Before modern hospitals and family clinics spread, health in Anatolia was not only a matter between a physician and a patient. The cause of an illness was sought at times in a disturbed balance within the body, at times in the evil eye, in fright, or in the influence of unseen forces; and the remedy was sought in plants and medicines, but also in prayers, rituals and a healing authority attributed to particular families. Amasya holds a distinct place within this wide world, because the city has hosted both one of Anatolia's oldest institutions of formal medicine and a living tradition of folk healing and the ocak. The practices of folk medicine are reported here purely as a cultural compilation; none of them is a treatment recommendation or medical advice.

The Legacy of Institutional Medicine in Amasya

Amasya's association with healing reaches back to the Anatolian Seljuk and Ilkhanid eras. In Seljuk Konya, a hospital for the sick and a bimarhane for the mentally ill stood side by side; in the same century many hospitals were built in centres such as Divriği, Çankırı, Kastamonu, Tokat, Erzurum, Erzincan, Mardin and Amasya, most of which have not survived. The only example still standing in Amasya is the Bimarhane, built in 1308-1309 under the Ilkhanids by Anber bin Abdullah. Sources differ on whom it was built for: some accounts say it was made for the Ilkhanid ruler Olcaytu and his wife, others that it was raised at the request of Yıldız Hatun. The building, faced in cut stone, is notable for the inverted column capitals typical of Anatolian Seljuk architecture and for a relief of a kneeling figure on the keystone of its doorway.

What made the Bimarhane famous is its reputation as one of the first places where music and the sound of water were used in treating the mentally ill. According to the accounts, a pool stood in the middle of the courtyard, one of the patient rooms around it was set aside for musical performances, and the acoustics of the building allowed sound to be heard clearly without echo. The detail that a ten-member ensemble played three days a week is reported for Seljuk and Ottoman bimarhanes in general and rests on Evliya Çelebi's description; no direct document showing that it applied exactly to the practice at Amasya has been seen in this compilation. The building lost its importance in the Tanzimat period, was badly damaged in the earthquake of 1939, and in 1945 had its exterior repaired and was handed over to the municipal conservatory. Today it is arranged as a museum and bears the name of the greatest physician this city produced.

Sabuncuoğlu Şerefeddin

The brightest name in Amasya's medical history is Sabuncuoğlu Şerefeddin. According to the TDV Encyclopaedia of Islam, he was born around 1386, judging from his statements that he was eighty-three years old when writing the Cerrâhiyye-i İlhâniyye in 1465 and eighty-five when writing the Mücerrebnâme in 1468. A neighbourhood in Amasya still called Sabuncuoğlu (Hacı İlyas) keeps the family's trace in the city. Şerefeddin was the grandson of Sabuncuoğlu Mevlânâ el-Hâc İlyas Çelebi Bey, chief physician to Çelebi Sultan Mehmed. He probably trained under Burhâneddin Ahmed en-Nahcuvânî at the Amasya Dârüşşifâ, practised there for fourteen years, and spent some time in Kastamonu in the days of the Candarid İsfendiyar Bey. After writing the Cerrâhiyye-i İlhâniyye he went to Istanbul and presented the book to Mehmed the Conqueror, stopping on his return at Bolu, Gerede and Tosya. His death date is unknown; since his last work was written in 1468, he must have died after that year.

Sabuncuoğlu left three works. The first is the Akrâbâzîn Tercümesi, a translation of the final section, containing drug formulae, of İsmâil b. Hasan el-Cürcânî's Persian Ẕaḫîre-i Ḫârizmşâhî; it is cited under the date 1444 and expands the thirty-one chapters of that section to thirty-three with additions. Sources say the translation was made at the request of Prince Bayezid, but since 1444 does not fit that prince's governorship of Amasya, one should allow for some confusion of name or date. The second work is the Cerrâhiyye-i İlhâniyye, regarded as the first work in the history of medicine to show surgical interventions in miniature painting. The book rests largely on the surgical section of the Andalusian physician Abū al-Qāsim al-Zahrāwī, yet it differs from it by two additional chapters and by original miniatures of instruments and patient treatments. Made up of three chapters on cauterisation, operations, and the treatment of fractures and dislocations, it is best known in the Paris copy, presented to Mehmed the Conqueror and bearing the seal of Bayezid II. Researchers have also noted that some of its cauterisation points coincide with acupuncture points.

The third work, the Mücerrebnâme, was written in 1468 at the request of the circle of physicians in Amasya, according to its author's preface. It describes the preparation and use of medicines tried on animals, on other people and on the author himself, in a language resembling modern case presentations, and consists of seventeen sections that order the medicines from most to least used. It is regarded as the first monograph in Turkish medical history in which a physician describes medicines and treatments of his own devising. That Sabuncuoğlu's name went unnoticed in the Ottoman scientific world for so long is attributed to his writing in Turkish rather than Arabic, the scientific language of the day, and to his living in Amasya. The choice also matters for folk medicine, because a medical text in Turkish was knowledge within reach of literate healers who were remote from Arabic.

The Beginnings of Turkish Medical Writing

Amasya's share in this field is not limited to Sabuncuoğlu. Research on Turkish medical literature indicates that, after the tenth-century Uyghur Turkish medical texts from Turfan, one of the works through which Turkish medical writing gained continuity was the Tuhfe-i Mübarizi, which Hakim Barakat dedicated in the thirteenth century to Alp Gazi, the ruler of Amasya. This work is not a folk medicine compilation; it reflects the theoretical medicine of its time, nourished by Indian, Chinese and Islamic medicine. Turkish medical books of the period were written within the same framework as classical Islamic medicine, based on the four humours, that is, the balance of blood, yellow bile, black bile and phlegm. The physician made a diagnosis from the pulse and the urine, put questions to the patient, and chose medicines that were dry or moist, hot or cold in quality accordingly.

The boundary between this theoretical framework and folk medicine was not sharp. Prescriptions attributed to Ibn Sina's Canon, the narratives of Luqman the Physician and the tradition of Prophetic medicine are counted among the sources of practices used among the people. A formula taken by a physician from a medical book in Amasya and a word or practice passed down over generations by a village ocaklı therefore existed side by side in the same city, and often complemented one another.

The Ocaklı and the Ocak Tradition

One of the most distinctive aspects of folk medicine is the ocak tradition. An ocaklı is a person believed to hold the authority to heal a particular illness. In Anatolia every disease is held to have its own ocak; the spleen ocak, the jaundice ocak, the malaria ocak, the wart ocak and the erysipelas ocak are some of them. This authority is not acquired through training but inherited within the family. Most ocaklı are women, and women are said to be regarded as more capable. In Anatolian folklore studies the ocaklı is interpreted as the form in which the Central Asian shaman has survived to the present; the very notion of the ocak is tied in old Turkic culture to the fire at the centre of the home, to the family and to the continuity of the lineage. In folk medicine, the ocak denotes the family believed to hold the power to heal particular illnesses.

An ocaklı who does not receive the authority by blood is called an izinli. One who has no children or close relatives takes a talented child under their wing, trains them, and when the time comes passes on the power in a ceremony called elverme. Learning within a master-apprentice relationship is called el almak among the people. Those believed to foretell illness rather than treat it, and who take their gift from their family without training, are called orumçu. Ocaklı do not generally make their living from this work. During treatment they pray, recite verbal formulae, and perform symbolic acts of drawing out or binding the illness. In one frequently cited formula the true owner of the cure is not the ocaklı but a sacred figure, and the ocaklı is only an intermediary. This saying is thought to be a form in which old healing prayers addressed to Umay Ana were redirected, within an Islamic framework, to Fatima.

For Amasya-specific counts of ocaklı, names of ocaks and their families, no widespread field study available in full text could be found in this compilation. One of the most comprehensive works on the subject is the unpublished doctoral thesis by İ. Gündüz Alptürker, submitted to Gazi University in 2018, titled Geleneksel Tıbbın Şifa Ritüelleri Üzerine Bir Araştırma: Amasya Örneği. It could be reached only through citations in other articles, so an inventory of Amasya's ocaks cannot be given here. Most of the practices described below were recorded across Anatolia and have not been separately verified for Amasya.

Lead Pouring, Needle Throwing and the Evil Eye

One of the most widespread practices among the people is lead pouring. Lead melted in a vessel is poured over the patient's head into cold water, and the shapes that appear are read to interpret the source and weight of the evil eye. In popular belief the hot lead burns away the harmful influence, and on meeting cold water gives it form and separates it from the person. The evil eye is a belief with deep roots in both folk culture and daily life; it is thought to leave heaviness, headache, loss of appetite and weariness in a person. Against it, charms such as the evil-eye bead, the nazarlık, the amulet and the hamayıl are carried. The bead resembling a blue eye is believed to draw the hostile effect of the gaze onto itself.

The most concrete folkloric record that can be tied to Amasya is the ritual of throwing a needle or knife, associated with lead pouring. In a study on Mersin and Selendi in Manisa, it is reported that the ritual recorded by Alptürker in the Amasya region appears as throwing a knife or needle. In this practice the needle or knife is thrown into water, an ocak or shrine is intended in the mind, and the source from which healing will be sought is determined by the result. What sets the Amasya account apart from other regions is that the practice is independent of lead pouring, that three needles or knives are thrown into the water, and that these must be taken from a family in which a person named Mehmet lives. In forms recorded elsewhere, the needle is left in water overnight and, according to which part rusts or moulds, healing is interpreted as coming from the doctor, the hodja or the shrine. These examples show that in folk medicine the decision about which door the patient should go to was itself lived as a ritual.

Fumigation, Cupping and Leeches

The belief in old Turkic religion that fire purifies and protects lives on in the practice of fumigation in Anatolia. The smoke of plants such as harmal, juniper, sage and bay is carried around the patient and burned in the corners of the house, and it is believed to disperse harmful influences. Researchers draw attention to the shamanic roots of this practice and to its post-Islamic interpretation combined with prayer and intention.

More concrete bodily practices also appear in folk medicine compilations. Bottle drawing, known as dry cupping, involves a bottle or glass in which alcohol-soaked cotton has been lit being pressed to the skin and removed after a few minutes. Scratching the skin to draw blood is called wet cupping. In some regions ocaklı are said to let a few drops of blood from particular places for jaundice, and before the cupping instrument appeared blood was drawn with ox horns. The leech, a freshwater animal that sucks blood and prevents clotting with its secretion, was used for various complaints, mostly in the month of May. Cauterisation is known as alazlama, burning or en vurma, and was carried out with metal or wooden tools, chemicals or plants. These practices are today subject to oversight by health authorities in Turkey and are mentioned here only as a record of folk culture.

The presence of cauterisation among the people is of added interest for Amasya, because Sabuncuoğlu's Cerrâhiyye-i İlhâniyye has a detailed section on it. The first chapter of the book is devoted to the treatment of various illnesses by cauterisation, with fifty-six miniatures and eleven surgical instrument figures. A physician's cauterisation and the people's alazlama may have a common root, but no source establishing this connection has been seen in this compilation, and it is left as an interpretation.

Plants and Natural Products

One of the broad resources of folk medicine was plants. Among the most often mentioned in Anatolia are juniper, thyme, harmal, black cumin, linden, sage, mistletoe, St John's wort, lemon balm and mint; the healers are called by names such as otacı, emçi and kocakarı ilacı. It is said that linden, thyme, sage, nettle and mint gathered from the meadows and gardens of Amasya were boiled, made into poultices or drunk as tea, and that honey, grape molasses, vinegar and olive oil belonged to the same stock. Knowledge of which plant to gather when, how to dry it and how to use it was passed down within the family. Popular experience and scientific findings do not always agree on which plant helps with what; this text therefore recommends no plant.

The written side of plant knowledge is also linked to Amasya. In the Mücerrebnâme, plant drugs such as onion seed, saffron and rose appear in the drug compositions; Sabuncuoğlu used more than twenty drugs and cited physicians such as Hippocrates, Galen and Ibn Sina as his sources. This is an example of the permeability between knowledge accumulated by the people through experience and knowledge that had entered books.

The Phrase Kocakarı İlacı and the Tradition Today

That healing approaches among the people are called kocakarı ilacı (old wives' remedy) in some circles often carries a belittling sense. Yet these practices are highly varied and rest on a tradition of knowledge learned in a master-apprentice relationship. With modernisation and the spread of the modern health system the number of such people has fallen, but some practices embedded in local culture continue. A point folklorists stress is that these rituals are not only a method of treatment but also carry social solidarity, cultural transmission and collective memory. The bond formed among the patient's neighbours, relatives and the ocaklı offers a frame that does not reduce a health problem to the body alone.

These practices do not replace modern medicine today, and what is described here is not advice. A person with a health problem should consult a physician. The folk medicine tradition of Amasya is a cultural record showing that, in a city where written medicine was carried into Turkish by a figure such as Sabuncuoğlu and where music and the sound of water were part of patient care in the Bimarhane, the prayer of the ocaklı, the knowledge of the herbalist and the help of a neighbour were also part of the understanding of health.

Chronology

1308-1309: The Amasya Bimarhane was built under the Ilkhanids by Anber bin Abdullah.

c. 1386: Birth date of Sabuncuoğlu Şerefeddin, calculated from his own statements of age.

1444: The date cited for the Akrâbâzîn Tercümesi.

1465: The Cerrâhiyye-i İlhâniyye was written.

1468: The Mücerrebnâme was written.

1939: The Bimarhane was badly damaged in an earthquake.

1945: Its exterior was repaired and the building was handed to the municipal conservatory.

Sources

Academic studies

  • Nuran Yıldırım, Sabuncuoğlu Şerefeddin, TDV Encyclopaedia of Islam, vol. 35, 2008, pp. 358-359.
  • Ali Haydar Bayat, Cerrâhiyye-i İlhâniyye, TDV Encyclopaedia of Islam, vol. 7, 1993, p. 420.
  • Aslı Bali and Serdar Türe, Şifa Arayışı Bağlamında İğne Atma Ritüeli ve Ocak Kültü, DergiPark.
  • İ. Gündüz Alptürker, Geleneksel Tıbbın Şifa Ritüelleri Üzerine Bir Araştırma: Amasya Örneği, Gazi University, unpublished doctoral thesis, 2018 (through citation only).

Other sources

  • Geleneksel Anadolu Halk Hekimliği, Wikipedia article (with its bibliography drawing on Fuzuli Bayat, Nil Sarı and Ali Haydar Bayat). tr.wikipedia.org
  • Sevgi Şar, Anadolu Tıbbında Ocaklar ve İnanışlar, Zeytinburnu Medicinal Plants Garden, 2003 Medicine Festival.
  • Süleyman Güngör, Türk Halk İnançlarında Sağlık, Hastalık ve Şifa Sembolizmi, Turkish Health Foundation. saglik.org.tr
  • Süleyman Güngör, Türk Halk Tababetinde Şifanın Sembolleri: Anadolu'da Ocaklı Şifacılık Geleneği, Turkish Health Foundation.

Online sources