History
In ancient cultures religion and medicine were linked. The earliest known institutions aiming to provide cure were Egyptian temples. Greek temples dedicated to the healer-god Asclepius might admit the sick, who would wait for guidance from the god in a dream. The Romans adopted his worship. Under his Roman name Æsculapius, he was proved with a temple (291 B.C.) on a island in the Tiber in Rome, where similar rites were performed.
The first institutions created specifically to care for the sick appeared in India. Brahmantic hospitals were established in Sri Lanka by 431 B.C., and King Ashoka founded 18 hospitals in Hindustan c.230 B.C. The latter were provided with physicians and nurses, and supported from royal funds.
The Romans created valetudinaria for the care of sick slaves, gladiators and soldiers around 100 B.C. The adoption of Christianity as the state religion of the empire drove an expansion of the provision of care, but not just for the sick. The First Council of Nicaea in 325 A.D. urged the Church to provide for the poor, sick, widows and strangers. It ordered the construction of a hospital in every cathedral town. Among the earliest were those built by the physician Saint Sampson in Constantinople and by Basil, bishop of Caesarea. The latter was attached to a monastery and provided lodgings for poor and travelers, as well as treating the sick and infirm. There was a separate section for lepers.
Medieval hospitals in Europe followed a similar pattern. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries. Others were independent and had their own endowments, usually of property, which provided income for their support. Some were multi-function. Others were founded specifically as leper hospitals, or as refuges for the poor or for pilgrims. Not all cared for the sick.
Meanwhile Moslem hospitals developed a high standard of care between the eighth and twelfth centuries A.D. Hospitals built in Baghdad in the ninth and tenth centuries employed up to 25 staff physicians and had separate wards for different conditions. State-supported hospitals also appeared in China during the first millennium A.D.
In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one, but it was in the eighteenth century that the modern hospital began to appear, serving only medical needs and staffed with physicians and surgeons.
Britain led the field. Guy's Hospital was founded in London in 1724 from a bequest by wealthy merchant Thomas Guy. Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. In the British American colonies the Pennsylvania General Hospital was founded in Philadelphia in 1751, after £2,000 from private subscription was matched by funds from the Assembly. In Continental Europe the new hospitals were generally built and run from public funds. Whatever the financing, by the mid-nineteenth century most of Europe and the United States had established a hospital system.
