Hospitals: Islamic Medicine’s Contribution to Modern Medicine
Ibrahim B. Syed,
Islamic Research Foundation International, Inc.
7102 W. Shefford Lane
Louisville, KY 40242-6462, USA
A B S T R A C
" Hospital" is
derived from the Latin "hospitium"- a guest, because the institutions were first
designed for the reception of pilgrims, wayfarers, and the infirm.1
In the West almost all were established by the Church. In the Muslim world they
are known as "bimaristans." Many great hospitals were built by rulers or by
private individuals throughout the Islamic World. Hospitals were either
constructed for a particular physician, or later put under the direction of a
particularly eminent doctor.
The development of efficient hospitals was an outstanding
contribution of Islamic medicine. The hospitals served all citizens free and
without any regard to their color, religion, sex, age or social status.
Hospitals had separate wards for male and female patients and were staffed with
nursing and other ancillary staff of the same sex. Patients with different
diseases were allocated different wards. Hospitals provided patients with
unlimited water supply and bathing facilities. Only qualified and licensed
physicians were allowed to practice medicine. The hospitals were teaching
hospitals to educate and train medical students. They had housing for students
and house-staff, and contained pharmacies dispensing free drugs to patients. All
hospitals had their own conference rooms and extensive and expensive libraries
containing the most up-to-date books. Universities, cities and hospitals
acquired large libraries, physicians had their own extensive personal book
collections, at a time when printing was unknown and book editing was done by
skilled and specialized scribes putting in long hours of labor. These hospitals
kept records of all their patients and their medical care, something done for
the first time in medical history. The hospital was divided into two main
departments, outpatient and in-patient departments. The in-patient department
differed only slightly from any modern in-patient department. On admission the
patients were given special apparel while their clothes, money, and valuables
were stored away, and returned to them at the time of their discharge. On
discharge, they also received five gold pieces each to tide them over until they
could support themselves. The hospital also provided facilities for performing
prayers. Medical officers regularly visited the prisons. At a time when Paris
and London were mud streets and hovels, Baghdad, Cairo, and Cordova had
hospitals, which incorporated innovations, which sound amazingly modern. It was
chiefly in the humaneness of patient caring that the Muslim hospitals excelled.
Near the wards of those afflicted with fever, fountains cooled the air; the
insane were treated with gentleness; and at night music and storytelling soothed
Key Words: Bimaristan,
Music therapy, and famous hospitals, Efficient Hospitals, Islamic medical
therapy techniques, Prophetic traditions.
During the Islamic
civilization, hospitals had developed and attained specific characteristics:2
1. Secular: Hospitals
served all peoples irrespective of color, religion, or background. They were run
by the government rather than by the church, and their directors were commonly
physicians assisted by persons who had no special religious color. In hospital,
physicians of all faiths worked together with one aim in common: the well-being
2. Separate wards:
Patients of different sexes occupied separate wards. Also different diseases
especially infectious ones, were allocated diffe-rent wards. There were
different wards for fever, wounds, mania, eye conditions, cold diseases, and
diarrhea. Convalescents had separate sections within them.
3. Separate nurses:
Male nurses were to take care of male patients, and vice-versa.
4. Baths and water
supplies: Five times a day praying is an important pillar of Islam. Before
praying one has to perform wudu or ablution. For certain conditions full
bath is obligatory. Therefore the Muslim hospitals had to provide the patients
and employees with unlimited supply of water and adequate bathing facilities.
5. Physicians: Only
qualified physicians were allowed to practice medicine by law. In 931 CE, the
chief court-physician Sinan Ibn-Thabit was ordered by Caliph A; -Muqtadir to
grant licenses to practice medicine to only quali-fied physicians out of the 860
physicians in Baghdad. His counterpart Abu-Osman Sai'id Ibn-Yaqub was ordered to
do the same thing in Damascus, Mecca and Medina. The latter two cities were very
important because of hundreds of thousands of pilgrims visiting them every year
for Umra and Hajj.
6. Medical Schools:3
The hospital served as a medical school to educate and train medical students,
imparting medical knowledge and advancing medical knowledge. Extensive libraries
were attached to the hospitals, containing most up-to-date books. Tulum Hospital
in Cairo in 872 CE had 100,000 books. (Mustansiriyya University in Baghdad had
80,000 volumes. Cordova library had 600,000 volumes; Cairo had 2,000,000 and
Tripoli 3,000,000). Physicians had their own extensive personal book
collections, at a time when printing was unknown and book editing was done by
skilled and specialized scribes putting in long hours of manual labor. There
were conference halls for lectures and meetings. There were housing facilities
for both students and staff of the hospital.
7. Medical records: The
Muslim hospitals were the first in history to keep regular records of patients
and their medical treatment.
8. Pharmacy: The
hospital pharmacy of the Muslim hospitals was highly developed and performed an
outstanding service to the patients. Chemistry became an advanced science and
pharmacy developed into a specialized subject.
The caliphs of the
Islamic Empire built magnificent hospitals, because of Islam's emphasis on
charity, to attain everlasting name, and to show to the public that they really
cared for their welfare.
In the twelfth and
thirteenth centuries, hospitals in Syria and Egypt had achieved such high levels
of performance that travelers and historians regarded them as one of the
treasures of Muslim civilization. They attracted gifted students and best
medical educators and enjoyed rich endowments and generous patronage. They were
elegant, spacious buildings, equipped with comfortable lecture halls, extensive
libraries, well-stocked pharmacy shops, and efficient laboratories, where
medications could be freshly prepared and dispensed.
Al-Nuri Hospital: the
Umayyad Caliph, Al-Walid, built the first hospital in Islam in Damascus in 706
CE. Al-Nuri hospital named after King Nur Al-Din Zanji was built in 1156 CE
during the crusades. It was a first class hospital and medical school. The
hospital initiated medical record keeping-the first in the world. Eminent
physicians, like Ibn Al-Nafis (discoverer of pulmonary circulation),
graduated from the medical school. The hospital served the public for over seven
It was built in Jerusalem in 1055 CE by the Crusaders as Saint John Hospital. It
was renamed Al-Salahani Hospital in 1187 CE. Salah Al-Din expanded the hospital
and it served the people until 1458 CE when it was destroyed by an earthquake.
Built in Baghdad in 918 CE by Caliph Al-Muqtadir.
Al-Adudi Hospital: It
was built in 981 CE and named after King Adud Al-Dawlah. It was the most
magnificent hospital built in Baghdad before modern times. It was outfitted with
the best equipment and supplies available at that time. It had residents,
interns, and twenty-four consult-ants to care and look after the patients. Haly
Abbas was a staff physician. It was destroyed by Hulagu, the grandson of Chengiz
Khan in 1258.
Al-Fustat Hospital: It
was built in 872 CE by Ahmed Ibn-Tulum in the city of Al-Fustat(part of old
Cairo). It had separate wards. On admission the patients were given special
garments while their personal belongings were stored away and returned to them
at the time of discharge. It served the population of Cairo for six centuries.
Hospital:Built in 1248 CE by King Al-Mansur Qalawun in Cairo. While fighting the
Crusaders, general Qalawun became sick and was treated in Al-Nuri hospital. On
recovery, he vowed that if he ever became the ruler of Egypt, he would build a
larger and magnificent hospital in Cairo for the sick, poor and rich alike.
Music therapy was used as a line of treatment for psychiatric patients. It
served four thousands patients daily. Hospital stay was free and upon discharge
the patient was given food and money as a compensation for the wages he lost
during his stay in the hospital. It has served for the past seven centuries.
Today it is used for ophthalmology and is called Mustashfa Qalawun.
In 830 CE Prince Ziyadat Allah I, built this hospital in the district of the
Qayrawan city called Al-Dimnah. Subsequently all hospitals in Tunisia were
called Dimnah instead of Bimaristan. It had spacious wards, waiting rooms
for visitors and patients, and female nurses from Sudan-the first use of
nursing in Arabic history. The hospital had a mosque for prayers.
Marakesh Hospital: In
1190 CE, King Al-Mansur Ya'qub Ibn-Yusuf, built this hospital in the capital
city of Morocco-Marakesh. It was beautifully landscaped with fruit trees and
flowers. Aqueducts carried water to all sections. Patients were provided with
special attire: one for winter and another for summer. Specialists called
Sayadlah ran the pharmacy. There was an expensive private room where patients
were charged today's equivalent of $150.00 per day. This fee was quite expensive
thousand years ago.
Granada Hospital: In
Spain in 1366 CE, Prince Muhammed Ibn-Yusuf Ibn Nasr built this hospital in the
city of Granada which had a population of half million. This hospital had the
beauty of the Arabic architecture and served the people until the fall of
Granada in 1492 CE.
Delhi Hospitals: In the
fourteenth century in Delhi, India, there were one thousand schools and colleges
(madrasas) and seven hundred hospitals, two thousand Sufi lodges and hospices in
and around Delhi.
Technique of Therapy
in Islamic Medicine5
The patients were
treated according to a well-defined treatment plan. Initially the treatment
began with physiotherapy and diet. If this treat-ment failed, then the patients
were treated with drugs. Only as a last resort surgery was employed. The
physiotherapy included exercises and water baths. The Muslim physicians were
aware of food deficiencies and hence developed a detailed system of diet
therapy. Drugs were divided into two groups: simple and compound drugs. The
Muslim physicians were aware of interaction between drugs. First they used the
simple drugs. If these drugs did not work then they used two or more compounds.
When all these traditional measures failed, surgery was performed.
AHADITH ON MEDICAL
1. The Muslims are
exhorted to visit the sick and give them hope and comfort.
2. Hadith Qudsi # 18: "
O son of Adam, I fell ill and you visited Me not. He will say: O Lord, and how
should I visit You when You are the Lord of the worlds? He will say: Did you not
know that My servant So-and-so had fallen ill and you visited him not? Did you
not know that had you visited him you would have found Me with him?...."
3. When the Prophet
visited a sick person (after 3 days of illness) he would say "Do not fear, it
(illness) is a Catharsis (purification), God willing."
4. People visiting the
sick are asked to say such things to them as would make them happy.
5. God also visits the
sick and says, "O my servant! Health unites you
With yourself, but
sickness unites you to Me."
The Umayyad caliph
al-Waleed (ruled 705-715 CE) is said to have been the first to set up
institutions for lepers and the blind where servants and guides were employed to
help the inmates. The hospitals proper did not begin until the Abbasid caliphate
(750-1257). Caliph Harun al-Rashid ordered the establishment of the first
hospital at Baghdad. This hospital was set up by the Christian Jibra'IL ibn
Makhtishu, a doctor at Gundaishapur. A Persian Christian, Yuhanna ibn Masawaih,
eventually became the head of this hospital. The Persian term bimaristan,
"the place for the sick" was used for hospital by both the Arabs and
later the Turks. After Harun's hospital, at the end of the ninth century a
number of new hospital foundations were followed in quick succession. The first
of these was established by the page of the caliph al-Mutadid (d.902) and named
for the caliph. Ali ibn Isa, the "good vizier", founded a bimaristan in
914 and appointed Abu Uthman al-Dimashqi, a Christian who also made translations
from the Greek, as the director of this hospital as well as those in Mecca and
Medina. Sinan ibn Thabit, a Christian succeeded him as the superintendent of
these hospitals. He himself set up a new hospital in 914.
Many larger hospitals
had quarters for mental patients. Still several hospitals were specifically
established for them. The same vizier, Ali ibn Isa ordered Sinan ibn Thabit to
organize a team to visit the sick in jails. Again the same vizier ordered mobile
dispensaries to be established to look after the health needs of the
countryside, particularly surrounding the towns where no doctors were available.
Many doctors are
mentioned in the history of Islamic medicine that, from their income from
medicine, set up their own hospitals and charitable clinics. The governments
(called musadara) confiscated the wealth of politicians, viziers, governors and
military generals, the wealth of professionals like doctors were immune from
Besides the hospitals
and asylums, there were other types of health establishments. Special health
centers were located near Jamia Masajids.
There were Army
hospitals, with their own doctors and services. They were mobile hospitals and
they followed the movements of the army. It is reported that the army of the
Ghaznavid sultan Mahmud (d.1030) was accompanied by a special medical caravan
consisting of forty camels.
The Adudi hospital set
up in Baghdad in 982 by the Buyid Adud al-Daula (d.983) became the most famous
of the early hospitals. Abu-Bakr al-Razi was the administrator who was chosen
out of one hundred applicants. He selected the hospital site at the banks of the
river Tigris after hang-ing a piece of meat in several places for a few days and
deciding in favor of the place where meat was found to be least infected. This
hospital had 24 doctors with different specializations. A doctor who did his
duty two days and two nights a week is said to have been paid 300 dirhams per
month. THIRTEENTH CENTURY HOSPITAL IN PARIS7
The hospital in Paris
was called Hotel-Dieu (House of God) and it was a house of refuge for the poor,
sick, and infirm, as well as a shelter for travellers and pilgrims.
There were four
main wards and several annexes. The ceilings were
High, the average being 18 to 25 feet high. A
system of pulleys and cords provided excellent ventilation, and assisted in the
regulation of temperature. Heat was provided in each ward by means of charcoal
stoves with chimneys.
work of the hospital was conducted by thirty lay brothers, four clerical
brothers, four priests, and twenty-five sisters.
The hospital was
controlled by an administrative board. The prior was
in charge of six departments: household, kitchen,
chapel, cellar, baths, and charity-box.
Diet: Meat was served
on Sundays, Tuesdays, Thursdays, and on certain religious holidays, including
Christmas. Food was served twice a day. The patients were served before the
staff. Each patient had his own dishes, including a wooden plate and a spoon.
Beef was the most common meat. Fowl, soup, eggs, fish, and fruits such as figs,
raisins, apples, and pears appeared regularly. They had wine with each meal, and
each ward received three pints of milk weekly.
patients: (1) the aged, (2) the sick (3) the poor
and (4) the pensioners.
The pensioners were not patients but lived
on the estates of the
hospital by paying money for boarding and lodging.
Admission criteria: The
patient presents himself at the door, where he was received by a sister. He
confessed his sins, took communion, and was then placed in a ward according to
the apparent seriousness of his condition. Men and women were admitted to all
wards, but there was one
ward exclusively for
women with eighty beds. They placed several persons in one bed. At Hotel-Dieu
there were not more than two in one bed.
Visitors were admitted
at any time, but came most frequently to spend the afternoon.
Hotel-Dieu had medical
and surgical staff. The members were licensed. Obstetrics was left entirely in
the hands of midwives. Victims of plague, leprosy and other widely feared
contagious diseases were isolated. Emphasis was laid on natural treatments
rather than on the extensive use of herbs and drugs. Purgatives were freely
prescribed, both medicines and fruits being used for that purpose. Baths and
exercise were usually prescribed to follow. Since Hotel-Dieu was run by the
church, great attention was paid to the religious needs of the sick. Priests and
clerical brothers performed regular services for them. They visited the sick,
confessed them, adminis-tered sacraments to the dying, conducted funerals, made
and executed the wills.
The Qur'an does not
say anything about music directly one
way or the other,
however it looks upon melodious voice with favor.
Says al-Dhahabi author
of Prophetic Medicine, (famous traditionist and historian, d.1348 CE),
"Singing is the soul's pleasure, the heart's delight and food for the spirit; it
constitutes part of the most exalted spiritual medicine. It is pleasurable even
to some animals. Its moderate enjoyment kindles natural warmth, strengthens the
activity of the various faculties, slows down aging, and repels many diseases."
Abu Nu'aim (d.1038), the theologian and man of piety who was among the first to
write a work on the Prophetic Medicine, reports from the Prophet that "music
beautifies and refreshes the body just as excessive worry ails it." The best
part of singing is, of course, the melodious recital of the Qur'an because,
apart from the beauty of its words, the soul benefits from its lofty idea. The
Prophet said, "embellish the Qur'an with your beautiful voices."
Ibn Qutaiba (d.889), a
famous ninth-century man of letters, a profound defender of Hadith, and a
secretary of state in the Abbasid caliphate was heavily in favor of music and
its healthy effects, both spiritual and physical. Al-Dhahabi tells us that music
can be unlawful, reprehensible, permissible, recommended, and even religiously
obligatory (that is Qur'an-recital with tajweed, when accompanied by an
understanding of its meaning). The only unlawful and reprehensible forms of
music are found where the singers are low-class ruffians performing with
beautiful young girls who excite the people's passions.
It was chiefly in the
humaneness of patient caring that the Muslim hospitals excelled. Near the wards
of those afflicted with fever, fountains cooled the air; the insane were treated
with gentleness; and at night music and storytelling soothed the patients.
Islamic medicine is one
of the most amazing and best-known facets of Islamic civilization, and is an
area in which the Muslims excelled most.
E F E R E N C E S
Carstens HR: The History of
Hospitals, with Special Reference to some of the World's Oldest
Institutions. Ann Intern Med 1937; 10:670-682.
by Dehlvi, AS, Chapter 8"Paying a visit
To a Patient
and Patient in Miseries, Taj Publishers, Bombay,
Al-Ashi A: Visiting the
Sick. MWL Series on Islam No.25, Muslim World League Canada Office,
Etobicoke, Ontario, Canada, 1998.
Hadees-E-Qudsi, ibid p.55.
Tibbe Nabawi. Edited by
Alam K, In: Dehlvi AS, Prophetic Medical Sciences. Bombay: Taj Publishers,
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Health and Medicine in the Islamic Tradition. Cross Road Pub Co, New York-, Pub
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Development of Hospitals in Islam. J History of Med and Allied Sciences 1962;
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Medicine and Medical Education in Islamic History. In: Athar S, Ed, and Islamic
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Health and Medicine in the Islamic Tradition. Cross Road Pub Co, New York-, Pub
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and Civilization in Islam. Barnes & Noble Books, New York, 1992:89,