Changes

In Florence, Italy, the most active period for hospital foundation beginning in the mid-thirteenth century was linked to population growth.  Specialized hospitals served a variety of different groups, such as women, religious pilgrims, the old, the destitute, etc. As civic authorites worried more and more about contageous diseases and epidemics, the priority shifted to the medical treatment of the sick poor. Most new hospitals were created by philanthropic local bankers and businessmen, but the city oversaw hospitals, perceiving them as socially useful institutions both for assisting and for controlling the poor. The number, size, and facilities of Florence's hospitals, and the beauty of their buildings, became a source of frequently expressed civic pride.

In Florence, Italy, the most active period for hospital foundation beginning in the mid-thirteenth century was linked to population growth.  Specialized hospitals served a variety of different groups, such as women, religious pilgrims, the old, the destitute, etc. As civic authorites worried more and more about contageous diseases and epidemics, the priority shifted to the medical treatment of the sick poor. Most new hospitals were created by philanthropic local bankers and businessmen, but the city oversaw hospitals, perceiving them as socially useful institutions both for assisting and for controlling the poor. The number, size, and facilities of Florence's hospitals, and the beauty of their buildings, became a source of frequently expressed civic pride.

No concept of hygiene existed before the 19th century. The Hôtel-Dieu, for example, housed up to six patients in the same bed, with no attempt made to isolate those with contagious diseases.

No concept of hygiene existed before the 19th century. The Hôtel-Dieu, for example, housed up to six patients in the same bed, with no attempt made to isolate those with contagious diseases. 

 

Until the discovery of the anesthetic agents ether, (1842) and chloroform (1847), only the simplest, most urgent operations could be attempted.  Mortality from infection was very high in the procedures that were performed, until [[Joseph Lister]] introduced [[antiseptic]] techniques in the operating rooms of England in 1865. English pioneer nurse [[Florence Nightingale]] during the Crimean War (1854 to 1856), and the nursing school in London that she founded, transformed nursing into a skilled profession requiring formal training. Her graduates went on to found their own schools throughout the English-speaking world.

==Missionaries==

==Missionaries==

Christian missionaries throughout Asia and Africa in the 19th and 20th centuries made modern medical care a high priority, opening many local clinics that sometimes grew into hospitals.

Christian missionaries throughout Asia and Africa in the 19th and 20th centuries made modern medical care a high priority, opening many local clinics that sometimes grew into hospitals.

==Early American hospitals==

==Early American hospitals==

In 1639, three Augustinian nuns from Dieppe, France, established North America's first hospital, the Hôtel-Dieu in Quebec City.  

In 1639, three Augustinian nuns from Dieppe, France, established North America's first hospital, the Hôtel-Dieu in Quebec City. It was originally set up to to care for (and isolate) the victims of a smallpox epidemic.  

In the [[Thirteen Colonies]] that became the United States, almshouse infirmaries sometimes developed into public general hospitals (for example, Philadelphia General Hospital opened as the infirmary of an almshouse in 1732; Bellevue in New York began as the hospital ward of the public workhouse in 1736).   

In the [[Thirteen Colonies]] that became the United States, almshouse infirmaries sometimes developed into public general hospitals (for example, Philadelphia General Hospital opened as the infirmary of an almshouse in 1732; Bellevue in New York began as the hospital ward of the public workhouse in 1736).   

====Nurses====

====Nurses====

About 21,000 women served in Union hospitals. One in ten was black; they worked as laundresses and cooks (rather than as nurses or matrons). Most Union hospitals were built in cities. Confederates used mostly makeshift facilities in private residences, and were operated by upper class women "matrons." For example, Juliet Opie Hopkins, the wife of a wealthy Alabama businessman, organized and ran three hospitals in Richmond, Virginia, despite chronic shortages of medicine and other necessary supplies.  Despite the local nature of their service, Southern women generally met with more resistance than Northern ones from men who thought hospital work to be inappropriate for "ladies." It took the image of English woman [[Florence Nightengale]] and American [[Clara Barton]] to change make the role of the woman nurse generally acceptable.

About 21,000 women served in Union hospitals. One in ten was black; they worked as laundresses and cooks (rather than as nurses or matrons). Most Union hospitals were built in cities. Confederates used mostly makeshift facilities in private residences, and were operated by upper class women "matrons." For example, Juliet Opie Hopkins, the wife of a wealthy Alabama businessman, organized and ran three hospitals in Richmond, Virginia, despite chronic shortages of medicine and other necessary supplies.  Despite the local nature of their service, Southern women generally met with more resistance than Northern ones from men who thought hospital work to be inappropriate for "ladies." It took the heroic reputations of Florence Nightingale and American [[Clara Barton]] make the role of the woman nurse generally acceptable.

After the war veteran's care became a major activity.  

After the war veteran's care became a major activity.  

*2 Mayo Clinic, Rochester, Minnesota

*2 Mayo Clinic, Rochester, Minnesota

*3 Ronald Reagan UCLA Medical Center, Los Angeles  

*3 Ronald Reagan UCLA Medical Center, Los Angeles  

*4 Cleveland Clinic, Cleveland Ohio

*4 Cleveland Clinic, Cleveland

*5 Massachusetts General Hospital, Boston  

*5 Massachusetts General Hospital, Boston  

*6 New York-Presbyterian University Hospital, New York

*6 New York-Presbyterian University Hospital, New York

*7 UCSF Medical Center, San Francisco  

*7 UCSF Medical Center (University of California at San Francisco)

*8 Brigham and Women's Hospital, Boston  

*8 Brigham and Women's Hospital, Boston  

*8 Duke University Medical Center  

*8 Duke University Medical Center, Durham NC

*10 Hospital of the Univ. of Pennsylvania, Philadelphia  

*10 Hospital of the U. of Pennsylvania, Philadelphia  

*10 University of Washington Medical Center, Seattle  

*10 U. of Washington Medical Center, Seattle  

*12 Barnes-Jewish Hospital/ Washington University. St Louis  

*12 Barnes-Jewish Hospital/ Washington U., St Louis