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History of Hospitals.



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  • 2. INTRODUCTION • The evolution of the hospital is traced from its onset in ancient Mesopotamia towards the end of the 2nd millennium to the end of the Middle Ages. • Medicine was magical and mythological, and diseases were attributed mostly to the supernatural forces. The foundation of modern medicine can be traced back to ancient Greeks. Priests/doctors were part of the ruling class with great political influences and the temple/hospital was also a meeting place. • In the earliest prehistoric days, a different kind of medicine was practiced in countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and others.
  • 3. MESOPOTAMIAN MEDICINE • Medicine as an organized entity first appeared 6000 years ago in the ancient region of Southwest Asia known as Mesopotamia , between the Tigris and Euphrates rivers, which have their origin in Asia Minor and merge to flow into the Persian Gulf. • The first recorded doctor’s prescription came from Sumer in ancient Babylon under the rule of the dynasty of Hammurabi (1728-1686BC). Hammurabi's code of law provides the first record of the regulation of doctors ‘practice, as well as the regulation of their fees. • The Mesopotamian civilization made political, educational, and medical contributions to the later development of the Egyptian, Hebrew , Persian and even Indian cultures.
  • 4. GREEK MEDICINE • The classic period of Greek medicine was the year 460- 136 B.C. • An early leader in Greek medicine was Aesculapius(1200 B.C).Aesculapius bore two daughters- Hygeia and Panacea. Hygeia was worshipped as the goddess of health and Panacea as the goddess of medicine. Hygeia and panacea give rise to curative and preventive medicine. • The temples of Saturn, Hygeia and Aesculapius, the Greek god of medicine all served as both medical schools for practitioners and resting places for patients under observation or treatment.
  • 5. • Hippocrates(460-370 B.C), the father of medicine, Hippocrates is usually considered the personification of the rational non-religious approach to medicine, and in 480 BC, he started to use auscultation, perform surgical operations and provide historians with detailed records of his patients and descriptions of diseases ranging from tuberculosis to ulcers. • Hippocrates's lectures and writings, as compiled later by the Alexandrian scholars into the "corpus Hippocraticum." Hippocrates was an epidemiologist , his concept of health and disease stressed the relation between man and his environment.
  • 6. • Although patients were treated by magic rituals and cures were related to miracles and divine intervention, the Greek recognized the natural causes of diseases and rational methods of healing were important. • Greeks believed that matter was made up of four elements_ earth, air, fire and water and were represented in the body by the four humors_ phlegm, yellow bile, blood and black bile similar to the "tridosha theory".
  • 7. ROMAN MEDICINE • By the first century B.C., the centre of civilization shifted to Rome. • Galen(130-205 A.D), a medical teacher, gave a important contribution in the field of comparative anatomy and experimental physiology. Galen observed the disease is due to three factors- predisposing, exciting and environmental factors. • In Roman times the military and slave hospitals which existed since the 1st century AD, were built for a specialized group and not for the public, and were therefore also not precursors of the modern hospital • Around 370AD St Basil of Caesarea established a religious foundation in Cappadocia that includes a hospital, an isolation unit for those suffering from leprosy and buildings to house the poor, the elderly and the sick.
  • 8. • St Benedict at Monte Cassino, founded early in the 6th century, where the care of the sick was placed above and before every other Christian duty. • It was from this beginning that one of the first medical schools in Europe ultimately grew at Salerno and was of high repute by the 11th Century. The Roman military hospitals and the few Christian hospitals were no match for the number, organization and excellence of the Arabic hospitals.
  • 9. CHINESE MEDICINE • Chinese medicine developed as a concept of yin and yang, acupuncture and acupressure, and it has even been used in the modern medicine. • During medieval Europe, major universities and medical schools were established. In the ancient time, before hospitals had developed, patients were treated mostly in temples.
  • 10. MIDDLE AGES(500 -1500 A.D), "Dark Ages of Medicine" • Developed the Unani system of medicine. • During the time of Mohammed, a real system of hospitals was developed. He was the first to order the establishment of small mobile military Bimaristan (hospital) . • In addition, Islamic physicians were responsible for the establishment of Pharmacy and chemistry as sciences. • the best known of the great hospitals in the middle Ages were in Baghdad, Damascus and Cairo.
  • 11. • In the early Middle Ages (6th to 10th century), under the influence of the Benedictine Order, an infirmary became an established part of every monastery. During the late Middle Ages (beyond the 10th century) monastic infirmaries continued to expand, but public hospitals were also opened, financed by city authorities, the church and private sources. Specialized institutions, like leper houses, also originated at this time.
  • 12. • Religion continued to be the dominant influence in the establishment of hospitals during the middle age. • Religious communities " Monasteries" assumed responsibility for care of the sick . • Yet hospital construction increased in Europe during the middle Ages for two reasons. First, Pope Innocent III in 1198 urged wealthy Christians to build hospitals in every town and second, increased revenues were available from the commerce with the crusaders. • The oldest hospital still in existence are the “Hotel –Dieu” in Lyons and Paris, France.
  • 13. • Military hospitals came into being along the traveled routes: the knights Hospitalers of the Order of St John in 1099 established in the Holy Land, a hospital that could care for some 200 patients. • It is to the Christians that one must turn for the origin of the modern hospital. Hospices, initially built to shelter pilgrims and messengers between various bishops, were under Christian control developed into hospitals in the modern sense of the word.
  • 14. Renaissance Age: • The renaissance period lasted from the fourteenth to the sixteenth centuries. • The gradual transfer of responsibility for institutional healthcare from the church to civil authorities continued in Europe after the dissolution of the monasteries in 1540 by Henry VIII, which put an end to hospital building in England for some 200 years. • Only the powerful hospitals in London survived when the citizens petitioned the King to endow St Bartholomew, St Thomas and St Mary of Bethlehem hospitals.
  • 15. • The loss of monastic hospitals in England caused the secular authorities to provide for the sick, the injured and the handicapped, thus laying the foundation for the voluntary hospital movement. • . The first voluntary hospital in England was probably established in 1718 by Huguenots from France and was closely followed by the foundation of such London hospitals as the Westminster hospital in 1719,Guy’s hospital in 1724 and the London Hospital in 1740. • In 1506, the Royal College of Surgeons was organized in England, followed by organization of the Royal College of Physicians in 1528.
  • 16. • The major contribution of the Renaissance to the development of hospitals was in improved management of the hospital, the return to the segregation of patients by disease, and the higher quality of medicine provided within the hospital. Royal Victoria Hospital
  • 17. INDIAN MEDICINE • The Indian medicine system development are Ayurveda and Siddha system . Dhanvantari was considered as "the Hindu god of medicine". • The celebrated authorities in Ayurvedic medicine were Atreya, charaka, Susruta and Vaghbhatt. • Atreya(800)- is the first Indian physician and teacher lived in ancient university of Takshashila. • Charaka(200A.D)- compiled his famous treatise on medicine the "Charaka samhita" • Susruta( father of surgery)- compiled the surgical knowledge of his classic "susruta samhita". • Ayurveda is a "Tridosha theory of disease" The doshas are: vata(wind), pitta( gall) and kalpa( mucus).
  • 18. INDIAN MEDICINE • Historical records show that efficient hospitals were constructed in India by 600 BC . • During the splendid reign of King Asoka (273-232 BC), Indian hospitals started to look like modern hospitals. They followed principles of sanitation and cesarean sections were performed with close attention to technique in order to save both mother and child. • Physicians were appointed –one for every ten villages-to serve the health care needs of the populations and regional hospitals for the infirm and destitute were built by Buddha.
  • 19. HOSPITAL IN INDIA • The Indian medicine begins to decline from the Mohammedan invasions in the tenth century. • During Akbar’s period the Unani medicine system spread all the way through the greater part of India.. • During his period, there were a good number of government hospitals, as well as private clinics run by many physicians. • The modern system of medicine in India was introduced in the 17th centaury with the arrival of Christian missionaries in South India. • In the 17th centaury, British empire established first hospital at Chennai in 1664.
  • 20. • Organized medical training was started with the first medical college opening in Calcutta in 1835, two in Delhi in 1835 and 1836, followed by Mumbai in 1845 and Chennai in 1850. • The oldest college of Asia was established in Calcutta on JAN 28 1835 followed by Madras Medical College . • MPUH i.e. Muljibhai Patel Urological Hospital, Nadiad (Gujarat/India), popularly known as Nadiad Kidney Hospital, is the first hospital in Gujarat to have da Vinci Si Robot for robotic-assisted surgeries. • AIIMS is established in 1956 which is leading hospital in India in 21st centaury.
  • 21. TOP EIGHT HOSPITAL IN INDIA AIIMS Apollo Hospitals Fortis Hospitals NIMHANS Christian Medical College PGIMER TATA Memorial Hospital Sankara Nethralaya Bombay Hospital
  • 22. REFERENCES • K .Park, PREVENTIVE AND SOCIAL MEDICINE,22nd edition, Feb 2013, page number, 1,2,3,4 and 5. • BM Sakharkar, PRINCIPLES OF HOSPITAL ADMINISTRATTION AND PLANNING, 2nd edition, jaypee publications, page -7 • www. •