This paper discusses the history of an 1845 Ottoman hospital founded by Bezm-i Alem, mother of the reigning sultan Abdülmecit I (reigned 1839-1856), embedded in the medical and political contexts of the Middle East in the nineteenth century. The main focus of this paper is the Ottoman discourse of modernization, which identified progress with modernization and westernization and induced a belief in the positive character of progress, with a high degree of optimism regarding the success of the process. The Bezm-i Alem hospital illustrates the medical reality of the 19th century, reconstructed through Ottoman eyes rather than from the perspective of foreigners with their own agenda and biases. In many respects it continued previous medical traditions; other aspects reveal brand new developments in Ottoman medicine and hospital management. Ottoman medical reality was one of coexistence and rivalry: traditional conceptions of medicine and health were believed and practiced side-by-side with new western-like concepts and techniques.