The Skilliter Centre conference on The Ottomans and health: a comparative perspective was held from 3-6 July, 2013. The conference set out to consider health in the widest possible sense with papers on areas ranging from concepts of hygiene, morality and philanthropy, to healthscapes, architecture and gravestones.

Wednesday 3 July

14.00-18.00 Registration

18.45-20.30 Reception

A reception will be given by the Principal of Newnham College, Professor Dame Carol Black, to be held at the Principal’s Lodge.

Thursday 4 July

09.30-11.00 Panel I – Morality

Chair: Professor Elizabeth Zachariadou (Crete)

Professor Angeliki Konstantakopoulou (Ioanina), Pure soul in unclean body: some remarks on Christian-Islamic divergences.
Professor John Alexander (Thessaloniki) and Dr Sophia Laiou (Ionian University, Corfu), Health and philanthropy among the Ottoman Orthodox population, eighteenth to early nineteenth century.
Dr Ebru Boyar (ODTÜ, Ankara), The moral road to health in the late Ottoman empire and early Turkish republic.

11.00-11.30 Coffee

11.30-13.00 Panel II – Cleanliness

Chair: Dr Colin Heywood (Hull)

Professor Elizabeth Archibald (Durham), Therapeutic bathing in the medieval West: literary and historical evidence.
Dr Svetla Ianeva (New Bulgarian University, Sofia), Hygiene in nineteenth-century Ottoman Bulgaria.
Dr Kate Fleet (Cambridge), The little frogs in Terkos: providing water to Istanbul in the late Ottoman empire.

13.00-14.30 Lunch

14.30-16.00 Panel III – Trade

Chair:Dr Kate Fleet (Cambridge)

Dr Tara Alberts (York), Rose water from Mecca and gall-nuts from the Levant: the trade in curative commodities between Southeast Asia and the Middle East in the early modern period.
Erol Baykal (Cambridge), Selling medicine in the late Ottoman empire.
Dr Vera Costantini (Venice), Well-protected remedies. The Venetian pharmacopoeia in the Ottoman empire.

16.00-16.30 Coffee

16.30-18.00 Panel IV – State and Health in the Late Ottoman Empire

Chair: Dr Gábor Ágoston (Georgetown)

Dr Tuba Demirci (Kemerburgaz University, Istanbul), Mother and children’s health in the late Ottoman empire: critical issues regarding welfare, pronatalism and population progeny between 1839-1908.
Dr Emine Ö. Evered (Michigan State), Confronting disease, controlling society: late Ottoman experiences with syphilis and regulation.
Dr Yücel Yanıkdağ (University of Richmond), Firar as psychogenic fugue: the dilemma of Ottoman military desertion in the Great War.

19.30 Dinner

Friday 5 July

09.30-10.30 Panel V – Medical Knowledge I

Chair: Professor Ben Fortna (SOAS)

Dr Debby Banham (Cambridge), ‘The East’ as a source of medical ideas and materials in early medieval England.
Dr Birsen Bulmuş (Appalachian State University), Feyzi Mustafa Hayatizade and the Ottoman conception of syphilis in the eighteenth century.

10.30-11.00 Coffee

11.00-12.00 Panel VI – Medical Knowledge II

Chair: Professor Abdul-Karim Rafeq (College of William and Mary)

Dr Maurits van den Boogert (Leiden), Dr Russell’s clinical eye: western reports on Ottoman medicine from the eighteenth century.
Dr Kyle Evered (Michigan State), Locating malaria in the late Ottoman context: between republican narratives and the historical record.

12.00-13.00 Panel VII – Hospitals

Chair: Professor Filiz Yenişehirlioğlu (Başkent University, Ankara)

Dr Miri Shefer-Mossensohn (Tel Aviv), The many masters of early modern Ottoman hospitals: between the imperial palace, harem, bureaucracy, and the Muslim legal courts.
Dr Nina Ergin (Koç University, Istanbul), Healing by design? A multi-sensorial approach to early modern Ottoman hospital architecture.

13.00-14.30 Lunch

Afternoon free

Saturday 6 July

9.00-12.00 Panel VIII – City and Health

Chair: Professor Elizabeth Zachariadou (Crete)

Professor Abdul-Karim Rafeq (The College of William and Mary), Traditional and institutional medicine in Ottoman Damascus.
Dr Amina El-Bendary (AUC, Cairo), A social history of medicine in medieval Egypt and Syria.

10.00-10.30 Coffee

Dr Nükhet Varlık (Rutgers), Imagined healthscapes: places of health and disease in early modern Ottoman cities.
Dr Colin Heywood (Hull), Edirne-Izmir-Larnaca, 1690-1710: experiences of disease and death in three Ottoman milieux.
Dr Antonis Anastasopoulos (Crete), Communicating death: Ottoman gravestones from Crete.

12.00-13.00 Roundtable Discussion:

Discussant: Dr Gábor Ágoston (Georgetown)

13.00-14.30 Lunch

The organizers gratefully acknowledge the support of the George Macaulay Trevelyan Fund and Newnham College

For further details please contact Kate Fleet (khf11@cam.ac.uk) or Ebru Boyar (boyar@metu.edu.tr)

Abstracts

Rose water from Mecca and gall-nuts from the Levant: the trade in curative commodities between Southeast Asia and the Middle East in the early modern period

Tara Alberts (University of York)

Recent scholarship has stressed the vibrant trade in spices and other commodities between Southeast Asia and the Middle East. Historians have explored the effect of these diplomatic, mercantile and religious exchanges on the societies, cultures and economies of both regions. The arrival of Europeans in Southeast Asia brought added complexity to these trade networks: disrupting some established connections and influencing the creation of new diplomatic and mercantile links between the two regions. European accounts are frequently very detailed about the commodities available in the entrepôts of Southeast Asia. In particular, these accounts can reveal the flourishing medical market place which existed in many port-cities, illustrating the wide range of medicines, ritual objects and other materials which could be used for healing. This paper explores European perceptions of the trade between the Middle East and Southeast Asia, and in particular of the curative commodities (purportedly) arriving in Southeast Asia with Middle Eastern merchants. Many European accounts made rhetorical reference to the supposed struggle between cross and crescent in the region, as Islam and Christianity both gained converts. Against this backdrop, medicines and ideas about health and healing often took on added significance in narratives of the encounter. Some missionaries expressed concern, for example, that Muslim proselytisers would be able to persuade Southeast Asians of the veracity of Islam through providing access to novel cures. This paper will explore the ways in which monitoring the exchange of curative commodities between Southeast Asia and the Middle East became linked to wider European objectives and anxieties in the region and the wider world.

Health and philanthropy among the Ottoman Orthodox population, eighteenth to early nineteenth century

John Alexander (Thessaloniki) and Sophia Laiou (Ionian University, Corfu)

For the Orthodox Christian urban population of the Ottoman Empire the eighteenth century was identified with demographic and economic development. This development resulted in obvious socio-economic differentiation between the Orthodox urban strata and the formation of “internal” elites, which interacted with the Ottoman administrative system and/or participated in the commercial networks within or outside the Ottoman empire.

A means of reproduction of the power structure within the boundaries of the Orthodox Ottoman population was the practice of philanthropy. In the second half of the eighteenth and beginning of the nineteenth century in large Ottoman cities wealthy Christian reaya funded the building of hospitals, aiming at the comfort of the co religious lower social layers. On the other hand, Orthodox bishops, continuing the philanthropic tradition of the Orthodox Church, donated money to the monasteries for the relief of the ill and infirm people.

In this paper the above mentioned aspects of the philanthropic activity will be addressed, focusing on issues referring to: a) the restriction of this activity in large urban centers, in full correspondence with the restricted number of the hospitals established as vakıfs by members of the Ottoman dynasty; if in the case of the Ottoman Muslims the offer of food was considered a more significant act of philanthropy and piety, in the case of the urban Orthodox Ottoman population were there other priorities concerning the donation of cash for philanthropic reasons? b) What was the social profile of the donors and what was their motivation? How strong was their class consciousness towards their co religious? c) What was the role of the Orthodox monasteries in the nursing of the sick poor Christians? d) In what way the rules that the Orthodox donors imposed can be compared with the stipulations of the Muslim cash vakıfs?

Communicating death: Ottoman gravestones from Crete

Antonis Anastasopoulos (University of Crete and Institute for Mediterranean Studies/FORTH)

The aim of my paper is to examine how death is represented in the epitaphs of the Islamic gravestones of Rethymno (Ott. Resmo), Crete. Death is the result of factors such as ill health, accident, crime, or old age, but most of the time citing the cause of death on an Ottoman gravestone was considered irrelevant. By definition, the aim of the epitaphs was not to systematically record the lives and circumstances of death of the persons concerned, but rather to mourn death and praise the dead. Thus, the paper will focus on socially acceptable ways to talk about death in the context of funerary practices, and will also seek to address the issue of the bounds between social conformity and the expression of genuine feeling on gravestones as permanent markers of death placed in a cemetery, which in the case of Rethymno, as in other Ottoman settlements, was an open area situated outside the district of the living, the walled town. The Rethymno gravestones will be examined in the context of the extensive literature on Ottoman gravestones, and an attempt will also be made to locate references to death in other types of sources from Ottoman Crete, such as folk poems.

Therapeutic bathing in the medieval West: literary and historical evidence

Elizabeth Archibald (University of Durham)

Therapeutic bathing was widely practiced in the medieval West. In this paper I shall consider various kinds of evidence, literary and historical. Baths were widely available in private homes and in public bathhouses, though public baths were on a much smaller scale than Roman ones. Visits to the baths were often excuses for amorous encounters, according to literary texts including the Roman de la Rose, the Occitan romance Flamenca, Boccacio’s Decameron and Macchiavelli’s play Mandragola. Bathing as a cure for medical problems was very widespread in continental Europe (I am less confident that it was common in England, which has only one hot spa, Bath). It is recommended in many medical texts for everyone from newborn babies to the old, with many qualifications according to the season and the ailment to be cured. Many images offer further evidence of the popularity of bathing; our spa and jacuzzi culture today is nothing new.

‘The East’ as a source of medical ideas and materials in early medieval England

Debbie Banham (University of Cambridge)

The twelfth century is widely known as the period when ‘Arabic’ medical knowledge (some of it originating even further east) became widely available in western Europe, but western texts had in fact been showing an interest in places to the east for a couple of centuries before that. This paper will focus on medical texts written in the vernacular in England in the tenth and eleventh centuries, showing how they foreshadow developments normally asociated with the twelfth-century ‘Renaissance’. In common with other writings from early medieval England, the Old English medical texts do envisage Asia as a locus of strangeness and special knowledge, as well as holiness, but they also associate it with particular medical authorities and ingredients. The paper will investigate the identity of those authorities and ingredients, and the sources of the latter, and place the texts’ ‘Orient’ in its context, both within medical developments in the medieval West, and in wider ideas about the East in England in the early middle ages.

Selling medicine in the late Ottoman empire

Erol Baykal (University of Cambridge)

The public discourse about different types of drugs in the Ottoman empire took two distinct forms, namely the discussion of new and established medication in professional journals on the one hand and the marketing of branded drugs on the other. Both forums addressed a distinctly different audience: the former, medicine professionals and pharmacists, and the latter, the general public. Interestingly, dichotomies occurred between what was, according to expert opinion, proper good value medication and the type of drugs the general consumers, influenced by advertising campaigns, preferred. This paper examines the behaviour of Ottoman consumers within these parameters in order to establish how much expert opinion and advertising could influence consumer behaviour.

A social history of medicine in late medieval Egypt and Syria

Amina El-Bendary (AUC, Cairo)

The history of medicine is one of the richest areas of medieval and early Islamic history. Much research has focused on the medical discourses of classical Islam, especially on medical texts written by physicians. These texts have revealed to us the continuation of Galenic medicine under the Arab caliphates and the persistence of the humoral theories. This study of medical discourses is also complemented by studies that focus on the practice. For medieval Islamic societies, surviving waqf documents are also an important source for studying the bimaristans of the period.

However, in addition to this high tradition of specialized medicine, other traditions existed and practice varied. Surviving Arabic chronicles can also add to our understanding of the practice of medicine on a popular level. Historians such as al-Maqrizi or Ibn Taghribirdi or Ibn Tawq as they chronicled the everyday affairs of their societies also gave us an idea of how these societies perceived and dealt with health concerns and illnesses. The references to health issues and concerns by medieval historians suggest that practice was more varied than the study of normative texts suggests. These references also help us to better appreciate the challenges facing medieval societies, and the social anxiety at a time of different epidemics.

Dr Russell’s clinical eye: western reports on Ottoman medicine from the eighteenth century

Maurits van den Boogert (Leiden)

The medical knowledge of the Arabs was held in high regard in the West for a long time, but this began to change in the eighteenth century. Due to new approaches to (the teaching of) physick in Europe, Western medical men began to look at the East from a different perspective. Scholars and practitioners in Europe continued to be interested in medical texts – mostly still in Arabic – from the Ottoman empire, but the Levant also became a territory where first-hand experience could be acquired with diseases that were uncommon in the West. The British merchant navy and the Levant Company provided fruitful infrastructures for such medical inquiries. Alexander and Patrick Russell – the two half-brothers who are all too often conflated into the singular “Dr Russell” – embodied many aspects of these developments during the Enlightenment. As students of the pupils of Boerhaave, they were genuinely interested in actual patients, and both relied more on clinical observation than on venerable medical theories. On the basis of the publications of both Alexander and Patrick Russell, this paper will discuss their attitudes towards Ottoman medicine; their reports about the plague; and what accounts like those of the Russells tell us about Ottoman folk medicine, including inoculation.

The moral road to health in the late Ottoman empire and the Early Turkish Republic

Ebru Boyar (Middle East Technical University, Ankara)

This paper aims to trace the developments in the state policy towards syphilis, one of the four big diseases in the late Ottoman and early Republican period. For the state, syphilis was a “terrible disease” endangering not only public health but also threatening the security of the state and even the very survival of the population. The way the state sought to combat the spread of the disease was to make it a moral issue and it therefore adopted an increasingly moral tone in its discourse, developing from the comparatively relaxed tone of the Abdülhamidian era to the more stridently moral pronouncements of the CUP and the more stigmatising rhetoric of the early Republican government. However, this increasing moralistic tone proved counter-productive and undermined the ability of the state to enforce its health policy. The state was thus forced to shift its discourse, on the one hand toning down its moralistic approach in its relations with the urban upper classes, further driven into concealment rather than disclosure by social stigmatisation, and, on the other, stressing the moral unacceptability of syphilis in rural areas, in combination with a strong-arm policy of enforced medical treatment.

Mustafa Feyzi Hayatizade Efendi’s Risale-i İllet-i Merakiyye:a case study in pre-modern Ottoman conceptions of syphilis

Birsen Bulmuş (Appalachian State University)

Mustafa Feyzi Hayatizade Efendi’s Risale-i İllet-i Merakiyye, written in 1093 (1682-1683), represents a pivotal moment in Ottoman conceptions about syphilis, an infectious disease that possibly originates from transmission from America in the wake of Christopher Columbus’s “discovery”. This work, thoroughly based on the findings of late sixteenth- and early seventeeth-century European writers such as Hieronymous Fabricius, Amatus Lucitanus, and Daniel Sennert, endorsed the claim that syphillis had changed in nature, and had, in time, become distinct from the French pox (maraz-i Efrenci). In Hayatizade’s opinion, illicit sex was only one cause of the illet-i merakiyye, “the disease of curiosity/passion”. Poor diet, or anything else that could cause a preponderance of black bile in the internal organs, could upset the Galenic bodily balance, and set off a chronic infection.

Hayatizade, like the European sources which he used, aimed in large part at elite audiences. The Galenic methods which they advocated required the individualized attention of courtly doctors, and could not readily be applied to the poor. They also focused on male patients, and blamed women as being much more naturally predisposed towards the disease, and possibly helping to spread the bile.

Hayatizade’s work is also of interest because of its lack of reference towards spiritual causes. This may in part be due to his own background as a Jewish convert to Islam, and to his role as the chief court physician (Hekimbaşı) to Mehmed IV, whose job might have been in part to transmit the latest knowledge and methods from abroad.

Some two centuries later, Ottoman or foreign-born doctors, also working from a European secular medical understanding of medicine, would redefine syphilis and the methods used to cure and prevent the disease in radically different terms.

Mother and children’s health in the late Ottoman empire: critical issues regarding welfare, pronatalism and population progeny between 1839-1908

Tuba Demirci (Kemerburgaz University, Istanbul)

The period between the late eighteenth to the twentieth century was the time for ever-increasing concern about demographic dynamics such as population decline and rise, population hygiene and public health both for the industrialized and modernizing polities. The Ottoman empire was not an exception; the massive demographic transformation and the anxiety of depopulation coloured many different aspects of Ottoman administration in the nineteenth century. Medical authorities sought ways to hinder the factors that led to the decrease of imperial population and initiated policies to promote its further increase. Beginning from the mid-nineteenth century, Ottoman imperial administration handled population issues by introducing centralized, better and sometimes compulsory health services as well as preventive measures. Parallel to these, health administration also developed as a concept that functioned through control and disciplining of medical professionals and subject people, various regulatory discourses for vaccination, proper treatment and information on various health related complications. From the 1840s onwards, pronatalism became an integral component of Ottoman public health policies that a regulatory modern discourse was formed through anti-abortion policies, institutional arrangements to train modern midwives and obstetricians, measures for difficult deliveries and post partum fever, and prevention of venereal diseases together with various child welfare schemes. From the 1870s onwards, Ottoman advice genre also started to provide guidelines for families, mainly for women about maternal and children’s health by elaborating issues which were either dealt with inadequately or were not within the scope of pronatalist regulations put in force. This paper, therefore, will deal with the content and scope of children’s and maternal health as critical dimensions of Ottoman pronatalism and public health on the one hand, and Ottoman institutional modernization on the other. Gendered, disciplinary and medicalized discourses about child and maternal health will also constitute the scope of my discussion.

Healing by design? a multi-sensorial approach to early modern Ottoman hospital architecture

Nina Ergin (Koç University)

“Hospital patients should never be imbued with the idea that they are sick…” Frank Lloyd Wright commented in a 1948 interview on modern hospital design. Ironically, in the subsequent decades architects moved farther and farther away from the restorative environments that the Ancient Greeks had already emphasized in medical treatment, instead allowing functional efficiency to become their sole guiding principle. Since the 1980s, however, the medical establishment has once more shown interest in the architectural environment in which health care is delivered, as well as in the ways in which buildings and gardens can either support or undermine the healing process—a turn summarized by the concept “healing by design.”

In Ottoman Medicine: Healing and Medical Institutions, 1500-1700, Shefer-Mossensohn has considered Ottoman hospital gardens in relation to the modern concept of “healing by design” and provided a brief discussion of architectural space, which also includes its multi-sensorial, experiential qualities contributing to an integralistic therapy. Yet, a detailed discussion of Ottoman hospital architecture in relation to the qualities of space that characterize good design — such as attention to the variety of sensory experiences within the space, orientation, connection, scale, and symbolic meaning — is still a desideratum. This paper will take as a starting point the present knowledge of good hospital design, as it is based on psychological and physiological research studies. Through the lens of this knowledge, it will then examine early modern Ottoman hospital architecture, together with textual sources, in order to understand how far Ottoman architects either consciously or intuitively designed hospitals that appealed to the senses, promoted well-being, and assisted in the therapeutic process.

Confronting disease, controlling society: late Ottoman experiences with syphilis and regulation

Emine Ö. Evered (Michigan State University)

In the late Ottoman era, the empire was confronted by an increase in figures of reported cases of syphilis. These numbers that seemed to reveal an increased incidence in the occurrence of the sexually-transmitted disease — and particular concerns about its occurrence among Ottoman troops — compelled the state to adopt a more interventionist posture vis-à-vis its citizenry in the name of public health and effectual governance. In particular, from the end of the Crimean War (1853-1856) until the final years of the empire in the early 1920s, imperial authorities expressed their anxieties over syphilis not only in terms of morality or religiosity but also with regard to concerns over demography and economy. Based upon primary sources — both archival and published — this paper explores and analyzes how the late Ottoman state increasingly positioned itself to govern its citizens in terms of their health, fertility, and sexuality.

Locating malaria in the late Ottoman context: between republican narratives and the historical record

Kyle T. Evered (Michigan State University)

Among ailments found to occur in Anatolia during the late Ottoman era, malaria constituted not the most pressing of concerns, but it was one of appreciable significance. In this regard, it troubled not only Ottoman authorities and citizens but also foreign interests, such as those proposing to build railways or undertake other initiatives within the empire. In many accounts, malaria was viewed and depicted thus as an impediment to development — more than as a malady of lethal consequence. As greater knowledge of malaria’s etiology and epidemiology emerged throughout the world — including the Ottoman region, efforts to modify the physical environment (e.g., to drain wetlands) were initiated by the late nineteenth century — often modeled upon similar campaigns such as those undertaken in Italy. Moreover, by the 1890s — and with European participation, an institute of bacteriology was established in Istanbul. Additional institutional and legislative remedies soon followed. Though constrained severely by the declining empire’s scarcity of resources and a lack of widespread political concern over malaria, such measures reveal the emergence of an imperial initiative to confront the disease. Despite this track record, the subsequent republic’s characterizations of the empire regarding the malaria problem were replete with condemnation on the grounds of inaction and indifference. Relying upon primary and secondary sources, this paper engages with not only the conduct of anti-malaria campaigns in the late Ottoman era, it also confronts the early republican historical account regarding the disease and the Ottoman state — a narrative that championed the Kemalist state’s initiatives in public health and nation-building.

The little frogs in Terkos: providing drinking water to Istanbul in the late Ottoman empire

Kate Fleet (University of Cambridge)

The provision of clean drinking water to Istanbul, with its very large population, was an attractive proposition for foreign concession hunters who regarded it as a lucrative venture. For the Ottoman state, the provision of water for the city’s population was in the late nineteenth century, as it had been in the previous centuries, an important issue. This paper will consider the attempts to obtain concessions to provide drinking water to various parts of the city, including in particular Beyoğlu, in the early years of Abdülhamid’s reign, the conditions under which the Ottoman government was prepared to grant concessions, the requirements it imposed, and the way in which granting such a concession was viewed.

Edirne – Izmir – Larnaca, 1670-1710: experiences of disease and death in three Ottoman milieux

Colin Heywood (University of Hull)

The interaction of climate and health – or disease – and history is a complex and multifaceted phenomenon which in recent decades has not lacked its investigators. On the one hand, classic studies such as Le Roy LaDurie’s; on the other, semi-popular studies such as Zinsser’s or W. H. Macneill’s. Certain tropes spring to mind: the climatic rigours of the 1310s and 20s in western Europe, with a series of cold, wet summers, incessant rain, and widespread dearth and famine, and the possible interconnections between this and the outbursting in western Eurasia of the Black Death a quarter of a century later.

Moving on, the effect of the bitter winters and climatic downturn in the 1590s are well-documented and have generated an extensive literature. Less well-studied has been the last decade of the seventeenth century, which contained probably the coldest series of years in the whole period of the ‘Little Ice Age’. In the studies of all these phenomena, the Ottoman component fails, almost entirely, to find a place.

And yet, questions may be asked: was it coincidence that the critical years in which the Ottoman beylik came into existence and then made the leap across the Straits into Rumeli were those of the early fourteenth-century climatic crisis in much of Europe, and then of the Black Death. Was it also coincidence that the two longest of the interminable series of European wars in which the Ottoman state involved itself – the original “Long War” of 1593-1606, and the even longer war between 1683 and 99, were both fought in years of extreme climatic pressure. How do war, climate and disease fit together in the Ottoman context? For the present paper I have chosen to illustrate some provisonal connexions in three disparate Ottoman loci of the late seventeenth/early eighteenth century, from 1670 to 1710 – one (Edirne) in Rumeli; one (Izmir) in Anatolia, and one (Larnaca) on the island of Cyprus. It is hoped some tentative conclusions may emerge as a result of this preliminary sketch of a much larger problem.

Hygiene in nineteenth-century Ottoman Bulgaria

Svetla Ianeva (New Bulgarian University, Sofia)

Based on a variety of primary sources such as private correspondence, diaries, travel accounts, memoir, and combining macro with micro-historical approaches, the paper will try to outline the main hygienic notions and practices in nineteenth-century Ottoman Bulgaria. It will examine the most important elements of personal, home and everyday life hygiene (washing, bathing and body hygiene, cleaning, ways of prevention of diseases, etc.) as well as several aspects of public hygiene such as the availability and public use of water, fountains, baths, the state of cleanliness of the streets and other public places (such as bazaars, caravanserais, hospitals), the location and state of the graveyards, some public measures for the prevention of the spread of diseases (isolation and quarantine, etc). The differences in the hygienic notions, habits and practices of the local population based on religion, culture and tradition as well as the existence or absence of mutual influences in this respect will be considered. The paper will also address the question of the begnning of some transformations in the traditional patterns of hygiene in the region during the second half of the nineteenth century under European influence or under the influence of modern education.

Pure soul in unclean body: some remarks on Christian-Islamic divergences

Angeliki Kostantakopoulou (University of Ioannina)

As the title implies, our topic tries to conceive two divergent dimensions, namely the transcendental (spotless soul, i.e. psychic/mental cleanness/health) and the material ones (dirty body, i.e. negligence of cleaning/corporal health); yet in this paper both issues will be analyzed as being simultaneously transcendental and material, on the basis of the platonic idea of mimesis, according to which religious norms and admonitions, as constituents of worldviews and behavioural systems, acquire an uncontested materiality, alias, they are incorporated: “A corporally acquired knowledge is not something that one has got, but something that one has become” (“Ce qui est appris par corps n’est pas quelque chose que l’on a … mais quelque chose que l’on est”, Pierre Bourdieu, Le sens pratique, Paris 1980, 123, n. 12).

Our remarks –tentative as they are– are formed out of a comparative investigation of Christian-Islamic perceptions and stances. It is specially intended to draw the attention to the above-mentioned issues, which are conceived rather as historically determined phenomena than as simply cultural ones. Thus, our aim is neither at tracing discriminations among the flock nor at seeking diachronic and inviolable norms. We are more interested in attempting explanations regarding (a) the differences between Christian/Islamic soul-body perceptions and practices, especially during the late-middle ages, when the mystic-version of Orthodoxy (Hesychasm) became the dominant piety model and political ideology, and (b) modes of communication between the two religious thought-patterns, like the practices of religious syncretism which have a long-range impact upon the traditional societies, still visible in modern ones.

The above research issue is only one aspect of a wider historical phenomenon, namely the origins of the Balkan traditionality – conceived as “backwardness”.

Traditional and institutional medicine in Ottoman Damascus

Abdul-Karim Rafeq (The College of William and Mary)

A turning point in the official attitude toward medical health in Ottoman Damascus occurred under Egyptian rule in Syria in the 1830s. The Egyptians, among other things, introduced the quarantine and built a hospital for the army in Damascus. During the Ottoman Tanzimat that followed, the chief Hanafi judge in Damascus issued an order on 3 Rabi’ II 1259/3 May 1843 to the judges in the Damascus Shari’a courts to not accredit anyone who claims to be a physician but to consult with the Hekimbaşı (the chief physician) who alone has the authority to nominate a credible physician.

In the Ottoman centuries that preceded these state innovations, medicine in Damascus was practiced by physicians from all religious faiths, but with a higher percentage of Christians and to a lesser extent of Jews, who nevertheless figured as druggists. Most of the physicians had inherited the profession from their fathers, thus constituting families of physicians. The acknowledged physician was appointed to a paid position in the public hospital, the Bimaristan al-Nouri, in Damascus which is heavily endowed with vakıfs (waqfs).

The main sources of information about traditional medicine are the literary sources and the Shari’a court records. The literary sources, notably the biographical dictionaries of Muslim notables that exclude non-Muslims, mention those persons who had studied medicine alongside other disciplines but fail to give proof of their clinical expertise except in very few cases. By contrast, the Shari’a court records give details about the appointment of physicians regardless of their religion in the Bimaristan al-Nouri, the level of their position, and their pay. In addition to his hospital position, the physician could practice his profession in his hanut (shop). The probate inventories (muhallafat) give detailed information about the estates of deceased physicians, including the medical books and the equipment they had. To guard against malpractice, a Muslim patient, for example, who had a hernia to be removed by a Christian surgeon declared in his presence in the Damascus Shari’a court on 28 Sha’ban 1138/28 April 1726 that he will not hold the surgeon responsible if he dies.

No medical guilds are reported in Ottoman Syria with the exception of the guild of the barbers-surgeons (ta’ifat al-hallaqin wa’l-jarrahin) who performed minor surgery, such as circumcision and bloodletting, and also sold leeches. Popular medical practices, such as cupping, creating a hole in the leg to drain pus (hummust al-kayy), and visitations to healers and shrines were widely practiced.

During the Tanzimat, and especially during the rule of Sultan Abdülhamid II (1876-1909), the state introduced several medical facilities into Damascus. The sultan, who declared himself caliph, favored Damascene notables, and himself belonged to the Shadhilliyya Sufi order based in Damascus, built the Hamidian hospital in Damascus in 1899 and established a medical school which began to function in 1903-4 to provide services to the 4^th Turkish army in Syria but also to placate the local Muslims. The irony is that the medical school in Damascus taught medicine in Turkish until the end of Ottoman rule when it shifted into Arabic and continued to do so under the French mandate. By contrast, the American medical school established by American Presbyterians in Beirut in 1867 as part of the Syrian Protestant College established a year earlier began teaching medicine in Arabic until 1882 when it shifted into English.

The many masters of Ottoman hospitals: between the imperial palace, harem, bureaucracy, and the Muslim legal courts

Miri Shefer-Mossensohn (Tel Aviv University)

This paper focuses on hospitals in the Ottoman urban centres during the early modern period analysing them as Ottoman institutions. During this period several hospitals were established as part of the vakıf system in imperial centres which included the three capitals, some princely seats in Anatolia, and various other provincial centres. How were these hospitals managed individually and as a group? Why did the system operate in its specific ways within the wider imperial administrative circles? Why did vakıf institutions become so entangled with so many branches of the state: the Imperial palace and harem, the central bureaucracy and the Shari’a courts?

Relying on sources produced within the state apparatus for the sake of running hospitals (archival documents of appointments and financial budgets found at the Osmanlı Başbakanlık Arşivi), it will be clear that Ottoman hospitals were fully co-opted into the Ottoman state. I will suggest the complex and seemingly chaotic system of administration were one cause for these hospitals to endure for several centuries and enjoy an image of efficient institutions.

Understanding the hospital system will then enlighten us not only regarding one Ottoman institution, about which we still do not know as much as we should, but also educate us some more on the working of the Ottoman state during the sixteenth and seventeenth centuries.

Imagined healthscapes: places of health and disease in early modern Ottoman cities

Nükhet Varlık (Rutgers University-Newark)

With a view to exploring how an association between health and place developed in the early modern Ottoman imagination, I will focus on three Ottoman cities, namely Istanbul, Edirne, and Bursa, and seek to understand what natural, spiritual, and cultural qualities of these cities came to be associated with health and disease. For example, Edirne is often portrayed in the sources as a place of retreat for Ottoman sultans and other elite members of Ottoman society, especially at times of crises in Istanbul; this is where the Ottoman sultans went for “hunting” or “to get the fresh air of the mountains”. In a similar vein, Bursa is often praised for its clean mountain air, green trees, and therapeutic waters. However, in the early modern era, both Edirne and Bursa were small, crowded, and filthy cities, as suggested by contemporary observers. So, what factors contributed to their being imagined as places of health and healing? I shall argue that the answer to this question can be found in the multifaceted competition between these cities. A close reading of sources reveals that Edirne and Bursa were imagined in this way precisely as a response to the critical rise of the imperial capital Istanbul, which, as a result of a complex social and political transformation came to be associated with disease in the sixteenth century. Thus, looking at the fabrication of these imagined healthscapes enables us to offer a critical reading of resistance to the Ottoman imperial project.

Firar as psychogenic fugue: the dilemma of Ottoman military desertion in the Great War

Yücel Yanıkdağ (University of Richmond)

During the Great War, approximately 500,000 Ottoman soldiers, or roughly 18 per cent of all men fielded during the war, were considered to have deserted their ranks. Several Ottoman and Turkish military officers at the time and a handful of Ottoman historians since then have offered their interpretations on the causes of this extremely high rate of desertion. From the perspective of social, cultural, and military history, these reasons are important, as they can tell us something about the concerns, fears, and mentalities of the Ottoman peasants who were conscripted into military service, sometimes against their will. There was yet a third group of experts whose views on desertion have been completely overlooked. These were the Ottoman-Turkish neuro-psychiatrists, who argued that a majority of desertions during the war were pathological (marazi firar) in nature. Almost always divorced from the war itself, in this socio-medical interpretation desertion became a symptom of a number of mental ailments which, they believed, afflicted these men. For the neuro-psychiatrists, desertion became the ultimate sign of a larger medical problem—hysteria, epilepsy or schizophrenia to name a few—with those individuals who numbered in the hundreds of thousands. While focusing mostly on medicalization, this paper also hopes to deal with problems of historical interpretation of desertion raised by this pathologization. If these neuro-psychiatrists were correct in their diagnoses, then modern historians finding only non-medical reasons for desertion as they do could be missing half the picture. Yet, we must also question the motivations of neuro-psychiatrists for ignoring those non-medical reasons at the expense of medical ones.