126-684: Theodor Puschmann (4 May 1844 – 28 September 1899) was a German psychiatrist and one of the founders of the history of medicine as a discipline. His "diagnosis" of Richard Wagner 's supposed mental illness was a significant contribution to the idea of degenerate music . Theodor Puschmann was born at Lowenberg in Prussian Silesia. He studied medicine in Berlin, Marburg, Vienna and Munich. He qualified in medicine at Marburg in 1869. He continued his medical training in England, France and Italy and spent
252-421: A chargemaster ; however, these prices may be lower for health care obtained within healthcare networks . Legislation requires hospitals to provide care to patients in life-threatening emergency situations regardless of the patient's ability to pay. Privately funded hospitals which admit uninsured patients in emergency situations incur direct financial losses, such as in the aftermath of Hurricane Katrina . As
378-620: A medical records department , release of information department , technical support , clinical engineering , facilities management, plant operations , dining services, and security departments. The COVID-19 pandemic stimulated the development of virtual wards across the British NHS . Patients are managed at home, monitoring their own oxygen levels using an oxygen saturation probe if necessary and supported by telephone. West Hertfordshire Hospitals NHS Trust managed around 1200 patients at home between March and June 2020 and planned to continue
504-468: A pharmacy , pathology , and radiology . Hospitals are typically funded by public funding , health organizations ( for-profit or nonprofit), health insurance companies, or charities, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders , or by charitable individuals and leaders. Hospitals are currently staffed by professional physicians, surgeons, nurses, and allied health practitioners . In
630-416: A production line . A teaching hospital delivers healthcare to patients as well as training to prospective medical professionals such as medical students and student nurses . It may be linked to a medical school or nursing school, and may be involved in medical research . Students may also observe clinical work in the hospital. Clinics generally provide only outpatient services, but some may have
756-831: A complex, experimental, and communicative medical tradition that has been uncovered through surviving documents, most made of papyrus , such as the Kahun Gynaecological Papyrus , the Edwin Smith Papyrus , the Ebers Papyrus , the London Medical Papyrus , to the Greek Magical Papyri . Herodotus described the Egyptians as "the healthiest of all men, next to the Libyans", because of the dry climate and
882-407: A disproportion of the humors. For example, if someone was suspected to have too much blood, then the physician would perform bloodletting as a treatment. Likewise, if a person believed to have too much phlegm should feel better after expectorating, and someone with too much yellow bile would purge. Another factor to be considered in the balance of humors is the quality of air where one resides, such as
1008-477: A dream-like state of induced sleep known as enkoimesis ( ἐγκοίμησις ) not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing. In the Asclepeion of Epidaurus , three large marble boards dated to 350 BCE preserve
1134-401: A few inpatient beds and a limited range of services that may otherwise be found in typical hospitals. A hospital contains one or more wards that house hospital beds for inpatients . It may also have acute services such as an emergency department , operating theatre , and intensive care unit , as well as a range of medical specialty departments. A well-equipped hospital may be classified as
1260-481: A few related medical specialties . Subtypes include rehabilitation hospitals , children's hospitals , seniors' ( geriatric ) hospitals, long-term acute care facilities , and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital ), cancer treatment , certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. In Germany , specialised hospitals are called Fachkrankenhaus ; an example
1386-604: A hospital bed, but be considered outpatient and "under observation" if not formally admitted. In the U.S., inpatient stays are covered under Medicare Part A, but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to additional coinsurance costs. In 2013, the Center for Medicare and Medicaid Services (CMS) introduced a "two-midnight" rule for inpatient admissions, intended to reduce an increasing number of long-term "observation" stays being used for reimbursement. This rule
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#17330861520871512-449: A hospital just for diagnosis , treatment, or therapy and then leave (" outpatients ") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months (" inpatients "). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are often described as clinics . The best-known type of hospital
1638-692: A hospital; Pennsylvania Hospital in Philadelphia opened in 1752, New York Hospital , now Weill Cornell Medical Center in New York City opened in 1771, and Massachusetts General Hospital in Boston opened in 1811. When the Vienna General Hospital opened in 1784 as the world's largest hospital, physicians acquired a new facility that gradually developed into one of the most important research centers. Another Enlightenment era charitable innovation
1764-507: A key source of medical knowledge during the Vedic period . The use of herbs to treat ailments would later form a large part of Ayurveda . Ayurveda, meaning the "complete knowledge for long life" is another medical system of India. Its two most famous texts (samhitas) belong to the schools of Charaka and Sushruta . The Samhitas represent later revised versions (recensions) of their original works. The earliest foundations of Ayurveda were built on
1890-408: A large body of traditional medicine. Much of the philosophy of traditional Chinese medicine derived from empirical observations of disease and illness by Taoist physicians and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales. These causative principles, whether material, essential, or mystical, correlate as
2016-489: A particularly important provider of healthcare to uninsured patients and patients with Medi-Cal (which is California's Medicaid program, serving low-income persons, some senior citizens , persons with disabilities , children in foster care , and pregnant women). In 2012, district hospitals provided $ 54 million in uncompensated care in California. A specialty hospital is primarily and exclusively dedicated to one or
2142-922: A phenomenon known as international healthcare accreditation , by groups such as Accreditation Canada in Canada , the Joint Commission in the U.S., the Trent Accreditation Scheme in Great Britain , and the Haute Autorité de santé (HAS) in France . In England , hospitals are monitored by the Care Quality Commission . In 2020, they turned their attention to hospital food standards after seven patient deaths from listeria linked to pre-packaged sandwiches and salads in 2019, saying "Nutrition and hydration
2268-549: A range of archaeological periods have been developed to account for the differing contexts of technology, sociocultural developments, and uptake of writing systems throughout early human societies. Prehistoric medicine is then highly contextual to the location and people in question, creating an ununiform period of study to reflect various degrees of societal development. Without written records, insights into prehistoric medicine comes indirectly from interpreting evidence left behind by prehistoric humans. One branch of this includes
2394-462: A significantly greater number of patients. It has 3,000 beds and performs 3,000 paediatric cardiac operations annually, the largest number in the world for such a facility. Surgeons are paid on a fixed salary instead of per operation, thus when the number of procedures increases, the hospital is able to take advantage of economies of scale and reduce its cost per procedure. Each specialist may also become more efficient by working on one procedure like
2520-621: A sudden illness. A district hospital typically is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers , rehabilitation hospitals , children's hospitals , geriatric hospitals, and hospitals for specific medical needs, such as psychiatric hospitals for psychiatric treatment and other disease-specific categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on
2646-551: A synthesis of traditional herbal practices together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 600 BCE onwards, and coming out of the communities of thinkers which included the Buddha and others. According to the compendium of Charaka , the Charakasamhitā , health and disease are not predetermined and life may be prolonged by human effort. The compendium of Suśruta ,
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#17330861520872772-411: A trauma center. They may also have other services such as a hospital pharmacy , radiology , pathology , and medical laboratories . Some hospitals have outpatient departments such as behavioral health services, dentistry , and rehabilitation services . A hospital may also have a department of nursing , headed by a chief nursing officer or director of nursing . This department is responsible for
2898-702: A year as a physician in Egypt. In the Franco-Prussian War of 1870-1 he worked as a doctor in the reserves. In 1872 he began to practise in Munich and developed an interest in psychiatry under the influence of Bernhard von Gudden . In 1872 Puschmann published Richard Wagner: eine psychiatrische Studie , which set out the ways in which he believed the composer was suffering from mental illness, including persecution mania and sexual depravity. The book kicked off decades of speculation about Wagner's morals and medical condition, and
3024-463: Is Fachkrankenhaus Coswig (thoracic surgery). In India, specialty hospitals are known as super-specialty hospitals and are distinguished from multispecialty hospitals which are composed of several specialties. Specialised hospitals can help reduce health care costs compared to general hospitals. For example, Narayana Health 's cardiac unit in Bangalore specialises in cardiac surgery and allows for
3150-717: Is another academic branch that contributes to understanding prehistoric medicine in uncovering the sociocultural relationships, meaning, and interpretation of prehistoric evidence. The overlap of medicine as both a root to healing the body as well as the spiritual throughout prehistoric periods highlights the multiple purposes that healing practices and plants could potentially have. From proto-religions to developed spiritual systems, relationships of humans and supernatural entities, from Gods to shamans , have played an interwoven part in prehistoric medicine. Ancient history covers time between c. 3000 BCE to c. 500 CE , starting from evidenced development of writing systems to
3276-490: Is both a study of medicine throughout history as well as a multidisciplinary field of study that seeks to explore and understand medical practices, both past and present, throughout human societies. The history of medicine is the study and documentation of the evolution of medical treatments, practices, and knowledge over time. Medical historians often draw from other humanities fields of study including economics, health sciences , sociology, and politics to better understand
3402-466: Is caused by an excess of black bile, which is sedimentary and dark in colour. Being extroverted, talkative, easygoing, carefree, and sociable coincides with a sanguine temperament, which is linked to too much blood. Finally, a choleric temperament is related to too much yellow bile, which is actually red in colour and has the texture of foam; it is associated with being aggressive, excitable, impulsive, and also extroverted. There are numerous ways to treat
3528-405: Is digested into blood, muscle, and bones, while the humors that were not blood were then formed by indigestible materials that are left over. An excess or shortage of any one of the four humors is theorized to cause an imbalance that results in sickness; the aforementioned statement was hypothesized by sources before Hippocrates . Hippocrates ( c. 400 BCE ) deduced that the four seasons of
3654-493: Is part of a patient's recovery." The World Health Organization reported in 2011 that being admitted to a hospital was far riskier than flying. Globally, the chance of a patient being subject to a treatment error in a hospital was about 10%, and the chance of death resulting from an error was about one in 300. according to Liam Donaldson . 7% of hospitalised patients in developed countries, and 10% in developing countries, acquire at least one health care-associated infection . In
3780-485: Is produced in the liver and carried through veins to organs. Blood enhanced with pneuma, which means wind or breath, is carried by the arteries. The path that blood take is as follows: venous blood passes through the vena cava and is moved into the right ventricle of the heart; then, the pulmonary artery takes it to the lungs. Later, the pulmonary vein then mixes air from the lungs with blood to form arterial blood, which has different observable characteristics. After leaving
3906-432: Is produced in the liver. Animal or vital faculty controls respiration and emotion, coming from the heart. In the brain, the psychic faculty commands the senses and thoughts. The structure of bodily functions is related to the humors as well. Greek physicians understood that food was cooked in the stomach; this is where the nutrients are extracted. The best, most potent and pure nutrients from food are reserved for blood, which
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4032-538: Is the general hospital, also known as an acute-care hospital. These facilities handle many kinds of disease and injury, and normally have an emergency department (sometimes known as "accident & emergency") or trauma center to deal with immediate and urgent threats to health. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States and Canada, have their own ambulance service. A district hospital typically
4158-432: Is the major health care facility in its region, with large numbers of beds for intensive care , critical care , and long-term care. In California, "district hospital" refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of hospital beds in many local communities. Even today, district hospitals are the sole public hospitals in 19 of California's counties, and are
4284-584: Is the oldest written text mentioning enemas . Many medications were administered by enemas and one of the many types of medical specialists was an Iri, the Shepherd of the Anus. The earliest known physician is also credited to ancient Egypt : Hesy-Ra , "Chief of Dentists and Physicians" for King Djoser in the 27th century BCE. Also, the earliest known woman physician, Peseshet , practiced in Ancient Egypt at
4410-541: Is wounded and Podaleirius is in combat Eurypylus asks Patroclus to "cut out the arrow-head, and wash the dark blood from my thigh with warm water, and sprinkle soothing herbs with power to heal on my wound". Asklepios, like Imhotep , came to be associated as a god of healing over time. Temples dedicated to the healer-god Asclepius , known as Asclepieia ( Ancient Greek : Ἀσκληπιεῖα , sing. Ἀσκληπιεῖον , Asclepieion ), functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter
4536-566: The Mahavamsa , the ancient chronicle of Sinhalese royalty, written in the sixth century AD, King Pandukabhaya of Sri Lanka (r. 437–367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala). A hospital and medical training center also existed at Gundeshapur , a major city in southwest of the Sassanid Persian Empire founded in AD 271 by Shapur I . In ancient Greece , temples dedicated to
4662-523: The examination , diagnosis , treatment , and prognosis of numerous ailments. The Kahun Gynaecological Papyrus treats women's complaints, including problems with conception . Thirty-four cases detailing diagnosis and treatment survive, although some of them are mere fragments. Dating to 1800 BCE, it is the oldest surviving medical text of any kind. Medical institutions, referred to as Houses of Life, are known to have been established in ancient Egypt as early as 2200 BCE. The Ebers Papyrus
4788-513: The Edwin Smith Papyrus may date to a time as early as 3000 BCE. Imhotep in the 3rd dynasty is sometimes credited with being the founder of ancient Egyptian medicine and with being the original author of the Edwin Smith Papyrus , detailing cures, ailments and anatomical observations. This papyrus is regarded as a copy of several earlier works and was written c. 1600 BCE. It is an ancient textbook on surgery almost completely devoid of magical thinking and describes in exquisite detail
4914-557: The Latin hospes , signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By metonymy , the Latin word then came to mean a guest-chamber, guest's lodging, an inn . Hospes is thus the root for the English words host (where
5040-563: The Suśrutasamhitā defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life. Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments. The Suśrutasamhitā is notable for describing procedures on various forms of surgery, including rhinoplasty , the repair of torn ear lobes, perineal lithotomy , cataract surgery, and several other excisions and other surgical procedures. Most remarkable
5166-687: The Third Dynasty of Ur ( c. 2112 BCE – c. 2004 BCE ). Following the conquest of the Sumerian civilisation by the Akkadian Empire and the empire's eventual collapse from a number of social and environmental factors, the Babylonian civilisation began to dominate the region. Examples of Babylonian Medicine include the extensive Babylonian medical text, the Diagnostic Handbook, written by
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5292-791: The Yellow Emperor in his Jiayi jing , c. 265. During the Tang dynasty , the Suwen was expanded and revised and is now the best extant representation of the foundational roots of traditional Chinese medicine. Traditional Chinese medicine that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years. Critics say that TCM theory and practice have no basis in modern science , and TCM practitioners do not agree on what diagnosis and treatments should be used for any given person. A 2007 editorial in
5418-687: The archaeology of medicine; a discipline that uses a range of archaeological techniques from observing illness in human remains, plant fossils, to excavations to uncover medical practices. There is evidence of healing practices within Neanderthals and other early human species. Prehistoric evidence of human engagement with medicine include the discovery of psychoactive plant sources such as psilocybin mushrooms in c. 6000 BCE Sahara to primitive dental care in c. 10,900 BCE (13,000 BP ) Riparo Fredian (present-day Italy) and c. 7000 BCE Mehrgarh (present-day Pakistan ). Anthropology
5544-499: The neo-Assyrian ( c. 900 – 600 BCE ) and neo-Babylonian ( c. 600 – 500 BCE ) periods, as the last empires ruled by native Mesopotamian rulers. These discoveries include a huge array of medical clay tablets from this period, although damage to the clay documents creates large gaps in our understanding of medical practices. Throughout the civilisations of Mesopotamia there are a wide range of medical innovations, including evidenced practices of prophylaxis , measures to prevent
5670-489: The p was dropped for convenience of pronunciation) hospitality , hospice , hostel, and hotel . The latter modern word derives from Latin via the Old French romance word hostel , which developed a silent s , which letter was eventually removed from the word, the loss of which is signified by a circumflex in the modern French word hôtel . The German word Spital shares similar roots. Some patients go to
5796-527: The ummânū , or chief scholar, Esagil-kin-apli of Borsippa , in the middle of the 11th century BCE during the reign of the Babylonian king Adad-apla-iddina (1069–1046 BCE). This medical treatise devoted great attention to the practice of diagnosis , prognosis , physical examination, and remedies. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on
5922-544: The 1970s and have since expanded rapidly across the United States. The Catholic Church is the largest non-government provider of health careservices in the world. It has around 18,000 clinics, 16,000 homes for the elderly and those with special needs, and 5,500 hospitals, with 65 percent of them located in developing countries. In 2010, the Church's Pontifical Council for the Pastoral Care of Health Care Workers said that
6048-402: The 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers opened in the early 20th century, often connected with major hospitals . The mid-20th century was characterized by new biological treatments, such as antibiotics . These advancements, along with developments in chemistry , genetics , and radiography led to modern medicine . Medicine
6174-581: The Church manages 26% of the world's health care facilities. Modern hospitals derive funding from a variety of sources. They may be funded by private payment and health insurance or public expenditure , charitable donations . In the United Kingdom , the National Health Service delivers health care to legal residents funded by the state "free at the point of delivery", and emergency care free to anyone regardless of nationality or status. Due to
6300-664: The French government sent two scholar administrators, Coulomb and Tenon , who had visited most of the hospitals in Europe. They were impressed and the "pavilion" design was copied in France and throughout Europe. English physician Thomas Percival (1740–1804) wrote a comprehensive system of medical conduct, Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons (1803) that set
6426-581: The Hippocratics invented the Hippocratic Oath for physicians. Contemporary physicians swear an oath of office which includes aspects found in early editions of the Hippocratic Oath. Hippocrates and his followers were first to describe many diseases and medical conditions. Though humorism (humoralism) as a medical system predates 5th-century Greek medicine, Hippocrates and his students systematized
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#17330861520876552-524: The Islamic world was built in 805 in Baghdad by Harun Al-Rashid . By the 10th century, Baghdad had five more hospitals, while Damascus had six hospitals by the 15th century, and Córdoba alone had 50 major hospitals, many exclusively for the military, by the end of the 15th century. The Islamic bimaristan served as a center of medical treatment, as well nursing home and lunatic asylum . It typically treated
6678-577: The Roman population, were occasionally privately built in extremely wealthy Roman households located in the countryside for that family, although this practice seems to have ended in 80 AD. The declaration of Christianity as an accepted religion in the Roman Empire drove an expansion of the provision of care. Following the First Council of Nicaea in AD 325 construction of a hospital in every cathedral town
6804-407: The U.S., 1.7 million infections are acquired in hospital each year, leading to 100,000 deaths, figures much worse than in Europe where there were 4.5 million infections and 37,000 deaths. Modern hospital buildings are designed to minimise the effort of medical personnel and the possibility of contamination while maximising the efficiency of the whole system. Travel time for personnel within
6930-449: The administration of professional nursing practice, research , and policy for the hospital. Many units have both a nursing and a medical director that serve as administrators for their respective disciplines within that unit. For example, within an intensive care nursery, a medical director is responsible for physicians and medical care, while the nursing manager is responsible for all the nurses and nursing care. Support units may include
7056-459: The average length of stay, time to service, patient satisfaction, physician performance, patient readmission rate, inpatient mortality rate, and case mix index . In the United States , the number of hospitalizations grew to its peak in 1981 with 171 admissions per 1,000 Americans and 6,933 hospitals. This trend subsequently reversed, with the rate of hospitalization falling by more than 10% and
7182-425: The best place to check the balance of temperaments was in the palm of the hand. A person that is considered to be phlegmatic is said to be an introvert, even-tempered, calm, and peaceful. This person would have an excess of phlegm, which is described as a viscous substance or mucous. Similarly, a melancholic temperament related to being moody, anxious, depressed, introverted, and pessimistic. A melancholic temperament
7308-404: The birth of specialised medicine. By the late 19th and early 20th centuries, medical advancements such as anesthesia and sterile techniques that could make surgery less risky, and the availability of more advanced diagnostic devices such as X-rays , continued to make hospitals a more attractive option for treatment. Modern hospitals measure various efficiency metrics such as occupancy rates,
7434-402: The body of a patient with their diagnosis and prognosis. Here, clearly developed rationales were developed to understand the causes of disease and injury, supported by theories, agreed upon at the time, of elements we might now understand as natural causes, supernatural magic and religious explanations. Most known and recovered artefacts from the ancient Mesopotamian civilisations centre on
7560-400: The body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body. Some of this vital spirit reaches the brain, where it is transformed into animal spirit, which is then distributed by the nerves. The Romans invented numerous surgical instruments , including the first instruments unique to women, as well as
7686-535: The climate and elevation. Also, the standard of food and drink, balance of sleeping and waking, exercise and rest, retention and evacuation are important. Moods such as anger, sadness, joy, and love can affect the balance. During that time, the importance of balance was demonstrated by the fact that women lose blood monthly during menstruation, and have a lesser occurrence of gout, arthritis, and epilepsy than men do. Galen also hypothesized that there are three faculties. The natural faculty affects growth and reproduction and
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#17330861520877812-567: The crown; this was the first instance of secular support being provided for medical institutions. In 1682, Charles II founded the Royal Hospital Chelsea as a retirement home for old soldiers known as Chelsea Pensioners , an instance of the use of the word "hospital" to mean an almshouse . Ten years later, Mary II founded the Royal Hospital for Seamen, Greenwich , with the same purpose. The voluntary hospital movement began in
7938-556: The debate on degenerate music . In 1879 he became Professor of the History of Medicine in Vienna . His most significant publications in the history of medicine include Die Medicin in Wien während der letzten hundert Jahre (1884) and Die Geschichte der Lehre von der Ansteckung (1895). His Handbuch der Geschichte der Medizin (1902-05) was "one of the most important books on the subject, ranking with
8064-425: The dissections and surgical procedures, Galen concluded that blood is able to circulate throughout the human body, and the heart is most similar to the human soul. In Ars medica ("Arts of Medicine"), he further explains the mental properties in terms of specific mixtures of the bodily organs. While much of his work surrounded the physical anatomy, he also worked heavily in humoral physiology. Galen's medical work
8190-473: The earliest known writing systems in the 3rd millennium BCE , and created numerous cuneiform clay tablets regarding their civilisation. These included detailed accounts of drug prescriptions and operations, as well as exorcisms. These were administered and carried out by highly defined professionals including bârû (seers), âs[h]ipu (exorcists), and asû (physician-priests). An example of an early, prescription-like medication appeared in Sumerian during
8316-455: The early 18th century, with hospitals being founded in London by the 1720s, including Westminster Hospital (1719) promoted by the private bank C. Hoare & Co and Guy's Hospital (1724) funded from the bequest of the wealthy merchant, Thomas Guy . Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St Bartholomew's in London
8442-441: The end of the classical era and beginning of the post-classical period. This periodisation presents history as if it were the same everywhere, however it is important to note that socioculture and technological developments could differ locally from settlement to settlement as well as globally from one society to the next. Ancient medicine covers a similar period of time and presented a range of similar healing theories from across
8568-662: The expression of the natural order of the universe . The foundational text of Chinese medicine is the Huangdi Neijing , (or Yellow Emperor's Inner Canon ), written 5th century to 3rd century BCE. Near the end of the 2nd century CE, during the Han dynasty, Zhang Zhongjing , wrote a Treatise on Cold Damage , which contains the earliest known reference to the Neijing Suwen . The Jin dynasty practitioner and advocate of acupuncture and moxibustion , Huangfu Mi (215–282), also quotes
8694-437: The field of medicine, as he was one of the first physicians to initiate the exploration and dissection of the human body. The banned practice of human dissection was lifted during his time within the scholastic community. This brief moment in the history of Greek medicine allowed him to further study the brain, which he believed was the core of the nervous system. He also distinguished between veins and arteries , noting that
8820-591: The first physician to describe the Hippocratic face in Prognosis . Shakespeare famously alludes to this description when writing of Falstaff 's death in Act II, Scene iii. of Henry V . Hippocrates began to categorize illnesses as acute , chronic , endemic and epidemic, and use terms such as, "exacerbation, relapse , resolution, crisis, paroxysm , peak, and convalescence ." The Greek Galen (c. 129–216 CE )
8946-462: The foundations for the scientific study of anatomy and physiology, Herophilus of Chalcedon and Erasistratus of Ceos . Other Alexandrian surgeons gave us ligature (hemostasis), lithotomy , hernia operations, ophthalmic surgery , plastic surgery , methods of reduction of dislocations and fractures, tracheotomy , and mandrake as an anaesthetic . Some of what we know of them comes from Celsus and Galen of Pergamum. Herophilus of Chalcedon ,
9072-483: The healer-god Asclepius , known as Asclepeion functioned as centers of medical advice, prognosis, and healing. The Asclepeia spread to the Roman Empire . While public healthcare was non-existent in the Roman Empire, military hospitals called valetudinaria did exist stationed in military barracks and would serve the soldiers and slaves within the fort. Evidence exists that some civilian hospitals, while unavailable to
9198-517: The hospital and the transportation of patients between units is facilitated and minimised. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design. However, many hospitals, even those considered "modern", are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As
9324-483: The hospitals. They also changed from being mere homes of refuge to being complex institutions for the provision and advancement of medicine and care for sick. The Charité was founded in Berlin in 1710 by King Frederick I of Prussia as a response to an outbreak of plague. Voluntary hospitals also spread to Colonial America ; Bellevue Hospital in New York City opened in 1736, first as a workhouse and then later as
9450-554: The human body to usually be banned in ancient times, but in the Middle Ages it changed. In 1523 Galen's On the Natural Faculties was published in London. In the 1530s Belgian anatomist and physician Andreas Vesalius launched a project to translate many of Galen's Greek texts into Latin. Vesalius's most famous work, De humani corporis fabrica was greatly influenced by Galenic writing and form. Two great Alexandrians laid
9576-537: The institutions, practices, people, professions, and social systems that have shaped medicine. When a period which predates or lacks written sources regarding medicine, information is instead drawn from archaeological sources. This field tracks the evolution of human societies' approach to health, illness, and injury ranging from prehistory to the modern day, the events that shape these approaches, and their impact on populations. Early medical traditions include those of Babylon , China , Egypt and India . Invention of
9702-453: The journal Nature wrote that TCM "remains poorly researched and supported, and most of its treatments have no logical mechanism of action ." It also described TCM as "fraught with pseudoscience ". A review of the literature in 2008 found that scientists are "still unable to find a shred of evidence" according to standards of science-based medicine for traditional Chinese concepts such as qi , meridians, and acupuncture points, and that
9828-528: The lack of scientific soundness in the theoretical foundations of ayurveda and the quality of research have been criticized. The theory of humors was derived from ancient medical works, dominated Western medicine until the 19th century, and is credited to Greek philosopher and surgeon Galen of Pergamon (129 – c. 216 CE ). In Greek medicine, there are thought to be four humors, or bodily fluids that are linked to illness: blood, phlegm, yellow bile, and black bile. Early scientists believed that food
9954-406: The latter pulse and the former do not. Thus, while working at the medical school of Alexandria , Herophilus placed intelligence in the brain based on his surgical exploration of the body, and he connected the nervous system to motion and sensation. In addition, he and his contemporary, Erasistratus of Chios , continued to research the role of veins and nerves . After conducting extensive research,
10080-497: The liver, half of the yellow bile that is produced travels to the blood, while the other half travels to the gallbladder. Similarly, half of the black bile produced gets mixed in with blood, and the other half is used by the spleen. Around 800 BCE Homer in the Iliad gives descriptions of wound treatment by the two sons of Asklepios , the admirable physicians Podaleirius and Machaon and one acting doctor, Patroclus . Because Machaon
10206-417: The medieval concept of Christian care evolved during the 16th and 17th centuries into a secular one. In England , after the dissolution of the monasteries in 1540 by King Henry VIII , the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of London, were the hospitals St Bartholomew's , St Thomas's and St Mary of Bethlehem's (Bedlam) endowed directly by
10332-511: The microscope was a consequence of improved understanding, during the Renaissance. Prior to the 19th century, humorism (also known as humoralism) was thought to explain the cause of disease but it was gradually replaced by the germ theory of disease , leading to effective treatments and even cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in
10458-481: The modern hospital was beginning to take shape with a proliferation of a variety of public and private hospital systems. By the 1870s, hospitals had more than trebled their original average intake of 3,000 patients. In continental Europe the new hospitals generally were built and run from public funds. The National Health Service , the principal provider of health care in the United Kingdom, was founded in 1948. During
10584-529: The modern profession of nursing during the Crimean War when she set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration. The first official nurses' training programme, the Nightingale School for Nurses, was opened in 1860, with the mission of training nurses to work in hospitals, to work with the poor and to teach. Nightingale was instrumental in reforming
10710-496: The names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium. Alcmaeon of Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked
10836-399: The nature of the hospital, by improving sanitation standards and changing the image of the hospital from a place the sick would go to die, to an institution devoted to recuperation and healing. She also emphasised the importance of statistical measurement for determining the success rate of a given intervention and pushed for administrative reform at hospitals. By the late 19th century,
10962-444: The need for hospitals to prioritise their limited resources, there is a tendency in countries with such systems for 'waiting lists' for non-crucial treatment, so those who can afford it may take out private health care to access treatment more quickly. In the United States , hospitals typically operate privately and in some cases on a for-profit basis, such as HCA Healthcare . The list of procedures and their prices are billed with
11088-494: The nineteenth century, the Second Viennese Medical School emerged with the contributions of physicians such as Carl Freiherr von Rokitansky , Josef Škoda , Ferdinand Ritter von Hebra , and Ignaz Philipp Semmelweis . Basic medical science expanded and specialisation advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna , being considered as
11214-406: The notable public health system that they possessed. According to him, "the practice of medicine is so specialized among them that each physician is a healer of one disease and no more." Although Egyptian medicine, to a considerable extent, dealt with the supernatural, it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics. Medical information in
11340-457: The number of US hospitals shrinking from 6,933 in 1981 to 5,534 in 2016. Occupancy rates also dropped from 77% in 1980 to 60% in 2013. Among the reasons for this are the increasing availability of more complex care elsewhere such as at home or the physicians' offices and also the less therapeutic and more life-threatening image of the hospitals in the eyes of the public. In the US, a patient may sleep in
11466-476: The original meaning of the word, hospitals were original "places of hospitality", and this meaning is still preserved in the names of some institutions such as the Royal Hospital Chelsea , established in 1681 as a retirement and nursing home for veteran soldiers. During the Middle Ages, hospitals served different functions from modern institutions in that they were almshouses for the poor, hostels for pilgrims , or hospital schools. The word "hospital" comes from
11592-573: The past, however, this work was usually performed by the members of founding religious orders or by volunteers . However, there are various Catholic religious orders, such as the Alexians and the Bon Secours Sisters that still focus on hospital ministry in the late 1990s, as well as several other Christian denominations, including the Methodists and Lutherans, which run hospitals. In accordance with
11718-406: The poor, as the rich would have been treated in their own homes. Hospitals in this era were the first to require medical licenses for doctors, and compensation for negligence could be made. Hospitals were forbidden by law to turn away patients who were unable to pay. These hospitals were financially supported by waqfs , as well as state funds. In India, public hospitals existed at least since
11844-436: The present era and more accurately refers to studies and exploration of early healing practices. This period extends across the first use of stone tools by early humans c. 3.3 million years ago to the beginning of writing systems and subsequent recorded history c. 5000 years ago. As human populations were once scattered across the world, forming isolated communities and cultures that sporadically interacted,
11970-412: The quality of health care has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this matter. Independent external assessment of quality is one of the most powerful ways to assess this aspect of health care, and hospital accreditation is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries,
12096-513: The reign of Firuz Shah Tughlaq in the 14th century. The Mughal emperor Jahangir in the 17th century established hospitals in large cities at government expense with records showing salaries and grants for medicine being paid for by the government. In China, during the Song dynasty , the state began to take on social welfare functions previously provided by Buddhist monasteries and instituted public hospitals, hospices and dispensaries . In Europe
12222-469: The renowned Alexandrian physician, was one of the pioneers of human anatomy. Though his knowledge of the anatomical structure of the human body was vast, he specialized in the aspects of neural anatomy. Thus, his experimentation was centered around the anatomical composition of the blood-vascular system and the pulsations that can be analyzed from the system. Furthermore, the surgical experimentation he administered caused him to become very prominent throughout
12348-426: The sensory organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by dissection. Hippocrates of Kos ( c. 460 – c. 370 BCE ), considered the "father of modern medicine." The Hippocratic Corpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously,
12474-432: The sole locally accessible hospital within nine additional counties in which one or more other hospitals are present at a substantial distance from a local community. Twenty-eight of California's rural hospitals and 20 of its critical-access hospitals are district hospitals. They are formed by local municipalities, have boards that are individually elected by their local communities, and exist to serve local needs. They are
12600-470: The sources of income received. A teaching hospital combines assistance to people with teaching to health science students and auxiliary healthcare students. A health science facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and urgent care ) and specialist units such as cardiology . Some hospitals have outpatient departments and some have chronic treatment units. Common support units include
12726-574: The spread of disease, accounts of stroke, and an awareness of mental illnesses. Ancient Egypt , a civilisation spanning the valley of the river Nile (throughout parts of present-day Egypt , Sudan , and South Sudan ), existed from its unification in c. 3150 BCE to its collapse via Persian conquest in 525 BCE and ultimate downfall from the conquest of Alexander the Great in 332 BCE . Throughout unique dynasties, golden eras, and intermediate periods of instability, ancient Egyptians developed
12852-402: The standard for many textbooks. In the mid-19th century, hospitals and the medical profession became more professionalised, with a reorganisation of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practise for at least half a year at a hospital as part of their training. Florence Nightingale pioneered
12978-431: The student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation , operative skills, cooking, horticulture, metallurgy , sugar manufacture, pharmacy , analysis and separation of minerals, compounding of metals, and preparation of alkalis . The teaching of various subjects was done during the instruction of relevant clinical subjects. For example,
13104-410: The surgical uses of forceps , scalpels , cautery , cross-bladed scissors , the surgical needle , the sound , and speculas . Romans also performed cataract surgery . The Roman army physician Dioscorides ( c. 40 –90 CE), was a Greek botanist and pharmacologist. He wrote the encyclopedia De Materia Medica describing over 600 herbal cures, forming an influential pharmacopoeia which
13230-555: The system after COVID-19, initially for respiratory patients. Mersey Care NHS Foundation Trust started a COVID Oximetry@Home service in April 2020. This enables them to monitor more than 5000 patients a day in their own homes. The technology allows nurses, carers, or patients to record and monitor vital signs such as blood oxygen levels. In early India , Fa Xian , a Chinese Buddhist monk who travelled across India c. AD 400 , recorded examples of healing institutions. According to
13356-448: The teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines. Even today Ayurvedic treatment is practiced, but it is considered pseudoscientific because its premises are not based on science, some ayurvedic medicines have been found to contain toxic substances. Both
13482-405: The thinking that illness can be explained by an imbalance of blood, phlegm, black bile, and yellow bile. Hippocrates is given credit for the first description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung disease, lung cancer and cyanotic heart disease . For this reason, clubbed fingers are sometimes referred to as "Hippocratic fingers". Hippocrates was also
13608-600: The time of the 4th dynasty . Her title was "Lady Overseer of the Lady Physicians." Medical and healing practices in early Chinese dynasties were heavily shaped by the practice of traditional Chinese medicine (TCM). Starting around the Zhou dynasty , parts of this system were being developed and are demonstrated in early writings on herbs in Classic of Changes ( Yi Jing ) and Classic of Poetry ( Shi Jing ). China also developed
13734-482: The traditional principles of acupuncture are deeply flawed. There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese compounds, as well as the facilitation of disease. Trafficked and farm-raised animals used in TCM are a source of several fatal zoonotic diseases . There are additional concerns over the illegal trade and transport of endangered species including rhinoceroses and tigers, and
13860-427: The two Alexandrians mapped out the course of the veins and nerves across the human body. Erasistratus connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence . He sometimes employed experiments to further his research, at one time repeatedly weighing a caged bird, and noting its weight loss between feeding times. In Erasistratus ' physiology, air enters
13986-562: The welfare of specially farmed animals, including bears. The Atharvaveda , a sacred text of Hinduism dating from the middle Vedic age (c. 1200–900 BCE), is one of the first Indian texts dealing with medicine. It is a text filled with magical charms, spells, and incantations used for various purposes, such as protection against demons, rekindling love, ensuring childbirth, and achieving success in battle, trade, and even gambling. It also includes numerous charms aimed at curing diseases and several remedies from medicinal herbs, overall making it
14112-1068: The work of Haeser " and "many authorities collaborated in the writing of the histories of the various subjects treated". He left his legacy and his library as the basis of museum of medical history. In 1896 he wrote a highly autobiographical novel entitled Leonie . Ueber die Therapie der Peritonitis . Marburg 1869 (Dissertation). Richard Wagner. Eine psychiatrische Studie . Berlin 1873. Alexander von Tralles. Amsterdam 1963. Die Medicin in Wien während der letzten hundert Jahre . Wien 1884. Nachträge zu Alexander Trallianus: Fragmente aus Philumenus und Philagrius nebst einer bisher nach ungedruckten Abhandlung über Augenkrankheiten . Berlin 1886. Geschichte des medicinischen Unterrichts von den ältesten Zeiten bis zur Gegenwart. Leipzig 1889. Zu Ostern in Spanien, Reiseschilderunge n. Breslau 1893. Die Geschichte der Lehre von der Ansteckung . Wien 1895. Handbuch der Geschichte der Medizin . Jena 1902–1905. History of medicine The history of medicine
14238-454: The world connecting nature , religion, and humans within ideas of circulating fluids and energy. Although prominent scholars and texts detailed well-defined medical insights, their real-world applications were marred by knowledge destruction and loss, poor communication, localised reinterpretations, and subsequent inconsistent applications. The Mesopotamian region, covering much of present-day Iraq , Kuwait , Syria , Iran , and Turkey ,
14364-411: The year and four ages of man that affect the body in relation to the humors. The four ages of man are childhood, youth, prime age, and old age. Black bile is associated with autumn, phlegm with winter, blood with spring, and yellow bile with summer. In De temperamentis, Galen linked what he called temperaments, or personality characteristics, to a person's natural mixture of humors. He also said that
14490-864: Was Susruta's surgery specially the rhinoplasty for which he is called father of plastic surgery. Susruta also described more than 125 surgical instruments in detail. Also remarkable is Sushruta's penchant for scientific classification: His medical treatise consists of 184 chapters, 1,120 conditions are listed, including injuries and illnesses relating to aging and mental illness. The Ayurvedic classics mention eight branches of medicine: kāyācikitsā ( internal medicine ), śalyacikitsā (surgery including anatomy ), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya ( pediatrics with obstetrics and gynaecology ), bhūtavidyā (spirit and psychiatric medicine), agada tantra ( toxicology with treatments of stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa ( aphrodisiac and fertility). Apart from learning these,
14616-426: Was a pioneer of hospital design in having "pavilions" to minimize the spread of infection. John Wesley visited in 1785, and commented "I never saw anything of the kind so complete; every part is so convenient, and so admirably neat. But there is nothing superfluous, and nothing purely ornamented, either within or without." This revolutionary design was made more widely known by John Howard , the philanthropist. In 1787
14742-456: Was begun, including among the earliest hospitals by Saint Sampson in Constantinople and by Basil, bishop of Caesarea in modern-day Turkey. By the twelfth century, Constantinople had two well-organised hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialised wards for various diseases. The earliest general hospital in
14868-545: Was dominated by a series of civilisations including Sumer , the earliest known civilisation in the Fertile Crescent region, alongside the Akkadians (including Assyrians and Babylonians ). Overlapping ideas of what we now understand as medicine, science, magic, and religion characterised early Mesopotamian healing practices as a hybrid naturalistic and supernatural belief system . The Sumerians developed one of
14994-477: Was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970). Prehistoric medicine is a field of study focused on understanding the use of medicinal plants , healing practices, illnesses, and wellness of humans before written records existed. Although styled prehistoric "medicine", prehistoric healthcare practices were vastly different from what we understand medicine to be in
15120-410: Was later dropped in 2018. In 2016 and 2017, healthcare reform and a continued decline in admissions resulted in US hospital-based healthcare systems performing poorly financially. Microhospitals, with bed capacities of between eight and fifty, are expanding in the United States. Similarly, freestanding emergency rooms, which transfer patients that require inpatient care to hospitals, were popularised in
15246-409: Was one of the essential procedures in truly understanding medicine. He began to dissect different animals that were anatomically similar to humans, which allowed him to learn more about the internal organs and extrapolate the surgical studies to the human body. In addition, he performed many audacious operations—including brain and eye surgeries—that were not tried again for almost two millennia. Through
15372-438: Was one of the greatest physicians of the ancient world, as his theories dominated all medical studies for nearly 1500 years. His theories and experimentation laid the foundation for modern medicine surrounding the heart and blood. Galen's influence and innovations in medicine can be attributed to the experiments he conducted, which were unlike any other medical experiments of his time. Galen strongly believed that medical dissection
15498-522: Was rebuilt from 1730 to 1759, and the London Hospital, Whitechapel, opened in 1752. These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centers of medical innovation and discovery and the principal place for the education and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at
15624-458: Was regarded as authoritative until well into the Middle Ages. He left a physiological model of the human body that became the mainstay of the medieval physician's university anatomy curriculum. Although he attempted to extrapolate the animal dissections towards the model of the human body, some of Galen's theories were incorrect. This caused his model to suffer greatly from stasis and intellectual stagnation. Greek and Roman taboos caused dissection of
15750-850: Was the dispensary; these would issue the poor with medicines free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the British Empire . The idea was slow to catch on until the 1770s, when many such organisations began to appear, including the Public Dispensary of Edinburgh (1776), the Metropolitan Dispensary and Charitable Fund (1779) and the Finsbury Dispensary (1780). Dispensaries were also opened in New York 1771, Philadelphia 1786, and Boston 1796. The Royal Naval Hospital, Stonehouse , Plymouth ,
15876-408: Was used extensively for the following 1,500 years. Hospitals A hospital is a healthcare institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to
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