Tıphane-i Âmire’den Dârülfünun’a İstanbul Tıp Fakültesi’nde Fizyoloji, 1827-1933
Nuran YıldırımÜlkemizde bağımsız araştırma enstitüleri olmadığı için, fizyoloji bilimi tıp eğitimine paralel olarak gelişmiştir. Ülkemizde modern anlamda tıp eğitimine geçiş, 14 Mart 1827 tarihinde eğitime başlayan Tıphane-i Âmire ile başlamış ve 1933 Üniversite Reformu’na kadar; Mekteb-i Tıbbiye-i Şahane, Mekteb-i Tıbbiye-i Mülkiye, Dârülfünun-ı Osmani /İstanbul Darülfünunu Tıp Fakültesi’nde devam etmiştir. İstanbul Tıp Fakültesi’nin nüvesini oluşturan bu okullara, eğitimini bir zaman Dârülfünun-ı Osmani Tıp Fakültesi’ne bağlı olarak sürdüren Şam Mekteb-i Tıbbiye-i Mülkiyesi de eklenmiştir. Bu çalışmada İstanbul Tıp Fakültesi’nin 1827’den 1933 Üniversite Reformu’na değin eğitimini sürdürdüğü bu tıp okullarında fizyoloji dersi verenler üzerinden; fizyoloji eğitimi, deneysel fizyolojiye geçiş, fizyoloji laboratuvarının kuruluş ve gelişimi ele alınmıştır. Bu süreçte genç hekimler maaşından başka geliri olmayan fizyolojiye itibar etmemiş, fizyoloji derslerini zaman zaman başka branş mensupları vermiştir. Fizyolojiye gönül veren Şakir Paşa hayvan deneyleri eşliğindeki fizyoloji dersleri ile ülkemize deneysel fizyolojinin esaslarını getirmiş, Kemal Cenap Berksoy ise deneysel fizyolojiyi bir öğretim ve araştırma dalı olarak yerleştirmiştir.
Physiology in Istanbul Faculty of Medicine from Tıphane-i Âmire to Dârülfünun, 1827-1933
Nuran YıldırımSince there were no independent research institutes in Turkey, the science of physiology developed in parallel with medical education. The transition to modern medical education in Turkey started with Tıphane-i Âmire, which started education on March 14, 1827, and continued until the 1933 University Reform; Mekteb-i Tıbbiye-i Şahane, Mekteb-i Tıbbiye-i Mülkiye, Dârülfünun-ı Osmani /Istanbul Darülfünunu Faculty of Medicine. The Mekteb-i Tıbbiye-i Mülkiye in Damascus, which continued its education under the Dârülfünun-i Osmani Faculty of Medicine for a while, was also added to these schools that formed the nucleus of the Istanbul Faculty of Medicine. This study focuses on physiology education, the transition to experimental physiology, and the establishment and development of the physiology laboratory through the physiology lecturers at these medical schools, where the Istanbul Medical Faculty continued its education from 1827 until the University Reform of 1933. During this period, young physicians did not respect physiology, which had no income other than their salaries, and physiology courses were taught by members of other branches from time to time. Şakir Pasha, who was devoted to physiology, brought the principles of experimental physiology to Turkey with his physiology courses accompanied by animal experiments, and Kemal Cenap Berksoy established experimental physiology as a branch of teaching and research.
Since there used to be no independent research institutes in Turkey, the science of physiology has developed within medical education. The transition to modern medical education in Turkey commenced with Tıphane-i Âmire’s (The Imperial Medical School) inception on March 14, 1827. Until the 1933 University Reform, medical education continued in institutions named as the Mekteb-i Tıbbiye-i Şahane (Imperial Faculty of Medicine), Mekteb-i Tıbbiye-i Mülkiye (School of Civil Medicine), Dârülfünun-ı Osmani Tıp Fakültesi (The Ottoman University Faculty of Medicine), Şam Mekteb-i Tıbbiye-i Mülkiyesi (Damascus School of Civil Medicine) which at one time continued its education affiliated with the Darülfünun-ı Osmani Tıp Fakültesi, was also added to these schools that constituted the core of Istanbul University Faculty of Medicine. This study addresses the establishment and development of the physiology course in the schools where Istanbul Medical Faculty maintained its education from 1827 until the 1933 University Reform.
From 1834 onward at Tıphane-i Âmire, physiology education was conducted by Osman Saib Efendi through translations of a contemporary French physiology book. Osman Saib Efendi also taught physiology for several years at the Mekteb-i Tıbbiye-i Şahane, resulting from the merging of Tıphane-i Âmire and Cerrahhane-i Mamûre (School of Surgery) beginning French-based education in 1839. Until 1873, at Mekteb-i Tıbbiye-i Şahane, physiology professors additionally taught courses in anatomy, pathology, pathological anatomy, zoology, botany, hygiene, surgical internal diseases, and clinical medicine.
The commencement of Turkish education at Mekteb-i Tıbbiye-i Mülkiye (1867), followed by the transition to Turkish education at Mekteb-i Tıbbiye-i Şahane (1870), led to the challenge of a lack of Turkish-speaking instructors and a shortage of Turkish textbooks. In response, the translation of French medical books into Turkish began. Kâtipzâde Mehmet Nuri Birgivî, an assistant surgical instructor at Mekteb-i Tıbbiye-i Şahane, translated a physiology book named Traité élémentaire de physiologie humaine comprenant les principales notions de la physiologie comparée (Paris 1866, 5th edition) authored by Prof. Dr. Jules Béclard, renowned for his studies in anatomy and physiology during that era. This translated physiology book was published as Menâfi'ül-azâ Fisioloci (Istanbul,1873-1874). Şemsi Şerif Bey, the Physiology Instructor, utilized this book in his theoretical lessons between 1873 and 1881.
Dr. Mehmet Şakir (Şakir Pasha), who specialized under Dr. Claude Bernard, returned to Istanbul (1876) driven by the inspiration and high energy acquired during his apprenticeship and with a determination to bring newly learned knowledge to his country. In the same year, he was appointed as an assistant instructor alongside the physiology instructor Şemsi Şerif Bey at the Mekteb-i Tıbbiye-i Şahane. In addition to this role, he assumed the position of assistant physiology instructor at Mekteb-i Tıbbiye-i Mülkiye (1878). Upon his promotion to an instructor, he departed from Mekteb-i Tıbbiye-i Mülkiye (1888). From then on, he solely worked at Mekteb-i Tıbbiye-i Şahane. The lectures where he discussed the latest developments in physiology were compiled by students through note-taking. Şakir Pasha revised and corrected these notes before publishing them as “Dürûs-ı Hayat-ı Beşeriye” (Lessons on Human Life, Istanbul 1893).
Upon his arrival from Paris, Şakir Pasha made considerable efforts to establish a physiology laboratory. However, instead of the envisioned laboratory, he initiated experimental physiology classes in a small room using equipment he procured with his own funds. He personally conducted practical and demonstration classes every Thursday. His experiments involved dogs, island rabbits, and frogs. Due to the absence of allocated funding for the physiology laboratory, the dogs used in the experiments were either brought by attendants or enthusiastic students from around the Karacaahmet cemetery or the vicinity surrounding the school in Sirkeci-Demirkapı, while the frogs were collected from the botanical garden pond of the school.
Şakir Pasha succeeded in introducing the fundamentals of experimental physiology to Turkey through his physiology classes conducted alongside animal experiments in this modest laboratory. His requests for new equipment to enhance the physiology laboratory were disregarded by the authorities, and after years of waiting, he managed to procure some new equipment for his laboratory (1896), albeit not to the extent he desired. Due to the reluctance of the Babıâli (Sublime Porte) that sent him to France for specialized training to comprehend and establish a fully equipped physiology laboratory, Şakir Pasha couldn’t engage in scientific research. Another misfortune for Şakir Pasha was that the assistants who began working with him, having no income apart from their salaries, did not embrace physiology and shifted to clinical fields. Consequently, he had to single-handedly continue theoretical and experimental physiology education for years. As those who started their careers in physiology education eventually transitioned to clinical specialties, the education was sustained with contributions from instructors and assistant instructors of other disciplines. The names we have identified as contributing to physiology education are listed in the table “Contributors to Physiology Education, 1827-1933” at the end of this article.
After settling into the monumental building of Mekteb-i Tıbbiye-i Şahane in Haydarpaşa, Dr. Kemal Cenap (Berksoy), Şakir Pasha’s persevering assistant in physiology, pushed the limits of the era’s resources to facilitate the expansion and equipping of Şakir Pasha’s modest laboratory with new tools. Despite this effort, the laboratory, which fell short compared to its European counterparts, saw Kemal Cenap Bey publish his experimental studies in European physiology journals and receive citations. He particularly emphasized experimental studies on digestive physiology, notably identifying the most effective secretion occurring within the deep mucosal layer of the duodenum, a contribution that entered the physiology literature. Kemal Cenap Bey, who achieved international recognition for his scientific research, established experimental physiology as both a teaching and research discipline by conducting experiments with his students during classes.