House of Healing

I love Sunday mornings; a time of togetherness, when my family of eight sits around our sofra (circular floor table) and indulges in our plentiful breakfast spread: Turkish white cheese, tomatoes, olives, bread, honey and kaymak, eggs with sucuk – all staples since childhood. But the best accompaniment to the cay and muhabbet (tea and conversations) was the blanketing hum of Osmanli sanat musiki (Ottoman classical music) from our old family desktop, filling the silence in the house with centuries-old ancestral art.

My exploration of music as a source of healing began with research dating back to 9th century CE, showing that, alongside broader advances in health and science, Islamic medical and philosophical writing began to develop theoretical discussions of music’s effects on the body and psyche. Al-Kindi (c. 801–873) was an early figure to connect musical relationships with the human body and humoral medicine. Al-Farabi (c. 870–950) subsequently developed musical theory and explored its psychological effects, while Al-Razi (c. 854–925) discussed the therapeutic use of music, including in relation to melancholy. This intellectual tradition continued through scholars such as Ibn Sina (Avicenna, 980–1037), also known as the “father of early modern medicine” in the 11th century, and Safi al-Din al-Urmawi (d. 1294) in the 13th century, whose work helped systematise musical theory.

By the 13th century, these wider Islamic medical and musical traditions were being incorporated into medical institutions established by the Anatolian Seljuks. The darüşşifa [daa-roosh-shifaa], literally “house of healing”, were hospitals, and led to the establishment of famous institutions such as the Gevher Nesibe Darüşşifa in Kayseri, dating to 1205–1206, and the Divriği Darüşşifa, established in 1228–1229, pioneering organised medical care.

The practice became documented in considerably greater detail during the Ottoman period, particularly at the Sultan Bayezid II Darüşşifa in Edirne, established in 1488. It was described as music within the institution’s therapeutic environment in which architecture and sensory experience were imperative to treatment. Courtyards featured a central water fountain or pool (şadırvan), and the sound of running water, fresh cool air circulating, and regular live music in the courtyard's open, arched halls (iwans) were intentionally used to soothe anxiety and treat patients. Healing was not imagined as something confined to a physician, a diagnosis or a single physical symptom. The hospital environment itself was a part of treatment: the movement of water, the circulation of air, the architecture of the space and, eventually, the music heard within it building a space designed to restore the person.

At the centre of this medical-musical tradition was makam. Often translated simply as “musical mode”, a makam is significantly more complex: it is a melodic system characterised by particular pitches, intervals, melodic movements, and patterns of progression. Ottoman music theorists attributed distinct emotional and physiological effects to different makams, creating a detailed theoretical framework to understand how music could affect a person’s state.

Makam can be split into different categories, with different treatment suggestions:

Firstly, you have the Psychological and Emotional Regulation. Muslim physicians believed that music acted as a bridge between the body and soul, using specific modes to rebalance the mind with different makams evoking different emotions.

Rast Makam brought happiness, comfort, and tranquillity, and was commonly used to treat depression, clear the mind, and foster a sense of stability. Hüseyni Makam induced calm, ease, and serenity and was frequently used in darüşşifas to soothe highly anxious or aggressive psychiatric patients. Uşşak Makam was meant to evoke laughter, joy, and lightness and was heavily prescribed for melancholia, deep grief, and severe boredom. Saba Makam instilled courage, physical strength, and vitality and was played to motivate patients who had grown lethargic or despondent during a long illness. Buselik Makam boosted strength and inner power and helped dispel negative thoughts, while the Küçek Makam purposefully evoked sadness and emotional release, used therapeutically for patients who were emotionally repressed and needed to cry to achieve catharsis.

Then there were the Physical and Clinical Prescriptions. People have different natures, and these hospitals took this into account by first diagnosing which makam might be most suited to the patient. Different makams were mapped out depending on the patients fitrat (personality). They weren't necessarily claiming that music magically cured a broken body, but rather, they understood the person as an interconnected whole, in which emotional and bodily states could influence one another. 

Ottoman physicians considered certain physical illnesses to be likely rooted in something psychological, such as stress, or any other ailment of the mind and soul, exploring the relationship between the emotional, spiritual and physical dimensions of a person. With modern science stating that even stress can trigger cancer, the purpose of makam was to alleviate the mind for the body to heal itself, using music to soothe agitation, melancholy or distress, and contribute to the broader restoration of the individual. 

Within this system, Rehavi Makam was prescribed for headaches, nosebleeds, and facial paralysis, believed to aid in nervous system disorders, and Isfahan Makam was used to clear the mind and protect against colds/fevers. Irak Makam was famously prescribed by Gevrekzade Hasan Efendi to treat childhood meningitis and soothe pediatric agitation, and Zirefkend Makam was recommended for stroke recovery, joint pain, and severe backaches. Neva Makam alleviated hip pain and spinal tension and was also noted to stimulate courage and vitality.

Darussifa physicians also believed that the human body's receptivity to music shifted with the sun's movement. Playing a makam at the wrong time could disrupt a patient's sleep or digestion, and thus was also categorised. For example, Zirgüle makam was strictly played at bedtime as it was highly effective at inducing deep sleep and curing insomnia. And then there were the instruments through which these makams were performed: the ney, oud, kanun, rebab, and tanbur each possessed distinctive timbres and roles within Ottoman musical practice. These instruments elicited peace and tranquillity in the soul, and were made entirely from natural materials.

 Sometimes I fantasise about traveling back in time and experiencing the serenity and peace, the genuine love for scholarship and societal progress, which the remnants of these historical accounts make me nostalgic for a life I never had. I have found myself deliberately moving in the opposite direction of the capitalist hustle, towards ascetic music that calms and rejuvenates the body, both physical and mental. The serene energy of Turk Osmanli Sanat Musiki, to me, feels like a saving grace for the pace I am expected to maintain, nurturing something within my soul that Western medicine has yet to explore. I believe that music reaches parts of us that conscious language sometimes cannot; and in this world, which is increasingly designed to keep us stimulated, distracted and moving, there is something deeply compelling about an older musical tradition built around the idea that healing might sometimes begin by slowing down and hearing the Earth take a deep breath along with you.