The document traces the history and evolution of hospitals from ancient Mesopotamia through the Middle Ages. It discusses early hospitals in Mesopotamia, Greece, Rome, China, India, and the development of religious hospitals during the Middle Ages. It then covers the Renaissance period and establishment of some of the earliest voluntary hospitals in England in the 18th century.

1. HISTORY OF HOSPITAL

2. INTRODUCTION
• The evolution of the hospital is traced from its onset in ancient Mesopotamia
towards the end of the 2nd millennium to the end of the Middle Ages.
• Medicine was magical and mythological, and diseases were attributed mostly to
the supernatural forces. The foundation of modern medicine can be traced back
to ancient Greeks. Priests/doctors were part of the ruling class with great
political influences and the temple/hospital was also a meeting place.
• In the earliest prehistoric days, a different kind of medicine was practiced in
countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and
others.

3. MESOPOTAMIAN MEDICINE
• Medicine as an organized entity first appeared 6000 years ago in the ancient
region of Southwest Asia known as Mesopotamia , between the Tigris and
Euphrates rivers, which have their origin in Asia Minor and merge to flow into
the Persian Gulf.
• The first recorded doctor’s prescription came from Sumer in ancient Babylon
under the rule of the dynasty of Hammurabi (1728-1686BC). Hammurabi's code
of law provides the first record of the regulation of doctors ‘practice, as well as
the regulation of their fees.
• The Mesopotamian civilization made political, educational, and medical
contributions to the later development of the Egyptian, Hebrew , Persian and
even Indian cultures.

4. GREEK MEDICINE
• The classic period of Greek medicine was the year 460- 136 B.C.
• An early leader in Greek medicine was Aesculapius(1200 B.C).Aesculapius
bore two daughters- Hygeia and Panacea. Hygeia was worshipped as the
goddess of health and Panacea as the goddess of medicine. Hygeia and
panacea give rise to curative and preventive medicine.
• The temples of Saturn, Hygeia and Aesculapius, the Greek god of medicine
all served as both medical schools for practitioners and resting places for
patients under observation or treatment.

5. • Hippocrates(460-370 B.C), the father of medicine, Hippocrates is usually
considered the personification of the rational non-religious approach to
medicine, and in 480 BC, he started to use auscultation, perform surgical
operations and provide historians with detailed records of his patients
and descriptions of diseases ranging from tuberculosis to ulcers.
• Hippocrates's lectures and writings, as compiled later by the Alexandrian
scholars into the "corpus Hippocraticum." Hippocrates was an
epidemiologist , his concept of health and disease stressed the relation
between man and his environment.

6. • Although patients were treated by magic rituals and cures were related to
miracles and divine intervention, the Greek recognized the natural causes
of diseases and rational methods of healing were important.
• Greeks believed that matter was made up of four elements_ earth, air, fire
and water and were represented in the body by the four humors_ phlegm,
yellow bile, blood and black bile similar to the "tridosha theory".

7. ROMAN MEDICINE
• By the first century B.C., the centre of civilization shifted to Rome.
• Galen(130-205 A.D), a medical teacher, gave a important contribution in the
field of comparative anatomy and experimental physiology. Galen observed the
disease is due to three factors- predisposing, exciting and environmental factors.
• In Roman times the military and slave hospitals which existed since the 1st
century AD, were built for a specialized group and not for the public, and were
therefore also not precursors of the modern hospital
• Around 370AD St Basil of Caesarea established a religious foundation in
Cappadocia that includes a hospital, an isolation unit for those suffering from
leprosy and buildings to house the poor, the elderly and the sick.

8. • St Benedict at Monte Cassino, founded early in the 6th century, where the
care of the sick was placed above and before every other Christian duty.
• It was from this beginning that one of the first medical schools in Europe
ultimately grew at Salerno and was of high repute by the 11th Century.
The Roman military hospitals and the few Christian hospitals were no
match for the number, organization and excellence of the Arabic hospitals.

9. CHINESE MEDICINE
• Chinese medicine developed as a concept of yin and yang, acupuncture
and acupressure, and it has even been used in the modern medicine.
• During medieval Europe, major universities and medical schools were
established. In the ancient time, before hospitals had developed, patients
were treated mostly in temples.

10. MIDDLE AGES(500 -1500 A.D), "Dark Ages of
Medicine"
• Developed the Unani system of medicine.
• During the time of Mohammed, a real system of hospitals was developed.
He was the first to order the establishment of small mobile military
Bimaristan (hospital) .
• In addition, Islamic physicians were responsible for the establishment of
Pharmacy and chemistry as sciences.
• the best known of the great hospitals in the middle Ages were in
Baghdad, Damascus and Cairo.

11. • In the early Middle Ages (6th to 10th century), under the
influence of the Benedictine Order, an infirmary became an
established part of every monastery. During the late Middle
Ages (beyond the 10th century) monastic infirmaries
continued to expand, but public hospitals were also
opened, financed by city authorities, the church and private
sources. Specialized institutions, like leper houses, also
originated at this time.

12. • Religion continued to be the dominant influence in the establishment of
hospitals during the middle age.
• Religious communities " Monasteries" assumed responsibility for care of
the sick .
• Yet hospital construction increased in Europe during the middle Ages for
two reasons. First, Pope Innocent III in 1198 urged wealthy Christians to
build hospitals in every town and second, increased revenues were
available from the commerce with the crusaders.
• The oldest hospital still in existence are the “Hotel –Dieu” in Lyons and
Paris, France.

13. • Military hospitals came into being along the traveled routes: the knights
Hospitalers of the Order of St John in 1099 established in the Holy Land, a
hospital that could care for some 200 patients.
• It is to the Christians that one must turn for the origin of the modern
hospital. Hospices, initially built to shelter pilgrims and messengers
between various bishops, were under Christian control developed into
hospitals in the modern sense of the word.

14. Renaissance Age:
• The renaissance period lasted from the fourteenth to the sixteenth
centuries.
• The gradual transfer of responsibility for institutional healthcare from the
church to civil authorities continued in Europe after the dissolution of the
monasteries in 1540 by Henry VIII, which put an end to hospital building
in England for some 200 years.
• Only the powerful hospitals in London survived when the citizens
petitioned the King to endow St Bartholomew, St Thomas and St Mary of
Bethlehem hospitals.

15. • The loss of monastic hospitals in England caused the secular authorities to
provide for the sick, the injured and the handicapped, thus laying the
foundation for the voluntary hospital movement.
• . The first voluntary hospital in England was probably established in 1718
by Huguenots from France and was closely followed by the foundation of
such London hospitals as the Westminster hospital in 1719,Guy’s hospital
in 1724 and the London Hospital in 1740.
• In 1506, the Royal College of Surgeons was organized in England, followed
by organization of the Royal College of Physicians in 1528.

16. • The major contribution of the Renaissance to the development of
hospitals was in improved management of the hospital, the return to the
segregation of patients by disease, and the higher quality of medicine
provided within the hospital.
Royal Victoria Hospital

17. INDIAN MEDICINE
• The Indian medicine system development are Ayurveda and Siddha system .
Dhanvantari was considered as "the Hindu god of medicine".
• The celebrated authorities in Ayurvedic medicine were Atreya, charaka, Susruta
and Vaghbhatt.
• Atreya(800)- is the first Indian physician and teacher lived in ancient university
of Takshashila.
• Charaka(200A.D)- compiled his famous treatise on medicine the "Charaka
samhita"
• Susruta( father of surgery)- compiled the surgical knowledge of his classic
"susruta samhita".
• Ayurveda is a "Tridosha theory of disease" The doshas are: vata(wind), pitta(
gall) and kalpa( mucus).

18. INDIAN MEDICINE
• Historical records show that efficient hospitals were constructed in India
by 600 BC .
• During the splendid reign of King Asoka (273-232 BC), Indian hospitals
started to look like modern hospitals. They followed principles of
sanitation and cesarean sections were performed with close attention to
technique in order to save both mother and child.
• Physicians were appointed –one for every ten villages-to serve the health
care needs of the populations and regional hospitals for the infirm and
destitute were built by Buddha.

19. HOSPITAL IN INDIA
• The Indian medicine begins to decline from the Mohammedan invasions
in the tenth century.
• During Akbar’s period the Unani medicine system spread all the way
through the greater part of India..
• During his period, there were a good number of government hospitals, as
well as private clinics run by many physicians.
• The modern system of medicine in India was introduced in the 17th
centaury with the arrival of Christian missionaries in South India.
• In the 17th centaury, British empire established first hospital at Chennai
in 1664.

20. • Organized medical training was started with the first medical college
opening in Calcutta in 1835, two in Delhi in 1835 and 1836, followed by
Mumbai in 1845 and Chennai in 1850.
• The oldest college of Asia was established in Calcutta on JAN 28 1835
followed by Madras Medical College .
• MPUH i.e. Muljibhai Patel Urological Hospital, Nadiad
(Gujarat/India), popularly known as Nadiad Kidney Hospital, is the first
hospital in Gujarat to have da Vinci Si Robot for robotic-assisted surgeries.
• AIIMS is established in 1956 which is leading hospital in India in 21st
centaury.

21. TOP EIGHT HOSPITAL IN INDIA
AIIMS
Apollo Hospitals
Fortis Hospitals
NIMHANS
Christian Medical College
PGIMER
TATA Memorial Hospital
Sankara Nethralaya
Bombay Hospital

23. REFERENCES
• K .Park, PREVENTIVE AND SOCIAL MEDICINE,22nd edition, Feb
2013,
page number, 1,2,3,4 and 5.
• BM Sakharkar, PRINCIPLES OF HOSPITAL ADMINISTRATTION AND
PLANNING, 2nd edition, jaypee publications, page -7
• www. Pubmed.com
• ww.google.com