and the greatest impact was its success, as was un- derlined by Kaysunizade Bedreddin Muhammed. In 1690, upon being treated for his illness with quinine in “the lands of Franks” and learning there about its use and effects, Tunis-born Husayn Khujah (d. ca. 1732), who served as the grand scribe at the court of Al Husayn ibn ʿAli I, brought some to Tunis where he used it to treat others, also treating himself with it when he fell ill with fever. Impressed with this medicine, Husayn Khujah was interested to learn more and therefore contacted various European physicians, who responded promptly but unfortunately in a language Husayn Khujah did not know. The communication lay dormant until another wave of fever struck Tunis and quinine was once more used successfully in its treatment, becoming in

57 Demirhan, Ayşegül, Mısır Çarşısı Drogları (Istanbul: Sermet Matbaası, 1975), p. 52. 58 Dols, Micheal W., “Medicine in sixteenth century Egypt”, in Transfer of Modern Science and Technology, ed. Ekmeleddin İhsanoğlu (Istanbul: ircica, 1992), pp. 216–17; Ben Yahia, Boubaker, “La science dans les pays musulmans au xvie siècle. Dawud al Antâki et sa Tadhkira”, in La science au seizième siècle. Colloque international de royaumont 1–4 Juillet 1957 (Paris: Hermann, 1960), p. 224. 59 For Hayatizade’s life see Şişman, Cengiz, “iii. Hayatizade Mustafa Efendi (Moshe ben Rafael Abranavel), the Physician-in-Chief of the Ottoman palace: Marrano legacy, Otto- man medicine and the Sabbatean movement”, in Transcending Diaspora: Studies on Sab- bateanism and Dönmes (Istanbul: Libra, 2016), pp. 57–93. 60 Adıvar, Osmanlı Türklerinde İlim, p. 112; Ağırakça, “Osmanlı Tıbbının Kaynakları”, p. 159; Yıldırım, Nuran, “Hayâtîzâde Mustafa Feyzî”, tdv İslam Ansiklopedisi, vol. 17 (1998), p. 16.

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consequence a most popular medicine. It was at this point that Husayn Khujah turned again to his letter from the European doctors, translated it with help, and wrote a treatise on quinine.61 While the desire to find a cure motivated Husayn Khujah to pursue the knowledge of Europe, the same desire motivated the long journey of a Kızılbaş Turkmen from Adana, in central Anatolia, to Iran in the sixteenth century in order to obtain one of Shah Tahmasp’s kerchiefs which was perceived as having healing power which the Turkmen would use to make his father at home better and in return for which the Turkmen presented a horse to the shah.62 Hence searching for remedies for illnesses regardless of whether they were spiritual or material, was a part of Ottoman daily life. In this context, one of the ways to understand the transfer of medical knowledge is to look at medicinal trade, for along with the drugs inevitably came medical knowledge itself. The Ottoman empire was both a seller and a buyer of pharmacological ingredients. According to Paul Lucas, sent to the Ottoman empire by Louis xiv in 1714 in order to gain a greater understanding of medicine and medicinal plants, medicinal ingredients were exported from Anatolia.63 The most popular medicinal ingredients from Anatolia, were opium, alum, cotton and cloves.64 According to Evliya Çelebi, the poison of the “Faruq snake”, which was the main ingredient of tiryaq faruq, “a celebrated antidote and all around panacea of pre- nineteenth century healing traditions in many parts of Eurasia”,65 extracted in Sultan Qala’un hospital in Cairo was much sought after in Europe.66 Not only did Ottoman lands provide Europe with medicinal products, but the Otto- mans themselves also purchased medicine from many different sources.67 As Şehsuvaroğlu expressed it, such medicines were so internalized that “although

61 “17 1726–1727: On Quinine, in Husayn Khūjah, al-Asrar al Kamīnah, ed. Al-Karray Al- Qusantīni, 31–43”, in Matar, Europe through Arab Eyes 1578–1727, pp. 238–40. 62 Membré, Michele, Mission to the Lord Sophy of Persia (1539–1542), trans. A.H. Morton (Wiltshire: Gibb Memorial Trust, 1999), p. 41. 63 Lucas, Paul, Voyage du Sieur Paul Lucas, fait en M. dccxiv, &c. par ordre de Louis xiv. Dans la Turquie, l’Asie, Sourie (Amsterdam: Steenhouwer & Uytwerf, 1720), vol. 2, p. 120. 64 Şehsuvaroğlu, Eczacılık Tarihi Dersleri, p. 269. 65 Attewell, Guy, “Chapter one. Interweaving substance trajectories: Tiryaq, circulation and therapeutic transformation in the nineteenth century”, in Crossing Colonial Histog- raphies. Histories of Colonial and Indigenous Medicines in Transnational Perspective, ed. Anne Digby, Waltraud Ernst and Projit B. Mukharji (Newcastle upon Tyne: Cambridge Scholars Publishing, 2010), p. 9. 66 Dankoff, Robert and Sooyong Kim (eds.), An Ottoman Traveller. Selections from Travels of Evliya Çelebi (London: Eland, 2010), p. 377 and p. 379. 67 Şehsuvaroğlu, Eczacılık Tarihi Dersleri, pp. 266–74.

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226 Boyar medicines like tiryaq and mithridaticum came to our country from Europe, they gained an almost national character”.68 This easy appropriation of Euro- pean medicine was in fact a result of a common medicinal culture and understanding among the Ottomans and their European counterparts, and it was that reason that medicine or medicinal products were regarded as valuable presents. The Ottoman Grand Vezir Ali Paşa presented Ogier Ghiselin Busbecq, the Habsburg Ambassador to the Ottoman court between 1554 and 1562, with “a box full of the antidote to poison of the finest quality” and “a glass vessel full of balm” which according to Ali Paşa, was priceless and of the highest quality, presents which were very much appreciated by the ambassador.69 The most important element in the transfer of medical knowledge to the Ottoman empire was without doubt human beings. Apart from those specifi- cally involved in medicine, merchants travelling from Europe to Ottoman ter- ritory, European diplomats and their entourages, travellers, religious figures, slaves and captives all potentially contributed to the spread of medical knowledge. If knowledge was power, then medical knowledge meant greater power and those who had a good medical reputation were very much revered. Ottoman sultans gave great importance to the ability and knowledge of their doctors and they were always in search of good ones;70 they did not pay much attention to where these physicians came from as long as they were experts in their fields. The Ottomans employed physicians from Iran71 and Egypt. The father of Süleyman i’s head physician Kaysunizade Bedreddin Muhammed, Kaysunizade Muhammed Şemseddin (d. 1524), who was the head physician of the Mamluk sultan Qansuh al Gawri, was taken into the service of Selim i after being made a prisoner of war by the Ottoman army in Aleppo in 1516. Selim trusted this physician so much that he took him and his brother, who also served as a head physician in the Mamluk court, to Istanbul with him and Kaysunizade Muhammed Şemseddin served him until Selim’s death.72

68 Şehsuvaroğlu, Eczacılık Tarihi Dersleri, pp. 266–7. For this appropriation, see Bayat, Ali Haydar, “Mithridates’ten Mesir’e”, Yeni Tıp Tarihi Araştırmaları, ed. Nil Sarı, vol. 4 (1998), 67–78. 69 Forster, Edward Seymour (trans.), The Turkish Letters of Ogier Ghiselin Busbecq. Imperial Ambassador at Constantinople 1554–1562 (Oxford: Clarendon Press, 1968), pp. 230–1. 70 Shefer, Miri, “Tobias the Ottoman: Tobias Cohen as the Ottoman physician”, Korot, 20 (2009–2010), p. 51. 71 Heiderzadeh, Tofiqh, “İran Alimlerinin Osmanlı Devletine Gelişi ve Osmanlı Bilimine Katkıları (Timur Döneminin Başından Safevi Döneminin Sonuna Kadar)”, Osmanlı Bilim Araştırmaları, 2 (1998), 211–42. 72 Özel, Ahmed, “Kaysûnîzâde”, tdv İslam Ansiklopedisi, vol. 25 (2002), pp. 105–7.

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The reputation of a physician was not bounded by state borders or distance. When the treatment of Mehmed i by his own doctor did not work, the doctor of the ruler of the neighbouring beylik of Germiyan was called to take care of the sultan.73 In 1568, hearing about “the skills in medical knowledge and ability in all aspects of medicine” of Seridüddin and Ahmed, physicians in Egypt, Selim ii ordered the beylerbeyi of Egypt to send whichever one of them was “prepared and skilled in medical knowledge” after “investigation and examina- tion” by “knowledgeable people” to Istanbul.74 Thus physicians arrived at the Ottoman court with the expertise they had attained in their native lands. Among them, European or European-trained Ottoman subjects also took their place. The most well-known example was of course that of the Jewish refugees from Italy, Portugal and Spain who not only brought their knowledge of Galenic medicine, of which Ottoman theoretical medicine was a part, but also the practical knowledge which they had gained in own their countries.75 As observed in the mid-sixteenth century by Nicolas de Nicolay, who was a member of the French embassy to Istanbul, Jewish doctors held a dominant position in the city because of their knowledge of languages, Greek, Arabic, Chaldean, Hebrew and Turkish, in which the main medical texts and treatises on natural philosophy and astronomy, sciences connected to and necessary for medicine, were written.76 Some of them were employed in the Ottoman court, such as Joseph Hamon, who was originally from Granada, and who served Bayezid ii, and his son Moses Hamon who was a palace physician during the reign of Süleyman i and was esteemed highly by the sultan until his fall from grace.77 Even before the arrival of these refugees after 1492, Jewish doctors of European origin were active in the Ottoman realm, as was the case of the Italian Jew Jacobo di Gaeta (Hekimbaşı Yakup Paşa), who later converted to Islam and who served Murad ii, Mehmed ii and Bayezid ii.78

73 Akdeniz (Sarı), Nil, Osmanlılarda Hekim ve Hekimlik Ahlâkı (Istanbul: n.p., 1977), p. 143. 74 Ahmet Refik, On Altıncı Asırda İstanbul Hayatı (1553–1591) (Istanbul: Devlet Basımevi, 1935), no. 7, pp. 3–4. 75 İhsanoğlu, Ekmeleddin, “Endülüs menşeli bazı bilim adamlarının Osmanlı bilimine katkıları”, Belleten, 58/223 (1994), pp. 567–79, 588–90. 76 De Nicolay, Nicolas, Dans l’empire de Soliman Magnifique, introduced and annotated Marie-Christine Gomez-Géraud and Stéphane Yérasimos (Paris: Presses du cnrs, 1989), p. 181. 77 Heyd, Uriel, “Moses Hamon, chief Jewish physician to Sultan Süleymān the Magnificient”, Oriens, 16 (1963), pp. 155–64. 78 Galante, Avram, “Medecins Juifs jusqu’a l’epoque du Tanzimat”, in Histoire des Juifs de Tur- quie, vol. 9 (Istanbul: isis, [1985]), pp. 82–5.

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Jewish physicians were also instrumental in the transfer of European medical knowledge to the Ottoman world through their works and translations. Ahi Çelebi (Ahmed ibn Kemal el-Tabrizi) (d. 1522–24), who was the head physician of Bayezid ii, ordered a Jewish physician, Musa Calinus el-İsraili (Moshe Galliano ben Yahude), to compile a work on the characteristics of drugs and their compounds for which the physician made use of Greek, Islamic, Jewish and ‘Frankish’ sources.79 Making use of both Islamic and European sources, Moses Hamon presented Süleyman i just after his Mohács Campaign in 1526 with an original work on dentistry, which is considered “the oldest work devoted solely to dentistry in Europe”.80 Similarly, a Jewish physician, possibly the Portuguese Jew Don Manuel Brudo, who was a member of a well-known physician family and practiced medicine in England for some considerable time, presented a treatise in Ottoman Turkish, Asa-i Piran (The Staff of the Old), on ailments and challenges encountered by old men and on how they should lead their lives, to Süleyman i in the mid-sixteenth century. This work was not only based on Greek and Arabic medical texts as well as on Jewish tradition, but also relied on the physician’s own experiences of treating the elderly both in Portugal and in the Ottoman empire, and on his personal knowledge about various European customs and practices concerning health matters.81 This movement of European Jewish physicians continued well into the seventeenth century. Tobias Cohen, who ended up in the Ottoman court in 1683, was born in Metz (France), received a Jewish education in Krakow (Poland), and was then trained in medicine in Frankfurt (Oder) and Padua.82 Apart from these Jewish doctors, there were also Greek Ottoman subjects who received their medical training in Europe, such as Panagiotis Nicoussias and Alexander Mavrocordato who studied medicine in Italy in the seventeenth century. Al- though Mavrocordato was appointed Grand Dragoman and gained his reputation not as a physician but as a statesman,83 it is clear that the channels of

79 Adıvar, Osmanlı Türklerinde İlim, p. 53; İhsanoğlu, “Endülüs menşeli bazı bilim adamlarının Osmanlı bilimine katkıları”, pp. 574–5. 80 Terzioğlu, Arslan, “Kanûnî Sultan Süleyman’ın Saray Hekimi Musa Bin Hamun’un Diş Ta- babetine Dair Türkçe Eseri ve Bunun Türk ve Avrupa Tababeti Tarihi Bakımından Önemi”, Bifaskop, 5 (April 1981), p. 20. Terzioğlu dates this text earlier than the first early modern European text devoted solely to dentistry, i.e. Artzney Büchlein published in 1530. 81 Heyd, Uriel, “An unknown Turkish treatise by a Jewish physician under Sūleymān the Magnificient”, Eretz-Israel: Archaeological, Historical and Geographical Studies, l.a. Mayer Memorial Volume (1895–1959) (1964), 48–53 and pl. xlix. 82 Shefer, “Tobias the Ottoman: Tobias Cohen as the Ottoman physician”, pp. 46–7. 83 Adıvar, Osmanlı Türklerinde İlim, pp. 113–14; Camariano, Nestor, Alexandre Mavrocordato le grand drogman, son activité diplomatique (1673–1709) (Thessaloniki: Institute for Balkan Studies, 1970).

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Medicine in Practice 229 communication with European medical institutions were open, and if wanted or needed, every kind of information could have been transferred. Not only did Ottoman subjects or Jewish refugees have links with various European medical institutions and access to European learning, but physicians from Europe practiced medicine in Ottoman territories. Pay registers for medical staff in Topkapı Palace from the sixteenth and seventeenth centuries clearly demonstrate that the Ottomans saw no problem in employing people from the land of ‘Franks’.84 Europeans were employed in the palace and were also allowed to practice medicine privately. In 1700, among the physicians who passed the state-run exam to open their practices, the majority was non- Muslim and among these non-Muslim physicians, there were doctors from France, the Netherlands, Italy and Spain.85 Indeed, Ottoman lands were attractive destinations for physicians since such physicians who proved their accomplishments could attain vast power, prestige and wealth. As early as the 1330s, the Moroccan ibn Battuta reported an incident at the court of the ruler of the principality of Aydın, about which he was not very happy:

While we were still sitting with the sultan there came in an elderly man, wearing on his head a turban with a tassel, who saluted him. The qāḍī and the doctor [müderris, perhaps Muhyi-al Din] stood up as he came in, and he sat down in front of the sultan, on the bench, with the Qur’ān readers beneath him. I said to the doctor ‘Who is this shaikh?’ He just laughed and said nothing, but when I repeated the question he said to me ‘This man is a Jew, a physician. All of us need his services, and it was for this reason that we acted as you saw in standing up at his entry.’ At this my old feeling of indignation flared up anew, and I said to the Jew ‘You God-damned son of a God-damned father, how dare you sit up there above the readers of Qur’ān, and you a Jew?’ and went on berating him in loud tones. The sultan was surprised and asked what I was saying. The doctor told him, while the Jew grew angry and left the chamber in the most crestfallen state. When we took our leave, the doctor said to me ‘Well done, may God bless you. Nobody but you would dare to speak to him in that way, and you have let him know just what he is.’86

84 See the state registers of surgeons and physicians including non-Muslim and non- Ottoman identities published by Meriç, Rıfkı Melül, “Osmanlı Tabâbeti Tarihine Ait Vesîkalar. I. Cerrâhlar-Kehhâller”, Tarih Vesikaları, 1 (16) (1955), pp. 37–113. 85 Sarı, “Osmanlı Hekimliği ve Tıp Bilimi”, p. 39. 86 Gibb, Hamilton (ed.), The Travels of ibn Battuta, vol. 2, trans. C. Defrémery and R. Sangui- netti (Cambridge: The Hakluyt Society, 1962), p. 443.

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Although this event was not at the Ottoman court, it gives a clear idea about the reverence displayed to medical knowledge in the Anatolian beyliks which crossed religious boundaries. Ottoman palace doctors, regardless of their religious beliefs, were able to obtain power and prestige. The proximity to the political power, in this case Süleyman i, provided Moses Hamon with “great power and prestige. In his case we know something of the ways in which his position enabled him, or perhaps forced him, to become one of the most important personages in representing the Jewish community and in protect- ing its position in the Empire”.87 This power of court physicians stemming from proximity to the sultan was not overlooked by the Venetians who used such Jewish physicians in the Ottoman court to get information about court politics in the late sixteenth century.88 Mehmed ii appears to have issued two fermans granting exemption to the Jew Jacobo di Gaeta (Hekimbaşı Yakup Paşa) and his descendants from taxes and similar financial burdens “because of his love for him”.89 Such tax concessions could also be granted by the Ottoman govern- ment not just to physicians at the Ottoman court but also to those who had served other men of importance.90 Authority stemming from medical knowledge was not limited to healing patients but could also be employed in solving court disputes. For instance, court cases from the Istanbul kadı court records demonstrate how the kadıs used physicians as expert witnesses in order to reach decisions. In two cases from 1663–1664, two imperial physicians, Mustafa Efendi ibn Mehmed and Ahmed Efendi ibn Mehmed, testified as expert witnesses and their testimonies de- termined the verdicts. In the first case, Ayşe bint Şaban took the slave dealer İbrahim ibn Himmet to court accusing him of selling her a Russian female

87 Epstein, Mark Alan, The Ottoman Jewish Communities and Their Role in the Fifteenth and Sixteenth Centuries (Freiburg: Klaus Schwarz Verlag, 1980), pp. 86–8. 88 Pedani, Maria Pia, “Safiye’s household and Venetian diplomacy”, Turcica, 32 (2000), pp. 29–30. 89 Even if it is not a hundred per cent certain that these fermans were written for Yakup Paşa, Lewis states that this is highly probable, Lewis, Bernard, “The privilege granted by Mehm- ed ii to his physician”, Bulletin of the School of Oriental and African Studies, 14/3 (1952), pp. 562–3 and 552. Similarly, a female Catholic healer who treated the son of Mahmud ii was rewarded by the sultan with an exemption from the poll tax for her and her family. Balıkhane Nazırı Ali Rıza Bey, Eski Zamanlarda İstanbul Hayatı, ed. Ali Şükrü Çoruk (Istanbul: Kitabevi, 2001), pp. 335–6. 90 For an example of such a tax exemption granted in 1673 for a retired Jewish physician who served the Crimean Khan Selim Giray and his son, see Document xiii, Andreev Stefan (ed.), Ottoman Documents on Balkan Jews. xvith–xviith Centuries (Sofia: cibal, 1990), pp. 26–7.

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Medicine in Practice 231 slave afflicted with tuberculosis. İbrahim did not accept this accusation but the two doctors testified in the court that indeed the slave did have this chronic disease. As a result, the court ordered İbrahim to return the fee paid by Ayşe. In the second case, Süleyman Ağa ibn Mehmed took Ümmühan bint Mehmed to court accusing her of selling him a female slave with a chronic defect of the womb and asked for his money back. However, Mustafa Efendi ibn Mehmed and Ahmed Efendi ibn Mehmed testified that the slave was not afflicted with the aforementioned disease.91 Even if not perhaps stretching to every part of Ottoman society, it is clear that religious, social, gender and political differences lost their significance when medicine and health were involved. The ‘Infidel’ foreigner Paul Lucas was apparently able, for example, to enter the harems of Kayseri households as a doctor and was thus able to comment on the beauty of the women he observed there.92 Ottoman women were able to visit the shops of physicians and other healers for health purposes.93 Women were not only patients, but also health practitioners, working as midwives, healers, bonesetters and surgeons and there are even cases showing that women surgeons performed hernia operations on men.94 Things which were not permissible according to religious law or moral code could be acceptable when used for medicinal purposes. Hayatizade Mustafa Feyzi suggested an ointment prepared with mercury which was mixed with “pig, chicken and goose fat” and turpentine.95 Reli- gious authorities, sometimes, also acted with leniency about health matters. Şeyhülislam Yenişehirli Abdullah Efendi (d. 1743), for instance, issued a fetva stating that a man who, while fasting in Ramazan, was bitten by a rabid dog could break his fast in order to escape death by eating the brains of the rabid dog either on his own initiative or on the advice of a doctor without atoning

91 Erol, Rasim, et al (eds.), İstanbul Kadı Sicilleri, İstanbul Mahkemesi 12 Numaralı Sicil (H. 1073–1074 / M. 1663–1664) (Istanbul: isam, 2010), no. 547, pp. 451–2, and no. 813, p. 615. 92 Quoted in Jennings, Ronald C., “Women in early 17th century judicial records: the Sharia court of Anatolian Kayseri”, Journal of the Economic and Social History of the Orient, 18/1 (1975), pp. 55–6. 93 Yılmaz, Coşkun and Necdet Yılmaz (eds.), Osmanlılarda Sağlık ii, Arşiv Belgeleri (Istanbul: Esen Ofset, 2006), p. 281; Çeşmizade Mustafa Reşid, Çeşmî-zâde Tarihi, ed. Bekir Kütükoğlu (Istanbul: Edebiyat Fakültesi Basımevi, 1959), p. 92. 94 Sahillioğlu, Halil, “Üsküdar’ın Mamure (Cedide) Mahallesi Fıtık Cerrahları”, Yeni Tıp Tarihi Araştırmaları, 4, ed. Nil Sarı (1998), pp. 59–66; Yılmaz and Yılmaz, Osmanlılarda Sağlık ii, Arşiv Belgeleri, pp. 113, 140, 156; Sarı, Nil, “Osmanlı Sağlık Hayatında Kadının Yeri”, Yeni Tıp Tarihi Araştırmaları, 2–3, ed. Nil Sarı (1996/7), pp. 16–22, 53. 95 Uludağ, Osmanlılar Devrinde Türk Hekimliği, p. 140.

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232 Boyar for breaking his fast.96 With similar leniency, Şeyhülislam Feyzullah Efendi (d. 1703) ruled that a sick woman could drink the milk of a lactating woman if this was suggested by a “Muslim physician” in order to get well.97 In some cases, what religious authorities condoned or did not condone did not matter. Şeyhülislam Ebussuud Efendi totally condemned the use of wine or rakı for medicinal purposes98 to the extent that even if a concoction mixed with wine was the last hope of a patient as agreed by consensus among the doctors, it was still not permissible to take this medicine and the doctors’ consensus was regarded as “null and void” because “God forbid that there is remedy in wine”.99 Those who suggested that “it is religiously permissible as a cure to drink a couple of glasses of wine”, had to “reaffirm their faith”.100 But, the author of Yadigar-i İbn-i Şerif, a popular work written at the end of the fifteenth or beginning of the sixteenth century giving practical information about healthy living, praised the benefits of wine for health purposes.101 The eighteenth-century physician Ömer Şifai, who was a follower of Şeyh Hasan Halveti, in his Tıbb-ı Cedid-i Kimyai, a translation of a work in an unspecified European language which was prepared as a guide for Ottoman physicians dealing with chemistry,102 provided a section on alcohol. This section included information about the benefits of alcohol, how alcohol should be distilled, various medical recipes using alcohol, together with information about how these recipes should be used and for which diseases.103 Alcohol was in fact one of the prominent ingredients of many recipes in this book.104 In his work on morality written in the seventeenth century, Katip Çelebi raised no objection to the use of opium administered by physicians for medical purposes, but condemned its use for recreational purposes.105

96 Şeyhülislam Yenişehirli Abdullah Efendi, Behcetü’l-Fetâvâ, ed. Süleyman Kaya, Betül Algın, Zeynep Trabzonlu and Asuman Erkan (Istanbul: Klasik, 2011), no. 204, p. 42. 97 Şeyhülislam Feyzullah Efendi, Fetâvâ-yı Feyziye, ed. Süleyman Kaya (Istanbul: Klasik, 2009), no. 2444, p. 417. 98 Düzdağ, Ertuğrul (ed.), Şeyhülislâm Ebussuûd Efendi Fetvaları Işığında 16. Asır Türk Hayatı (Istanbul: Enderun Kitabevi, 1983), no. 707 and no. 708, p. 146. 99 Düzdağ, Şeyhülislâm Ebussuûd Efendi Fetvaları Işığında 16. Asır Türk Hayatı, no. 708, p. 146. 100 Düzdağ, Şeyhülislâm Ebussuûd Efendi Fetvaları Işığında 16. Asır Türk Hayatı, no. 709, p. 146. 101 Adıvar, Osmanlı Türklerinde İlim, pp. 52–3. 102 Kahya, Esin, “Ömer Şifaî”, Osmanlı Tarihi Araştırma ve Uygulama Merkezi Dergisi (otam), 4 (1993), p. 172. 103 Kahya, “Ömer Şifaî”, pp. 177–8. 104 Kahya, “Ömer Şifaî”, pp. 176–9. 105 Katip Çelebi, Mizanü’l Hakk fi İhtiyari’l-Ahakk, ed. Orhan Şaik Gökyay (Istanbul: Milli Eğitim Basımevi, 1972), pp. 42–3.

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Medicine in Practice 233

Therefore, there was a clear openness to and flexibility about medical knowledge and the high esteem in which physicians were held was the result of such importance being given to medical knowledge. But this does not necessarily mean that physicians did not on occasion encounter the heavy hand of the Ottoman state. Such treatment, however, was not generally the result of physicians being Muslim or non-Muslim or Ottoman or European, but the result of accusations of malpractice or because treatments they prescribed were considered dangerous.106 Nidai advised physicians not to claim that they had cured their patients as God cured all; if patients did not get better, physicians then did not have any responsibility.107 However, contrary to Nidai’s claim, medical professionals were held responsible for malpractice since they could be taken to court. Fear of punishment led some Ottoman medical professionals not only to get verbal agreements from their patients or the patients’ relatives, but also to enter contractual relations with their patients registered in court before any physical intervention in order to protect themselves from any kind of legal liability. In 1663, before hernia operations he had agreed to perform on his various Muslim and non-Muslim patients, the surgeon İstati, son of Yani, registered eight different contracts with the kadı court of Galata, dissolving him of any liability in case of the death of his patients.108 The death of a sultan at the hands of physicians was clearly dangerous for the physicians concerned and not regarded as merely a matter of fate. Accord- ing to Domenico,109 himself a doctor to Murad iii, when the sultan became ill two of his doctors were summoned and made to stay in the sultan’s private quarters of the palace and were not allowed to leave until the sultan recov- ered. “If the Grand Turk dies of his illness, it quite often happens that one of these doctors is not seen again”.110 Even the highly esteemed head physician

106 There were exceptions, for during the reign of Mehmed iv Jewish physicians were strongly encouraged to convert to Islam so as not to lose their positions. But this conversion fever under Mehmed iv was the result of his own political ambitions. 107 Kahya, Esin and Adnan Ataç, “Nidai. Sixteenth century physician: medical history”, Tür- kiye Klinikleri J Med Sci, 30/2 (2010), p. 455. 108 Kahriman, Salih, Fuat Recep and Coşkun Yılmaz (eds.), İstanbul Kadı Sicilleri Galata Mah- kemesi 90 Numaralı Sicil. Cilt 40: H. 1073–1074/M. 1663 (Istanbul: isam, 2012), no. 56, p. 84; no. 124, p. 130; no. 147, p. 146; no. 160, p. 154; no. 164, p. 157; no. 200, p. 181; no. 217, p. 193; no. 223, p. 197. 109 Domenico Hierosolimitano (c. 1552–1622), a Jew from Palestine, trained as a physician and rabbi, served as a doctor to Murad iii and then converted to Catholicism and moved to Rome. Austin, Michael (trans.), Domenico’s Istanbul, ed. Geoffrey Lewis (Warminster: e.j.w. Gibb Memorial Trust, 2001), pp. i–iii. 110 Austin, Domenico’s Istanbul, p. 36.

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234 Boyar

Hayatizade Mustafa Feyzi was removed from his post and jailed in Yedikule as a result of an accusation of mistreatment of Süleyman ii: “too much for- bidding of food to the late sultan Süleyman and the preventing [his drinking] even distilled water and isolating him was the reason for his death”.111 Trusting physicians completely was not recommended either, as was evident from Koçi Bey’s advice to Sultan İbrahim. Sending bread that had been blessed to the sultan, Koçi Bey (d. c. 1650), who was the author of various treaties about reforms in the empire, advised İbrahim: “My most excellent sultan, do not become very dependent on the medicine of the doctors. From time to time go out in a boat on the sea or wander round the gardens; sometimes go horse riding and in- dulge yourself. Let your blessed spirits rise”.112 The physician’s responsibility was one of the most important reasons for the Ottoman state’s attempts to regulate the medical profession. There were various fetvas ordering the punishment of those who claimed to be physicians but “had no knowledge of medicine” and those physicians who indulged in malpractice.113 The Ottoman sultans from time to time became directly involved in preventing the practice of those who did not have sufficient qualifications as physicians, qualifications which were of course those acceptable within the existing boundaries of the official medical paradigm as practiced in the empire. In 1573, on intelligence provided by his head physician about the harmful practices of those who “in Istanbul and other protected domains…go around claiming to be surgeons, doctors and oculists and set up stalls and open shops”, Selim ii ordered that those who wished to practice medicine should be sub- jected to an exam by the head physician and if they passed this exam, they should then be permitted to practice medicine. He ordered the head physician to punish “those to whom you did not give a permit, whom you did not exam- ine [but] who without any right make themselves doctors, open stalls and who, contrary to medical knowledge, give things to Muslims”.114 Obviously such pre- cautions did not end the practice of medicine by unqualified people. In 1592, two decades later, Selim’s successor, Murad iii, upon the head physician’s written complaint, ordered that the practice of medicine by those who did not have any medical knowledge, were not trained by skilled physicians, had no practical experience and who were in consequence completely ignorant, be

111 Defterdar Sarı Mehmed Paşa, Zübde-i Vekayiât, Tahlil ve Metin (1066–1116/ 1656–1704), ed. Abdülkadir Özcan (Ankara: Türk Tarih Kurumu Basımevi, 1995), p. 398. 112 Çakmakcıoğlu, Seda (ed.), Koçi Bey Risaleleri (Istanbul: Kabalcı Yayınevi, 2008), p. 142. 113 Özcan, Tahsin (ed.), Fetvalar Işığında Osmanlı Esnafı (Istanbul: Kitabevi, 2003), p. 173. 114 Ahmet Refik, On Altıncı Asırda İstanbul Hayatı (1553–1591), no. 8, pp. 62–3.

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Medicine in Practice 235 banned.115 Not only physicians, surgeons and oculists, but also herbalists were responsible for public health. When Murad iii was informed in 1581 about the malpractice of certain herbalists, who had been selling incorrectly made up medicine, he wanted this issue investigated by the herbalist guild.116 These and similar concerns continued in the years to follow. The reason for setting up such legal and political control mechanisms over the practice of medicine was the fact that medicine was a lucrative business and hence attracted many charlatans. According to the court historian Çeşmizade Mustafa Reşid, who recorded events between 1766 and 1768, abuses in medical practice were very se- rious from the mid-eighteenth century onwards, to the extent that in Istanbul and its environs men from the lower orders, such as blacksmiths and porters, who “quite apart from having no medical skill, had perhaps never spoken to anyone familiar with medicine”, opened medical practices and deceived their “naive” male and female patients and took money from them saying “you have ‘fuvak’ in your eye, ‘sulak’ in your knee, ‘bahar’ in your head, and a sign of magic in your foot. You need treatment and medicine for a long time. Treatment for a patient costs. Those who keep their money away from a doctor, never find health and healing”.117 According to Andrew Wear, in early modern England, “the existence of a large number of empirics at the end of the seventeenth century who used a variety of theories, often mixing Galenic with newer chemical and mechanical ones, indicates that medical theories often were employed more as a means of gaining patients (the appeal of traditional scholarly learning, the attraction of the latest most fashionable philosophy) than for any desire to identify any ‘truth’”.118 This was not much different in the Ottoman realms and new methods in medicine were attractive to Ottoman subjects, too. Hence, European doctors using Tıbb-ı Cedid (The New Medicine) were able to open practices in Edirne at the beginning of the eighteenth century, then the de facto capital of the empire. However, in 1703, patients who were harmed by drugs given to them by European physicians who “abandoned the old ways, and used drugs called new medicine”, complained to the sultan and as result three European physicians practicing in Edirne were banished. The sultan banned the practice

115 Ahmet Refik, Hicri On Birinci Asırda İstanbul Hayatı (1000–1100) (Istanbul: Devlet Matbaası, 1931), no. 16, pp. 8–9. 116 Ahmet Refik, On Altıncı Asırda İstanbul Hayatı (1553–1591), no. 10, pp. 63–4. 117 Çeşmizade Mustafa Reşid, Çeşmî-zâde Tarihi, p. 92. 118 Wear, Andrew, “Making sense of health and the environment in early modern England”, in Medicine in Society. Historical Essays, ed. Andrew Wear (Cambridge: Cambridge Univer- sity Press, 1992), p. 121.

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236 Boyar of Tıbb-ı Cedid and ordered the expulsion of European doctors who practiced it.119 Despite the fact that the Ottoman authorities found such new practices, which were against the traditional and formal medical understanding, harmful, these physicians did not have any difficulty in finding customers among the Ottoman population and this demonstrates the popularity of the new fashion in medical practices and shows how some ordinary Ottoman subjects were familiar with such novelties.

The Limits of European Medical Knowledge: Culture and Life-Style

As understood from contemporary Ottoman accounts, it is clear that the Ot- toman elite, too, did not find the medical world they met foreign to them. In fact, they already had a familiarity with ideas of the world they encountered and grasped them well. When in 1720, Yirmisekiz Mehmed Çelebi (d. 1732), the Ottoman ambassador to France, was kept in quarantine for 40 days near Mont- pellier before being allowed to proceed to Paris, he explained this experience, which he undoubtedly found irritating, not as something extraordinary or something unheard of but as an exercise which he himself found exaggerated and put down to the excessive French fear of the spread of disease.120 More than 50 years before Yirmisekiz Mehmed Çelebi’s visit to France, in the spring of 1665, the famous traveller Evliya Çelebi (d. 1682) went to Vienna as a member of Kara Mehmed Paşa’s embassy to King Leopold i after the Otto- man defeat at the Battle of St Gotthard in the summer of 1664.121 Evliya Çelebi’s eye-witness account of a surgeon’s removing a bullet from the skull of a man who was the king’s relative, clearly indicates familiarity with and appreciation of a well-practiced operation. During the operation the surgeon asked him to approach and look at the brain of the patient whose skull had been opened, which Evliya Çelebi did, first covering his nose and mouth with a handkerchief. When the surgeon asked why he did so, he replied: “Perhaps, while looking I might sneeze or cough and so, to prevent a wind entering into the head of the man, I covered my mouth and nose”. Much impressed, the surgeon con- gratulated him and said “may God give you blessings. If you had taken up this

119 boa, md, nr. 114/171/730 in Yılmaz and Yılmaz, Osmanlılarda Sağlık ii, Arşiv Belgeleri, p. 238. 120 Rado, Şevket (ed.), Paris’te Bir Osmanlı Sefiri. Yirmisekiz Mehmet Çelebi’nin Fransa Seya- hatnamesi (Istanbul: Türkiye İş Bankası Kültür Yayınları, 2006), p. 17. 121 Dankoff and Kim, An Ottoman Traveller. Selections from Travels of Evliya Çelebi, p. 218.

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Medicine in Practice 237

profession you would have been an excellent surgeon”.122 The result of the operation was so successful that the patient was well enough to appear before the king.123 Evliya Çelebi also observed a surgeon treating a patient with tooth- ache. After removing the aching tooth, the surgeon immediately smeared a blue liquid on the gum. After treating the tooth, the surgeon put it back into its cavity, this time smearing it with a red liquid. Deeply impressed, Evliya Çelebi entrusted the surgeon with the treatment of his own loose teeth. The surgeon offered to teach him how to prepare the blue and red concoctions which he had used in return for 100 gold pieces. Evliya Çelebi found this price very steep and, being stingy, only offered 50, and so no deal was struck. Later, however, he regretted this and his failure to obtain this important medical knowledge which he then described as being worth 1,000 gold pieces.124 Impressed by all he saw, by the surgeons he met and the hospital he visited, Evliya Çelebi had only one objection. The food served in the hospital, although prepared by cooks who were so skilful that they prepared food for the king’s guests, was not to his liking, for “the food of the whole of the lands of the infidels is not famous. All infidels drink wine and consume a small quantity of food which they eat on the point of metal forks. Real food is found only in the Ottoman empire. Even in India, China and Persia there is no food apart from their rice which is famous”.125 If there was a border which medical knowledge did not traverse, it was one created by everyday custom, not by any Muslim/Christian divide or rejection of knowledge from outside. Tobacco was introduced into the Ottoman empire in the last quarter of the sixteenth century by European merchants, and it became very popular126 and esteemed for its medicinal qualities. Ibn Cani translated from Spanish to Arabic the section on tobacco from Spanish physician Nicolás Monardes’s Historia medicinal de las cosas que se traen de nuestras Indias Occidentales (Medical History of the Things Brought from Our West Indies), first published in 1565, about the benefits of the use of tobacco leaves and methods of treatment using its juice.127 While the use of tobacco, for example, was acceptable as a remedy for diseases caused by dampness and

122 Dağlı, Yücel, Seyit Ali Kahraman and Robert Dankoff (eds.), Evliyâ Çelebi Seyahatnamesi, 7. Kitap (Istanbul: Yapı ve Kredi Yayınları, 2003), p. 108. 123 Dağlı, Kahraman and Dankoff, Evliyâ Çelebi Seyahatnamesi, 7. Kitap, p. 109. 124 Dağlı, Kahraman and Dankoff, Evliyâ Çelebi Seyahatnamesi, 7. Kitap, p. 110. 125 Dağlı, Kahraman and Dankoff, Evliyâ Çelebi Seyahatnamesi, 7. Kitap, p. 110. 126 Yılmaz, Fehmi, “Tütün”, in tdv İslam Ansiklopedisi, vol. 42 (2012), p. 1. 127 İhsanoğlu, Ekmeleddin, “Eğitim ve Bilim”, in Osmanlı Devleti ve Medeniyeti Tarihi, 2. Cilt, ed. Ekmeleddin İhsanoğlu (Istanbul: ircica, 1998), p. 276; İhsanoğlu, “Endülüs menşeli bazı bilim adamlarının Osmanlı bilimine katkıları”, pp. 588–90.

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238 Boyar was even regarded as useful for sailors on watch to stop them falling asleep, it was condemned by the seventeenth-century Ottoman historians Peçevi128 and Katib Çelebi129 when used for recreational purposes. Perceptions of health could be related to culture and custom, rather than to any medical reality. When Christians and Jews were banned in 1580 from wearing turbans and were instead made to wear hats like European foreigners,130 Jews, according to Gelibolulu Mustafa Ali (d. 1600), bribed the authorities to reverse this order but without much success. According to Gelibolulu Mustafa Ali, the reason for such a reaction was their perception that, as a result of this new headgear, they developed inflammation of the eyes, head colds and head- aches: “By wearing a hat made of a single layer in place of the many-layered, coiled turban, they could not save themselves from various pains and fatigues, and the knives of remorse and loss cut their lungs to pieces”.131 The Europe- ans, too, were on occasion influenced not by medical certainty but by cultural conviction. Although persuaded of the benefits of bathing, Grelot, writing in the late seventeenth century, felt the Turks did this to excess. Spending far too much time in the hamam, “their brains are thereby so over moisten’d that they are generally troubled with a continual Rheume in their eyes”.132 However, for his compatriot Tournefort, who published his travels four decades after Grelot, this time the bath was not harmful; and in fact, Turkish women who washed themselves two times a week were extremely clean and this had positive effects on their health.133 It was thus cultural habituation which could dictate the acceptance or rejection of medicine or medical treatment. Paul Lucas in 1714 requested permission from the local kadı (administrative official), when he was near Adana, to search for plants in the region, permission which was willingly granted on the agreement that Lucas would both give the kadı medicinal herbs and teach him how to use them. The kadı had already requested medicine from him for himself and for his servants, Lucas noting that it was essential to travel with one’s own medicinal supplies when voyaging in foreign lands. Although the kadı was

128 Boyar and Fleet, A Social History of Ottoman Istanbul, pp. 183–6. 129 Katip Çelebi, Mizanü’l Hakk fi İhtiyari’l-Ahakk, pp. 30–8. 130 Ahmet Refik, On Altıncı Asırda İstanbul Hayatı (1553–1591), no. 14, pp. 51–2. According to Gelibolulu Mustafa Ali these events took place circa 1584. Gelibolulu Mustafa Ali, Geli- bolulu Mustafa Âlî ve Künhü’l-Ahbâr’ında ıı. Selim, ııı. Murat ve ııı. Mehmet Devirleri, three vols., ed. Faris Çerçi (Kayseri: Erciyes Üniversitesi, 2000), vol. 3, p. 423. 131 Gelibolulu Mustafa Ali, Künhül Ahbar, 3, pp. 423–4. 132 Quoted in Boyar and Fleet, A Social History of Ottoman Istanbul, p. 267. 133 Tournefort, Joseph de, Tournefort Seyahatnamesi, trans. Teoman Tunçdoğan (Istanbul: Kitap Yayınevi, 2005), vol. 2, p. 71.

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Medicine in Practice 239 willing to give all necessary support to Lucas in his search for medicinal plants, the locals, convinced that he was some sort of sorcerer, were not.134 It was this local opposition, and not that from the kadı, which led to the cancellation of Lucas’s expedition, clearly showing how, while there could be a mutual interest and understanding among Europeans and the higher echelons of Ottoman society, this did not necessarily transcend cultural boundaries among the pro- vincial population. European doctors’ prohibition in the 1840s, the period when European medicine dominated formal Ottoman medical practice, of soldiers in the Selimiye barracks in Üsküdar eating cheese and nuts because this caused itching and mange, was rejected by a local greengrocer who protested that this was affect- ing his income and that “the people of our country are used to eating nuts. There is no harm in it. They are stopping them eating them now but every day they have eight to ten people taken to hospital. Whatever a European says, they do it”.135 Perhaps such a reaction from common Ottoman subjects was not a surprise considering that such people believed that they would get malaria by staring intensely at a comet136 and the population could not be expected fully to em- brace the restrictions and rules brought about by the western medicine which were effecting their daily lives and attacking their cultural habits. However, writing in 1872, Namık Kemal complained about the Ottoman population’s lax- ity over taking measures for the protection of public health, including some of the Ottoman elite: “Even in times of cholera, it seems more difficult to prevent those who are regarded as being from the knowledgeable class from eating wa- termelon and aubergine than it is to capture castles”.137 Indeed, “the Obstinacy of the Patient” was, as Edward Brown noted in the eighteenth century when comparing Spain and Egypt, a universal condition.138 The Ottoman population’s dislike of health restrictions became very evident in the reactions to quarantine which was first implemented in the Ottoman

134 Lucas, Voyage du Sieur Paul Lucas, fait en M. dccxiv, &c. par ordre de Louis xiv. Dans la Turquie, l’Asie, Sourie, 2, pp. 191–4. 135 Kırlı, Cengiz (ed.), Sultan ve Kamuoyu. Osmanlı Modernleşme Sürecinde “Havadis Jurnal- leri” (1840–1844) (Istanbul: İş Bankası Kültür Yayınları, 2009), no. 1044, p. 388. 136 Cabi Ömer Efendi, Câbî Târihi (Târîh-i Sultân Selîm-i Sâlis ve Mahmûd-ı Sânî) Tahlîl ve Tenkidli Metin, ed. Mehmet Ali Beyhan (Ankara: Türk Tarih Kurumu Basımevi, 2003), vol. 2, p. 797. 137 Namık Kemal, “ix. Nüfus”, in Namık Kemal ve İbret Gazetesi, ed. Mustafa Nihat Özön (Istanbul: Remzi Kitabevi, 1938), p. 70 (İbret, 25 June 1872). 138 Brown, Edward, The Travels and Adventures of Edward Brown Esq. (London: Printed by J. Appplebee, 1739), p. 410.

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240 Boyar empire in 1831. In 1840, this reaction, which was accentuated by the heavy handed and culturally inconsiderate implementations of the French doctor who was in charge of quarantine organization in Amasya, a city in central Ana- tolia, turned into mob violence under the leadership of the Muslim religious establishment, and as a result, the doctor was killed in the Greek church where he sought refuge.139 This dislike combined with distrust brought about the reaction of a grave-digger in Istanbul, Mehmed, whose talk was reported by in- formers in April 1841 in Istanbul:

Our state does not respect skilful men, but if someone has no skill but is wearing a hat it respects [that person]. Not one of the patients who come from all the barracks to that hospital in Topçular gets better. The Frank doctor looks after the patient for five or 10 days and then poisons and kills him. A few days ago I heard from Bekir, the hospital grave digger, that the poison from a patient who had died seeped from his winding sheet. Does an infidel show mercy to a Muslim? They want all Muslims to die. Is there no Muslim doctor, that the sons of the umma of Muhammad do not die at their appointed time?140

Conclusion

Ottoman borders were by no means impervious and Ottoman territories were open to the reception of knowledge from much earlier than the seventeenth century, from both West and East. What dictated the acceptance or rejection of new medical knowledge was not whether it came from Europe, or was ‘Chris- tian’ or ‘non-Muslim’ in origin, which was of no relevance, but whether the new knowledge was, or was perceived to be effective, and whether it did or did not clash with established custom. The openness to the transfer of medical knowledge, evident in the early period of the empire’s existence, continued into the nineteenth century. What was different in the nineteenth century from the preceding centuries was not the openness of Ottoman society to European ways but the shift in the balance of power. Whereas before, the Otto- mans could pick and choose, they were now, in the nineteenth century, obliged to accept. After Mahmud ii’s clothing reform in 1828, the statesman and poet

139 Yıldırım, Nuran, “‘Karantina İstemezük’ Osmanlı Coğrafyasında Karantina Uygulamalarına İsyanlar”, in 14. Yüzyıldan Cumhuriyet’e Hastalıklar, Hastaneler, Kurumlar. Sağlık Tarihi Yazıları – 1 (Istanbul: Tarih Vakfı Yurt Yayınları, 2014), pp. 76–8. 140 Kırlı, Sultan ve Kamuoyu, no. 535, p. 259.

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Medicine in Practice 241

Edhem Pertev Paşa took his sons, dressed in new European-style trousers, to see the sultan. Mahmud was pleased with their outfits, but not with their hair style, for instead of the new “Avrupa” (Europe) hair, long with a parting, the sons had shaved heads in Ottoman fashion. Mahmud asked “Why have you shaved their heads? Let their hair be in the “Avrupa” style”. Edhem Pertev Paşa replied that the European hair style gave them head colds, to which the sultan responded “They will get used to it, they will get used to it. Let their hair be “Avrupa””.141 However, even then there was no universal recognition of the authority of European medical knowledge throughout the Ottoman population despite the fact that by this time it was this knowledge that dominated Otto- man medicine.

141 Koçu, Reşat Ekrem, Türk Giyim Kuşam ve Süslenme Sözlüğü (Ankara: Sümerbank Kültür Yayınları, 1969), pp. 18–19.

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