District health services through pharmacies in Istanbul (1845-1895)
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 day-round 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 (1845-1895) 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.
Key words : History of pharmacy, health services, emergency services, social healthcare, smallpox vaccination, hekim-eczacı işbirliği, belediye sağlık teşkilatı, Imperial School of Medicine;Anahtar kelimeler : Eczacılık tarihi, Mekteb-i Tıbbiye-i Şahane, acil servisler, yoksulların muayene ve tedaveri, çiçek aşısı, hekim-eczacı işbirliği, belediye sağlık teşkilatı