In the Fourth Courtyard of Topkapı Palace, overlooking the unique view of the Bosphorus, lies a modest tower: the Hekimbaşı’s Chamber. This structure, often overlooked by visitors, was actually a strategic center housing an empire’s health secrets, healing traditions, and scientific pursuits. This was the seat of the Hekimbaşı, who was responsible for the health not only of the Sultan but of the entire palace community. Ottoman palace medicine, unlike the mechanical approaches of the West, was a holistic and sophisticated system blending the legacy of Islamic scholars like Ibn-i Sina and Razi, ancient Greek medicine, and Anatolia’s thousands of years of herbal tradition. In this article, we will open the door to the Hekimbaşı’s Chamber, wander the corridors of the Enderun Hospital, and delve into the depths of this rich medical culture, from royal pastes (macuns) to healing sherbets.
The Palace’s Health Center: The Hekimbaşı’s Chamber and Enderun Hospital
Topkapı Palace was like a self-sufficient, enormous city, and one of its most important institutions was its healthcare infrastructure. The palace’s health system was managed under the authority of the Hekimbaşı, by the Enderun Hospital and its affiliated units. The Topkapı Palace Hekimbaşı’s Chamber functioned as the administrative and scientific brain of this system. Here, the Hekimbaşı would examine patients, prepare drug formulas, teach medical students, and review health-related reports from all corners of the empire. The chamber’s location was strategic, both for its easy access to other parts of the palace and for providing the Hekimbaşı with a serene environment to conduct his work.
The main treatment center within the palace was the Enderun Hospital. Hundreds of pages (students of the Enderun school), harem members, and other officials living and working in the palace were treated here. This hospital was not only a treatment center but also an important practical area for medical education in the Ottoman Empire. Young physician candidates would participate in patient examinations alongside master physicians, learn drug preparation, and gain experience by observing surgical interventions. This master-apprentice relationship played a key role in the transmission of medical knowledge from generation to generation.
Who was the Hekimbaşı and What were His Duties?
The Hekimbaşı was one of the most respected and influential figures in the Ottoman bureaucracy. He was not only a physician but also a scholar, an administrator, and one of the Sultan’s closest confidants. The Hekimbaşı’s duties were quite extensive and varied. His foremost duty was to protect the health of the Sultan and the members of the dynasty. He would taste every meal before the Sultan ate it, prepare special health cures and pastes, and perform the first intervention for any of the Sultan’s health problems.
Furthermore, the Hekimbaşı was, in a sense, in charge of the entire empire’s health system. He supervised other palace physicians, surgeons, and pharmacists, undertook the management of the Enderun Hospital, and was in communication with the Darüşşifa tradition (hospitals) throughout the empire. It was also among his responsibilities to control the quality of medicinal raw materials brought into the country, test the competence of new physicians, and develop measures against epidemics. This multifaceted role placed the Hekimbaşı in a unique position, combining scientific authority with administrative power.
The Palace Pharmacy and Drug Preparation (Terkiphane)
The heart of Ottoman palace medicine beat in the unit called Terkiphane or Darüşşifa Pharmacy, where medicines were prepared. This was a treasure trove where the empire’s rarest and highest quality plants, minerals, and animal products were collected. Hundreds of types of drugs (medicinal raw materials) from Egypt, India, Iran, and Europe were expertly processed here into pastes, sherbets, pills, ointments, and theriacs (antidotes).
Drug preparation was an art based on carefully calculated formulas called terkip. The Hekimbaşı and other palace physicians would prepare personalized medicines according to the patient’s temperament (humoral balance), the nature of the illness, and seasonal conditions. This can be seen as an early example of the personalized medicine concept in modern medicine. Every prepared medicine was recorded in ledgers, its formula kept secret, and preparations for the Sultan were made with great secrecy and security.
The Sultan’s Healing: Pastes, Sherbets, and Special Formulations
Since the Sultan’s health was considered equivalent to the survival of the state, the food, drinks, and medicines prepared for him were done with extraordinary care. Among these special products, the most famous were the Sultan’s pastes (macuns) and sherbets.
From Mesir Paste to Sultan’s Sherbets: Famous Formulas
One of the best-known products of the Ottoman medical tradition is Mesir Paste, whose origin is attributed to the illness of Hafsa Sultan, the mother of Suleiman the Magnificent. This paste, consisting of a mixture of 41 different spices and herbs, gained fame as a potency paste believed to give strength to the body, strengthen immunity, and cure many diseases. In the palace, there were many similar paste formulas prepared for the Sultan and dynasty members, containing richer and rarer ingredients (such as amber and musk).
Medicinal herbs and sherbets were also an integral part of the palace cuisine and medicine. Sherbets were not just refreshing drinks but also medicines containing the essences of medicinal plants. Sherbets made from plants like rose, tamarind, poppy, violet, and ginger were consumed for purposes such as aiding digestion, reducing fever, cheering the heart, and calming the nerves. Each sherbet had a specific temperament (hot, cold, moist, dry) according to the humoral balance theory inherited from Hippocrates and Ibn-i Sina, and was consumed according to the physician’s recommendation.
Medicinal Herbs and Botanical Knowledge
Ottoman physicians were also competent botanists. They fully utilized Anatolia’s rich flora, knowing through generations of accumulated knowledge which plant was good for which disease, how to collect and dry them, and with which substances to combine them. In the palace gardens (Hasbahçe), not only ornamental plants but also medicinal herbs were cultivated. Plants like chamomile, mint, sage, linden, and licorice root were frequently used both in the kitchen and in the Terkiphane. This deep botanical knowledge formed the basis of Ottoman palace medicine practice.
Between Science and Tradition: Methods of Ottoman Palace Medicine
Ottoman medicine had a holistic structure that combined rational observation with spiritual belief. Diagnosis and treatment methods reflected this dual nature.
Observations, Diagnoses, and Surgical Interventions
Ottoman physicians carefully observed the patient when making a diagnosis. Among the most common methods were pulse measurement (nabz) and urine examination (karure). The color, odor, and sediment of the urine would give the physician important clues about imbalances within the body. These observations were interpreted within the framework of Ahlat-ı Erbaa (Humoral Theory), based on the balance of the four basic fluids in the body (blood, phlegm, yellow bile, black bile). Treatment included methods such as diet, regimen, medication, and bloodletting (hacamat) aimed at correcting this imbalance.
Surgical interventions (cerrahiye) were generally performed by a separate group of specialists called surgeons. Procedures such as cauterization, treatment of fractures and dislocations, abscess drainage, and especially wound treatment in military medicine were carried out. Eye specialists (kehhaller) were quite successful in cataract surgeries. However, due to the lack of modern knowledge of anesthesia and antisepsis, major surgical operations were highly risky and rare.
Amulets, Prayers, and Spiritual Healing Methods
In addition to scientific observation, spiritual healing methods were an integral part of treatment. It was believed that illness was not only a bodily ailment but also a spiritual imbalance. Therefore, alongside medicines, healing verses and prayers (rukye) were recited to patients. Talismanic shirts, inscribed with special symbols and prayers, were worn to protect sultans from diseases and the evil eye. These practices were a reflection of the holistic relationship people of that era established with the universe and faith, and it was believed that physical treatment and spiritual healing complemented each other.
Measures Taken in the Palace Against Epidemic Diseases
The Ottoman Empire frequently had to face major epidemics such as plague and smallpox. The densely populated palace was a highly risky area for such epidemics. During epidemic periods, strict measures were taken in the palace. Tahaffuzhane (quarantine) practices were implemented where suspected patients were isolated. Palace rooms were fumigated with censers burning substances believed to be germicidal, such as agarwood and Syrian rue seeds. Furthermore, it is known that the Ottomans applied a primitive variolation technique called telkih or aşı against smallpox, much earlier than modern vaccination, and that this technique was introduced to Europe through Lady Montagu. This demonstrates the practical ingenuity of Ottoman medicine in the field of preventive medicine.
Medical Tradition Inherited from the Palace to the Present Day
Although Ottoman palace medicine retreated from the stage of history along with the empire, its legacy has reached us in different forms today. The Darüşşifa tradition, where healing patients was seen as an act of worship and charity, laid the foundation for modern Turkey’s culture of charitable hospitals. Numerous medicinal herbs used for centuries are now being rediscovered and scientifically researched in the fields of phytotherapy and alternative medicine. The culture of hygiene and cleanliness developed in the palace, the bath tradition, and the understanding of preventive medicine remain a valuable legacy that still holds importance for public health today. The Hekimbaşı’s chamber continues to whisper to us not only the medical secrets of the past but also an ancient wisdom that healing lies at the intersection of science, art, and faith.
