Osmanlı-Türk Psikiyatrisinde KraepelinŞahap Erkoç, Fatih Artvinli
Alman psikiyatrist Emil Kraepelin’in (1856-1926) günümüz psikiyatrisinde çağdaş kavramların oluşturulmasında ve hastalıkların sınıflandırılmasında önemli yeri vardır. Hastalıkların sınıflandırılmasıyla ilgili koymuş olduğu ilkeler, adlandırmalar ve sınıflamalar günümüzde de geçerliliğini korumaktadır. Kraepelin yalnızca Almanya’dan değil dünyanın farklı ülkelerinden pek çok nöropsikiyatristin yetişmesine katkıda bulunmuştur. Kraepelin’in Osmanlı ve Türkiye psikiyatri tarihinde ise özel bir önemi ve Türkiye’de psikiyatrinin şekillenmesinde ciddi bir etkisi vardır. Osmanlı son döneminden başlayarak, Türkiye’de psikiyatrinin kurumsallaşmasında önemli katkıları olan üç farklı kuşaktan hekimler, Kraepelin ekolünde yetişmiş ve bizzat onun yanında çalışma imkânı bulmuştur. Bu makalede Kraepelin’in Osmanlı-Türkiye psikiyatrisine etkisi ve Türkiye’de farklı kuşaklardan psikiyatristlerin Kraepelin ile ilişkileri ve hakkındaki düşünceleri incelenmektedir.
Kraepelin in Ottoman-Turkish PsychiatryŞahap Erkoç, Fatih Artvinli
Emil Kraepelin (1856-1926), a German psychiatrist, had a significant role in the development of contemporary principles in psychiatry and disease classification. The principles, the nomenclature, and the classifications he devised for diseases are still in use today. Kraepelin was instrumental in the training of many neuropsychiatrists not only in Germany but all over the world. Kraepelin holds a distinctive place in Ottoman-Turkish psychiatric history and had a significant impact on the shaping of psychiatry in Turkey. Starting in the late Ottoman period, three generations of physicians who contributed significantly to the institutionalization of psychiatry in Turkey were taught in Kraepelin’s school and had the opportunity to work directly under him. This article investigates Kraepelin’s impact on Ottoman-Turkish psychiatry and the relationship between Kraepelin and psychiatrists of different generations in Turkey.
The article delves into the relationship between Emil Kraepelin (1856-1926), a prominent figure in modern psychiatry, and Ottoman-Turkish psychiatry circles during the late 19th and early 20th centuries. It explores Kraepelin’s influence on the development of psychiatric practices and classifications in the Ottoman Empire.
The development of psychiatry in modern Turkey traces back to the mid-19th century, during the period of Tanzimat Reforms (1839-1876), which aimed to modernize the Ottoman State and institutions. Luigi Mongeri senior (1815-1882), known as the Pinel of Constantinople, played a significant role in reforming the Süleymaniye Bimarhanesi, the largest mental asylum in the Ottoman Empire. Mongeri abolished the practice of chaining patients, implemented reforms in patient care, and published statistical data and case studies on insanity. He emphasized the importance of treating mental illness within a medical framework and influenced the perception of insanity and mental hospitals in society. Mongeri later transferred the asylum from Süleymaniye to Toptaşı and prepared the first regulation on mental asylums, which came into effect in 1876.
The first generation of professionally trained neuropsychiatrists in the Ottoman Empire worked at the Süleymaniye and Toptaşı asylums. These physicians, including Luigi Mongeri, Avramino De Castro, and Avni Mahmud, followed the French school of psychiatry and adopted French terminology and classification in their diagnoses. They frequently referenced French psychiatrists like Philippe Pinel, Jean-Étienne Dominique Esquirol, and Bénédict Morel in their work. In the early 20th century, the classification system developed by Régis gained prominence. Until the end of the 19th century, the limited resources on psychiatry and neurology in Turkey heavily relied on the French school.
During the late 19th and early 20th centuries, a Franco-German rivalry emerged in the field of medicine in the Ottoman Empire. Medical school graduates started being sent to Germany, in addition to France, due to the growing interest of the Prussian state and the political response of Wilhelm II to Abdulhamid II’s policies. This period witnessed the establishment of psychiatry clinics at the Gülhane Academic Military Hospital and the military medical school Mekteb-i Tıbbiye-i Şahane, which brought in teachers from Austria and Germany. Raşit Tahsin [Tuğsavul] and his student Mazhar Osman [Uzman] played key roles in introducing Emil Kraepelin, a prominent figure in modern psychiatry, to OttomanTurkish psychiatry. The historical context allowed Kraepelin’s ideas to gain acceptance in the Ottoman Empire.
Emil Kraepelin was a German psychiatrist who played a crucial role in shaping the field of psychiatry of the late 19th century. He emphasized research, observation, and experimentation in psychiatry, considering it a branch of medical science. Kraepelin focused on investigating the physical causes of mental illnesses and laid the foundation for the modern classification of mental disorders. His major distinction was between “manic-depressive” illness, characterized by affective elements, and “dementia praecox” (later known as schizophrenia), without affective elements. Kraepelin’s classification of mood disorders and his approach to psychiatric diagnosis had a lasting impact on psychiatric thought and clinical practice.
Luigi Mongeri junior established contact with Emil Kraepelin and sent several letters to him from Istanbul, discussing topics such as postpartum madness and seeking guidance on treatment methods. In 1895, Kraepelin visited Istanbul and was guided by Mongeri. Their paths continued to cross, and Kraepelin expressed admiration for Mongeri’s work in improving mental healthcare in the Ottoman Empire. Kraepelin’s influence on OttomanTurkish psychiatry was further strengthened through his seminal work, Psychiatrie: Ein Lehrbuch für Studierende und Ärzte (4 vols., 1909-1915, Psychiatry: A Textbook for Students and Physicians), which was widely translated and read across Europe.
Emil Kraepelin’s influence on Ottoman-Turkish psychiatry was significant during the late 19th and early 20th centuries. His emphasis on research, classification, and a scientific approach to psychiatry resonated with some of the emerging psychiatric practitioners in the Ottoman Empire. Pioneers like Mazhar Osman played a crucial role in introducing and integrating Kraepelin’s concepts into the Ottoman-Turkish psychiatric discourse. They recognized the importance of research, classification, and a scientific approach to psychiatric diagnosis. The impact of Kraepelin’s ideas on Ottoman-Turkish psychiatry was reflected in the publications and research conducted during that period. Many psychiatrists began adopting Kraepelin’s diagnostic categories and classification system. His influence can be observed in the works of prominent Ottoman-Turkish psychiatrists such as Raşid Tahsin and Mazhar Osman. However, it is important to acknowledge that various psychiatric approaches coexisted during this period, and the influence of the French school of psychiatry continued. The development of Ottoman-Turkish psychiatry was shaped by a combination of international influences and local factors, ultimately contributing to the evolution of mental healthcare in modern Turkey.
To conclude, Emil Kraepelin’s impact on Ottoman-Turkish psychiatry during the late 19th and early 20th centuries was profound. His emphasis on research, classification, and a scientific approach resonated with emerging psychiatric practitioners in the Ottoman Empire. Through the work of pioneers like Mazhar Osman, Kraepelin’s ideas were introduced and integrated into the Ottoman-Turkish psychiatric discourse, influencing diagnoses, classifications, and the overall approach to mental healthcare.