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By late in the century, however, as society became increasingly industrialized and mobile and as medical practices grew in their sophistication and complexity, the notion that responsible families and caring communities took care of their own became more difficult to apply. Even surgery was routinely performed in patient’s homes. When middle- or upper-class persons fell ill, their families nursed them at home. For most of the nineteenth century, however, only the socially marginal, poor, or isolated received medical care in institutions in the United States. Physicians also provided the impulse for the establishment of early hospitals as a means of providing medical education and as a source of prestige.
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Benjamin Franklin was instrumental in the founding of Pennsylvania Hospital in 1751, the nation’s first such institution to treat medical conditions.
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However, almshouses were not intended to serve strictly medical cases since they also provided custodial care to the poor and destitute. In the United States, cities established isolation hospitals in the mid 1700s, and almshouses devoted to the sick or infirm came into being in larger towns. Then in 1859, Florence Nightingale established her famous nursing school-so influential on future nurses’ training in the United States-at St. These hospitals became centers for clinical teaching. Large hospitals, consisting of a thousand beds or more, emerged during the early nineteenth century in France when Napoleon established them to house his wounded soldiers from his many wars. The idea that one could recover from disease also expanded, and by the eighteenth century, medical and surgical treatment had become paramount in the care of the sick, and hospitals had developed into medicalized rather than religious spaces. Also at this time, cities established institutions for people with contagious diseases such as leprosy.ĭuring the medieval and early Renaissance eras, universities in Italy and later in Germany became centers for the education of medical practitioners. The Alexian Brothers in Germany and the Low Countries, for example, organized care for victims of the Black Plague in the fourteenth century. Religious orders of men predominated in medieval nursing, in both Western and Eastern institutions. Monasteries added wards, where to care meant to give comfort and spiritual sustenance. This religious ethos of charity continued with the rapid outgrowth of monastic orders in the fifth and sixth centuries and extended into the Middle Ages. Ī nursing tradition developed during the early years of Christianity when the benevolent outreach of the church included not only caring for the sick but also feeding the hungry, caring for widows and children, clothing the poor, and offering hospitality to strangers. These influences have included the changing meanings of disease, economics, geographic location, religion and ethnicity, the socioeconomic status of clients, scientific and technological growth, and the perceived needs of populations. Patient at the Philadelphia Hospital (Philadelphia General Hospital) receiving eye treatment, 1902The evolution of hospitals in the Western world from charitable guesthouses to centers of scientific excellence has been influenced by a number of social and cultural developments.
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