During the aftermath of the death of the prophet Muhammed, the Islamic community faced the daunting task of appointing his successor to lead the ummah, or Muslim community. The community chose Abu Bakr, the senior companion and father-in-law to Muhammed, as the first Islamic caliph. The Arabic term is khalifa, which means a deputy, viceroy, or successor. The term appears in the Quran in reference to Adam’s role as Allah’s viceroy upon the earth and so it was used to refer to the prophet’s successor as being Allah’s earthly representative. The caliphate thus became an important institution of the Islamic religion, specifically of the Sunni tradition, when the Arab people founded their empire in the seventh century. There would be many caliphates or dynasties throughout the middle ages, as each empire grew weak and was replaced by another. One of the largest and most influential of these dynasties was that of the Abbasid Caliphate, which ruled most of North Africa and the Middle East between the years 750 A.D. and 1258 A.D. The third Islamic caliphate, the Abbasid dynasty ushered in what has become known as the “Golden Age of Islam,” due to the great scientific and cultural advancements that were made during that period in history. As a result of these advancements, the Abbasids were able to better take care of their people by providing them with better forms of healthcare, a concern which was influenced by the ethics of their religion.
The Abbasids came to power in the waning years of the Umayyad Caliphate, when the Umayyad were growing weak from rebellions in North Africa. The Abbasids, who were descendants of one of Muhammed’s uncles, Abbas ibn Abd al-Muttalib, claimed the right to the caliphate over the Umayyad caliphs by virtue of the fact that they were more closely related to Muhammed. The Abbasids offered a fairer Islamic order in which all Muslims, regardless of their national origin, would be able to participate on even terms, and they contrasted themselves against the Umayyad caliphs that had squandered the empire that they had inherited. The Abbasid revolution grew quickly as they marched upon Umayyad holdings in Iran and Iraq, finally defeating the last Umayyad caliph, Marwan II, in battle near the Tigris. Marwan himself fled to Egypt but was captured and executed six months later. With the Abbasid caliph, Abu’l-‘Abbas al-Saffah leading them, the Abbasid forces took Damascus, slaughtering all the Umayyad forces within. Later, with the ascension of the second caliph, Abu Ja’far al-Mansur, the Abbasids would move the political capital from Damascus in Syria to the newly established city of Baghdad in Iraq.
Once the Abbasids had established their capital in Baghdad, they began to strengthen their empire, and one of the ways in which they did this was by the accumulation of knowledge, especially the sciences. The scientists and philosophers of the empire had a heavy interest in astronomy, which had a very utilitarian purpose for them because it allowed them to determine the correct times of prayer, agricultural dates, and the direction of Mecca in order to properly align the construction of their Mosques. Mathematics was also closely linked to astronomy and was the focus of early translation activity, as the Abbasid scholars worked to translate ancient Greek works of mathematics and philosophy into their native Arabic tongue. Medicine was also among the sciences that were of immediate interest and utility to the Abbasids.
The study of medicine and healthcare was important to Muslims because of the importance Islam places upon helping take care of other people. One of the hadith attributed to Muhammed says the following: “The best gift from Allah to mankind is good health. Everyone should reach that goal by preserving it for now and the future.” For the Muslims, therefore, it was important to not only look after a person’s spiritual health but also their physical health as well. This belief caused them to embrace the achievements of classical Greek and Roman physicians, as well as from Syrian, Persian, and Indian sources. The Greco-Roman physicians had come to define illness in general as natural phenomenon within the humoral framework, which consisted of four constitutional humors (melancholic, guineous, choleric, and phlegmatic), three functional fluids (arterial and venous blood and nervous fluid), and the spirits (vital, natural, and animal) which controlled these fluids. This belief was spelled out in the writings of Hippocrates and Galen, which, under the support of the Abbasid caliphs such as al-Ma’mun, were translated into Arabic and became the basic reference texts for the medical students of the empire. The Abbasids also used their organizational talents and resources to put this knowledge into practice with regard to the health of their citizens.
The institution of the hospital had already been around for centuries before the Muslims adopted it, especially in Christian, Jewish, and Zoroastrian cities, and some scholars feel that the numerous Christian charitable foundations that provided help for the sick in Islamic lands after the Arab conquests provided inspiration for the later Islamic foundations.  The first and most elaborate of these hospitals was constructed in the eight century during the reign of Caliph Harun al-Rashid, and was soon followed by similar institutions throughout the Abbasid Empire. These hospitals were paid for and maintained by financial support from caliphs, philanthropists, religious groups, and other rulers. The Arabic leaders had the foresight to preserve and utilize the medical institutions that they found in North Africa and Asia, such as famous hospital and academy in Gondeshapur, founded in fifth century Persia.
But what drove the Abbasids to establish these hospitals and to work so hard in the studyof medicine? The answer lies within the ethics of their religion, which placed a great emphasis upon saving human lives and treating the less fortunate in society with respect. According to the hadith attributed to the prophet:
Verily, Allah, the Exalted and Glorious, would say on the Day of Resurrection: O son of Adam, I was sick but you did not visit Me. He would say: O my Lord; how could I visit Thee whereas Thou art the Lord of the worlds? Thereupon He would say: Didn’t you know that such and such servant of Mine was sick but you did not visit him and were you not aware of this that if you had visited him, you would have found Me by him?
This hadith echoes a similar teaching found within the Christian gospel of Matthew, inwhich Jesus tells his disciples the same thing when speaking of judgment day. In addition to the hadith, the Islamic concept of Zakat or “charity” also played a big role in the establishment of these hospitals. One of the five pillars of Islam, zakat is the responsibility of every Muslim and they developed a legal framework for the administration charitable trusts called awqaf. These charitable trusts then allowed devout Muslims to donate their property to pious causes, such as taking care of the poor and sick, which would help ensure their reward in the next life. There is historical evidence that links together the institution of the waqf(the singular of awqaf) to that of the hospital, especially for those within the Abbasid capital of Baghdad.
The organization of these hospitals was also advanced for their time. They offered separate wards for male and female patients, special wards for internal diseases, surgical patients, the mentally ill, those with ophthalmic disorders and orthopedic cases, and patients with contagious diseases. Extensive training and pharmacological facilities were standard, and physicians from all over the Muslim world stayed to perform their duties as administrators, practitioners, specialists, and visiting teachers. In funding these hospitals the Abbasids were providing their people with an Islamic alternative to Christian charitable institutions, as well as superior healthcare when compared to the hospitals found within medieval Europe. But this healthcare was not limited to Muslim patients, but was provided to Christians and Jews as well based on the historical records that we have from the era. Thus while being founded as Islamic charitable organizations, these hospitals were secular in the sense that a person’s religion did not determine who was treated there and how.
2. Amira K. Bennison, The Great Caliphs: the Golden Age of the ‘Abbasid Empire (London: Yale University Press, 2010), 24.
3. Ibid., 25-26.
4. Ibid., 183.
5. Howard R. Turner, Science in Medieval Islam: an Illustrated Introduction (Austin: University of Texas Press, 1997), 131.
6. Ibid., 131-132.
7. Peregrine Horden, “The Earliest Hospitals in Byzantium, Western Europe, and Islam,” Journal of Interdisciplinary History, Volume 35, Number 3, Winter 2005, 369.
10. Matthew 25:31-40.
11. Peter E. Pormann, “Islamic Hospitals in the Time of al-Muqtadir,” in ʻAbbasid Studies II: Occasional Papers of the School of ‘Abbasid Studies, Leuven, 28 June – 1 July 2004. (Leuven: Peeters Publishers, 2010), 369-370.
13. Turner 134.
14. Yasser Tabbaa, “The Functional Aspects of Medieval Islamic Hospitals” in Poverty and Charity in Middle Eastern Contexts (Albany: State University of New York Press, 2003), 1.
15. Pormann 368.