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Journal of Contemporary Urban Affairs
2017, Volume 1, Number 1, pages 10– 23
The influence of Mediterranean modernist

movement of architecture in Lefkoşa:
The first and early second half of 20th century
Ph.D. Candidate Salar Salah Muhy Al-Din *
Department of Architecture, Faculty of Engineering, Bharati Vydiapeeth University, Pune, Maharashtra- India
E mail: salars.muhyaldin@yahoo.com
A R T I C L E I N F O: ABSTRACT
Article history: The twentieth century modern architectures in Lefkosia in North Cyprus are
Received 20 October 2016 changing especially in residential building. This change is occurs based on the
Received in revised form 5 client’s orders or because of the dilapidated condition of the buildings.
December 2016 Identify the characteristics of modernist architectural movement will help in
Accepted 25 December 2016
identifying these buildings and recognize the changes applied on them. The
Available online 2 January
2017 paper aims to reach the rationale understanding about the norms of modern
Keywords: architecture in Lefkoşa in the twentieth century. The methodology is based
Modern Architecture; on analyzing the residential buildings designed by local architects and
Mediterranean “Ahmet Vural Bahaeddin” selected as one of the famous modernist architect
modernist architect; in the twentieth century in North Cyprus. Residential buildings from Milan and
Vernacular Rome in Italy, as well as Baecelina in Spain selected for analysis. The paper
architecture; tries to demonstrate the presence of vernacular elements in modern
Cyprus. architecture in Lefkoşa. Two vernacular elements were studied, i) the patio
(outside and inside interrelation), and ii) the façade materials (exposed stone)
as vernacular elements in “Mediterranean modernist architecture”. The paper
This work is licensed under a
Creative Commons Attribution -
delineated the influence of the “Mediterranean modernist movement” on
NonCommercial - NoDerivs 4.0. modern architecture in Lefkoşa in the 20th century. The findings show that there
"CC-BY-NC-ND" is influence by Modernist movement of architecture in other Mediterranean
cities in Italy and Espain on the modern architecture in Lefkoşa. The results
contribute evidence to promote our understanding regarding the modernist
architecture in Lefkoşa.
JOURNAL OF CONTEMPORARY URBAN AFFAIRS (2017) 1(1), 10-23.
https://doi.org/10.25034/1761.1(1)10-23
www.ijcua.com
Copyright © 2017 Journal of Contemporary Urban Affairs. All rights reserved.
differences in opinions that had developed

1. Introduction during the 1920s between the architects of the
“Mediterranean Modernism movement” in North and the South of Europe toward the role
architecture was one of the dialects between of technology and tradition continued to define
the presumed universalism of modernist postwar production. “Mediterranean modernist
architecture and the privacies of distinct places. movement” in architecture came out as
It considered the vernacular building traditions modernist architectural philosophy in south of
of the Mediterranean region as a source for Europe. Vernacular architecture started to be
modernism in architecture in this region. This
notion crystallized after the discourses between *Corresponding Author:
north and south of Europe about the modernism Department of Architecture, Faculty of Engineering, Bharati
Vydiapeeth University, Pune, Maharashtra, India
in architecture in the beginning of the last
E-mail address: salars.muhyaldin@yahoo.com
century (Lejeune, and Sabatino, 2010). The
JOURNAL OF CONTEMPORARY URBAN AFFAIRS, 1(1), 10-23 / 2017
discussed as a source of modernism in the new movement became international after

“Mediterranean modernism philosophy”. For World War I, where consist the development of
example James Stirling’s mentioned in his essay simple geometric figures and simple facades
on Regionalism and Modern Architecture (1957) free from ornaments released from any historical
that: “The most visually stimulating chapters of references. Buildings were to be “machines for
Kidder Smith’s recent book Italy Builds were not living,” reflecting the industrial revolution age
those on Italian Modern and Italian (Le Corbusier, 1931). Consequently, Modernist
Renaissance, but that on the anonymous movement in architecture had been crystallized
architecture of Italy”(Sabatino, 2010). as real movement. The best known of this
Hence, Vernacular elements considered as the movement were, between many, Walter
primary sources of modern architecture in the Gropius, Le Corbusier in France, and Mies Van
southern Mediterranean. The influence of this der Rohe in Germany. Gropius was the founders
philosophy could be observed in modern of the ‘Bauhaus’ (1919-1933) were established in
residential buildings in the first and early second Dessau focused on philosophy of modernism in
half of 20th century in Lefkoşa, in North Cyprus. architecture (Magdalena, 2002).
The designs have been held some vernacular Gropius in ‘Bauhaus’ wanted to show a new
elements in the modern buildings specially the consideration for technique and craft in all
stone facades and in the interrelation between artistic world, and asked for re-assessment for art
inside and outside of the buildings (Patio). The and craft characteristic of the medieval age,
paper tries to answer following questions; before art and manufacturing had diverted
whether or not the Cypriot modernist away. The Bauhaus was considering
architecture was influenced by “Mediterranean rationalization in design as well (Evans, and
modernism philosophy” in first half of 20th Jeffery, 2005). After World War II, this movement
century? Whether or not, other external factors became more present in plain facade of high
affected the modernism in the architectural rise buildings with curtain walls in large houses.
design of residential buildings in that period?
The paper aims to define the character of 2.1.1. General characteristic of Modernism in
modern architecture houses between first and Architecture
second half of 20th century in Lefkoşa. The study Le Corbusier, one of Modern Architecture’s
tries to demonstrate the similarity between pioneers in 1926 pointed his five points for new
Ahmet Vural Bahaedden’s design as North Architecture. One of the points was "free plan”,
Cypriot pioneer in modern architecture and which focus on continuity, transparency of
other Italian and Spanish design in the same place. This point is one of the important points
periods. The paper hypothesize that if the for theory of Modern Architecture. He pointed
“Mediterranean modernism” were influencing "free façade" as complementary to free plan
the architectural style in Lefkoşa after the first and took in consideration interaction between
half of 20th century, then the introduction of interior and exterior, and their relation to nature
vernacular elements in the residential buildings as well. Those two points were very crucial in
designed by ‘Ahmet Vural Bahaeddin’ is new idea of architecture. The other three points
partially or totally result of that influence. of new architecture, which Le Corbusier
described, were: the "pilotis" which means the
2. Literature review columns in French language, where allowing
2.1. Modernist movement of Architecture the garden to creep under the building and "the
With the end of nineteenth century and the horizontal window “and "the roof garden"
beginning of twentieth century, because of (Benton, 2007).
Modern Movement in the societies of west
Europe, architects started to leave past styles
and began to work on a new form of
architecture (Evans and Jeffery, 2005).
Modernism in architecture focuses on Sullivan’s
saying that “form follows function”, based on
functional concerns. In this study the modern
movements of architecture will be delineated to
the first half of twentieth century. The first
decade or so after the ‘World War I’ was a
crucial and innovative time for architecture. The
Salar Salah Muhy Al-Din 11

above the windows and louvers for human

thermal comfort is another character for
modern architecture (Jones, 2011).
The characteristic of Modernist architecture
depend on the time periods of the design,
where some time emphasizes on some elements
more than others. Another factor is the location
and climatic zones, where the advantages of
climatic characteristics affect the design.
2.2. Mediterranean area

According to Gravagnuolo, B. (2010) “When we
say Mediterranean we mean above all the solar
stupor that generates the panic stricken myth
Figure 1. The five points of Le Corbusier and the metaphysical immobility.”
(Monteaguda, 2013). Mediterranean word has come from the Latin
meaning "in the middle of the land" (Medius,
refers to "middle" and terra, refers to "land"). It is
Generally Modern Architecture is characterized
an almost close sea between the European,
by some recognized elements as; refuse the
African and Asian continents as shown in the
past traditional and historical styles as a source
figure ‘2’. The total area of Mediterranean area
for the architectural forms. Modern architecture
estimated by 2.5 million km2, it is connected to
is characterized by lack of ornament unless
the Atlantic with only 14 km wide through ‘Strait
shows the functionality in the building. It focuses
of Gibraltar- Narrow’ (Calcerano, and Cecchini,
on the rectangular forms and horizontal and
2014).
vertical lines. A Simple and smooth form in the
design eliminates the excessive detail. Shapes of
the buildings based on boxes, or connected
boxes (Jones, 2011). Usage the modern
materials, such as steel columns, and new
masonry unites, by new construction systems,
and emphasizing on exposed structural
elements, such as beams and columns, with flat
roofs. Construction of the buildings by using
reinforced concrete or steel structure system.
Later on the facade characterized by plain Figure 1. Mediterranean basin Area (Calcerano
glass ‘curtain walls’ and ‘honor façade’ and Cecchini, 2014).
exposed concrete texture façade with getting
rid of bearing wall in the facades became the Because of the diversity in geography and its
evident of international modernist style. extension on large area, the architecture of
Stonework and bricks are unadorned, and used the Mediterranean has its own impression and
in rectilinear masses and planes (Monteaguda, own character. Several cities known as
2013). The relationship between inside and Mediterranean cities such as; ‘Barcelona’ in
outside of the buildings is one of the important Spain; ‘Aix en Provence’ in France; ‘Rome,
elements in modernist architecture. That Sicily, Palermo’ in Italy, ‘Dubrovnik’ in Croatia,
relation achieves through usage of large ‘Athens and Crete’ in Greece, ‘Istanbul and
expanses of glasses which brings the building’s Antalya’ in Turkey; and ‘Nicosia or Lefkoşa’ in
site into the building, taking advantage of wide Cyprus, etc. The diversity could be imagined
view to surrounded landscape. Consequence, in these cities. Thereby the architectural
large windows from floors to ceilings introducing character of these cities will be diverse
natural light and penetrate it deep into the through their history, culture, socio-politics,
interior space of the buildings. Achievements of tradition and religion in one side and
the maximum efficiency through apply a good topography and microclimatic conditions in
orientation to take advantage of nature’s forces another side. However, the similar language
to provide passive solar heating and cooling in of architecture could be perceived
different seasons. Hence, using the overhangs (Calcerano, and Cecchini, 2014).

2.2.1. Cyprus and ‘Lefkoşa’ fireplace. Kitchen is widely used in the winter,
Cyprus historically had been returns to whereas the terraces and patio or outdoor
approximately 10000 BC. In the Mediterranean spaces prepared to stay during the day in shady
Sea after Sicily and Sardinia, Cyprus is the third areas or to sleep at night (Zoranic’, 2012). The
biggest island. Cyprus is located in a north- use of local materials, mainly earth and stone, is
eastern corner of Mediterranean Sea. Cyprus one of the characters of vernacular
was divided into north part & south part in 1974. architecture and adapted to regional climate,
North Cyprus area is around 3,355 km2, shares a see figure ‘4’. A good U-Value (Heat transfer
maritime border with Syria to the east, and coefficient value) for the building materials
Turkey to the north. ‘Lefkoşa’ or Nicosia was moderate the indoor temperature ‘keep inner
started to be a capital city, since 600 AD. The space cool in the morning and warm in the
walled city in Lefkoşa surrounded by 8-10 meters night’ (Fernandes, et al., 2014).
high stone walls which were built between 1489 Vernacular architecture reflects the spirit of
and 1571 by Venetian to provided safety local people and the real response to local
(Mesda, 2012). Today, Lefkoşa is the environment, their culture and history. It identify
government center and main business center by the regional characteristics. In general
on the island. It is the last divided capital city in vernacular buildings may not meet, in many
the world and this division gave to it a special cases, with today standards of life style or
character comfort, but could give some advises about
strategies to mitigate the use of non-renewable
2.3. Vernacular Architecture in Mediterranean energy.
area
In the countries of Mediterranean area the sun
is desirable in the winter while in the summertime
sun should be blocked and the cooling and
ventilation are necessary. Clustered
agglomeration houses because of the natural
environment of the Mediterranean climate, is a
part of the landscape. Clustered settlements
are defendable and climatic responded
through creating shades and protection from
harsh winds with green plantation cover around
the buildings extended on agricultural land, Figure 3. Mediterranean vernacular house
(Fernandes, et al., 2014). See figure ‘3’. shows local stones in façade and patio.
2.4. Mediterranean Modernist architecture

“Mediterranean modernism of architecture”
can be known as a modern architecture that
adopts vernacular buildings as a resource in
order to harmonize material and space with
context and culture (Zoranic’, 2012). During his
travels through Italy, 1907, Turkey and Greece
1911, and later Spain as well as the Western
Balkans, Le Corbusier showed his interest for
vernacular architecture (Vidal, 2008). This was
the beginning of dichotomy between North
Figure 2. ‘Santorini’in Greece.
Europe and south Europe to determine the
concept of modernism in architecture and
Climatic characteristics of Mediterranean area
appearance of Mediterranean modernist
allow staying outdoors during all year; affect the
architecture. The vernacular of the southern
organization of the houses courtyards, patio,
Mediterranean started to be discussed as a
terraces and gardens as essential elements of
source of modernism. The differences in opinions
residential units. Vernacular or traditional house
that had developed during the 1920s between
in the Mediterranean region has a summer and
the architects of the North and the South toward
winter portions the upper level used in the
the role of technology and tradition continued
summer and ground floor in the winter with
to define postwar production (Lejeune and
Sabatino, 2010). In addition to the diversity of the The houses ostensibly have the elements of
Mediterranean area and its climate character modernist movement in architecture which
and interest for classical and vernacular includes; absence of classical architectural
environment, many other events after the World adornment and elongated or large-pane
War I stimulate to develop this opinion (Vidal, windows. The horizontal surfaces and strong
2008). rectilinear geometry is generally seen in the
Le Corbusier was more than any other modernist modernist houses and architectural elements
interested in the Mediterranean classical and precisely rendered, typically white. Columns,
vernacular environment. Le Corbusier attribute beams and cantilevered parts (roof overhangs,
was reaction for many events. Globally louvers and balconies) often are seen in the
because of the great economic depression in buildings. Steel or reinforced concrete used in
1930s and critique of industrial the construction. Free plan and focuses on
capitalism in, empower the right wing in continuity, transparency of place (Fricker, J. and
Germany etc. in other hand finally the Flicker, D., 2010).
consequences of his loss at the ‘Palais des Figure 5, shows ‘Villa Savoye’ the manifesto of
Nations competition’ in Geneva.His tendency modernist residential houses, which designed by
shifted from an arts and crafts, which was clear ‘Le Corbusier’ and built (1929-1931) in ‘Poissy-sur-
in the first projects in “La Chauxde Fonds” and Seine’, France, (Morrissey, 2010).
his machine oriented Modernism of the
mid1920s (Plan Voisin, 1925) conveyed to a
southern version. The main events were the
great economic crisis and the industrial
capitalism criticism in the 1930s, the rise of
German rightwing parties and the rise of
National Socialism that let Le Corbusier’s in crisis,
which made modernist arguments in the north
difficult. Consequence was his loss at the Palais
des Nations competition in Geneva. These
events coincided with Le Corbusier’s first
meeting with ‘Josep Lluis Sert’ a Spanish
architect in Barcelona and the other journeys to Figure 4. Villa Savoye, Le Corbusier (Morrissey,
Athens as part of the fourth CIAM (International 2010).
Congresses of Modern Architecture) meeting at
which witnessed poor attendance of German Although the concentration on the modernist
architects (Lejeune and Sabatino, 2010). architecture elements could be changed from
The modernity of the North that crystallized in region to other based on climate, culture and
Germany was conceptualized around society. But generally modernist residential
‘Industriekultur’, incorporate art and industry. In buildings consist of the majority of those
Southern Europe like Italy, Spain, Greece, and mentioned characters.
Southern France as the Mediterranean region
include modernity, was shaped less strict in 2.5.1 Mediterranean modernist residents
adherence to technology. In one hand they simulates Patio and Local stone façade
adopted innovation, through Italian Rationalists Patio means "Inner courtyard", that space of
like ‘Luigi Figini and Gino Pollini, and Adalberto house which use for sitting and dining or other
Libera’ as Mediterranean modernists, in other types of outdoor home activities (Anarjani,
hand tended to employ both new materials and 2013). Patio is related with a garden that is
building technologies and traditional ones. depending of the culture, protected from
outside view. The patio creates a comfortable
2.5. Modern Residential Architecture environment if adapted with perfected use of
Residential place is a basic need since the origin water evaporation. It incorporates the external
of humanity. The functions and form of primitive with internal to alleviates the shiny and hot
dwellings changed to new form and functions outside and conveys it to shaded and pleasant
which in modern dwelling. Human always tries to interior. In warmer climates, patios are
improve the quality of his dwelling and update extensions of interiors that can double the living
it according to upgrading life styles standards spaces, and giving to the home penetration in
and according his private needs.

the nature around the house. (Anarjani, 2013). Figini and Pollini were designing their buildings
Despite patio is an vernacular architectural through pure geometric forms and ideal
element, but it demonstrate its functionality in proportions, and applying aesthetic principles of
modern residences, and recall the traditional rationalism. Villa studio for an artist (1933) and
Mediterranean life style which used to spend “Environment with living room and terrace”
part of the day in houses outdoors. Many Italian (1936) are two works of Figini & Pollini during their
architects in the 1930s expressed their interest in partnership. Villa studio for an artist designed by
the Mediterranean patio house, which used to Luigi Figini and Gino Pollini for the Fifth Milan
practice with the typology of patio house Triennale in 1933 was one of modern
according to Mediterranean tradition with new architecture showing a local, Italian declension.
outcomes. Figini and Pollini mixed the modern building
elements and technology with traditional
2.5.1.1. Villa studio for an artist designed by Luigi elements in the patio house, see figure ‘6’. ‘Villa
Figini and Gino Pollini 1933 Studio’ design with one-story, and flat roof,
Luigi Figini is Italian architect he born in 1903 several open air courtyards applied in the
and died in 1984. He was one of the building which give the opportunity to enjoy
considered Italian Rationalist. They were external spaces as extensions of the interiors. The
considered Italian Rationalist. Gino Pollini, design is not symmetrical, the architects gave
(1903–1991) Born in Milan, in 1926 Pollini joined the occupants transparency to outdoor spaces.
Gruppo 7, and from 1929 he worked with his White surfaces on the exterior elevation are
partner Luigi Figini (Blakely, 2011) incorporate with exposed brick, see figure ‘7’,
(Sabatino, 2010).
Figure 6. Villa studio for an artist Facades.

(Costanzo, 2015)
After three years, the Figini & Pollini designed

an “Environment with living room and terrace”
(1936), which they described dialect between
Figure 5. (Villa studio for an artist), Milan, V the organic (vernacular) and the machine age
Triennale, 1933. Luigi Figini and Gino Pollini. aesthetic through the concept of the patio(
(Lejeune, 2010) Evilien, 2015). See figure ‘8’.
They had partnership since 1926 and they were

between the founders of Gruppo 7 and then
members o M.I.A.R. (Italian Movement for
Rational Architecture) to promote the
research to renew architecture they designed
and extended the Olivetti Factory, Ivrea,
where Modern Movement principles applied.
Moreover, they involved to design Church of
the Madonna dei Poveri (1952–1954), Milan (A
Dictionary of Architecture and Landscape
Architecture).

but are arranged following a geometrically

controlled and repetitive pattern.
Fig 9, illustrates that the courtyard has L-Shape
with interior opening system, means all the main
rooms opening to the internal patios. Each four
houses interlocked together and arranged in
groups following vernacular concepts through
cluster the houses in groups to promote the
safety. In the same time the houses touching the
walls of each other to promote thermal comfort
Figure 7. Casa Dei Giornalisti Milano in different climates, emphasize on the opening
“Environment with living room and terrace” by of the rooms toward the courtyard. Three of the
Figini & Pollini. (Costanzo, 2015). houses facing the same interior L- Shape open
space and the fourth one is opened towards
2.5.1.2. Adalberto Libera‘s “Unità orizzontale” outside, as shown in figure ‘10’. In this context
(Horizontal Unit) in the Tuscolano neighborhood the design formulating open space ‘Patio’ to
in Rome 1950-1954 each one of the houses. Each group of four
Adalberto Libera (1903 -1963) was born in 16th of houses is included between two ‘pedestrian
July 1903 in Villa Lagarina (Trento). streets’ with 2.70 m large which are irradiated
He is a great modern architect, one of the from the main central open space (Fabrizi,
inviters to revive the architecture in Italy 2014).
(Rovereto, 2013). He was one of the announcers
to the movement for modern architecture in
Italy. In 1927, he joined the Gruppo 7,
established in 1926 in the Politecnico di Milano
by Luigi Figini, Gino Pollini, Guido Frette,
Giuseppe Terragni, Sebastiano Larco, Carlo
Enrico Rava, and Ubaldo Castagnoli. He was
responsible in 1930s, for many public projects in
Rome, like Palazzo postale all’Ostiense of 1933
(with Mario De Renzi) and the Palazzo dei
Ricevimenti e dei Congressi of 1937. During the
2nd World War, he stopped his professional
activity and starts to think about the new
fundamental themes of architecture. He
returned to Rome in 1947 and started to
collaborate with Ina-casa as director of the Figure 8. L- Shape patio ‘Courtyard’ Sources:
architecture section, and started his project Fabrizi, M. (2014)
‘Unità di abitazione orizzontale’ (‘Horizontal
residential unit’) at ‘Tuscolano’ in Rome in 1954.
In March 1963, he died suddenly (Rovereto,
2013). Adalberto Libera‘s “Unità orizzontale”
(Horizontal Unit) in the ‘Tuscolano’
neighborhood in Rome is an neighborhood built
in the capital of Italy just after WWII. It consists of
200 houses for 800-1000 people, with three
categories: the one-floor courtyard houses, the
multi-storey building with accesses from
balconies, and the services block. The study will
concentrate on the first category which is one
floor courtyard houses. The courtyard houses
tissue responds to an isolation logic where the Figure 9. Opened towards outside ‘Patio’
room, the patio, the house and the whole toward pedestrians streets ( Fabrizi, 2014).
neighborhood are all inter-dependent elements
through the frontage patio and the corridors or Figure ‘11’ shows using exposed stone in the
accesses ways as in vernacular architecture, façade by ‘Adalberto Libera’ as one of the

characters for ”Mediterranean modernist

architecture”.
Figure 11. Week End house in ‘Garraf

Barcelona’.
Figure 10. Roma, (Horizontal Unit) in the
Tuscolano neighborhood in Rome 1950-1954.
2.5.1.3. Jose Luis Sert and J. Torres Clave. House

“WeekEnd,” type A, Costas de Garraf,
Barcelona, 1935
José Luis Sert, was a Spanish Architect, born in
July 1, 1902, in Barcelona and died March 15,
1983, Barcelona (José Luis Sert: American
architect, 2003). He worked with Le Corbusier
and Pierre Jeanneret in Paris between 1929- Figure 12. Plan of Week end house Garraf-
1937, after his graduation from School of Barcelona.
Architecture (Barcelona). The work of that
period produced many projects like, weekend
2.6. Modernist architecture in Cyprus
houses in Garraf with Torres Clavé , apartment
With industrialization and the following
houses in Barcelona, , and a master plan for the
Modernist Movement in architecture in north
city of Barcelona. Later he had his own office in
Europe and south Europe, the local architecture
Barcelona, (José Luis Sert: American architect,
in Cyprus has also been affected. Cypriot
2003). Josep Torres Clavé, (1906-1939) is an
architects in that period gave many good
architect, designer and town planner. He studied
examples of modern architecture on the Island.
architecture at Barcelona graduating in 1929
Nicosia General Hospital by Polis Michaelides
from the School of Architecture. He is one of the
between (1936-1939), which faced many
Spanish avant-garde artistic and modernist
changes in the 1950s, represents one of the
names in the 30s. In 1929 he became a founding
examples of the international style of modernist
member of GATCPAC (Group of Catalan
movement in architecture and its influences on
Architects and Technicians for Architectural
Michaelides from his experience in the office of
Progress). After one year gave rise to the
Le Corbusier in the years 1930-32.(Kiessel, 2014).
establishment of the GATEPAC, to be on a state
Ahmed Vural Bahaeddin, Neoptolemos
level. He worked with Sert in many projects
Michaelides, Abdullah Onar and Ayar Kashief
(Josep Torres Clavé: Barcelona, 1906 – 1939.
are significant names of local Cypriot modernist
(n.d.). The Week End house in ‘Garraf Barcelona,
architecture.
1935), was One of the manifesto style of
Mediterranean modernist architecture by Jose’
3. Methodology
Loius Sert with Torres Clave’. The building shows
3.1. Research Design
the usage of the stone in the facades, as well as
This paper approaches the qualitative and
presence of patio, recall the “Mediterranean
descriptive method, following to the theoretical
vernacular architecture”. See figure ’12 & 13’
part. The theoretical analysis has been
developed for assessment on case study’s
examples. Interview carried out with one of the
pioneers in Modern architecture in north Cyprus

‘Ayer Kashif’ who graduated from Faculty of

Architecture in Turkey after four years from his
colleagues ‘Bahaeddin’ regarding the subject.
The Analysis, which has been applied, consists of
three main parts:
1. Through literature review we tried to identify
key information that could help in identifying the
influence of Cypriot modernist architecture by
Mediterranean Modernist movement in south
Europe which started in the end of 20s from the
last century. Theoretical analysis applied
through analyzing several works done for South
European Modern architects, like ‘Luigi Figini
and Gino Pollini, and Adalberto Libera’ as in
other to investigate the vernacular elements
interference in their design; first is the naked
stone walls and second is the patio (outside and
inside interrelation), as characteristic of
Mediterranean modernist architecture.
2. The presence of patio and exposed stone Figure 13. Methodology Framework (Developed
walls in the modernist building design in Cyprus by Author).
in 50s , 60s and beginning of 70s from twentieth
century, as a vernacular elements and one of 3.2. Case Studies
the characteristic of Mediterranean modernist Two case studies selected in Lefkoşa to be
architecture, as elucidated in literature review. analyzed. The case studies selected based on
This was implemented through The Case Study’s several considerations, which are; i) selected
examples are two residential buildings for the buildings are both residential houses, ii) both
north Cypriot modernist architect Ahmet Vural buildings have been design by Architect ‘
Bahaeddin. He was one of pioneers who Ahmet Vural Bahaeddin’, iii) the buildings
adopted modernist architecture in his works in classified as modernist architecture holding the
the North part of Cyprus. He is worth of special characteristic of Modern architecture in the first
attention to focus on his works as one of the half of twentieth century or after that by few
oldest ‘Modernist’ architects. Bahaeddin born in years.
1927, he graduated from Faculty of
Architectural Engineering, Istanbul Technical 3.2.1. Efruz Houses (1962-1976)
University. He started his career between the Efruz Mass Houses or Müdüroğlu Houses are
years 1955-1993. His works were mainly private designed between, 1962-1976 at Kumsal
residences, except few educational buildings Quarther in Lefkosia by Ahmet Vural Behaeddin.
and office buildings, such as building of ‘Turkish These houses are considered one of the
Lyceum’ in Lefkoşa, built in 1962. In his early distinctive mass housing construction in Lefkosia.
professional life, he was a modernist who The construction company was Efruz Company,
focused on importance of function. Later, he one of the famous construction companies in
tended to “Organic Architecture” (Celik and North Cyprus. The houses designed for high
Erturk, 2007). income householders. Typology of the houses is
3. The interview with architect ‘Kashif’ consist the two storey row houses. The total area of one
following question; house is 200 meter square; the plan of the
- Either or not he thinks that his colleague houses consists of two stories. The ground floor
‘Bahaeddin’ was affected by has an entrance, family lounge or living room,
Mediterranean movement in architecture, kitchen, toilet, laundry, garage and back
which arose in south Europe in the beginning courtyard and forecourt. The first floor consists of
of twentieth century? three bedrooms (one of them master bedroom),
Methodology frame work has been developed bathroom with toilet and transition space
by author to reach the answer about the study corridor to other spaces on the first floor
questions assigned in the introduction of the (Esentepe, 2013). See figure ‘15’.
study, as shown in figure ‘14’.

Figure 14. Plan of Ground and first floor Figure 17. Exposed stone facades in Efrus
(Developed by Author). Houses.
There are three different plans for ‘Efruz’ Houses Using the white color to paint the façade and
but all the types have courtyards (forecourt and envelope of the building could be also one of
backyard) of houses. Those backyards and the vernacular characteristic in ‘Bahaeddin’
forecourts can be associated to the patio in designs. Hence the design of these houses holds
vernacular architecture, which is one of the more than one character of the vernacular
main resources to Mediterranean modernist in architecture. It approaches the “Mediterranean
architecture. See figure ‘16’. modernist architecture” in the first half of
twentieth century in south Europe; these
examples could be detected in Spain and Italy
as well as other Mediterranean countries.
3.2.2. Sömek House and Clinic (1957-1959)

‘Somek House’ is another design for ‘Ahmet
Vural Bahaeddin’ the first registered architect of
Cyprus Chamber of Architects in TRNC. The
house was built in the years (1957-1959) in Lefke
(Celik, 2005). Lefke is a small town belongs to
Lefkoşa, located on the northern slopes of the
‘Troodos Mountains’. American company with
Mining Company of Cyprus (CMC) was quite
developing that place because copper
deposits were discovered in 1912. They built the
Figure 15. The Patio in the Efruz houses between
town theater building which exists until today,
two rows of building and forecourts in the
post office, municipal building, and workers’
frontage of each house.
housing. The building stands as one of the early
applications of modernist architecture. It
formed according to the principles of modern
architecture in a new housing concept, with the
beginning form of modern life in North Cyprus.
Sömek House, designed considering the
environmental conditions, socio-cultural
Figure 16. Facade of the buildings (Esentepe, characteristic and the needs of modern life
2013). besides being an architectural product. The
building holds (Celik, 2005).
In other hand the façade of ‘Efruz’ houses is
covered partially by exposed local stones, see
figure ’17 & 18’, which is another characteristic
of the Mediterranean Modernist.

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Figure 18. Somek house exposed stone facades,

Plan and Façade. (Celik, 2005)
Figure 20. Relation between inside and outside.
Free open space and introducing inside to

outside, moreover, using iron columns in the
building characterize the plan of the house. It is
also shows the mix with local and vernacular
strategies, through transparency between
inside and outside, as well as using local pebbles
as exposed stone in the façade (Hera, 2010).
See figure ‘22’. Hence once again ‘Bahaeddin’
Figure 19. Details on plan and elevation demonstrate his trends to introduce the
(Developed by Author) vernacular elements in his modernist works.
‘Sömek’ house and clinical spaces is located in

four acres of gardens, including the farms of
orange and flowers garden outside the
courtyard and terraces are enriched with
intense green. Clinical façade is covered with
large pebbles collected from local area. The
building is divided into two parts; one is clinic
and other part is the house. See figure 19& 20. Figure 21. Using Iron forks in the right and
After passing through the courtyard, to the large exposed stone facade in the left (Hera, 2010)
garage, it will lead to into the house on the left.
Central hall facing terrace and courtyard 3.3. Interview
directly and it is opposite the entrance, and During the meeting face to face with Architect
lounge terrace separated by glazing door. See ‘Ayar Kashif’ based on invitation from lecture of
figure 21. The building demonstrates modernist “Advance Research in Modern Architecture”
elements, such as perpendicular horizontal and Dr. Valentina Dona, the meeting held in Girne
vertical surfaces with big windows provided by American University on 25th of March 2016.
louvers. Architect “Ayar Kashif” who is the pioneer in
establishing department of Architecture in Girne
American University, since 1994 and he
graduated from Turkey was one of the earliest
modernist architects in North Cyprus with his
colleague ‘Ahmet Vural Bahaeddin’. The author
asked him the following question;
- Either or not he thinks that the works of his
colleague ‘Bahaeddin’ had something in
common with the movement of architecture
in other Mediterranean countries which arose
in south Europe in the beginning of twentieth
century?

- His answer was that “ He cannot aver that design “the Patio and exposed stone facades’,
‘Bahaeddin’ have been influenced by the as shown in table 2.
Mediterranean movement of architecture in
that period, but as architects we were, and Table 2. Shows the vernacular resources in
even ‘Bahaeddin’, respecting the client’s Modern architecture design of ‘Bahaeddin’
opinion which was affecting the decision of buildings in Lefkosia developed by author.
the design deeply”.
4. Discussion
Several samples of modern architecture
(residential buildings) from south Europe
between 1900s-1950s have been showed in the
literature review. Italy and Spain were the main
sources of “Mediterranean modernist
movement” in architecture. Theoretical analysis
applied on four buildings, three of them were in Hence, the case studies as modernist
Italy designed by Italian architects like Figini & architecture in North Cyprus, designed by one
Pollini as well as Adalberto Libera. The fourth of the earliest modernists on the island
building was in Spain designed by Jose Luis Sert demonstrate the similarity to Mediterranean
& Torres Clave’. The analysis focused on the modernist architecture characteristic.
simulation or existence of two main vernacular Moreover, architect ‘Bahaeddin’ represent one
elements ‘Patio and exposed stone façade’ in of the pioneers in the modern architecture
modern design of the buildings which is movement in North Cyprus. Thus, his influence to
concerned in this study. The results Mediterranean modernist movement will
demonstrate that all the projects have the influence other modernist architects to follow
sources of vernacular architecture, three of him. Therefore based on the findings above, the
them combined both elements ‘ Patio & study shows that the modernist architecture in
Exposed stone facades’ and only one of them north Cyprus was influenced by the
has only ‘patio’ elements as vernacular source Mediterranean movement in south Europe. The
in the modern design (See table 1). opinion of ‘Ayar Kashif” who was one of the
modernist architects in that period, clarifies one
Table 1. Vernacular resources in Modern important fact. The fact is that the architects
architecture design in south Europe (Developed were affected by clients opinion, hence that
by author). could be one of the reasons to let architects
follow the needs of the indigenous people on
the island. Indigenous people affected until
today by the vernacular elements in their
houses, which exposed stone facades and
house Patio are part of it. That led us to think the
modernist architects and ‘Ahmet Vural
Bahaeddin’ one of them were influenced by
two main factors. One of them is the
“movement of Mediterranean modernism” in
Mediterranean countries. They were aware
about it, because they studied outside of the
island and had a connection abroad. Another
one is the intendancy of local people who likes
to keep the vernacular elements even in their
The two case studies for the modernist Cypriot modern houses as we see until today. Those
architect ‘Ahmet Vural Bahaeddin’, ‘Efruz results supports hypothesis of the paper, which
House & Somek House’ have been analyzed. Hypothesize that the vernacular elements in the
Both considered as modernist architecture in modern residential buildings designed by
North Cyprus and had been designed later of ‘Ahmet Vural Bahaeddin’ and modernist
the previous bu ildings in South Europe. The architecture generally is somehow affected by
findings demonstrated that both of ‘Bahaeddin’ “Mediterranean modernism movement” in the
houses had the vernacular elements in their first half of last century.
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been no paralysis, and the hemorrhages were probably not the
immediate cause of death.
Durand-Fardel gives a table of supposed causes in 21 cases of

persons over fifty: 8 of these were connected with either habitual use
of liquor or a debauch; 9 had an attack immediately after a meal.
After naming all these causes, it must be said that in many cases it is
impossible to find any reason for the occurrence of the hemorrhage
at the particular moment it comes. A person may go to bed in
apparent health, and be found some hours afterward unconscious
and comatose, or unable to stir hand or foot on one side, or to
speak. Gendrin, as quoted by Aitken, states that of 176 cases, 97
were attacked during sleep. The attack may come on when the
patient is making no special muscular effort and under no special
excitement. It is simply the gradual progress of the lesion, which has
reached its limit.
SYMPTOMATOLOGY.—If we take as a point of departure the fully-

developed attack, such as most frequently is found with a large and
rapid hemorrhage into the cerebral hemispheres, pons, or
cerebellum, the symptoms are those usually spoken of as an
apoplectic attack, shock, or stroke, or, as the Germans say,
Hemorrhagische Insult. Trousseau quotes as a satisfactory definition
the words of Boerhaave: “Apoplexia dicitur adesse, quando repente
actio quinque sensuum externorum, tum internorum, omnesque
motus voluntarii abolentur, superstite pulsu plerumque forti, et
respiratione difficili, magna, stertente, una cum imagine profundi
perpetuique somni.”
Loss of consciousness, abolition of voluntary motion and sensation,

and usually stertor, the appearance of the patient being that of one in
deep sleep, are found in the extreme cases. In others the loss of
consciousness and sensation are not complete; the patient can be
aroused enough to utter a grunt or raise a hand to his face in order
to brush away a fly or the hand of the physician who is trying to raise
his eyelids, or can make a grimace to show that he is hurt, the face
returning to its indifferent expression as soon as the cause of
irritation is removed. Although the grade of action, both sensitive and
motor, seems to be a little above the purely reflex, it is but very
slightly so, and probably is not sufficient to remain an instant in the
memory.
The rapidity with which this condition comes on varies widely, from a
very few minutes, or even seconds, to some hours. It may even
diminish for a time and return. The cases in which unconsciousness
is most rapidly produced are apt to be meningeal and ventricular,
and presumably depend upon the rupture of vessels of considerable
size, although the location among the deeper ganglia, where the
conductors of a large number of nervous impulses are gathered into
a small space, will, of course, make the presence of a smaller clot
more widely felt. Even in these, however, the onset is not absolutely
instantaneous, and the very sudden attack is rather among the
exceptions. Trousseau denies having seen, during fifteen years of
hospital and consulting practice, a single case in which a patient was
suddenly attacked as if knocked down with a hammer, and that since
he had been giving lectures at the Hotel Dieu he had seen but two
men and one woman in whom cerebral hemorrhage presented itself
from the beginning with apoplectiform phenomena. In each of these
the hemorrhage had taken place largely into the ventricles.
Lidell gives the following case: A colored woman, aged forty-nine,

was engaged in rinsing clothes, and while in a stooping posture
suddenly fell down upon her left side as if she had been struck down
by a powerful blow. She was picked up insensible, and died in ten or
fifteen minutes. The hemorrhage was chiefly meningeal, and
especially abundant about her pons and medulla oblongata. The
fourth ventricle was full of blood, and there were clots in the lateral
ventricles.
A woman, aged about forty, had been hanging out clothes in an

August sun. She was observed to run out of the house screaming,
and fell to the ground unconscious. This was at 1 P.M., and she died
at 3.30 P.M. Her temperature just after death was 107.2°. The
neighborhood of the posterior surface of the pons Varolii was
occupied by a broken-down-looking mass, appearing like an
aggregation of small apoplexies (hemorrhages), involving and
breaking down the middle crura of the cerebellum. There was no
fatty degeneration nor any miliary aneurism. (I do not know upon
how thorough an examination this last statement rests.)
In a large number of cases it is difficult to say, in the absence of any

observation, intelligent or otherwise, exactly how rapid the onset of
the symptoms may have been, but in those which occur where the
patient is watched or is in the company of observant persons it is
almost invariable to meet with symptoms less than unconsciousness
which denote the actual beginning of the hemorrhage. From the
nature of the lesion it can rarely give rise to symptoms which justify
the epithet of fulminating in the sense of struck with a thunderbolt.
The unconsciousness, so far as can be known, does not depend on
the injury of any one special small point of the brain in which
consciousness resides, but upon the compression of a considerable
portion, which must necessarily take place gradually, but with a
rapidity proportioned to the size of the current which issues from the
ruptured vessel and the ease with which pressure can diffuse itself
over a large area. It is undoubtedly the greater facility offered to such
diffusion by the communication of the hemorrhage with the so-called
cavity of the arachnoid and the ventricles which gives to these forms
a peculiar severity. The difference between a hemorrhage spreading
through all the ventricles or over a large surface of the brain, and
one which is limited to a focus in the substance of one hemisphere,
being restrained by more or less firm tissue, may be illustrated by the
gain in power in the hydraulic press from the transfer of the stream of
water from a small cylinder to a larger one.
Vomiting is a symptom of some importance in diagnosis, being not

very common in cerebral hemorrhage, but very frequent in
cerebellar.
Whether of sudden, rapid, or slow development, the apoplectic

attack is, in its main features, described in the aphorism of
Boerhaave given above. The muscular relaxation of the face imparts
to it an expressionless, mask-like character; the limbs lie motionless
by the side, unless they can be excited to some slight movement by
some painful irritation or are agitated by convulsions, or in a
condition of rigid spasm; the face may be pale or flushed; the cheeks
flap nervelessly—le malade fume la pipe.
Swallowing, in the deepest coma, is not attempted. The fluid poured

into the mouth remains, and distributes itself according to the laws of
gravity without exciting reflex movements of the pharynx. When the
depression is less profound, it may excite coughing or be swallowed.
An attempt to swallow when the spoon touches the lips indicates a
considerably higher degree of nervous activity. Respiration may be
slow, but when the case is to terminate fatally rises with the pulse
and temperature. It is often stertorous and difficult, the obstruction
consisting partly in the gravitation backward of the soft palate and
tongue, and partly in the accumulation of fluids in the pharynx.
Hence stertor is in some cases only an accidental phenomenon,
depending upon the position of the patient on the back, and can be
relieved by turning him on his side and wiping out the mouth as far
back as can be reached. Cheyne-Stokes respiration occurs in severe
cases, though not confined to necessarily fatal ones.
The general temperature in cerebral hemorrhage has been studied

enough to make it of considerable value, especially in prognosis. In a
case which extends over a sufficiently long time several stages can
be distinguished which in shorter ones may be wanting. An initial
period of depression is described by Bourneville17 as occurring
immediately after an attack, in which the temperature falls a degree
or two below the normal, and, according to his view, continues
depressed if death takes place rapidly. He gives the case of a man
who died very shortly after an attack (his second one), where the
temperature, taken in the rectum at the moment of death, was 35.8°.
In cases which survive longer this initial fall passes either into a
stage where it oscillates within the neighborhood of the normal or
immediately begins to rise; the latter occurrence indicates an
impending fatal termination (unless, of course, something else can
be found to account for it). In the former condition we find patients
whose life may be indefinitely prolonged for days or weeks, when, if
a fatal termination is to result, the thermometer again indicates a
rise.
17 Études cliniques et thermométriques sur les Maladies du Système nerveux, 1872.
The initial fall of temperature is not so likely to be observed except in

institutions like the Salpêtrière, where large numbers of old persons
are collected and under close medical surveillance; and, indeed, it
may be doubted, even from Bourneville's own table, whether the rule
is one without exceptions. At any rate, the rise is a more important
phenomenon than the fall. When the rise of temperature is
interrupted by a fall, and then continues again, it is due, according to
the author already quoted, to a renewal of the hemorrhage.
These changes of temperature may be noted with various locations

of the lesion, but it seems probable that further study might make
them useful in diagnosis as well as prognosis. Hale White reports the
case of a boy aged six and a half years, who was found unconscious
with right hemiplegia, and who afterward had many and various
paralyses with hyperpyrexia, the highest temperature being 107°. He
lived long enough for secondary degeneration to extend down the
crura and into the anterior cornua. A small soft patch a quarter of an
inch in diameter existed at the anterior part of each corpus
striatum.18
18 Guy's Hosp. Rep., 1882.
FIG. 37.
The chart W. H. (Fig. 37) is from a man aged fifty who fell in the
street while returning from work at noon, and whose axillary
temperature was taken at 5 P.M. and every two hours thereafter until
death. The hemiplegia was not very marked, but the hemorrhage
was extensive, involving the pons and left crus cerebri, the external
capsule, left crus cerebelli, and medulla, bursting through into the
fourth ventricle.
FIG. 38.
The chart M. M. (Fig. 38), as taken from Bourneville, represents the
course of the temperature in a rapid case: each perpendicular line
denotes an hour.
The difference in the temperature of the two sides has been

variously stated, and probably depends on a number of factors
besides the length of time that has elapsed since the first attack.
There is probably, however, a tendency to excess of heat on the
paralyzed side soon after the attack, owing to vaso-motor paralysis;
and this difference will be more marked in the hands than in the
axillæ. After a length of time which may be from days to months the
temperature becomes equalized, or more frequently the relation is
reversed, the paralyzed side being colder as atrophy takes place.
Lepine19 gives a case where the axillary temperatures of the two
sides continued the same within a small fraction of a degree for three
days, and then separated very slowly, until at death the paralyzed
side was six-tenths of a degree (Cent.) hotter than the other, in both
being inferior to the rectal (107° Cent.).20
19 Mémoires de Société de Biol., 1867.
20 The chart in the original, and as reproduced by Bourneville, is wrongly lettered. The
text says that the left side was the hotter.
FIG. 39.
The chart C. M. (Fig. 39) shows the excess of temperature in a case

of meningeal hemorrhage. The dotted line is from the paralyzed side.
The first observation was made two and a half hours after the attack.
A very interesting case is reported by Johnson21 of crossed
hemiplegia, where the temperature was about a degree higher on
the paralyzed side of the body, and, corresponding to this, the
sphygmograph showed a great diminution of tension; the lesion is
supposed to have been a hemorrhage in the pons. Johnson, in
commenting on the statement of Lorain that in all cases of
hemiplegia the pulse is more full on the paralyzed side, says that it is
incorrect for ordinary cases of hemorrhage into the corpus striatum,
though true in his own case.
21 Brit. Med. Journ., Jan. 6, 1877.
The most marked differences of temperature have been observed

where the lesion has been in the neighborhood of the pons, crus
cerebri, or medulla oblongata. In a case reported by Allbutt there
was a difference of 1.6°; the radial pulse was softer and fuller on the
paralyzed side, and the cheek upon that side was flushed.22 The
pulmonary hemorrhages which have been noticed by Brown-
Séquard and others in animals after cerebral lesions, and the
extravasation, congestion, subpleural ecchymoses noted by Ollivier23
in cerebral apoplexy, are probably to be referred to vaso-motor
disturbances.
22 Med. Times and Gaz., Dec. 4, 1869.
23 Archives générales, 1873, 167.
Much more attention has been paid to the pulse than to the
temperature, but it is less easy to lay down definite rules in regard to
it. It may vary in either direction. When the case is approaching a
fatal termination the pulse is apt to accompany the temperature in a
general way in its rise, though not necessarily following exactly, as is
seen in the chart in Fig. 38.
The throbbing or bounding of the arteries often described may

indicate increased activity of heart, but means at the same time
vaso-motor relaxation. The urine and feces are often passed
involuntarily.
In some rare cases symptoms closely resembling those produced in
animals by section of the sympathetic have been seen. These are
false ptosis, narrowing of the palpebral opening and sinking of the
globe of the eye into the orbit, diminution in the size of the pupil,
higher temperature on the paralyzed side of the face and the
corresponding ear, abnormal secretion of the eye, nose, and mouth
on the same side.24 They are supposed to indicate a paralysis of the
sympathetic.
24 Nothnagel, quoted by Grasset.
The condition of general relaxation may be so profound as to cover

up everything else, but in many cases true paralytic symptoms may
be discovered or provoked, which even at an early period give us
information as to the locality and nature of the lesion.
A greater degree of muscular relaxation may be manifest on one

side of the face than the other; the forehead may be a little smoother
on one side, the corner of the mouth drooping, the downward line
from the ala of the nose flattened, and the cheek flapping. There
may be a little greater resistance to passive motion of the limbs on
one side; one hand on being raised may drop helplessly back to the
bed, while the other is laid slowly down; the right hand when pinched
lies motionless and without power to escape the pain until the left
comes to its assistance. Irregularity of the pupils, if present, is an
important sign, but its absence signifies nothing.
One of the most significant signs is the conjugate deviation of the

eyes, both eyes and the head being turned strongly to one side or
the other. When the lesion is above the pons and is irritative, as in
the early stage of hemorrhage, the deviation is toward the side of the
body affected and away from the lesion; when paralysis is
established, away from the paralysis and toward the lesion. Below
the pons the rule is reversed. The spastic stage of conjugate
deviation may coincide with stiffness (early rigidity) of the paralyzed
limbs. This deviation must not be mistaken for an accidental position
of the head. The patient should be addressed from the side away
from which he is looking. Sometimes the eyes can be brought to the
median line, and not beyond. An attempt to turn the head forcibly
beyond the median line occasionally causes pain. The value of this
symptom in diagnosis has been denied, but a part at least of the
apparent contradictions have arisen from the neglect to notice
whether it were of a paralytic or spastic character.
As the condition of unconsciousness gradually passes off, the face

regaining, at least in part, its natural and more intelligent expression,
the eyes trying to follow the movements of surrounding persons, an
attempt being made, perhaps only by an unintelligible sound or by a
nod, to answer questions, the tongue being protruded, or at least an
attempt toward it made, and some motions being made with the
limbs,—the exact extent and intensity of the paralysis become more
apparent. Conjugate deviation, if it have existed, may disappear
before the other symptoms, or, if it has been of the rigid form
depending on an irritative lesion, it may become paralytic, and is
then in the opposite direction. The patient is then usually found to be
in a condition of hemiplegia, and at this point the history of
hemorrhagic apoplexy becomes identical with that of paralysis from
hemorrhage where no truly apoplectic condition has been present.
Lidell states that in more than one-third of all cases of cerebral

hemorrhage hemiplegia is developed without loss of consciousness
or coma. In some, the paralysis precedes unconsciousness, which
then slowly supervenes.
Hemiplegia (ἥμι, half, πληγη blow) is a paralysis or paresis of a part

of the voluntary muscles of one side of the body, and a few, in some
cases, on the other, and is undoubtedly to be referred to a lesion
interrupting the nervous communication between the cortical centres
of motion and the nuclei of the motor nerves, cerebral and spinal; the
conductors passing through the corpora striata, the internal capsule,
the peduncles, and crossing in great part to the other side above or
at the lower border of the medulla oblongata, and passing down the
crossed pyramidal tracts of the cord, to be finally connected with the
anterior gray columns of the cord. The portion which does not
decussate passes down the inner border of the anterior columns
under the name of columns of Türck. The amount of decussation
which takes place varies somewhat, and the suggestion has been
made, in order to explain certain cases of paralysis occurring on the
same side with the lesion, that possibly in some rare cases there
may be no decussation. It has never been shown, however, that this
condition, highly exceptional if even it ever occurs, is present in such
cases.
It may be said in a general way, although exceptions to the rule can

be found, that it is those muscles trained to separate, specialized, or
non-associated movements which are chiefly affected, while those
which are habitually associated in function with those of the other
side are less or not at all so. It would not, however, be in the least
correct to say that specialized or educated movements of any set of
muscles are alone paralyzed, since the fingers, which are trained to
the most independent movements, are often just as incapable of
making the slightest movement of simple flexion as of writing or
sewing.
We have in ordinary hemiplegia more or less paralysis of the upper

facial, the patient not being able to close his eye or to wink quite so
well as on the paralyzed side. The forehead may be smoother on the
paralyzed side. This condition is usually slight and of short duration,
but varies in different cases. Paralysis of the lower facial angle of the
mouth and cheek is usually better marked, but not absolute. The
corner of the mouth droops, perhaps permits the saliva to escape;
the naso-labial fold is less deep, and the glabella deviated away from
the paralyzed side. The cheek flaps with respiration. The difference
between this facial paralysis connected with hemiplegia and that
dependent upon a lesion of the trunk or distribution of the nerve
(Bell's), as in caries of the temporal bone or the so-called rheumatic
paralysis, is very striking, the latter being so much more complete,
and, by affecting the orbicularis palpebrarum so as to prevent
closure of the eye, giving a very peculiar expression to the
countenance. This distinction between the two portions of the facial
seems to make an exception to the rule stated above, since in most
persons the movements of the corner of the mouth and of the cheek
are quite as closely bilaterally associated as those of the eyelids.
Paralyses of the third, fourth, and sixth pairs upon one side of the
body are comparatively rare in hemiplegia, and when present are
usually referable to localized lesions in the pons. They are to be
looked upon as something superadded to the ordinary hemiplegia.
These nerves, however, are affected in the peculiar way already
spoken of as conjugate deviation, which phenomenon would seem to
denote that muscles accomplishing combined movements in either
lateral direction of both eyes, rather than all the muscles of each, are
innervated from opposite sides—i.e. that the right rectus externus
and the left rectus internus are innervated from the left motor
centres, and vice versâ. Exactly the same remark will apply to the
muscles of the neck which cause the rotation of the head seen
together with the deviation of the eyes. The muscles controlling
deviation to one side, although situated upon both sides of the
median line, are apparently innervated from the side of the brain
toward which the head is turned in paralysis.
The tongue is usually protruded with its point toward the paralyzed
side; and this is simply for the reason that it is pushed out instead of
pulled, and the stronger muscle thrusts the tongue away from it. The
motor portion of the fifth is, according to Broadbent, affected to a
certain extent, the bite upon the paralyzed side being less strong.
The hand and the foot are the parts most frequently and most
completely affected, but one or the other may be partially or wholly
spared, though the latter is rare. The muscles of the limbs nearer the
trunk may be less affected, so that the patient may make shoulder or
pelvis movements when asked to move hand or foot. In severe
cases even the scapular movements may be paralyzed. The
muscles of the trunk are but slightly affected, though Broadbent
states that a difference in the abdominal muscles on the two sides
may be perceived as the patient rises from a chair. The respiratory
movements are alike on the two sides. A woman in the hospital
service of the writer had a quite complete left hemiplegia at about the
seventh month of pregnancy. There was some return of motion at
the time of her confinement. None of the attendants could perceive
any difference in the action of the abdominal muscles of the two
sides, although, of course, the usual bracing of the hand and foot
upon the left side was wanting. The pains were, however, generally
inefficient, and she was delivered by turning. Muscular weakness
often exists, and in some cases the non-paralyzed side shows a
diminution of power.
The sphincters of the bladder and rectum frequently, and in severe

cases almost invariably, lose their activity for a time. It is possible,
however, that in some cases of alleged inability to retain urine and
feces the defect is really mental, and akin to the dirty habits of the
demented. The involuntary muscles probably take no part in
hemiplegia, with the very important exception of the muscular coats
of the arteries, which apparently share to a certain extent, and
sometimes the iris.
Speech may be attempted, and the words be correct, so far as they

can be understood, though the patient is apt to confine his remarks
to the shortest possible answering of questions. It is, however, thick
and indistinct, since the muscles of the tongue and lips are but
imperfectly under the control of the will. This condition may be
connected with paralysis of either side, and is to be sharply
distinguished from aphasia or mental inability to select the proper
word or to determine the necessary movements for its pronunciation.
Aphasia is almost invariably connected with paralysis of the right
side, and will be minutely spoken of hereafter. There is, of course,
nothing to prevent the coexistence of the two conditions, but aphasia
cannot well be shown to exist until we have reason to suppose, first,
that the patient has ideas to express, and secondly, that the
paralysis of the muscles of the lips and tongue has more or less
completely disappeared. The patient may indistinctly mumble a word
which, however, can be understood to be appropriate to the occasion
(defective articulation, glosso-labial paralysis), or, on the other hand,
pronounce with distinctness an entire wrong word or a number of
sounds without meaning (aphasia).
Sensibility—that is, ordinary cutaneous sensation—and, so far as we
can judge, the special senses, are not greatly affected after the deep
coma has passed off, but exceptions to this rule will be noted later.
Having described this most typical but not most common form of
cerebral hemorrhage—that is, the form in which both lesion and
symptoms are most distinct and can be most clearly connected—we
have a point of departure for conditions less clearly marked and less
easily explained.
It is probable that cerebral hemorrhage is much less likely than

cerebral embolism to take place without any disturbance of
consciousness or abnormal sensations; but there can also be little
doubt that a certain amount of paralysis is often accompanied by no
other symptoms, and post-mortem appearances often show the
remains of small hemorrhages which have passed unnoticed or are
lightly estimated. It is highly probable that small hemorrhages may
give rise to symptoms which pass for only a little accidental vertigo
or a slight feeling of faintness, until a later and more serious attack
gives a more definite explanation.
On the other hand, we have a set of cases in which all the symptoms
of cerebral hemorrhage may be present without the lesion. Many of
these are of course due to embolism, which will be considered later;
but besides this condition, recognized as softening for many years,
we find described under the head of simple, congestive, serous, and
nervous apoplexy cases where sudden or rapid loss of
consciousness occurs with general muscular relaxation, which, when
fatal, show nothing beyond changes in the circulation—i.e. in the
amount of blood in the cerebral vessels or of serum in the meshes of
the pia or at the base of the brain.
Besides these, there are cases of temporary unconsciousness with

complete recovery—the coup de sang of the French, or rush of blood
to the head, which are attributed to congestion of the brain—a theory
difficult to prove or disprove, but not in itself unreasonable.
Trousseau, without denying the possibility, or even probability, of
such a condition, says that which has been called apoplectiform
cerebral congestion is in the greater number of cases an epileptic or
eclamptic accident, sometimes a syncope. Simple epileptic
vertigoes, vertigoes connected with a bad condition of the stomach
or diseases of the ear, are wrongly considered as congestions of the
brain. He speaks of various conditions, such as violent attacks of
whooping cough, the expulsive efforts of women in labor, the
congested faces of laborers under heavy burdens, to show that
cerebral congestion does not give rise to an apoplectiform attack;
and it is undoubtedly true that, as a rule, no long-continued attack is
the result; but it must be within the personal experience of almost
every one that decided cerebral disturbance is produced for a few
moments by such efforts, as, for instance, blowing a fire with the
head down. Besides this, a laborer under a heavy load is
presumably healthy and accustomed to his work, so that his arteries
may be supposed capable of maintaining a due balance between
arterial and venous blood in the brain; and, again, although the
ordinary efforts of women in labor do not cause unconsciousness,
puerperal convulsions, involving a longer period of violent muscular
action, may do so, and even give rise to hemiplegia.
Whatever name we may adopt for the temporary cases which

recover, there are others, and fatal ones, which are not explained by
any change in nomenclature. Epilepsy may, it is true, occur under
such circumstances that no convulsion is observed, but, on the other
hand, convulsions may accompany not only an attack of
unconsciousness, but actual cerebral hemorrhage.
Cases of sudden death with no discoverable lesion furnish abundant

opportunity and temptation for conjecture, and it is well known that
too much dependence must not be placed upon the post-mortem
appearances as to the amount of blood in the brain before death,
and probably just as little upon the amount of serum, except as
indicating a condition of atrophy.
Syncope, either from over-stimulation of the pneumogastric or from

simple failure of the heart, may be put forward to explain some cases
of sudden death, but seems to have no advantage as a universal
theory over the older one, which meets with so little favor. Lidell
gives no less than seventeen cases which he classifies as
congestive or serous apoplexy. They are not all equally conclusive,
and were almost all of alcoholics. In some of these there were
absolutely no appearances which could account for death. The two
most characteristic of congestive apoplexy were, first, a young
negress who experienced a violent fit of passion, became
unconscious, with stertorous breathing, and died, having had some
tonic spasms. The brain contained a large amount of blood in the
vessels, but no effusion. Second, a semi-intoxicated woman, aged
thirty, became very angry, fell insensible, and expired almost
immediately. The brain contained an excess of blood, with no
effusion. In both these cases the patients were subject to fits under
the influence of strong excitement, but in both the author took pains
to inquire into and negative the probability of epilepsy of the ordinary
kind; and a change of name does not go far toward clearing up the
pathology.
Lidell's case (XXII.) was that of a man accustomed to alcohol, thin

and pale, who had an apoplectic fit with coma and hemiplegia. He
regained consciousness on the second day, and the hemiplegia
disappeared in a fortnight. This rapid and complete recovery,
exceptional to be sure, cannot be regarded as proof of the absence
of hemorrhage or embolism. In fact, the latter is highly probable. It is
possible that the clot may have been partially dislodged, so as to
allow some blood to pass by it, or that an exceptionally favorable
anastomosis allowed a better collateral circulation than usual to be
established.
The following case occurred in the service of the writer: An elderly

negress, who had extensive anasarca and signs of enfeebled action
of the heart without any valvular lesion being detected, after washing
her face was heard to groan, and found speechless and unable to
swallow, with complete right hemiplegia. There was a slight
improvement in a few hours, but she died two days later. The
autopsy disclosed some hypertrophy and dilatation of the heart
without valvular lesion. A careful search failed to discover any
change in the brain or obstruction in its vessels, although there was
chronic endarteritis.
The relations between epilepsy, apoplexy, and syncope are

interesting and important, but are certainly far from clear. Little is
gained by shifting obscure cases from one category to the other. If
sudden deaths be synonymous with apoplexy, we shall certainly
have to admit that apoplexy does not always demand for its cause
cerebral changes sufficiently marked to be recognizable after death.
If, on the other hand, we refer them to heart disease, we shall have
to admit that a heart without valvular disease or extensive changes
in its muscular substance may cease to beat under influences as yet
not well understood.
Since the paralysis arising from hemorrhage resembles so closely in

its progress that dependent upon occlusion of the cerebral vessels, a
further description will be deferred until the latter lesion has been
described; but this remark does not apply to the premonitory and
initiative symptoms, which may be of great importance, and which
are not always the same with the two or three sets of lesions. There
are many of them, but, unfortunately, no one among them taken
alone can be considered of high significance, unless we except what
are sometimes called premonitory attacks, which are in all probability
frequently genuine hemorrhages of so slight extent that they produce
no unconsciousness, and but slight paralysis easily overlooked. A
little indistinctness of speech or a forgetfulness of words, a droop of
one angle of the mouth, or heaviness in the movement of a foot or
hand, lasting but a few moments, may be real but slight attacks,
which may be followed either by a much more severe one, by others
of the same kind, or by nothing at all for a long time. They are
sufficient to awaken apprehension, and to show in what direction
danger lies, but they give little information as to the time of any future
attack.
Retinal hemorrhage is admitted by all modern authors to be

connected with disease of the vascular system, and hence also with
renal inflammation and cerebral lesions. The writer is greatly
indebted to Hasket Derby for the following facts: Out of 21 patients
who had retinal hemorrhage, and of whose subsequent career he
had information, 9 had some sort of apoplectic or paralytic attack; 1
had had such an attack before she was examined; 3 died of heart
disease, 1 suddenly, the cause being variously assigned to heart
disease or apoplexy; and 6 were alive when heard from, one of
these, a man of forty-eight, being alive and well fourteen years after.
Bull25 describes four cases of his own where retinal hemorrhage was
followed by cerebral hemorrhage, demonstrated or supposed in
three, while in the fourth other symptoms rendered a similar
termination by no means improbable. He quotes others of a similar
character. The total number of cases which were kept under
observation for some years is, unfortunately, not given. In a case
under the observation of the writer a female patient, aged fifty-seven,
who had irregularity of the pulse with some cardiac hypertrophy, was
found to have a retinal hemorrhage two and a half years before an
attack of hemiplegia. The hemorrhage was not accompanied by the
white spots which often accompany retinitis albuminuria.
25 Am. Journ. Med. Sci., July, 1879.
In a case reported by Amidon26 retinal and cerebral hemorrhages

seem to have been nearly simultaneous a few hours before death.
There was diffuse neuro-retinitis and old hemorrhages besides the
recent one.
26 N. Y. Med. Rec., 1878, xiv. 13.
The highly interesting observation has been made by Lionville27 that

when miliary aneurisms are present in the brain, they may often be
found in the retina also. In one case where they were very numerous
in the cerebrum, cerebellum, pons, and meninges, aneurismal
dilatations were found also in the pericardium, mesentery, cervical
region, and carotids (the latter not being more minutely described).
There was very general atheroma and numerous points of arteritis.
The retinal aneurisms varied in size from those requiring a power of
ten or twenty diameters to be examined up to the size of a pin's head
or a millet-seed. He thinks they might have been recognized by the
ophthalmoscope.
27 Comptes Rendus de l'Acad. des Sci., 1870.
The hemorrhages accompanying idiopathic anæmia and other

diseases with a similar tendency are not to be taken into this
account. Hemorrhage accompanying optic neuritis is likely to be due
to some disease of the brain other than the one under consideration.
Mental disturbances of various kinds have been considered as

significant, and Forbes Winslow gives a great many instances of
different forms, but they are to be looked upon rather as indicating
chronic cerebral changes which may result in various conditions, of
which hemorrhage may be one, than as furnishing any definite
indication of what is to be expected. Loss of memory should be
regarded in this way. Some acute or temporary conditions of
depression may affect the nutrition of the brain in such a way, without
having anything to do with hemorrhage actual or anticipated.
Aberrations of the special senses are often observed, such as noises

in the ears more or less definite, the sight of colors (red), or being
unable to see more than a portion of an object. The fact to which
these testify is probably a localized disturbance of the circulation
which may not precede rupture of the vessels.
Distinct hallucinations of hearing, followed by those of smell and

succeeding irritability, sleeplessness, were observed by Savage28 in
a case which terminated soon after in apoplexy.
28 Journ. Ment. Sci., 1883, xxix. 90.
There are few symptoms which are more likely to excite alarm and
apprehension of a stroke of paralysis than vertigo or attacks of
dizziness, but it is too common under a great variety of
circumstances to have much value, and is, as a matter of fact, rarely
a distant precursor of intracranial hemorrhage, although it frequently
appears among the almost initiatory symptoms, especially when the

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‘Ayer Kashif’ who graduated from Faculty of

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3.2.2. Sömek House and Clinic (1957-1959)

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Figure 18. Somek house exposed stone facades,

Figure 20. Relation between inside and outside.

Free open space and introducing inside to

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Durand-Fardel gives a table of supposed causes in 21 cases of

SYMPTOMATOLOGY.—If we take as a point of departure the fully-

Loss of consciousness, abolition of voluntary motion and sensation,

Lidell gives the following case: A colored woman, aged forty-nine,

A woman, aged about forty, had been hanging out clothes in an

In a large number of cases it is difficult to say, in the absence of any

Vomiting is a symptom of some importance in diagnosis, being not

Whether of sudden, rapid, or slow development, the apoplectic

Swallowing, in the deepest coma, is not attempted. The fluid poured

The general temperature in cerebral hemorrhage has been studied

The initial fall of temperature is not so likely to be observed except in

These changes of temperature may be noted with various locations

The difference in the temperature of the two sides has been

The chart C. M. (Fig. 39) shows the excess of temperature in a case

The most marked differences of temperature have been observed

23 Archives générales, 1873, 167.

The throbbing or bounding of the arteries often described may