Abstract:

Ottoman archival documents and the Ottoman Yearbooks  (Devlet  Salnameleri) published between 1854 and 1896, as well as the primary sources  of the period under study reveal that health services were extended to districts in  ‘rooms’  annexed  to pharmacies  in thoughout  Istanbul. The earliest of these sugeries  were opened in 1845  in Beyazıt/Koska, Eyüp  and Üsküdar districts. These were followed by rooms  that  were set  in the districts of Salıpazarı/Fındıklı (1866) and Topkapı (1870). The residents of Anadoluhisarı  and Kasımpasa sent  petitions  in 1887  and 1888  to  the government  for the creation of rooms in their districts; these demands could not be executed due to  economical shortage. Administered by the Imperial School of Medicine, these rooms  were called nöbet  mahalleri (literally, ‘localities on duty’ where physicians were served day and night) or nöbet eczaneleri (pharmacies on duty). Medical service, including examination and care of patients, dispensing  of medication, and prescription of drugs was extended in these rooms. During  the day, minor surgical operations  were performed, as  well. Professors  and  graduates of the Imperial Medical School were in charge of this medical service. Well off patients would pay for the medicaments, while the  expenses  of poor were covered by the Palace as the charity of the Sultan, and were reimbursed to  the pharmacists. The state would also pay a rent to the pharmacist for his room. Thanks to  the payments by the government and rich patients, the pharmacist would benefit  from a larger income than usual. In  fact, this  practice intiated by the State  allowed doctors and pharmacist to cooperate for a common interest. Doctors  would  mostly  deal  with  emergency cases. They  would  visit  patient’s house when necessary. Thus, people of the district day­round access to  medical care and medication. The doctors  and surgeons  in charge, fixed  luxations and fractures, dressed wounds and extracted pieces of foreign bodies  from patients. Physicians  also  performed  bloodletting, plaster (sinapism) application, drained abcesses. Free vaccination was also offered.  The rooms annexed  to  pharmacies that  funcioned for about  fifty years  (1845­1895) can be considered as  early examples of district  health and  emergency units. These units had to close down in late 19th century when the town council decided to appoint doctors to the municipality and employ them to  extend health services to local people.

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