Bimaristan


Bimaristan, in the Islamic world, was used to indicate a hospital where the ill were welcomed and cared for by qualified staff. Additionally, the name dar al-shifa or the shorter version maristan were also used for this purpose. In English literature, these words are often used to designate the historical or pre-modern institutions which existed in the Islamic world, but these words are also still used sometimes in their native languages to refer to modern hospitals or to specific types of medical institutions.

Etymology

Bimaristan is a Persian word meaning "hospital", with Bimar- from Middle Persian of vīmār or vemār, meaning "sick" or "ill person" plus -stan as location and place suffix.

Overview

Islamic hospitals served many purposes. Bimaristans served the purpose of being a designated place where medical treatment would be given to individuals in need. Along with being a central place for medical treatment to be given, Islamic hospitals also served the purpose of being a designated place where recovering individuals could go to help gain back their strength. The individuals were typically recovering from accidents as well as sicknesses.
Most Islamic hospitals did not discriminate on who could be a patient; even wealthy individuals used the bimaristans when they became ill when traveling instead of an outpatient facility or home care. Islamic hospitals were able to care for many diverse people who all had unique accidents, illnesses, injuries, and needs due to the different sections within the bimaristans. Patients were divided into these different sections based on their needs. Patients were also divided up to minimize the risk of spreading illnesses to other patients. Not only were Islamic hospitals used to provide care for individuals, they were also used to advance medical students’ knowledge in the medical field, especially the most well-known bimaristans located in Baghdad, Damascus, and Cairo. Islamic hospitals, books, and apprenticeships are the main three ways medical students learned different types of medical information to make tremendous advances in Islamic Medicine.
Islamic hospitals can best be understood by being viewed as a philanthropy because they gave public assistance to individuals who needed care. Bimaristans were able to provide these services at no costs due to waqfs, which were endowments that paid for the costs of creating bimaristans as well as maintaining them.
Islamic hospitals were different from other hospitals because Muslims were led to form bimaristans by Muhammad, who taught that God would not create a disease without creating a cure. Mobile hospitals were the first version of the bimaristans. According to tradition, the first mobile hospital was located in a tent to treat war victims from the Battle of the Ditch. Mobile Hospitals consisted of medications, food and water, doctors, and pharmacists to aid the patients. These services from the mobile hospital transitioned into the other Islamic hospitals that were built as well. Bimaristans were generally located in urban areas. Though the Islamic realm was very large, Baghdad, Damascus, and Cairo housed the most well-known Islamic hospitals. The first six bimaristans show major changes within Islamic hospitals in a short period of time. The first bimaristan, built in 706 in Damascus by the Umayyad Caliph named Al-Walid, focused on treating individuals with leprosy. Around the same period the second bimaristan was built in Cairo. The third and fourth Islamic hospitals were built in Baghdad. The third bimaristan was built in 805 by Caliph Harun al-Rashid. This Islamic hospital in Baghdad was the first documented general hospital.
Muhammad ibn Zakariya al-Razi, Hunayn ibn Ishaq, Ibn Sina, Ali ibn Isa al-Kahhal, Ibn al-Nafis, and Mir Mu’min Husayni Tunikabuni were all students that trained at Islamic hospitals in order to advance their knowledge in the medical field. These students were key players in the advancement of bimaristans because of contributions to Islamic Medicine from their observations and writings. Muhammad ibn Zakariya al-Razi was an Islam philosopher, physician, and alchemist, who trained well in the Greek science and is known for his Comprehensive Book of Medicine. Hunayn ibn Ishaq was viewed as a mediator between Greek sciences and Arabs due to his translations of multiple documents that were tremendously important. Hunayn ibn Ishaq was also an optometrist. Avicenna was a physician as well as a government official. The Canon of Medicine constructed by Avicenna systemized medicine logically. Like Hunayn ibn Ishaq, Ali ibn Isa al-Kahhal was also an optometrist, who classified more than one hundred diseases of the eyes. Ibn al-Nafis was also a physician and an author, most known for his commentary on pulmonary circulation. Lastly, Mir Mu’min Husayni Tunikabuni focused on how yogic breath control can control the humours. While all of these people did many different things, they all contributed to advancements in medicine.

History of hospitals

There is evidence that the beginning of the human study of medicine was around 3500 B.C.E. Religious priests and medicine men were the first medical practitioners. In ancient Mesopotamia, c. 3500 B.C.E., there were two kinds of medicine men–the "ashipu" who diagnosed the disease or injury, and the "asu" who practiced healing medicine and was practiced in herbal remedies. Practices in this early period included bandaging and making plasters for wounds. Although many patients were treated in their home, the first houses of medicine were often placed near rivers, so the evil substances and spirits would be washed away. This tradition continues into the Greek and Roman periods, both societies placing their centers of healing near the ocean, a river or spring. Temples to gods and goddesses of healing were often used as healing centers, with spiritual and scientific remedies practiced there.
Ancient Indian medicine, or the Vedic tradition, encouraged the balance of body, mind and spirit between 3000 B.C.E. to about 800 B.C.E. They had knowledge of surgery and even the beginnings of plastic surgery were founded here.
Ancient Egyptian medicine was quite advanced for c. 2500 B.C.E. They had a solid understanding of anatomy because human dissection did not have the taboo much later Christian societies experienced. There are a few medical texts that have been preserved to the present that help us understand the medical practices of ancient Egypt. The Edwin-Smith papyrus, written c. 17th century B.C.E. and probably based on much older knowledge, is a text on trauma surgery. It is suspected to be written based on military battles and battle wounds. Most medical practitioners were literate and often priests. Once again, there is a connection between gods and medicine – the earliest recorded physician was Imhotep, who lived c. 2725 B.C.E., and who was later lauded as a deity and called the god of medicine and healing. The practice of combining religious centers and medical centers was continued through the Greek and Roman periods, as well as into the medical practices of Muslims and Christians.
These ascelpia took the environment of their grounds into account as well as their healing rituals. Most of the ascelpia were centered on a spring or a fountain and were near a gymnasium or theater. This was encouraged by the medicine at the time, which focused on balance of the whole person, both of body and mind. There were no official schools of medicine at the time, most practitioners learned their art through apprenticeships or assisting a practitioner. Even after the Christian conversion of Constantine, the Askelpian cult continued their practices and rituals well into the fourth century CE. Towards the end of the century, Theodosius outlawed any pagan traditions and the cult finally died.
After the Christening of Constantine, as well as the influx of refugees into cities as populations grew and land did not, the church became the center for healing. The term xendocheia began to be used, which came to mean a hostel for the poor. Bishops became known as spiritual healers, or physicians of the soul. One such bishop who was associated with an institution of healing was Saint Basil of Caesarea. Saint Basil built a hostel for the poor and the ill and placed it in the care of a monastery. It is described by fifth century historian Sozomen as “a storehouse of piety where disease is regarded in a religious light and sympathy put to the test.” Similar to the Askelpian cults, the idea of healing through incubation was also practiced under Christian empires. Patients would sleep in specific rooms that housed relics of a saint and hoped for the saint to appear in their dreams.
The church was often charged with the care of the sick, although students were not allowed to study theology and medicine at the same time. Statute 590 stated that students of theology could not even reside in the same area as medical students, because “books of the craft of the world should not be read with books of holiness in one light.”
These centers of health in antiquity helped shape the many new advances Muslim scholars would pursue in medicine.
As for healing centers in the Islamic world, the first bimaristans were mobile centers that date back to the time of Muhammed. They were transported by beast of burden, primarily camels. Before there were major towns and cities, the mobile bismaristans were able to travel to patients and the remote areas of the region.

Features of bimaristans

As hospitals developed during the Islamic civilization, specific characteristics were maintained. For instance, Bimaristans served all people regardless of their race, religion, citizenship, or gender. The Waqf documents stated nobody was ever to be turned away. The ultimate goal of all physicians and hospital staff was to work together to help the well-being of their patients. There was no time limit a patient could spend as an inpatient; the Waqf documents stated the hospital was required to keep all patients until they were fully recovered. Men and women were admitted to separate but equally equipped wards. The separate wards were further divided into mental disease, contagious disease, non-contagious disease, surgery, medicine, and eye disease. Patients were attended to by same sex nurses and staff. Each hospital contained a lecture hall, kitchen, pharmacy, library, mosque and occasionally a chapel for Christian patients. Recreational materials and musicians were often employed to comfort and cheer patients up.
The hospital was not just a place to treat patients, it also served as a medical school to educate and train students. Basic science preparation was learned through private tutors, self-study and lectures. Islamic hospitals were the first to keep written records of patients and their medical treatment. Students were responsible in keeping these patient records, which were later edited by doctors and referenced in future treatments.
During this era, physician licensure became mandatory in the Abbasid Caliphate. In 931 AD, Caliph Al-Muqtadir learned of the death of one of his subjects as a result of a physician's error. He immediately ordered his muhtasib Sinan ibn Thabit to examine and prevent doctors from practicing until they passed an examination. From this time on, licensing exams were required and only qualified physicians were allowed to practice medicine.

Purpose

The first few Islamic hospitals that arose in Baghdad, in the early 9th century, were to quarantine those who suffered from leprosy. At first, it was considered by many as a "leprosorium" due to its limited purpose; nonetheless, these hospitals still salaried doctors whose specialties were not solely limited to leprosy. The function of these hospitals soon became diversified over time as newly built hospitals in Baghdad began to incorporate the knowledge from Islamic physicians, scientists such as the Al-Razi. Al-Razi's hospital in Baghdad, had 24 physicians on staff; these physicians had diverse specialties, including, physiologists, occultists, surgeons, and bonesetters.
Madrasas, in Islamic civilizations, were teaching institutions, some of which focussed on medicine. These madrasas were often closely linked with hospitals so that students could learn in the institutions and put their theoretical knowledge into practice in the hospitals. Physicians were not exclusively Muslim; practicing physicians included Jews, and Christians. In the major hospitals at Cairo, Baghdad, and Damascus, students could visit patients often with the supervision of a practicing physician, in a system that is comparable to that of medical residents today.
The greatest contribution of the Islamic hospitals was the structure itself and how it functioned in Islamic culture. The first documented general hospital arose in Baghdad, in 805, built by vizier to the caliph, Harun al-Rashid. Although not much is known about this hospital due to poor documentation, the system of the general hospital itself set forth an example for the many other hospitals to come. Soon after, 34 new hospitals were built throughout the Islamic world with the number increasing annually. Islamic hospitals were even the first to specialize in treating convicts as the prison population was continually increasing.
Newly founded hospitals strived to be better than their preceding counterparts in the Islamic world. The purpose was to compete with European hospitals as well in order to attract more physicians and scholars. Many of these hospitals also contained a conjoined library typically filled with any possible writings that may be relevant to the medicine practiced in the hospitals.

Function and organization

In order to meet the demands of these specialties, Islamic hospitals were subdivided into departments for surgery, ophthalmology, orthopedics, mental illness, and systemic diseases. The systemic disease department was designated for general illnesses that did not fall into categories of other departments. In some hospitals, they were further divided into subsections to address the needs of the patient depending on the symptoms. Examples include, but are not limited to, infections, fevers, and digestive issues. Hospital staff was not limited to physicians. Much like today's hospitals, they also relied on pharmacists, nurses, sanitary inspectors, supervising specialists, secretaries, and superintendents. The superintendents, or in Arabic, sa'ur, ensured that hospitals met certain standards in addition to managing the entire hospital institution. Pharmacists produced drugs as means for treatment of the hospitals' patients; they relied on a knowledge of chemistry, or Alchemia.
Before the 10th century, hospitals operated throughout the day and closed at night. Later hospitals operated on a 24-hour basis. Nonetheless, the practicing physicians worked a set number of hours with their salaries prescribed by law; the physicians were paid generously enough so as to retain their talent. Chief of staff physician, Jabril ibn Bukhtishu, was salaried 4.9 million Dirham; for comparison, a medical resident worked significantly longer hours salaried at 300 Dirham per month.
Islamic hospitals attained their endowment through charitable donations or bequests, called waqfs. The legal documents establishing a waqf also set forth rules for how the hospital should be organized and operate in relation to the patient, stating that anyone can be admitted irrespective of race, gender, or citizenship. Patients of all socioeconomic statuses would have had access to full treatment, that is, costs were borne by the hospital itself. An example was the Al-Mansuri Hospital, in Cairo, built under the orders of the Mameluke ruler of Egypt, Al-Mansur Qalawun. Its maximum capacity was around 8000, and the annual endowment alone was said to be one-million Dirhams. The design was intended to accommodate various pathologies, for both men and women; as well as a pharmacy, a library, and lecture halls. The lecture halls were used for regular meetings on the status of the hospital, lecturing residents, and staff as well

Notable Islamic hospitals

Baghdad

The existence of hospitals in Baghdad has been documented since the 9th century CE, with the first having most likely been established by the vizier of caliph Harun al-Rashid. By the end of the 10th century CE, five more hospitals had been built in Baghdad.

Al-Adudi Hospital

Among the most important of these was the Al-Adudi Hospital. The Al-Adudi Hospital was founded in 981 by the then ruler of Baghdad, Adud al-Dawlah, and was also named after him. Within Baghdad, the Al-Adudi Hospital's location was decided upon by its administrator, Abu-Bakr al-Razi. He determined where it should be located by "hanging a piece of meat in several places for a few days and deciding in favor of the place where meat was found to be least infected." Al-Razi eventually decided to build the hospital along the Tigris River. At its inception, the Al-Adudi Hospital had twenty-five staff members, specializing in fields ranging from optics to surgery. In addition to these specialists, the Al-Adudi Hospital also served as a teaching hospital for new doctors. The Al-Adudi Hospital remained operational into the 12th century CE when, in 1184, it was described as "...being like an enormous palace in size." Ultimately, the Al-Adudi Hospital was destroyed in 1258 by Mongols led by Hulagu Khan in the siege of Baghdad.

Cairo

Al-Fustat Hospital

One of the first Egyptian hospitals was the Al-Fustat Hospital, which was founded in 872 CE. It was founded by Ahmed Ibn-Tulum and was so named because of its location within Cairo. The Al-Fustat Hospital shared many common features with modern hospitals. Among these were bath houses separated by gender, separate wards and the safekeeping of personal items during a patient's convalescence. In addition to these practices, the Al-Fustat Hospital is the first to have offered treatment for mental disorders. Beyond the practice of medicine, the Al-Fustat Hospital was also a teaching hospital and housed approximately 100,000 books. The Al-Fustat Hospital remained in operation for approximately 600 years. Another key feature of the Al-Fustat Hospital was that it offered all treatment for free. This was made possible by waqf revenue, which the Al-Fustat Hospital was likely the first to have been endowed with. Near the Al-Fustat Hospital, Ibn-Tulum also established a pharmacy to provide medical care in emergencies.

Al-Mansuri Hospital

The Al-Mansuri Hospital was another hospital located in Cairo, and was completed in 1284 CE. Its founder, Al-Mansur Qalawun, was inspired to establish a hospital after his own experience being hospitalized in Damascus. Because of Al-Mansur's vision for the hospital, treatment was free to make the hospital accessible to both the rich and the poor. Furthermore, "...upon discharge the patient was given food and money as a compensation for the wages he lost during his stay in the hospital." The Al-Mansuri Hospital was so accessible, in fact, that it treated roughly 4,000 patients every day. Like the Al-Fustat Hospital before it, the Al-Mansuri Hospital also treated mental patients and introduced music as a form of therapy. The Al-Mansuri also obtained the personal library of Ibn al-Nafis upon his death in 1258. The Al-Mansuri Hospital remained operational through the 15th century CE and still stands in Cairo today, though it is now known as "Mustashfa Qalawun."

Damascus

Al-Walid Hospital

Damascus is credited with being the home of the first ever Islamic hospital, which was established between 706 and 707 CE. Founded by Walid ibn 'Abdulmalik, this hospital was meant to serve as a treatment center for both those with chronic illnesses, like leprosy and blindness, as well as the poor or impoverished. This began with ibn 'Abdulmalik gathering lepers and preventing them from spreading the illness by providing them money. This was done to prevent them from begging strangers for money, thereby curtailing the spread of leprosy. To accomplish these objectives, separate wards existed for infectious diseases such as leprosy, and patients faced no cost to receive treatment. The Al-Walid Hospital has been compared to the Byzantine nosocomia, which was a charitable institution tasked with treating "...the sick, the lepers, the invalid, and the poor."

Al-Nuri Hospital

The Bimaristan of Nur al-Din or Al-Nuri Hospital was founded in Damascus nearly four and a half centuries after the Al-Walid Hospital, in 1156 CE. It was named after Nur al-Din Zanji. The Al-Nuri Hospital, which operated for some 700 years, was the same hospital where Al-Mansur Qalawun was treated and inspired to establish his own hospital in Cairo. The Al-Nuri Hospital, in addition to bringing about the Al-Mansuri hospital, was innovative in its practices as it became the first hospital to begin maintaining medical records of its patients. The Al-Nuri Hospital was also a prestigious medical school, with one of its most noteworthy students being Ibn al-Nafis, who would later pioneer the theory of pulmonary circulation.
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Other notable bimaristans in the Islamic world

Advancements in medicine

With the development and existence of early Islamic hospitals, came the need for new ways in which to treat patients. While the institution of a complex hospital was still comparatively new, Islamic hospitals brought forth many groundbreaking medical advancements in Islamic culture during this time, which eventually spread to the entire world. These revolutionary medical practices came not only from Islamic hospitals, but also distinguished physicians of this era, in the form of surgeries, techniques, discoveries and cures for ailments, and the invention of countless medical instruments.

Al-Mawsili and Ibn Isa

Among the many developments stemming from Islamic hospitals, were those designed to treat specific ailments, diseases, and anatomy. For example, a revolutionary treatment for cataracts was developed by al-Mawsili, a 10th-century physician. The practice included a hollow syringe and removing the cataract through suction. Although this procedure has further developed throughout the centuries, the basic treatment remains the same even today. Diseases of the eye were further expanded upon during this era by ʻAli ibn ʻIsa al-Kahhal or Ibn Isa, who practiced and taught in the Al-Adudi Hospital in Baghdad. He wrote and developed the https://www.wdl.org/en/item/17604/ Tadhkirat al-kaḥḥālīn Anatomy of the eye, 2) Causes, symptoms and treatments of diseases, and 3) Less apparent diseases and their treatments. This work was translated into Latin in 1497, and then into several other languages which allowed it to benefit the medical community for centuries to come.

[Al-Zahrawi

Perhaps the largest contribution to Islamic surgical development, came from Abū al-Qāsim Khalaf ibn al-‘Abbās al-Zahrāwī, Abū al-Qāsim, or Al-Zahrawi. He contributed to advancements in surgery by inventing and developing over 200 medical instruments which constituted the first independent work on surgery. Such instruments included tools like forceps, pincers, scalpels, catheters, cauteries, lancets, and specula, which were accompanied by detailed drawings of each tool. Al-Zahrawi also wrote the At-Taṣrīf limanʿajazʿan at-Taʾālīf, or At-Taṣrīf, which was a 30-part text based on earlier authorities, such as the Epitomae from the 7th-century Byzantine physician Paul of Aegina. It was largely composed of medical observations, including what is considered the earliest known description of hemophilia. The 30-volume encyclopedia also documented Zahrawi and his colleagues’ experiences with treatment of the ill or afflicted. Aside from the documentation of surgical instruments, the work included operating techniques, pharmacological methods to prepare tablets and drugs to protect the heart, surgical procedures used in midwifery, cauterizing and healing wounds, and the treatment of headaches. Although Zahrawi was somewhat disregarded by hospitals and physicians in the eastern Caliphate, his advancement and documentation of medical tools and observations contained in his work had a vast influence on the eventual medical development in Christian Europe, when it was translated into Latin during the 12th century.

Al-Razi (Rhazes)

The Abbasid Caliphate in Baghdad underwent extreme intellectual and medical experimentation during the 10th and 11th centuries. Among the many skilled physicians and intellectuals there was Abū Bakr Muḥammad ibn Zakariyyāʾ al-Rāzī, or in Latin, Rhazes. Rhazes served as chief physician in a hospital in Rayy, Iran, before holding a similar position in the Baghdad hospital. He developed two significant works regarding advancements in medicine and philosophy. The Kitāb al-Manṣūrī and the Kitāb al-ḥāwī, which surveyed early Greek, Syrian, and Arabic medicine, and added his own judgement and commentary. He also wrote several minor treatises, perhaps the most famous being Treatise on Small Pox and Measles. This treatise was translated into several modern languages as well as Latin and Byzantine Greek for teaching purposes and medical treatment of such infectious diseases.

Ibn Sina (Avicenna)

Although surgical developments and advancements made in the medieval Islamic period are of extreme importance, the largest and most wholesome contribution to the medical world stemming from Islamic medicine and hospitals came from the Baghdad firmament from Ibn Sina, or “Avicenna” in the West. Ibn Sina, who had already become a doctor by the age of 18, developed the Al-Qanun fi al-Tibb. This work is largely known as one of the most famous medical works of all time. The ways in which Ibn Sina's Canon of Medicine worked to bring together various disciplines and cultures, essentially revived Greek authors and philosophers and fostered new thought patterns to develop much of the future medical practices we see today. Ibn Sina did this by combining the medical developments of Greek physician and philosopher Galen, with the philosophy of Aristotle. Furthermore, as Islamic medicine recognized that many diseases are contagious, such as leprosy, smallpox, and sexually transmitted diseases, Ibn Sina recognized tuberculosis as a contagious disease, among others which can be spread through soil and water. The Canon of Medicine continued to be studied by European medical professionals and institutions even into the 18th century. This combination and rationalization of practical science, religion, and thought highlighted the pinnacle of Muslim medical scholarship, and the nature of the true developments which were made in the medical world.

Legacy and aftermath

Much of the legacy surrounding the Islamic influence on modern hospitals and science can be found in the discoveries, techniques, and practices introduced by scholars and physicians working in these hospitals between the tenth and nineteenth century. This time period was extremely important to the advancement of modern medicinal practices, and is known as one the greatest periods of development. Many of these discoveries laid the foundation for medical development in Europe, and are still common practice in modern medicine. Among these discoveries in astronomy, chemistry, and metallurgy, scholars developed techniques for medicine such as the distillation and use of alcohol as an antiseptic, which is still being used in hospitals today. Not only did these discoveries lead to lasting improvements in medicine in the Muslim world, but through the influence of early Islamic and Arabian hospitals, medical institutions around the world were introduced to various new concepts and structures, increasing the efficiency and cleanliness which can still be found in modern-day institutions.
Some of these influential concepts include the implementation of separate wards based on disease and gender, pharmacies, housing of medical records, and the education associated with practicing medicine. Prior to the Islamic era, most European medical care was offered by priests in sanatoriums and annexes to temples. Islamic hospitals revolutionized this by being operated secularly and through a government entity, rather than being solely operated by the church. This introduction of government operated hospitals lead to not having any discrimination against people for any reason allowing the hospital to solely focus on their main goal of serving all people and working together to help everyone out.
Separate wards
Islamic hospitals also brought about the idea of separate wards or segments of the hospital that were separated by patient diagnostic. When Islamic hospitals first brought this about, not only were the wards separated by diagnostic but by sex as well. While hospitals today are not as strict and do not separate by sex anymore, they still separate people by disease or problem. By doing so, different wings could specialize in certain treatments specific to their patient. This practice not only still exists today in modern hospitals but also lead to the advancement of treatments back then that now comprise the “Canon of Medicine.” This separation of diseases not only helped the timely treatment of patients but also helped the patients and physicians from getting sick with other diseases that surrounded them because they only had to worry about the prevention of one disease. By separating patients, the specialization of certain wings and treatments really advanced the medicine and improved the efficiency of hospitals ultimately leading to how modern day hospitals are designed.
Medical records
With Islamic hospitals advancing medicine so quickly, they needed a way to catalogue all of their findings which in the end lead to the first medical records. This made hospitals more efficient as they were able to check records of other people with patients that had similar symptoms and hopefully treat them the same way they were able to with the other patients. Not only did physicians keep medical records but they kept notes on patients and provided them for peer review as a way to not be held responsible for malpractice. This information also enabled physicians to start to notice patterns in patients more making the medicinal practices more accurate as everything is with more trials. The efficiency gained from keeping records allowed hospitals to run more smoothly and treat patients faster. This information also enabled physicians to start to notice patterns in patients more making the medicinal practices more accurate as everything is with more trials. This keeping of records ultimately lead to the accumulation of the “Canon of Medicine,” which is a book of medicine compiled by the Persian philosopher Avicenna that was completed in 1025.
Education and qualification
Another legacy that vastly changed the way through which medical practices were developed, was the method of education and perpetuation of medical knowledge. Islamic hospitals modernized the qualification of physicians and education leading to a license to practice medicine in hospitals. In 931 CE, Caliph Al –Muqtadir started the movement of licensing physicians by telling Siban Ibn- Thabit to only give physician licenses to qualified people. Seeing as how one of the chief objectives of Islamic hospitals was the training of new physicians or students, senior physicians, and other medical officers would often hold instructive seminars in large lecture halls detailing diseases, cures, treatments, and techniques from class manuscripts. Islamic hospitals were also the first to adopt practices involving medical students, accompanied by experienced physicians, into the wards for rounds to participate in patient care. Hospitals doubling as schools not only provided hospitals with more fresh working hands but also helped in the advancement of medicine. Education in hospitals during the Islamic period modernized hospitals today in that now before people can become doctors they must complete a period of residency in which students study at a hospital and job shadow licensed physicians for a number of years before they are fully able to become licensed physicians. This came at a time when much of Europe's medical practices were much less advanced, and with the compilation and creation of Avicenna's medical textbook, the “Canon of Medicine,” these groundbreaking Islamic discoveries were able to influence Europe and the rest of the world for centuries to come.
Pharmacies
One other lasting impression from the ninth century was the birth of pharmacies. Due to the major chemistry advancements, actual medicine during this time period flourished and became highly developed to the point of needing a separate place to distribute medicine which came to be known as a pharmacy. With the advancement of science and medicine, pharmacy became a specialized subject itself. This ultimately lead to pharmacy becoming its own established profession people could pursue.