Key words : al-Mūjaz fī al-Ṭibb, Anmūdhaj al-Ṭibb, Emir çelebi, History of medicine, Ibn al-Nafīs, Kidney and bladder diseases

Introduction

The real name of Emir çelebi, the 11th Chief Physician of the Ottoman Empire (March 1629 to August 1638) is Mehmed Seyyid.¹ He studied medicine in Cairo before becoming the Chief Physician in the Qalawun Bīmāristān (Hospital).1-3 According to the literature, he was brought to Istanbul by the Grand Admiral of the Ottoman Navy Receb Pasha, who set out on a Mediterranean expedition and arrived in Cairo in 1622 to 1623.^1,3,4 In Istanbul, he worked as a Court Physician and then as a Chief Physician (1629) during the reign of Sultan Murad IV (reign 1623-1640). His work Anmūdhaj al-Ṭibb (A Sample of Medicine) is important.^1,3,4 Emir çelebi finished this work on 5 Ramaḍān 1034 (June 11, 1625)⁵ and dedicated it to the Grand Admiral of the Ottoman Navy Receb Pasha.^1,3,4 The presence of numerous manuscripts in libraries demonstrates that this work has received considerable attention.^4,6 The book is divided into a prologue, 6 teachings, and an epilogue.

In the prologue of the work, he argues that it is not appropriate for the authors to use what was written before them without adding anything and recording the outcomes of their own experiences is necessary.^1,2 In the final chapter, he advises physicians in a deontological section. He quotes Hippocrates to state the 10 characteristics a physician should have, as well as the duties and responsibilities of physicians toward their patients, colleagues, and those from whom they have learned the profession.^1,7 At the end of this section, he emphasizes the importance of learning the “science of dissection,” a prerequisite for practicing medicine. Emir çelebi also states that what can be learned from the book will be insufficient and suggests the dissection of people who died in war or on animals that resemble humans, such as monkeys and pigs.^1,2,7

In this study, we aimed to review the kidney and bladder disease sections in Emir çelebi’s Anmūdhaj al-Ṭibb by presenting and discussing his own experiences with these issues.

Materials and Methods

A copy of Anmūdhaj al-Ṭibb registered in İstanbul Süleymaniye Manuscript Library, Mihrişah Sultan Collection, no. 342/1,⁵ and a printed copy of al-Mūjaz fī al-Ṭibb in Arabic,⁸ as well as a copy of the Turkish translation of this work by Surūrī registered in Ankara National Library, A1437,⁹ were used. The sections of the works on kidney and bladder diseases that were mentioned were compared. Furthermore, studies on these works mentioned in Turkish medical history literature were also reviewed.

Results

We discovered that the sections on kidney and bladder diseases in Emir çelebi’s Anmūdhaj al-Ṭibb are actually the Turkish translations of relevant parts of Ibn al-Nafīs’s al-Mūjaz fī al-Ṭibb (Table 1).^1,8,9 However, we noticed that Emir çelebi has also shared additional knowledge with the reader in some sections, either by incorporating information from other authors or by writing about his own experiences and observations.

The first personal experience he shared with the reader is in the section titled “Bāb-ı thāmin ḥaṣāt beyānındadur” (chapter 8 declares stone), where he discussed kidney and bladder stones. In this section, Emir çelebi mentions Yad-Allāh (Hand of Allāh/God), a drug made from the blood of a 4-year-old male goat. He claims it to be very effective and goes into great detail about how it is made. Emir çelebi also mentions Galen and Aflīnūs [?] praising this medicine in their own works. He also claims to have used this drug on Receb Pasha and to have extracted 2 plates of fragmented kidney stones from him.⁵

The second personal experience of Emir çelebi is also located in the same section and is about Sultan Osman II’s (reign 1618-1622) Grand Vizier, İstanköylü Ali Paşa (Ali Pasha from İstanköy [Kos/Cos]) (died March 1621). According to Emir çelebi, Ali Pasha died because of kidney stones, and the reason for this is that Ali Pasha did not act carefully when the kidney stones were small.⁵

Emir çelebi writes that, during the viziership of Ali Pasha, he treated the Chief Treasurer Mustafa Efendi, brother of his dear friend Kasımpaşalı Kurd çelebi (Qurd Chelebi from Qasimpasha), for paralysis; that the vizier Ali Pasha was also very pleased with this and invited him to the assembly; that he guided him with treatments made from inside the penis after presenting numerous proofs and that the vizier himself consented; that he warned Mustafa Efendi that, if the vizier ignored his advice and did not begin treatment within 6 months, the vizier would not be able to overcome the attack of matter; and that because of some difficulties, the vizier did not pay attention to the treatment and died.⁵

The third experience that Emir çelebi shared with the reader is about kidney and bladder wounds or ulcers. He claims that, after eating cherries, the seeds are collected, thoroughly washed and cleaned, well beaten with the peel, ground into powder, and crushed with sikanjubīn buzūrī (oxymel with seeds) and celery juice. Drinking it in the morning and evening for 7 days will be a beneficial drug for ulcerated wounds of the kidney and bladder. This drug not only heals wounds but also cleans the urinary tract and acts as a diuretic.⁵

The fourth personal experience of Emir çelebi is also related to kidney and bladder wounds. He described a treatment for an ulcerated wound or a fistula on the penis using bāslīqūn merhemi (ointment) applied through a lead-made probe. He claims that if this treatment had been used on the Vizier Ali Pasha from İstanköy (Kos/Cos), who died because of this disease, the fistula would have healed.⁵

At the end of the “jarab al-mathāna” (itch of the bladder) section, Emir çelebi added a medicine recipe that he quoted from Ibn Māsawayh⁵: “Ibn Māsawayh says that they should melt musk and horseradish tree oil in one place, add camphorated wax and mastic, and apply it on their groin and abdomen when it becomes like an ointment”5 (f.209r).

Emir çelebi’s most recent addition is in the “ʿusr al-bawl” (difficulty of passing urine) section, and he quotes the author of al-ḥāwī fī al-Ṭibb, Muḥammad ibn Zakariyyā al-Rāzī. He reported that inserting a finger of Hacı Bektaş salt (rock salt) into the anus caused urination.⁵

Discussion

The sections on kidney and bladder diseases written by Emir çelebi in Anmūdhaj al-Ṭibb are translations of related sections in Ibn al-Nafīs’s al-Mūjaz fī al-Ṭibb.^1,8,9 He occasionally added his observations and experiences to these translations and some information he obtained from other sources.⁵ We know from the literature on this work that its sections on pregnancy, childbirth, and breast diseases were similarly created.¹⁰

When we traced back the interesting medicine made from the blood of a 4-year-old male goat, which Emir çelebi called Yad-Allāh (Hand of Allāh/God) and mentioned and claimed as effective in his first personal experience, we discovered the following medical works from the Ottoman classical period and their authors: Dāwūd al-AnṬakī’s¹¹ (died 1599) Arabic work al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija mentions the medicine with the same name, Yad-Allāh, reports on how to prepare it, and claims that Galen gave this medicine this name.

On the other hand, Ahī çelebi¹² (died 1524) in his Turkish work Risāla fī ḥaṣāt al-kilya wa l-mathāna on kidney and bladder stones refers to the medicine as Yad-Allāh and describes how it is made. ʿAbd al-Vahhāb b. Yūsuf b. Aḥmed al-Mardānī¹³ briefly mentions the medicine in his Turkish work Kitāb al-Munteḥab fī al-Ṭibb (1420) without providing a description but states that only goat blood is effective. The same drug can also be found in the Middle Ages, written in the Islamic and Roman worlds.

Kitāb al-Mukhtārāt fī al-Ṭibb of Ibn Hubal al-Baghdādī14 (1122-1213), Kitāb al-Qānūn fī al-Ṭibb of Ibn Sīnā^15,16 (980-1037), and al-Taṣrīf of al-Zahrāwī17 (936-1013) described this medicine, but the name Yad-Allāh is never used. Rhazes^18,19 (865-925), on the other hand, defines this medicine as the admirable medicine of Philagrius in Kitāb al-Hāwī fī al-Ṭibb (Liber Continens) and describes how it is prepared in detail. According to his information, the person who revealed the medicine was Philagrius.^18-20 Paul of Aegina^20,21 (625-690) also describes the drug in his Epitome but does not give any information about the inventor. Finally, Aetius of Amida^20,22 (fifth to sixth century) also reports this drug as belonging to Philagrius (third century) under the title of “de hircino sanguine.”

With this information, it seems possible to say that Philagrius introduced this intriguing medicine and that the name Yad-Allāh was most likely first used by Ibn al-Nafīs. While Emir çelebi was writing Anmūdhaj al-Ṭibb, he incorporated this medicine into his work because he benefited from these sections of Ibn al-Nafīs’s al-Mūjaz fī al-Ṭibb. However, it is clear that Ibn al-Nafīs is not referring to Galen or any other name. We searched the works of Galen, but no information about such a medicine provided by Galen could be found. If that is the case, then how could Emir çelebi have established a connection between this drug and Galen? Given that Dāwūd al-AnṬakī was in Egypt when he wrote al-Nuzhat al-mubhija²³ and Emir çelebi received his medical education in Cairo before becoming the Chief Physician at Qalawun Hospital, his reasoning for linking this medicine with Galen is understandable.

In his second experience, Emir çelebi shared information about the disease of Vizier Ali Pasha and his treatment recommendation, but in his fourth experience, he wrote the details of the treatment that he recommended. He claims that Ali Pasha died due to a kidney stone and that the treatment he recommended could have saved his life. Ottoman historian and the first official Ottoman chronicler, Naʿīmā24 (1655-1716), also writes that Ali Pasha died on 15 Rābīʿ al-ākhir 1030 (March 8, 1621) due to an exacerbation of the “maraḍ ḥaṣāt al-mathāna” (bladder stone disease). This information appears to confirm Emir çelebi’s account.

We also learn from this information that Emir çelebi was in Istanbul during the vizierate of Ali Pasha (16 Muharram 1029 [December 23, 1619] to 15 Rābīʿ al-ākhir 1030 [March 8, 1621]).²⁵ However, Bayat1 and şehsuvaroğlu2 claimed that Emir çelebi arrived in Istanbul in 1032 (1622) by joining the entourage of Grand Admiral Receb Pasha in Cairo. In this regard, it appears that Emir çelebi came to Istanbul earlier and was present during the Grand Vizierate of Ali Pasha and that he joined the assembly of Receb Pasha after April 1623, when Pasha became the “Vizier Captain.”²⁶ On 5 Ramaḍān 1034 (June 11, 1625), the Anmūdhaj al-Ṭibb was also completed.5

Another personal experience of Emir çelebi is the use of beaten and pulverized cherry seeds with sikanjabīn buzūrī and celery juice. He claims it is beneficial for kidney and bladder wounds, cleanses the urinary tract, and is a diuretic. As a result of our research, we discovered some interesting facts about cherries.

Although Ibn Sīnā’s^15,27 al-Qānūn fī al-Ṭibb contains no information about cherries, al-Bīrūnī^28,29 (died 1048) provides information but does not explain the effects of cherries as medicine in Kitāb al-ṣaydana fī al-Ṭibb. Ibn Zuhr³⁰ (Avenzoar) (died 1162) also discusses cherries in his book Kitāb al-Aghdhiya and explains some of their effects; however, there is no mention of cherries regarding kidney and bladder diseases. In his Kitāb al-Jāmiʿ li-mufradāt al-adwiya wa-l-aghdhiya, famous Islamic botanist Ibn al-Baytār31 (died 1248), quoting from Galen and Dioscorides, mentions cherries and also their effects on patients who have stones.^31,32 Among the sources we could find, it is clear that the work of Dioscorides³³ (from approximately 40-90), specifically the section on “Kerasia/Prunus Cerasus/Cherry” contains the following information: “And being dranck with wine, it is good for such as are troubled with the stone.”33 Almost the same sentence as this is found in Galen’s (129-200) De simplicium medicamentorum temperamentis ac facultatibus.³⁴

In this context, we noticed that, in his work, Emir çelebi shared a therapeutic feature of cherry seed with his reader, which was not widely known at the time. This situation is consistent with Emir çelebi’s account in the preface of his work, in which it is stated that it is not right for the authors to simply transmit what has been written before them without adding anything and that the results of their own experiences should be recorded.

Conclusions

What Emir çelebi wrote about the kidney and bladder was quoted from Ibn al-Nafīs’s al-Mūjaz fī al-Ṭibb. He supplemented these sections with personal observations, experiences, and brief information from other works. His accounts provide detailed information about the illness and the cause of death of Ali Pasha from İstanköy (Kos/Cos), one of the important viziers of the Ottoman Empire, and also shows that Emir çelebi was in İstanbul before 1622. The information about the effect of cherry seed on kidney and bladder diseases appears novel.

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