On the avenue that runs along the Yeşilırmak in Amasya stands a tall façade of cut stone, crowned by a monumental portal. This is the building known as the Bimarhane or Darüşşifa. It was constructed in 1308-1309 under Ilkhanid rule and worked for centuries as a medical madrasa, a place where patients were treated and physicians were trained. It is regarded as the Ilkhanid-period work of Amasya that has survived to the present day. It is also known as the place where the mentally ill were treated with music and the sound of water, and today the same building can be visited as the Sabuncuoğlu Şerefeddin Museum of Medical and Surgical History.

Name and Location

In Persian, bimar means "sick", and bimarhane means a house for the sick, that is, a hospital. In the Seljuk and Ottoman worlds, the same institution was called by several names at once: darüşşifa, bimaristan, maristan, şifahane and darüssıhha. The narrowing of the word to mean only a place for the mentally ill is a much later development. Scholars note that the word bimarhane began to be used in the sense of tımarhane (asylum) after the seventeenth century, and that darüşşifa buildings were generally referred to as houses for the insane in the late eighteenth and early nineteenth centuries. The building in Amasya settled into popular usage under the name Bimarhane accordingly. Yet its inscription and the sources describe it as a general hospital, more precisely as a healing institution that also provided medical education. It came to be known as a bimarhane because of the belief that only the mentally ill were treated there. The records also contain the names Amasya Tımarhanesi and the Anber bin Abdullah Hospital.

The building stands in what used to be the Yakutiye quarter, beside the main avenue running parallel to the Yeşilırmak. Its plot is bounded by Atatürk Avenue to the south, Sabuncuzade Street to the west and Habibe Street to the east. Its present address is Atatürk Avenue in the Pirinççi quarter. The portal faces the avenue on the western side; the other façades were later strengthened with buttresses and have lost their original appearance.

The Darüşşifa Tradition in Anatolia

To understand the Amasya Darüşşifa, one has to see why the hospital was also an educational institution in the Islamic world. According to the Turkey Tourism Encyclopedia, the first examples of these buildings appeared under the Abbasids, and in the time of Harun al-Rashid and al-Ma'mun darüşşifas serving both treatment and teaching were founded. The Bimaristan of Adud al-Dawla, built in Baghdad in 981 by the Buyid emir of that name, is among the most important examples of the tenth century. Under the Great Seljuks, medical units attached to the Nizamiye Madrasas were opened, and the Nur al-Din Hospital in Damascus (1154) became one of the best-known buildings of this tradition. In Anatolia the principal surviving examples are the Gevher Nesibe Darüşşifa and Medical Madrasa in Kayseri (1206), the Keykâvus Darüşşifa in Sivas (1217), the Turan Melek Darüşşifa in Divriği (1229), the Atabey Ferruh Darüşşifa in Çankırı (1235), the Ali b. Pervane Hospital in Kastamonu (1272) and the Pervane Bey Darüşşifa in Tokat (1275).

The Bîmâristan entry in the İslâm Ansiklopedisi describes how physicians in these hospitals taught their students at the bedside, and how the treatment of patients and medical education went hand in hand. The same entry says that the principles of treating the mentally ill with medicines and music should be sought in the Seljuk hospitals. It also notes that the Mongols, taking Seljuk hospitals as their model, founded various hospitals in cities such as Amasya, Sivas, Tabriz, Hamadan, Sultaniyya, Shiraz and Baghdad. The hospital founded in Amasya in 1309, although built under Mongol rule, bears all the characteristics of Seljuk hospital architecture. The building is a concrete example of how the Anatolian Seljuk heritage continued in the Ilkhanid period.

Its Construction and the Inscription

After the Battle of Kösedağ in 1243, the Mongols, who held Anatolia, also took Amasya, and for a time the city was governed by Mongol governors. The Bimarhane is the monumental building that has reached Amasya from this period of tutelage, and its inscription records that it was a charitable undertaking by someone from the ruler's circle.

The date of construction and the founder of the building are learned from the Arabic inscription that runs in a single line around three sides of the portal's niche. The inscription is dated to the year 708 of the Hijra, that is, 1308-1309. According to the Turkish translation given by the Municipality of Amasya, this blessed darüşşifa came into being under the reign of the great sultan Olcaytu Mehmed Han and in the time of the great queen İldüş Hatun, built by Anber bin Abdullah, who calls himself a weak servant. The inscription ends with the wish that God accept this good work, and it also mentions the emir of Anatolia. The name of the Anatolian Emir Ahmed Bey also appears in the inscription, and some publications therefore write that Anber and Ahmed Bey had the building built together. According to the inscription, Anber was a slave of İldüş (Yıldız) Hatun, the ruler's wife. Some researchers note that the work was begun while Sultan Olcaytu and his wife were visiting Amasya in 1308. Nothing at all is known about who the architect of the building was.

The inscriptions on the walls and on the portal show that construction began in 1308 and ended in 1309. The endowment deed of the darüşşifa is known to have been drawn up in the year 712 of the Hijra, that is, 1312, but the deed itself has not survived. For this reason we have no firsthand information about how much income was set aside for the foundation or who was assigned to it. The fact that the Ottoman-period endowment register names Sultan Alâeddin as the founder of the building has been regarded as a mistake in that register. According to local accounts, the person who had the deed drawn up was Alâeddin bin Ali Pervane, accepted to be İldüş Hatun's brother; he is said to be buried, together with his father İzzeddin Mehmed, in the Pervane Mosque in Amasya.

There is also a second view on the dating of the building. According to the museum's guide notes and to publications cited by Prof. Dr. M. Şerefittin Canda, it is hardly likely that the Ilkhanids, arriving in Amasya in 1308, built the structure in so short a time. According to this view, the building was erected in the 1220s, in the time of the Anatolian Seljuk Sultan Alâeddin Keykubad I, while the Ilkhanids had repairs carried out in 1308-1309 and set up a new inscription. The fact that the Ottoman archives refer to the building as the Sultan Alâeddin Darüşşifa is also offered as a clue supporting this view. This thesis has not replaced the widely accepted Ilkhanid dating; most of the governorship, encyclopedia and municipality texts present the building as constructed in 1308-1309 in the Ilkhanid period. Unless a new document is found that can decide between the two views, the plain statement of the inscription remains the basis.

Architecture

The building follows the plan scheme of a classical Seljuk madrasa. Porticoes run along both sides of a rectangular courtyard, parallel to its long axis, with rooms behind the porticoes. The entrance iwan and the main iwan facing it give the building a two-iwan scheme around a courtyard. This scheme is seen in a similar form in the Sivas and Divriği darüşşifas in Anatolia and in centres founded by the Ilkhanids such as Sultaniyya. The main iwan opens onto the courtyard through a pointed arch and is covered with a roof-and-vault system; in its east wall is a tall rectangular window framed by jambs of brick. The transverse rectangular corner chambers on either side of the iwan are entered from the porticoes through doors with segmental arches, and they are covered by barrel vaults. The main iwan measures 7.10 × 5.70 metres inside, and the corner chambers 6.10 × 7.80 metres. A notable feature of the corner chambers on the portal side is that they open to the west façade through large windows 1.30 metres wide; toward the side façades they look out through loophole windows. The doors of the western corner chambers, unlike those on the east, are made of wall masonry with pointed arches, and the barrel vault of these chambers is reinforced by a brick arch 0.70 metres wide that projects beyond the wall. The iwan-like spaces in the same section resemble corridors giving access to the 7.80 × 4.40 metre rooms on either side of the portal iwan.

The porticoes on the two sides of the courtyard are covered with flat stone blocks, and the pointed arches that carry them are of regular cut stone. The capitals of the columns on which the arches rest differ from one another: some are plain, some have muqarnas, some are moulded. Behind the porticoes are long hall-like spaces, each opening onto the portico through three segmental-arched doors. These halls, measuring 4.65 × 14.10 metres, are closed by a long barrel vault carried on pointed brick arches 0.60 metres wide, and the arches rest on springer stones set into the walls. They open to the outside through loophole windows. According to one account, there are three rooms on the right of the courtyard and two on the left, and on the entrance side a large room in the middle with a small one on each side, making nine rooms in all; the building is 24.5 metres wide and 34 metres long. Prof. Dr. M. Şerefittin Canda gives the total number of rooms as ten; the variation between sources depends on which spaces are counted. The article on the Amasya Darüşşifa in the TDV İslâm Ansiklopedisi gives the outer measurements of the building as 33.60 × 25.60 metres and places its long axis in an east-west direction; this differs by about a metre from the 24.5 × 34 metre measurement above, and since it is not stated from which points the two were taken, the difference cannot be explained.

The truly monumental side of the building is its west façade facing the avenue. This façade, built of regular cut stone, is bounded at the top by a thin, moulded stone frieze. The portal is taller than the façade by about a third and projects outward; the large windows on either side and the cylindrical corner towers that bound the façade at its two ends balance this height and give a symmetrical appearance. The portal space, measuring 4.10 × 6.50 metres, was conceived like a pointed-arched, barrel-vaulted iwan, and the segmental-arched niches on either side, 0.70 metres deep, make the volume more effective. The door opening has a broken arch with moulded sides, and the iwan is joined to the façade by a niche two metres deep. The restitution drawing of the building published in A. Gabriel's Monument Turc d'Anatolie (Paris 1934) shows its original layout. Almost all the decoration of the building is gathered on this portal and the windows beside it; the other façades are plain and partly of rubble stone.

The stonework of the portal brings together various elements of Seljuk stone decoration. Within the triangular niche filled with muqarnas can be seen geometric interlacing, star motifs, vegetal rûmî, lotus and palmette reliefs, as well as ornament based on writing. The geometric ornament, arranged in three bands each, is completed by fine carvings of curling branches and leaves. Some researchers see in this portal the characteristics of the Konya, Sivas and Divriği buildings together with the more superficial style of the first half of the century, and say that it shows the period of Anatolian Seljuk dominance in stone craftsmanship drawing to its end. The inverted column capitals made of Turkish triangles, said to have been tried for the first time in Anatolian Seljuk architecture on the façade edges of this building, also draw attention.

Another feature of the portal is the human relief carved on the keystone of the arch. The sources describe it differently, as a figure kneeling, sitting cross-legged, crouching, or turned with its back to the viewer; all stress that the figure is unique to this building. According to the museum's guide notes, the stones forming the portal are set in an interlocking manner. Since Amasya lies in a first-degree earthquake zone, this arrangement is said to have been chosen to keep the building whole during tremors. In the building, the portal, which is the main element of ornament, is worked in stone, and in the courtyard façade the columns and capitals are of stone, while the walls and vault coverings are of irregular stone courses; brick is used in the vault arches that serve to prevent spreading.

Medical Education and Physicians

Soon after its foundation the darüşşifa became a centre of practical medical teaching. It was a building where patients were treated and surgical procedures were shown to students, so that education and care went on together. This is why it has been compared to the teaching hospital of a modern medical faculty. The sources record that scholars of medicine emerged among those trained here and that physicians appointed as teachers in the madrasa were to be found. Among the physicians reported to have trained in the building, the following names are mentioned: Şükrullah, who died in 1488, Halîmî in 1516, and Atûfî of Merzifon and Mehmed bin Lütfullah in 1561.

The most famous of these physicians is Sabuncuoğlu Şerefeddin of Amasya. That he practised as physician and surgeon here is learned from his own Mücerrebnâme, and the Darüşşifa article repeats the information from that work. The İslâm Ansiklopedisi writes that he worked at the Amasya Darüşşifa for fourteen years as physician and teacher. Since he states that he was eighty-three years old when writing the Cerrâhiyye-i İlhâniyye and eighty-five when writing the Mücerrebnâme, his birth year is calculated as 788 (1386); the museum gives 1385. He was the grandson of a family of physicians whose name lives on in the quarter called Sabuncuoğlu (Hacı İlyas) in Amasya today: his grandfather was Sabuncuoğlu Mevlânâ Hacı İlyas Çelebi, chief physician of Çelebi Sultan Mehmed. It is noted that he probably studied under Burhâneddin Ahmed en-Nahcuvânî at the darüşşifa and that, after working for fourteen years, he spent some time in Kastamonu with the Candaroğlu İsfendiyar Bey. Prof. Canda writes that he began working as a physician at the Amasya Darüşşifa at the age of seventeen.

Sabuncuoğlu's best-known work is the Cerrâhiyye-i İlhâniyye (Cerrâhiyyetü'l-Hâniyye), which he completed in 1465. The book is based on the surgical section of the Kitâbü't-Taṣrîf of Ebü'l-Kāsım ez-Zehrâvî of Andalusia, to which the author added his own experience. The work is significant in the history of medicine because it contains miniatures showing operations and is written in plain Turkish; the miniatures of the Istanbul Institute of the History of Medicine copy were studied by Gönül Güreşsever in a paper given at the Turkology Congress in 1973. Prof. Canda reports that the first part of the book contains 54 treatments, seven instruments and four incision methods, and the second part 58 treatment methods, 138 drawings of instruments and ten incision methods. Sabuncuoğlu took the book to Istanbul and presented it to Mehmed the Conqueror, and on the return journey he stopped at Bolu, Gerede and Tosya. One copy of the work is kept in the Millet Library in Istanbul and another in Paris. Earlier, in 1444, he had translated into Turkish the Akrâbâzîn section of Jurjani's Zakhîra-i Khwârazmshâhî, which contains information on medicines, and in 1468 he wrote the Mücerrebnâme. The Mücerrebnâme is a work in which medicines are arranged by their effects and areas of use, from the most commonly used to the least, and in which the author describes the medicines he tried on animals, on other people and on himself; its preface states that it was written at the request of the circle of physicians in Amasya. The TDV İslâm Ansiklopedisi records that this monograph is the first work in the history of Turkish medicine in which a physician describes medicines and treatment methods of his own invention.

It is also noted that Sabuncuoğlu's name was for a long time not sufficiently known in the Ottoman scientific world. His name first appears in the 1505 work Alâim-i Cerrâhîn by the surgeon İbrâhim b. Abdullah. His student Gıyâs b. Muhammed İsfahânî praises his teacher's achievements in the Mirʾâtü'ṣ-ṣıḥḥa, which he dedicated to Bayezid II, and another student, Muhyiddin Efendi, later became chief physician at the Ottoman palace. The TDV gives as the main reasons for his insufficient recognition the fact that he lived in Amasya and that he wrote his works in Turkish rather than in Arabic, the scientific language of the day. His death is estimated to have occurred after 1468, when the Mücerrebnâme was written, around 1470.

The museum's account also relays some stories about Sabuncuoğlu. One is that he tested the antidote he had developed against snakebite first on his own finger and then on a rooster. According to the same account, the handles of his surgical instruments were shaped differently from one another, so that the surgeon, who had no assistant, could recognise the instruments easily. These stories are relayed in the guide notes without reference to a written document, and they should therefore be taken as museum narrative rather than as verified historical fact.

Treatment with Music and the Sound of Water

The aspect of the building mentioned most often is the claim that the mentally ill were treated here with music and the sound of water. Most sources present the Amasya Darüşşifa as the first hospital in Anatolia to practise treatment with music. According to the account of the municipal museum, in the Ilkhanid period there was a fountain in the middle of the courtyard, and the mentally ill were seated around it and treated with the sound of water. In the Ottoman period, makam music began to be applied to patients, and an ensemble of singers (hanende) and instrumentalists (sazende) performed suites (fasıl) for the patients on three days of the week. A health encyclopedia writes that this practice also gave rise to the first musical ensemble in the Ottoman Empire. The records concerning the Fatih Bimarhane (1470) and the Edirne Bayezid II Darüşşifa (1488) show that treatment with music was later carried on more widely in the Ottoman world. Studies based on these records say that the belief that the vibrations of sound affect brain tissue led to the practice being applied to the mentally ill.

There is no surviving written document on what kind of music was performed in the founding period. The accounts that patients were treated according to makam have been handed down from generation to generation and passed into the writings of later periods. The claim of being "the first" is also open to debate. One source places Amasya third in chronological order in Anatolia, while another calls it the first mental hospital in Anatolia and Europe; yet it is known that the treatment of the mentally ill with medicines and music was already practised in most Seljuk hospitals. The value of Amasya lies less in the claim of being "the first" than in being a well-preserved, inscribed and dated example of this tradition.

In the Ottoman Period and After

After Amasya passed to Ottoman rule, the building continued to be used for the same purpose. There are two separate reports from Evliya Çelebi. The municipal text writes that Evliya refers to the building as the "Lodge of the Lepers" (Miskinler Tekkesi), which is thought to have arisen from the fact that the building was then set aside for the mentally ill. Another source reports that Evliya speaks of a very old great tımarhane near the Mehmed Paşa Han. The two records do not exclude each other; both show that in that century the building was known as an institution serving the mentally ill.

According to the Ottoman endowment register, records of physicians and assistants were kept from the end of the seventeenth century onward. As physician, Ahter-i Bâlî is named until 1693, Kostuce in that year, and Esarbali in 1708; then Hacı Mahmud Efendi is appointed, and it is noted that he had studied at the medical school in Istanbul. His sons İsmail and İbrahim were also physicians. In 1731 two sons of İsmail Efendi took up posts at the hospital, and in 1747 both were dismissed and Mehmed Halife took their place. After his death in 1751 Abdullah Efendi, and after Abdullah Efendi's death in 1758 his son Mustafa Efendi, was appointed. The last physicians in the register are Hafız Emin and Seyid Mehmed Efendi, sons of Yusuf Efendi. The names of the assistants are also recorded. The same register states everyone's duties and salary, and there seem to have been no large pay gaps among the staff. Since appointments to the headship of the madrasa were made in 1693, 1708, 1747, 1800, 1809 and 1815, the madrasa and hospital were working at least until the beginning of the nineteenth century.

After the Tanzimat the building lost its former function. Part of it was used as a depot by silk-cocoon dealers, then by timber merchants and Amasya tradesmen, and the abandoned building fell into ruin. One source, however, writes that the building was used for medical purposes until a time close to the proclamation of the Republic; since this statement cannot be reconciled with its use as a depot after the Tanzimat, the difference between the records remains an unresolved point.

Repairs and the Museum

The building was heavily damaged in the Erzincan earthquake of 1939. Its outer façade was repaired in 1945, and according to information cited by Prof. Canda, further repairs were also carried out in 1948-1951 under the direction of Ali Saim Ülgen. The most comprehensive restoration began in 1992 and was completed in 1997. From that date on, with some sources stating after 1999, the building was used as the Amasya Municipality Conservatory. One source reports that Turkish art music and folk music concerts were given at the conservatory on two days of the week, and that through the day the courtyard filled with the sounds of people and instruments rising from the work going on in the side rooms. One of the rooms has been arranged as a Museum of Turkish Music Instruments.

From 2011 the building was converted into a museum and took the name Amasya Sabuncuoğlu Şerefeddin Museum of Medical and Surgical History; the museum is run by the Municipality of Amasya. The museum has the Sabuncuoğlu Hall, where medical and surgical instruments in ten different branches, made on the basis of the drawings in the Cerrâhiyye-i İlhâniyye, are displayed; the Sabuncuoğlu Clinic, where surgical operations and treatments are re-enacted; and the Music Therapy Hall, where the instruments used in music therapy and the Turkish music makams are introduced. In glass cases, 172 exact replicas of the instruments Sabuncuoğlu used are displayed. In the surroundings there is a garden of useful plants. In Amasya, the Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, opened on 19 January 2004, also bears the name of the same physician.

Chronology

1308: According to the portal inscription, construction begins on the darüşşifa built by Anber bin Abdullah in the name of the Ilkhanid ruler Olcaytu Mehmed Han and İldüş (Yıldız) Hatun (708 H.).

1309: The building is completed.

1312: The endowment deed, which has not survived, is drawn up (712 H.).

1386 (approximately): The physician and surgeon Sabuncuoğlu Şerefeddin is born in Amasya.

1444: Sabuncuoğlu completes his translation of the Akrâbâzîn.

1465: The Cerrâhiyye-i İlhâniyye is written and presented to Mehmed the Conqueror.

1468: The Mücerrebnâme is completed.

1693-1815: Appointments of physicians and madrasa heads are recorded in the endowment register.

1939: The building is heavily damaged in the Erzincan earthquake.

1945: The outer façade is repaired.

1992-1997: Comprehensive restoration is carried out; the building is used as the Municipal Conservatory.

2011: The building is converted into a museum under the name Sabuncuoğlu Şerefeddin Museum of Medical and Surgical History.

Bibliography

Academic studies

Official sources

Other sources

Online sources