Engines of Our Ingenuity

No. 991:
INVENTION OF THE HOSPITAL

by John H. Lienhard

Click here for audio of Episode 991.

Today, the invention of the hospital. The University of Houston's College of Engineering presents this series about the machines that make our civilization run, and the people whose ingenuity created them.

Hospitals have formed slowly for 2000 years. Doctors of classical Greece tended the sick in their homes. The methodical Romans had systematic, if brutal, means for handling wounded soldiers, but no public houses for sick civilians.

Hospitals were a very altruistic Christian invention. The word itself is all mixed up with the words hotel and hospitality. By the 4th century AD, newly Christianized Romans began running homes for the sick and needy. By the 8th century, the functions of Christian hospitals, or hospices, were highly specialized. Some served the sick, some the needy, lepers, the insane, and orphans.

The new nations of Islam followed suit in the 9th century AD. By the 12th century, the Christian Order of St. John of Jerusalem, and the St. Augustine nuns, had shaped Medieval hospitals, with their diverse functions, into fine institutions.

Deterioration set in as control shifted away from the Church during the late 13th century. Secular hospitals grew increasingly crowded and dirty. Hospitals remained, but the well-to-do didn't use them. Small wonder that, in 1642, Sir Thomas Browne would write,

For the world, I count it not an inn, but an hospital; and a place not to live, but to die in.

In 1524 Cortes set up the Hospital of Jesus of Nazareth in Mexico City. It's still running. French missionaries built Montreal's Hotel Dieu in 1639. Quakers set up the Philadelphia Almshouse in 1713. It became an insane asylum in 1731, and today it's the Philadelphia General Hospital. But we didn't build a true hospital here until about 240 years ago. In 1751 a Dr. Thomas Bond went to Ben Franklin and asked him to help form one.

Ben Franklin secured funds from the Colonial legislature. A small building went up under the motto, "Take care of him and I will repay thee," from the story of the Good Samaritan. It's now the East Wing of Pennsylvania Hospital.

But it took another force to make hospitals a place you would enter willingly. That force was Florence Nightingale. She restored the ingredient that'd left hospitals in the 13th century -- the ingredient was a place for women. Before 1850, a nurse stood on a lower rung of the social ladder than a trollop.

When Nightingale was done, not only women's place in hospitals, but hospitals themselves, had been re-civilized. Hospitals as we know them didn't really exist until after the Crimean War. It was only then that Elizabeth Barret Browning could write,

How many desolate creatures on the earth
Have learnt the simple dues of fellowship
And social comfort, in a hospital.

I'm John Lienhard, at the University of Houston, where we're interested in the way inventive minds work.

(Theme music)


Sources for this episode are widely scattered. See the Encyclopaedia Britannica articles on hospitals, and Saint John of Jerusalem. Stanley Joel Reiser discusses the origins of hospitals in his chapter on Medical Specialism and the Centralization of Medical Care. Medicine and the Reign of Technology, Cambridge: Cambridge University Press, 1978. Pennsylvania Hospital is the subject of a recent article in Colonial Homes, (Colonial Health Care. February, 1995, pp. 48-51.) The Browning quote is from Aurora Leigh, Book II. The Sir Thomas Brown quote is from Religio Medici, Part II, Sect. IX.


The Engines of Our Ingenuity is Copyright © 1988-1997 by John H. Lienhard.

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