In Islamic cities, which benefited greatly from drier and warmer climates, hospitals were set up to encourage the circulation of light and air. Some of the large non-profit corporations have rescued public facilities through lease agreements, such as that between the Seton Medical Center of the Daughters of Charity and Brackenridge Public Hospital in Austin, Texas, in 1995.The first documented general hospital was built about a century later, in 805, in Baghdad by the vizier of the caliph Harun al-Rashid. While in Europe, Bond spent time at the famous French hospital, the Hotel-Dieu in Paris, and was impressed by the new hospital movement on the continent. Of the 5,408 institutions they reported (hospitals, dispensaries, homes for adults and children, institutions for the blind and deaf), 1,896 (35%) received public aid from one source or another.
The first Muslim hospital was no more than a leprosarium, an asylum for lepers built in the early 8th century in Damascus under the rule of the Umayyad caliph Walid ibn 'Abd al-Malik. For patients, the hospital's services were free of charge, although individual doctors occasionally charged. By 1965, more than 90 per cent of large hospitals and 31 per cent of small hospitals had intensive care units staffed by increasingly skilled nurses. In developed countries, the hospital as an institution is complex, and becomes even more so as modern technology increases the range of diagnostic capabilities and expands treatment possibilities.
In 1932, during the nadir of the Great Depression, a census of hospitals conducted by the Council on Medical Education and Hospitals revealed a shift in use from privately owned hospitals to public institutions. However, for much of history, a hospital provided shelter for the poor (hence the term hospitality) as its primary function rather than healing. In the late 9th century, the prominent physician and polymath Muhammad ibn Zakariya al-Razi helped establish a Bimaristan hospital in Baghdad with 25 physicians, optometrists, surgeons and bonesetters. The physical conditions of many of these hospitals were truly lavish, especially those established by princes, rulers and viziers.
Physicians were also the driving force behind the establishment of early hospitals as a means of providing medical education and as a source of prestige. One of the defining characteristics of hospitals during this period is the way in which the power of science increasingly affected hospital decisions.