The harmonic healing houses of Turkey

Darüsiffa means 'the healing house' (Benek et al., 2015). Divriği Great Mosque and Hospital was one of the first and finest examples of a Darüsiffa, built in the time of Anatolian Seljuks in the 13th century and then reinforced in the Ottoman Empire era (Erdal & Erbaş, 2013). The culture of both the Ottoman Empire and the Anatolian Seljuks were steeped in religion, and so this institution was a Darüsiffa adjacent to a mosque. Mental health problems were treated in the Darüsiffas and prayers were completed in the mosques.

The buildings and the treatment methods of the time included a lot of religious components, with motifs carved into the buildings to demonstrate devotion to God. Although several factors made these institutions different from an average building, the architecture was, without a doubt, the most valuable. One of the most fascinating components at Divriği was its 'Western Portal', also known as the 'Textile Portal' as it was embroidered like lace. Two columns that were situated on the right and the left sides were said to be turning according to the arrows on them (after the 1939 earthquake, they stopped turning). It is reported that, between May and September, just 45 minutes before the noon prayer, the turning movement of these columns created a silhouette of a praying man reading the Quran on the portal [pictured, far left]. How such architecture led to the creation of this silhouette is still not fully known, but it led this health facility to be taken under the World Heritage List by the United Nations Educational, Scientific and Cultural Organization (UNESCO) (Benek et al., 2015).

Most of the Darüsiffas were situated just near the mosques and were used as places of education in the Ottoman Empire. Music and the sound of nature were used as a treatment, mostly for mental health patients. As the respected scientists of the time, such as Ibn-i Sina and Farabi, believed in the serenity and calmness of running water, these buildings would be positioned in nature. An average Darüsiffa was a building among gardens and orchards, and they would contain a pool and a running fountain in their courtyards for patients to see and hear. Inside of the Darüsiffas were patient rooms in the sides of the building, which was constructed to create the best echo and to convey the sounds in higher performance (Erdal & Erbaş, 2013). It is said that almost every patient was able to hear the running fountain from their room.

Makam and more

As such a valued facility for both the world and Turkey itself, the facility still bears an immense value for Turkish health workers. Professionals can turn back time and explore the effective treatment methods of their history.

Although the Darüsiffas had different treatment methods depending on the facility, the most well-known method was the use of sounds and music. They were considered a strategic tool, with particular sounds and instruments administered to patients at a particular time of day. Knowing when to use an instrument required previous experience (Erdal & Erbaş, 2013).

Sufie and Sidik (2017) contributed to this notion and stated that these various types of music had their own functions – called 'makam'. It was believed that each makam had a different influence on the patient's condition and emotions. For example, while 'Ussakmakam' could make the patients laugh, 'Zirgulemakam' would induce sleepiness. It was believed that if the makam was not used at the proper time, it would not benefit the patient… the specified period of time for each makam was different. If one was supposed to use the Ussakmakam, for example, the most beneficial time would be midday.

Another distinction was made between the instruments by their purpose. For instance, a lute (Ud) and a bamboo flute (Nay) were considered to be the primary instruments of a therapy session. Without these two instruments a session wouldn't be considered complete. They also represented a symbolic value. According to Sufie and Sidik (2017), the bamboo flute was a representation of the human psyche and each string in an old-type lute would represent the four main elements of nature; fire, water, air and earth.

The delicate balance of the sound and the human mind was emphasised and the interconnectedness of that relation was greatly cherished. The power of these instruments for an effective therapy session was acknowledged by the health workers and it was a strict principle to not use one tune to treat every health condition. For instance, the tune named 'tune Büzürg' means 'Great' in Persian and it was believed to clear the mind and guide one's thoughts. It was believed to help with anxiety and fear when it was used after the night prayers (Erdal & Erbaş, 2013). Another, named 'tune Uşşak' was believed to help induce sleepiness in children when it was used at noon (Erdal & Erbaş, 2013).

Complex of Sultan Bayezid

Another well-known Darüsiffa is the Complex of Sultan Bayezid II in Edirne, Turkey (again, included on UNESCO's list). The construction was made by the Ottoman Empire, and although the facility no longer operates as it is supposed to, it is currently serving as a health museum for the community. As the common feature of Darüsiffas, this institution has been known to use running water sounds, music and pleasant fragrances.

According to UNESCO, the Complex of Sultan Bayezid II was a medical centre that used a 'Holistic Medicine' understanding in its Darüsiffa. Every little detail that had the potential of affecting a patient's mood was taken into consideration. The sounds, the lighting details, even the meals that patients ate, were planned meticulously. The souls of the patients were thought to be fed and cleansed from illness with the help of music (Erdal & Erbaş, 2013). The approach of the treatment was focused on the manner of uniting 'the body and the soul' in Darüsiffas (UNESCO, 2016).

The music therapy was conducted by ten assigned officials that were responsible for playing music in the courtyards, three times every week (Republic of Turkey Ministry of Culture and Tourism, n.d.). Musicians used different tunes to address different health conditions and it was stated that even patients in the worst conditions would relax under the influence of stringed instruments (Erdal & Erbaş, 2013). The treatment was free in the Darüsiffas and the institution would send medications to the public without any cost.

Solid foundations

As the demands of the modern world increased, Darüsiffas lost their convenience and are, unfortunately, no longer active. This situation has led these institutions to be turned into educational museums or protected as the national heritages of the country. While Darüsiffas were places of mental treatment, they were also hospitals that provided valuable learning opportunities for medical students of the time. With this in mind, the methods used in the 13th century still bear immense value as a pioneering roadmap for the music therapy of today's Turkey.

While no institutions operate as Darüsiffas, there are foundations promoting music therapy in Turkey. The Group for the Research and Promotion of Turkish Music (TUMATA), Music Therapy Application and Research Center (MÜTEM), and the Music Therapy Association (MUZTED), aim to strengthen the use of music therapy in Turkey and to protect this culture, as they are the few examples of such institutions (Yılmaz & Can, 2019).

Music therapy is still practiced in Turkey. One session conducted with the collaboration of TUMATA works with adolescents and children that have autism spectrum disorder and patients who experience pain. The music therapy session consists of two parts as the active and the passive music. In the active part, the session consists of Turkish instruments and the 'Baksı dance'. The participants are expected to move their limbs in improvised ways as though they are living a moment of trans as a part of this dance. The passive part of the session, on the other hand, has aligned features of a treatment session in Darüsiffas. This time, participants are expected to lie down, relax, and listen to the Turkish music. The music includes the lute, the bamboo flute and the sound of running water (Ucaner & Oztürk, 2009).

The founder of the TUMATA, Dr Rahmi Oruc Guvenc, believes that the way we experience or manage pain mainly depends on the perceptions we have of it, and that music has a key role to play. Perhaps it's time we revisited the harmonic healing houses of Turkey…

- Asude Uçal is a third-year psychology student from Istanbul, Turkey. [email protected]

Key sources

Benek, B.S., Sakar, H., Bayram, R. & Gumustekin, K. (2015). An example for the application of music therapy in the medical history: Divrigi Darüssifa. Acta Medica Anatolia, 3(2), 63–66.
Erdal, G. & Erbaş, İ. (2013). Darüşşifas where music therapy practiced during anatolian Seljuks and Ottomans. Journal of History Culture and Art Research, 2(1), 1–20.
Haberler. (2007). Hastanede Ağrı Tedavisi Gören Hastalara 'Müzik Terapisi'. https://www.haberler.com/hastanede-agri-tedavisi-goren-hastalara-muzik-haberi/
Republic of Turkey Ministry of Culture and Tourism. (n.d.). Edirne - Complex of Sultan Bayezid Health Museum. https://kvmgm.ktb.gov.tr/TR-44003/edirne---sultan-ii-bayezid-kulliyesi-saglik-muzesi.html
Sufie, S.N.M. & Sidik, R. (2017). What is medical music therapy in islamic civilization? International Journal of Business and Social Science, 8(3), 195–199.
The Government of Edirne. (n.d.). Complex of Sultan Bayezid Health Museum. http://www.edirne.gov.tr/sultan-ii-bayezid-kulliyesi-saglik-muzesi
TUMATA. (n.d.). Baksı Dance. https://tumata.com/muzik-terapi/baksi-dansi/
Ucaner, B. & Oztürk, B. (2009). Türkiye'de ve dünyada müzikle tedavi uygulamaları. Uluslararasi Egitim Arastirma Kongresi, 1–13.
UNESCO. (2016, April 16). Sultan Bayezid II Complex: A Center of Medical Treatment. https://whc.unesco.org/en/tentativelists/6117/
Yılmaz, B. & Can, Ü.K. (2019). Türkiye'de müzik terapi uygulamalarında kullanılan müzikler. International Journal of Society Researchers. 13(19), 594–620.