The sentence most often repeated about the Amasya Dârüşşifâ is that it cured the mentally ill with music and the sound of water, and that it was the first place in the world to do so. The claim rests partly on firm ground and partly on ground that needs testing. That the effect of music on body and soul was debated in Islamic medicine for more than a thousand years, that Ottoman physicians wrote tables matching musical modes (makam) with illnesses, zodiac signs and hours of the day, and that musicians were assigned to some hospitals are well-documented facts. How any of this was actually practised in the building at Amasya, however, cannot be recovered from the sources available today. To weigh the part of the subject that belongs to Amasya, one has first to know the theory of this tradition, its texts and its traces in other hospitals, and only then return to the city's own documents. Taken this way, the subject shows at once the real depth of the idea of healing through music and the limits of what can be said about Amasya.

The Building in Brief

The Dârüşşifâ stands in the Yâkutiye quarter, beside the street that runs parallel to the Yeşilırmak, and was built on the plan of a madrasa. According to the Arabic inscription that runs around the niche of the portal on three sides, it was built in 708 (1308-1309) by Anber bin Abdullah, a slave of İlduş (Yıldız) Hatun, wife of the Ilkhanid ruler Öljeitü, together with Ahmed Bey, the Emir of Anatolia. The architect's name is unknown. The endowment deed drawn up four years later, in 712 (1312), has not survived, and its loss means that the most direct document on the daily running of the building, its staff and its expenses is missing. Some historians of medicine argue that the building actually dates from the reign of Alaeddin Kayqubad I, in the 1220s and 1230s, and that the Ilkhanid inscription records a restoration; this view has remained a minority one, and the accepted dating rests on the year 708 given in the inscription. Its status as the only Ilkhanid monument to survive in Amasya, the kneeling human figure carved on the keystone and the stonework of the portal also give the building a place of its own in the history of architecture.

In the inscription the building is called a dârüşşifâ, that is, a hospital in the general sense. The popular name Bîmarhâne arose from the notion that only the mentally ill were kept here; according to Gönül Cantay, the building functioned from the outset, and for a long time, as a general medical institution. Cantay suggests that the main iwan may have served as a teaching space for theoretical lessons, the side halls as patients' rooms, and the rooms beside the iwan as a pharmacy and consulting room, and she speaks of an institution in which physicians were trained through apprenticeship. On the authority of Hatemi it is reported that after the city passed under Ottoman rule the dârüşşifâ continued to serve with its physicians and pharmacists. The existence of a ward set aside for the mentally ill, however, has not so far been demonstrated by either architectural or written evidence. Even if the popular name hints at it, a name is no substitute for proof; as in the cases of Kayseri or Edirne, keeping the mentally ill in one section may simply have been the normal arrangement of a general hospital.

The Four Humours and the Place of Music in Medicine

The idea that music could do a sick person good rests on the theory of the four humours (ahlât-ı erbaa) at the foundation of Islamic medicine. In this view the body contains blood, phlegm, yellow bile and black bile (sevdâ); each is a compound of the qualities hot, cold, dry and moist, and each corresponds to one of the four elements, fire, air, water and earth. Health is the balance of these fluids, illness the disturbance of that balance. Passed from Hippocrates to Galen and from Galen to the physicians of Islam, this idea kept its hold until the nineteenth century. When it was joined to the Pythagorean assumption that sound is an order built on ratios and that the universe carries a harmony expressed in numbers, it became easy to conclude that a temperament whose harmony had been upset could be rebalanced by harmonious sounds. The attachment of zodiac signs, planets and elements to the musical modes grows out of this common ground.

The first thinker to treat music systematically on this basis was the philosopher al-Kindî, who lived in Baghdad in the ninth century. In his treatises on music, which survive only in part, al-Kindî matches the four strings of the oud with the four humours and the four elements. The thickest string, the bam, corresponds to earth and black bile, the mesles to water and phlegm, the mesnâ to air and blood, and the thinnest, the zîr, to fire and yellow bile. According to Recep Uslu's study, in al-Kindî's time the strings were even dyed accordingly: the bam black, the mesles white, the mesnâ red and the zîr saffron yellow. For al-Kindî the melodies of each string strengthen one humour and calm its opposite. The melodies of the mesnâ stir the blood and check the violence of black bile, while those of the zîr strengthen yellow bile and soothe phlegm.

Other details in al-Kindî's text are striking too. He divides the effects music arouses in people into three, joy, courage and sorrow; he says that rhythmic patterns (îkâ) suit morning, noon, the end of the day and bedtime respectively; and he writes that the hour at which music begins should vary with the listener's age, the season and the listener's temperament. To heighten the effect he also recommends using scents such as rose, narcissus, jasmine and violet, and colours as well. An important observation of Uslu's is that al-Kindî names no illness at all; the text stays at the level of emotions and temperaments. The story related by Ibn al-Qifti, that al-Kindî cured a paralysed boy with music, is regarded as doubtful because it does not appear in sources closer to al-Kindî's lifetime.

al-Fârâbî, the Ikhwân al-Safâ and Ibn Sînâ

A generation later, al-Kindî's treatises passed into the hands of al-Fârâbî (d. 950), who wrote the Kitâb al-Mûsîqâ al-Kabîr in Baghdad, and of the Ikhwân al-Safâ, the Brethren of Purity of Basra. al-Fârâbî's great book on music is essentially devoted to the theory of sound, intervals and rhythm. A list widely circulated in Turkish literature under his name, however, assigns emotional qualities to the modes: rast gives a person contentment, rehâvî the thought of eternity, küçek sorrow, büzürg fear, ısfahan movement and confidence, nevâ cheerfulness, hüseynî calm, bûselik strength, hicâz humility, sabâ courage, uşşâk the urge to laugh, and zirgüle sleep. Whether this list appears in this form in al-Fârâbî's own text is a question that needs separate examination. Given that most of the mode names became established in the centuries after al-Fârâbî, it is quite possible that the list belongs to a later compilation and was attached to his name.

The fifth of the Epistles of the Ikhwân al-Safâ, written in the tenth century and devoted to music, sees music as a reflection of the harmony of the universe and says that music used in the right place and at the right time heals the body. Among the melodies used for different purposes, the epistle also lists those played in hospitals in the early hours before dawn to ease the pain of the sick. The passage is valuable as an early and direct text on the use of music inside a hospital. The Mujmal al-Hikma, a free Persian translation of the Epistles made in the fourteenth century, likewise writes that a person well versed in the natural sciences and skilled in music can treat illnesses with music suited to the case.

Ibn Sînâ (Avicenna, 980-1037) was both a physician and a theorist of music. The music section of his Kitâb al-Shifâ is mainly theoretical; according to a sentence frequently quoted under his name in Turkish literature, one of the most effective ways of treatment is to strengthen the patient's mental and spiritual powers, to give him the courage to fight the illness, to make his surroundings pleasant, to let him hear the best music and to bring him together with the people he loves. The place where Ibn Sînâ joins medicine and music most concretely, however, is the subject of the pulse. In the sixth chapter of the Risâla-yi Ragshinâsî, written in Persian for Alâ al-Dawla Kâkûya after 1021, he explains that some pulses carry a regular rhythm like the metres of music, and that knowing rhythm (îkâ) and musical ratios helps one to feel the pulse correctly. He reports Galen's view on the matter, but says that the ratios Galen gives contain errors, and adds that a physician need not know music as thoroughly as a musician.

This link between pulse and rhythm in Islamic medicine is not peculiar to Ibn Sînâ. In his Kâmil al-Sinâ'a, Ali ibn Abbas al-Majûsî writes that a physician needs some knowledge of touching strings and holding melodies in his mind in order to feel the pulse with his fingers. Abû Zayd al-Balkhî, a pupil of al-Kindî, divides medicine in his Masâlih al-Abdân wa'l-Anfus into bodily and spiritual medicine, and describes listening to music as a kind of remedy for disorders of the soul. In al-Hâwî, Abû Bakr al-Râzî recommends musical gatherings for melancholy and nervous disorders, and in Firdaws al-Hikma Ali ibn Rabban al-Tabarî advises looking at gardens and listening to music to sharpen the appetite and overcome bodily weakness. What these texts have in common is that they treat music as an auxiliary element, considered together with the setting, the diet and the patient's state of mind.

al-Jurjânî and a Thread Leading to Amasya

The link in this chain that holds a special place for Amasya is Zayn al-Dîn Ismâ'îl al-Jurjânî (d. 1137), a physician of the Khwarazmshah period. His great Persian medical work, the Dhakhîra-yi Khwârazmshâhî, touches on the benefits of music in treatment and even gives the names of modes and rhythmic cycles for certain illnesses. As reported by Murat Salim Tokaç and Seyid Muhammed Taki Hüseynî, al-Jurjânî recommends, for insomnia caused by grief, sorrow or a disordered temperament, listening to pleasant sounds in the nihâvend and beste modes in a slow rhythm, or hearing the sound of slowly flowing water and of trees stirring in the wind. This is one of the clearest medical texts of known origin to associate the sound of water with healing.

The same work was read and translated in Amasya. Sabuncuoğlu Şerefeddin translated its last part, the Aqrâbâdhîn, which contains formulas for medicines, into Turkish in 1444, expanding its thirty-one chapters to thirty-three with additions of his own. This shows that the physicians of Amasya knew a medical encyclopaedia that also contained advice on treatment with music. Even so, the part Sabuncuoğlu translated is devoted to drugs, and no document is known that says al-Jurjânî's lines on music and the sound of water were put into practice in Amasya. The connection is valuable as a clue to the texts that fed the city's medical culture rather than as evidence specific to Amasya.

Zodiac Signs and Modes in the Edvâr Books

From the fifteenth century onwards, the books on music theory written in Turkish in Anatolia, known as edvâr, placed the effect of the modes on people within a cosmic framework. Hızır bin Abdullah, who followed authors such as Yûsuf Kırşehrî and Bedr-i Dilşâd, wrote his Kitâb al-Adwâr in Edirne in 1441 for Murad II. The first twenty-seven of the work's forty-eight sections are devoted to the stars, the zodiac and their influence on music and on people; the later sections deal with modes, rhythmic cycles, instruments and treatment with music. In these books the effect of a mode is described within a scheme that varies according to the illness, the zodiac sign, the hour, the nation, the profession and even the colour of the skin. Musicians kept pace with physicians: Abd al-Qâdir al-Marâghî (d. 1435) wrote in his Jâmi' al-Alhân that a physician without a knowledge of rhythm cannot tell a fast pulse from a slow one or a hard pulse from a soft one. In the following century Nesimî, in his Nesîm-i Tarab, matched certain kinds of pulse with rhythmic cycles.

Other names also recur in this literature. Ali Ufkî (1610-1675), Cantemir and, in the nineteenth century, Haşim Bey are counted among the Ottoman writers who mention the effect of music on people. Not all of them, however, left texts on treatment to the same degree. The medical material examined in the London copy of Ali Ufkî's Mecmûa-i Sâz ü Söz consists of drug recipes written in the margins for complaints such as headache, cough, back pain and wounds; it is not a table of modes and illnesses. Because secondary literature often cites these names in a single list, who actually wrote what needs to be checked separately.

Şuûrî Hasan Efendi and the Ta'dîl al-Amzija

The most fundamental text on music therapy in Ottoman medicine is the second chapter of the Ta'dîl al-Amzija fî Hifz Sihhat al-Badan by the Aleppo-born poet, linguist and physician Şuûrî Hasan Efendi (d. 1693-1694), dedicated to a vizier named Ahmed Pasha. Şuûrî, who served among the clerks of the Finance Office in Istanbul, turned to the Halveti order late in life, criticised the use of wine among medicines, and was buried outside the Edirnekapı gate. The colophon of the author's copy is dated Rajab 1088, that is, September 1677. The music section, transcribed by Ahmet Hakkı Turabi, occupies folios 79a to 87b of the copy in the Millet Manuscript Library. Şuûrî reinforced each paragraph on the effect of a mode on illness with a couplet, so that medical text and divan poetry advance side by side on these pages.

The chapter opens with traditions on the origin of music. It relates that Lamech invented the oud, that the science spread in the time of David, and that Pythagoras, after a dream, ordered harmony and rhythmic cycles with strings. Then it turns to the physician's own field. According to Şuûrî the pulse moves according to rhythm, and every measured beat corresponds to a mode, to a melody; when the pulse falls out of rhythm, it is a sign that the soul is departing. A physician who does not know rhythm and beat cannot diagnose an illness. The bond between music and medicine is therefore established as part of diagnosis. The twelve modes are tied to the twelve signs of the zodiac, the seven âvâze to the seven planets, the four şube to the four elements, and the twenty-four melodic forms are distributed among the hours of night and day.

The part of the text that contains legal and moral argument is also noteworthy. Şuûrî states plainly that the performance of music is regarded as forbidden in the Hanafi school, while part of it is considered permissible in the Shafi'i school. He cites Rûmî's couplets on the reed flute and the authority of Safî al-Dîn al-Urmawî as evidence, and writes that listening is permissible for those who have conquered their lower selves, while those who cannot hold the reins of the self should refrain. With a saying he attributes to Plato, he defines music as a science set forth for a purpose beyond entertainment: for spiritual delight, to soften dry temperaments, to balance black bile and to regulate the flow of the blood. He then immediately adds the following: in former times the hospitals in the cities had salaried musicians, the rooms of the dârüşşifâs were full of instruments, and for every patient an instrument was played to suit his condition and illness. In time the practice was banned altogether, on the grounds that some people were carried away by these melodies, disturbing the patients and neglecting their duties.

These sentences are on the one hand a precious clue to the existence of an institutional practice, and on the other suggest that by 1677, when they were written, the practice was already considered a thing of the past. In the text published by Turabi no particular hospital or city is named. The historian of medicine Nil Sarı, however, writes that in these lines Şuûrî describes the abandonment of music at the hospital of Bayezid II in Edirne, and interprets this as a rare critical record of music therapy being judged a failure for a time. The difference between the two readings may depend on which manuscript is taken as the basis; Amasya, in any case, is mentioned in neither.

Modes Matched with Illnesses

In the Ta'dîl al-Amzija the modes are taken up one by one. Rast removes paralysis. Irak benefits illnesses arising from a hot temperament, delirium (sersâm) and palpitations. Isfahan increases intelligence and the power of thought, and protects against cold and dry illnesses. Zirefkend is good for facial paralysis, for back and joint pain, and especially for lumbago. Rehâvî acts against headache, palpitations, and phlegmatic and sanguine illnesses. Büzürg purifies the mind and dispels obsessive thoughts, fear and anxiety. Zengûle benefits heart disease and heat of the liver, hicâz difficulty in passing urine, bûselik hip pain and cold headache, and uşşâk foot pain and the aches of gout, and it brings sleep. Hüseynî quenches inflammation of the heart and liver, stops thirst and strengthens the stomach, while nevâ helps against sciatica and disordered thoughts. What is striking is that the list covers neurological and bodily complaints far more than disorders of the mind. Paralysis or sciatica can hardly be counted as mental illness; within the theory of temperaments, soul and body were not conceived as two independent realms.

Şuûrî also wants the modes to be chosen according to the hours of the day. The day is divided into four parts, and each part is to be accompanied by a harmony of the opposite nature; for the cold and moist time from dawn to mid-morning, modes of a hot and dry nature are considered suitable, and for the hot and dry time from mid-morning to afternoon, modes of a cold and moist nature. The concrete choices are these: rast and rehâvî before dawn, hüseynî in the morning, nihâvend at noon, hicâz between the two prayers, bûselik in the afternoon, uşşâk at sunset, zengûle after the evening prayer, rast at midnight, and zirefkend in the last third of the night. Şuûrî notes that in a gathering it is impossible to suit the temperament of every listener, and that attending to the nature of the hour is therefore considered sufficient. The same section also proposes choices according to the listeners' origin and calling: hüseynî is thought suitable for Arabs, ırak for Persians, uşşâk for Turks, bûselik for Greeks and Franks, rast for a gathering of scholars, rehâvî for an assembly of Sufis and hicâz among dervishes. These pairings can be read less as a clinical note at a patient's bedside than as an etiquette of the gathering grounded in the theory of temperaments. Because the timetables circulating in modern literature reproduce this original text in differing forms, quotations made without returning to the source may not agree with one another.

The Treatise of Gevrekzâde Hafız Hasan Efendi

About a century later, Şuûrî's chapter was reworked by the chief physician Gevrekzâde Hafız Hasan Efendi (1727-1801). Under Mustafa III Gevrekzâde rose to be chief physician of the army; on returning from the Russian campaign of 1769 he joined the palace physicians, on 10 February 1786 he became chief physician of the empire, and five months later Selim III dismissed him and sent him to Aleppo as a judge. It is claimed that the music section of his Natîjat al-Fikriyya fî Tadbîr Wilâdat al-Bikriyya, on the diseases of children and women, was taken from Şuûrî; the passage describing which mode is good for which childhood illness was rendered into modern Turkish by Arslan Terzioğlu. A short treatise titled al-Risâla al-Mûsîqiyya min al-Dawâ' al-Rûhâniyya is also his. Recep Uslu further points out that the title Emrâz-ı Rûhâniyye-i Nagamât-ı Mûsikiyye, often given to this treatise in the literature, is incorrect. Turabi argues that the treatise's sole source is Şuûrî's book, and describes it as the only Ottoman work to deal with treatment through music as a subject in its own right.

Gevrekzâde's pairings largely coincide with Şuûrî's; the differences lie in the details. In his scheme rast is tied to the sign of Aries and the element of fire and benefits paralysis; ırak is tied to Taurus and earth and acts against feverish illnesses; ısfahan is in Gemini and increases the power of thought and memory; zirefkend, with Cancer and the element of water, benefits paralysis and lumbago; büzürg, with Leo and fire, keeps the mind alert and is good for melancholy. He also drew up a separate order for childhood illnesses: bûselik is good for pains of the hip, head and eyes, hicâz for urinary complaints, hüseynî for diseases of the liver and heart, ırak for meningitis in children, rehâvî for headache and nosebleeds, and uşşâk for foot pain and sleeplessness. It is also known that Gevrekzâde had no connection with musical practice, and that listing him among the teachers of the famous composer Hacı Sâdullah Ağa is a mistake. The work is the product of a physician and compiler rather than of someone from the world of musical performance. Turabi's book Gevrekzâde Müzikle Tedavi ve Amasya Darüşşifa Örneği, published in 2015 by the municipality of Amasya, treats this text together with Amasya; yet Gevrekzâde's biography shows no known connection with Amasya, and the document on which the two subjects are joined could not be identified in the sources examined here.

Music in the Hospitals from Damascus to Edirne

Records of music in hospitals are cited for many institutions both before and after Amasya, but the weight of these records varies greatly. The Bîmâristân of Nûr al-Dîn Zangî in Damascus (1154) was an early hospital with a section set aside for the mentally ill; that music was used in treatment there is repeated in secondary literature on the authority of Evliya Çelebi. For the Mansûrî Bîmâristân in Cairo, Michael Dols reports that patients suffering from insomnia were kept in a separate hall, where they listened to harmonious music and skilled storytellers told them tales. For the Gevher Nesibe hospital in Kayseri (1206) there is an interpretation according to which music and the sound of water were carried to the patients through air channels in the walls of the eighteen-room asylum section, and singers with fine voices performed three times a day according to the type of illness. This interpretation rests on a 1992 study by Köker; it is an inference drawn from the architecture of the building rather than from a document. The Turan Melik Dârüşşifâ at Divriği (1228) also appears in the same lists; an observation of Evliya's quoted from there, however, relates that in spring those stricken with lovesickness were isolated and bound on the physician's orders so that they would not harm themselves.

The clearest text describing music inside a hospital is what Evliya Çelebi wrote about the complex of Bayezid II in Edirne (1484-1488). Evliya reports that according to the old physicians fair faces, running streams, beautiful voices, instruments and songs cleanse a person of the grime of anxiety, and writes that the founder appointed ten singers and players to bring relief to the sick: three of them singers, one a ney player, one a kemençe player, one a miskal player, one a santur player, one a çeng player, one a çeng-santur player and one an oud player, who came three times a week to perform a musical suite for the patients and the insane. He also names the modes nevâ, rast, dügâh, segâh, çargâh and sûzinâk. There is an important caveat here: the surviving endowment deed of the hospital makes no mention of such a service. Evliya's lines were written about a century and a half after 1488, by a narrator given to exaggeration.

The architecture of Edirne seems to fit this account. The third section of the hospital is laid out on a hexagonal plan, with six iwans opening onto the hexagonal central hall. The hall is covered by a large dome with a lantern, and at its very centre stands a fountain with a jet. Behind the southern iwan there is a projecting section with five faces and many windows; some scholars have interpreted it as a place of prayer, others as the place where the musicians mentioned by Evliya sat. The building remained in use until the war of 1876, closed during the Balkan War, was restored and handed over to Trakya University, and today serves as the Sultan Bayezid II Complex Health Museum. The architectural historian Nina Ergin has studied early modern Ottoman hospitals in terms of the sensory experience created by courtyards, water and light, and has discussed the possibility that these buildings were designed with an idea of healing space in mind.

For the Fatih hospital in Istanbul, Evliya mentions seventy cells and eighty domes, a chief physician and a chief surgeon, and adds that singers and players were appointed for the sick and the insane to dispel their madness. The building opened in 1470 and was badly damaged in the earthquake of 1766; some sources state that it functioned until 1824, and today almost no trace of it remains. For the Süleymaniye hospital (1557) too it is reported that music was used alongside treatment with drugs. Another document to which Nil Sarı draws attention is a sixteenth-century endowment deed from Tire, which stipulated that the insane should listen to songs and instrumental music for two hours in the afternoon. It is the only known record that states the duration of the treatment.

Scholars who assess this picture as a whole are more cautious. Miri Shefer-Mossensohn, in her book on Ottoman hospitals, following Dols, stresses that the use of music in Islamic hospitals was the exception rather than the rule, and that the musicians who performed and the staff who cared for the patients were different people. Nil Sarı likewise notes that Turkish medical manuscripts contain no account of how music therapy was applied: there is no detail on the distance between player and patient, on how long the treatment should last, or on whether the patients themselves played. The texts record only which mode is good for which illness, and this information was handed down for centuries with almost no discussion. According to Sarı, only some of the medical books of the Ottoman period contain sections on music therapy, which suggests that music was not regarded as an indispensable form of treatment.

The Sound of Water and Healing

The idea that the sound of water soothes patients is an almost inseparable part of accounts of healing with music. The idea has a textual basis. al-Jurjânî recommends the sound of slowly flowing water for insomnia, and Evliya Çelebi, citing the old physicians, counts running streams among the things that cleanse a person of anxiety. The fountain with a jet at the centre of the hexagonal hall of the Edirne hospital is a concrete example of this idea reflected in architecture. Yet no hospital document is known that shows the sound of water being applied as part of a particular treatment programme, at set hours and to particular patients. Courtyard pools and fountains are found in many kinds of building in Islamic architecture, from mosques to madrasas; the presence of a fountain in a hospital does not in itself prove that it was installed for the purpose of treatment.

For the Amasya Dârüşşifâ the situation is even less clear. It is true that the building stands beside a street running parallel to the Yeşilırmak, but there is no document stating that the sound of the river was used in treatment. The courtyard is rectangular, surrounded by two rows of arcades with rooms behind them; the description of the building makes no mention of a pool or fountain in the courtyard. The installation photographed in Haluk Yücel's 2016 article as a water compartment used for mental illness, and the figures re-creating a musical ensemble in the courtyard, belong to the present museum's display. The article's conclusion that the interior of the building was planned with music therapy in mind therefore starts from the museum reconstruction and does not rest on a historical document.

The Limits of the Evidence for Amasya

The main basis for placing Amasya within this tradition is secondary literature that adds it to the list of hospitals where music therapy was practised. The list includes Damascus (1154), Kayseri (1206), Divriği (1228), Amasya (1308-1309), Fatih (1470), Edirne (1488) and Süleymaniye (1557). When the sentence claiming that Amasya was the first place in the world where mental illness was cured with music and the sound of water is traced back, it leads to a 2010 review article by Sezer Erer and Elif Atıcı, and from there to a popular book of 2005 by Adnan Çoban and a paper presented in Kayseri in 1982. Later publications, magazine articles and news reports repeat the sentence either without a source or by citing one another. The order of the list itself weakens the claim: Damascus, Kayseri and Divriği all come before Amasya chronologically. The museum's own presentation and some encyclopaedic sources use a more measured formula and introduce the building as the first hospital in Anatolia where music therapy was practised; this statement too is unsupported by documents and loses its force in the face of the same chronology.

The firm documents we have that are specific to Amasya are these: the inscription of 1308-1309, the information that the lost endowment deed was written in 1312, and Sabuncuoğlu Şerefeddin's own statements that he practised medicine here. Gönül Cantay's entry in the TDV Encyclopaedia of Islam draws a picture made up of these alone and does not mention music. Even in an article whose title claims to examine the hospitals where music therapy was practised, the section on Amasya consists of Cantay's interpretations of the function of the rooms and contains not a single record about music. Information on music and the sound of water lies outside this framework; most of it consists of accounts in secondary literature and the press, given without sources. The pictures showing music therapy in Amasya belong to the same category. The paintings in the Amasya book published in 2007 under Nil Sarı's editorship, showing Sabuncuoğlu treating patients with his pupils and patients listening to music, are modern reconstructions by Gaye Özen and İnci Özen; they are not historical depictions.

The documents that could resolve this uncertainty might be records of hospital staff in the Islamic court registers and endowment registers of Amasya, or a copy of the endowment deed that may come to light in future. A salary set aside for musicians or singers in a hospital endowment, as in the case of Tire, would count as the strongest evidence of the practice. Whether the pages devoted to the building in the first volume of Hüseyin Hüsâmeddin's Amasya Târihi contain any information on music could not be verified in this study. Nor do any of the secondary sources examined cite a passage on musical performance at the dârüşşifâ in Evliya Çelebi's account of his visit to Amasya in 1640; the fact that Evliya did not give for Amasya the detail he gave for Edirne and Istanbul may suggest that, at least in his time, there was no remarkable practice here.

The List of Modes Attributed to Sabuncuoğlu

Sabuncuoğlu Şerefeddin states that he was eighty-three when he wrote the Cerrâhiyye-i İlhâniyye in 1465 and eighty-five when he wrote the Mücerrebnâme in 1468, so he was born in 1386. He was the grandson of Hacı İlyas, chief physician to Mehmed I (Çelebi Mehmed). He probably trained at the Amasya Dârüşşifâ under Burhân al-Dîn Ahmad al-Nakhchuwânî, practised there as a physician for fourteen years, spent some time in Kastamonu, and travelled to Istanbul to present the Cerrâhiyye to Mehmed II (the Conqueror). He says that he wrote the Mücerrebnâme at the request of the physicians of Amasya; the book is valuable as the first Turkish monograph in which a physician describes medicines and treatments he had tested himself. The phrase "fourteen years as chief physician" found in museum presentations appears in the sources simply as practising medicine.

In the narrative of the Amasya Sabuncuoğlu Museum of the History of Medicine and Surgery and in local news reports, the following list of modes is given and linked to Sabuncuoğlu: rehâvî for headache, ırak for feverish illnesses, hicâz for aches and colic, uşşâk for sleeplessness, hüseynî for inflammation of the heart and liver and for the stomach, rast for paralysis. Every one of these pairings is found in Şuûrî's text of 1677 and in Gevrekzâde. In the publications that describe Sabuncuoğlu's works, no such table of modes is mentioned in the Cerrâhiyye, the Mücerrebnâme or the translation of the Aqrâbâdhîn. Its attribution to him therefore remains unverified, and it is far more likely to have been taken from the texts on Ottoman music therapy written in later centuries. The statement in news reports that Sabuncuoğlu treated patients with music and the sound of water likewise cannot be verified from his own works.

The Debate on an Invented Tradition

Historians looking at the subject from outside have also examined how Ottoman hospital music is presented today. Peregrine Horden opens his essay Ottomans, Neo-Ottomans and Invented Tradition in Hospital Music Therapy, published in 2017, with a newspaper report. According to a report in The Guardian on 28 August 2011, at the bedside of a patient who had undergone heart surgery at a private hospital in Istanbul, the surgeon Bingür Sönmez played the ney and the anaesthetist Erol Can the bowed tanbur, saying that they were reviving a thousand-year-old tradition of treatment. According to Erol Can, the rast mode is good for a patient suffering from loss of appetite, while hicâz should be played for a patient on a diet. Sönmez speaks more cautiously, saying that music can only complement modern medicine, and that by lowering the heart rate and blood pressure it may reduce the need for some drugs.

Horden's thesis is that a handful of contemporary descriptions of music played in late medieval and early modern hospitals should not be read as a whole tradition. A good number of these descriptions record the hospital orchestra as something out of the ordinary; Evliya's admiration for the musicians at Edirne is of this kind. In Horden's view, the claim to a tradition arises from reading texts written in theory about the healing power of music as descriptions of everyday hospital practice. The comparative study by Rania Awaad and Merve Nursoy-Demir, published in 2023, draws a more favourable picture, treating Ottoman music therapy between 1400 and 1800 alongside contemporary debates in Europe. The difference between the two approaches comes down to how the same small body of evidence should be weighed.

Amasya is a particularly instructive case in this debate. In Edirne at least a contemporary witness, an architectural arrangement and a later medical text come together. In Amasya, by contrast, a narrative of practice has been built by adding theoretical texts, testimonies written about other cities and modern museum reconstructions to one another. This does not mean that music was never used in Amasya. The institution stood for more than five centuries, trained physicians who, at least in the fifteenth century, knew authors such as al-Jurjânî whose works contained advice on music, and lay in a city open, as an Ottoman princely sanjak, to the musical culture of the court. It is plausible that instruments were sometimes played at patients' bedsides, but no document showing this has yet been brought to light.

The Museum, Congresses and Symposia

The Dârüşşifâ lost its importance in the nineteenth century and was used first by silkworm-cocoon dealers and then by tradesmen as a storehouse. Damaged in the Erzincan earthquake of 1939, the building had its outer façade repaired in 1945 and was fully restored between 1992 and 1997. Used from 1999 as the Municipal Conservatory, it was transferred by the Regional Directorate of Pious Foundations to the municipality of Amasya, in 2010 according to some sources and in 2011 according to others, and reorganised as the Sabuncuoğlu Şerefeddin Museum of the History of Medicine and Surgery. The museum contains the Sabuncuoğlu Hall, displaying surgical instruments in ten branches made on the basis of the drawings in the Cerrâhiyye, the Sabuncuoğlu Clinic with a re-enactment of an operation, and a Music Therapy Hall. In this hall the kemençe, rebab, ney, kanun, santur and plucked tanbur are displayed and the effects of the modes on illnesses are presented. The museum's narrative states that only instrumental music was used in treatment and that vocal works were not; since this is given without a source, it should be regarded as the museum's interpretation rather than as a historical fact.

Sabuncuoğlu's name lives on in other institutions in the city as well. The Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital opened on 19 January 2004, and the Şerefeddin Sabuncuoğlu and Amasya Darüşşifası Congress was held on 15-18 October 2014. The latest link in the subject is the Sabuncuoğlu Şerefeddin Music Therapy Symposium, held at the historic asylum on 5 September 2026 under the coordination of the municipality of Amasya and with the contribution of Amasya University. At the meeting, attended also by the provincial governor Önder Bakan, the rector of Amasya University, Ahmet Hakkı Turabi, spoke on the cultural place and historical development of music in therapy; Levent Öztürk and Şükrü Torun presented current studies on the clinical effects of music in brain health, neurology, dementia and psychology; and Oktay Alver described the place of the Amasya asylum in the history of medicine. The announcements and reports of the symposium again repeated the statement that the building treated the mentally ill with the sound of water and with musical modes in the Seljuk and Ottoman periods. The lasting value of such meetings will depend on how far they lead to the collection and publication of archival documents specific to Amasya.

Rahmi Oruç Güvenç, TÜMATA and Modern Music Therapy

The most influential figure in bringing Ottoman music therapy back into view in the twentieth century was Rahmi Oruç Güvenç (1948-2017), born in Tavşanlı in the province of Kütahya. Having studied philosophy at Istanbul University, Güvenç completed a doctorate in clinical psychology on music therapy under Ayhan Songar at the psychiatric clinic of the Cerrahpaşa Faculty of Medicine. TÜMATA, the group he founded to research the origins, performance practice and therapeutic value of Turkish music, began its work in 1975 according to some sources and in 1976 according to others. Between 1991 and 1996 Güvenç headed a department of music ethnology and music therapy at Istanbul University, gave seminars in Germany, Austria, Switzerland and Spain, and led the founding of a music therapy school in Austria. TÜMATA's performances, on instruments such as the oud, rebab, ney and drum, offer an approach that combines the Ottoman tables of modes and illnesses with Central Asian shamanism and the Mevlevi tradition. No practice or research specific to Amasya has been found in this work.

The legal framework of music therapy in Turkey was set by the Regulation on Traditional and Complementary Medicine Practices, which came into force on 27 October 2014. The regulation lists music therapy among fifteen practices and defines it as a practice in which music and musical activities are used in a clinical and evidence-based way to meet the physical, psychological, social and mental needs of individuals. It is carried out under the responsibility of a certified physician and by trained personnel. The definition points to modern music therapy based on a regular relationship with a trained therapist and makes no mention of matching modes with illnesses.

The present state of scientific evidence supports this distinction. A review by Aalbers and colleagues, published in the Cochrane Library in 2017, examined nine studies with a total of 421 participants and found moderate-quality evidence that music therapy added to usual treatment reduces depressive symptoms and anxiety in the short term. Whether music therapy is superior to psychotherapy, or whether active or receptive forms are more effective than one another, remained unclear. Claims of the kind found in the Ottoman tables, that rast is good for paralysis or hüseynî for inflammation of the liver, have not been tested by modern clinical research. They should be read as historical texts and not put in place of present-day treatment.

Chronology

9th century: al-Kindî matches the four strings of the oud with the four humours and the four elements; al-Balkhî and al-Râzî recommend music for disorders of the soul.

10th century: The Epistles of the Ikhwân al-Safâ mention melodies played in hospitals before dawn.

After 1021: Ibn Sînâ discusses the relation between the pulse and musical rhythm in the Risâla-yi Ragshinâsî.

1154: The Bîmâristân of Nûr al-Dîn Zangî in Damascus resumes operation.

1206: The Gevher Nesibe hospital is built in Kayseri.

1228: The Turan Melik Dârüşşifâ is built at Divriği.

1308-1309: The Amasya Dârüşşifâ is built; the inscription names Anber bin Abdullah and Ahmed Bey.

1312: The endowment deed is drawn up; its text has not survived.

1441: Hızır bin Abdullah writes the Kitâb al-Adwâr in Edirne for Murad II.

1444: Sabuncuoğlu translates the Aqrâbâdhîn section of the Dhakhîra-yi Khwârazmshâhî into Turkish.

1465: The Cerrâhiyye-i İlhâniyye is written.

1468: The Mücerrebnâme is written at the request of the physicians of Amasya.

1470: The Fatih hospital opens in Istanbul.

1484-1488: The complex of Bayezid II is built in Edirne.

1677: Şuûrî Hasan Efendi completes the Ta'dîl al-Amzija.

1786: Gevrekzâde Hafız Hasan Efendi becomes chief physician; he dies in 1801.

1939-1945: The façade of the building, damaged in the Erzincan earthquake, is repaired.

1992-1997: The building is fully restored.

1999: It begins to be used as the Municipal Conservatory.

2010-2011: It is reorganised as the Sabuncuoğlu Şerefeddin Museum of the History of Medicine and Surgery.

2014: The Regulation on Traditional and Complementary Medicine Practices defines music therapy; the Şerefeddin Sabuncuoğlu and Amasya Darüşşifası Congress meets in Amasya.

2017: Rahmi Oruç Güvenç dies; a Cochrane review assesses the effect of music therapy on depression.

2026: On 5 September the Sabuncuoğlu Şerefeddin Music Therapy Symposium is held at the asylum.

Bibliography

Academic studies

  • Gönül Cantay, "Amasya Dârüşşifâsı", TDV Encyclopaedia of Islam, vol. 3, Istanbul 1991, pp. 5-6; also Anadolu Selçuklu ve Osmanlı Darüşşifaları, Ankara 1992.
  • Nuran Yıldırım, "Sabuncuoğlu Şerefeddin", TDV Encyclopaedia of Islam.
  • Recep Uslu, "Hasan Efendi, Gevrekzâde", TDV Encyclopaedia of Islam.
  • Recep Uslu, "Kindi'nin Eserinde Müzik Terapi", Yegâh Mûsikî Dergisi IV/1 (2021), pp. 1-14.
  • Ahmet Hakkı Turabi, "Hekim Şuûrî Hasan Efendi ve Ta'dîlü'l-Emzice Adlı Eserinde Müzikle Tedavi Bölümü", Journal of the Faculty of Theology of Marmara University 40 (2011), pp. 153-166.
  • Sezer Erer - Elif Atıcı, "Selçuklu ve Osmanlılarda Müzikle Tedavi Yapılan Hastaneler", Journal of the Uludağ University Faculty of Medicine 36/1 (2010), pp. 29-32.
  • Gülşen Erdal - İlknur Erbaş, "Selçuklu ve Osmanlı Darüşşifalarında Müzikle Tedavi", Türk Akademik Araştırmalar Dergisi (TAKSAD) 2/1.
  • Emrah Koç - Hamit Önal, "Türk-İslam Medeniyetinde Müzikle Tedavi", İnönü University Journal of Culture and Art 9/2 (2023), pp. 177-190.
  • Enver Şengül, Kültür Tarihi İçinde Müzikle Tedavi ve Edirne Sultan II. Bayezid Darüşşifası, MA thesis, Trakya University, Edirne 2008.
  • Local press reports on the Sabuncuoğlu Şerefeddin Music Therapy Symposium (Amasya, 5 September 2026); museum presentation of the municipality of Amasya.

Official sources

  • Ahmet Hakkı Turabi, Gevrekzâde Müzikle Tedavi ve Amasya Darüşşifa Örneği, Amasya Municipality Cultural Publications, Amasya 2015.

Books

  • S. Aalbers et al., "Music therapy for depression", Cochrane Database of Systematic Reviews 2017, no. 11, CD004517. cochrane.org

Other sources

  • Murat Salim Tokaç - Seyid Muhammed Taki Hüseynî, "Şeyhü'r-Reis İbn Sinâ'nın Regşinâsî Adlı Eserinde Nabız İle Mûsikî İlişkisi", Erdem 84 (2023), pp. 205-218.
  • Haluk Yücel, "Türk İslam Medeniyetinde Müzikle Tedavi Yöntemlerinin Uygulandığı Şifahaneler: Amasya Darüşşifası", TURAN-SAM 8/29 (2016), pp. 53-63.
  • Nil Sarı, "Ottoman Music Therapy", Muslim Heritage (FSTC).
  • Miri Shefer-Mossensohn, Ottoman Medicine: Healing and Medical Institutions, 1500-1700, Albany 2009.
  • Peregrine Horden, "Ottomans, Neo-Ottomans and Invented Tradition in Hospital Music Therapy", A Verray Parfit Praktisour: Essays Presented to Carole Rawcliffe, Woodbridge 2017, pp. 175-184.
  • Rania Awaad - Merve Nursoy-Demir, "Melodies in the hospital courtyard: A comparative history of Ottoman music therapy in the early modern period (c. 1400-1800)", The Arts in Psychotherapy 86 (2023), 102092.
  • Nina Ergin, "Healing by Design? An Experiential Approach to Early Modern Ottoman Hospital Architecture", Turkish Historical Review 6/1 (2015), pp. 1-37.
  • Nils Peterson, "The Music Man: TUMATA and Turkish Music Therapy", Liberated Arts 8/1 (2021).
  • Pervin Somer - E. Elif Vatanoğlu-Lutz, "Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği'nin Hukuki ve Etik Açıdan Değerlendirilmesi", Anadolu Kliniği 22/1 (2017).

Online sources