Religious orders ran hospitals for the poor while the wealthy were cared for at home during the Middle Ages and early modern period. The first hospitals were established in the 12th century as lodgings for poor travelers. The hospital of Notre-Dame-et-des-douze-Apôtres was founded before 1127 adjacent to the collegiate church of Saints-Michel-et-Gudule, later named the hospital of Saint-Gertrude. The Saint-Nicolas hospital was established near the Grand' Place before 1129 and the hospital of Saint-Jacques near the Coudenberg Palace before 1162. The Saint-Gertrude hospital evolved into a convent. The city counted four institutions that cared for poor pilgrims during the medieval period: Saints Julien, Carmel, Jacques, and Laurent.
   Hospitals for the sick arose in the second half of the 12th century. In 1174, the Saint-Pierre leprosarium was founded and, in 1190, the hospital of Saint-Esprit, later the Saint-Jean hospital. Only the latter was under communal jurisdiction, subject to regulations and inspection by the magistracy. These two institutions remained the city's sole hospitals for the public until the French regime.
   The oldest known medical ordinance dates from 1424 when authorities published a decree regulating the functions of physicians, surgeons, and midwives. Physicians, who practiced medicine, and surgeons, who performed operations, were organized into guilds. A city surgeon and city doctor date from the Burgundian regime when the former was mandated to visit Saint-Jean's once a day and the latter once a week. An ordinance of 1501 stipulated patients had to be placed in a bed with clean sheets and a blanket and be suitably clothed in winter. By 1780, Saint Jean's counted 135 beds but no operating room.
   Religious houses and the Beguines generally included an infirmary for their members. In the mid-1300s, the first homes for the elderly opened. Many were established by the guilds. A total of 17 houses were founded to lodge and care for poor widows and five for elderly, destitute men. In 1580, a city ordinance created the first orphanage, built on the corner of rue de Laeken and rue des Échelles. A royal decree of 8 October 1540 set conditions for practicing medicine and an official city pharmacy (Pharmacopoeia bruxellensis) appeared in 1641. A college of medicine was created by a decree of 12 November 1649, which defined and set standards for physicians, surgeons, and pharmacists.
   Health care providers could do little for those afflicted by the epidemics that were a recurring event in Brussels as elsewhere in Europe. The Black Death (1348-1349) claimed many thousands as did outbreaks of plague in 1489 and 1578. The cholera epidemic in the early 1830s and in 1866 sparked efforts to improve sanitation and the latter was a contributory cause to vaulting the Senne River.
   The college was closed in 1797 and the ensuing disorder necessitated an edict in 1799 under which a commissioner of health and safety resumed the former's tasks. In 1806, an imperial decree under Napoléon Bonaparte led to the creation of a Conseil Général des Hospices et Sécours to train health providers and manage the city's hospitals. Courses were offered beginning on 19 December 1809 at the Saint-Pierre hospital. They continued on a provisional basis during the Dutch regime, which mandated that a medical school be organized. Such a school began operations in the 1820s but the school at Saint-Pierre formed the core of the faculty of medicine and pharmacy founded at the Université libre de Bruxelles (ULB) in 1834.
   The Saint-Jean hospital remained largely unchanged over the centuries. Consequently, it became cramped and outdated. A modern facility was built (1838-1843) at a site along the boulevard du Jardin Botanique, which was later demolished, at which time facilities were integrated with those of Saint-Pierre. The Hospice des Aveugles was built on the boulevard du Midi between 1853 and 1855 following a design of Jean-Pierre Cluysenaar (1811-1880).
   Institutes for the study of physiology, bacteriology, and anatomy and histology were founded from 1892 to 1894. A notable school for nursing was established in 1907 by Antoine and Marie Depage, with Edith Cavell as director. The Brugmann hospital opened in 1923.
   In 1970, the ULB started construction of the Erasmus teaching hospital in Anderlecht, and the Erasmus hospital is now the site of the university's faculty of medicine and school of public health. There are currently five university hospitals associated with the ULB: Saint-Pierre, Brugmann, Erasmus, Hôspital des Enfants Reine Fabiola, and Institut Jules Bordet. The director of the latter, Albert Claude (1899-1983), was one among three to share the 1974 Nobel Prize in medicine for research on the nature and chemical composition of cells. The Clinique universitaire Saint-Luc (avenue Hip-pocrate 10) is the teaching hospital of the Université Catholique de Louvain. An anticancer center was inaugurated at the facility in April 2000.
   Public hospitals in the Brussels Capital Region have been largely reorganized and regrouped into a regional network (IRIS) following mounting deficits that the communes could no longer meet.
   The Musée de la Medicine (Museum of Medicine) is located on the Erasmus campus. The Musée Pharmacologie (Museum of Pharmacology) is also found at the Université libre de Bruxelles.

Historical Dictionary of Brussels. .

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