Akil Muhtar Özden

Akil Muhtar Özden (1877–1949), was a Turkish physician known for being the pioneer of experimental pharmacology in Turkey. He was educated at the Medical School of Geneva, whereupon graduation worked at the Pasteur Institute in Paris and prepared a doctoral thesis on ‘‘Long Lasting Cerebrospinal Meningitis’. He carried out research on ‘chloralose’ and 'opium alkaloids’. In 1909, he was appointed to the Civil Medical School of Istanbul as a lecturer and embarked on a long career of medical teaching until his retirement in 1943. After his retirement, Özden continued working in the medical field and had a short stint as a senator in the parliament.

Biography Early life and education Akil Muhtar Özden was born in Cağaloğlu, Istanbul on 1 October 1877. His father, Mehmet Muhtar Efendi, was among the founders of the Turkish Medical Academy. He followed in the footsteps of his two elder brothers and entered the Military High School of Medicine after completing his secondary education. Upon receiving his graduation certificate from the Military High school of Medicine, he attended the Military College of Medicine (Mekteb-i Tıbbiye-i Askeriye) in Demirkapı for one year. In those years, the Military College of Medicine was known for harboring an environment that opposed the oppressive government of Sultan Abdulhamit and was a place of assembly for those who supported the idea of a national parliament. Due to the brewing political turmoil, having a good education was getting difficult for students due to insufficient education and research opportunities. During this process, Özden decided to flee to Switzerland in October 1896 and began his education at the Geneva Faculty of Medicine.

Akil Muhtar frequently traveled to France to take lectures from renowned medicine professors in Parisian hospitals such as Georges-Fernand Widal, Anatole Chauffard, and Joseph Jules Dejerine. He finished his medical education in 1902, went to the Pasteur Institute in Paris for a year, and then returned to Geneva in 1903. He worked as an assistant intern for half a year next to Louis Bard, a professor of internal medicine. He then earned the title of doctor of medicine by presenting his thesis titled “Contribution á l'étude de la Méningite Cérébrospinale á Forme Prolongée” which translates into “Contribution to Examinations in Long-lasting Cerebrospinal Meningitis”. Afterward, Akil Muhtar became a polyclinic assistant next to Prof. Dr. Mayor and served as an honorary assistant next to Prof. Dr. Cristiani. He became associate professor of Pharmacodynamics Privat in 1906 and taught practical pharmacology and medical curriculum courses between 1907 and 1908. Meanwhile, he published his studies on chloralose and opium alkaloids.

When Sultan Abdülhamit was deposed in 1909, he returned to his country. In 1914, when Tevfik Vacit Pasha was dismissed from the Haydarpasa Faculty of Medicine staff, Akil Muhtar was appointed to the post as the professor. In 1916, he was elected to replace Nuri Pasha and became the dean of the faculty.

The years between 1916 and 1921 were the most critical and dark periods for the faculty. Almost all of the assistants and professors were drafted into the military. During his deanship, he tried not to disrupt the education of his students and the treatment of patients. Amidst the occupation of Istanbul by the Allied forces, the Faculty of Medicine implemented a successful policy to prevent them from closing.

Muhtar reflex In 1909, Akil Muhtar conducted animal experiments to search for the local anesthetic effects of opium alkaloids; and during his research, he found a method for measuring the effects of local anesthetics, which later was called by his name: The Muhtar reflex. He had observed that when touched by a needle, the superficial muscles under and around the skin at the stimulated site contracted and that a general backward pull was noticed. When a diluted local anesthetic like cocaine or procaine was injected at the site, no contraction occurred due to the anesthetic effect of the drugs. When the anesthetic effect was weakened and lost by time, contraction upon stimulation occurred again. The time interval between the loss and the recurrence of the reflex pointed to the activity period of the anesthetic drug. Thus he was able to determine the activity periods and the relative strengths of various local anesthetics by this method. For this innovation, he was endowed with the Turkish Scientific and Technical Research Organization's Award in 1973.

Determination of liver insufficiency with santonin To measure the detoxifying function of the liver, Özden created an experiment, using a colorimeter that he designed. Santonin is an alkaloid substance obtained from the plant artemisia cina and is not absorbed from the intestines because it does not dissolve in water, but is absorbed after it becomes soluble in a very small amount of alkaline environment. Absorbed santonin is rapidly converted into oxy-santonin in the liver, and oxysantonin stains the urine yellow. The color of urine dyed yellow changes to red with the help of kalevis. By using the amount of oxy-santonin, which is excreted in the urine and turns red with the help of alkalis, colorimetric measurements are made to measure how much the liver can perform its detoxification function. Akil Muhtar showed with these studies that the amount of oxy-santonin excreted is different in liver patients and healthy people. He published his findings in 1933. The method was used widely in France and Germany and was accepted as one of the best liver function tests until 1955.