Medicine through time – blog for teachers and learners of medicine through time
Hospitals in the Ancient World
There are several examples of places where people could go to get treatment in the Ancient World. One was borne out of Religious beliefs, the Asclepion, the other, Roman Military Hospitals, out of pragmatism.
Asclepions were temples to the Greek god of Healing, Asclepios. Invalids could go to the temple where they would be looked after in dormitories. There was an emphasis on rest and cleansing, called incubation. Priests would administer remedies and cures which they attributed to the work of the god. Asclepions were popular from the 4th century BC and spread through the Greek and Roman worlds. See this site for more about the cult.
The Romans built military hospitals throughout their vast empire. These were usually attached to a military fort. These hospitals provided relieve and rest for the sick in and around the fort. They would also serve as a place for some operations to take place. They were also often used as a place in which visitors could be housed, so the purpose wasn’t entirely health based. See this site for further information.
Nursing in the Ancient World
In Asclepions the ‘nursing’ was done by Priests. The Romans used slaves to assist surgeons in their hospital. During the Ancient period the role of Midwives was clearly established and within Greek and Roman worlds they were highly respected and rules were in place about who could and couldn’t become a midwife.
Hospitals in Medieval Europe
There were several types of ‘hospital’ available in the Middle Ages. There were Leper Houses where people with Lepresy were housed and cared for; Hostels, often for pilgrims where care could be sought; Almshouses, which are a bit like a medieval care home and; hospital buildings.
These buildings varied greatly in size. Some were designed to look after just a handful of people, often with a specific condition. Others, like the Great Hospital, Norwich, were able to cater for many more and had designs that are recognisable as being hospitals. In France the Hotel Dieu was founded in the 7th century and was incredibly busy – over 9000 sheets were washed a week. These hospitals were paid for by donations and endowments from wealthy lords and taxes raised by the church.
Hospitals in the Islamic World (Medieval)
European hospital development at this time was rather mixed and access to hospitals varied greatly in terms of quality, availability and the standard of medical knowledge deployed there. For these reasons some people argue that it was a period of medical stagnation or regression. This certainly wasn’t the case everywwhere in the world though. The Islamic Empire retained and developed the knowledge of the Ancient world and placed a high value on investment in public health, hospitals and the training of doctors. Unlike European hospitals, the primary and only function of Islamic hospitals of this period was to provide healthcare. Doctors were well trained and large hospitals were built throughout the empire. See this site for further information and examples.
Nursing in the Middle Ages
In this period there was a lack of training available for nurses. Many ‘nurses’ were indeed nuns who were caring for people out of religious conviction. In the late middle ages the dissolution of the monasteries and nunneries resulted in many of the nursing institutions ceasing to exist and consequently the ‘word of mouth’ training that would have happened in the monasteries no longer happened. This led to a period in which the standard of nursing in England was, generally speaking, very poor. See this page for a more detailed account.
The Development of Modern Nursing
Nursing as we know it began to develop in the mid 19th century, largely as a result of work done by Florence Nightingale. She trained in Germany – which in itself says something about training of Nurses in Britain! – and began working as a superintendent of a Gentlemans hospital in London. When the Crimean War broke out she was asked to lead a team of nurses to lok after the wounded soldiers. Her team were very successful in reducing the number of deaths and she was widely praised in the media. When she returned to England after the war she established a Training school for nurses. In it she instilled the need for clean wards, seperation of diseases and other things we take for granted today. As the graduates of her school found jobs, they introduced these ideas into hospitals and soon they became accepted as the best way of nursing.
Royal College of Nursing
The RCN was established in 1916. It looks after the interests of the nursing profession and also ensures that there are suitable standards of training and ongoing development of nurses throughout their career. This helps to make sure that nursing is up to date and able to respond to new technologies, methods and diseases.
Voluntary and Charity Hospitals
Before the National Health Service was established many ordinary people would have made use of Voluntary and Charity hospitals. In larger cities, like London, there were several of these (London had 7 large voluntary hospitals by 1809). You can find a detailed account of how these Voluntary hospitals worked on this site. Another source of care were the Poor Law Infirmaries. These were wards attached to workshouses. At first the conditions in these infirmaries were not very good but pressure n the authorities to reform led to improvements being made over the course of the 19th century. See this page for further information. To find out what hospitals were available in your local area before the NHS, enter your towns name into this search engine and it will return the names of all hospitals for which there are records in that town. For example my pupils would enter ‘Halifax’ and find that the General hospital was opened in 1901 and that it had periods as a Poor Law Infirmary, as a war hospital and under local authority control. They’d also find that there was an Infirmary at the Gibbet Street Workhouse.
Following the introduction of the NHS most hospitals in the UK are now managed by Primary Care Trusts. They provide a wide range of services and are equipped with specialist equipment. Some of these hospitals specialise in certain conditions and are regional or national centres of excellence. There are still some criticisms of modern hospitals. Critics argue that they are not clean enoughh, require additional funding for maintenance; increased numbers of beds and speed of service. There also remain a number of companies who run private hospitals.