Medieval Period:
The word “hospital” originates from the Latin ‘hospice.’ In fact the word hospital, hostel and hotel all derive from the common Latin root hospice. The place or establishment where a guest is received was called the hospitium or hospitable.
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The term hospital has at different times been used to refer to an institution for the aged and infirm, a place of rest, a hostel where people lived as a small community, and an institution for the care of the sick and wounded.
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Lodging for the pilgrim and the wayfarer was also one of the primary functions of the early hospital.
In its earliest form, the hospital was aimed at the care of the poor and the destitute, giving the aura of an “almshouse”.
In the early Greek and Roman civilisations, the temples of the gods were used as hospitals. These hospitals were not separate entities but formed an integral part of the temples.
Little distinction was made between the disease and the supernatural powers that caused diseases, where mysticism and superstition saddled medical practice, and where more soul healing than physical healing was practised.
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The Greeks and Romans considered the temples of gods and their priests responsible for providing shelter and sustenance to the sick. Charity was the principal source for defraying illness costs of the poor.
It was in Greece that Hippocrates universally acknowledged as the father of western medicine—was born, in 460 BC
With the birth and spread of Christianity there was an impetus to hospitals which became an integral part of the Church and its monasteries. Medicine was reverted to religion, the nuns and monks practising it.
Gradually, these Christian hospitals replaced those of Greece and Rome. During the crusades (Christian expeditions to recover the Holy land from Mohammedans, 1100-1300 AD) over 19,000 hospitals were founded in Europe to cater for those suffering from war injuries and diseases.
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The order of St. John was one such sect, responsible for creating chains of hospitals. This order has survived all these centuries and still functions as St. John Ambulance Corps in England with its branches all over the world, including India.
Subsequently, certain decrees issued by the Church for divesting religion from medical succor had the effect of lowering the status of the entire medical profession and stopping the monks from practising medicine.
In 1163 AD, the Church formally restricted the clergy from working as physicians, and this restriction heralded the beginning of the end of hospitals towards the end of the Crusades (around 1300 AD).
During early nineteenth century, nurses of religious orders were replaced by lay people who treated patients badly. Patients were crowded together in common bed, and infection and gangrene were commonplace all over the hospitals.
Some of the notable hospitals established in the Western world date back to the ancient times. In 542 AD the earliest hospital was founded at Hotel Dieu in Paris. St. Bartholomew’s hospital in London dates from the year 1123 AD.
In keeping with the hospital philosophy then prevalent, there was a general tendency to lump together the sick, the physically handicapped, the socially unwanted and the pauper all together.
The Spanish built the first hospital in Mexico City in 1524 and the French in Canada.
In North America, the first general hospital, Pennsylvania Hospital, opened in 1751, Bellevue hospital in New York in 1736 and Massachusetts hospital in 1811 AD. This was followed by establishment of hospitals in quick succession in many other places in USA.
Nineteenth Century:
The middle of the nineteenth century saw the arrival of Florence Nightingale on the hospital scene.
It fell upon Florence Nightingale to revolutionise nursing by supplementing good intentions and humane concern with scientific approach to nursing through training.
The working of hospitals underwent a sea change as a result of her efforts when she was sent to attend to the sick and wounded at the Crimean War (1853-1856 between the joint forces of Britain and France with Russia total casualties: Allies—2, 52,000, Russian—2, 56, 00) in 1854. This was the turning point in the history of hospitals in the Western World.
Various developments in medical sciences gave impetus to further progress in the hospital field. Discovery of anaesthesia and the principles of antisepsis (asepsis was to follow later) were two most important influences in the development of hospitals.
Discovery of steam sterilisation in 1886, X-ray in 1895 and rubber gloves in 1890 revolutionised surgical treatment and gave further Philip to hospital development. Great progress was being made in cellular pathology, clinical microscopy, and bacteriology and so on during the period from 1850 to 1900, and each one of these had a definite impact on hospital progress.
Besides the scientific advances during this period, rapid industrialisation during the last quarter of 19th century generated enormous funds in the Western World.
Hospital development in the 20th century has, therefore, been explosive, especially in the USA and Europe. A hospital was no longer a place where people went to die.
The advances in medical science brought about by antibiotics, radiation, blood transfusion, improvement in anaesthetic techniques and the spectacular advances in surgical techniques and medical electronics have all brought about tremendous growth and improvement in hospital services.