History Hospital

1 history

1.1 examples
1.2 late roman empire , sassanid persia
1.3 medieval europe

1.3.1 st giles, norwich
1.3.2 st. anthony s, london
1.3.3 st leonards, york


1.4 medieval islamic world
1.5 modern , enlightenment europe
1.6 19th century

history


early examples

view of askleipion of kos, best preserved instance of asklepieion.

the earliest documented institutions aiming provide cures ancient egyptian temples. in ancient greece, temples dedicated healer-god asclepius, known asclepieia functioned centres of medical advice, prognosis, , healing. asclepeia provided controlled spaces conducive healing , fulfilled several of requirements of institutions created healing. under roman name Æsculapius, provided temple (291 b.c.) on island in tiber in rome, similar rites performed.

institutions created care ill appeared in india. fa xian, chinese buddhist monk travelled across india ca. a.d. 400, recorded in travelogue that: heads of vaisya [merchant] families in them [all kingdoms of north india] establish in cities houses dispensing charity , medicine. poor , destitute in country, orphans, widowers, , childless men, maimed people , cripples, , diseased, go houses, , provided every kind of help, , doctors examine diseases. food , medicines cases require, , made feel @ ease; , when better, go away of themselves.

the earliest surviving encyclopaedia of medicine in sanskrit charakasamhita (compendium of charaka). text, describes building of hospital dated dominik wujastyk of university college london period between 100 b.c. , a.d. 150. according dr. wujastyk, description fa xian 1 of earliest accounts of civic hospital system anywhere in world and, coupled caraka s description of how clinic should equipped, suggests india may have been first part of world have evolved organised cosmopolitan system of institutionally-based medical provision.

according mahavamsa, ancient chronicle of sinhalese royalty, written in sixth century a.d., king pandukabhaya of sri lanka (reigned 437 b.c. 367 b.c.) had lying-in-homes , hospitals (sivikasotthi-sala) built in various parts of country. earliest documentary evidence have of institutions dedicated care of sick anywhere in world. mihintale hospital oldest in world. ruins of ancient hospitals in sri lanka still in existence in mihintale, anuradhapura, , medirigiriya.

the romans constructed buildings called valetudinaria care of sick slaves, gladiators, , soldiers around 100 b.c., , many identified later archaeology. while existence considered proven, there doubt whether widespread once thought, many identified according layout of building remains, , not means of surviving records or finds of medical tools.

late roman empire , sassanid persia

the declaration of christianity accepted religion in roman empire drove expansion of provision of care. following first council of nicaea in a.d. 325 construction of hospital in every cathedral town begun. among earliest built physician saint sampson in constantinople , basil, bishop of caesarea in modern-day turkey. called basilias , latter resembled city , included housing doctors , nurses , separate buildings various classes of patients. there separate section lepers. hospitals maintained libraries , training programmes, , doctors compiled medical , pharmacological studies in manuscripts. in-patient medical care in sense of today consider hospital, invention driven christian mercy , byzantine innovation. byzantine hospital staff included chief physician (archiatroi), professional nurses (hypourgoi) , orderlies (hyperetai). twelfth century, constantinople had 2 well-organised hospitals, staffed doctors both male , female. facilities included systematic treatment procedures , specialised wards various diseases.

a hospital , medical training centre existed @ gundeshapur, major city in southwest of sassanid persian empire founded in a.d. 271 shapur i. large percentage of population syriacs, of whom christians. under rule of khusraw i, refuge granted greek nestorian christian philosophers including scholars of persian school of edessa (urfa) (also called academy of athens), christian theological , medical university. these scholars made way gundeshapur in a.d. 529 following closing of academy emperor justinian. engaged in medical sciences , initiated first translation projects of medical texts. arrival of these medical practitioners edessa marks beginning of hospital , medical centre @ gundeshapur. included medical school , hospital (wēmārestān), pharmacology laboratory, translation house, library , observatory. indian doctors contributed school @ gundeshapur, notably medical researcher mankah. later after islamic invasion, writings of mankah , of indian doctor sustura translated arabic @ baghdad s house of wisdom.

medieval europe

the church @ les invalides in france showing close connection between historical hospitals , churches

the romans first introduced hospitals britain during anglo-saxon period. during period, hospitals confined domestic household or existed small, military hospitals function of caring sick, travellers, , of long-term infirm. during middle ages (476\529–800) , middle time period (ca. 800–1100), rise of christianity had great effect on practice of medicine. church-sponsored hospitals began appear after a.d. 350, furnished bed , board , seldom ventured actual treatment. on next 7 centuries, hospitals gradually passed church monastic control. many christian monasteries became centers of accumulation of medical knowledge , practical experience in europe.

around 529 a.d. st. benedict of nursia (480-543 a.d.), later christian saint, founder of western monasticism , order of st. benedict, today patron saint of europe, established first monastery in europe (monte cassino) on hilltop between rome , naples, became model western monasticism , 1 of major cultural centers of europe throughout middle ages, wrote rule , containing directions monks , christians. rule of saint benedict 1 of important written works in shaping of western civilian society because included written constitution, authority limited law, , degree of democracy. besides, mandated moral obligations care sick. in monte cassino st. benedict founded hospital considered today have been first hospital in europe of new era. there benedictine monks took care of sick , wounded according benedict s rule. monastic routine called hard work. care of sick such important duty caring them enjoined act if served christ directly. benedict founded twelve communities monks @ nearby subiaco (about 64 km east of rome), hospitals settled adjuncts monasteries in order provide charity , care soldiers , patients. since time benedictines involved in healing , caring sick , dying, in many cases medieval medicine closely connected christianity , benedictines in particular. why middle ages called benedictine centuries .

soon many monasteries founded throughout europe, , everywhere there hospitals in monte cassino. 11th century, monasteries training own physicians. ideally, such physicians uphold christianized ideal of healer offered mercy , charity towards patients , soldiers, whatever status , prognosis might be. in 6th–12th centuries benedictines established lots of monk communities of type. , later, in 12th–13th centuries benedictines order built network of independent hospitals, provide general care sick , wounded , treatment of syphilis , isolation of patients communicable disease. hospital movement spread through europe in subsequent centuries, 225-bed hospital being built @ york in 1287 , larger facilities established @ florence, paris, milan, siena, , other medieval big european cities.

in north during late saxon period, monasteries, nunneries, , hospitals functioned site of charity poor. after norman conquest of 1066, hospitals found autonomous, freestanding institutions. dispensed alms , medicine, , generously endowed nobility , gentry counted on them spiritual rewards after death. in time, hospitals became popular charitable houses distinct both english monasteries , french hospitals.

the primary function of medieval hospitals worship god. hospitals contained 1 chapel, @ least 1 clergyman, , inmates expected prayer. worship higher priority care , large part of hospital life until , long after reformation. worship in medieval hospitals served way of alleviating ailments of sick , insuring salvation when relief sickness not achieved.

the secondary function of medieval hospitals charity poor, sick, , travellers. charity provided hospitals surfaced in different ways, including long-term maintenance of infirm, medium-term care of sick, short-term hospitality travellers, , regular distribution of alms poor. though these general acts of charity among medieval hospitals, degree of charity variable. example, institutions perceived religious house or place of hospitality turned away sick or dying in fear difficult healthcare distract worship. others, however, such st. james of northallerton, st. giles of norwich, , st. leonard of york, contained specific ordinances stating must cater sick , entered ill health should allowed stay until recovered or died .

the tertiary function of medieval hospitals support education , learning. originally, hospitals educated chaplains , priestly brothers in literacy , history; however, 13th century, hospitals became involved in education of impoverished boys , young adults. after, hospitals began provide food , shelter scholars within hospital in return helping chapel worship.

three well-documented medieval european hospitals st. giles in norwich, st. anthony s in london, , st. leonards in york. st. giles, along st. anthony s , st. leonards, open ward hospitals cared poor , sick in 3 of medieval england s largest cities. study of these 3 hospitals can provide insight diet, medical care, cleanliness , daily life in medieval hospital of europe.

st giles, norwich

discrepancies exist among sources regarding founding of st. giles of norwich, or great hospital known today. sources maintain founded in 1246. other sources state founded in 1249. though date may debatable, seems agreed upon great hospital founded walter suffield, bishop known liberal poor in city of norwich. st giles provided thirty beds , maintained within ten-acre precinct, many meadows courtyards, ponds, , fruit trees until late fifteenth century. hospital cultivated many productive gardens abundant in apples, leeks, garlic, onions , honey. gardens productive surplus goods sold on open market. st giles of norwich owned 6 manors , advowson of eleven churches.

st giles unique in food provided children getting free education elsewhere. noted st giles arranged 7 poor scholars receive board @ hospital during term @ norwich school. accommodations of medieval hospitals communal. example, in st giles, master , brothers ate in common hall while sisters ate themselves. st giles hospital complex building housed community of clergy cloister , residential accommodation, hospital , parish church. st giles wealthy enough maintain own kitchen , staff. allowed poor men receive dish of meat, fish, eggs or cheese in addition customary daily ration of bread , drink.

st. anthony s, london

st. anthony s erected in thirteenth century (some time before 1254), in heart of london on threadneedle street, atop less ideal site of jewish synagogue. chapel of st. anthony s built in 1310 without permission of bishop of london. prevents degradation, hospital petitioned chapel on bishops terms. unlike st. giles, there insufficient land @ st. anthony s, london, recreation or food production. result, herbs or erbys , vegetables had bought on daily basis consumption entire community. accounts of foreign expenses @ st. anthony s show purchase of various spices, intrinsic medicinal qualities alter level of heat , moisture within body. of spices bought include, saffron, cloves, ginger, cinnamon, lavender, pepper , mustard. interestingly, amount spent on herbs, produce, , spices far surpassed amount spent on fish , meat. according quarterly expenditure reports, fifty-eight percent of quarterly budget spent on meat, thirty-four percent on fish, 3 percent on pottage, 2 percent on dairy, 1 percent herbs , 1 percent on eggs. unusually detailed records of diet , expenditures @ st. anthony s have revealed diet of clerical establishment ( hall ) , diets of almsmen, patients , children ( hospital ) quite different , class-based. during typical week, entire community shared dishes of pottage, veal, mutton , eggs; hall alone consumed pork, ribs of roast beef, duck, fresh salmon , eels; , hospital supplied mutton, plaice , haddock. clear hall, or more wealthy, enjoyed extravagant meals of meat , fish, while hospital, patients , poor, fed simpler , cheaper food.

in addition reputation of spending lavishly on food, st. anthony s famous grammar school, choir , pigs, roamed freely among streets identified bells. pigs on sale in london, considered officials unfit food handed on st. anthony s. pigs fed through charity or scavenging , later, when condition improved, taken hospital use food poor or sick.

as mentioned, medieval hospitals became concerned in education , in feeding , housing of students thirteenth century. in 1441, john carpenter, master of st. anthony london, able finance grammar school teachings without fees student. first source of free education in london , remained 1 of london s leading schools 1 hundred years following founding.

in 1449, st. anthony s received handsome legacy support of clerk train scholars in both polyphony , plainsong. st. anthony s became famous choir in 1469, royal minstrels set fraternity @ hospital may study music.

st leonards, york

st leonard s 1 on england s largest , richest hospitals primary purpose of caring poor, sick, old , infirm. maintained 200 beds , in prosperous days, maintained eighteen clergy, 16 sister , female servants, 30 choristers, 10 private boarders (corrodarians) , between 144 , 240 poor sick people. additionally, during easter of 1370, records show accommodation of 224 sick , poor in infirmary , 23 children in orphanage.

the records of st leonard provide best details of daily hospital worship , patient life. in 1249, example, matins , lauds said in morning hours of darkness, followed mass of virgin mary held members of clergy. lesser hours , mass of day said @ mid-morning, vespers in afternoon , compline in evening after supper. sisters @ st. leonard s instructed feed poor , sick, wash them, , lead them around grounds. although food given sick simple, , quite cheap, daily provisions, sisters allowed distribute special food if ill.

at st leonard s, charity , care sick not given inmates of hospitals, poor in other neighboring institutions inmates of local leper houses. additionally, 1 or 2 of chaplains @ st leonard s instructed minister spiritually poor speaking consoling words, hearing confessions, , administering sacraments .

medieval islamic world


entrance qawaloon complex housed notable qawaloon hospital.

the earliest general hospital built in 805 in baghdad harun al-rashid. tenth century, baghdad had 5 more hospitals, while damascus had 6 hospitals 15th century , córdoba alone had 50 major hospitals, many exclusively military. of prominent islamic hospitals believed have been founded assistance of christians such jibrael ibn bukhtishu gundeshapur; there no evidence associate construction of earliest hospital christian physicians gondeshapur, may have played role in function of first hospital in baghdad.

the united states national library of medicine credits hospital being product of medieval islamic civilization. compared contemporaneous christian institutions, poor , sick relief facilities offered monasteries, islamic hospital more elaborate institution wider range of functions. in islam, there moral imperative treat ill regardless of financial status. islamic hospitals tended large, urban structures, , largely secular institutions, many open all, whether male or female, civilian or military, child or adult, rich or poor, muslim or non-muslim. islamic hospital served several purposes, center of medical treatment, home patients recovering illness or accidents, insane asylum, , retirement home basic maintenance needs aged , infirm.

the typical hospital divided departments such systemic diseases, surgery , orthopedics larger hospitals having more diverse specialties. systemic diseases rough equivalent of today s internal medicine , further divided sections such fever, infections , digestive issues. every department had officer-in-charge, presiding officer , supervising specialist. hospitals had lecture theaters , libraries. hospitals staff included sanitary inspectors, regulated cleanliness, , accountants , other administrative staff. hospitals typically run three-man board comprising non-medical administrator, chief pharmacist, called shaykh saydalani, equal in rank chief physician, served mutwalli (dean). medical facilities traditionally closed each night, 10th century laws passed keep hospitals open 24 hours day.

for less serious cases, physicians staffed outpatient clinics. cities had first aid centers staffed physicians emergencies located in busy public places, such big gatherings friday prayers take care of casualties. region had mobile units staffed doctors , pharmacists supposed meet need of remote communities. baghdad known have separate hospital convicts since 10th century after vizier ‘ali ibn isa ibn jarah ibn thabit wrote baghdad s chief medical officer prisons must have own doctors should examine them every day . first hospital built in egypt, in cairo s southwestern quarter, first documented facility care mental illnesses while first islamic psychiatric hospital opened in baghdad in 705.

hospitals in era first require medical diplomas license doctors. licensing test administered region s government appointed chief medical officer. test had 2 steps; first write treatise, on subject candidate wished obtain certificate, of original research or commentary of existing texts, encouraged scrutinize errors. second step answer questions in interview chief medical officer. physicians worked fixed hours , medical staff salaries fixed law. regulating quality of care , arbitrating cases, related if patient dies, family presents doctor s prescriptions chief physician judge if death natural or if negligence, in case family entitled compensation doctor. hospitals had male , female quarters while hospitals saw men , other hospitals, staffed women physicians, saw women. while women physicians practiced medicine, many largely focused on obstetrics.

hospitals forbidden law turn away patients unable pay. eventually, charitable foundations called waqfs formed support hospitals, schools. part of state budget went towards maintaining hospitals. while services of hospital free citizens , patients given small stipend support recovery upon discharge, individual physicians charged fees. in notable endowment, 13th-century governor of egypt al mansur qalawun ordained foundation qalawun hospital free patients , contain mosque, library doctors , pharmacy , hospital used today ophthalmology. hospital had accommodation 8,000 people - served 4,000 patients daily.

early modern , enlightenment europe

in europe medieval concept of christian care evolved during sixteenth , seventeenth centuries secular one. in england, after dissolution of monasteries in 1540 king henry viii, church abruptly ceased supporter of hospitals, , direct petition citizens of london, hospitals st bartholomew s, st thomas s , st mary of bethlehem s (bedlam) endowed directly crown; first instance of secular support being provided medical institutions.

a hospital ward in sixteenth century france.



1820 engraving of guy s hospital in london 1 of first voluntary hospitals established in 1724.

the voluntary hospital movement began in 18th century, hospitals being founded in london 1720s, including westminster hospital (1719) promoted private bank c. hoare & co , guy s hospital (1724) funded bequest of wealthy merchant, thomas guy.

other hospitals sprang in london , other british cities on century, many paid private subscriptions. st bartholomew s opened in london in 1730, , london hospital in 1752.

these hospitals represented turning point in function of institution; began evolve being basic places of care sick becoming centres of medical innovation , discovery , principal place education , training of prospective practitioners. of era s greatest surgeons , doctors worked , passed on knowledge @ hospitals. changed being mere homes of refuge being complex institutions provision of medicine , care sick. charité founded in berlin in 1710 king frederick of prussia response outbreak of plague.

the concept of voluntary hospitals spread colonial america; bellevue hospital center opened in 1736; pennsylvania hospital opened in 1752, new york hospital in 1771, , massachusetts general hospital in 1811. when vienna general hospital opened in 1784 (instantly becoming world s largest hospital), physicians acquired new facility gradually developed 1 of important research centres.

another enlightenment era charitable innovation dispensary; these issue poor medicines free of charge. london dispensary opened doors in 1696 first such clinic in british empire. idea slow catch on until 1770s, when many such organisations began appear, including public dispensary of edinburgh (1776), metropolitan dispensary , charitable fund (1779) , finsbury dispensary (1780). dispensaries opened in new york 1771, philadelphia 1786, , boston 1796.

the royal naval hospital, stonehouse, plymouth, pioneer of hospital design in having pavilions minimize spread of infection. john wesley visited in 1785, , commented never saw of kind complete; every part convenient, , admirably neat. there nothing superfluous, , nothing purely ornamented, either within or without. revolutionary design made more known john howard, philanthropist. in 1787 french government sent 2 scholar administrators, coulomb , tenon, had visited of hospitals in europe. impressed , pavilion design copied in france , throughout europe.

19th century

a ward of hospital @ scutari florence nightingale worked , helped restructure modern hospital

english physician thomas percival (1740–1804) wrote comprehensive system of medical conduct, medical ethics, or code of institutes , precepts, adapted professional conduct of physicians , surgeons (1803) set standard many textbooks. in mid-19th century, hospitals , medical profession became more professionalised, reorganisation of hospital management along more bureaucratic , administrative lines. apothecaries act 1815 made compulsory medical students practise @ least half year @ hospital part of training.

florence nightingale pioneered modern profession of nursing during crimean war when set example of compassion, commitment patient care , diligent , thoughtful hospital administration. first official nurses training programme, nightingale school nurses, opened in 1860, mission of training nurses work in hospitals, work poor , teach. nightingale instrumental in reforming nature of hospital, improving sanitation standards , changing image of hospital place sick go die, institution devoted recuperation , healing. emphasised importance of statistical measurement determining success rate of given intervention , pushed administrative reform @ hospitals.

by late 19th century, modern hospital beginning take shape proliferation of variety of public , private hospital systems. 1870s, hospitals had more trebled original average intake of 3,000 patients. in continental europe new hospitals built , run public funds. national health service, principal provider of health care in united kingdom, founded in 1948. during nineteenth century, second viennese medical school emerged contributions of physicians such carl freiherr von rokitansky, josef Škoda, ferdinand ritter von hebra, , ignaz philipp semmelweis. basic medical science expanded , specialisation advanced. furthermore, first dermatology, eye, ear, nose, , throat clinics in world founded in vienna, being considered birth of specialised medicine.