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Reflections of the Past,” Is Adapted from the Book Hospital Organization and Management by Malcolm T © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALECHAPTER OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1 © Jones & BartlettR Learning,eflections LLC of© Jones the & Bartlett Past Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC History is relevant to understanding the to the sick, provided patients with fresh fruits and vegetables, NOT FOR SALE OR past,DISTRIBUTION defining the present, and influencing NOT FORprepared SALE their medicines, OR DISTRIBUTION gave massages, and maintained their the future. personal cleanliness. Hindu physicians, adept at surgery, were required to take daily baths, keep their hair and nails short, wear Author Unknown white clothes, and promise that they would respect the confi- © Jones & Bartlett Learning, LLCdence of their patients. Although© Jones bedside care& Bartlett was outstanding Learning, LLC NOT FOR SALE OR DISTRIBUTIONfor those times, medicine wasNOT only beginning FOR SALE to find ORits way. DISTRIBUTION Egyptian physicians were probably the first to use drugs This chapter provides the reader with a brief overview such as alum, peppermint, castor oil, and opium. In surgery, of the advance of civilization as disclosed in the history of anesthesia consisted of hitting the patient on the head with hospitals. A study of the past often reveals errors that then a wooden mallet to render the patient unconscious. Surgery can ©be Jonesavoided, &customs Bartlett that persistLearning, only because LLC of tradi- was largely© limitedJones to &fractures, Bartlett and Learning, medical treatment LLC was tion, and practices that have been superseded by others that NOT FOR SALE OR DISTRIBUTION usually givenNOT in FORthe home. SALE Therapy OR awayDISTRIBUTION from home was are more effectual. The past may also bring to light some often available in temples, which functioned as hospitals. long-abandoned practices, which may be revived to some advantage. The story of the birth and evolution of the hos- pital portrays the triumph of civilization over barbarism and GREEK AND ROMAN HOSPITALS the progress of civilization toward an ideal characterized by © Jones &an Bartlett interest in Learning, the welfare of LLC the community. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FORThe SALE term hospital OR DISTRIBUTION derives from the Latin word hospitalis, which relates to guests and their treatment. The word reflects EARLY HINDU AND EGYPTIAN HOSPITALS the early use of these institutions not merely as places of healing, but also as havens for the poor and weary travelers. Hospitals first appeared in Greece as aesculapia, named Two ancient civilizations,© Jones the &Hindu Bartlett (in what Learning, is now LLC after the Greek god of medicine,© Jones Aesculapius. & Bartlett For many Learning, cen- LLC India) and the Egyptian,NOT had FOR crude SALEhospitals. OR Hindu DISTRIBUTION litera- turies, hospitals developed inNOT association FOR SALEwith religious OR DISTRIBUTION in- ture reveals that in the 6th century BC, Buddha appointed stitutions, such as the Hindu hospitals opened in Sri Lanka in a physician for every 10 villages and built hospitals for the the 5th century BC and the monastery-based European hos- crippled and the poor. His son, Upatiso, built shelters for the pitals of the Middle Ages (5th century to 15th century). The diseased and for pregnant women. These examples probably Hotel-Dieu in Paris, a monastic hospital founded in 660 AD, moved© Jones Buddha’s & devotees Bartlett to erect Learning, similar hospitals. LLC Despite is still in operation© Jones today. & Bartlett Learning, LLC a lackNOT of records,FOR SALE historians OR agree DISTRIBUTION that hospitals existed in NOT FOR SALE OR DISTRIBUTION Ceylon as early as 437 BC. During his reign from 273 to 232 BC, King Asoka built Note: This chapter, “Reflections of the Past,” is adapted from the book Hospital Organization and Management by Malcolm T. MacEachern, MD, 18 hospitals that hold historical significance because of their CM, DSc (Hon), LLD (Hon), FACS, FACP, FACHA, FAIHA (Australia), similarities to the modern hospital. Attendants gave gentle care with permission from the Physician’s Record Company. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1 © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. 2 CHAPTER 1 REFLE C TIONS OF THE PAST © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR InSALE early GreekOR DISTRIBUTION and Roman civilization, when medical NOTor FOR by wealthy SALE Romans OR DISTRIBUTION who had converted to Christianity. practices were rife with mysticism and superstitions, temples By the year 500, most large towns in the Roman Empire had were also used as hospitals. Every sanctuary had a sacred erected hospitals. Nursing, inspired by religion, was gentle altar before which the patient, dressed in white, was required and considerate, but soon began to discard the medical pre- to present gifts and offer prayers. If a patient was healed, the cepts of Hippocrates, Antyllus, and other early Greek phy- cure was credited to miracles© Jones and divine & Bartlett visitations. Learning, If the LLCsicians because of their pagan© origins. Jones Instead, & Bartlett health care Learning, LLC patient remained ill or died,NOT he orFOR she wasSALE considered OR DISTRIBUTION to be turned toward mysticism and theurgyNOT FOR (the working SALE of OR a di- DISTRIBUTION lacking in purity and unworthy to live. vine agency in human affairs) as sources of healing. Greek temples provided refuge for the sick. One of these Hospitals rarely succeeded during the centuries leading sanctuaries, dedicated to Asclepius, is said to have existed to the Middle Ages; only a few existed outside Italian cities. as early as 1134 BC at Titanus. Ruins attest to the existence Occasional almshouses in Europe sheltered some of the sick, of another,© Jones more famous & Bartlett Greek temple Learning, built several LLC centu- whereas inns© along Jones the Roman & Bartlett roads housed Learning, others. No LLC pro- ries laterNOT in the FOR Hieron, SALE or sacred OR grove, DISTRIBUTION at Epidaurus. Here, vision appearsNOT to have FOR been SALEmade for OR care DISTRIBUTIONof the thousands of physicians ministered to the sick holistically in body and helpless paupers who had been slaves and were later set free soul. They prescribed medications such as salt, honey, and when Christianity was introduced into the Roman Empire. water from a sacred spring. They gave patients hot and cold baths to promote speedy cures and encouraged long hours © Jonesof & sunshine Bartlett and Learning, sea air, combined LLC with pleasant vistas, as © Jones & Bartlett Learning, LLC ISLAMIC HOSPITALS NOT FORan importantSALE OR part DISTRIBUTION of treatment. The temple hospitals housed NOT FOR SALE OR DISTRIBUTION libraries and rooms for visitors, attendants, priests, and phy- sicians. The temple at Epidaurus even boasted what might be The followers of Mohammed were almost as zealous described as the site of the first clinical records. The columns as the Christians in caring for the sick. In Baghdad, Cairo, of the temple were inscribed with the names of patients, brief Damascus, Cordova, and many other cities under their con- histories of their cases, and© Jonescomments & asBartlett to whether Learning, or not trol,LLC luxurious hospital accommodations© Jones &were Bartlett frequently Learning, LLC they were cured. NOT FOR SALE OR DISTRIBUTIONprovided. Harun al-Rashid, theNOT glamorous FOR caliph SALE (a title OR for DISTRIBUTION The asclepia spread rapidly throughout the Roman a religious or civil ruler claiming succession from Muham- Empire as well as through the Greek world. Although some mad) of Baghdad (786–809 AD), built a system of hospitals, hospitals were simply spas, others followed the therapy out- paying the physicians himself. Medical care in these hos- lined by the leading physicians of the day. Hippocrates, for pitals was free. Approximately 4 centuries later, in 1160, a example,© aJones physician & born Bartlett about 460 Learning, BC, advocated LLC medical Jewish traveler© Jonesreported &that Bartlett he had found Learning, as many LLCas 60 theoriesNOT that haveFOR startling SALE similarity OR DISTRIBUTION to those of the present dispensaries NOTand infirmaries FOR SALE in Baghdad OR DISTRIBUTION alone. The Persian day. He employed the principles of percussion and ausculta- physician Rhazes, who lived from approximately 850 to tion, wrote intelligently on fractures, performed numerous 923 AD, was skilled in surgery. He was probably the first to surgical operations, and described such conditions as epi- use the intestines of sheep for suturing and cleansed patient lepsy, tuberculosis, malaria, and ulcers. He also kept detailed wounds with alcohol. He also gave the first rational accounts © Jonesclinical & Bartlett records Learning,of many of his LLC patients. Physicians like Hip- © Jonesof smallpox & Bartlett and measles. Learning, LLC NOT FORpocrates SALE not OR only DISTRIBUTION cared for patients in the temples, but also NOT FORIslamic SALE physicians OR likeDISTRIBUTION Rhazes received much of their gave instruction to young medical students. medical knowledge from the persecuted Christian sect known as the
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