Midical

HistoryA physician visiting the in a hospital. German from 1682.In ancient cultures, religion and medicine were linked. The earliest known institutions aiming to provide cure were temples. dedicated to the healer-god might admit the sick, who would wait for guidance from the god .The adopted his worship. Under his Roman name Æsculapius, he was provided with a temple (291 BC) on an island in the where similar rites were performed. The) are perhaps responsible for introducing the concept of dedicated hospitals to the world. According to the, the ancient chronicle of Sinhalese royalty written in the 6th century A.D., King Pandukabhaya (4th century BC) had lying-in-homes and hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documentary evidence we have of institutions specifically dedicated to the care of the sick anywhere in the world. Hospital is perhaps the oldest in the world. Ruins of ancient hospitals in are still in existence in and Medirigiriya. Institutions created specifically to care for the ill also appeared early in. King is said to have founded at least 18 hospitals ca. 230 BC, with physicians and nursing staff, the expense being borne by the royal treasury. Stanley Finger (2001) in his book Origins of Neuroscience: A History of Explorations Into Brain Function cites an translated as: "Everywhere King Piyadasi (Asoka) erected two kinds of hospitals, hospitals for people and hospitals for animals. Where there were no healing herbs for people and animals, he ordered that they be bought and planted However Dominik Wujastyk of the disputes this, arguing that the edict indicates that Ashoka built rest houses (for travellers) instead of hospitals, and that this was misinterpreted due to the reference to medical herbsThe first where students were authorized to methodically practice on patients under the supervision of physicians as part of their education, wasMedieval IslamThe earliest recorded hospital in the was that of (ruled 705-715 CE) which he built in 86 AH (706-707 CE). It somewhat resembled the Persian and Byzantine nosocomia, but was more general as it extended its services to, invalid and destitute people. All treatment and care was free of charge and there was more than one physician employed in this hospital. In the, the word "" was used to indicate an establishment where the ill were welcomed and cared for by qualified staff. In this way distinguished between a hospital and a or -house, all of which were more concerned with isolating the and the from society than offering them a cure. Some thus consider the medieval Bimaristan hospitals as "the first hospitals" in the modern sense of the word. The first free was opened in Baghdad during the. The first hospital in Egypt was opened in 872 AD and thereafter public hospitals sprang up all over the empire from and the. As the system developed, physicians and surgeons were appointed who gave lectures to and issued to those who were considered qualified to practice - in essence the first medical schools. Between the eighth and twelfth centuries CE hospitals developed a high standard of care. Hospitals in in the ninth and tenth centuries employed up to twenty-five staff physicians and had separate wards for different conditions. Al-Qairawan hospital and mosque, in were built under the rule in 830 CE and was simple but adequately equipped with halls organized into waiting rooms, a and a special bath. The hospital employed female including nurses from, a sign of great breakthrough. In addition to regular physicians who attended the sick, there were Fuqaha al-Badan, a kind of religious group of religious scholars whose medical services included bloodletting, bone setting, and cauterisation. During rule, when hospitals reached a particular distinction, Sultan built a and medical, and a number of other early hospitals were also built in Turkey. The clerics working in these facilities employed far beyond that of their contemporaries in their treatment of patients.Medieval Europewas the largest hospital in colonial America. InThe church at in France showing the often close connection between historical hospitals and churches.Medieval hospitals in followed a similar pattern to the Byzantine. They were religious communities, with care provided by (An old French term for hospital is "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 hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor or for not all cared for the sick. The first Spanish hospital, founded by the Catholic bishop in 580 at, was a xenodochium designed as an inn for travellers (mostly pilgrims to the shrine of as well as a hospital for citizens and local farmers. The hospital's endowment consisted of farms to feed its patients and guests.founded the two earliest hospitals in: the Immaculate Conception Hospital and the Saint Lazarus Hospital. The oldest was the Immaculate Conception, now the, founded in 1524 to care for the poor. The first hospital in North America north of Mexico was the. It was established in in 1639 by three from l'Hôtel-Dieu de Dieppe in France. The project of the niece of was granted a royal charter by King and staffed by colonial physicianCriticismWhile hospitals, by concentrating equipment, skilled staff and other resources in one place, clearly provide important help to patients with serious or rare health problems, hospitals are also criticised for a number of faults, some of which are endemic to the system, others which develop from what some consider wrong approaches to health care.One criticism often voiced is the 'industrialised' nature of care, with constantly shifting treatment staff, which dehumanises the patient and prevents more effective care as doctors and nurses are rarely intimately familiar with the patient. The high working pressures often put on the staff exacerbate such rushed and impersonal treatment. The architecture and setup of modern hospitals is often voiced as a contributing factor to the feelings of faceless treatment many people complain about. Another criticism is that hospitals are in themselves a dangerous place for patients, who are often suffering from weakened either due to their body having to undergo substantial surgery or because of the illness which placed them in the hospital itself. As an example, it is estimated that as much as 10% of all patients in the United States contract a Due to the environment in which are used in large quantities, the infections are also often multi-resistant to various treatment methods, such as the relatively common infection, making them especially dangerous.FundingIn the modern era, hospitals are, broadly, either funded by the government of the country in which they are situated, or survive financially by competing in the private sector (a number of hospitals are also still supported by the historical type of charitable or religious associations).In the United Kingdom for example, a relatively comprehensive, "free at the point of delivery" healthcare system exists, funded by the state. Hospital care is thus relatively easily available to all legal residents (although as hospitals prioritize their limited resources, there is a tendency for 'waiting lists' for non-emergency treatment in countries with such systems, and those who can afford it often take out private healthcare to get treatment faster). On the other hand, many countries, including for example the USA, have in the 20th Century followed a largely private-based, -approach to providing hospital care, with few state-money supported 'charity' hospitals remaining today. Where for-profit hospitals in such countries admit uninsured patients in emergency situations (such as during and after the in the USA), they incur direct financial losses, ensuring that there is a clear disincentive to admit such patients.While for-profit-based systems have produced some of the best hospitals in the world, a proportion of the populace may have little or no access to healthcare services of adequate quality As quality of healthcare has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this. Independent external assessment of quality is one of the most powerful ways of assessing the quality of healthcare, and is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries, a phenomenon known as, by groups such as Accreditation Canada from Canada, the from the USA, The in the, showing the utilitarian architecture of many modern hospitals.ArchitectureModern hospital buildings are designed to minimize the effort of medical personnel and the possibility of contamination while maximizing the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimized. 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, the reality is that 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 a result, Dutch architectural historian has called many hospitals:"... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally unfit for the purpose they have been designed for ... They are hardly ever functional, and instead of making patients feel at home, they produce stress and anxietySome newer hospital designs now try to reestablish design that takes the patient's psychological needs into account, such as providing for more air, better views, and more pleasant color schemes. These ideas harken back to the late 18th century, when the concept of providing fresh air and access to the 'healing powers of nature' were first employed by hospital architects in improving their buildingsAnother major change which is still ongoing in many parts of the world is the change from a ward-based system (where patients are treated and accommodated in communal rooms, separated at best by movable partitions) to a room-based environment, where patients are accommodated in private rooms. The ward-based system has been described as very efficient, especially for the medical staff, but is considered to be more stressful for patients and detrimental to their privacy. A major constraint on providing all patients with their own rooms is however found in the higher cost of building and operating such a hospital, which causes some hospitals to charge for the privilege of private rooms.