The life of an Ottoman chief physician

Thud, thud, bam, bam, chop, chop. A number of young assistants were busy pounding, grinding and cutting up seeds, roots and plants that would be used alone and combined to treat sick people. The palace’s chief physician, who was also in charge of the pharmacy, stood overseeing the entire process.

He might be the chief physician to the sultan and the imperial court, but he remembered when he was one of those assistants, learning the intricacies of medicine and pharmacology.

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Medicine in the Islamic world was absorbed from doctors of Christian or Jewish background. Teaching was done in hospitals or even in homes since the tradition in Muslim culture was often for fathers to pass on their knowledge to their sons. Frequently this was also done in apothecary shops because the pharmacist was highly trained in the use of traditional medicines and would often prescribe remedies for their customers without their having to resort to a doctor. In fact the pharmacist was often more involved in a personal way with those who came to them for help. We can see that tradition today as pharmacists are willing to provide medicine that one would have thought needed a prescription simply on the basis of the customer’s symptoms.

A part of Islamic medical treatment that was largely based on prevention was the traditional hamam. Hamam attendants were well trained in the art of cleansing the human body, and doctors used this as part of their treatments if the situation warranted it. Today, the Turkish hamam or bath is a remnant of that tradition but is hardly ever used because it has become possible for people to have running water and baths/showers in their homes.

Pharmacology was an integral part of Islamic medicine and prescribing remedies was done on the basis of long experience and observation. Knowledge was inherited from generation to generation, but in addition to that “Materia Medica” by the Greek Dioscorides became the most important source of Islamic pharmacology once it was translated into Arabic in the ninth century.

Hospitals or medical complexes were originally developed in India and by the Greeks. Gradually the Islamic world incorporated these hospitals among the buildings that made up mosque complexes.

In Anatolia, the Byzantines had hospitals, but it was the Rum Seljuks who were responsible for the early work.

The Ottomans first built a hospital in Bursa when the city was the capital of their state. In the 15th century, Fatih Sultan Mehmet II had a hospital built into the complex of his mosque. It contained 70 rooms and even had a separate section for female patients. There was also a separate section for the mentally ill in which music was used as part of their treatment. Later Sultan Beyazid II included a hospital when he built a mosque complex in Edirne. It gained a special reputation for treating eye illnesses and the mentally ill. Today the complex for the most part still exists and has been restored so that one can get a feel for what it might have been like in its day.

The great hospital in Istanbul was built Kanuni Sultan Suleyman in his mosque complex. It was designed to be a kind of graduate school over all the other hospitals in the empire. There were two courtyards and 30 rooms. Students spent several days a week on theoretical issues, and the rest of the time gained practical experience and even performed their internships in the hospital. Today part of that complex – a maternity clinic – is still used for medical purposes. Suleyman’s wife Haseki Hurrem Sultan also built a hospital that was fully equipped and later was used only by women.

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The chief physician, looking back over the years, had never imagined he would end up in the palace. It was a stressful position to say the least. If he was called on to treat the sultan for an illness, he had to cure him of whatever ailed him at the risk of his own life. When the sultan went on campaign, he had to accompany him, ready for any emergency. Only if something should happen when he wasn’t with the sultan would he not be held responsible.

As Professor Ekmeleddin Ihsanoglu has pointed out in his work, “History of the Ottoman State Society & Civilisation,” the chief physician’s day was not his own because he had to accompany the sultan at all times and not just when he went on military campaign. He even had to be present whenever the sultan ate. He had further responsibilities in that his job was as much about prevention as providing cures.

Although he would oversee the assistants, he was ultimately responsible for the various herbal or medicinal potions and mixtures that were used to strengthen the body and increase appetite. In addition he oversaw the preparation of candies, soaps, incense, perfumes and sugar used in medicinal mixes.

The medicines for the sultan would be prepared by the palace pharmacist at the direction of the chief physician. During the course of the preparation, it would be witnessed by two Janissary guards. Once the medicines were prepared, they would be placed in containers depending on what type they were and then wrapped. Instructions on their use would be attached to them and then they would be sealed by the chief tutor of the palace.

He had his own office on the palace grounds in a low tower set amid the tulip gardens – his pharmacy was there, too, and there was a hospital on the grounds especially for members of the palace. He must have lived there, too, because it’s hard to see how he would be able to live away from the palace. He received a salary plus allowances for food and dress as he was responsible for all of the medical staff including surgeons, oculists, etc. on the palace grounds. At holiday times, he would receive valuable gifts and even furs that eased his life and lack of control over his own time and wishes.

As the chief physician, he oversaw the palace staff and eventually the five hospitals in Istanbul. He also oversaw hospitals throughout the Ottoman Empire and mental institutions and medical education. He approved appointments to hospitals and mental institutions and licenses for physicians and surgeons who wanted to practice in their own private clinics. He could also close the shops of those physicians and surgeons if they didn’t have the proper qualifications or meet certain standards.

In some ways, the chief physician had a comfortable life, but the pressure must have been horrendous. It’s hard to imagine why anyone would want to hold that position.