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Osmanlı döneminde isim yapmış ve hastaların şifa bulmak için akın akın kapısına gittikleri cerrahlar vardı. 17. yüzyılın en meşhur cerrahları Üsküdar 'da oturan Gazi oğlu Deniz ve eşi Saliha Hatun 'du. Mora , Tırhala , Tırnova , İnegöl , Trabzon , Erzurum , Sakız , Arapgir gibi imparatorluğun çok faklı yerlerinden hastalar, şifa bulmak için Üsküdar'a gelip ameliyat olmuşlardı. Kardiyoloji uzmanı Dr. Ekrem Karakaya'nın Konya 'da görev yaptığı hastanede uğradığı silahlı saldırı sonucu hayatını kaybetmesinin ardından doktor-hasta ilişkisinin Osmanlı döneminde nasıl olduğuyla ilgili "Eskiden cerrahların kapısında sırar girerdik şimdi öldürüyoruz" başlığıyla bir yazı kaleme alan Tarihçi-Yazar Erhan Afyoncu, 'ölürsem doktorumdan hesap sormayın' şeklinde beyanların yer aldığını örneklerle anlattı.
İşte Afyoncu'nun bugünkü yazısı;
Son zamanlarda sağlık çalışanlarının bilhassa doktorların çalışma şartlarını ve haklarını ihtiva eden yasal düzenlemeler gerçekleştiriliyor. Bu düzenlemelerin biri de teşhis ve tedavi süresince olan doktor kaynaklı hataların tazmini ve cezası hususunu oluşturan 'malpraktis' davaları. Geçmişte de hekim-hasta ilişkileri ve cezai müeyyideler hemen her medeniyette var olan birtakım kurallara bağlanmıştı. Bizim tarihimizde tedavi sonuçlarından dolayı hasta yakınlarından zarar görmek ya da ceza almak istemeyen cerrahların hastalarıyla yaptığı rıza senetleri vardır. Osmanlı dönemi mahkeme kayıtlarında ayak kesilmesi, mesanedeki taşın aldırılması, fıtık ameliyatı, vücuttaki bir urun alınması gibi cerrahi operasyonlar için cerrahla hasta veya hasta yakını arasında ameliyata izin verilmesi ve ödenecek ücretle ilgili yapılmış birçok antlaşmanın belgesi vardır. Bu konuyla ilgili Halil Sahillioğlu , Fethi Gedikli , Osman Çetin , Mustafa Akkaya ile Coşkun Yılmaz-Necdet Yılmaz'ın araştırmaları vardır.
Hasta arabası AMELİYAT RIZA SENEDİ Yapılan anlaşmaların hukuki bir bağlayıcılığı olması açısından mahkeme huzurunda gerçekleştirilen bu anlaşmalara Osmanlı mahkeme kayıtlarının kaydedildiği kadı sicillerinde sıkça rastlanmaktadır. Ancak hastanın bu muhtemel sonuçları kabul etiğini gösteren rızanın da sınırsız olmadığı bilinmelidir. Zira ceza alınmaması için gereken hususlar bu rıza mukavelelerinde belirtiliyordu. Buna göre hekimin hem ameliyatta hem tedavide hem de ilaç kullanırken "cerrahlar arasında mutad olan" yani erbabı tarafından bilinen profesyonel tedavi yöntemi uygulamalıydı.
Rahmetli Halil Sahillioğlu hocamızın yayınladığı bir rıza senedinin günümüz Türkçesiyle şu şekildedir: "İstanbul mahallerinden Atmeydanı mahallesinde sakin olan sipahi zümresinden Abdülmennan oğlu Mustafa Bey mahkemede, Üsküdar 'da Yenimahalle sakinlerinden cerrahlık ilminde üstatlığı olan Küpeli kızı Saliha Hatun adında Kıpti kadın huzurunda kendi rızasıyla şöyle bildirdi: Ben fıtık hastalığından rahatsızım ve tedaviye ihtiyacım vardır. Güvenilir kimselerden olan Saliha Hatun'un tedavisiyle bazı kimselerin bu hastalıktan tedavi olup kurtulduğunu duydum. Üstatlığı aşikâr olduğundan hastalığın tedavisi için 1.200 akçe ile Saliha Hatun ile anlaştım. 1.200 akçeyi peşin ödeyerek Saliha Hatun'a teslim ettim. O dahi alıp kabul etti. Saliha Hatun'un tedavisi sonrası iyileşemezsem ve Allah'ın emriyle ölürsem mirasçılarım veya başkaları kan ve diyet davası açmasınlar. Açarlar da hakimler nezdinde davaları kabul olmasın.
Mezkûr Mustafa Bey'den açıklandığı üzere ifadesini Saliha Hatun'da yüz yüze onaylayınca istekleri üzerine kaydedildi. 2 Eylül 1622". Bu rıza senetlerinde yukarıda da görüldüğü üzere genelde hasta ve doktorun "sicil bilgisi" diyebileceğimiz bilgilerinin verildiği ilk kısımdan sonra hekimin ilminin ve maharetini öne çıkaran ifadeler ve hastalığın ne olduğu ve ücret yazılır, akabinde ise rıza senedi diyebileceğimiz anlaşma bölümüne gelinirdi. Burada hasta iyileşemezse ve herhangi bir sebepten vefat ederse yakınlarının ve başkalarının bu ameliyat sebebiyle hekimden herhangi bir şey talep etmemesini hakim karşısında kendi ifadeleriyle kayıtlara geçiriyordu.
Bir hekim hastasını tedavi ediyor.
CERRAH AİLESİ 17. yüzyılda Üsküdar 'da Yeni (Mamure) Mahalle, fıtık cerrahlarıyla ön plana çıkmıştı. Asrın başlarında cerrahların en tanınmışı Gazi oğlu Deniz'di. Özellikle fıtık ameliyatlarıyla tanınmıştı. İmparatorluğun her tarafından gelen hastaları vardı. Bu fıtık ameliyatlarının türü yazılmasa da, başka bölgelere ait bazı sicillerde kasık fıtığı ameliyatı zikredilmiştir.
Cerrah Deniz 1620 sonbaharında öldü. Bayram ve Mehmed isimli iki oğlu vardı. Eşi Küpeli kızı Saliha, Hristiyan bir kıpti idi. Cerrah Deniz'den sonra Saliha Hatun ön plana çıktı. Muhtemelen ölmeden önce kocasıyla birlikte ameliyatlara giriyordu. Daha sonraki yıllarda oğulları Mehmed de tanınmış bir cerrah olacaktı.
Hekim
CERRAHE SALİHA HATUN Kocasının ölümünden sonra Saliha Hatun yaptığı fıtık ameliyatlarıyla imparatorlukta meşhur oldu. Bu yüzden cerrahenin İstanbul'un her semtinden hastaları olduğu gibi Tırhala 'dan Arapgir 'e kadar imparatorluğun dört bir köşesinden de ameliyat olmak için gelen yüzlerce hastası vardı. Saliha Hatun'un her taraftan birçok hastası vardı. Hastalarının, İstanbul Fatih (At Meydanı, Tokludede, Debbağ Yunus, Unkapanı), Galata, Üsküdar (Bulgurlu, Hasan Ağa), Rumeli (Tırhala, Florya, Tırnova , Yenişehir, Draboliçe-Mora ), Bursa (İnegöl ), Trabzon , Erzurum , Sakız , Arapkir gibi imparatorluğun muhtelif yerlerinden olduğu görülür. Gelen hastalarda erkek-kadın, müslim-gayrimüslim gibi bir ayrım da söz konusu değildir. Şifa bulmak isteyen herkes Saliha Hatun'a koşmuştu.
Saliha Hatun'un gerçekleştirdiği tespit edilen operasyonlar arasında en yaygın olanı fıtık ameliyatıdır. Saliha Hatun'un bu ameliyatlarının ücretleri 400 ile 3.000 akçe arasında değişmekteydi. Aradaki farklar hastalığın seyri ve ameliyatın zorluğuyla ilgili olabileceği gibi muhtemelen hastanın mali durumu da etkiliydi. Saliha Hatun'un gerçekleştirdiği bir diğer ameliyat ise ur ameliyatı idi. Unkapanı'ndan gelen Lika'nın başının sol tarafındaki uru almak için 300 akçe ücret almıştı.
Saliha Hatun'un girdiği ameliyatlar şüphesiz bunlarla sınırlı değildi. Zira kayıtlara yansıyan ameliyatlar rıza senetleri olan ameliyatlardır. Dolayısıyla yüzlerce ameliyat yapmış olmalıdır.
Ameliyat belgeleri
ÖLÜRSEM DOKTORUMDAN HESAP SORMAYIN Üsküdar 'a bağlı Bulgurlu köyünde oturan Abdullah oğlu Mahmud Efendi isimli kişinin mahkememize gelerek cerrahlık ilminde usta ve akranları arasında seçkin bir cerrah olan olan Küpeli kızı Saliha Hatun 'un huzurunda, "Hâlen ben fıtık hastalığından dolayı rahatsızım. Tedaviye acil olarak muhtacım. Tedavim için Saliha Hatun'a peşin olarak 600 akçe verdim. Eğer Cerrahe Saliha Hatun'un operasyonu sırasında şifa bulamayıp Allah'ın emriyle ölürsem, varislerimden ve dışardan herhangi bir kişi Saliha Hatun'u dava ederse hakimler nezdinde kabul edilmeye" dediği sicile kaydolundu. 3 Ağustos 1623.
Şahitler: Abdüllatif oğlu Ahmed Çelebi; Halil oğlu Abdüllatif Halil; Resul oğlu Mehmed
Anadolu'da Erzurum 'da oturan Mehmed oğlu Murad isimli kişi mahkememize gelip cerrahlık ilminde usta ve akranları arasında seçkin bir cerrah olan Cerrahe Küpeli kızı Saliha Hatun'un huzurunda, "Hâlen ben fıtıktan dolayı rahatsızım. Tedavi olmak istiyorum. Hastalığımı tedavi etmek için Saliha Hatun'la 3 bin akçe karşılığında anlaştım. Cerraheye tedavi ücretimin 600 yüz akçesini peşin olarak verdim. Kalan 2.400 akçe borcumdur. Vermeyi taahhüt ediyorum. Eğer ameliyatım sırasında iyileşemeyip Allah'ın emriyle ölürsem, varislerimden ve dışardan herhangi bir kişi Saliha Hatun'u dava ederse hakimler nezdinde kabul edilmeye" dedi. Saliha Hatun da söylenileni tasdik etti. 28 Ekim 1623.
Şahitler: Seyyid Halil oğlu Seyyid Ahmed Çelebi; Seyyid Abdullah oğlu Seyyid Halil; Mustafa oğlu Mehmed Beşe; Abdülkerim oğlu İsmail; Abdullah oğlu Yusuf; Mahmud oğlu Hasan; Ali oğlu Davud. Ruhban sınıfından Luiz oğlu Yuvan mahkemeye gelerek karşısında Cerrah Yani oğlu İstati bulunduğu halde hür iradesiyle; "Ben fıtık hastalığına müptelayım. Adı geçen Cerrah İstati, bu hastalığın iyileştirilmesinde mahir olduğundan tedavi için kendisini belirli bir süre dahilinde 600 akçe ücret ile onun da rızasıyla kiraladım. Âdet üzere kasığımı yarıp fıtık olan bölgeyi keserek tedavi etmesi için kendisine emrettim. Şayet ben bu ameliyatım nedeniyle ölürsem diyetimden onun sorumlu olmayacağını, bu bakımdan söz konusu davalarda kendisinin zimmetini kesin olarak ibra ettiğimi beyan ederim" dediğinde talep üzerine şer'î olarak tasdik edildi. 7 Mayıs 1663.
Şahitler: Recep oğlu Mustafa; Recep oğlu Musa; Abdullah oğlu Hüseyin; Abdullah oğlu Siyavuş.
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