Is the story that the Divriği Darüşşifa calmed patients with the sound of water documented? Historical facts, acoustic interpretations and today's science.
Divriği, a small district tucked among the mountains south-east of Sivas, is home to a group of buildings famous for their stonework. About the Divriği Darüşşifa (a historical hospital) standing right beside the Great Mosque, there is a sentence you will often come across online: "Here, people with mental illness were treated with the sound of water from the pool." It is a lovely sentence, and it immediately raises a question for visitors, documentary viewers and history enthusiasts alike: is this a documented practice, or an interpretation that developed later? In this article we look step by step at what is known, what is disputed, and how today's understanding of mental health might view this story.
What Is the Divriği Darüşşifa? A Brief History
The Divriği Darüşşifa was built in 1228 in the name of Turan Melek, daughter of Behram Şah, ruler of the Mengücek dynasty. For this reason it is also referred to in the sources as the "Turan Melek Darüşşifa". The building forms a single adjoining whole with the Great Mosque built in the same period, and the two were inscribed together on the UNESCO World Heritage List in 1985.
One of the most widely known examples of the hospitals built in Anatolia from the Seljuk period onwards is the Gevher Nesibe Darüşşifa in Kayseri (1206). Divriği is one of the early, smaller-scale links in this chain. These institutions, known as darüşşifa, bimaristan or şifahane, were generally founded through charitable endowments and offered their services free of charge. If you are curious about how they worked in general, our article what is a darüşşifa describes the shared features of Seljuk and Ottoman hospitals in detail.
In later centuries the tradition continued into the Ottoman period. The hospital in Amasya is known as the place where the surgeon Şerefeddin Sabuncuoğlu worked; in Edirne, the darüşşifa attached to the Bayezid II Complex served for around four hundred years; and the Hafsa Sultan Darüşşifa in Manisa operated as a mental hospital in its later period. In many of these institutions music, the sound of water or handicrafts are said to have been part of care, but the strength of the sources differs for each one. The water-sound story at Divriği, by contrast, rests less on a direct contemporary account than on interpretations drawn from the building's architecture. As we discuss in detail below, this difference directly affects how we should pass the information on.
What sets Divriği apart from the others is, to a large extent, its architecture. With its stone ornamentation and portals, the building is a major subject in art history. The focus of this article, however, is not the decoration but the accounts of how people in mental distress were cared for inside it.
Where Does the Story of Water Sound and Acoustics Come From?
The most widely shared claim about the Divriği Darüşşifa is that the sound of water flowing in the building's pool, together with the acoustics of the space, was used to help patients with mental illness feel calmer. Among the sources that popularised this interpretation are art historians' comments in newspapers and a number of academic publications.
For example, an article by Benek and colleagues published in 2015 in the journal Acta Medica Anatolia carries in its title the description of the Divriği Darüşşifa as "an example for the application of music therapy in the medical history". Studies of this kind are valuable attempts to connect the form of a building with the purpose it served.
There is, however, an important point to bear in mind: according to the available sources, this story is an interpretation. In other words, specialists who study the building think that the sound properties of the pool and the space may have been designed to calm patients. It has not, to date, been shown to rest on direct evidence such as a clause in a 1228 endowment deed saying "here patients are treated with the sound of water", a physician's record or a patient register.
The idea that the sound of water calmed patients at Divriği is a beautiful and meaningful interpretation; but presenting an interpretation as if it were a document does an injustice both to history and to the present.
Documents, Interpretations and Legends in Historical Writing
Sorting what we read about a historic building into three groups greatly reduces confusion:
- Documented information: Facts supported by inscriptions, endowment deeds or contemporary sources, such as when the building was constructed and in whose name. For Divriği, the date 1228 and the name Turan Melek fall into this group.
- Expert interpretation: Inferences reached by specialists in architecture, art history or medical history, based on the form of the building, comparable buildings and the intellectual world of the period. The water-sound and acoustics story belongs here.
- Legend: Stories of uncertain origin that circulate by word of mouth or on news websites and often become more elaborate with each retelling. Claims such as "there was a different water-sound setting for each illness" are of this type and have no verified basis.
This distinction does not diminish the value of the Divriği Darüşşifa. On the contrary, saying clearly what we know and what we do not know places curiosity about the building on firmer ground. A building's acoustics can be measured; but the effect those acoustics had on a given patient eight hundred years ago cannot. Moreover, the idea that acoustics are "healing" is not a scientifically tested finding even today.
Let us imagine a history teacher taking students on a trip to Divriği. If, standing in the courtyard, the teacher asks, "Specialists interpret the sound of this pool as possibly having been intended to calm patients; how do you think we could prove that?" instead of saying, "Patients here were treated with the sound of water", they will have taught both history and scientific thinking at the same time.
The Intellectual World of the Period: Sound, Water and Temperament
To understand why the water-sound interpretation seems so plausible, we need to look at the medical thinking of the time. In the medieval Islamic world and in Anatolia, medicine 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 was a matter of the balance of fluids in the body; air, food, sleep, sound and surroundings could all affect that balance.
Thinkers who wrote about the effect of music on the human soul were also part of this world. Al-Kindi associated the four strings of the oud with the four elements and the seasons, while al-Farabi and Ibn Sina treated music as one of the mathematical sciences. In such an intellectual climate, creating a calm soundscape in a hospital is consistent with the logic of the period. This does not prove that the practice actually took place; but it explains why the interpretation seems reasonable.
A reminder is needed here: the theory of temperaments was abandoned by modern medicine long ago. Today we do not explain mental health difficulties as an imbalance of four fluids. There is therefore a big difference between trying to understand a historical approach and trying to adapt it to the present day.
The Divriği Darüşşifa and Today's Science: Does Sound Really Help People Relax?
You might ask, "But doesn't the sound of water genuinely calm people?" Many people say they feel more relaxed listening to running water, rain or waves. This personal experience is real and not something to dismiss. But saying "some people find a sound pleasant and soothing" and saying "this sound treats mental illness" are very different claims.
Today, the most robust information about music and sound comes from music therapy research. According to a Cochrane review, music therapy added to usual treatment may reduce symptoms of depression in the short term; however, the evidence has been rated as low to moderate in certainty. Moreover, the review defines music therapy as a trained practitioner engaging in musical interaction with a person within a therapeutic framework; simply listening to a sound in the background does not fall within that definition. You can read how present-day practice works in our article on music therapy.
Research in this field also shares some common limitations. Most studies use small samples; because participants know they are listening to music or sound, blinding of the kind used in classic drug trials is not possible; results mostly rely on people's own reports of how they feel; and follow-up periods are short. For this reason, even when scientists say "music and sound may be supportive", they use cautious language. Passing a more definite verdict on a building from eight hundred years ago would mean attributing to the past a confidence that even today's controlled studies cannot provide.
At this point an interesting contrast also stands out. Popular stories about Divriği are often told in the spirit of "our ancestors knew this long ago". Yet the value of a historical practice does not depend on whether it matches today's science. That a society set aside a quiet courtyard, flowing water and careful architecture for its patients is a sign of a humane attitude, even if it carries no claim to cure. What deserves appreciation is this care, not a treatment prescription.
The same caution applies to commercially sold "healing water sounds", "frequency music" or products claiming that particular hertz values cure illnesses. There is no scientific evidence supporting these claims. Listening to a sound you enjoy can be a harmless self-care habit; but it should not be used in place of treatment.
When Visiting and Reading: A Healthy Way to Bring History into the Present
If you are thinking of visiting the Divriği Darüşşifa, or preparing an assignment, presentation or piece of writing on the subject, the following suggestions may help:
- Ask about the source. When you come across a piece of information, ask: "Does this come from an inscription, from an expert's interpretation or from a news website?"
- Adjust your language. Report interpretations with phrases such as "it is thought that" or "specialists interpret this as". This does not make the information smaller; it makes it honest.
- Experience the space. While visiting, stand quietly for a few minutes and listen to how sound travels across the stone surfaces. Noticing what you feel in your own body turns history from something in a book into something lived.
- Watch out for stigmatising words. Old texts may contain words for people with mental illness that are considered hurtful today. Giving their context when quoting them protects the perspective of today's reader.
- Compare similar stories. For the Bayezid II Darüşşifa in Edirne there are more direct testimonies, such as Evliya Çelebi's account of music. What distinguishes the Divriği story from these is that it does not rest on a direct contemporary account.
If a secondary school student preparing an assignment on Divriği titled their presentation "Divriği, water and sound: what do specialists think?" rather than "The hospital that cured with water sounds", it would be both more accurate and more intriguing.
Mental Health Support Today: More Than a Calming Environment
The Divriği Darüşşifa is a building that reminds us that, even centuries ago, people experiencing mental distress were considered worthy of care. A calm environment, regular care, fresh air and pleasant sounds can still contribute to feeling well today. However, most mental health difficulties require support that goes beyond arranging the surroundings.
If you notice any of the following in yourself or someone close to you, it may be helpful to consult a mental health professional:
- Anxiety, restlessness or tension that has lasted for weeks and is disrupting daily life
- Disturbed sleep, constant tiredness or a lack of motivation
- Being unable to enjoy things you used to enjoy
- Losing touch with reality, or hearing or seeing things that others do not perceive
- Thoughts of harming yourself or ending your life
If the last point applies, call 112 (emergency services) without delay or go to the nearest emergency department.
In psychological support today, noticing the sounds, places and activities that calm you can be discussed as part of self-care. For example, someone trying to cope with anxiety might try taking a few minutes of quiet breaks at certain times of day, or practising breathing exercises with nature sounds. The core work, however, is addressing the thought and behaviour patterns that feed anxiety through evidence-based methods such as cognitive behavioural therapy. Support in the area of anxiety and panic is built on this structured work; sounds and creative activities can play a supportive role according to the person's own preferences.
Frequently Asked Questions
When and in whose name was the Divriği Darüşşifa built?
The building was constructed in 1228 in the name of Turan Melek, daughter of the Mengücek ruler Behram Şah. It forms a single whole with the Great Mosque, and the two buildings have been on the UNESCO World Heritage List since 1985.
Is it documented that patients were treated with the sound of water?
According to the available sources, this information rests not on a direct document but on specialists' interpretations of the building's architecture and the thinking of the period. It is therefore more accurate to report it as "it is thought that". The healing effect of acoustics is not a scientifically tested finding either.
Does listening to water and nature sounds help with anxiety?
Some people find these sounds relaxing, and listening to them during short breaks can be a harmless self-care habit. However, there is no evidence that nature sounds treat anxiety disorders. For long-lasting anxiety, it is more appropriate to speak to a mental health professional.
What distinguishes Divriği from the Edirne Darüşşifa?
In Edirne, it is known from Evliya Çelebi's account and encyclopaedic sources that music was played to patients with mental illness. The water-sound story at Divriği, by contrast, rests more on architectural interpretation and is not supported by a contemporary account. Both buildings are valuable for understanding the history of care for people with mental illness.
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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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