Commentary:
Medicine:
Where Are the Oldest Hospitals in the World?
by Jean-François Moreau, M.D.,
F.A.C.R.
Emeritus Professor of
Radiology
Université Paris Descartes, Paris,
France
With Acknowledgement: Prof
Marta Braun, Ryerson University, Toronto,
Ontario, Canada.
The 850th anniversary of
Hôtel-Dieu of Paris
will be celebrated in 2014, just after that of Cathedral Notre-Dame, both of
them simultaneously built on the Isle de la Cité by King Louis VII (1). The
900th anniversary of both St. Bartholomew's Hospital and St.
Bartholomew the Great Church founded in Smithfield London by the Benedictine Rahere during
the reign of King Henry I will be celebrated in 2023 (2).
Are
those prestigious edifices the oldest hospitals in the world? The word “Hospital” has multiple definitions
according to the medical care/social welfare ratio expressed in the
constitution of a given institution dedicated to human health services.
Hippocrates of Cos delivered medicine from religious superstition (3). Schools
of medicine were invented one millennium (5th Century BC) before the first
“hospitals“. The Byzantine Empire created the
concept of charitable “hostels“administered religiously without a medical
mission (3). The Crusades were at the origin of several hospitable orders mainly
in charge of lepers (French “maladreries”); lazaretts hosted plague victims
kept in quarantine. Multiple Hôtels-Dieu welcoming pilgrims were built all
along the pilgrimage ways to Santiago de Compostella from the 10th Century. The
original Hôtel-Dieu and St. Bartholomew’s Hospitals were such institutions
actually segregating all kinds of miserable people, whether sick or not, out of
the active city districts; they had become university hospitals with schools of
medicine and research activities after the English Reformation (Harvey) (2) or
the French Revolution (Desaux, Dupuytren, Corvisart) (1).
Our contemporary academic
hospitals originate from the heritage of Hippocratic medicine recollected by
the schismatic Nestorians banned by the Byzantins out of Antiochus to Essina in
the Syriac territory. The Arab invasion in the VIIth Century respected the
paradigm associating hospital and school of medicine they termed with a Persian
name “bimaristans“(3). Damascus was the capital
of the first Muslim empire (Umeyyad); Bimaristan Nur al-Din founded in 1154 was
transformed in Museum
of Medicine and Science
of the Arab World in 1975; sadly the bimaristan Arhun of Aleppo dated on 1354
was destroyed by bombing in October 2012(4). Baghdad became the capital of the second Arab
Empire where Abbasid Harun al-Rashid Khalifa built the most prestigious
bimaristans starring Mesue, Alhacen and Rhazes. Ibn Sina (Avicenna) practiced
later in Persica. By the last quarter of the first Millennium AD the concept
disseminated from Middle East through Northern Africa to the Hispanic Peninsula
where it fructified in Cordoba,
capital of al-Andalus emirate, under Abd-ar-Rahman III (912-961) (5). The
glorious Arab Medicine developed during the first quarter of the second
Millennium because of the peaceful collaboration of Arab, Christian, Jewish and
Barbarian scientists and physicians (Abulcassis, Avenzoar, Averroes, Maimon).
Their spirit fertilized the schools of medicine at Salerno first (Constantine
the African introducing the Latin language beside Greek and Arab) then at
Montpellier (Arnaldus de Villanova); the trend followed the Rhone Valley up to
Lyon (Gui de Chauliac) before it reached Paris and Northern Europe (1,4).
Revisiting the hospital
history provides the lessons of civilization.
References
.
Destruction of Bimaristan Arghun of Aleppo. Archaeo
Life, 14 octobre 2012. http://archaeolife.blogspot.fr/2012/10/destruction-of-bimaristan-arghun-of.html
(11 july 2013).
5. Poulet J, Sournia JC,
Martini M (eds). Histoire de la médecine, de la pharmacie, de l’art dentaire et
de l’art vétérinaire. Paris:
Albin Michel/Laffont/Tchou; 1990. vol 1-10,
Acknowledgement: Prof Marta
Braun, Ryerson University,
Toronto, Canada.