By Hwaa Irfan
It is not encouraging as the British government continues to push through restructuring of its National Health Service to have official release results of the last 6 months that reveal over 5,000 patients died or were seriously harmed by NHS blunders in the midst of reducing alternative health options for the British public.
What is encouraging is the scope that Turkish doctors are allowed to work with for the benefit of the patient. That scope includes traditional Islamic practices which has used music as a form of therapy, especially mental illnesses since the 9th century – a practice that is based on Arab scales and musical patterns. This idea is not strange if one is familiar with the work of Master ‘oud player Naser Shamma’, whose schools of ‘oud has born witness to remarkable changes in temperament to the most errant child. From the impossible spoilt upper middle class child to the child who develops self respect and respect of all life is the transformation one can witness simply from playing the ‘oud (lute).
In Turkey it is the doctors who play a traditional instrument like the yayli tanbur or a flute, playing the mahur makam to cure depression, the Hicaz makam when dieting or the Segah makam when suffering from sleeping disorders. Reporter C. Letsch observed a doctor at the modern Memorial Hospital in Istanbul pull out a flute after Dr. Bingür Sönmez checks the blood pressure of a Cypriot patient. Sönmez tells Letsch:
“I learned to play the ney flute in order to play the kind of music that was used in traditional music therapy hundreds of years ago, making use of the psychological and physiological effects of the makam.”
“There is a different makam for every illness, every health problem,” Sönmez says. “There are makamlar that agitate, and there are makamlar that relax.”
“The so-called rast makami has a positive effect if a patient suffers from anorexia, whereas the hicaz makami should be played if a patient needs to be kept on a diet.”
He laughs. “A restaurant that plays music in the hicaz mode would probably go out of business after a while, because it keeps customers from eating!”
“We are not doing anything new, and we are not reinventing the wheel,”
“The positive effects of music therapy have been known for well over 900 years.”
“We don’t use music as an alternative to modern medical methods”
“It’s complementary treatment. Without having to prescribe additional drugs, five to 10 minutes of a certain musical piece lowers the heart rate and blood pressure.
Makam means “location/rank” and is a melodic set of notes with traditions and rules that define the tonal relationship between each note, the habitual patterns/phrases, and their melodic development- a technique that is peculiar to Arabic classical music, but is preceded by the Persian dastagh – a classical Iranian musician will spend years mastering the dastagh after which he excels in his own improvisation having learnt the art in his totality. It is a technique of improvisation that is learnt by ear and is based on the classical Arabic scale with the 5th note based on the 3rd harmonic. The tuning of the other notes is determined by the makam, and a particular note differs in pitch depending on the makam.
Muslim scientists and scholars Ar-Razi (854 – 932), El Farabi (870 – 950), and Ibn Sina (980 – 1037) laid the foundation for the principles of music as therapy. However, it was El Farabi who detailed the use of the Turkish makam and its uses as follows:
- Rast makam: makes one feel happy and comfort.
- Rehavi makam: instills the feeling of eternity.
- Kuçek makam: makes one feel sad and anxious.
- Büzürk makam: makes one feel fear.
- Isfahan makam: makes one feel secure, thus able to move into action
- Neva makam: makes one feel pleasure and contentment.
- Uşşak makam: makes one feel like laughing.
- Zirgüle makam: makes one sleep.
- Saba makam: makes one feel brave, power.
- Buselik makam: makes one feel strength.
- Hüseyni makam: makes one feel serene, at ease.
- Hicaz makam: makes one feel humility.
Along with this, there were particular times of the day/night given for the best effect.
Eighteenth century Hekimbaşı Gevrekzade Hasan Efendi who had studied Ibn Sina’s El Kanun fi’t-tıbbi – The Canon of Medicine much used in Europe, outlined the use of makams in childhood diseases as follows:
- Irak Makam: meningitis.
- Isfahan Makam: colds and fevers.
- Zirefkend Makam: fosters a sense of strength.
- Rehavi Makam: headaches, nosebleed, dry mouth, paralysis and phlegmatic diseases.
- Büzürk Makam: cramps, and eliminates fatigue.
- Zirgüle Makam: heart and brain disease, meningitis, heartburn and fevers of the liver.
- Hicaz Makam: diseases of the urinary tract.
- Buselik Makam: pains in the hips and head, and of eye diseases.
- Uşşak Makam: foot pain and insomnia.
- Hüseyni Makam: liver and heart disease, seizures and hidden fevers.
- Neva Makam: puberty, pains of the hips, and brings joy to the heart.
Turkey’s Health Care System
Unlike the British National Health System which is being streamlined along modern allopathic lines, The Turkish health system is complicated, but is coordinated by the Ministry of Health. That includes the supervision of private hospitals, training, and regulation of drugs, including pricing. Employers pay insurance to cover work-related injuries, diseases related to the job, and maternity leave, Employers, and employees pay for illnesses, disabilities, retirement and death benefits.
Hospitals Then and Now
As modern hospitals struggle to cope with seriously overworked staff, treatments that they cannot sustain, practices that lead to increasing fatalities, disabilities, and hospital born superbugs that are resistant to modern antibiotics, as well as wrong diagnosis, they would do well to consider their Islamic origins in terms of a sustainable future.
The first hospital was established during the rule of Al-Walid Ibn-Abdul Malek, 86 AH – 96 AH. It was a hospital that specialized in leprosy. The first quarantine foundation in Europe was in Saint Marie, Venice in the 14th century. Mobile hospitals with the aid of camels carried supplies, medical instruments and medication during the period of Caliph Mahmoud al-Salgouqy, (511 AH – 525AH).
Famous Islamic hospitals include Al- Adudi Hospital (371 AH) in Baghdad, al-Nuri Hospital (549 AH) in Damascus, and al-Mansouri Hospital (683 AH/ 1284 AD) in Cairo. Cordoba during the time of Islamic Spain had 50 hospitals alone. Islamic hospitals were also places of learning equipped with a library that included fiqh (Islamic jurisprudence), and a master teacher who take his students on rounds to instruct, record observations, and prescribe. They did not escape the written exams which were given at the end of each course.
Hospitals were not just physical structures, but were designed with Islamic planning in mind, that included sounds of nature revealed through courtyards with fountains, trees which attract birds, and hence birds that sing, all of which enhanced the process of healing. These important attributes of Islamic hospitals have been noted by Sönmez. In Sönmez’s interview with Letsch he shared:
“Medieval hospitals were built around a courtyard with a fountain. The sound of the water, the colours of glass windows, the intensity of the light, the types of flowers and plants – all of it was part of the complementary treatment of patients,”
“We are thinking of changing the light in the intensive care unit to pink,” he adds with a smile. “Pink light has a soothing effect.”
In the heyday’s of Islamic medicine, before the Mongol invasion destroyed the original hospitals, whatever illness a patient entered the hospital with, they would be put into a ward with patients who had the same illness, preventing cross exposure. In its heyday, the Al-Mansuri/Qalawun Hospital in Cairo, treated 4,000 patients daily using music, storytelling, jokes, religious songs before the morning adhan by the Mu’adhdhinun (pray caller). Tod ay, Al-Mansuri serves as specialist eye hospital.
Turkey is not alone in rekindling the Islamic art of music therapy. On the outskirts of Tehran, Iran, Kahrizak Charity Foundation without financial support serves the physically handicapped of all ages. Every Monday, Sadeq Jafari, a classical musician who uses his music to heal them. One such patient is Shahram Khodaie who was paralyzed in a car crash. As a result of attending Sadeq Jafari sessions, Khodaie managed to move his neck and used a short iron bar in his mouth to play several songs on the piano.
Good healthy music derived from the Laws of the Cosmos, whether consciously or unconsciously has the innate ability to establish harmony within a person. This basic concept underlines school music education today in some parts as an essential part of the school curriculum. This notion serves as a mission for masters like Naser Shamma’ who sees the music of the ‘oud as an important tool as healing and building a society. When the mind is healed, balance between the mind, body and soul is re-established as a process of moving towards one’s higher self instead of falling victim to one’s lower self. For each cell has its resonance, and in turn each tissue, organ, and part of the body, hence why music with set rhythms and patterns without melody do more harm than good to the body as a whole.
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Letsch, C. “Turkish Doctors Call the Tune with Traditional Musical Cures.” http://www.guardian.co.uk/world/2011/aug/28/turkish-doctors-traditional-music-therapy
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