In the medieval Islamic world, the word "Bimaristan" was used to indicate a hospital in the modern sense, an establishment where the ill were welcomed and cared for by qualified staff. In this way, Muslim physicians were the first to make a distinction between a hospital and other different forms of healing temples, sleep temples, hospices, assylums, lazarets and leper-houses, all of which in ancient times were more concerned with isolating the sick and the mad from society "rather than to offer them any way to a true cure." The medieval Bimaristan hospitals are thus considered "the first hospitals" in the modern sense of the word. The first public hospitals, psychiatric hospitals and medical universities were also introduced by medieval Muslim physicians.
The first Bimaristan after the Gundishapur was founded in 707 by the Muslim caliph al-Waleed bin Abdel Malek in Damascus. At the time, most Islamic hospitals had doctors that diagnosed and treated all patients, but the Bimaristan was unique in that it had doctors that specialized in certain diseases. Originally, these health centers were specifically for patients with specific afflictions such as pestilence and blindness, and all services were free of charge.
According to Sir John Bagot Glubb:
The largest hospital of the Middle Ages and pre-modern era was built in Cairo, Egypt, by Sultan Qalaun al-Mansur in 1285. According to Will Durant, the hospital had a spacious quadrangular enclosure with four buildings around a courtyard "adorned with arcades and cooled with fountains and brooks." The hospital had "separate wards for diverse diseases and for convalescents", and had laboratories, a dispensary, out-patient clinics, kitchens, baths, a library, a religious place of worship, lecture halls, and "pleasant accommodations for the insane." Treatment was given for free to patients of all backgrounds, regardless of gender, ethnicity or income, while convalescents were offered disbursements on their departure so that they wouldn't need to return to work immediately. "The sleepless were provided with soft music, professional story-tellers, and perhaps books of history. According to Howard R. Turner, the medieval Islamic hospitals in Cairo, Baghdad and Damascus were no less advanced than the later hospitals of England's Victorian era.
"The physician asks the patient about the cause of his illness and the pain he feels. He prepares syrups and other drugs, then writes a copy of the prescription to the parents attending with the patient. The following day he re-examines the patient and looks at the drugs and asks him how he feels, and accordingly advises the patient. This procedure is repeated every day until the patient is either cured or dies. If the patient is cured, the physician is paid. If the patient dies, his parents go to the chief doctor and present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job without negligence, he tells the parents that death was natural; if he judges otherwise, he informs them to take the blood money of their relative from the physician as his death was the result of his bad performance and negligence. In this honorable way they were sure that medicine was practiced by experienced, well trained personnel."
Once admitted into a Bimaristan, the patient can stay for as long as she/or he needed; there was no time limit. Once the patient has fully recovered, they were provided, not only with clean clothes, but with pocket money.
Another unique feature of medieval Muslim hospitals was the role of female staff, who were rarely employed in ancient and medieval healing temples elsewhere in the world. Medieval Muslim hospitals commonly employed female nurses, including nurses from as far as Sudan, a sign of great breakthrough. Muslim hospitals were also the first to employ female physicians, the most famous being two female physicians from the Banu Zuhr family who served the Almohad ruler Abu Yusuf Ya'qub al-Mansur in the 12th century. This was necessary due to the segregation between male and female patients in Islamic hospitals. Later in the 15th century, female surgeons were illustrated for the first time in Şerafeddin Sabuncuoğlu's Cerrahiyyetu'l-Haniyye (Imperial Surgery).
In addition to regular physicians who attended the sick, there were Fuqaha al-Badan, a kind of religious physio-therapists, group of religious scholars whose medical services included bloodletting, bone setting, and cauterisation. During Ottoman rule, when hospitals reached a particular distinction, Sultan Bayazid II built a mental hospital and medical madrasa in Edirne, and a number of other early hospitals were also built in Turkey. Unlike in Greek temples to healing gods, the clerics working in these facilities employed scientific methodology far beyond that of their contemporaries in their treatment of patients.
The waqf trust institutions funded the hospitals for various expenses, including the wages of doctors, ophthalmologists, surgeons, chemists, pharmacists, domestics and all other staff, the purchase of foods and remedies; hospital equipment such as beds, mattresses, bowls and perfumes; and repairs to buildings. The waqf trusts also funded medical schools, and their revenues covered various expenses such as their maintenance and the payment of teachers and students.
Hospitals in the Islamic world were secular institutions which treated patients of all ethnic backgrounds and financial statuses, including patients who were male and female, civilian and military, child and adult, rich and poor, and Muslims and non-Muslims. Like modern hospitals, medieval Muslim hospitals were often large urban structures which served a variety of different purposes, including its roles as a centre of medical treatment, a home for patients recovering from illness or accidents, an insane asylum for patients suffering from mental illness, a retirement home for the elderly, a medical school for students, and an outpatient clinic dispensing medical drugs. The dispensaries of urban hospitals "prescribed accurate amounts of drugs of controlled composition.
Muslim hospitals were the first to feature competency tests for doctors, drug purity regulations, nurses and interns, and advanced surgical procedures. As the pathology of contagion was better understood by Muslim physicians, hospitals were created with separate wards for specific illnesses for the first time, so that people with contagious diseases could be kept away from other patients.
Al-Nuri hospital in Egypt was a famous teaching hospital built by Nur ad-Din Zanqi, and was where many renowned physicians were taught. The hospital's medical school is said had elegant rooms, and a library which many of its books were donated by Zangi's physician, Abu al-Majid al-Bahili. A number of Muslim physicians and physicists graduated from there. Among the well-known students are Ibn Abi Usaybi'ah (1203-1270) the famous medical historian, and 'Ala ad-Din Ibn al-Nafis (d. 1289) whose discovery of pulmonary circulation and the lesser circulatory system marked a new step in the better understanding of human physiology and was the earliest explanation until William Harvey (1628).
One of the features in medieval Muslim hospitals that distinguished them from their contemporaries was their higher standards of medical ethics. Hospitals in the Islamic world treated patients of all religions, ethnicities, and backgrounds, while the hospitals themselves often employed staff from Christian, Jewish and other minority backgrounds. Muslim doctors and physicians were expected to have obligations towards their patients, regardless of their wealth or backgrounds. The ethical standards of Muslim physicians was first laid down in the 9th century by Ishaq bin Ali Rahawi, who wrote the Adab al-Tabib (Conduct of a Physician), the first treatise dedicated to medical ethics. He regarded physicians as "guardians of souls and bodies", and wrote twenty chapters on various topics related to medical ethics, including:
On a professional level, al-Razi (Rhazes) introduced many practical, progressive, medical and psychological ideas in the 10th century. He attacked charlatans and fake doctors who roamed the cities and countryside selling their nostrums and 'cures'. At the same time, he warned that even highly educated doctors did not have the answers to all medical problems and could not cure all sicknesses or heal every disease, which was humanly speaking impossible. To become more useful in their services and truer to their calling, Razi advised practitioners to keep up with advanced knowledge by continually studying medical books and exposing themselves to new information. He made a distinction between curable and incurable diseases. Pertaining to the latter, he commented that in the case of advanced cases of cancer and leprosy the physician should not be blamed when he could not cure them. To add a humorous note, Razi felt great pity for physicians who took care for the well-being of princes, nobility, and women, because they did not obey the doctor's orders to restrict their diet or get medical treatment, thus making it most difficult being their physician. He also wrote the following on medical ethics:
Most ancient and medieval societies believed that mental illness was caused by either demonic possession or as punishment from a god, which led to a negative attitude towards mental illness in Judeo-Christian and Greco-Roman societies. On the other hand, Islamic neuroethics and neurotheology held a more sympathetic attitude towards the mentally ill, as exemplified in Sura 4:5 of the Qur'an:
This Quranic verse summarized Islam's attitudes towards the mentally ill, who were considered unfit to manage property but must be treated humanely and be kept under care by a guardian, according to Islamic law. This positive neuroethical understanding of mental health consequently led to the establishment of the first psychiatric hospitals in the medieval Islamic world from the 8th century, and an early scientific understanding of neuroscience and psychology by medieval Muslim physicians and psychologists, who discovered that mental disorders are caused by dysfunctions in the brain.