During the Ottoman Empire period, the developments in Western medicine were closely followed and tried to be applied in the health area. Although archives of documents belong to the last years of the Ottoman Empire has been started in 1846, systematic access to these documents are possible after the establishment of the Ottoman Archives of the Prime Ministry in İstanbul, in 2013.
We searched the Ottoman Archives of the Prime Minister’s Office to find out whether there was any document regarding nephrological diseases. We have unearthed 19 records of urine analysis, and their interpretation, dates back to the 1906 (1). All of them were done in the Hamidiye Etfal Hospital, founded in 1899 (Figure 1) (2) This is the first hospital built for the care of children during the Ottoman Empire period.
The Brief History of Hamidiye Etfal Hospital
The daughter of Abdulhamid Khan II, Hatice Sultan, was struggling with diphtheria, and the Palace physicians’ could not diagnose the disease. While the situation of her was getting worse, Dr. İbrahim Bey, a talented physician awarded as “Major” because of the mastery and skills in medicine, just returned from Germany, had been invited to palace. He examined the Hatice Sultan who was at the point of death, and diagnosed her as “eklampsia”. Upon the order of the Sultan to him ‘tell the truth’, he said that there was no hope for her, and the lady sultan died after that day.
Abdulhamid Khan II strongly influenced by her daughter’s death, and said that “My child did not survive. Who knows how the poor children have been taken care of in other places. Let’s built a hospital, thus, at least many fathers would not have burning heart, like me”. He invites Dr. Ibrahim Bey to the palace and wanted to make a charity in memory of her daughter. At that time, a mosque, school or fountain was preferred for this purpose. While the Sultan was thinking to build a mosque, Dr. İbrahim Bey said that a ‘Children’s Hospital’ in the name of Hatice Sultan would bring greater benefits. Since there was no hospital for children in the Ottoman State, Hatice Sultan would be remembered with goodness until the Day of Judgment because of the cured poor children in that hospital. Abdulhamid Khan II said to think about it, and then made his decision at that night. The next day, he invited him to the Palace, and said that there was a plot in Şişli for children’s hospital, just see the place, if appropriate, immediately start to construction… (2)
Only three of 19 urinalysis in that archives mentioned above, were 24-hour urines, while the others were spot urine samples (1). These analysis had been made in Hamidiye Etfal Hospital Chemistry Laboratory by manual methods in Istanbul. Almost all parameters had been done in each sample. Although most of the patient names did not appear on the records, only the names of elite ones and the chief physician had been written in some documents. We could not find neither a prescribed treatment nor a medical advice regarding to these analyses, except one (Figure 2).
Of the 19 urine analyzes, five were demonstrating urinary tract infections, while three of them were compatible with pyelonephritis (1). Some examples of urinalysis are as follows (Figures 2, Figure 3, Figure 4);
The presence of polyuria, hyposthenuria, and a lot of leukocytes on microscopy (Figure 4) may suggest that this patient had pyelonephritis.
The report date of other 24 hours urine sample was 16 September 1906, and the physician was Dr Fehmi Rıza bin Muhammed. It has been noted that the amount was 3500 mL. Colour was light yellow, appearance was cloudy, smell was specific, reaction was alcaline, density was 1005, together with a little aggragate including pus. Urea: 10.68 g/L, phosphoric acid: 2.62 g/L, NaCl: 9.20 g/L, and trace albumin. On microscopic examination: a lot of leukocytes, a few epitelial cells, a few calcium phosphate crystals.
Although there is no information about the clinical findings, and no comment about this analysis, evaluation of above data may suggest the pyelonephritis.
It should be appreciated that, all urinalysis mentioned above made by manual methods in 1906. Sultan Abdülhamid Khan II founded Hamidiye Etfal Hospital in memory of her little daughter, died from diphteria. It is the first hospital built for the care of children at that time. It shows that the Khan followed new developments in medicine and wanted to bring them to his country.
- The record numbers of urinalysis documents in The Ottoman Archives of The Prime Minister’s Office: Y.PRK.KOM,11-13 (1-3),Y.PRK.KOM,15-13,Y.PRK.SGE,9-105,Y.PRK.SGE,10-65 (1-3),Y.PRK.SH,7-033 (1-7),Y.PRK.SH,7-33 (45, 46, 50, 51).
- Turgut S, Yıldırım N (2010) Hamidiye Etfal Hastahanesi (Book). Ajans Es, Istanbul. http://www.sislietfal.gov.tr/Hamidiye_Etfal.pdf Accessed on 29 October 2017