The history of the Amasya Darüşşifa, the surgical book Sabuncuoğlu wrote there, care for people in distress and how well its music stories are documented.
Many visitors come to Amasya to see the houses lined up along both banks of the Yeşilırmak river, the royal tombs carved into the rock and the mountainside glowing in the evening light. Yet many of them come across a stop they did not expect: an old hospital where patients were cared for centuries ago, and which can now be visited as a museum devoted to the history of medicine and surgery. The Amasya Darüşşifa (a historical hospital) arouses curiosity both because the famous surgeon Şerefeddin Sabuncuoğlu worked there and because of the stories about how people in mental distress were looked after. In this article we look at the building's history, the work written there, and how much of the accounts of mental health care and music therapy actually rests on documents, and we try to build a calm bridge from this history to today's understanding of mental health.
What Is the Amasya Darüşşifa? A Hospital from the Ilkhanid Period
According to encyclopaedic sources, the Amasya Darüşşifa was built in 1308–1309, when Anatolia was under Ilkhanid rule. In other words, it was founded at a time when the Ottoman state was still very young and the political balance in Anatolia shifted often, and it remained in use for centuries afterwards.
Its founder is widely named as Yıldız Hatun. However, since this information could not be separately confirmed in the source review behind this article, it is more accurate to read it as "commonly reported". For history enthusiasts this small distinction matters: the fact that a piece of information is repeated often does not mean it is supported by documents.
The word "darüşşifa" means "house of healing". The same type of institution is also called a "bimaristan", "bimarhane" or "şifahane". What these institutions had in common was that they were founded through charitable endowments (vakıf) and offered their services free of charge. A benefactor or ruler would endow income-generating property, and that income covered the salaries of physicians and attendants as well as patients' food, medicine and cleaning. If you are curious about the concept of the darüşşifa and other examples in Anatolia, our article what is a darüşşifa is a good place to start.
Together with the Gevher Nesibe hospital in Kayseri and the Divriği hospital in Sivas, the Amasya Darüşşifa is regarded as one of the early links in Anatolia's hospital tradition. Each reflects the architecture, endowment arrangements and medical thinking of its own era.
Şerefeddin Sabuncuoğlu and the Amasya Darüşşifa
The first name that comes to mind when the Amasya Darüşşifa is mentioned is Şerefeddin Sabuncuoğlu. The surgeon worked here and in 1465 wrote his illustrated surgical work, Cerrâhiyyetü'l-Hâniyye. The fact that the work is illustrated shows an effort to convey surgical procedures and instruments not only in words but also in images, which makes it remarkable in the history of medicine.
This tells the visitor something important: the darüşşifa was not only a place of care but also a place where knowledge was produced and passed on. Physicians here both looked after patients and put what they learned into writing. It is possible to see in these institutions something similar to the role a teaching and research hospital plays today, naturally within the conditions and level of knowledge of the time.
Sabuncuoğlu was a surgeon, so his name is associated mainly with physical illness and surgical intervention. The sources used for this article contain no information that he carried out any specific work on mental illness. So if you come across sentences such as "Sabuncuoğlu treated the mentally ill in this way", it is a fair question to ask what the documentary evidence is.
How Were People in Mental Distress Cared For in the Darüşşifa?
In Seljuk and Ottoman hospitals, body and mind were considered together. The medicine of the period was based on the theory of the four humours (blood, phlegm, yellow bile and black bile) and temperament, inherited from Hippocrates and Galen. According to this theory, health depended on the balance of fluids in the body, and factors such as food, sleep, air, sound and scent could upset or restore that balance.
Modern medicine has abandoned this view. But it contains a core we still find meaningful today: looking not only at a person's illness but also at the environment they live in, their sleep, their diet and the rhythm of their day. A person in mental distress staying in a calm, clean and orderly place, eating regular meals and receiving attention was a humane approach five hundred years ago and remains one today.
It is generally known that hospitals of this kind had sections or rooms set aside for patients with mental illness. However, detailed and verified information on how daily care worked specifically at the Amasya Darüşşifa, how many patients stayed there or which practices were used is limited. In museum displays and travel writing this gap is sometimes filled with vivid stories; when reading them, it is worth keeping the difference between enjoying a story and accepting it as established fact.
Looking back from today, we should also remember that people at the time did not have our present knowledge of the causes of mental distress. Concepts such as depression, anxiety disorders or psychosis, and today's research into how the brain and mind work, did not yet exist. Physicians tried to explain what they saw with the theory and observations available to them. So rather than judging the practices of the darüşşifa as "right" or "wrong" by today's standards, it is fairer to try to understand them within their own time. At the same time, this understanding explains why it is not appropriate to carry old practices unchanged into the present: our knowledge has changed, and our tools for measuring and testing have developed.
Then there is the question of language. Historical texts use words such as "deli", "divane" and "mecnun" (all meaning roughly "mad") for people in mental distress. These are the language of their time. Today we know how stigmatising such words can be, and we take care to use more respectful and more accurate language when speaking about people who are struggling with their mental health.
Stories of Music Therapy: What Do We Know, and What Don't We?
One of the most common claims about the Amasya Darüşşifa online is that people with mental illness were treated with music there. In academic studies, too, Amasya is cited as an example of music being used in historical hospitals. However, these studies do not give details of how it was done: which instruments were played, how often, for whom and in what kind of routine? We have no source that lets us answer these questions with confidence for Amasya.
The most thoroughly documented example of music being used in a darüşşifa is usually the Bayezid II Darüşşifa in Edirne. Evliya Çelebi writes that an ensemble of musicians came three days a week to play music for the patients there. Something similar may have happened in Amasya; but keeping the difference between "may have happened" and "is documented" is part of respecting history. You can find a broader picture of how music was played to patients in the Ottoman period in our article on music and healing in the Ottoman era.
Another story often found in online lists is that particular makams (the melodic modes of Turkish classical music) are good for particular illnesses. These pairings are based on treatises written in, or attributed to, the Ottoman period; they contradict each other from one source to the next and have not been tested scientifically. They are interesting as a historical belief, but they cannot be used as health advice.
That music was played in a darüşşifa is part of history; saying that the music cured illness is a weight the sources we have cannot carry.
So what do we know today about music and mental health? Music therapy today is defined as an approach in which a trained practitioner engages in musical interaction with a person within a therapeutic framework. According to a Cochrane review, music therapy added to usual treatment may reduce symptoms of depression in the short term; however, this evidence has been rated as being of low to moderate certainty. In other words, music can be a supportive element, but it does not replace medication, psychotherapy or medical care. If you would like to know how present-day practice works, you can read our article on music therapy.
Visiting the Amasya Darüşşifa Museum: Reading History Through Today's Eyes
When the Amasya Darüşşifa is visited as a museum today, visitors see both the building's architecture and displays on the history of medicine and surgery. A few suggestions to make your visit more meaningful:
- Separate documents from stories. Do not hesitate to ask which source a piece of information on a panel or in a guide's account is based on. The question "How do we know this?" turns the museum from a place of listening to stories into a space for thinking.
- Imagine the conditions of the time as you look at the surgical instruments. Thinking about what physicians and patients faced in a world without anaesthesia or antibiotics allows you to look at history with more empathy.
- Pay attention to the areas set aside for people in mental distress. How would someone staying here have spent their day? Who would they have talked to? What would they have heard? These questions remind us that mental distress is not just a "diagnosis" but a lived experience.
- If you are visiting with children, make room for their questions. A question such as "How did people help sad people back then?" can naturally open an age-appropriate conversation about mental health.
- Bring it back to your own life. As you leave the museum, you might ask yourself: What helps me when I am struggling? Who can I reach out to? This is a small self-awareness exercise reaching from history to the present.
Let's say a family from Samsun is visiting Amasya during the bayram (religious holiday) break and touring the museum. Their daughter, a secondary school student, looks at the drawings of surgical instruments and says, "These are terrifying, but in a way really brave too." Her father replies, "People back then did all they could with what they knew." This short exchange is a good example of reading history without either glorifying or belittling it.
When Should You Seek Professional Support?
Institutions such as the Amasya Darüşşifa remind us of a past in which mental distress was not ignored but recognised as something that needed care. That principle still holds today. If you notice any of the following in yourself or someone close to you, it may help to talk to a mental health professional:
- Low mood, lack of motivation or hopelessness lasting more than two weeks
- Marked changes in sleep, appetite or the ability to keep up with daily tasks
- Intense, uncontrollable anxiety, restlessness or fears
- Experiences such as losing touch with reality or hearing voices others do not hear
- Thoughts of harming yourself or ending your life
If the last point applies, call 112 (emergency services) without delay or go to your nearest emergency department.
In Turkey, seeking psychological support is still often put off. Thoughts such as "What will the neighbours say?", "No one in our family has ever seen a psychologist" or "It will pass if I rest a bit" can delay looking for help for months. Yet the fact that free care for people in mental distress was provided through charitable endowments even centuries ago shows that there is nothing shameful about this.
How Is Mental Health Support Approached Today?
Today's psychological support rests on a very different foundation from the theory of temperament used in the darüşşifas. A person's thoughts, feelings, behaviour, relationships and living conditions are assessed together, and which approach works for which problem is tested through research. Structured approaches such as cognitive behavioural therapy are among the methods supported by research for many problems, including depression and anxiety.
This does not mean that creative and sensory elements have no place today. In therapy, it can be discussed how a person might notice the music, sounds or places that calm them; add small creative breaks to their day; or sometimes express their feelings by drawing or writing. But these are supportive tools placed alongside the core work, not in place of it. This is exactly where the difference lies between the sounds heard in the courtyard of the hospital in Amasya and what is talked about in a therapy room today: back then there was belief and observation; today there is a science that tries to measure, test and adapt to the individual.
Therapy usually begins with an introductory assessment session. In that session, you talk about what is troubling you, how long it has been going on, how it affects your daily life and what you hope for. Goals are then set together and worked on through regular sessions. Where necessary, an assessment by a psychiatrist may also be recommended, because in some situations it is in the person's interest for psychotherapy and medical treatment to go hand in hand. This idea of cooperation is, in fact, reminiscent of the way physicians, attendants and carers worked together within the endowment system of the darüşşifas.
Even if you cannot quite put a name to what you are struggling with, talking to a professional can be the first step in discovering together what might help. In individual therapy, your needs, preferences and life circumstances are considered together.
Frequently Asked Questions
When and by whom was the Amasya Darüşşifa built?
According to encyclopaedic sources, the building was constructed in 1308–1309, during the Ilkhanid period. Yıldız Hatun is widely named as its founder; however, this information should be read alongside other sources.
Which work did Sabuncuoğlu write in Amasya?
While working at the hospital in Amasya, the surgeon Şerefeddin Sabuncuoğlu wrote his illustrated surgical work Cerrâhiyyetü'l-Hâniyye in 1465. The work stands out in the history of medicine for presenting surgical procedures with images.
Were people with mental illness really treated with music in Amasya?
Academic studies cite Amasya as an example of music being used in historical hospitals, but they do not give details of the practice. Music may well have been played; but there is no evidence, in today's sense, that it cured illness.
Can the methods used in the darüşşifa be used today?
Humane elements such as a calm environment, regular care and attention are still valuable today. However, practices based on the theory of temperament and pairings of makams with illnesses are not supported by science; for mental health problems, it is important to turn to methods that have been tested through research.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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