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

1. Delavierre P. L’Hôtel-Dieu de Paris. Paris: Pierre Téqui; 2011.

2. St Bartholomew's Hospital history timeline, 1123-2012 http://www.bartshealth.nhs.uk/our-hospitals/st-bartholomew%E2%80%99s-hospital/our-history/ (24 June 2013).

3. Gardenour B. Hospitals. In: Glick TF, Livesey SJ, Wallis F (eds). Medieval Science, Technology and Medicine: an Encyclopedia. New York: Routledge; 2005. p 226-28.

4. 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.



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