The Sultan Bayezid II Dar al-Shifa’ consisted of two interconnected courtyards and three sections forming the hospital property. In the first yard (Bîrun), there was a series of six rooms, where doctors, ophthalmologists, and surgeons made the fi rst examinations of the patients (policlinic). In some rooms, mental patients were isolated.
To the left of the yard, the laundry, pantry, and kitchen were located. The kitchen prepared meals for the patients, while the staff took their meals in the soup kitchen.
In the hospital section there were 6 winter rooms with hearths and 5 terraced summer rooms surrounding a
domed marble-fl oored salon with a basin. One of the halls was reserved for music therapy, while it is assumed that the fourth one was used as a summer room. At the top of the large dome, there was an opening (oculus) providing lighting and airiness as well as letting out spent air and unpleasant smells. The acoustics of this section is particularly well calibrated. These characteristics demonstrate the particular place that the Sultan Bayezid Dar al-Shifa’ occupies in the world history of hospital architecture.
HEALTHCARE STAFF OF THE DAR AL-SHIFA’
In 1490, the staff of the Dar al-Shifa’ consisted of a head physician (ra’is-i atibba’), two general physicians,
two eye doctors, two surgeons, four orderlies, and a drug mixer and grinder, a total of twelve employees. The head physician was supposed to be skilful and capable, knowledgeable of the rules of the art of medicine, mature, well mannered, and profi cient. The other physicians were expected to perform the services they were charged to do rightfully and carefully. The eye doctors had to be knowledgeable about all eye diseases, the surgeons should be skilful as well as having a swift hand.
ADMINISTRATIVE STAFF OF THE SULTAN
BAYEZID II DAR AL-SHIFA’
A superintendent (nazır) was responsible for all administrative tasks together with the administrative staff.
The scribe recorded the expenses, the majordomo purchased everything that was required for the patient treatment. The provisioner was in charge of the stock in the pantry. A servant looked after the waterworks, the garments, and the instruments. The doorman opened and closed the door of the hospital and
took care of security. The fumigator was to calm the minds of the patients by burning incense every morning and evening. In addition, a cleaner and a laundryman were employed.
BASIC PRINCIPLES OF OTTOMAN MEDICINE
Ottoman doctors described the anatomy of humans from head to toe. A physician of the 17th century, Shemseddin Itaki, illustrated his anatomy textbook “Anatomy of the Bodies” with drawings by the 14th-century Iranian anatomist Mansur Ibn Ilyas.
Secrets of a Health Life
Advice for a healthy lifestyle occupied a broad area in the Ottoman physicians’ books. In addition, books on
Prophetic Medicine (al-Tibb al-Nabawi) translated from the Arabic language guided the population towards a healthy life, compiling Prophetic traditions (hadith) pointing out the benefits of staying away from the leprous and suferers of plagues, cleaning one’s teeth, drinking sherbets, and observing the fast. Important for a healthy life were factors such as ai,r food, water, sleep, purifying tha body, and exercise (sports).
Food and drink were considered the most important elements to achieve a balance of the humors (blood, phlegm, yellow bile, black bill). It was recommended to eat two meals and get up from the table without being completely full.
For the preservation of health, deliberate exercise (sports) was very important. It was believed that excessive food would remain undigested in the blood vessels and consumed by body movements.Wrestling, archery, javelin throwing, horseback riding, weight lifting, ball games, running, vigorous walking, high jump and long jump counted as exercise for the whole body. Race walking would purify thighs, calves, and
feet; carrying stone weights or drawing a bow would remove excess matter from the hands, neck, chest, and back.
In Ottoman medicine, examination and diagnosis of a disease depended on the doctors’ ability, experience, and skill. First, doctors would listen to the patient’s complaints, observe their behavior, and watch them for symptoms like fever, sweating, jaundice, or swellings. For the diagnosis as
well as for the direction of therapy, pulse and examination of the urine (uroscopy) were important.
The application of surgery was limited to small interventions. It was not possible to operate inside the
skull, the thorax, or the abdominal cavity.Amputations of limbs were performed as last resort.In many conditions, especially those involving hemorrhage or open wounds, cauterization with a hot iron was used.To make the patient drowsy, a sponge soaked in opium would be held in front of his nose or herbs like mandrake would be used.
We know about the tools used by Ottoman surgeons from the miniatures in Sherefeddin Sabuncuoglu’s book
Cerrahiyetü’l-haniye (Imperial Surgery), illustrating operations and instruments.
Doctors would produce their own drugs, as there was no profession of pharmacy. In the hospitals, there were
artisans with various titles producing drugs. Perfume sellers and herbalists as well as other small merchants would sell raw material for medicines as well as preparations made by themselves. Most of their shops were located in the Spice Bazaar (Mısır Çarşısı) in Istanbul.
Some components of drug recipies were snails, worms, oysters, spiders, crabs, as well as milk, eggs, honey,
beeswax, tortoise shell, stag horns, goat hooves, beaver glands (castoreum), or owl brains.
Precious metals such as gold and silver, precious stones
like emerald, ruby, or chrysolite in pulverized form were
also included in drugs. It was thought that drinking water that had been infused with pearls would banish fear and relieve the heart. It was believed that clay from Lemnos, known as tin-i mahtum (Terra sigillata, Terra Lemnia), would help with plague and similar diseases and react to poisons. Drinks to be served to Sultan Mehmed the Conqueror would fi rst be poured into a cup made of terra sigillata, and if the clay showed no reaction, it would be decanted into a golden cup and served to the Sultan.