Hospitals and Medical Care in Seljuk Anatolia

In thirteenth-century Anatolia, in present-day Turkey, rulers and other patrons supported hospitals through endowed property as well as constructing buildings. At Kayseri, the complex named for Gevher Nesibe Sultan joined a hospital and a medical school. She was the sister of Seljuk ruler Kaykhusraw I, whose reign frames the foundation; the hospital was dated by its inscription to 1205–06. At Sivas, the Seljuk sultan Kaykavus I founded another hospital. Divriği belonged to the neighbouring Mengujekid principality, where Emir Ahmet Shah founded a mosque and his wife Turan Malik founded its adjoining hospital.

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Foundations in Seljuk Anatolia

The Seljuks of Rum ruled much of Anatolia from the late eleventh century into the early fourteenth. At Kayseri, in central Turkey, the hospital and medical school were completed in 1205–06. The two buildings stood together, with a hospital on one side and a school on the other. Later records show that estates, bathhouses and agricultural land supplied income to the complex. Their proximity placed care and teaching in a shared institution.

At Sivas, also in central Turkey, Kaykavus I founded a hospital in 1217–18. Its surviving endowment deed, written in 1220, identifies income from more than a hundred shops and several farms, as well as provisions for hospital staff. The surviving building is now called the Şifaiye Medrese. Its courtyard and the ruler’s tomb belong to the same complex; the Şifaiye Medrese article gives its architectural history.

At Divriği, in eastern central Turkey, a separate Mengujekid principality commissioned a hospital in 1228–29. UNESCO’s monument record attributes the mosque to Emir Ahmet Shah and the adjoining hospital to Turan Malik. This distinction shows that a large complex could unite buildings while giving their foundations to different members of a ruling family.

Endowments and hospital income

A waqf was property assigned to support a charitable or religious purpose; its deed identified assets and directed their income. At Kayseri, estates, bathhouses and farmland supported the complex. At Sivas, shops and farms were the revenue base. Collectors and a manager turned those sources into the money and supplies the hospital needed to operate.

The Sivas deed specifies that its manager was to secure the medicines needed by the hospital. It does not name pharmacists. Mebrure Değer’s study explains that medicines were prepared before administration from ingredients drawn from plants, animals or minerals. Değer infers that a pharmacy service and pharmacists would have been needed to dose and prepare these materials as simple or compound remedies. In Değer’s reconstruction, a pharmacy service measured and combined ingredients into patient-ready remedies; the deed itself assigns the manager responsibility for obtaining medicines.

Staff, medical ideas and teaching

The Sivas endowment names physicians, surgeons and specialists in eye diseases. These roles show that the institution assigned care to staff with distinct kinds of expertise. The manager’s supply duty linked the hospital’s income and administration with the medicine physicians could prescribe.

Medical learning drew on Hippocrates and Galen, Greek authorities whose works were studied in Arabic, and the Persian physician Ibn Sina, also known as Avicenna. One framework, humoral theory, treated health as a balance among four bodily fluids: blood, phlegm, yellow bile and black bile. Each was associated with qualities such as hot, cold, wet and dry. A physician could use that scheme to interpret symptoms and select a regimen. In the theory of opposites, for example, a medicine described as cooling might be chosen against a condition understood as hot; foods and other measures could also be judged by their qualities.

At Kayseri, the adjoining buildings connected medical study with patient care. A Turkish encyclopaedia account describes theoretical teaching in the Giyâsiye school and clinical instruction at the Şifâiye hospital, where students learned at the bedside. Its curriculum included anatomy and physiology alongside medicine. For connected coverage of the wider learning environment, see individual teachers and their texts.

Care for travellers

Medical assistance could also be attached to a caravanserai, a lodging place for travellers along a road. The foundation deed for Karatay Han, near Kayseri, set aside medicines and drinks for sick travellers. Medieval accounts cited by the TDV İslâm Ansiklopedisi also describe care for ill travellers at Anatolian caravanserais. These provisions extended some endowed medical assistance beyond permanent hospitals to people who became ill on a journey.