The Invention of the Hospital
A Credit to Islamic Medieval Medicine
by Ilene Springer
In modern times we take the hospital for grantedand hope that we never have to go there. But if we do, we count tremendously on it being a place that can save us and ease our pain in time of acute illness or accident.
Its interesting to think that there was a time that hospitals did not exist. The hospital is actually a medical/social invention. And the people we have to thank are the Caliphs, one of the early titles of civic and religious heads of the world of Islam, which included Egypt, Turkey, Persia, Syria, India and Spain, among other ancient nations.
"The idea of a hospital as an institutional place for the caring of the sick has not been recorded in antiquity," writes Husain F. Nagamia, MD., Chairman of the International Institute of Islamic Medicine. There were sanatoria and travel lodges that were attached to temples and by attendant priests." But most treatments consisted of prayers and sacrifices to the gods of healing. And when cures occurred, they were attributed to divine intervention only.
Many hospitals were developed early during the Islamic era. They were called Bimaristan or Maristan. But the idea of a hospital where the sick could get comprehensive attention was totally adopted by the early Caliphs. The first hospital was founded by Caliph Al-Walid I an Ummayad Caliph (705-715 AD) in Jundishapur, a Persian city in the province of Ahwaz, according to Nagamia. But some consider that this institution was only a place for lepers because it enforced segregation. However, it did have salaried staff physicians attending the sick. And it was here that Greek medicine with Zoroastrian (pre-Islamic Persian religion founded in the 6th century BC) ideas and local Persian medical practices began to flourish.
The first true Islamic hospital was built during the reign of Caliph Harun-ul-Rashid (786-809 AD) in Baghdad. A well-known physician, Jibrail Bakhtishu, was invited to head the new bimartistan. It achieved fame and other hospitals were built in Baghdad.
Theres a very intriguing story about how the great Islamic physician Al-Razi selected the site for the Audidi hospital. He had pieces of meat hung in various quarters of the city and watched how much and how quickly they putrefied. He then advised the Caliph to locate the hospital where the putrefaction was the slowest and the least! This showed the inception of the concept of germs carried through the air. When the hospital opened, it had 24 physicians on staff including specialists categorized as physiologists, oculists, surgeons and bonesetters.
The Art and Science of Islamic Medicine
How did the notion of the hospital come about? It developed from the philosophy of Islamic thought, religion, culture and the study of natural science. According to Nagamia, Islamic medicine is the body of medical knowledge that was inherited by the Muslims in the early phase of Islamic history (661-861 AD). At first, this knowledge mostly came from Greek and Roman sources, but then added information from Persia, Syria, India and the Byzantine Empire. As new knowledge became assimilated and discovered by Islamic physicians, voluminous medical texts were translated into Arabic, "the literary and scientific lingua franca of the time," writes Nagamia. Both Muslim and non-Muslim physicians added to their own observations and experiments and converted an initial body of medical knowledge into a thriving and practical science.
It not only helped in curing the ailments of the masses, writes Nagamia, but also increased their standards of health. The development of the hospital as a central location to study and treat the ill was a natural outgrowth of this explosion of medical exploration and discovery.
As everything Islamic, medical treatment was integrally woven into the philosophy of religion and caring for the unfortunate. There was a guiding text called the Waqf document, which stated: "The hospital shall keep all patients, men and women, until they are completely recovered. All costs are to be borne by the hospital whether the people come from afar or near, whether they are residents or foreigners, strong or weak, rich or poor, employed or unemployed, blind or sighted, physically or mentally ill, learned or illiterate. There are no conditions of consideration and payment; none is objected to or even indirectly hinted at for non-payment. The entire service is through the magnificence of Allah, the generous one."
The growth of Islamic hospitals
One of the largest hospitals ever built was the Mansuri Hospital in Cairo, completed in 1248 AD under the rule of the Mameluke ruler of Egypt, Mansur Qalaun. The hospital garnered many endowments for its functioning. According to Nagamia, men and women were admitted to different wards, and no attention was paid to religion, race or creed. Following the tenets of the Waqf document, no one was turned away and there was no limit to how long patients could stay.
There were different wards for different conditions, such as those requiring surgical procedures, fevers and eye diseases. The Mansuri Hospital had its own pharmacy, library and lecture halls. "There was also a mosque for Muslim patients, as well as a chapel for Christian patients," writes Nagamia.
The physical conditions of many of these hospitals were actually lavish, especially those established by princes, rulers and viziers. Some were even converted from palaces.
The invention of the hospital was one of the greatest achievements of Islamic medicine. Probably the most impressive aspect of this invention was its missionthe treatment of all people who came to it, regardless of their status. Its a mission that modern hospitals would be advised to follow, despite all their technological advances.