History of hospitals
The history of hospitals began in antiquity with
Early Chinese and Japanese hospitals were established by Western missionaries in the 1800s[
Antiquity
The earliest documented institutions aiming to provide cures were ancient Egyptian temples[citation needed]. In ancient history, hospitals have been documented in Greece, Rome, the Indian subcontinent, and Persia. In ancient cultures, religion and medicine were linked.[8]
Greece
In
At these shrines, patients would enter a dream-like state of induced sleep known as enkoimesis (ἐγκοίμησις) not unlike anesthesia, in which they either received guidance from the deity in a dream.[11] Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing.[9] In the Asclepieion of Epidaurus, three large marble boards dated to 350 BCE preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium.[11] The worship of Asclepius was adopted by the Romans.
The
Roman Empire
The Romans constructed buildings called valetudinaria for the care of sick slaves, gladiators, and soldiers around 100 BCE, and many were identified by later archaeology. While their existence is considered proven, there is some doubt as to whether they were as widespread as was once thought, as many were identified only according to the layout of building remains, and not by means of surviving records or finds of medical tools.[15]
The declaration of
India & East Asia
In ancient Sri Lanka, according to the Mahavansa chronicle from the 6th century CE, King Pandukabhaya constructed hospitals and lying-in-homes after fortifying his capital in Anuradhapura during the 4th century BCE This provides the earliest literary evidence of hospitals, where patients could be housed and treated collectively. The oldest archaeological evidence of a hospital in Asia can be found in the ruins of Mihintale, dating back to the ninth century.[20] Scholars suggest that this may be one of the oldest hospitals in the world.[4][21]
King
The benevolent and educated persons of this country have instituted a free hospital within the city; and hither come all poor or helpless inhabitants suffering from all kinds of infirmities. They are well taken care of, and a doctor attends them, food and medicine being supplied according to their wants. Thus they are made quite comfortable, and when they are well they may go away.[27]
The first clear archaeological evidence of such hospitals first appears in the eighth and ninth centuries. Nevertheless, it would be inaccurate to portray the period as a time where a system of hospitals had existed. Rather, rulers from time to time may have sponsored and allocated resources for particular medical care for the population in particular places.[28] In one case, a countrywide system of hospitals was established in 12th century Cambodia under the Cambodian king Jayavarman VII, who associated it with the Buddha of healing Bhaisajyaguru.[29]
Significant and asymmetric transfers of knowledge to the southeast Asian world from the Greek one began during the reign of Alexander the Great in the late 4th century BCE as Hellenization swept the continent.[30] While usually assumed that Tibetan medicine was largely Chinese in origin, it turns out that Tibetan medicine was actually largely Westernized, at least during the first century of the Tibetan Empire in the 7th–8th centuries. Persian and Arab doctors from the Islamic Caliphate could be found all across China in this time period.[31] It's also possible that Indian physicians played a role in a short-lived, but still one of the earliest Abbasid hospitals established by the Barkamid family.[32]
5th to the 15th century
5th (1) | 6th (2) | 7th (1) | 8th (1) | 9th (1) | 10th (2) | 11th (3) | 12th (16) | 13th (14) | 14th (7) | 15th (15) |
529 | Persian Persia[33]
|
---|---|
543 (about) | First hospital built at Monte Cassino by Saint Benedict, first of many Medieval Monastic hospitals[34] |
580 | First Spanish xenodochium (hospital) founded by the Catholic Visigoth bishop Masona at Mérida, Spain[35] |
706/707 | Al-Wahid Bimarstan, first Islamic hospital built in Damascus[36] |
727 | Ospedale di Santo Spirito in Sassia hospital established in Italy[37] |
800 or earlier | Early hospital established in Sri Lanka at Mihintale, Sri Lanka[38] |
805 | Medieval Islamic Bimaristan (hospital) built in Bagdad[39][40] |
829 | Hôtel-Dieu (French hospital) established in Paris[16] |
872 | Al-Fustat Hospital established in Cairo, one of the first hospitals to offer mental health treatment[41] |
981 | Al-'Adudi Hospital Bimaristan established in Baghdad by King 'Adud al-Dawla[41] |
1083–1084 | Hospital of St Nicholas, Nantwich, hospital for travelers in Nantwich, England[42] |
1085 | Hospital of St John the Baptist, Winchester, early almshouse that became a hospital in Winchester, England |
1090 | Santa Maria della Scala, Siena established in Siena, Italy[43] |
1123 | St. Bartholomew's Hospital, oldest hospital in the world still providing medical services on the site it was originally built on |
1140 (circa) | Old St. John's Hospital one of the oldest hospital buildings in Europe with its regulations dating back to 1188[44] |
1197 | Hôpital de La Grave, used to treat plague patients between 1508 and 1514[45] |
1211–1222 | Ospedale di San Paolo, early Franciscan hospital in Florence, Italy[46] |
1238 | Hospital ante Brunem, early Johanitte hospital still serving Brno, Czech Republic[47] |
1249 | Great Hospital, medieval hospital still serving Norwich, England[48] |
1277 | Ospedale del Ceppo, Medieval hospital founded for the poor in Pistoia, Italy |
1288 | Hospital of Santa Maria Nuova, oldest hospital still active in Florence, Italy[49] |
13th Century (late) | Maristan (hospital) in Fez, Morocco[50]
|
1325 (circa) | Hospital of St John the Baptist, Arbroath, Arbroath, Scotland; early Medieval hospital[51] |
1339 | San Giacomo degli Incurabili, medieval hospital in Rome, near the Porto di Ripetta[52] |
1354 | Nemocnice Na Františku, oldest hospital in Prague, still in use on the bank of Vltava river[53] |
1388 | University Hospital Heidelberg founded, oldest in Germany[54] |
1454 | Hôtel-Dieu de Lyon, medieval hospital in Lyon, France[55] |
1456 | Ospedale Maggiore di Milano, founded by the Duke of Milan, Italy; in continuous operation[37] |
1449 | Policlinico San Matteo, teaching hospital in Lombardy, Italy[56] |
1491 | Dar-ul-Shifa hospital established in Old Hyderabad, India[57] |
In the
During the thirteenth century an immense number of hospitals were built. The Italian cities were the leaders of the movement. Milan had no fewer than a dozen hospitals and Florence before the end of the fourteenth century had some thirty hospitals. Some of these were very beautiful buildings. At Milan a portion of the general hospital was designed by Bramante and another part of it by Michelangelo. The Hospital of Siena, built in honor of St. Catherine, has been famous ever since. Everywhere throughout Europe this hospital movement spread. Virchow, the great German pathologist, in an article on hospitals, showed that every city of Germany of five thousand inhabitants had its hospital. He traced all of this hospital movement to Pope Innocent III, and though he was least papistically inclined, Virchow did not hesitate to give extremely high praise to this pontiff for all that he had accomplished for the benefit of children and suffering mankind.[58]
Hospitals began to appear in great numbers in
Owing to a well-preserved 12th-century account of the monk Eadmer of the Canterbury cathedral, there is an excellent account of Bishop Lanfranc's aim to establish and maintain examples of these early hospitals:
But I must not conclude my work by omitting what he did for the poor outside the walls of the city Canterbury. In brief, he constructed a decent and ample house of stone…for different needs and conveniences. He divided the main building into two, appointing one part for men oppressed by various kinds of infirmities and the other for women in a bad state of health. He also made arrangements for their clothing and daily food, appointing ministers and guardians to take all measures so that nothing should be lacking for them.[60]
Persia
The
Medieval Islamic hospitals
The first Muslim hospital was an asylum to contain leprosy, built in the early eighth century, where patients were confined but, like the blind, were given a stipend to support their families.
The United States National Library of Medicine credits the hospital as being a product of medieval Islamic civilization. Compared to contemporaneous Christian institutions, which were poor and sick relief facilities offered by some monasteries, the Islamic hospital was a more elaborate institution with a wider range of functions. In Islam, there was a moral imperative to treat the ill regardless of financial status. Islamic hospitals tended to be large, urban structures, and were largely secular institutions, many open to all, whether male or female, civilian or military, child or adult, rich or poor, Muslim or non-Muslim. The Islamic hospital served several purposes, as a center of medical treatment, a home for patients recovering from illness or accidents, an insane asylum, and a retirement home with basic maintenance needs for the aged and infirm.[69]
The typical hospital was divided into departments such as systemic diseases, surgery and orthopedics with larger hospitals having more diverse specialties. "Systemic diseases" was the rough equivalent of today's internal medicine and was further divided into sections such as fever, infections and digestive issues. Every department had an officer-in-charge, a presiding officer and a supervising specialist. The hospitals also had lecture theaters and libraries. Hospitals staff included sanitary inspectors, who regulated cleanliness, and accountants and other administrative staff.[64] The hospital in Baghdad employed twenty-five staff physicians.[70] The hospitals were typically run by a three-man board comprising a non-medical administrator, the chief pharmacist, called the shaykh saydalani, who was equal in rank to the chief physician, who served as mutwalli (dean).[71] Medical facilities traditionally closed each night, but by the 10th century laws were passed to keep hospitals open 24 hours a day.[72]
For less serious cases, physicians staffed outpatient clinics. Cities also had first aid centers staffed by physicians for emergencies that were often located in busy public places, such as big gatherings for Friday prayers to take care of casualties. The region also had mobile units staffed by doctors and pharmacists who were supposed to meet the need of remote communities. Baghdad was also known to have a separate hospital for convicts since the early 10th century after the vizier ‘Ali ibn Isa ibn Jarah ibn Thabit wrote to Baghdad’s chief medical officer that “prisons must have their own doctors who should examine them every day”. The first hospital built in Egypt, in Cairo's Southwestern quarter, was the first documented facility to care for
Medical students would accompany physicians and participate in patient care. Hospitals in this era were the first to require medical diplomas to license doctors.[74] The licensing test was administered by the region's government appointed chief medical officer. The test had two steps; the first was to write a treatise, on the subject the candidate wished to obtain a certificate, of original research or commentary of existing texts, which they were encouraged to scrutinize for errors. The second step was to answer questions in an interview with the chief medical officer. Physicians worked fixed hours and medical staff salaries were fixed by law. For regulating the quality of care and arbitrating cases, it is related that if a patient dies, their family presents the doctor's prescriptions to the chief physician who would judge if the death was natural or if it was by negligence, in which case the family would be entitled to compensation from the doctor. The hospitals had male and female quarters while some hospitals only saw men and other hospitals, staffed by women physicians, only saw women.[64] While women physicians practiced medicine, many largely focused on obstetrics.[75]
Hospitals were forbidden by law to turn away patients who were unable to pay. ...The hospital shall keep all patients, men and women, until they are completely recovered. All costs are to be borne by the hospital whether the people come from afar or near, whether they are residents or foreigners, strong or weak, low or high, rich or poor, employed or unemployed, blind or sighted, physically or mentally ill, learned or illiterate. There are no conditions of consideration and payment, none is objected to or even indirectly hinted at for non-payment.[76]
The first, most well known physicians in the Medieval Islamic world were polymaths Ibn Sina, (Greek: Avicenna) and Al Rhazi (Greek: Rhazes) during the 10th and 11th centuries.[79]
Medieval European hospitals
Medieval hospitals in Europe followed a similar pattern to the
Around 529 CE St.
The first Spanish hospital, founded by the Catholic
During the late 8th and early 9th centuries, Emperor Charlemagne decreed that those hospitals that had been well conducted before his time and had fallen into decay should be restored in accordance with the needs of the time.[85] He further ordered that a hospital should be attached to each cathedral and monastery.[85]
During the 10th century, the monasteries became a dominant factor in hospital work. The famous Benedictine Abbey of Cluny, founded in 910, set the example which was widely imitated throughout France and Germany.[86] Besides its infirmary for the religious, each monastery had a hospital in which externs were cared for. These were in charge of the eleemosynarius, whose duties, carefully prescribed by the rule, included every sort of service that the visitor or patient could require.
As the eleemosynarius was obliged to seek out the sick and needy in the neighborhood, each monastery became a center for the relief of suffering. Among the monasteries notable in this respect were those of the Benedictines at Corbie in Picardy, Hirschau, Braunweiler, Deutz, Ilsenburg, Liesborn, Pram, and Fulda; those of the Cistercians at Arnsberg, Baumgarten, Eberbach, Himmenrode, Herrnalb, Volkenrode, and Walkenried.
No less efficient was the work done by the
The
The Normans brought their hospital system along when they conquered England in 1066. By merging with traditional land-tenure and customs, the new charitable houses became popular and were distinct from both English monasteries and French hospitals. They dispensed alms and some medicine, and were generously endowed by the nobility and gentry who counted on them for spiritual rewards after death.[88]
Late medieval European hospitals
The Hospitaller Order of St. John of Jerusalem, founded in 1099 (The Knights of Malta) itself has - as its raison d’être - the founding of a hospital for pilgrims to the Holy Land. In Europe, Spanish hospitals are particularly noteworthy examples of Christian virtue as expressed through care for the sick, and were usually attached to a monastery in a ward-chapel configuration, most often erected in the shape of a cross. This style reached a high point during the hospital building campaign of Portuguese St. John of God in the sixteenth-century, the founder of the Hospitaller Order of the Brothers of John of God.[89]
Soon many monasteries were founded throughout Europe, and everywhere there were hospitals like in Monte Cassino. By the 11th century, some monasteries were training their own physicians. Ideally, such physicians would uphold the Christianized ideal of the healer who offered mercy and charity towards all patients and soldiers, whatever their status and prognosis might be. In the 6th–12th centuries the Benedictines established many monk communities of this type. And later, in the 12th–13th centuries the Benedictines order built a network of independent hospitals, initially to provide general care to the sick and wounded and then for treatment of syphilis and isolation of patients with communicable disease. The hospital movement spread through Europe in the subsequent centuries, with a 225-bed hospital being built at York in 1287 and even larger facilities established at Florence, Paris, Milan, Siena, and other medieval big European cities. In 1120 a man named Rahere fell ill with malaria in Rome: he was taken care of by the monks of the small hospital near the church of San Bartolomeo, on the Tiber Island, and took a vow to found a hospital in case he was cured. Effectively cured, in 1123 he founded a small hospital for the poor outside London: it was the first nucleus of the famous St Bartholomew's Hospital, still active today, commonly called "Bart".
In the North during the late Saxon period, monasteries, nunneries, and hospitals functioned mainly as a site of charity to the poor. After the
The primary function of medieval hospitals was to worship to God. Most hospitals contained one chapel, at least one clergyman, and inmates that were expected to help with prayer. Worship was often a higher priority than care and was a large part of hospital life until and long after the Reformation. Worship in medieval hospitals served as a way of alleviating ailments of the sick and insuring their salvation when relief from sickness could not be achieved.[91][92]
The secondary function of medieval hospitals was charity to the poor, sick, and travellers. Charity provided by hospitals surfaced in different ways, including long-term maintenance of the infirm, medium-term care of the sick, short-term hospitality to travellers, and regular distribution of alms to the poor.[91]: 58 Though these were general acts of charity among medieval hospitals, the degree of charity was variable. For example, some institutions that perceived themselves mainly as a religious house or place of hospitality turned away the sick or dying in fear that difficult healthcare will distract from worship. Others, however, such as St. James of Northallerton, St. Giles Hospital of Norwich, and St. Leonard's Hospital of York, contained specific ordinances stating they must cater to the sick and that "all who entered with ill health should be allowed to stay until they recovered or died".[91]: 58 [93]: 23 The study of these three hospitals provides insight into the diet, medical care, cleanliness and daily life in a medieval hospital of Europe.
The tertiary function of medieval hospitals was to support education and learning. Originally, hospitals educated chaplains and priestly brothers in literacy and history; however, by the 13th century, some hospitals became involved in the education of impoverished boys and young adults. Soon after, hospitals began to provide food and shelter for scholars within the hospital in return for helping with chapel worship.[91]: 65
16th and 17th centuries
Notable hospitals in the 16th and 17th centuries with articles in Wikipedia
16th (19) | 17th (20) |
Early modern Europe
In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one.[94] Theology was the problem. The Protestant reformers rejected the Catholic belief that rich men could gain God's grace through good works – and escape purgatory – by providing endowments to charitable institutions, and that the patients themselves could gain grace through their suffering.[95]
After the
There were 28 asylums in Sweden at the start of the Reformation. Gustav Vasa removed them from church control and expelled the monks and nuns, but allowed the asylums to keep their properties and to continue their activities under the auspices of local government.[98]
In much of Europe town governments operated small Holy Spirit hospitals, which had been founded in the 13th and 14th centuries. They distributed free food and clothing to the poor, provided for homeless women and children, and gave some medical and nursing care. Many were raided and closed during the
In Denmark, the beginnings of modern hospital care started during the Scanian War (1675–79) when Denmark suffered disastrous losses. Five government-run hospitals were founded around the Sound: one at Elsinore, two at Copenhagen, one at Landskrona and one at Helsingborg. The one at Landskrona was based on the old Holy Spirit institution but now it was modernised and enlarged. One of the two Copenhagen institutions was placed in a former plague hospital. The government spent vast sums on equipment, from bone saws to beds and staff. Women nursed the wounded and sick soldiers on a day-to-day basis but men were always head of these hospitals. They had various surgeons and physicians, but never enough of them. The meals were based on porridge, herring, beer and peas. After Denmark lost the war, Helsingborg and Landskrona were surrendered to the Swedes but the hospitals in Elsinore and Copenhagen continued their work.[99]
Meanwhile, in Catholic lands such as France and Italy, rich families continued to fund convents and monasteries that provided free health services to the poor. French practices were influenced by a charitable imperative which considered care of the poor and the sick to be a necessary part of Catholic practice. The nursing nuns had little faith in the power of physicians and their medicines alone to cure the sick; more important was providing psychological and physical comfort, nourishment, rest, cleanliness and especially prayer.[100]
In Protestant areas the emphasis was on scientific rather than religious aspects of patient care, and this helped develop a view of nursing as a profession rather than a vocation.[101] There was little hospital development by the main Protestant churches after 1530.[102] Some smaller groups such as the Moravians and the Pietists at Halle gave a role for hospitals, especially in missionary work.[103]
Colonial Americas
The first hospital founded in the Americas was the
Conquistador Hernán Cortés founded the two earliest hospitals in North America: the Immaculate Conception Hospital and the Saint Lazarus Hospital. The oldest was the Immaculate Conception, now the Hospital de Jesús Nazareno in Mexico City, founded in 1524 to care for the poor.[104]
In Quebec, Catholics operated hospitals continuously from the 1640s; they attracted nuns from the provincial elite.
18th century
In the 18th century, under the influence of the Age of Enlightenment, the modern hospital began to appear, serving only medical needs and staffed with trained physicians and surgeons. The nurses were untrained workers. The goal was to use modern methods to cure patients. They provided more narrow medical services, and were founded by the secular authorities. A clearer distinction emerged between medicine and poor relief. Within the hospitals, acute cases were increasingly treated alone, and separate departments were set up for different categories of patient.
The voluntary hospital movement began in the early 18th century, with hospitals being founded in London by the 1710s and 20s, including Westminster Hospital (1719) promoted by the private bank C. Hoare & Co and Guy's Hospital (1724) funded from the bequest of the wealthy merchant, Thomas Guy. Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St. Bartholomew's in London was rebuilt in 1730, and the London Hospital opened in 1752.
These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centres of medical innovation and discovery and the principal place for the education and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at the hospitals.[107] They also changed from being mere homes of refuge to being complex institutions for the provision of medicine and care for sick. The Charité was founded in Berlin in 1710 by King Frederick I of Prussia as a response to an outbreak of plague.
The concept of voluntary hospitals also spread to
Another
Across Europe medical schools still relied primarily on lectures and readings. In the final year, students would have limited clinical experience by following the professor through the wards. Laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. Most schools were small, and only Edinburgh, Scotland, with 11,000 alumni, produced large numbers of graduates.[110][111]
19th century
English physician
In the mid 19th century, hospitals and the medical profession became more professionalized, with a reorganization of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practice for at least half a year at a hospital as part of their training.[113] An example of this professionalization was the Charing Cross Hospital, set up in 1818 as the 'West London Infirmary and Dispensary' from funds provided by Dr. Benjamin Golding. By 1821 it was treating nearly 10,000 patients a year, and it was relocated to larger quarters near Charing Cross in the heart of London. Its Charing Cross Hospital Medical School opened in 1822. It expanded several times and 1866 added a professional nursing staff.[114]
Florence Nightingale pioneered the modern profession of nursing during the Crimean War when she set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration. The first official nurses’ training programme, the Nightingale School for Nurses, was opened in 1860, with the mission of training nurses to work in hospitals, to work with the poor and to teach.[115]
Nightingale was instrumental in reforming the nature of the hospital, by improving sanitation standards and changing the image of the hospital from a place the sick would go to die, to an institution devoted to recuperation and healing. She also emphasized the importance of statistical measurement for determining the success rate of a given intervention and pushed for administrative reform at hospitals.[116]
During the middle of the 19th century, the
In Rome, where hospitality was highly patrimonial thanks to a long tradition of bequests and substantial donations (Spedalità romane), with a royal decree in 1896 the vast hospital patrimony was centralized in a single body: the Pio Istituto di Santo Spirito and Ospedali Riuniti, which thus became the largest in Europe.[118]
By the late 19th century, the modern hospital was beginning to take shape with a proliferation of a variety of public and private hospital systems. By the 1870s, hospitals had more than tripled their original average intake of 3,000 patients. In
In the U.S., the number of hospitals reached 4400 in 1910, when they provided 420,000 beds.
The National Health Service, the principal provider of health care in Britain, was founded in 1948, and took control of nearly all the hospitals.[123]
Paris Medicine
At the turn of the 19th century, Paris medicine played a significant role in shaping clinical medicine. New emphasis on physically examining the body led to methods such as percussion, inspection, palpation, auscultation, and autopsy.[124] The situation in Paris was particularly unique due to the fact that there was a very large concentration of medical professionals in a very small setting allowing for a large flow of ideas and the spread of innovation.[124] One of the innovations to come out of the Paris hospital setting was Laennec's stethoscope. Weiner states that the widespread acceptance of the stethoscope would likely not have happened in any other setting, and the setting allowed for Laennec to pass on this technology to the eager medical community that had gathered there. This invention also brought even more attention to the Paris scene.[124]
Before the start of the 19th century, there were many problems existing within the French medical system. These problems were outlined by many seeking to reform hospitals including a contemporary surgeon Jacques Tenon in his book Memoirs on Paris Hospitals. Some of the problems Tenon drew attention to were the lack of space, the inability to separate patients based on the type of illness (including those that were contagious), and general sanitation problems.[125] Additionally, the secular revolution led to the nationalization of hospitals previously owned by the Catholic Church and led to a call for a hospital reform which actually pushed for the deinstitutionalization of medicine.[126] This contributed to the state of disarray Paris hospitals soon fell into which ultimately called for the establishment of a new hospital system outlined in the law of 1794. The law of 1794 played a significant part in revolutionizing Paris Medicine because it aimed to address some of the problems facing Paris Hospitals of the time.
First, the law of 1794 created three new schools in Paris, Montpellier, and Strasbourg due to the lack of medical professionals available to treat a growing French army. It also gave physicians and surgeons equal status in the hospital environment, whereas previously physicians were regarded as intellectually superior.[126] This led to the integration of surgery into traditional medical education contributing to a new breed of doctors that focused on pathology, anatomy and diagnosis. The new focus on anatomy was further facilitated by this law because it ensured that medical students had enough bodies to dissect.[126] Additionally, pathological education was furthered by the increased use of autopsies to determine a patient's cause of death.[124] Lastly, the law of 1794 allocated funds for full-time salaried teachers in hospitals, as well as creating scholarships for medical students.[126] Overall, the law of 1794 contributed to the shift of medical teaching away from theory and towards practice and experience, all within a hospital setting. Hospitals became a center for learning and development of medical techniques, which was a departure from the previous notion of a hospital as an area that accepted people who needed help of any kind, ill or not.[127] This shift was consistent with much of the philosophy of the time, particularly the ideas of John Locke who preached that observation using ones senses was the best way to analyze and understand a phenomenon.[126] Foucalt, however, criticized this shift in his book The Birth of the Clinic, stating that this shift took attention away from the patient and objectified patients, ultimately resulting in a loss of the patient's narrative. He argued that from this point forward, in the eyes of doctors, patients lost their humanity and became more like objects for inspection and examination.[128]
The next advancement in Paris medicine came with the creation of an examination system, that after 1803, was required for the licensing of all medical professions creating a uniform and centralized system of licensing.[126] This law also created another class of health professionals, mostly for those living outside of cities, who did not have to go through the licensing pricess but instead went through a simpler and shorter training process.[126]
Another area influenced by Paris hospitals was the development of specialties. The structure of a Paris hospital allowed physicians more freedom to pursue interests as well as providing the necessary resources.[124] An example of a physician who used this flexibility to conduct research is Phillipe Pinel who conducted a four-year study on the hospitalization and treatment of mentally-ill women within the Salpêtriére hospital. This was the first study ever done of this magnitude by a physician, and the Pinel was the first to realize that patients dealing with similar illnesses could be group together, compared, and classified.[124]
Protestant hospitals
The
William Passavant in 1849 brought the first four deaconesses to Pittsburgh, in the United States, after visiting Kaiserswerth. They worked at the Pittsburgh Infirmary (now Passavant Hospital).[130]
The American
Catholic hospitals
In the 1840s–1880s era, Catholics in Philadelphia founded two hospitals, for the Irish and German Catholics. They depended on revenues from the paying sick, and became important health and welfare institutions in the Catholic community.[132] By 1900 the Catholics had set up hospitals in most major cities. In New York the Dominicans, Franciscans, Sisters of Charity, and other orders set up hospitals to care primarily for their own ethnic group. By the 1920s they were serving everyone in the neighborhood.[133] In smaller cities too the Catholics set up hospitals, such as St. Patrick Hospital in Missoula, Montana. The Sisters of Providence opened it in 1873. It was in part funded by the county contract to care for the poor, and also operated a day school and a boarding school. The nuns provided nursing care especially for infectious diseases and traumatic injuries among the young, heavily male clientele. They also proselytized the patients to attract converts and restore lapsed Catholics back into the Church. They built a larger hospital in 1890.[134] Catholic hospitals were largely staffed by Catholic orders of nuns, and nursing students, until the population of nuns dropped sharply after the 1960s. The Catholic Hospital Association formed in 1915.[135][136]
Chinese hospitals
Traditionally, Chinese medicine relied on small private clinics and individual healers until the middle of the 18th century when missionary hospitals operated by western churches were first established in China. In 1870, the
Integration of New Technology and Advancements
Anesthetics
A major change to procedures in the medical field was the introduction of anesthetics used to put patients to sleep.[139] While the use of anesthetics was first introduced in the 19th century, it became a favorable and widely used practice due to its ability to incapacitate a patient and make operations easier and less painful.[139] This, in turn, made operations such as amputations less fatal, because patients would stay still as well as not be in shock and lose less blood while being operated on.[139]
On November 7, 1846, the first amputation using a form of anesthesia called ether anesthesia was performed. This anesthetic was called letheon and was created by a dentist, Dr. William Morton.[139] This new, ether based anesthetic was administered to Alice Mohan in an amputation procedure to, first, subdue her during the amputation and second, to test the effects of the new letheon.[139] After being given to Alice Mohan, the anesthetic reportedly only took three minutes to take full effect. The amputation was carried out with little reaction from Alice Mohan, and she seemed completely unaffected by pain and outside stimuli until a static nerve was cut, when a small cry was noticed. There was also only a small amount of blood lost during the operation.[139]
Antisepsis
Another big change to the medical world was the introduction of the idea of germ theory. Germ theory is the idea that disease is caused by microscopic living organisms being introduced to the body.[140] Joseph Lister was able to apply germ theory to medical practice and tried to show that germ theory should be taken seriously.[140] This was not widely accepted at first due to the fact that Lister was determining that airborne germs were infecting open wounds, and it was not believed that this could be a single cause of infection.[141][139] Through experimentation, Louis Pasteur was able to determine that living organisms are the cause of fermentation, and demonstrated that the spread and growth of septicemia was dependent on a living microorganism.[142] Joseph Lister applied this idea to surgeries and used a carbolic acid solution to attempt to sterilize anything that would be on our around a wound. This method proved to be successful when Lister pointed out that, despite his patients, in most cases, being in a tighter space than standard wards, there was still a very low infection rate among them since he began using his methods.[139]
20th century
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Following the rapid growth of American cities in the 1870's, demand for centralized care rose and with it came fourth voluntary hospitals. Inspired by religion or charity, voluntary hospitals became admired for their nobility.[143] Being private, financial support was drawn from politicians and businessmen hoping to earn favor from the public for their generosity.[143] With the capacity to expand, hospitals began to compete for patients in part through a greater number of services using advancements in medical technology made in 20th century.[143]
Integration of New Technology and Advancements
X-ray
In the year after the discovery of x-ray in 1895, many experiments were conducted to serve medical results including during a surgery by John Hall-Edwards and over a fracture in Eddie McCarthy's wrist by Gilman and Edward Frost.[144][145] Hospitals all over the world grabbed onto the new technology. In January 1896, the Glasgow Royal Infirmary in Scotland is credited with having the first radiology department, headed by Dr. John Macintyre.[146] In America, the Pennsylvania Hospital in Philadelphia purchased an X-ray machine in 1897.[147]
See also
- Byzantine medicine
- Doctor of Medicine
- History of medicine
- List of the oldest hospitals in the United States
- Medieval medicine of Western Europe
- Nursing
- Timeline of nursing history
- Timeline of medicine and medical technology
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Further reading
General
- Bowers, Barbara S. (2007). Medieval Hospital and Medical Practice. Ashgate Publishing. ISBN 978-0754651109.
- Brockliss, Lawrence, and Colin Jones. "The Hospital in the Enlightenment," in The Medical World of Early Modern France (Oxford UP, 1997), pp. 671–729; covers France 1650–1800
- Chaney, Edward (2000),"'Philanthropy in Italy': English Observations on Italian Hospitals 1545–1789", in: The Evolution of the Grand Tour: Anglo-Italian Cultural Relations since the Renaissance, 2nd ed. London, Routledge, 2000. Google books
- Davis, Adam J. The Medieval Economy of Salvation: Charity, Commerce and the Rise of the Hospital (Cornell Univ. Press, 2019)
- Goldin, Grace (1975). Hospital: A Social and Architectural History. Yale U. P. (scholarly)
- Goldin, Grace (1994). Work of Mercy: A Picture History of Hospitals., popular
- Gorsky, Martin; Vilar-Rodríguez, Margarita; Pons-Pons, Jerònia, eds. (2020). The Political Economy of the Hospital in History. University of Huddersfield Press.
- Douglas Guthrie (1945). A History Of Medicine. BRAOU, Digital Library Of India. Thomas Nelson And Sons Ltd London.
- Harrison, Mark, ed. (2008). From Western Medicine to Global Medicine: The Hospital Beyond the West.
- Henderson, John, ed. (2007). The Impact of Hospitals 300–2000., 426 pages, 16 essays by scholars table of contents
- Henderson, John (2006). The Renaissance Hospital: Healing the Body and Healing the Soul.
- Horden, Peregrine (2008). Hospitals and Healing From Antiquity to the Later Middle Ages.
- Jones, Colin (1990). The Charitable Imperative: Hospitals and Nursing in Ancient Regime and Revolutionary France.
- Kisacky, Jeanne (2017). Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870–1940. U of Pittsburgh Press.
- McGrew, Roderick E., ed. (1985). Encyclopedia of Medical History.
- Morelon, Régis and Roshdi Rashed, ed. (1996). Encyclopedia of the History of Arabic Science.
- Porter, Roy; Granshaw, Lindsay (1989). The Hospital in History. Routledge. ISBN 978-0-415-00375-9.
- Risse, Guenter B. (1999). Mending Bodies, Saving Souls: A History of Hospitals. Oxford University Press. ISBN 0199748691., 752pp; world coverage excerpt and text search
- Scheutz, Martin, ed. (2009). Hospitals and Institutional Care in Medieval and Early Modern Europe.
Nursing
- Bullough, Vern L. and Bullough, Bonnie. The Care of the Sick: The Emergence of Modern Nursing (1978).
- D'Antonio, Patricia. American Nursing: A History of Knowledge, Authority, and the Meaning of Work (2010), 272pp excerpt and text search
- Davies, Celia, ed. Rewriting Nursing History (1980),
- Dingwall, Robert, Anne Marie Rafferty, Charles Webster. An Introduction to the Social History of Nursing (Routledge, 1988)
- Dock, Lavinia Lloyd. A Short history of nursing from the earliest times to the present day (1920)full text online; abbreviated version of M. Adelaide Nutting and Dock, A History of Nursing (4 vol 1907); vol 1 online; vol 3 online
- Donahue, M. Patricia. Nursing, The Finest Art: An Illustrated History (3rd ed. 2010), includes over 400 illustrations; 416pp; excerpt and text search
- Fairman, Julie and Joan E. Lynaugh. Critical Care Nursing: A History (2000) excerpt and text search
- Hutchinson, John F. Champions of Charity: War and the Rise of the Red Cross (1996) 448 pp.
- Judd, Deborah. A History of American Nursing: Trends and Eras (2009) 272pp excerpt and text search
- Lewenson, Sandra B., and Eleanor Krohn Herrmann. Capturing Nursing History: A Guide to Historical Methods in Research (2007)
- Schultheiss, Katrin. Bodies and souls: politics and the professionalization of nursing in France, 1880–1922 (Harvard U.P., 2001) full text online at ACLS e-books
- Snodgrass, Mary Ellen. Historical Encyclopedia of Nursing (2004), 354pp; from ancient times to the present
- Takahashi, Aya. The Development of the Japanese Nursing Profession: Adopting and Adapting Western Influences (Routledgecurzon, 2011) excerpt and text search
Hospitals in Britain
- Bostridge. Mark. Florence Nightingale: The Making of an Icon (2008)
- Carruthers, G. Barry. History of Britain's Hospitals (2005) excerpt and text search
- Cherry, Stephen. Medical Services and the Hospital in Britain, 1860–1939 (1996) excerpt and text search
- Gorsky, Martin. "The British National Health Service 1948–2008: A Review of the Historiography," Social History of Medicine, Dec 2008, Vol. 21 Issue 3, pp. 437–460
- Helmstadter, Carol, and Judith Godden, eds. Nursing before Nightingale, 1815–1899 (Surrey, UK: Ashgate, 2011) 219 pp. on England
- Nelson, Sioban, and Ann Marie Rafferty, eds. Notes on Nightingale: The Influence and Legacy of a Nursing Icon (2010) 172 pp.
- Reinarz, Jonathan. "Health Care in Birmingham: The Birmingham Teaching Hospitals, 1779–1939" (Woodbridge: Boydell Press, 2009)
- Sweet, Helen. "Establishing Connections, Restoring Relationships: Exploring the Historiography of Nursing in Britain," Gender and History, Nov 2007, Vol. 19 Issue 3, pp. 565–80
Hospitals in North America
- Agnew, G. Harvey. Canadian Hospitals, 1920 to 1970, A Dramatic Half Century (University of Toronto Press, 1974)
- Bonner, Thomas Neville. Medicine in Chicago: 1850–1950 (1957). pp. 147–74
- Connor, J. T. H. (1990). "Hospital History in Canada and the United States". Canadian Bulletin of Medical History. 7 (1): 93–104. PMID 11622358.
- Crawford, D.S. "Bibliography of Histories of Canadian hospitals and schools of nursing".
- D'Antonio, Patricia. American Nursing: A History of Knowledge, Authority, and the Meaning of Work (2010), 272pp excerpt and text search
- Fairman, Julie and Joan E. Lynaugh. Critical Care Nursing: A History (2000) excerpt and text search
- Judd, Deborah. A History of American Nursing: Trends and Eras (2009) 272pp excerpt and text search
- Kalisch, Philip Arthur, and Beatrice J. Kalisch. The Advance of American Nursing (2nd ed. 1986); retitled as American Nursing: A History (4th ed. 2003), the standard history
- Reverby, Susan M. Ordered to Care: The Dilemma of American Nursing, 1850–1945 (1987) excerpt and text search
- Rosenberg, Charles E. The Care of Strangers: The Rise of America's Hospital System (1995) history to 1920 table of contents and text search
- Rosner, David. A Once Charitable Enterprise: Hospitals and Health Care in Brooklyn and New York 1885–1915 (1982)
- Starr, Paul. The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry (1984) excerpt and text search
- Stevens, Rosemary. In Sickness and in Wealth: American Hospitals in the Twentieth Century (1999) excerpt and text search; full text in ACLS e-books
- Vogel, Morris J. The Invention of the Modern Hospital: Boston 1870–1930 (1980)
- Wall, Barbra Mann. Unlikely Entrepreneurs: Catholic Sisters and the Hospital Marketplace, 1865–1925 (2005)
- Wall, Barbra Mann. American Catholic Hospitals: A Century of Changing Markets and Missions (2010) excerpt and text search