The institutions in which Amasya cared for the sick and trained physicians can be traced from the Darüşşifa of the early fourteenth century to today's Training and Research Hospital. The best-known name in the city's medical history in the intervening period is Sabuncuoğlu Şerefeddin, a physician and surgeon born in Amasya around 1386. The book he wrote in Turkish, which illustrates surgical procedures with miniatures, is counted among the principal written sources of Turkish medical history. The hospitals opened in the Republican period carried this tradition forward with a deliberate gesture, naming the institution after the physician.

The Amasya Darüşşifa

The Darüşşifa stands in the Yakutiye quarter, beside the avenue that runs parallel to the Yeşilırmak. A single-line Arabic inscription wrapped around three sides of the portal niche states that the building was commissioned during the reign of the Ilkhanid ruler Olcaytu Sultan Mehmed Han by Anber bin Abdullah, believed to have been a slave of his wife İlduş Hatun, with the contribution of Ahmed Bey, the Emir of Anatolia. The date on the inscription is 708 (1308), and construction is generally taken to have begun in 1308 and been completed in 1309. Its foundation deed was drawn up in 1312, but this document has not survived. The architect is unknown. Among its contemporaries in Anatolia are the Gevher Nesibe hospital in Kayseri, the Izzeddin Keykavus I hospital in Sivas and the Turan Melik hospital in Divriği; the Amasya building is one of those showing that the Ilkhanids carried on the Seljuk hospital tradition.

The fact that the building looks at first glance like a Seljuk madrasa has also brought a dispute over its date. The plan, with two rows of arcades around a rectangular courtyard, two iwans facing each other and a monumental portal, matches the classical Anatolian Seljuk madrasa scheme. The portal carries low-relief ornament alongside high-relief palmettes and rûmî motifs, and the keystone of its arch bears a human figure described variously as cross-legged or with its back turned. Round, massive towers at the corners frame the entrance façade. Citing this style, some researchers argue that the building was erected in the reign of Alâeddin Keykubad I, between 1222 and 1232, and that the inscription of 1308-1309 documents a repair. The traditional view treats the inscription as a foundation text. Both views agree that the building reflects every phase of Seljuk stonework; the features of the Konya, Divriği and Sivas monuments and the shallower style of the first half of the century appear side by side on the portal.

The inscription calls the building a darüşşifa, that is, a hospital in the general sense. The popular name bimarhane arose from the notion that only the mentally ill were admitted. In fact the Darüşşifa operated as a medical institution for a long time, both in its beginnings and in later centuries. Patients were examined and treated here, surgery was performed when needed, and students were trained through practice. In this respect, comparing it with today's teaching hospitals is not out of place, and this is why it is cited as one of Anatolia's first medical schools.

One of the features that set the Darüşşifa apart is the treatment of patients with mental disorders through the sound of water and through music. According to the accounts, the central courtyard held a fountain-like arrangement of water, and patients were calmed by its sound. In the Ottoman period maqam music was introduced, and instrumentalists and singers performed suites for the patients on certain days of the week. Details of this practice come mostly from later compiled accounts, and how far contemporary documents record it is open to debate. Even so, it is an established view in the writing of medical history that Amasya was one of the first centres in Anatolia where mental illness was treated with music and the sound of water.

The Setting in Which Sabuncuoğlu Şerefeddin Grew Up

Sabuncuoğlu Şerefeddin was born in a quarter of Amasya that is still known today as Sabuncuoğlu (Hacı İlyas). His family was a well-known family of physicians: his grandfather, Mevlânâ el-Hâc İlyas Çelebi, was chief physician to Çelebi Sultan Mehmed, and his father, Ali Çelebi, had also served as chief physician. The year of his birth rests on no firm record. The TDV İslâm Ansiklopedisi gives 788 (1386), inferring it from his statements that he was eighty-three when he wrote the Cerrâhiyye-i İlhâniyye in 1465 and eighty-five when he wrote the Mücerrebnâme in 1468. The date of his death is likewise uncertain; since his last work is dated 1468 he must have died after that year, and some sources give 1470.

He began his education within the family, in a master-apprentice relationship, and continued it at the Amasya Darüşşifa. His teacher is probably named as Burhâneddin Ahmed of Nakhchivan. It is reported that he began practising medicine at seventeen and worked as a physician and surgeon at the Darüşşifa for fourteen years. After these years he spent some time in Kastamonu in the time of the Candaroğlu ruler İsfendiyar Bey. When he completed the Cerrâhiyye-i İlhâniyye he went to Istanbul and presented the book to Fâtih Sultan Mehmed; we learn from the Mücerrebnâme, which he wrote himself, that on his return he stopped at Bolu, Gerede and Tosya.

His name remained insufficiently known in the Ottoman scientific world for a long time. The first reference to Sabuncuoğlu appears in the Alâim-i Cerrâhîn of 1505 by the surgeon İbrâhim b. Abdullah, who there attributes to him a suppository formula taken from the Mücerrebnâme. His pupil Gıyâs b. Muhammed İsfahânî also praises his teacher's achievements in the Mirʾâtü'ṣ-ṣıḥḥa, which he dedicated to Bayezid II. According to the TDV entry, the fact that he lived in Amasya and wrote his works in Turkish rather than in Arabic, the scientific language of the day, is among the chief reasons he was not better known. His modern recognition began in the twentieth century: Rusçuklu Hakkı introduced the Mücerrebnâme in the newspaper İkdam in 1920, and Ali Canip (Yöntem) brought the Cerrâhiyye-i İlhâniyye to the attention of the scholarly world in 1927.

His Works

The Akrâbâzîn Translation

This work, dated 1444, is a Turkish translation of the final section, devoted to medicines, of İsmâil b. Hasan el-Cürcânî's Persian medical encyclopedia Ẕaḫîre-i Ḫârizmşâhî. Sabuncuoğlu expanded the section, which has thirty-one chapters, to thirty-three through additions. The book opens with the methods of preparing medicines, then separates simple from compound remedies and gives them in turn as electuaries, eyâriç, cevâriş, ıtrıfil, syrups, gargles, oils and ointments. The TDV entry records that the translation was made at the request of Prince Bayezid during his governorship of Amasya; but if Bayezid II was born in 1447, the date of 1444 and this information do not agree, and the discrepancy has not been resolved. It is also noted that at the end of the translation he listed separately the Turkish medical terms for which he had found equivalents. These terms later gained importance because they showed that Anatolian Turkish was usable in medicine at a time when Arabic or Latin was regarded as the scientific language.

The Cerrâhiyye-i İlhâniyye

The work is dated 870 (1465) and was presented to Fâtih Sultan Mehmed. It is largely a translation of the surgical section of the Kitâb al-Taṣrîf by the Andalusian physician Abū al-Qāsim al-Zahrāwī (d. 1013). Even so, it has a value of its own, since Sabuncuoğlu adds two chapters and supplies his own miniatures for certain instruments and patient treatments. This view is not shared everywhere. Some researchers argue that he used al-Zahrāwī only as a source and that the book is an original work that also contains his own observations and experience. Its importance for medical history, for the Turkish language and for the art of painting is beyond dispute. Its Turkish is plain, and because the text is vocalized it also shows how the Anatolian Turkish of the time was pronounced.

Three copies of the book are known. The copy in the Bibliothèque Nationale in Paris and the copy in the Millet Library in Istanbul were written in the author's own hand; the third copy, in the Medical History Library of the Istanbul University Faculty of Medicine, lacks many pages but is known for its miniatures. The finest of the three is the Paris copy, which was presented to Fâtih and bears the seal of Bayezid II. This manuscript left the palace at an unknown date, was given to a French physician by Yâsincizâde İlmî Efendi in 1860, and passed to the Bibliothèque Nationale in 1871. The copy consists of 205 folios of seventeen lines each, and red ink is used in the headings.

The work has three parts. The first treats the cauterization of various diseases and contains fifty-six miniatures and drawings of eleven surgical instruments. In the second, various operations are described with fifty-eight miniatures and 146 instrument drawings. The third is devoted to the treatment of fractures and dislocations and contains twenty-four miniatures and eleven instruments. The numbers of instruments and miniatures are given with small differences from source to source. Another feature singled out among the miniatures is that Sabuncuoğlu drew his own portrait. Research has also pointed out that some of the cauterization points coincide with acupuncture points.

The Mücerrebnâme

Sabuncuoğlu wrote his last work in 1468, according to its preface at the request of the physicians of Amasya. In the book, which has seventeen chapters, medicines are arranged by their effects and areas of use, in order from most to least frequently used. The text describes the preparation and use of medicines tried on various animals, on other people and on the author himself, and contains phrasing reminiscent of present-day case presentations. It is important because it is the first monograph in Turkish medical history in which a physician describes medicines and treatment methods he himself devised.

The experiments in the work are often cited. It is related that to test the antidote he had prepared against snake venom he had the bare skin of a rooster's leg, its feathers plucked, bitten by a venomous snake, then gave theriac and observed the animal, noting that a greenish sore appeared on the skin the next day and that the signs disappeared on the second day. He states that the theriac he used was Tiryak-ı Fâruk. The book also contains an episode from his own life: returning from Istanbul with his assistant he caught lice, prepared a mixture of mercury and pine resin, tied it around his neck with a linen wick and smeared the rest under his armpits, and found that the method also cured an old pain in his shoulder. It is also written that when he could not cure an illness he humbly accepted the methods of those who knew the subject and learned from them. His habit of citing sources, his naming of earlier physicians such as Hippocrates, Galen and Ibn Sīnā where he drew on them, and his recording of favourable and unfavourable effects without concealment are among the grounds of present-day researchers' admiration for him.

Bursalı Mehmed Tâhir had also attributed a work called Müfîd (Nazmü't-teshîl) to Sabuncuoğlu. Later studies showed that this book belongs to his pupil Muhyiddin Mehî. It is also related that this pupil, trained at the Darüşşifa, later served as chief physician at the Ottoman palace.

Modern research in medical history has also drawn attention to certain techniques in the Cerrâhiyye-i İlhâniyye. According to these studies, Sabuncuoğlu described drainage methods for hydrocephalus in children, axial traction in spinal operations and the use of wooden splints after hand surgery, recommended surgical removal of an early-stage breast tumour, and gave detailed information on obstetric complications. These findings rest on individually published articles; claims of "firsts" are received with differing weight among historians.

The Darüşşifa in the Ottoman Period

After Amasya passed to Ottoman rule the Darüşşifa continued to be used for the same purpose. Evliya Çelebi describes it as a very old great madhouse near the Mehmed Pasha Han. The TDV İslâm Ansiklopedisi entry on the bimaristan cites Amasya as an example showing that medical training in hospitals continued under the Ottomans after the Ilkhanids. The building is remembered as one of the important centres in Anatolia that trained physicians; among those said to have been trained here are Şükrullah, who died in 1488, Halîmî in 1516, and Atûfî of Merzifon and Mehmed bin Lütfullâh in 1561. From the foundation register one learns the names, posts and salaries of the Darüşşifa's staff. According to the register, the physician until 1693 was Ahter-i Bâlî; in 1693 Tabib Kostuce arrived, in 1708 Esarbali was appointed, and then Hacı Mahmud took up the post. Hacı Mahmud had studied at the Tıbbiye in Istanbul, and his sons also practised medicine. This line, in which medicine passed from father to son, continued after 1731. In 1747 Mehmed Halife took up the post, in 1751 Abdullah Efendi succeeded him, and in 1758 his son Mustafa Efendi was appointed. Records of assistant physicians are kept in the same register. The same register also contains an entry stating that the building was built by Sultan Alâeddin; this information does not agree with the inscription, which attributes the building to Anber bin Abdullah and the foundation deed to Alâeddin bin Ali Pervane, accepted as the brother of İlduş Hatun.

The institution lost its former function after the Tanzimat. It is related that the building was used first as a depot for silk cocoon merchants and then for timber merchants. Badly damaged in the earthquake of 1939, the building was partly repaired in 1945, and it is also reported that it was repaired between 1948 and 1951 by Ali Saim Ülgen. The restoration begun in 1992 was completed in 1997, and for a time the building was used as the Amasya Municipality Conservatory. In 2011 it was converted into a museum and took the name Amasya Municipality Sabuncuoğlu Museum of Medicine and Surgery History. The museum displays medical and surgical instruments in ten different branches along with musical instruments, and a music therapy hall is also open to visitors.

The city's medical heritage has also been kept alive in scholarly circles. In Kayseri the Gevher Nesibe Medical History Institute held a congress in Sabuncuoğlu's name on 14 March 1985. The International Anatolian-Turkish Darüşşifas and Sabuncuoğlu Congress, held in Amasya on 15-18 October 2008 in commemoration of the 700th anniversary of the Bimarhane under the leadership of the governor of the time, M. Celalettin Lekesiz, was supported by the Governorship, the universities of Amasya and Çukurova, and the Turkish Language, Turkish Historical and Turkish History of Medicine societies. Forty-one scientific papers were presented and 84 people attended in all. The museum stands in the city centre, opposite the Governorship.

The Nineteenth Century and the Gureba Hospitals

From the middle of the nineteenth century, health care in the Ottoman Empire took a new form. In Istanbul, Bezmiâlem Vâlide Sultan, the mother of Sultan Abdülmecid, saw that older institutions such as the Fâtih Hospital and the Süleymaniye Darüşşifa no longer met the need, and had a 200-bed men's hospital built for the poor and the destitute. The Bezmiâlem Gurebâ-yi Müslimîn Hospital opened on 2 April 1845; free treatment of patients without family or means was the core of the foundation's conditions. According to the TDV İslâm Ansiklopedisi, this was the first institution within the tradition of waqf darüşşifas to be called a "hospital" (hastahane), and it is the only gureba hospital that has kept its name and function to this day.

The same model spread to other cities with the contributions of the state and of benefactors. Gureba hospitals were opened under Sultan Abdülaziz at Ruse, Sarajevo, Tulcea, Mostar, Niš and Sofia, and under Abdülhamid II at Skopje, Salonica, Aleppo and Damascus and, in Anatolia, at Ankara, Konya, Erzurum, Antep, Urfa and Bursa; some of these became model or state hospitals in the Republican period. Amasya does not appear in the list given by the encyclopedia. No document was found in the sources consulted for a hospital founded in Amasya under the gureba name either, so the existence of such an institution cannot be confirmed. How hospital services were run in the city in the late nineteenth and early twentieth centuries could be clarified only by a study of the Ottoman archives and the Amasya yearbooks (salnames).

Amasya's Hospitals in the Republican Period

At the founding of the Republic, Anatolia faced infectious diseases, high child mortality and malnutrition after long wars. In these years health services began to be organized by the state, and hospitals gradually took on the character of state hospitals. In Amasya, however, the first modern hospital building came about through the initiative of a local benefactor rather than the state.

The hospital services that followed the Darüşşifa's loss of function became institutionalized in the Republican period. In the Fethiye quarter, Ruhi Tingiz, one of Amasya's notables, had a fifty-bed maternity hospital built in 1950 and donated the building to the Ministry of Health on the condition that his name be preserved. Expanded over time with additional buildings, the structure served for roughly half a century as the city's principal health institution under the name Amasya Ruhi Tingiz State Hospital and reached a capacity of two hundred beds. Details of the services carried out in this building, such as the names of the first physicians, annual patient numbers or the opening dates of departments, do not appear in the sources consulted; what is certain is that from 1950 to 2004 Amasya's hospital services were carried on in this building and its annexes. Although the building is no longer used as a hospital, Ruhi Tingiz's name lives on: the physical therapy and rehabilitation hospital opened in 2013 bears it.

When this building proved inadequate in physical space for meeting the public's needs and its maintenance and repair became uneconomical, the foundation of a new three-hundred-bed hospital was laid in 1991 on a 40,000-square-metre plot in the Kirazlıdere quarter. The building had 3,937 square metres of construction area and 25,235 square metres of service area; a 1,320-square-metre covered garage and 1,948 square metres of staff housing were also part of the complex. Construction took thirteen years. The hospital entered service in its new building on 19 January 2004. On the Governorship's proposal and with the Ministry's approval, its name was set as Amasya Sabuncuoğlu Şerefeddin State Hospital, in memory of Sabuncuoğlu Şerefeddin, one of the most famous physicians and surgeons of the time of Fatih Sultan Mehmed.

The Training and Research Hospital

From 2009 the hospital grew into its present form. On 1 July 2009 the administrations of the Amasya Women's Health and Children's Hospital, built in 1984 as the Amasya Social Insurance Hospital and later renamed Yeşilırmak State Hospital, and of the Sabuncuoğlu Şerefeddin State Hospital were merged under a single chief physician, raising the total bed capacity to 426. On 2 August 2012 a Joint Use Protocol was signed between the Ministry of Health and Amasya University; following it, the institution's name was changed on 25 September 2012, with ministry approval, to Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital. In April 2013 the first faculty member was appointed to its staff and the protocol came into practical effect. The Amasya University Faculty of Medicine had been founded on 4 April 2011, and the hospital's acquisition of its training and research status was a natural result of this development. Today the hospital is referred to as the faculty's teaching hospital. Its clinics include emergency, internal medicine, paediatrics, obstetrics and gynaecology, general surgery, orthopaedics, cardiovascular surgery, neurosurgery, ophthalmology, and ear, nose and throat. The Darüşşifa was an institution that carried on medical teaching and patient care together; today the hospital reunites the same two functions, this time within the joint use of the university and the Ministry of Health.

New units were added in the same years. On 21 October 2013 the fifty-six-bed Amasya Ruhi Tingiz Physical Therapy and Rehabilitation Hospital was opened as an annex; its name preserves the memory of the benefactor who donated the first hospital. On 28 October 2013 the former Yeşilırmak State Hospital building, which housed the Obstetrics and Paediatrics department, was closed and moved to the main building; on 13 February 2014 the Ministry of Health registered the hospital's capacity as 395 beds. On 7 March 2014 the Recep Akyılmaz Community Mental Health Centre entered service. Because of the inadequacy of outpatient services and in order to establish a Cardiovascular Surgery and Angiography Unit, which the province lacked, the Ministry approved the construction of a new annex. On 4 June 2018 the Martyr Gendarmerie Sergeant Kadir Çakı Neighbourhood Polyclinic opened, and from December 2018 the bed capacity reached 460.

The Private Hospital and the Plan for a New Hospital

Amasya's first private hospital is the Özel KOLMED Hospital. According to the speech made at its opening, before this hospital the people of Amasya went to Samsun for private hospital services. The same speech also stated that work had begun on a new 600-bed training and research hospital in the province and that the hospital site was being readied for its foundation stone. The later fate of this plan does not appear in the sources consulted, so it cannot be stated whether the new hospital was opened.

Chronology

1308-1309: According to the inscription, the construction of the Amasya Darüşşifa is completed; some researchers date the building to 1222-1232.

1312: The Darüşşifa's foundation deed is drawn up (the document has not survived).

Around 1386: Sabuncuoğlu Şerefeddin is born in Amasya.

1444: The Akrâbâzîn Translation is written.

1465: The Cerrâhiyye-i İlhâniyye is completed and presented to Fâtih Sultan Mehmed.

1468: The Mücerrebnâme is written.

1845: The Gureba Hospital of Bezmiâlem Vâlide Sultan opens in Istanbul.

1939: An earthquake leaves heavy damage at the Darüşşifa.

1950: The fifty-bed maternity hospital built by Ruhi Tingiz enters service.

1991: The foundation of the new hospital in the Kirazlıdere quarter is laid.

1992-1997: The Darüşşifa is restored.

19 January 2004: The Sabuncuoğlu Şerefeddin State Hospital begins service in its new building.

2008: The International Anatolian-Turkish Darüşşifas and Sabuncuoğlu Congress is held in Amasya.

2011: The Amasya University Faculty of Medicine is founded; the Darüşşifa opens as the Sabuncuoğlu Museum of Medicine and Surgery History.

25 September 2012: The hospital takes the name Training and Research Hospital.

2013-2014: The Ruhi Tingiz Physical Therapy Hospital opens, services move to the main building, and the Community Mental Health Centre enters service.

2018: Bed capacity reaches 460.

Bibliography

Primary sources

Academic studies

Official sources

  • Republic of Türkiye Ministry of Health, Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital, Tarihçemiz (Our History). https://amasyaeah.saglik.gov.tr/TR-1417264/hastanemiz.html
  • Amasya Provincial Directorate of Culture and Tourism, Kültür Portalı, "Sabuncuoğlu Tıp ve Cerrahi Tarihi Müzesi".
  • Amasya Governorship, news report on the opening of the Özel KOLMED Hospital.

Other sources

Online sources