Fatih Darüşşifası, facts and legends: its charitable foundation, stories of music, a comparison with Edirne and how to tell historical belief from science.
You may have found yourself asking this question while listening to a tour guide in the Fatih district of Istanbul, or while reading a social media post that begins, "The Ottomans cured the mentally ill with music": what was the Fatih Darüşşifası, remembered as one of the first Ottoman hospitals in Istanbul, really like? In this article we bring together what can reliably be said about the institution, the information that remains at the level of legend, and the comparisons that can be drawn with the better-documented examples in Edirne and Manisa. Our aim is not to tell a romantic story; it is to give readers curious about history a solid footing from which they can tell the beliefs of the period apart from today's scientific knowledge.
What Was the Fatih Darüşşifası? Its Name, Location and the Limits of the Sources
The Fatih Darüşşifası is a hospital (a "darüşşifa", literally "house of healing") that takes its name from the era of Sultan Mehmed II, known as Fatih ("the Conqueror"), and from the great mosque complex in the district that bears the same name today. It is counted among the early Ottoman health institutions of Istanbul. In popular accounts it is often presented as "Istanbul's first Ottoman hospital".
It is important to be honest from the outset. Details such as the year it was founded, the number of beds, the physicians and staff, and the present state of the building are reported differently in different sources. The academic and encyclopaedic sources we consulted while preparing this article list the Fatih and Süleymaniye hospitals, together with Edirne, among the important institutions where music was used; however, details of daily life at Fatih do not appear in these sources in verified form. For this reason, rather than giving you precise dates or figures, we have chosen to describe the tradition the institution belonged to and what is genuinely known about that tradition.
This approach is not a shortcoming; it is in fact what reading history involves. It is common in Ottoman medical history for the name of a building to be widely known while what went on inside it remains unclear. Documents may have been lost, scattered or not yet published in detail. Over the centuries, fires, earthquakes and repairs have also altered the original form of buildings, sometimes making even the question of which part of a building served which purpose a matter of debate. So saying "this is not known" where certainty is lacking is part of respecting history.
The Darüşşifa as an Institution: Charitable Foundations, Free Care and the Mosque Complex
To understand the Fatih Darüşşifası, you first need to know what kind of institution a darüşşifa was. "Darüşşifa", "bimaristan" or "bimarhane", and "şifahane" are different names for the same type of institution. These hospitals were founded through charitable endowments (vakıf) and offered their services free of charge. In other words, patients did not pay for their treatment out of their own pockets; the costs were met from the income the founder had endowed.
Darüşşifas were usually not stand-alone buildings but part of complexes (külliye) planned together with a mosque, a madrasa, a soup kitchen and other charitable institutions. This arrangement reflects a world in which health was not kept separate from religious, social and educational life. Students attending lessons, poor people receiving meals and patients being cared for might all be found in the same courtyard.
Looking at the roots of this tradition in Anatolia, we find better-documented examples:
- The Gevher Nesibe Darüşşifası in Kayseri was built in 1206 by Gıyaseddin Keyhüsrev I in accordance with the will of his sister, Gevher Nesibe Sultan, and can be visited today as the Museum of Seljuk Civilisation.
- The Divriği Darüşşifası was built in 1228 in the name of Turan Melek, daughter of the Mengujekid ruler Behram Şah, and is on the UNESCO World Heritage List together with the Great Mosque.
- The Amasya Darüşşifası dates to 1308–1309; the surgeon Şerefeddin Sabuncuoğlu worked there and in 1465 wrote his illustrated work on surgery.
The Fatih Darüşşifası is one of the Istanbul links in this long chain. If you would like to know more about the general concept of the darüşşifa, its different names and how it worked, you can read our article what is a darüşşifa.
Music at the Fatih Darüşşifası: What Is Known and What Is Told
When people think of the Fatih Darüşşifası, the subject that arouses most curiosity is music. Some posts claim that a different makam (a mode in Turkish classical music) was played for each illness here, and that singers and instrumentalists gave concerts to patients on certain days. Some of these accounts actually arise from information reported about Edirne being generalised to Fatih as well.
One academic study lists the Fatih and Süleymaniye hospitals among the institutions where music was used. This suggests that music had a place in these institutions too. However, information about which instruments were played, who performed, on which days of the week and for which patients has not been verified in the sources we consulted.
At this point we can suggest two things to the reader:
- Pay attention to the difference between "it is known" and "it is said". If a piece of information appears in an encyclopaedia or an academic study with its source given, it comes closer to "it is known". If it is only repeated on news sites without a source, it is more accurate to say "it is said" or "according to tradition".
- Be cautious about generalising. It may be tempting to assume that a practice documented in Edirne was carried out in exactly the same way at Fatih, but institutions could differ in period, staff and the terms of their endowments.
Respect for history begins with listening to what it actually says, not to what we want to hear from it.
Edirne and Manisa for Comparison: Better-Documented Examples
Because detail about the Fatih Darüşşifası is limited, it is useful to consider it alongside its better-known sister institutions.
The Bayezid II Darüşşifası in Edirne: The complex was completed in 1488, served for around four hundred years and can be visited today as the Trakya University Health Museum. It is said that patients suffering mental distress were cared for there with the sound of water, music and the scent of flowers. Evliya Çelebi writes in his Book of Travels (Seyahatname) that an ensemble of musicians performed for the patients three days a week. This is one of the most frequently cited accounts of the use of music in Ottoman hospitals. Those who want to know more about Edirne can read our article on the Edirne darüşşifa.
The Hafsa Sultan Darüşşifası in Manisa: This was added in 1539 to the complex begun by Ayşe Hafsa Sultan. It is reported that during roughly its last two hundred years it operated as a mental hospital and that handicrafts, music and the sound of water were used in care. Today it serves as a museum of medical history.
These two examples also offer a framework for the Fatih Darüşşifası: in darüşşifas, care was not seen as consisting solely of medicines and surgery; surroundings, sound, scent and occupation were also considered part of it. But a "framework" and "evidence" are not the same thing. What happened in Edirne does not tell us for certain what happened at Fatih.
Makam and Temperament: How Was Illness Understood in the Era of the Fatih Darüşşifası?
Ottoman 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 balance of the fluids in the body, and illness was a disturbance of that balance. Music, sound and scent were thought to be able to affect this balance.
The older roots of this thinking go back to the philosopher-physicians of the Islamic world. Al-Kindi associated the four strings of the oud with the heavenly bodies, the seasons and the four elements. Avicenna (Ibn Sina) devoted a section of his Kitab al-Shifa (The Book of Healing) to music and defined it as a mathematical science studying sounds and the intervals of time between them. Al-Farabi is also counted among the thinkers who held that music affects the human soul.
In treatises written in later centuries, makams were matched with particular emotions and illnesses. In popular lists, for example, the rast makam is said to be good for paralysis and the buselik makam for headaches. It is important to know three things about these lists:
- The lists contradict one another from source to source; the same makam is matched with different complaints in different texts.
- These pairings have never been tested by scientific method in today's sense.
- The four-humour theory they rest on has been abandoned by modern medicine.
People often mention a treatise on music and healing attributed to the chief physician Gevrekzâde Hasan Efendi; however, the attribution itself is disputed. A music therapy specialist also criticised, in an assessment made in 2011, the way information based on al-Farabi and Avicenna is often used in a sensationalist manner that does not follow scientific method.
In short, the treatises of the period state that makams were good for illnesses; this was the belief of that era and is not knowledge supported by science today. Listening to makam music can be enjoyable and meaningful; but it cannot be recommended as a treatment for an illness.
What Does Science Say Today? From Historical Narrative to Evidence
So does music have no connection at all with mental health? It does; but that connection is far more measured and much less ambitious than in the darüşşifa stories.
Today the term "music therapy" describes work led by a trained practitioner, based on musical interaction with the person within a therapeutic framework. Simply listening to recorded music does not fall within this definition. A Cochrane review published in 2017 reported that music therapy added to usual care may reduce depressive symptoms in the short term; however, the certainty of the evidence is low to moderate, and guidelines do not yet recommend adding it routinely.
This finding tells us two things. First, music and creative activities can be a valuable aid in psychological support. Second, these approaches do not replace psychotherapy or, where needed, an assessment by a psychiatrist; they accompany them. We described how music is used today, and its limits, in detail in our article on music therapy.
What can you look out for when visiting Fatih or preparing homework?
Imagine that your child, a secondary-school student, is preparing a presentation on health in the Ottoman period for a history lesson, or that you are joining a walking tour of Fatih at the weekend. The following questions can make things easier:
- What source is this information based on: an encyclopaedia, an academic study, or a news item of uncertain origin?
- Does the practice described belong to this institution, or is it being carried over from another darüşşifa?
- When it says patients "were treated", is it talking about treatment in today's sense, or about the period's understanding of care?
- If a figure is given, is the source of that figure shown?
Asking these questions does not diminish history; on the contrary, it gives it the seriousness it deserves.
Ideas from the darüşşifa that can be carried into daily life
The emphasis on the sound of water, gardens, music and occupation in darüşşifa stories is not a proven treatment prescription today; but it can inspire us to think about the kind of surroundings we offer ourselves. At the end of a day in a crowded city, spent between the school run and traffic, trying the following can be small parts of self-care:
- Putting your screen down for a few minutes during the day and simply listening to music you love, without combining it with anything else
- Taking a slow walk once a week in a park, along the seafront or in a historic courtyard, paying attention to the sounds around you
- Making time for an activity that keeps your hands busy, such as knitting, gardening or painting
- Keeping short notes on how you feel while doing these activities
These are not therapy; they are everyday ways of supporting your mood and getting in touch with yourself. If you are experiencing intense and long-lasting distress, they may not be enough on their own.
How Is Mental Health Support Approached Today? When Should You Seek Professional Support?
Darüşşifas represent a tradition in which caring for people in mental distress was seen as a duty of society. This is still a valuable idea today. Mental health difficulties are not a weakness but experiences that may call for support.
Today, mental health support is based on methods that have been tested by research. You might consider speaking with a mental health professional in the following situations:
- Reluctance, unhappiness or anxiety lasting for weeks is affecting your daily tasks
- There are marked, long-lasting changes in your sleep and appetite
- You feel increasingly distant from your family, your friends and the activities you love
- You are finding it hard to recover after a loss, a disaster or a difficult event
In individual therapy, work is done with evidence-based approaches such as cognitive behavioural therapy; enjoyable activities such as listening to music, painting or crafts can also be included in the process as things that support daily life. If you are having thoughts of harming yourself or someone else, call 112 (emergency services) without delay.
Frequently Asked Questions
Can the Fatih Darüşşifası be visited today?
We recommend getting up-to-date information on the institution's current state and whether it is open to visitors from the relevant museum and municipal sources. For those who want to see the darüşşifa tradition in person, the Health Museum in Edirne and the Museum of Seljuk Civilisation in Kayseri are well-documented options.
Were patients at the Fatih Darüşşifası treated with music?
One academic study lists the Fatih Darüşşifası among the institutions where music was used; however, the details of the practice have not been verified. Music was part of the period's understanding of care; it should not be thought of as treatment in today's sense.
Is it harmful to listen to music according to Ottoman makam lists?
There is nothing wrong with listening to makam music in itself, and many people enjoy it. The problem lies in treating these lists as a cure for an illness and putting off the medical or psychological support that is needed.
What did the darüşşifa tradition contribute to today's psychology?
The most meaningful legacy of this tradition today is the idea that care can be directed not only at the body but also at a person's surroundings, the sounds around them and their everyday occupations. Today's approaches take up this idea within research-tested methods and an ethical framework.
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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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