Bimaristans of medieval Islam

Bimaristan comes from Persian: bimar, an ill person, and stan, a place. The earliest hospital known to have been founded by an Islamic ruler was built in Baghdad in the 9th century, probably by the vizier of the caliph Harun al-Rashid, and little else is known about it. Some accounts credit the Umayyad caliph al-Walid I, who ruled from 705 to 715, with an earlier hospice in Damascus, possibly for lepers; other versions say he only provided guides for the blind, servants for the crippled and money for lepers. Within little more than a century Baghdad had five more bimaristans.

In 872 Ahmad ibn Tulun, the Abbasid governor of Egypt, built a hospital in what is now Cairo. It is the earliest for which there is clear evidence of care for the insane. Adud al-Dawlah's hospital in Baghdad, founded in 982, opened with 25 doctors, among them oculists, surgeons and bonesetters. Hospitals also rose in Damascus, Mecca, Medina, al-Qayrawan and Iran, where al-Razi headed the one at Rayy.

The Syrian and Egyptian hospitals of the 12th and 13th centuries are the best documented. Built around four vaulted halls, they had fountains and baths, a pharmacy, a separate hall for women, and areas for eye disease, dysentery, fevers, surgery and the mentally ill. Many ran outpatient clinics with a free dispensary. Physicians worked to a roster and made rounds, helped by pharmacists, orderlies and male and female attendants. The Mansuri hospital in Cairo, completed in 1284 after eleven months of building, had the largest budget of any public institution in the city. When Ibn al-Nafis, Cairo's chief of physicians, died in 1288, he left it his house and library.

Care was meant to be free, though individual physicians might charge fees. Many hospitals took men and women, rich and poor, Muslims and non-Muslims, and they also sheltered convalescents and old people with no family. The wealthy were usually treated at home. The money came from waqfs, pious endowments of shops, mills, caravanserais or whole villages, and a discharged patient sometimes received a small stipend. When endowments ran short or their lands were confiscated, most hospitals declined. The Nuri hospital in Damascus, founded in the middle of the 12th century, was still a major hospital well into the 15th.