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The Origin of Hospitals

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The Origin of Hospitals 44 THE ORIGIN OF HOSPITALS Mr. Paterson referred to a case of per- is that of the origin and gradual evolutioll forated ulcer, in which it was absolutely of our highly-organized scientific institu- impossible to suture the perforation at all, tionls, particularly the development of but he had performed gastro-jejunostomy, modern hospitals. On inquiring into the and the patient had made a complete re- derivation of that familiar word "hospital" covery. He pointed out that two objection-s it is discovered that it springs from the had been raised to this procedure. The first Latin word "hospes," meaning equially was that the tissues are not in a conditioln "guest " or " host." for a plastic operation, anid the second that The first form of " hospital " was entirely it unduly prolongs the operation, but in; his ecclesiastical, and many of them, as shown opinion, neither objection is valid, his ex- by their consecration vows, xvere especially perience being that,, even in cases of septic associated with bishops ; the institutions peritonitis, the -peritoneal surfaces unite being pre-eminiently for the refreshment of perfectly well if kept in apposition by the the soul, the care-and more rarely the cure firm pressure of a continuous suture. With -of the body being a secondary considera- regard to the second objection, he considers tion. At first hospitals wvere primarily that the procedure ought not to pr-olong the houses of rest for travellers, more especially operation more than five or seveni minutes. for pilgrims of whom at one period in our He mentioned that several times he had island histor-y there were a great number. sutured a perforated ulcer and performed For about a huindred years after tne Corn- gastro-jejunostomy in less than twenty-five quest there was an immense amount of miinutes. He thought too, that gastro- journeying up and down the couLntry, in jejunostomy was more specially indicated in spite of the difficulties of transport, and the later, and not so much in the earlier many were the pilgrimages undertaken to cases, although the contrary has been asserted such places as the Shrine of St. Thomas of by a well-known writer. Canterbury. This necessitated the pr-ovision In this particular case it would have been of rest-houses for the pilgrims, and these futile simply to suture the ulcer, as, owing places were made to fill the twofold ftunc- t1o the hour-glass constriction, the patient tion of guest-house and infirmary. Towards would have continued vomiting, and so have the end of the thirteenth century genuine had little chance of recovery. pilgrimages were on the decline, but the The patient, on her return to the ward, rest-houses or hospitals continued to be had continuous saline by the rectum. The filled by an incr-easing number of rogues woman- gradually r-allied, and was in fairly and vagabonds, who found it a simpler form good condition by the evening. *She left the of acquLiring bed and board than by honest Hospital five weeks later quite well, and in work. This vagrancy became an ever-ini- better.health than she had been for many creasing problem, and the tenidenicy grew to years. discriminate among the applicants at the hospitals anid slowly to provide more beds for chronic sufferers than for casual way- THE ORIGIN OF farers. Of the hospitals at presetnt existing (in a HOSPITALS. very different form from their original NOWADAYS when one is so accustomed to foundation) in or near Londoni, St. Bartholo- take everything for granted it is sometimes mew's and Bethlem 'provide some of the well worth inquiring into the origin of most inter-esting history. St. Bartholomew's, instituitions with which one is familiar. of course, was founded in the twelfth cen- Perhaps one of the most interesting subjects tury by the monk Rahere, as the direct result 45 T149THI. ORIOINORIGIN OF HOSPITALS 45 of a vision vouchsafed to him. The land founded in I247, derived its name from the on which the present hospital still stands Basilica of the Nativity built in Bethlehem, was granted to the monik by Henry I; to Palestine, by the Emperor Constantiine. In the original site was added two further plots its early years it was situated in Bishopsgate in Smithfield given by Edward II in 1326, Without (London), which was then a country anld finally in I9Of the hospital took over site "without" the old London Wall; the the site of the Bltue Coat School when Broad Street stationi of the Great Eastern Christ's Hospital was removed to Horsham. Railway and the Metropolitani Railway now St. Bartholomew's had a very fluctLiating occupies most of this site, which is well career in its ear-ly days, and an interesting within the boundaries of Greater London. coincidenice is that ill I754 a complaint was There is no record of the building having macle " of the resort of idle, loose and dis- been used as an asylum for mental cases orderly persons, beggars and others, cryinig until I377, but sinice that date it has always and selling all manner of commodities very been associated with psychological cases. improper for the patients in and about the The hospital, like St. Bartholomew's, ex- staircases and wards . to the great perienced manv tips and downs, and the discredit of the good government of the following incidents taken at random from house," and apparently during the late war the detailed records are of interest. a certain amount of difficulty was experi- As far back as I367 the Mayor and eniced with a similar class of person, who Aldermen of London wrote to the then managed to penietrate into the wards on Bishop of " Bedlem," who resided in France, var-ious pretexts when it became knowin that praying him not to "farm out" the hospital soldiers with a certain amount of money to to the highest bidder-apparently quite a spenid were inmt-iates. usual practice in those days. It was nearly Some initerestinig characters in history forty years later that Henry IV commis- have lived -within the hospital precincts at sioned an inquiry into the charges of mis- various times, of whom the following may management, and this was followed some be mentioned: Dr. Caius, founder of Caius thirty years later by yet another inquiry into College, Cambridge; Dr. Roderigo Lopez abuses. Iron chains, manacles and stocks (fir-st physician to the hospital, who was for the restrainit of mad persons are mentioned hanged, drawn and quartered for having in the inventory of I398. brought about the death of Queen Elizabeth); In the sixteenth century a brother of the Dr. Timothy Bright, "father" of shorthand, unhappy Queen Anne Boleyn was appointed and abridger of Foxe's " Book of Martyrs"; as Master of the Hospital, and only Sir Thom-ias Bodley, founder of the Bodleian seventeen days before his death, in 1547, Library, Oxford (he, by the way, paid an Henry VIII ratified a deed of covenant annual rent of f5 6s. 8d. for his house); and which granted the " mayor, commonialty, and Colonel Thomas Pride (of " Pr-ide's Purge " citizens and their successors " to be " masters, fame), who lived there in the time of the rulers, and governors of the hospital, or Commoniwealth. house, called Bethlem." During Queen The hospital was rebuilt in the eighteenth Mary's reign Bridewell Hospital and Beth-' century and James Gibbs, who gave his lemn were placed under the same management. services free, was the atrchitect; other build- There is a record that in I609 the keeper ings to this same architect's credit being at Bethlem was given an increase of St. Mary-le-Stranid, St. Martins-in-the-Fields, remuneration from sixpence per patient per St. Peter's, Vere Street, the Radcliffe Camera, week, to sevenpence "on account of the Oxford. dearness of the times," and in I693 a nurse The Bethlem Royal Hospital, which was was installed " as an experiment" POST-GRADUATE NEWS Nearly five hundred vears after the Royal Institute of Public Hecalth, 37, RLISSCII foundation of the hospital, the first moove was Square, W.C. i. made from. Bishopsgate Without to buildinigs A course of lectur-es on "'The Health of in Moorfields, wher-e it stayed uniitil I8I5, the Citizeni " is in progress at the Institute when a second miiove was made to St. Lecture Hall, at 4 p.m. on Wednesdays. George's-in-the Fields. The last move was The lectures for December are as follows: mnade in I930, when the niew buildinigs were opened at Eden Park, niear Beckenham, ani December 9.-Professor E. L. Collis, M.D., amazing cotntrast in their efficiency anid comn- "The Health of the Industiial pleteness to the originial institutionis. Apart Worker" (with lantern illus- fromu the uisuatl accommodation for patients trations). and staff, there is a chapel, a recreation hall, December i6.-Sir Pend(lrill Varr-ier-Jonies, accommodation 'for- hiydrother-apy, massage, M.R.C.P., " The Welfare of the dental and electrical treatment, X-ray and Tuberculous Citizen " (with psychotlherapy, &c., developments certainly lantern illustrations). not foreseen by the originial founders. There is nio fee for attendance. Celitral Lonidonl Throat, Noseandl Ear Hospital, Gray's Inn Road, W.C.i. POST-GRADUATE NEWS. The following lectures will be given durinig December on Fridays at 4 p.m.:- Nattionlal Associationi for the Prevention oJ N. " Chroniic Intfant Mortality, Carnegie Hotuse, December Ii.-Mr. Asherson, II7, Piccadilly, W i. Otorrhcea." December X 8.-Mr. A. Lowndes Yates, " The The remaiiiing lecture in the cour-se of Complications of Catarrhlal lectures on Maternity anid Child Welfare Inflammation of the Nose." being giveni at the Infanits Hospital, Vincenit Square, will take place on Moniday, There is no fee for attendance.
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