Islamic Psychology

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Islamic Psychology


Socio-Psychiatric Institutions in
Old Turks Under Islamic Tradition
Prof. Dr. Ayhan Songar, TURKEY.

We may say that, psychiatry is one of the oldest medical arts and the newest of medical sciences. In fact, it will be convenient to consider that history of human interest in his own soul, psychology and psychiatric maladjustments is as old as his firs creating of thoughts. Psychiatric medicine has shown a very intimate relationship and parallellism with and to ways of thought, philosophical and political tendencies, traditions and norms, religions and modes of living within the overall historical development. For-example, whilst psychoanalysis of Sigmund Freud led to long-lasting researches and discussions in the western world, it was rejected with no argue, in a book of Psychiatry published in the Soviet Russia in 1969 (Referring only 5 lines) saying that "as the argument originates from wrong theoretical principles, it is very natural not to obtain any concrete result therefrom". Besides this, we observe the paramount progress of neurophysiology and psychopharmacology in spite of the traditional psychoanalysts who reject any organic view and medical treatment of any kind. As seen, psychiatry has been a field wherein empirical and mental fanaticism have easily rooted up and grown.

In the similar way as thousand of heads were cut off during the French revolution, many people were tried before the religious courts (Enquisition) of the Medieval Age Europe for the sake of "spiritual welfare" or "spiritual treatment", and their lives were ended before the public by burning. It will be useful to review briefly the western would at that time for the purpose of giving a clearer idea of how Muslim Turks treated the insane, with full affection, humanistic thoughts and medical care.

First, we observe that, Aesclepiades from the Ancient Rome, in the first century B.C., described and defined the errors in perception and reasoning of the insane emphasized the point that they should be treated under favorable environmental conditions, Hippocrates (460-337 B.C.) argued that psychological disorders originated from natural reasons as other diseases, and defined such clinical pictures as mania and melancholia. He further pointed out the relationship between the human brain and epilepsias and mentioned of dementia. Thus, it is evident that, in the starting period from Hippocrates until Galenus who lived in around 200 A.D., the insane were subject to humanistic treatment in the Western World to a certain extend.

However, we also observe the fact that as from the time of Hippocrates, the attitudes towards the insane started to get tougher. As a matter of fact, Celcus from the Ancient Rome, who lived at the time of Jesus Christ defended the idea that "a sort of force" had to be applied during treatment of insane. To him, the insane had to be punished with famins, fetters and beating when they made something wrong or eat something not usual. He argued that a sudden sense of fear could cause the insane to recover. This horrible and inhuman consideration, as treatment of insane by applying torture has prolonged for long centuries in the Western World. Even until a few centuries ago, the insane were put into water-wheels and turned; hung over the rocks; sunk into deep waters until they are almost drowned; beaten terrible; chained up with fetters; as we see in the books defining the treatment of the insane. It is a sort of defence mechanism developed as a result of fear and anxiety by the community felt for the insane.

In the second century A.D, Caelius Aurelianus, from the Ancient Rome, announced that devils were existing in the appearance of male or female human beings, whose primary task was to deceive the opposite sex". Therefore, thousands of the insane were being murdered for the purpose of getting rid of the evil-souls and devils.

The Pope, Innocent XIII, commissioned two priests to prepare a book concerning how to get rid of the devils and demons from the Christian World, by getting acquianted with them. These priest then prepared a book describing the devil, the ways to know it, and how to kill it, as well as the method of torturing the insane, with full details of various torturing methods and techniques. The insane were prosecuted before the religious courts (Equisition) and burned alive to get rid of the devil located in their souls. Thus, more than hundred thousand mentally ill people were killed during the reign of Francois the First (1515-1547) in France. In the 16th. Century, in Geneva of Switzerland, more than five hundred insane people insane people were burned in the squares of the city before the public, by fastening them to poles, within three months. Even in the 16th, century, Johann Wayer was thinking that seven million of devils were existed in the universe and advising to torture the insane who carried the devils in their body.

We had to wait until the 18th, Century AD, when humanistic tendencies started to emerge for the admittance of the insane by the community to a certain extend, in the West. For the first time, in France, a physician named Pinel, employed in the Bicetre Hospital, was nominated as the very first man who dared to untie the fetters of the insane. T

he first patient, whose fetters were untied by Dr. Pinel, a woman, felt the taste of freedom by madly running in the yard of the hospital until her heart is stopped.

However, the definition of the insanity in Germany, even that period , as "a punishment and anthema by God announced for his slaves due to their sins" shows that the reaction towards the insane still continued.

While this was the case in the western world, in European the insane were treated in a completely different manner by Turks under the impact of Islamic faith. We may say that the honour of regarding the insane as an ordinary "ill person" and applying them a treatment in the real meaning of the sense belongs to the Muslims and Turks. The great physician, Avicenna (Ibn Sina), who lived between 980-1037 A.D. was advicing that the insane should be treated with mercy and under humanistic rules. To him, should contained a moral-ore, running all mechanisms of the body and vitality would be lost when the should is apparted from the body. According to Avicenna, the relationship between the brain and sentiments and movements is provided by means of nerves. Thus, Avicenna who prescribed the fundamentals of neuroanatomy is the character who first applied a sort of analytical treatment and used free association method for the insane.

The Holy Quran commands as follows:
DO NOT GIVE YOUR PROPERTY WHICH GOD ASSIGNED YOU TO MANAGE, TO THE INSANE; BUT, FEED AND CLOTHE THE INSANE WITH THIS PROPERTY AND TELL SPLINDID WORDS TO THEM. (S4:V5).

In the holy order of the sentence, the fundamentals of Islamic principles in treating the insane are clearly summarized: "The insane are not competent and eligible to manage on their own property. The legal trustees, to be appointed on their behalf, shall manage their property and all result obtained therefrom shall be used for the benefit of the insane. The insane shall be treated under humanistic rules; shall be clothed and fed, and pleasant words shall be told". This rule is the main principle covering up-to-date psychiatric understanding and legal applications. Under the impact of this religious order and mystical thoughts which developed in time, "the insane" were regarded as a group of people by Muslim Turks, who must be given full assistance and be protected more than the others. Even from time to time, the insane, who wandered around and harmed nobody were named "veli" (saint, or friend of God) and they were remembered even after their death. Such persons were subject to a sort of respect by inhabitants of neighbors and fed up and clothed.

We know the existence of so-called "hospital-villages", dealing with the treatment of the mentally ill people, during the reign of Seldjuk Empire, in the medieval age in Anatolia. Even at that time, the insane were not regarded as a character who were feared from or tortured; but, the insane were treated as the ill-persons who where admitted to the community and protected and treated. In such hospital-villages, the insane were treated free of any charge, and against, this, the inhabitants of these villages were exempted from income tax, for their incomes obtained from agricultural and commercial activities.

The Dervish Convents, which emerged as a social institution, have had great services in this respect. The Sheikhs of such Convents were treating the insane, Even more that, there were some families who adopted the treatment of the insane as a business, a profession for generation. Among these, Karacaahmed Family has a unique place. The religious-poem written on their memory starts with the following lines:

Karacaahmed ulu veli
Akillanir gelen deli
(Karacaahmed the great seint All the insane recover when met….)

The Karacaahmed Convents prolonged for about seven centuries. The insane brought were subject to various psychological treatments, and specially prepared plant-origin medicines were used, there.

The great mosques of Istanbul, constructed during the reigns of the Ottoman Sultans are the typical samples of the social organization of that time. Besides the mosque, usually kitchens were established to feed the poor free of charge. Also there were small rooms for the accomodation of the fellows and assistant to the Hodjas. Some of such mosques incorporated hospitals, dispensaries and lunatic asylums, completely allocated for treatment of physical and mental diseases.

They were a sort of "mental-health dispanseries" complying with today's technology and understanding. They were mostly built up by the foundations established by the rich. These foundations were so much complete and well-thought that we have met a parsley field, allocated for supplying parsley for the soup which was served to the insane at Toptasi Asylum, served as the Government Mental Hospital of Istanbul for a long time, among deeds of trusts of such foundations. Mongeri Pere, who once worked at that asylum, wrote at Annales Medico-Psychologiques as follows:

"If the civilization of a nation is to be assessed using such criteria as the interest of the government in the problems of the public and abundance of public charity institutions, we may well say that Istanbul pioneered such a civilization three centuries ahead of Europe".

Ottomans taught the nations which were conquered, how to get cleaned at bath and imposed medical science by introduced hospitals and asylum and introduced humanity by social institutions and foundations. At the period when we build public baths all over the cities and each individual house had bath-rooms, the streets of Paris were flooded by sewerage. And in the medical books published in the west at that time, it was noted that applying plenty of water on body would kill us.

During the Ottoman Empire, the first asylum in Edirne was opened in the Mosque of Sultan Bayazit II. Before that, a small asylum was existing there. Sultan Bayazit Asylum was kept until 1915, with 40 patients recently.

After the conquer of Istanbul (1453 A.D.) Mehmed the Conquerer established an asylum named "Bimarhane-i-Ebulfeth Sultan Mehmed" in 875 (hegira - Islamic year). As the great voyager Evliya Celebi told, that asylum contained 70 rooms, 80 domes, 200 nurses and one chief physician. The patients were used excellent bed-sheets and silk-shirts. Singers and players performed to enjoy them. The patient s were fed with pheasant and quail meat. Esquirol, one of the outstanding characters of European psychiatry, who visited that asylum writes that it could only be imagined as a remote ideal and goal.

We should note that, treatment of the insane by music could only be attained by the natural and enriched tones of Turkish music. The "tampered" western music, based on a rigid mathematical system, countrary to human nature, provides no assistance in treating the insane.

The second asylum erected in Istanbul is Haseki Sultan Asylum, built in 936 (hegira). After the second declaration of the Parliamentary Regime, it became Haseki Medical Observation Centre. Thus for the first time in the world, application of forensic psychiatry emerged in Turkey. This centre had 250 beds.

The third asylum is "Bimarchane-i-Sultan Suleyman" built in 963 (Hegira). It served as an asylum for a long time, a state mental hospital, and them upon an epidemy of cholera, the mental patients were transferred to Uskudar.

The fourth asylum is the Mental Hospital of Toptasi, at Uskudar, known as "Bimarhane-I-Valide-I-Atik" (Mental Hospital of M.M. the Queen Mother) built in 991 (Hegira). That hospital was constructed by Nurbanu Sultan, Mother-Queen of Murad III, wife of Sultan Suleyman II. Until the Parliamentary Regime, its kitchen was active to serve soup and food to the poor, rice and "zerde" (a kind of dessert made from rice) were served once a week, on Thursdays. In the holy month of Muharrem, "Asure" was made to serve to the poor. The asylum, which was also a medical-scientific institution, a university within the standards of the time, contained sections as Darulhadis (a kind of religious school) and Meva-I Muhaddisin (Home for teachers). A lot of today's prominent turkish psychiatrists worked at that hospital or were trained there. Among them we may cite three great characters. Namely, Mazhar Osman Uzman, Ihsan Sukru Aksel and Fahrettin Kerim Gokay.

During the presidency of Ataturk, when Dr.Tevfik Rustu Aras was the Minister of Health and Social Welfare, a decree of Council of Ministers was issued, upon recommendation of Mazhar Osman and the Resadiye Barraccks at Bakirkoy became Bakirkoy Hospital for Mental and Nervous Diseases on June 15, 1927. This institution, which is one of the well-known mental hospitals of the world, is still active and has been recently modernized to suit to conditions of today's modern psychiatrical science.

As a conclusion, we may say that, Turkey has a tradition in psychiatry, by joining her own culture and belief with the scientific standards of the modern world.