AHLAT KAZASINDA FRENGİ (XIX. YY. SONU-XX. YY. BAŞI)

Salgın hastalıklar, devletleri siyasi, askeri, sosyal ve ekonomik yönden etkileyen en önemli faktörlerden biri olmuştur. Osmanlı Devleti'ni özellikle 19. yüzyılda derinden etkileyen ve devleti sağlık konusunda uğraştıran en önemli hadise, frengi hastalığının salgın şeklinde yayılmasıdır. Frengi, masum ve masum olmayan yollarla Anadolu topraklarının neredeyse tamamında, Ortadoğu, Rumeli ve Balkanlar'da çok geniş bir alanda etkisini göstermiştir. Salgın halinde yayılan hastalık; çocuk, yaşlı, erkek, kadın, şehirli, köylü, mahkûm, esnaf, halk ve askerler arasında görülmüştür. Frengi aynı dönemde ya da farklı dönemlerde olmak üzere sadece belirli bir vilayeti, birden fazla vilayeti, vilayetlerin sadece belirli kazalarını veyahut kazanın bir bölümünü etkisi altına almıştır. Devlet dönemin zor şartları altında frengiyle etkin bir şekilde mücadele etmek ve frenginin yayılmasını önlemek için bir takım tedbirlere başvurmuştur. Devlet ilk etapta frenginin yoğun olarak görüldüğü yerlere uzman tabip göndermiş ve hastane açmıştır. Hastane açılması mümkün olmayan yerlere ise seyyar ekipler ve seyyar hastaneler göndermiştir. Ayrıca çıkarılan nizamname ve talimatnameler ile hastalık kontrol altına alınmaya çalışılmıştır. Frengi salgının görüldüğü yerlerden biride Bitlis Vilayetine bağlı Ahlat Kazasıdır. Ahlat'ta frengi, özellikle 19. yüzyılın sonu ve 20. yüzyılın başında oldukça etkili olmuştur. Bu dönemde frenginin tedavisi ve yayılmasının önlenmesi için gerek merkezi gerekse ve yerel yöneticiler tarafından müdahale edilmiştir. Ancak devletin Ahlat'ta almış olduğu tedbirler işe yaramamış ve imkansızlıklar nedeniyle hastalığın yayılması önlenememiştir

SYPHILIS IN AHLAT DISTRICT (LATE 19TH - EARLY 20TH CENTURY)

Epidemic diseases have been one of the most important factors affecting states in political, military, social and economic aspects. The most important incident that deeply affected the Ottoman State in the 19th century and engaged the state in health was the spread of syphilis in the form of an epidemic. Syphilis, through innocent and non-innocent ways, took effect far and wide in almost all parts of the Anatolian lands, and the Middle East, Rumelia and the Balkans. The disease, which was spread in an epidemic form was common among children, elderly, men, women, city-dwellers, peasants, prisoners, tradesmen, public and soldiers. Syphilis exercised influenced over a specific province, multiple provinces, only certain districts of provinces or a specific part of a district in the same period or at different times. The state resorted to a number of measures in order to effectively fight against and prevent the spread of syphilis under the difficult conditions of the time. In the first stage, the state sent specialist doctors to and opened hospitals in places where syphilis was seen in a widespread manner. Mobile teams and mobile hospitals were deployed where it was not possible to open hospitals. Additionally, attempts were made to control the disease through the regulations and instructions issued. One of the places where the syphilis epidemic was seen, was the Ahlat District of Bitlis Province. Syphilis was particularly influential in Ahlat in the late 19th and early 20th centuries. In this period, not only central but also local administrators stepped into find a cure for and prevent the spread of syphilis. However, the measures taken by the state in Ahlat did not serve the purpose, the spread of the disease could not be prevented due to the impossibilities Epidemic diseases have been one of the most important factors affecting states in political, military, social and economic aspects. It was in 19th century that epidemics were common in Ottoman Empire. The soldiers who were sent to the front during wars and the movements of the emigration experienced as a result of wars that were lost were the main reasons for diseases to spread. Traders, pilgrims, famine, hunger, nutrition, housing problems, cleanliness and adverse economic conditions are other factors that increase the impact of epidemics. The most important incident that engaged the Ottoman State in health issues in the 19th century was the spread of syphilis in the form of an epidemic. Syphilis, through innocent and non-innocent ways, took effect far and wide in Ottoman lands. Syphilis had a widespread effect on almost all parts of the Anatolian lands, and on the Middle East, Rumelia and the Balkans to a wide extent. It is observed that at the end of the century the disease was effective throughout the state being more intense in provinces such as Kastamonu, Hudavendigar, Erzurum, Van, Bitlis, İzmir, Adana, Istanbul, Konya, Trabzon, Beirut and Thessaloniki. However, syphilis exercised influenced over a specific province, multiple provinces, only certain districts of provinces or a specific part of a district in the same period or at different times. The disease, which was spread in an epidemic form was common among children, elderly, men, women, city-dwellers, peasants, prisoners, tradesmen, public and soldiers. In this period, the state was busy with significant political, military and economic issues, while it had to struggle with the epidemic of syphilis. Towards the end of the 19th century, it can be said that the state carried out a more systematic and programmed health policy within the scope of the struggle against syphilis. The state, accordingly, resorted to a number of measures in order to effectively fight against and prevent the spread of syphilis under the difficult conditions of the time. The first measure that the state took in the fight against the disease was to train a specialists in syphilis. As a matter of fact, it is understood from the records that there were specialists under the name of "syphilis doctors". However, considering the conditions of the time and the spread of the diseases in a wide area, it can be stated that the above-mentioned doctors were inadequate. On the other hand, the provinces and districts throughout the country were asked to send reports in order to reveal the course of the disease. Additionally, hospitals were opened in places where syphilis was seen in a widespread manner. On the other hand, if the hospital could not be built where the syphilis appeared, it was decided that a part of the regular hospitals be reserved for the treatment of syphilis and venereal diseases. And, mobile teams and mobile hospitals were deployed where it was not possible to open hospitals. In addition to these measures, it was imposed that the women who were working in disorderly houses be screened for the disease through the issued regulations and instructions, that the people were going to get married be screened for syphilis before marriage, that the people who were suspected to have caught the disease be reported, the tradesmen undergo a medical examination, and cleaning and hygiene be paid special attention. It was demanded that syphilis, which was common in various provinces of Anatolia, be interfered in since it was a contagious disease, and the people catching the disease be treated on site. In this direction, it was forbidden for those diagnosed with syphilis in the countryside to be transferred to Istanbul even for therapeutical purposes. It seems that the state attempted to fight the disease according to an order of priority in terms of the place, severity of the disease, military, political, commercial activity and size of the disease-stricken place. In the direction of the health politics that the state addressed with the aim of fighting against and preventing the spread of syphilis, the methods of fighting against syphilis were shaped in Ahlat. Owing to the socioeconomic differences between the urban centers and the rural areas in the battle against syphilis, some difficulties arose. Factors such as the economic structure of the urban centers, transportation, climate, consciousness of the people, hygienic environment and cleanliness facilitated the fight against the disease in city centers or its vicinity. On the other hand, a number of difficulties were encountered in the rural areas in the fight against the disease. Syphilis was particularly influential in Ahlat in the late 19th and early 20th centuries. In this period, not only central but also local administrators stepped in to find a cure for and prevent the spread of syphilis. It was concluded that municipal doctors were put into action but they were inadequate in the treatment and control of the disease and that the disease became more and more common. The fundamental problems encountered in the fight against syphilis in Ahlat were; finding specialists, even so the late coming of the doctors to the district, doctors' wages, failing to identify the patients and failing to take the disease under control. It is seen that two mobilized doctors made examinations in the whole province of Bitlis, and reported on issues such as the extent and spreading course of syphilis, the number of those catching the disease, the necessity of medicine and hospital buildings and that this report was sent to the central government through the province upon an order from the centeral government in 1887. It is understood that syphilis reached a serious dimension in Ahlat in 1890 and the local administrators applied to open a hospital in Ahlat. In 1900, it was reported, bringing to the agenda again, that it was necessary to build a hospital in Ahlat, that the disease spread in Ahlat day by day and that there was a spreading risk for the disease to the nearby districts. The government correspondence about syphilis between the years of 1900 and 1905 taking place between the local administrators and the central government was focused more on sending specialists and the wages of these specialists. As a result, it was seen that the hospital needed in Ahlat could not be opened due to financial impossibilities and that the government resorted to new measures in Ahlat as well as in the country. In places where syphilis was seen and it was necessary to build a hospital yet it could not be built, it was decided that a part of the regular hospitals be reserved for the treatment of syphilis and venereal diseases. The municipalities, which were financially sufficient, covered the wages of the doctors, but the wages of the doctors in districts with financial impossibilities, were covered by the state treasury. However, the measures taken by the government in Ahlat did not serve the purpose, the spread of the disease could not be prevented due to the impossibilities.

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