Lesson Objective: Students will learn about the influence of ancient near-and middle-easterners in the development of modern academic medicines through the establishment of hospitals (bimaristans)

                                                                       

Homira Pashai 3-14-2021

 

Studies on Persianate Manuscripts, Arts, and Literature

Illustrations: Courtesy of Library of Medicine.

Source:  Modanlou, HD. “Historical evidence for the origin of teaching hospital, medical school and the rise of academic medicine.” Journal of Perinatology (2011) 31, 236-239.

Najmabadi M. History of Medicine in Ancient Iran [in Persian]. 2nd ed. Tehran: Tehran University Press, 2001: 86. Nayernouri T. Zakariya Razi. The Iranian Physician and Scholar. History of ancient medicine in Iran. Arch Iranian Med 2008; 11(2): 229–234.

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The Establishment of Early Hospitals (bimaristans)

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The great physician Rhazes was summoned to Transoxiana to attend the Amir Mansur, who was suffering from a rheumatic affection of the joints which baffled all his medical attendants.

On reaching Bukhara, he tried various treatment methods on the Amir without success. Finally, he said to him, " Tomorrow, I shall try a new treatment, but it will cost you the best horse and best mule in your stables." The Amir agreed and placed the animals at his disposal. The next day, Rhazes brought the Amir to a hot bath outside the city. He tied up the horse and the mule, saddled and bridled outside, and entered the hot room of the bath alone with his patient, to whom he administered douches of hot water and a draught which he had prepared “till such time" says the narrator, “as the humor in his joints were matured.” Then he went out, put on his clothes, and, taking a knife in his hand, came in, and stood for a while reviling the Amir, saying, “Thou didst order me to be bound and cast into the boat, and didst conspire against my life. If I do not destroy thee as a punishment for this, my name is not Muhammad ibn Zakariya!” The Amir was furious, and, partly from anger, partly from fear, sprang to his feet." Rhazes at once fled from the bath to where his servant was awaiting him outside with the horse and the mule, rode off at full gallop and did not pause in his flight until he had crossed the Oxus and reached Marv, whence he wrote to the Amir as follows:

'' May the life of the King be prolonged in health and authority! Agreeably to my undertaking, I treated you to the best of my ability. There was, however, a deficiency in the natural caloric. This treatment would have been unduly protracted, so I abandoned it in favor of psychotherapeutics (‘ilaj-i-nafsani), and, when the peccant humor had undergone sufficient coaction in the bath, I deliberately provoked you to increase the natural caloric, which thus gained sufficient strength to dissolve the already softened humors. But henceforth, it is inexpedient that we should meet.

The Amir, having recovered from his anger, was delighted to find himself restored to health and freedom of movement, and caused search to be made everywhere for the physician, but in vain, until on the seventh day his servant returned with the horse and mule and the letter cited above. As Rhazes persisted in his resolution not to return, the Amir rewarded him with a robe of honor and a pension of 2000 gold dinars.

Subsequently, Rhazes became physician-in-chief to the great hospital at Baghdad, about the foundation of which he is said to have been consulted. Being asked to select the most suitable site, he is said to have caused pieces of meat to be hung up in different quarters of the city, and to have chosen the place where they were slowest in showing signs of decomposition.

 

      The ‘Adudi Hospital بیمارستان عضدی was established in 982 AD during the ‘Adud al-Dawla Daylami عضد الدوله دیلمی, one of the Amir’s of the Buyid dynasty.  According to Edward Granville Brown, the Amir consulted Al-Razi (Rhazes) رازی for choosing the proper location of the hospital in Baghdad. Al-Razi decided to hang up fresh meat in various quarters of the city and observed the decomposition of the flesh. Al-Razi chose the place with the slowest rate of decay as the construction site of the hospital. Bimaristan ‘Adudi (‘Adudi Hospital), which was destroyed in 1068 due to the flood of the Tigris River, was rebuilt and used until it was destroyed during the Siege of Baghdad in 1258 by the command of the Mongol Hulagu Khan.

 

      The Jundi-Shapur جندی شاپور medical facility funded in about 555 AD, by Khusraw Anushirawan خسرو انوشیروان in the south-west of Persia, which is now marked by the ruins near the city of Ahwas اهواز . It served as a model for contemporary academic medical centers that exist in the world today. It was in Jundi-Shapur that Persians, Greeks, Indians, Zoroastrians, Jews, and Nestorians worked together for the advancement of philosophical and medical traditions set to occur under Muslim rule. It is known that the Prophet Mohammad’s physician, Harith ibn Kalada was trained at Jundi-Shapur. The city of Jundi-Shapur had become a melting pot, and refuge for intellectuals from various regions since Syrians and Nestorians took refuge there when Antioch was captured, and later when the School of Edessa was purged by the Byzantines in 457. When the Byzantine Emperor Justinian (529 AD) closed the Athenian school, many learned Greek physicians moved to Jundi-Shapur. As a result, the Jundi-Shapur became a unique place for scholarship and learning.

      During the Abbasid, Caliph Abu Ja’far- al- Mansur  جعفر المنصورsummoned Jurjis ibn Bakhtishu جرجیس ابن بختیشو , the chief of the Jundi-Shapur Hospital to Baghdad in 726 AD, since al-Mansur was ill. As a result, the Bakhtishu family of physicians became in contact with the Abbasid court. During the reign of Caliph Harun al-Rashid (786-809 AD) هارون الرشید , Jibrail ibn Bakhtishu  جبرییل ابن بختیشوwas invited to Baghdad to build the first bimaristan of Baghdad. Tulun hospitalبیمارستان طولونی constructed in Cairo in 872 AD by the governor of Egypt Ahmad ibn Tulun, in the 12th century Saladin Ayubi صلاح الدین ایوبی founded the Nasiri hospital بیمارستان نصیری of Cairo, and the Nuri hospital بیمارستان نوری was made in Damascus. Al- Mansuri bimaristan بیمارستان منصوری  was constructed in Cairo in 1284 AD. The al-Mansuri hospital had a total capacity of 8000 beds and served all citizens without any regard to color, religion, sex, age, or social status. It had separate wards for medicine, surgery, fever, wounds, mania, and eye diseases. The hospital was equipped with pharmacy, library, lecture halls, mosque, and sometimes a chapel. Music therapy was also used to comfort and cheer patients. Medical records were developed by students keeping the records of each patient along with the medical treatment available to each patient. The records that the students compiled were known as treatments based on repeated experiences. Anatomy was taught through lectures, illustrations, and ape dissections. Students also studied medicinal herbs and pharmacology.

      Jundi-Shapur, as a result, was the predecessor of institutionalized establishments that were the models of modern hospitals. Later Spain and Portugal, under the Islamic empire for over 700 years, were riddled with bimaristans. Returning from crusades, the Knights of St. John, who were called “Hospitallers” later, constructed hospitals based on the Arabic models founded by Saladصلاح الدین ایوبی . As the Jundi-Shapur traditional model of learned physicians and apprentices turned into new models of medical students working under the direction of medical faculties, the bimaristans of antiquity served as models for the modern hospitals appearing in our world.

 

Activity: Choose a hospital (historical or modern) and explain the establishment, history, geographical location, and departments. You can be creative in explaining one department in- depth concerning the historical and geographical location or briefly cover the entire departments.

 

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Terms:

Bimar  (ill person) + stan (place)

 

Jundi-Shapur

 

Saladin Ayubi

 

Jurjis ibn Bakhtishu

 

Al-Razi

 

Hulagu Khan

 

Khusraw Anushirawan

 

Harun al-Rashid

 

 

https://www.nlm.nih.gov/hmd/arabic/therapeutics_tb.html#top

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1676324/

 

https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html

 

https://www.wdl.org/en/item/4276/

 

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Kitab al-Hawi fi al-tibb (The comprehensive book on medicine), which was translated into Latin in 1279 under the title Continens Rasis. 

 

the Kitab al-Mansouri fi al-Tibb (The book on medicine dedicated to al-Mansur) Liber al-mansoris.