Introduction
Throughout history, Cyprus has hosted many civilizations and states due to its strategic location in the Mediterranean. One of them is the Ottoman Empire. The Ottomans conquered the island in 1571 and maintained their rule until 1878. The scholarly attempt to grasp the Ottoman Empire with its all institutional, political, social, economic and cultural aspects has been one of the fields of interest for world historiography. It is obvious that local history studies in the countries experienced the Ottoman rule, would help and contribute to draw a general picture of the Ottoman Empire. In this context, the current work, mainly relying on the Cyprus religious court registers, aims to identify the diseases -excluding the contagious ones such as cholera, plague and malaria- and the doctors, the main actors in healthcare services, and to investigate and analyse the doctor-patient relations within social, economic and juridical context in Ottoman Cyprus.
The reason of exclusion of the epidemics diseases from the scope of the work, is not because of the fact that Cyprus did not witness such diseases, but it is because that the authors of the paper, have been working on a separate study investigating the contagious diseases with their negative effects on the population, and the measures taken by the Ottoman central and local government in island against them, and finally the establishment and mechanism of the quarantine system in Cyprus. As a matter of fact, the plague, also known as Black Death, continued to be one of the destructive factors for the population of Cyprus until to the mid-19th century, when a quarantine system was established in the island.[1] However, from time to time, the other contagious diseases such as cholera and malaria were prevalent in Cyprus in the second half of the 19th century. [2]
There are many literary works examining the Ottoman Medicine, healthcare services and medical education from various perspectives. The most common of these studies are those on the Ottoman medicine in terms of history of Ottoman science and medicine. Moreover, there are some studies that place and approach the issue in the framework of the history of Ottoman political thoughts or institutions. In addition to these, there are works that view and places the Ottoman medicine within the scope of biographical studies of the famous doctors and their works.[3] In recent times, a new sort of academic studies in the history of Ottoman medicine have appeared. These academic studies, relying mainly on the Ottoman sharia court records, discuss the patient-doctor relations in accordance with the social, economic, cultural and judiciary aspects.[4] Thus, one can categorize the current work in similar manner. In this context, this study, relying mainly on the Nicosia sharia court registers, and partly on the travellers’ observations and reports, aims to identify the diseases, doctors, the doctors’ fee paid by the patients, medical and surgical devices, and analyse the patient-doctor relationships with regard to the social, economic and judiciary aspects. Resultantly, the study argues that until the second half of the 19th century when the Ottomans started the centralization and modernization of its institutions including the health services, and thus to view the healthcare services as a public service, the overwhelming majority of the doctors operating in Cyprus had been the non-Muslims in private practice.
The study, regarding the analysis of patient-doctor relations, also points out that prior to the surgery, the doctors who were going to perform the procedures were given assurances through consent approved by judge that the patients would not make additional demands from the patient themselves or their relatives, even if they lost their lives during the operation. Another finding that the study revealed is that the doctors beside their principal functions in healthcare services, acted as legal experts when required some cases.
Doctors
Inherited from the previous Islamic societies, the Ottomans maintained the medical institutions such as bimaristan, bimarhane, tımaristan, timarhane and der al-shifa which were established as waqf foundations. Until the foundation of Süleymaniye madrasa, the Ottoman government employed some Muslim physicians from Egypt, Iran, and Syria, beside the doctors from the previous Seljuk domains. In addition to these, some converts and non-Muslim doctors worked in the Ottoman palaces.
The Süleymaniye Complex (külliye) designed as a socio-religious centre in Istanbul, had a medical school and a hospital (Dar’el-shifa), a drugstore (Dar alakakir, and a Tabhane, beside the madrasas for different levels of education levels and other buildings functioned for different purposes. The medical students (danishmends) trained in the medical madrasa, used the Dar el shifa for the practicing the theoretical lessons.[5]
As the pioneer of the Ottoman medical education institutions, the Süleymaniye medical madrasa occupied a very important place in the history of Ottoman medicine. It sets an example for the others to be established in later periods. The medical madrasa was administered by Chief Physician’s office called Hekimbaşı. The principal responsibility of Hekimbaşı was the health of sultan and the other elites in palace, and to administer the all state health institutions. He also appointed the doctors to the vacant posts including those served in the army.[6]
From the Nicosia Court Registers dated 21 April 1823, it is understood that a similar institution of Chief physician (Hekimbaşılık) was established in Cyprus. In this year Hekimbaşı in the island was a non-Muslim called Hamut.[7] Additionally, the expenditure list of Cyprus between August 26, 1824 and March 20, 1825 in the register, indicated that 1,625 kurus (piaster) was paid per month to the head physician.[8] It should be added that a document dated April 9, 1870, refers to one of the streets in the Ayayanni Neighbourhood in Nicosia as Hekimbaşı Street (Head Physician Street).[9] It could not be determined from the records which doctor the street had actually been named after. It is most likely that Hekimbaşılık in Cyprus was a post appointed by the Hekimbaşı in İstanbul, and responsible for monitoring all the doctors and the craftsmen in the field of Health in Cyprus. Although many madrasas were established in Cyprus during the Ottoman rule, they were at secondary school level and therefore, it is unlikely that they had a curriculum which included medical courses.[10] The attempts to modernize the state towards westernization and thus to prevent the process of disintegration in 19th century, manifested itself also in the areas of Ottoman medicine and medical education.
The first modern medical, the School of Medicine (Tıphane-i Amire) was founded in 1827, during the reign of Sultan Mahmud II, to educate military physicians. This was followed by the opening of the Imperial Medical School at Galatasaray, where the non-Muslim students were also allowed to study, in 1839.[11] In 1866, the first Civil Ottoman Medical School (Mekteb-i Tıbbıye-yi Mülkiye) was established. This institution, which produced its first graduates in 1874, was planned to educate “municipal doctors” who would graduate from the school with the aim of providing healthcare services in the provinces. In 1871, separate legislation was prepared for the physicians who would perform public health services in the provinces, and the application of the local doctor (memleket tabipliği) based on the municipal administrations was introduced.[12]
The Regulation of Administration of Public Medical Affairs (İdare-yi Umumiyye-i Tıbbiye Nizamnamesi) issued in 1871, envisaged that a memleket tabibi would be appointed for each administrative division (province, country, district), whose salary be paid by the municipal governments. Yet, during the period between 1871 and 1878, there was no document indicating the permanent employment of a local doctor under the Cyprus municipalities.
From the record dated 19 February 1873, it was found that, as there was no local doctor present in the relevant year, Antuan Efendi, the Artillery Head Physician, provided health services to the criminals in the prison. Antuan Efendi claimed 500 piaster per month in addition to his basic salary, but this request was not found to be appropriate because the income generated by the Municipality of Nicosia was insufficient. In fact, when the municipalities were financially incapable, they requested money from the public. However, because the majority of the prisoners in Nicosia had committed crimes outside out the island and were ordered to Cyprus to serve their sentence, it was thought that agreement to Antuan’s increase request would not be appropriate for the local people. Thus, it was decided that he would undertake both tasks under his existing salary.[13]
From the records of 1875, it can be understood clearly that a Frenchman named Jean Euclides served as a doctor in the Municipality of Nicosia. This document also shows that there had been no doctor in Famagusta at that time. At the order of the Famagusta district governor, Euclides also provided treatment to prisoners in Famagusta. One of the prisoners was Mustafa Asım, the son of Zade Kemal Bey, also known as Namık Kemal, who was one of the leading figures in the Young Ottomans and who had lived in Famagusta for two and a half years. In his report on Namık Kemal on 29 September 1875, Euclides wrote that Namık Kemal was extremely sick due to malaria and Famagusta’s “bad weather” and that this disease could eventually turn into tuberculosis and would ultimately be fatal. Additionally, Euclides stated that there was not even a single doctor in Famagusta and Namık Kemal, who was sick, needed to be immediately transferred to a different location where the humidity was less.[14] As it is understood from the archive records, on December 24, 1876, the Leymesun (Limassol) Municipality was served by a non-Muslim doctor named Konstantin.[15]
As reflected in the existing documents, one of the tasks foreseen by the Cypriot municipalities regarding health services was the vaccination of children in need. The salaries of those Vaccinators’ who were commissioned for this task, had to be covered by municipal revenues. However, as understood from the records, there were also problems in this regard. In 1872, for the vaccination of children living on the island, Sokrat Efendi was assigned a salary of 400 piaster. Nevertheless, Sokrat Efendi alone was not able to vaccinate all the children in Cyprus. Therefore, it was decided that the children from the Famagusta, Nicosia, Kyrenia, Tuzla and Limassol districts and the surrounding villages, would be vaccinated by the surgeons who were connected to the artillery units in those fortresses. Sokrat Efendi would vaccinate children from the town of Paphos and other outside villages with the assistance of Halil Onbaşi (corporal), an artillery battalion soldier who understood the “art of vaccination” (aşı fenni). It was envisaged that Sokrat Efendi and Halil Onbaşı’s 700 kurus monthly salaries would be paid by the municipal governments. Accordingly, the municipalities of Nicosia, Paphos, Famagusta and Kyrenia each contributed 100, and the municipalities of Tuzla and Limassol each contributed 150 piasters.[16]
Bekir Efendi, who was sent to Cyprus due to an outbreak of smallpox in 1876, received a salary of 600 piaster per month that would be paid by the municipalities according to the record dated June 14, 1877.[17] However, according to the decision made by the Cyprus Administrative Council dated 10 June 1877, Bekir Efendi had not been paid 1,089 piaster owed to him by Tuzla Municipality, along with 605 kuruş from Paphos Municipality, 600 kuruş from Kyrenia municipality and 950 piaster from Famagusta Municipality. According to the decision of the Cyprus Administration, if the revenues of the related municipalities were not available, the debts owed to Bekir Efendi would paid by Cyprus Funds to be procured from future income.[18] A new decision was passed on July 9, 1877, for the implementation of the previous decision, as it became clear that after approximately one month that the Cyprus Administrative Council had come to the agenda and, resultantly, the municipalities were unable to pay a total of 2,950 kurus. [19]
It is possible to say that, during the period when the Ottomans’ rule in Cyprus was approaching its end, contrary to the expectations, even in Nicosia, the residence of Cyprus governor, the post of memleket tabibliği did not institutionalise and there was no memleket tabibi employed permanently, and paid by the municipal government regularly. In fact, the doctors working for the Ottoman army in Cyprus continued to carry out the services supposed to be fulfilled by the civil doctors. As a matter of fact, as of 1877-1878, a Local Doctor’s salary was not included in the expenses of the municipality of Nicosia.[20]
Another reform attempt was to increase the quality of the medical service through standardization of the doctors. The orders disseminated throughout the Ottoman territory stipulated that doctors were obliged to cure everyone as required and that they should not receive payment from the poor. It was also requested that doctors should be appointed on the basis of an examination, and doctors without diplomas and licensees could not be employed. Once the Regulation of doctors (Etibbâ Nizamnâmesi), recorded in the register dated March 1, 1849 was sent to the island, it is ordered that they should be distributed to the interested parties and were acted upon according to the regulations.[21] The relevant regulation was also important in respect to the significance it demonstrated respect for human health. From the record dated May 23, 1871, Vasakaki, a doctor who had been serving in Tuzla for forty years, appeared to be a private physician who had treated patients at reasonable prices, with no charges stipulated for the poor.[22] Another special physician identified in the documents was Efliru who worked in Nicosia (1877- 1878).[23]
The record dated 8 November 1876, states that diplomas were required for the doctors to work and they required approval from the Ottoman Medical School (Mekteb-i Tıbbiye).[24] With the regulations issued by the Ottoman State, one of the principal aims of the authorities was that they attempted to introduce measures into health institutions that would prevent the uncertified doctors from practicing. From some sources, it is understood that uncertified doctors sometimes caused the deaths of patients while they were being treated. For example, according to a document dated September 25, 1875, while the Vaccinator İbrahim Efendi was treating a sick non-Muslim from the Kumyalık village of Karpas nahiye, he actually caused his death.[25] These people, who regarded themselves as physicians and were referred to as ‘Vaccinators’ among the people and the patients seeking healing, did not escape the administrators’ notice at the beginning of the British colonial era and their work was prohibited. One of the people who tried to perform medicine using traditional methods was a woman named Pembe Molla and an example can be found where one of her patients, Hafiz son of Ali, became blind while receiving treatment. Ali Efendi, can also be considered to be one of the uncertified physicians who worked in Nicosia.[26]It can be argued that seeking medical treatment from the ‘uncertified doctors’ was not Cypriots’ preference. As it was the common case in the empire[27], there were not adequate doctors available in service. And this situation must have drove the people to these uncertified doctors and most probably, to the traditional medical treatment methods, interdependent with the professional medicine, based on magic, popular custom, and religious belief.[28] Despite the court records in Cyprus do not reflect any sample to support this argument, it is a well-known fact that the Cypriots up to modern times continued to resort to some practices related to their religious beliefs. For example, some of the women in Cyprus, whether they were followers of Mevleviyah or not, visited the tomb, believed to be the burial place of Ahmet Pasha, in Mevlevi Tekke in Nicosia to prevent the premature deaths and to save their new-born infants. According to the belief;
“Anyone wishing to venerate the tomb of Ahmet Paşa at the Mevlevi Tekke used to visit the tomb on Thursday night and/or on Friday. They used to tie a piece of cloth to the railing of the window to the west of the tomb. They would light a candle and supplicate for their wishes to come true. Women who had lost a child would devote their last-born child to Ahmet Paşa, so as to ensure their new child lived. They would give them the name Ahmet and charge another woman to take the new-born child to the tekke and leave it there. Later, another woman would pick up the new-born child from the tekke and bring it back to the mother, following another route; it would then be sold to the mother for a certain amount of money. It was believed that new-born infants were thus saved from premature death.”[29]
An other quotation from the Turkish Cypriot Community leader Dr. Fazıl Küçük’s memoirs, tells about how the Mevlevi Tekke was seen as a popular place of religious practices where the patients sought healing;
“The master used to sit in the tekke...He used to pray and tear a piece from the underwear of the patient, and tie it to the railings of the window. It was believed that the disease would remain there”[30].
The concern shown by the authorities towards ensuring that all doctors should be educated with relevant diplomas was also extended pharmacists and other associated health workers. In fact, a document dated July 14, 1876 put forth that those who were or desired to become pharmacists in Cyprus were required to have diplomas and were obliged to acquire a license from the Ottoman Medical School (Mekteb-i Tıbbiye-i Sahane) in order to be permitted to perform this profession. In order to successfully obtain the license, candidates were also required to enter and pass exams that the Medical School would organize on specified dates.[31]
It is revealed from documents that the majority of doctors operating in the island were non-Muslims in private practice. The doctors operating in Cyprus are reflected in the documents as the following: Usta Recep, Andreya the son of Luka, Surgeon Pedro, the son of Ergiro, Moorish Haji Bedreddin, Surgeon Usta Şahin, Surgeon Yanni, the son of Covanni, Surgeon Nikolo, the son of Esterya from Yanya, Surgeon Hristodili, the son of Yannici, Usta Şahin, the son of Yorgi, Doctor Rollo, Doctor Kostantiye, Doctor Yanaci, Head Doctor Hamud, Doctor Elhum, Doctor Karliti, Physician Atanas, Doctor Dimitri, physician Sari Dimitri, Doctor Barsamacı, Doctor Efkalandi, Doctor Monseur Lakon, Doctor Sabas, Doctor Lahun, Doctor Atnas, Doctor Mandovani and Doctor Yasmacı, Doctor Anotyotyadi, Doctor Haji Ustamadi, Andaliko, the son of Corci, Thessalonian Doctor Selim Agha the son of Abdullah, Doctor Oralla, Doctor Mehmed Aghason of Abdullah, Doctor Marfaci, Doctor Hristodoli, the son of Yano from Ioannina (Yanya), Doctor Veli Mehmed son of Veli Ali, Doctor Françesko Kaydano Eskoti, Doctor Yanni Efkalazi, Doctor Aklidi, the son of Tomazo, Doctor Angelidi, the son of Yorgi, Surgeon Mehmed Şakir Efendi the son of Osman Agha,[32] and the Head Doctor of Imperial military establishment (Asakir-i Şahane Sertabibi), Hristaki Efendi.[33]
Considering the above findings, it can be argued that, as in the other parts of the Ottoman Empire in classical age, the dominancy of the non-Muslim and foreign doctors, continued in Cyprus. Actually, after the 17th century Ottoman medicine began to turn to the west, and from 1800s onward an increasing number of European physicians were employed both in healthcare and in medical education institutions.[34]
The Ottoman Empire mandated that the consuls, who were representatives of foreign states, reside in Tuzla District, a trade centre on the island of Cyprus.[35] The city, which was a trading port, was also threatened by outbreaks of illness. As it is presented in the documents, there were foreign doctors who worked in Tuzla district as well as physicians working under consuls who were on duty on the island. It is understood from the travellers’ diaries, that even those who visited the island, maintained the presence of a physician.[36]
Doctor-Patient Relationship
The relationships between the doctors who were active in Cyprus and the patients were generally recorded in the registry as a variety of interactions. Among them, disagreements between doctors and patients were often observed. On July 20, 1610, as documented in the Nicosia Registry, discussion over the fee for medical treatment between the physician Usta Recep and his patient Mehmet was transferred to the court. The physician Recep agreed with Mehmet to prepare an ointment (cream) for 7 piasters in order to heal Mehmet’s wounds. However, Mehmet later applied to the court claiming that the fee was excessive. In accordance with the court’s decision, it was adjudicated that Mehmet would pay the doctor 4 piaster and that the cream to be made would be financed by the patient himself.[37]
It appears that consents were recorded in order to prevent any doctor-patient disagreement escalating in the future. For example, in the record dated August 20, 1610, Numan the son of Ahmet declared that, in order to cure her daughter, a fee of 800 akca (coin) was agreed with a physician named Anderya, the son of Luka. The conditions of the agreement stipulated that Numan would pay 200 akca (coin) to the doctor in advance for the treatment of her daughter, Ayşe. The remaining amount would be given if the physician was successful.[38]
According to a document dated May 27, 1818, there was a patient who expressed gratitude to his doctor. In the village of Meniko, Veli the son of Huseyin became ill and, although he consulted various physicians on the island, he was unable to find a cure. Veli finally approached the court, stating that he was eventually cured with the help of a doctor named Moors Haji Bedreddin.[39]
Surgical Operations in Island
Within the framework of the records, it is possible to obtain information about various medical activities that were implemented in order to improve public health in Cyprus. It has been observed that people who were sick would go to any lengths to recover; for example, those who had the opportunity would visit the doctor and even undergo surgical procedures. However, prior to the surgery, the doctors who were going to perform the procedures were given assurances that the patients would not make additional demands from the patient themselves or their relatives, even if they lost their lives during the operation. In accordance with the documents, it is clear that various surgical procedures were performed in Cyprus during the related years. These included hernia, bladder (urine bladder) and child abortion (ilgâ-yı cenin) surgeries.
Upon the request of the military class in Cyprus, it was demanded that a surgeon be appointed from Istanbul to meet the island’s needs as well as in the whole of the Ottoman territory. As a result of this request, Surgeon Usta Sahin was appointed as the surgeon in Cyprus and was exempted from any tax, as observed in the document dated July 22, 1724.[40] Examples of the operations performed by Usta Sahin on the island are given below.
In the surgical intervention document found in the Nicosia records, there was a guarantee that the surgeon would not be held responsible if something occurred during the patient’s intervention. In the record dated June 23, 1610, Nurettin Mahmut from Nicosia’s Husrev Bey Neighbourhood stated that Mehmet, the son of Mustafa, the son of his sister, had an illness on his chest under the skin, and allowed Surgeon Pedro, the son of Ergiro, to operate on Mehmet’s wound. Nurettin also clarified that the declaration recorded that, in case of Mehmet’s death, he would not regard Surgeon Pedro as the responsible party.[41]
In 1709, a hernia operation in Cyprus was performed for 12 kurus. In the related document, Menail the son of Yanni, who resided in Tuzla, agreed with Surgeon Yanni, the son of Covanni, that he would perform hernia surgery for 12 piaster. Additionally, Menail declared that if he died during the surgery, the surgeon would bear no responsibility and that his heirs would not claim any rights.[42] The same operation was performed in Crete in 1686 for 7 piaster.[43] In the record dated August 12, 1722, a priest named Pope Hristodolo, the son of Bedro, the son of Enzolo in Nicosia’s Aya Sava Neighbourhood agreed with the Ionian Surgeon Nikolo, the son of Esterya, who resided in Han-i Cedid to perform hernia surgery for 10 piaster. Furthermore, Papa Hristodolo came to the Nicosia Court, and provided assurances that the doctor would not be responsible if he died during this operation, and his heirs would not claim any rights from the doctor. In addition, it is mentioned that the surgeon was staying in a workplace located in Unkapanı, Istanbul, although he resided in Han-i Cedid in Nicosia, Cyprus, for a period of time.[44] Similarly, before the hernia operation, Lakuri the son of Parmo from Anayoli, who was originally French and produced mattresses in Tuzla, had a hernia and agreed in the court that the surgeon Hristodili the son of Yannici, would perform the hernia operation for 15 gold coins. Furthermore, he made a statement stipulating that, in the case of his death, his relatives would not request the physician to pay any blood money (dem-i diyet) (July 29, 1730).[45]
In another record detailing an operation dated February 17, 1732, Mustafa Beşe the son of Mehmet, who lived in Han-ı Komari, agreed with the physician Usta Şahin the son of Yorgi, that urinary bladder surgery would be performed. In a similar vein to the previous record, Mustafa Beşe provided copious assurances to the doctor who was tasked with performing the operation.[46] Additionally, some of the people who required surgery were not Cypriots, but were travellers who had come to Cyprus for trade purposes. These people were often struck by sudden illnesses that required surgery during their stay in Cyprus, or were interested in returning to their home country after their surgery, in the knowledge that there were well-known physicians in the area. No related records could be found indicating whether these surgeries were successful or not. Nonetheless, if those who were to be operated on had died during the procedures, their deaths would inevitably have been recorded.
In the period investigated, there were no records of abortions (ilga-yı cenin) in the blood money cases. The heirs of the deceased Kadelo the daughter of Marakrova, from Famagusta, claimed that Kadelo, who had served Konstantin, one of the Cyprus court translators, for a period of six years died as a result of an abortion that Konstantin performed on her after she became pregnant. Also, because Konstantin died before the case could be resolved, blood money was demanded by the family of Kadelo. However, since sixteen years had passed during the investigation, the court decided to close the case (March 20, 1732).[47]The reason for the closure of this case was the statute of limitations expired after 15 years. Although the claim in this case was rejected due to the time period involved, it has been shown that abortions were conducted by non-Muslims during that time period. As the case resulted in death, this also reveals the risk dimension. Furthermore, if the assertion that Konstantin performed the abortion was true, it can be assumed that such activities were sometimes performed by members of society that were not official doctors.
In the documents from the mentioned period, it is revealed that an interesting skin disease was encountered in Cyprus. In the related records, the health problem of Hristoglu and Haceleno’s daughter Maryo, born in 1804 in Livadya village of Tuzla, is explained. Ten years prior to the document date, a boil appeared on the left side of Maryo’s head, which grew to the size of a chicken egg, burst, and then transformed into a horn with the approximate size of a small child’s finger. After Maryo had spent three years in this condition, Zerlandi, from the same village, cut the horn with a razor. Forty days after the horn was removed, another boil on the left side of Maryo’s head again turned into a horn. It is stated in the document that this horn was active because it was not attached to the skull as in animals but was attached to the skin. Three years later, a walnut size boil appeared on the top of Maryo’s head and on the left side, three more boils appeared which did not explode. Since it was assumed that these would transform into horns, this desperate situation was reported to Istanbul with demands for treatment (August 21, 1864). In fact, a photograph showing the patient’s condition was taken and sent to Istanbul. Examining the results of the application provided to medical supervisor, it is stated that the condition was an extremely rare kind of skin disease. It is also stated that the related disease may also have occurred in other parts of the body (November 29, 1864).[48] Even though the disease was detected, there was no information provided in the registers about how it was to be cured.
Consequently, in the surgical interventions described above, in addition to the value given to human health in Cyprus during these years, further insight is provided regarding the medical situation and the patient-doctor relations.
As understood from the documents, sick patients were frequently sent to places where they could receive abundant oxygen in order to heal, in addition to surgical intervention and drug treatment. Among these places, Degirmenlik (Kythrea) was a prime location. In the registry dated 15 Safer (a month in Hijri calendar) 1223 (April 12, 1808), in the expenditure list it was stated that 1,088 piaster was spent on sending patients to Degirmenlik (Kythrea) district for convalescence in the fresher air (tebdil-i hava) through KocabaşıYorgaki the son of Konomo in Nicosia.[49] It is understood that the Degirmenlik (Kythrea) district was established in the foothills of the Kyrenia Mountains to provide a location for patient convalescence at that time. In a record dated August 20, 1827 in the Nicosia Record, Hursit Agha, one of the merchants, was given permission to import and sell rice from Cairo and Damietta with the aim of ensuring that Cyprus did not suffer from food shortages as well as for the purpose of supplying rice for making soup for the sick patients.[50]
Among the costs incurred by the state officials passing through Cyprus between March 12, 1800 and October 7, 1800, such as the Chief Admiral, Cypriot Governor Huseyin Agha and Cyprus Commander Yusuf Pasha, there were also other expenses for various diseases. For the patients left in Limassol by Captain Pasha, 100 piaster was paid to a doctor from that location. In Tuzla, the amounts of 60 piaster and 105 piaster were spent through the court translator because of an outbreak of the plague. For the patients in Degirmenlik (Kythrea),165 piaster was spent. For the Tatar brought from Damietta, they paid 37 piaster and 20 pare[51] to a physician for eating and drinking costs for 30 days (until healed). Physician Rollo was paid 80 piaster for treating a wounded Tatar. Finally, 250 piaster was paid to Physician Kostanti who served in the Ottoman Army, as travel pay and expenses.[52]
Deaths Related to Diseases
Some of those who lost their lives in the Ottoman administration were believed to have died as a result of various diseases. However, it is important to point out that it is only possible to gain information regarding those who were registered. For example, a registry record provides details on a death that resulted from a disease. Haji Mehmed the son of Mustafa, from the village of Çimi and originally from the village of Alaiye, purchased a black child slave, who was named Abdullah, from the black community in Karaman for 80 piaster with a renouncing period of 3 days. He had purchased the slave Süleyman Çelebi ibn Ali from the Nicosia Arab Ahmed Pasha Neighbourhood. Fifteen days after the sale, Haji Mehmet made an official complaint to Karaman Judge el-Hac Mehmet that the slave he had bought was experiencing difficulty in breathing (diyk-ı sadır). In the meantime, the under-aged slave lost his life due to shortness of breath. Haji Mehmet came to Nicosia with the paper he received from the Karaman court and applied to the court to cancel the sale and retrieve the money he had spent. However, Haji Mehmet lost the case because the legal period in the case had passed and the seller, Suleyman Çelebi the son of Ali from Arap Ahmet Pasha neighbourhood, avowed that he was unaware of the slave’s sickness (June 28, 1745).[53] In the register dated May 1806, a record notes that, while the eunuch Cevher Agha was travelling to Egypt for a new mission, his ship was forced to seek shelter in Limassol due to adverse weather conditions. Cevher Agha suffered from a genetic disease (zâk-ı illet). Due to the bad weather conditions, Cevher Agha’s situation worsened and he landed in Limassol to recover. However, in spite of the medical treatment he received, the fever increased, and the disease became more severe, ultimately leading to Cevher Agha’s death.[54]
In some cases, it is understood from the various registers that physicians were assigned to investigate suspicious deaths. After the death of Arab Haji Ahmet the son of Abdullah, who died in the village of Tarhun in the Degirmenlik (Kythrea) district, Doctor Salih Efendi, who was dispatched by the government to investigate the cause of death, was paid a 100 piaster fee. Additionally, 25 kurus was paid for the animal that was used to transport the doctor to the village of Tarhun from Nicosia (July 20, 1865).[55] Another source states that Salih Efendi was a vaccine officer.[56]
Fees Paid to Doctors in Heritages
It is noteworthy that, in the probate records in the Nicosia Records, there are also indications of compensations paid to doctors within the expenses. Payments made to doctors in the probate records were made for debts, fees and medicine. However, it is often not mentioned in the documents how long the doctors attempted to treat patients or what drugs they used.
A document dated September 30, 1743, stated that Fezalzâde Süleyman Bey, who died in Nicosia, was owed 200 pare to Physician Yanaci priest among his payments.[57] Among the payments made within the probate of Mehmet Tahir Efendi, who was a deceased chamberlain of Cyprus Governor Seyyid Mehmet Emin Efendi, there was a 250 kurus payment to Physician Frenk from Tuzla for treatment, medicine and surgery (mu‛âlece bahâsı) (October 10, 1814).[58] In the register dated August 15, 1828, the assets of Ahmet Efendi, who was from Istanbul and died while he was the major domo (vekil-i harc) of Ali Ruhi Efendi the Cyprus Governor, were handed over to public treasury. With the permission of Ahmet Efendi, 12 kurus was paid to physician from his assets for the medicines that were used to treat him.[59] Ahmet Muhtar Efendi the son of Ebubekir Agha, who was taken ill while on duty in Nicosia in Cyprus, was taken to Tuzla Harbour in order to be treated. However, Ahmet Muhtar Efendi died while receiving treatment. When Ahmet Muhtar Efendi’s probate was examined, it was understood that 352 kurus was paid to his physician as a doctor and medicine fee (ücret ve edviye). Noretheless, no information was provided in the record about the type of disease involved (December 31, 1843).[60] The important fact here is that the patient was sent from Nicosia to Tuzla.
The document dated August 20, 1859, reveals how the assets of Major Ali Efendi the son of Mühendis Izzet Efendi, who was originally from Istanbul and died in Nicosia, were sold at auction and divided between his heirs. Among the payments in the probate made by Major Ali, there was also a 200 kurus payment for a medical treatment fee (bahâ-i mu’âlece), which was paid to the physician Atanas.[61] When the assets of the deceased Yağcıbaşı (head of oilmaker) Haralanbi, the son of Hristodolo from Nicosia, Ayaandoni neighbourhood, are examined, it is found that they were sold at an auction and divided between his heirs. In the probate proceedings, it is found that he paid 119 kurus for a doctor’s fee (ücret-i tabîb) and a medical fee (bahâ-i mu’âlece) (January 13, 1866).[62] It is understood that, in the court records dated March 18, 1866, Merchant Dedezâde Haji Mehmet Kelami Agha the son of Mustafa Aghathe son of Hussein, who died in Nicosia’s Ayasophia neighbourhood, paid 139 kurus and 10 pare as a fee for medication from his assets (eczâbahâ and fee). [63] Mufti (Müsevvidülfetva) Osman Zinnureyn Efendi the son of Terzi Derviş Mehmet the son of Abdullah, who died in the Ömeriye neighbourhood of Nicosia, paid 100 kurus as a medication fee (eczâbahâ and fee) to the physician Efkalandi, after his assets were sold at auction and shared with his heirs after paying his debts. (March 22, 1866).[64] In the registered document dated March 22, 1866 detailing the heritage of the deceased knife maker Yorgaki the son of Haji Serafim, the son of Yanni from the Fenaromeni neighbourhood of Nicosia, it was revealed that 150 kurus was paid for medicine and doctor fees in the payment section of his probate, which was shared between heirs after all debts were paid.[65] The deceased Boraniki the daughter of Artin Bogos, who was from Nicosia’s Armenian neighbourhood, paid a 363 piaster doctor and medicine fee (mu’âlecebahası) as a result of his illness (May 1, 1866).[66] It is understood from the record dated May 11, 1866 that, the deceased Melikon, the son of Kigorko the son of Atam from İzmir (Simyrna) who was living in the Armenian neighbourhood, paid 45 kurus to physician Atnas as a doctor and medicine fee for treatment of his illness.[67]
In some probate records, only the doctor’s fee was registered. Since the Merchant Aleksi Hamut, who passed away in Karpasia, had no heirs, the rest of his assets were awarded to the Cyprus local treasury (mal sandıgı) after it was sold through an auction and payments were made for debts and expenses. There was also a 57 kurus fee, which was paid to head physician Hamut and was included in the probate costs (April 21, 1823).[68] In a similar record from July 25, 1826, the fee paid to the doctor was revealed to be slightly different. As Mahmut Agha from the Van community, who died while residing in Nicosia Yeni Han (New Inn), had no heirs, the money obtained from selling the heritage was given to Beytulmal Emini (public treasury) Mazlum Agha. When Mahmut Agha’s probate is examined, it is displayed that the doctor Elhum who attempted to treat him, was paid 20 kurus as a doctor fee.[69]
When the probate of the deceased Mehmet the son of Mustafa from Nicosia’s Ebukavuk neighbourhood is examined, a 24 kurus payment can be found as a physician’s fee in the expenses (January 6, 1848).[70] In the document dated 26 October 1857, 250 kurus was paid to the physician Karliti among the probate payments of the deceased Haji İbrahim Agha the son of Korkut Mehmet the son of Abdullah, who was from the Karamanizâde neighbourhood in Nicosia.[71] In the expenses part of the probate of the deceased Haji Ahmet Efendi, who was a Nicosia resident from the Cami-i Cedid (Yeni Camii) neighbourhood, it was found that he had paid 82 kurus to the physician with the authorization that he had assigned to his trustee Hüseyin Agha while he was still alive (December 23, 1859).[72] It is understood from the record dated December 21, 1860 that 75 kurus was paid to the physician Dimitri from the assets of the deceased Ayşe the daughter of Haji Osman, who was from the Nicosia Arap Ahmet Pasha neighbourhood.[73] A resident of the village of Polemidya in Psikobu Village, the deceased Muezzin Hadji Ali the son of Ali, had paid 184 kurus from his probate for treatment from a doctor (February 4, 1861).[74] In a record from the Nicosia register dated March 23, 1865, among the expenses in the probate of a Captain of the Artillery Regiment Second Battalion First Company, Osman Agha the son of Abdullah from Yozgat, an amount of 184 kurus was paid to Doctor Basmacı, who was from Tuzla township.[75]In the probate of Lazaro, the son of Papas Kiryako, the son of Papas Okoni, who was from Nicosia’s Ayayanni neighbourhood and who had lost his life due to illness, 230 kurus was paid to Doctor Monsieur Lakon for his treatment (December 4, 1866).[76]
In the document dated June 26, 1867, when the probate of Mehmet Said the son of Mehmet Lebki the son of Seyyid Said from Aleppo, who died of illness in the Nicosia Nevbethâne neighbourhood, was examined, a 28 kurus debt was found that was owed to the physician Dimitri and 52 was also owed to the physician Sari Dimitri. An amount of 20 kurus was also paid to physician Sabas as a medical visit fee.[77] The amount of the visit fee was learned from the related record from the relevant date. It is also presented a property sales document dated August 15, 1868 in the Nicosia registry that the Doctor Sari Dimitri had a house in the Aya Andoni neighbourhood on Medus Street.[78]
In the probate of the deceased Fatma Molla the daughter of Haji Bayrakdar Kara Mehmet the son of Haji Veli the son of Abdullah, from the Tophâne neighbourhood of Nicosia, 60 kurus was paid to Physician Dimitri (September 14, 1870).[79] In the probate of Ropemaker Haji Hasan the son of Abdullah from Damascus, who was living in Ayasofia neighbourhood in Nicosia and who had lost his life, it is understood that 56 kurus was paid to Physician Atnas (May 17, 1871).[80]
In the document dated 16 December 1872 in the Nicosia registry, the goods in the heritage of the deceased Ehliya, the son of Hristoforo, the son of Atam, who lived in the Ayayanni neighbourhood of Nicosia, were sold and distributed among his heirs. There were 38 trusses valued at 185.5 kurus, among his total assets. This figure reveals that it is likely that Ehliya was either the truss producer or a person trading in trusses. Furthermore, it is probable that the trusses were used by those who did not want to have hernia surgery. Additionally, among the payments made from the probate records, it is understood that a 567 kurus fee was paid to the physicians named Lahun, Atnas, Mandovani and Yasmacı. In the meantime, a 40 kurus fee was paid from the assets of the barber Haji Mihaili for leech treatment.[81] As an alternative form of medicine, leeches have been used throughout history and are still used for their blood-sucking capabilities.
In the record dated December 16, 1872, 1,500 kurus was paid to the military physician Anotyotyadi from the assets of Ahmet Efendi the son of Laptavî Haji Ibrahim Agha the son of Mehmet Agha, who lost his life in the Aghia Sophia neighbourhood of Nicosia.[82] When the probate of Hafız Eyüp Efendi, who passed away while he was Nicosia Alemdar Gazi Zawiyah Sheikh, was examined, it was found that 50 kurus was paid as a payment for surgery (June 16, 1878).[83]
Caregivers in Heritages
In addition to doctors, patient caregivers also occupied an important place in the health records of the Nicosia Register. In a heritage record dated April 4, 1784, it is revealed that there was a fee paid to those who had assisted patients during their illnesses. In the relevant document, among the probate payments of the Monk Lavzitos Sincillos, who died in Nicosia and had no heirs, 80 pare were paid to the nurses who had served him during his illness.[84]
The money that was obtained by selling goods from the heritage of İbrahim from Tripoli, who lost his life in Han-ı Cedid, Tuzla Harbour, were handed over to Ömer Sıdkı Efendi, who was assigned as the trustee, to be given to his heirs in Damascus. Among the expenses in the probate, 50 kurus was paid to the physician who had treated İbrahim while he was sick, and 20 kurus was paid to the caregiver who had served him during his illness (December 19, 1845).[85] It is understood from the probate proceedings that the woman who had served the deceased Şerife from Euboea (Eğriboz), who was living in the Ebukavuk neighbourhood of Nicosia, during her disease, was paid a fee of 30 kurus (February 3, 1852).[86] Haji Hasan the son of Abdullah, who was originally from Alexandria, was imprisoned for bribery while he was in the service of Cypriot Regent Mehmet Emin Efendi. Haji Hasan was affected by this unfortunate situation and became ill; despite being removed from the prison due to the deterioration of his health, he ultimately died. When Haji Hasan’s probate was examined, it is understood that he paid a 50 kurus fee to his caregiver who had served him during his illness (January 2, 1861).[87] It can therefore be considered from these records that there were various people who provided nursing or care services during this time.
Doctor’s Heritages
In the Nicosia register, there are also probate records for doctors who had lost their lives while providing health services on the island. Some of the tools and medicines used by doctors are also found in these records. In the record of a probate document dated November 11, 1807, the assets of the physician Haji Ustamadi who died in the Çakmakli Kenise (Church) neighbourhood in Nicosia while he was a guest and had no heirs, were given to the public treasury (beytulmal) after the assets were sold and his wife was given her share. In the relevant probate record, the listed products of the physician Haji Ustamadi’s listed products were; 1 saddlebag worth 129 pare and the pharmacy items contained within it, a broadcloth worth 135 pare, an antiquated rug worth 120 pare, a used woollen cloth (aba) worth 121 pare, a small fur worth 122 pare, an antiquated belt worth 50 pare, second-hand multi-coloured dress worth 284 pare, a rosary worth 15 pare, a second-hand broadcloth (shalwar) worth 203 pare, 2 waistcoats worth 80 pare, and white knee braces worth 80 pare. It is understood that the value of all the goods in the probate were worth1,479 pare. Additionally, the remaining 614 pare from the heritage after the payment of 866 pare as expense, was delivered to the Emir of the public treasury (beytulmal). The expenses included 370 pare, which was the share awarded to the deceased doctor’s wife. Among the expenses there are 370 pare, which is the share of deceased doctor’s wife. From the money that was transferred to the responsibility of the public treasury, 225 pare was assigned to pay the deceased doctor’s debt to Attar Menla Abdullah.[88]
The value of the heritage of the Army Corps (Asakir-i Mansûre) Doctor Andaliko, the son of Corci, who settled in Cyprus and ultimately died on the island, was 1,549.5 kurus. After deducting the costs of 1,382.5 kurus from the probate, 167 kurus remained. Among the expenses, there was a 322 kurus debt owed to Osman, the Agha of the Patients and a 20 kurus debt owed to Ayvaz Keles who was in charge of the hospital. At the same time, these records identify that there was a hospital in Nicosia during that period (December 22, 1839). [89]According to the document dated January 19, 1865, the Thessalonian (Selanikli) physician Selim Agha the son of Abdullah died in Nicosia on the 20th of December 1864. Since Selim Agha had no heirs, his assets were sold at auction and the income was delivered to the Cyprus Treasury. When his probate is examined, it is calculated that the value of the sold goods was 203 kurus and 20 pare. After spending 79.5 kurus from his assets, the remaining 124 kurus were delivered to the Cyprus Treasury.[90]
Doctors Equipment
By analysing various documents in the Nicosia registers, numerous information about the medical supplies and tools used in Cyprus was found.[91] At the beginning of the 1798-1802 Ottoman-French, the French consulate in the island and its affiliates were imprisoned, as was the case in the rest of the Ottoman territory. One of those imprisoned was the doctor Oralla who was on duty at the consulate. Additionally, the properties of Henri, the French Consul in Cyprus and 20 Frenchmen, including the former Consul Benadito Estir and a physician, were confiscated. When the list of goods and items that were held was examined, it was found that there were medical instruments with their associated prices. Among the equipment belonging to the former French Consul, was a physician’s pump worth 342 pare. Furthermore, among the items of Kirbani the son of Yanni, a physician’s pump worth 88 pare was recorded, while physicians’ tools, bottles and pharmacy items (eczâ-i mütenevvi) in a box that worth was 800 pare were among the items belonging to Oralla (March 26, 1799).[92]
Since Derviş Hasan the son of Abdullah, who was from Antakya and died in Nicosia while staying at Komari Inn, had no heirs, in the goods from his probate were sold, and the proceeds were transferred to the public treasure. Among his assets, there was doctor’s equipment worth 27 kurus and 39 pare (June 15, 1814).[93] In the record dated October 1, 1824, the assets of the deceased Arif Agha, who was the Harem Chamberlain of the Cyprus Governor Seyyid Haji Mehmet Agha, were assigned to his trustee for the purposes of selling them at auction and the payment would be delivered to his heirs. Arif Agha’s belongings included a truss with a value of 2 kurus and 26 pare. [94] The probate of Ibrahim Efendi the son of Emir Haji Mehmet, who was from Nicosia Arab Ahmad Pasha neighbourhood, and whose debt exceeded the value of his heritage, was sold at auction at the request of his heirs, and the proceeds were distributed to his creditors. Among the items was a set of small (sagir) sticks valued at 39 kurus and 30 pare, a coffee grinder and medicine book (October 13, 1836).[95]
According to the document dated September 11, 1839, at the request of his heirs, the assets of the deceased painter Haji Yusuf Agha, who was living in the Abdiçavuş Neighbourhood of Nicosia, were ordered to be sold and paid to his creditors. There was also one truss worth 11.5 kurus and one serving tray in the probate. [96] When the deceased Tellioğlu Haji Mehmet’s probate is examined, even though his debts were more than his assets while he was living in the Ömeriye neighbourhood, there was a truss worth 2 kurus and 25 pare among his belongings (June 17, 1848).[97]
The document dated May 2, 1871 revealed that, among the items in the heritage of Costantino, the son of Yanni, the son of Sava, who died in the Fenaromeni neighbourhood of Nicosia, was a10-volume Doctor’s Book worth 50 kurus, 8 pieces of surgical equipment worth 42 kurus, 10 dental instruments worth 65 kurus, 15 surgical instrument worth 40 kurus, 4 bottles of sulphate worth 120 kurus and 1 syringe (Marbuçlu hukne) worth 15.5 kurus. Although no specific information was provided about Costantino’s profession, the fact that so many medical items were listed is a strong indication that he was a doctor. It is also understood that the physician Lahun was given 460 kurus as a payment from his probate.[98]
Medical Reports given in Various Cases
In some injury cases in the court records, it is seen that, in accordance with the reports taken from the doctors, the court also decided to pay compensation to the victims as well imprisoning doctors in some cases. Nikola, the son of Hristofi, a shoemaker from Baş neighbourhood, made a plea against the farrier Mustafa Çavuş the son of Haji Mehmet in the Tophâne neighbourhood, as he had injured him with a knife, restricting his ability to perform his work. It was also documented that Nikola was unable to work according to his doctor’s report and Mustafa Çavuş was order to pay five thousand silver dirhams as compensation (May 31, 1879).[99] In a similar case, it was revealed that blood money was paid for two of the teeth that were white. Kostanti, the son of Nikola, from the village of Balikitre, Degirmenlik (Kythrea) in Nicosia, complained that, while they were drinking alcohol together, Kara Hussein the son of Abdullah became intoxicated and struck him with a, causing two of his teeth to be broken. As a result of the trial, Kara Hussein was found guilty and was sentenced to two months imprisonment. Additionally, Kostanti opened a case against Kara Hussein, demanding blood money for the broken teeth. In response, it was decided that Kara Hussein would pay 500 dirhams per tooth, which meant that a total of 1,000 dirham of silver was paid in blood money to Konstanti (July 9, 1879).[100]
In the record dated August 17, 1879, Tuğlı the son of Hristofi, a Greek Cypriot and a resident of the Degirmenlik village in the Degirmenlik (Kythrea) District, was stabbed in his right shoulder by Mihail, the son of Haji Haralanbo, who was also a Greek Cypriot, and was declared unfit for work, according to a doctor’s report. In terms of the compensation for this act, it was decided that Mihail the son of Haji Haralanbo, should pay 5,000 dirham of silver.[101] Hristallo the daughter of Yorgi, a resident of Cira village in Omorfa (Morphou) under the Degirmenlik district, also complained to the Nicosia court that he fought with Mariko the daughter of Nicola over two chickens and Mariko had injured his left eye with a stick. As a result of the trial, Mariko was sentenced to three years imprisonment. However, when Hristallo requested compensation for the injured eye, which was also confirmed by a doctor’s report, the court decided that Mariko would pay 2,500 hundred dirham in silver blood money (December 16, 1879).[102]
In a document dated August 10, 1858, Hasan, who was accused of the murder of Osman the son of Hussein the son of Abdullah in the Istavrakonno village of Kukla (Kouklia), was not ordered to pay compensation to Osman’s heirs. When the relevant record was examined, it was found that the accidental discharge of a loaded rifle that Osman was holding hit his left thigh and severely injured him. Later, a doctor intervened and removed the bullets from Osman’s leg and the treatment was successfully. However, Osman later lost his life because of a boil in his throat. In the mentioned record, it is stated that this boil was growing rapidly, although the name of the disease was not mentioned.[103]
According to the results of the census conducted in 1831, it is demonstrated that 46 of the non-Muslims living in Tuzla had disabilities. Of these people, 41 were blind, 3 were mentally ill, 2 were mute, and 1 was lame.[104] It is obvious that 13 Muslims living in Tuzla at the same time had disabilities. Of these, 7 were blind, 2 were lame, 1 was mentally ill, 1 was paralyzed and 1 was mute. It is also stated that Yusuf the son of Osman, who was a 40 years old resident of Todori village, was a leprosy (Hansen’s disease) patient.[105] From the records of the year 1876-77, it is understood from the information given about people living with disabilities in the villages of Kukla district that there was a person who was mentally ill and incapacitated (meczub and amel-mande) in the village of Aya Nikola. Additionally, 5 of the Muslims and 6 of the non-Muslims, were blind (a’mâ) in both eyes, 8 of the Muslims were blind in their left eyes, and 6 were blind in their right eyes. In total, 14 non-Muslims were blind in one eye. Two of the Muslims and five of the non-Muslims were deaf and mute (sağır ve bî-zebân). One person’s left foot was lame, three people could only use one hand, one person only had a right hand and one person had no nose. It is also presented that there were 6 Muslims and 3 non-Muslims who had hernia injuries from accidents. It is also seen that the deaf people in the district were usually deaf and mute.[106]
Hospitals in Various Records
A record from 25 April 1842 in the Nicosia Register, reveals that Musa the son of Hasan from the village of Deftera, who was found wounded in the hospital next to the Arab Ahmed Pasha Mosque in Lefkoşa, was questioned by the court judge Ahmet Efendi, who was dispatched by the court to determine what had occurred. During the questioning, Musa declared that 15 days ago, he had been travelling to Ibselmolof village in the evening, when he was wounded with a knife in his left thigh by Yorgi, the son of Hristoglu (April 25, 1842). The relevant document reveals that there was a hospital next to the mosque in the Arap Ahmet Pasha neighbourhood in Nicosia.[107]
From the document dated January 13, 1865 in the Nicosia Register, it can be understood that Mehmet Ali the son of Abdullah, from Adana, was sentenced to penal servitude for a crime and, while he was in prison in Cyprus, he became sick and was treated in the prison hospital, where he subsequently died on the ninth day of the sixth lunar month.[108] In a similar document in the record, Süleyman the son of Abdurrahman from the village of Gucus in the Ilgın district, who had been imprisoned in Cyprus for 3 years with penal servitude for the crime of rape, was taken to the prison hospital due to illness and succumbed to his sickness on November 23, 1864 (January 13, 1865).[109]Hussein Aceve the son of Abdullah was from Dura village in the Halilürrahman’s district in Jerusalem became ill while he was serving a 10 year prison sentence with penal servitude in Cyprus. Despite receiving treatment in the prison hospital, he ultimately died (August 17, 1866).[110] Büyümezoğlu Osman the son of Abdullah, who was from Antakya (Antioch) and a brigand, passed away while he was serving a seven years prison sentence in Cyprus. Osman could not be cured, even though he was treated in the hospital (March 13, 1867).[111] In the document dated May 2, 1867, Cici the son of Halil the son of Abdullah, who was another prisoner and was from the Dura village of Halilürrahman district in Cairo, died from illness while serving a 10 years sentence with penal servitude in Cyprus. Cici, in a similar manner to the other sick prisoners, had been treated in the hospital but could not be cured.[112] In addition, it was revealed that the prison had a hospital or an infirmary through the data in the documents.
Hysteria Attack Disease
As was the case in across the Ottoman territory, there were also patients in the island who were considered mentally unstable and were generally declared to be insane or suffering from hysteria attacks (cünûn ârız, cenûn-ı mutlak). Those who were suffering from this disease generally lived in the care of their families because they were incapacitated. In some cases, even a guardian could be appointed by the court to those who were mentally ill. In the early 19th century, the mentally ill in Istanbul were treated in three psychiatric hospitals, namely Haseki, Süleymaniye and Sultanahmet Darüşşifa (psychiatric hospital).[113]
In the document dated September 24, 1729, Huseyin the son of Mehmet had a mental disorder was assigned a guardian by the court to protect and manage his property, namely Ali the son of Ibrahim, who was from Nicosia Aya Sofia neighbourhood.[114] Seyyid Mustafa Efendizade Seyyid Ali Efendi, who was the district governor of (sadat-i kiram) in Cyprus, was removed from his position because he was suffering from a mental illness (cünûn ârız) and was not mentally stable; he was replaced by Bekir Aghazade Seyyid Ibrahim Efendi (Kasım 1804).[115] Based on the information provided about the people living with disabilities in the Kukla district, there was a person who was mentally ill (meczub) in the village of Aya Nikola.[116]
Epilepsy Patients
Records reveal that epilepsy patients were sometimes endured epileptic fits and passed out, causing them to fall to the ground. Furthermore, there are examples where such patients lost their lives because of these falls. Therefore, on some occasions, people with epilepsy went to the court and gave declarations in order to prevent anyone from being considered responsible if something happened to them during their epileptic seizures. On 17 February 1699, the non-Muslims in the village of Aya Androniko in Nicosia applied to the court and registered with the witnesses Mehmet Sipahi the son of Ahmet and Recep Sipahi the son of Abdullah, that one of their local villagers, Yerolmi the son of Yorgi, one of the Degirmenlik (Kythrea) residents, was an epilepsy patient. Additionally, they declared that they would not be held responsible if Yerolmi died.[117] In the document dated June 5, 1750 in the Nicosia district, it is stated that, Simyo, the son of Yakimo, who was from the Headquarters of the Degirmenlik district in Nicosia and had epilepsy, registered in the Nicosia Court in order to protect the neighbourhood residents from blood money demands if something happened to him accidentally.[118]
In the records, it is understood that the villagers went to the court in order to investigate the causes of deaths of epilepsy patients. In the record dated December 21, 1698, Christodia and others from the village of Matyat in Nicosia, reported to the court that Filipo, the son of Françesko, a sick patient who was from the same village, drowned while taking water from the water ditch due to an epileptic seizure and they asked the court to investigate the situation. Mevlânâ Mustafa Efendi the son of Hüseyin was dispatched from the court to investigate the situation. As a result of the research, it was registered that Filipo drowned as a result of falling into the water ditch in the village without anyone’s intervention.[119] Thus, the villagers resorted to the court and were prevented from being held responsible for the death of their fellow villager. It is understood that similar examples can be found in Crete as well as in other parts of the Ottoman territory.[120]
In the record dated December 21, 1724, Mihail the son of Papa Nikolo, who was an epilepsy patient in the Orta Neighbourhood of the Degirmenlik (Kytheria) Township, fell into the water at the Syriac (Süryani) Mill and drowned. Mevlânâ Menlâ Mustafa the son of el-Hâc Osman Efendi was dispatched by the Nicosia Court to investigate this suspicious death. It was decided that Mihail’s death was not suspicious and that he died due to drowning in the water channel while he was experiencing a seizure caused by his illness.[121] In the document dated May 30, 1841, the muhtar (village headman) of Kaymakli, Haji Hürrem, requested that the court investigate the death of Ali the son of Ahmet from the Iplik Pazari neighbourhood, who had fallen into the Kaymakli stream and had drowned. Resultantly, as a result of the research conducted by Salih, it was decided that Ali, who was also an epilepsy patient, drowned because he had an epileptic seizure while passing by the stream near the village.[122]
Conclusions
Cyprus had been a part of the Ottoman Empire since 1571. The empire maintained its character as a traditional state until the second half of the nineteenth century. Afterwards, reformation in institutions regarding governance was implemented and this continued until the ultimate decline of the empire. The institutions of the Ottoman Empire were already established and had become advanced by the year 1571, when Cyprus was conquered. Therefore, these institutions were adapted to Cyprus after the conquest. Among other areas, this can be observed in health care services.
As in all parts of the empire, there was neither a governmental institution nor a public service to provide health care for every individual in Ottoman Cyprus during the classical period. However, the central government of the empire did not consider that it was irresponsible for this service. Health care services including doctors and surgeons were under the civil and legal control of Ottoman governance. A medical service (hekimbaşılık) was based in the capital city of the empire (payitaht), mainly for health care services of the court. It is obvious therefore, that other provinces as well as Cyprus had similar health services.
Health care services provided by doctors and surgeons, including the relationship between doctor and patient, in some aspects, need to be a part of the government’s judgement and judiciary mechanism. There were court records regarding health issues in this period. Individuals who had an illness or infection and required treatment that presented certain risks were required to accept that surgeons and the doctors would not be responsible and no compensation would be demanded if unwanted consequences materialised. Such situations could be observed in the court records of Muslim judges as they occurred in their presence.
Doctors, the main actors in health care services, were not only expected to providing health services to the public, but they also assumed responsibility in judiciary issues as legal experts. In the Ottoman period, it was not possible for the cadi (the judge), to be an expert in every subject. Therefore, doctors were asked for information regarding compensation after a suspicious death or physical injury. Medical reports provided by doctors were used to reach fair decisions in such cases.
Another remarkable point about the health care services in Ottoman Cyprus is the fact that active doctors and surgeons were largely non-Muslim. The first medical school of the Ottoman government (Tıbbıye-i Mülkiye) was established in 1866 in order to educate civil doctors. Additionally, non-Muslim population of the island outnumbered the Muslim community. Therefore, it was expected that nonMuslim doctors and surgeons would provide the health care services on the island.
In the Tanzimat reform era, the Ottoman government assumed more responsibility in implementing health care services in a similar manner to other public services. Although the reformations could not be successfully applied, the establishment of the Country Medical Profession (Memleket Tabibliği) as well as regulations to control doctors and chemists were indicative of the efforts of the Ottoman government. In this period, the establishment of a quarantine system was one of the most vital reformatory attempts for the protective health care services. The quarantine area established in Tuzla (Larnaca) at the beginning of the Tanzimat era, was developed and provided services for all the harbour towns throughout this period. Therefore, the injurious effects of epidemic illnesses on the Cypriot population were minimized.
BIBLIOGRAPHY
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NationalArchives of North Cyprus in Kyrenia
Cyprus/Nicosia Judicial Records-Kıbrıs/Lefkoşa Şer’i Sicil Defterleri 1-53.
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BOA. MVL. 794/24
2. Published Documents
Adıyeke, Nükhet, “XVII. Yüzyıl Girit (Resmo) Kadı Sicillerinde Zımmi Davaları”, Pax Ottomana Studies in Memoriam Prof. Dr. Nejat Göyünç, Ankara 2014, pp. 77-95.
Akdeniz, Nil, Osmanlılarda Hekim ve Hekim Ahlâkı, N. Akdeniz, İstanbul, 1977.
Akdeniz (Sarı) Nil, “Osmanlılarda Tıbhanenin Kuruluşuna Kadar Tıp Eğitimi”, Türk Dünyası Araştırmaları, 22, 1983, pp. 152-182.
Akdeniz (Sarı), Nil, “Educating the Ottoman physician”, Tıp Tarihi Araştırmaları, 2, 1988, pp. 40-64.
Akkuş, Yakup, Şifahaneden Hastahaneye Osmanlı Toplumunda Vakıf, Sağlık ve Tıp, Atıf Yayınları, İstanbul, 2018.
An, Ahmet, Tıp alanındaki İlk KıbrıslıTürkler, Kıbrıs Türk Tabibler Birliği Yayınları, Lefkoşa, 2006.
Aydın, Erdem, “19. Yüzyılda Osmanlı Sağlık Teşkilatlanması”, Ankara Üniversitesi Osmanlı Tarihi Araştırma ve Uygulama Merkezi Dergisi,VX, 2004, pp. 185-207.
Aydüz, Salim, “Süleymaniye Medical Madrasa (Dar al Tib) in the History of Ottoman Medicine”, Foundation for Technology and Civilization, pp. 1-16.
Bağışkan, Tuncer, Kıbrıs’ta Osmanlı-Türk Eserleri, Lefkoşa, 2005.
Balta, Evangelia et al., “Gayr-i Muslims in Tuzla (Larnaca): The Census Register of 1831”, Histories of Ottoman Larnaca, Ed. E. Balta et al., Isis Press, İstanbul 2012, pp. 139-244.
Balta, Evangelia, Oğuz, Mustafa, “Muslims in Tuzla (Larnaca): The Census Register TŞR. KB. D. 40”, Festschrift in Honor of Ioannis P. Theocharides Studies on Ottoman Cyprus, Ed. E. Balta et al., Isis Press, İstanbul 2014, pp. 15-77.
Balta, Evangelia, Oğuz, Mustafa, Özkul Ali Efdal, Kouklia in The Nineteenth Century Cyprus On the Ruins of a once Glorious Paphos, Ed. Evangelia Balta, Isis Press, İstanbul 2015.
Bayat, Ali Haydar, Osmanlı Devletinde Hekimbaşılık Kurumu ve Hekimbaşılar, Atatürk Kültür Merkezi Başkanlığı Yayınları, Ankara 1999.
Cobham, Claude Deleval, Excerpta Cypria: Materials for a History of Cyprus, University Press, Cambridge, 1908.
Dağlıoğlu, H. Turan, “Tababet tarihimize ait vesikalar”, Türk Tıb Tarihi Arşivi, 4(13), 1939, pp. 40-46.
Dinç, Güven, “Osmanlı Döneminde Kıbrıs, 1800-1839”, Unpublished PhD thesis, Akdeniz Üniversitesi Sosyal Bilimler Enstitüsü, Antalya 2010.
Domingo, B. L. (Ali Bey Al-Abbasi), Travels of Ali Bey in Morocco, Tripoli, Cyprus, Egypt, Arabia, Syria, and Turkey, Between the Years 1803 and 1807, Vol. I., Printed for Longman, Hurst, Rees, Orme and Brown, London 1816.
Dramur, Rengin, Osmanlı Devleti Saraylarında Tıp ve Eczacılık, Rengin Dramur, İstanbul 2008.
Durmuş, Mehmet Ali, “Hicri 1120-21 Tarihli Lefkoşa’nın 7 Numaralı Şer‘iye Sicili”, Unpublished Master thesis, Ege Üniversitesi Sosyal Bilimler Enstitüsü, İzmir 1997.
Göktaş, Hanım, “XIX. Yüzyılda Osmanlı Devleti’nde Hekim Hasta İlişkileri ve Diplomasız Hekimler”, Journal of History Studies, VI(6), 2014, pp. 99-115.
Gürlek, Mehmet, “Osmanlı Tıp Metinlerinde Geçen Cerrahi Alet Adları Üzerine”, Fırat Üniversitesi Sosyal Bilimler Dergisi, 25(1), 2015, pp. 39-49.
İlikan-Rasimoğlu, C. Gülser, “Boundaries, Education and Licence: The Nineteenth Century Ottoman Standardization of Medical Professions”, Trakya Üniversitesi Sosyal Bilimler Dergisi, 19(1), 2017, pp. 227-245.
Kılıç, Rüya, “Osmanlı Devletinde DeliliğinTarihi: Toptaşı Örneği”, Bilig, 67, 2013, pp. 91-110.
Kökçü, A. Tunga, Nilüfer Demirsoy, “Hekimbaşı Mustafa Behçet Efendi ve 19. Yüzyılda Osmanlı Tıp Eğitiminde Yenilikçi Hareket”, Türkiye Klinikleri Journal of Medical Ethics-Law and History, 24(2), 2016, pp. 67-75.
Livatyalı, Hüsnü, “Osmanlı Döneminde Kıbrıs Türk Eğitim Kurumları ve Yönetimi”, İkinci Uluslararası Kıbrıs Araştırmaları Kongresi Bildirileri, C. II, Doğu Akdeniz Üniversitesi Kıbrıs Araştırmaları Merkezi, Mağusa 1999, pp. 239- 380.
Murphey, Rhoads, “Ottoman Medicine and Transculturalism From the Sixteenth through the Eighteenth Century”, Bulletin of the History of Medicine, 66 (3), 1992, pp. 375-403.
Özkul, Ali Efdal, Kıbrıs’ın Sosyo-Ekonomik Tarihi 1726-1750, Dipnot yayınları, Ankara, 2010.
Özkul, Ali Efdal, “The Consuls and Their Activities in Cyprus Under the Ottoman Administration (1571-1878)”, Turkish Studies-International Periodical for The Languages, Literature and History of Turkish or Turkic 8, no. 2, 2013, pp. 239-283.
Samani, Hasan, “Tanzimat Devrinde Kıbrıs (1839-1878)”, Unpublished Phd thesis, Hacettepe Universitesi Sosyal Bilimler Enstitüsü, Ankara 2006.
Samani, Hasan, “Social, Cultural and Religious Aspects of Ottoman Cyprus: The Nicosia Mevlevi Tekke”, The Northern Face of Cyprus, Ed. L.Summerer and H.Kaba, Ege yayınları, İstanbul 2016, pp. 417-425.
Samani, Hasan, “Tanzimat Döneminde Kıbrıs’ta Modern Belediyeciliğin Başlangıcı ve Lefkoşa Belediyesi”, Belleten, LXXX(294), 2018, pp. 587-626.
Sarı, Nil, “Turkey and its international relations in the History of Medicine”, Vesalius, VII(2), 2001, pp. 86-93.
Sarı, Nil, (ed.), Proceedings of the 38th International Congress on the History of Medicine (1-6 September 2002), Türk Tarih Kurumu Yayınları, Ankara 2005.
Sayıl, Altay, “Kıbrıs Tekkelerinde Geçmişte Yapılan Zikir, Tören ve Şenlikler”, Ü.Vancı Osam (ed.) IV. Uluslararası Kıbrıs Araştırmaları Kongresi Bildirileri, 28-29 Kasım, Gazimağusa 2002, pp. 443-444.
Shefer-Mossensohn, Miri, Ottoman Medicine. Healing and Medical Institutions, 1500- 1700, State University of New York Press, Albany 2010.
Süha, Ali, “Kıbrıs’ta Türk Maarifi”, Milletlerarası Birinci Kıbrıs Tetkikleri Kongresi (14-19 Nisan 1969), Türk Kültürünü Araştırma Enstitüsü, Ankara 1971, pp. 221-234.
Şevki, Osman, Beşbuçuk Asırlık Türk Tababeti Tarihi, Matbaa-i Amire, İstanbul 1925.
Tok, Özen, “Osmanlı Dönemi Hekim-Hasta İlşkileri (Kadı Sicillerine Göre XVII. ve XVIII. Yüzyıllarda Kayseri Örneği)”, Turkish Studies, III(4), 2008, pp. 788- 805.
Ulman, Yeşim Işıl, “Medical Modernization in 19th Century Ottoman Empire with Special Reference to the Introduction of Rontgen Rays in Turkey”, History of Medicine in the Ottoman Empire and the Middle East From the 19th Century Onwards, Ed. A.M. Moulin and Y.Ş. Ulman, The Isis Press, İstanbul 2010, pp. 105-118.
Ünver, Süheyl, “Başvekalet Arşivinde Türk Tıb Tarihine ait Vesikalar”, TTTA, 4 (15), 1940, pp. 129-130.
Ünver, Süheyl, “Süleymaniye Külliyesinde Darüşifa, Tıp Medresesi ve Darülakakire dair (1555-1557)”, Vakıflar Dergisi, II, 1942, pp. 963-965.
Ünver, Süheyl, Türkiye’de Çiçek Aşısı ve Tarihi, İstanbul 1988.
Yıldız, Abdullah, “Osmanlı İmparatorluğu’nda sivil ve Türkçe Tıp Eğitimine Geçiş”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, 70 (3), 2017, pp. 1-8. DOI:10.1501/Tıpfak_000000977.
Zorlu, Süleyman, Osmanlı Tıp Hukuku, Adalet Yayınevi, İstanbul 2017.