Mustafa Behçet Efendi and the Birth Certificate of Modern Turkish Medicine

April 24, 1774: A Poet-Physician Born into a Medical Family

Mustafa Behçet Efendi was born on April 24, 1774, in Istanbul's Eyüp Sultan district. His father, Mehmed Emin Şükûhî Efendi, was a clerk of the Imperial Council and a well-known poet of the period. His mother, Nefîse Hanım , was the daughter of an important figure in medical history, a chief physician during Mustafa III's reign: Büyük Hayrullah Efendi. Two great traditions therefore ran in Mustafa Behçet's veins: literature from his father and medicine from his mother. Both remained with him throughout his life; even in old age, he wrote poetry as well as medical treatises.

This family was a typical example of what could be called a “medical dynasty” within the Ottoman bureaucracy. His younger brother, Abdülhak Molla , would later also become a chief physician of Mahmut II and hold an important place in medical history. The famous poet of a later generation, Abdülhak Hâmid Tarhan, was Mustafa Behçet's great-nephew: Turkish literary and medical history thus proceeded as two branches growing from the same family tree.

Young Mustafa grew up within the standard Ottoman education system of the period: madrasa education, followed by medical training at the Süleymâniye Medical Madrasa. Founded in 1556 by Sultan Süleyman the Magnificent, it was the Ottoman Empire's central institution for medical education. Teaching centered on the traditional Islamic-Arabic medical corpus: Ibn Sina's Al-Qanun fi al-Tibb, the works of al-Razi, and Akşemseddin's Maddetü'l-Hayât. But during Mustafa Behçet's studies, the Süleymâniye curriculum had not yet caught up with the modern anatomical revolution begun three centuries earlier by Vesalius (1543), Harvey's discovery of blood circulation (1628), or Morgagni's pathological anatomy (1761).

This was precisely what made Mustafa Behçet exceptional: despite being a physician trained in a madrasa, he recognized the madrasa's shortcomings. In his twenties, he learned from the Imperial Council interpreter Yahya Naci EfendiLatin and Italian. This determined the direction of his life: he gained access to the original sources of European medicine. Through Latin, he could first read the channels leading to Ibn Sina's original Greek sources; through Italian, he could then directly read contemporary works from the medical schools of Padua, Bologna, and Florence.

From 1803 to 1827: The Chief Physician's Turbulent Twenty-Five Years

Mustafa Behçet's official career began in 1791 with teaching at the Sinan Ağa Madrasa (an assistant position). In 1796, at just 22, he joined the court physicians. In 1803, aged 29, Sultan Selim III appointed him to his first term as chief physician . It was a highly prestigious position in the Ottoman bureaucracy: the chief doctor responsible for the sultan's health also headed the organization of healthcare throughout the empire.

In 1805, Mustafa Behçet first proposed establishing a modern medical school: Kuruçeşmewas to be its location. The initiative matched the reformist atmosphere of Selim III's reign but could not be implemented because of opposition from the ulema, the religious scholars. At the heart of the obstacle was the ban on dissection : in Islamic law, cutting and examining the human body after death was considered contrary to the body's dignity, and the ulema did not permit it. Since anatomy teaching, the cornerstone of modern medical education, could not be conducted without dissection, creating a European-style medical school still appeared impossible.

In 1808, the Janissary uprising, Selim III's dethronement, and his subsequent killing changed the political climate. Mustafa Behçet was removed from office during this process. In 1815, Mahmut II appointed him chief physician for a second time . These were his most productive years: In 1817, Tertib-i Ecza was published as a health guide for Muslims traveling on pilgrimage. It is among the first medical books printed in Turkish; some medical historians consider it “the first medical book printed in Turkish”. In the same years, he translated Buffon's Histoire Naturelleinto Turkish under the title Tarih-i Tabîî . This was one of the first major introductions of natural science into Ottoman intellectual life from a European source.

But in 1821 came the most disruptive break in his career: allegedly speaking against Halet Efendi , a member of Mahmut II's inner circle, he was dismissed as chief physician and, together with his brother Abdülhak Molla, exiled to Keşan. He spent 11 months in exile. Pardoned in 1822, he returned to Istanbul and, in 1823, was appointed chief physician for a third time — a position he would hold until his death.

The First Curriculum, the First Teachers, and the First Barrier to Dissection

Tıbhâne-i Âmire (“Imperial Medical School”) and Cerrahhâne-i Âmire (“Imperial Surgical School”) were established as two separate disciplines in the same building, following the European model. The medical school taught internal medicine and theoretical sciences, while the surgical school taught surgical practice. The course was set at four years , the same as the standard duration in Europe. Mustafa Behçet Efendi became the school's first nâzır (director/dean).

This limitation has considerable significance for oncology's history. In 1827, Europe had already completed the pathological anatomy revolution extending from Morgagni to Bichat: the foundations had been laid for locating disease in organs, tissues as the building blocks of organs, and cells as those of tissues. At the medical school, however, medicine was taught without fully corresponding concepts, because without dissection there could be no pathological anatomy. Modern pathology's establishment in Türkiye would require 1843 (Bernard's first dissection) and later Hamdi Suat (Aknar) in the early 20. centuryreturning from Germany and founding a modern pathology chair at Istanbul Darülfünun.

Still, the opening of the medical school in 1827 was a starting point. Even without pathology, European physical examination methods (including Laennec's auscultation), clinical diagnostic concepts, pharmacy standards, the organization of pharmacies and hospitals, and epidemic control practices slowly entered Ottoman medicine. The torch Mustafa Behçet lit created a field that would be illuminated in increasingly fine detail over the following century.

An Architect Not Only of Education but Also of Modern Public Health

Mustafa Behçet's contribution to modern Turkish medicine was not limited to founding the school. He also helped establish the Ottoman modern quarantine system. During the great cholera epidemic of the 1830s, to prevent plague and cholera cases arriving from Europe from spreading to Istanbul, he persuaded the sultan to adopt quarantine procedures (keeping people and goods under observation for specified periods). This step was a critical stage in bringing 19. century Ottoman healthcare organization up to European standards.

His work written in the same years, Hezâr Esrâr (“A Thousand Secrets”), sought to systematically record Ottoman traditional folk medicine, herbal remedies, old treatments, and popular medical practices. Mustafa Behçet died before the work was completed, but the material he collected became a source for later generations of Ottoman physicians. This is another important paradox in modern Turkish medical history: The same man brought European medicine to the Ottomans while also ensuring that Ottoman folk medicine was recorded. Both modernist and traditional: a typical portrait of an intellectual from a transitional generation.

Where and How Was Cancer Encountered in Türkiye in 1827?

When the medical school opened in 1827, there was no separate specialty called “oncology”, not even in Europe, and certainly not in Türkiye. Cancer was one of many diseases physicians encountered; it had neither a systematic definition, treatment regimens, nor statistical infrastructure. Yet Ottoman medical knowledge of cancer was not nonexistent.

In the principal source of classical Islamic-Arabic medicine, Ibn Sina's Al-Qanun fi al-Tibb(“The Canon of Medicine,” around 1025), cancer (“saratan”, Arabic for crab) was described in detail. Ibn Sina said cancer arose from the accumulation of melancholic humor(black bile) in certain parts of the body, following the Hippocratic-Galenic tradition. He recommended diet, bloodletting, purgatives, and mixed medicinal-surgical approaches. This doctrine was a cornerstone of the Süleymâniye Medical Madrasa curriculum, and Mustafa Behçet was trained in it.

The cancer cases encountered in Ottoman court and folk medicine were usually advanced-stage tumors: scirrhous breast tumors (like those seen by the surgeons who operated on Frances Burney in Paris in 1811, or the type that killed Anne of Austria at 67), fungating masses of the face and mouth, stomach cancer (pyloric obstruction similar to Napoleon's), and cervical cancer. Surgery was rarely used because there was neither anesthesia nor a low risk of surgical infection. Instead, palliative approaches predominated: opium for pain control, herbal laxatives for purgation, and porridges and sherbets for nutritional support.

Opening the medical school did not directly change this situation, but in the long term it initiated the following chain:

The Medical School's Architect, Just Seven Years After Its Opening

Mustafa Behçet Efendi served as the medical school's director for seven years after it opened. He continually expanded the curriculum, brought additional teachers from Europe, and increased student numbers. He also worked on organizing the quarantine system and continued Hezâr Esrâr during the same period.

He died in Istanbul on April 17, 1834. One week before turning 60. The cause of death is not clearly documented historically; sources of the period describe it as “a prolonged illness”. The medical school's directorship passed to others, but it continued growing from the seed he had planted.

In his final years, Mustafa Behçet also worked on translating a European work on physiology . The translation remained unfinished, but later generations worked with the material he collected. The modern medical historian E. Kâhya, in her dissertation published in 1995, studied Mustafa Behçet's “Physiology Translation” in detail and showed its direct connection to contemporary European physiology, particularly Bichat's Recherches physiologiques sur la vie et la mort. In other words, Bichat's work in Paris in 1800 reached Istanbul in the 1820-1830s through Mustafa Behçet's translation. This quiet route of transmission in medical history provides concrete evidence of how closely modern Turkish medicine developed alongside Europe.

An Important Note: Two Behçets, Two Different Stories

The name “Behçet” belongs to two important, distinct figures in Turkish medical history, who are often confused. The subject of this article is Mustafa Behçet Efendi (1774-1834), chief physician and founder of the medical school. He should not be confused with the figure to be covered on Day 133. of the series: Hulusi Behçet (1889-1948), who described the globally known Behçet's disease(a vascular-immunological syndrome), Türkiye's first eponymous scientist in medical history. Between them lie 115 years, two different centuries, and two entirely different scientific contributions. They did not share a surname, only a given name: Behçet means “joy, happiness” and is of Arabic-Persian origin, a common Ottoman name. Mustafa Behçet belongs to this series' Day 75., Hulusi Behçet to Day 133.. Both have separate importance in the backbone of Turkish oncology's history.

This article is Day 75. of the Cancer History in 365 Days Series and its first Türkiye file. The institutional evolution of Turkish medicine and oncology will be explored in depth in upcoming installments: Cemil Topuzlu (Day 92.), the Second Constitutional Era and Haydarpaşa Medical School (Day 113.), Hulusi Behçet (Day 133.), the Turkish Association for Cancer Research and Control (Day 135.), Hacettepe and the Ankara oncology generation (Day 146.), Ayhan Çavdar (Day 173.), modern oncology units in 1972 (Day 174.), Cengiz Yakıcıer (Day 208.), Türkan Saylan (Day 209.), and Memorial Göztepe (Days 271-279.). This series tells the story of two hundred years of physicians who passed through the door Mustafa Behçet opened on March 14, 1827. The article was prepared from a popular historical perspective and provides no medical treatment guidance.