HOSPITALS, History and Construction. History.— Hospitals in the sense of institu tions for the care of the ailing poor first occur in history as Christian foundations. Public hospitals are mentioned by no classical writer before the time of Christ, and no trace of one is to be found in the explorations. As Meyer Steineg points out, Vitruvius, the Greek archi tectural authority, treats of every kind of public building, but not hospitals. Private hospitals were common enough among the Greeks, and many physicians set aside portions of their buildings for the care of patients. According to ancient Irish traditions (300 s.c.), hospitals of this kind were so common as to be the rule, and there were special Brehon laws regulating their ventilation and other conditions. In India there are some not very definite details with regard to hospitals for men and animals, even before the time of Christ. The only thing re sembling our modern hospitals in ancient times were the valetudinaria for slaves, and the mili tary lazarettos for wounded soldiers. These latter were supported by government funds. There were a number of health resorts, as at Cos and Epidaurus, but these were for the well-to-do and as in our time, were more fre quented by neurotic patients than by the seri ously ill.
With the advent of Christianity, there came a new development, and Christ's example in healing the sick made this one of the features of the early history of the Church. Saint Luke was a physician and emphasized this phase of Christ's work in his Gospel. Care for the ailing became a Christian tradition. A portion of the bishop's house in the primitive Church was set aside for the care of those who had no other shelter, and as Harnack notes, at times the bishop was a physician and gave medical attention to the ailing poor in them. Until' the end of the persecutions, there could be no pub lic hospitals, but Saint Zoticus is said to have built one at Constantinople during the reign of Constantine. A letter of Julian the Apostate (361) makes it clear that the Christians had many such institutions, for he insists that the old Imperial religion cannot be brought back without charitable institutions similar to those of the Christians, where all, regardless of faith, were cared for. Saint Basil established a hos pital at Cxsarea in Cappadocia (369), which shows how seriously the duty of caring for the ill poor was taken. His foundation was out side the city proper and was so extensive that it was called New Town?) There were struc tures for different classes of the needy,— for children, for the old, and strangers as well as the sill, besides buildings for physicians and nurses, workshops for what we have learned to call reconstruction work, and even industrial schools and an employment bureau. Basil's example was followed very widely throughout the East. In the West the earliest hospital foundation, according to Saint Jerome, was that of Fabiola at Rome about the end of the 4th century. With it was connected a system of visiting the sick, Fabiola herself organizing it. In the hospital work of Christians there was no distinction of creed, and its open-hearted charity deeply influenced the people of the time.
After this, hospital development continues uninterrupted. The Hotel Dieu of Paris is said to have been founded in the 7th century, or perhaps the 6th. There is a record of a hospital in Spain at Augusta Emerita (modern Merida) in 580. This was for the ill, ((slave or free, Christian or Jew.'" Charlemagne (circa 800) decreed that there should be a hospital in connection with every cathedral and monastery.
During the Crusades, the hospitals of the Hospitallers of Saint John of Jerusalem accom plished an immense amount of good for the very large numbers of the Crusaders at long distances from their homes, in the East. Their hospital in Jerusalem is said to have accommo dated 2,000 patients and became so famous for its successful effort to meet every need of the patients that according to an old legend, Saladin, the Sultan of the Saracens, went in disguise to the hospital as a patient to see for himself if it could possibly be true that so much was done for the patients there as he had heard. The hospital of Saint Mary Mag
dalene in Jerusalem was under the female branch of the Hospitallers which had another large hospital in the Holy Land and a number of branches in various parts of Europe to which the wounded and sick were sent to convalesce. These hospitals became famous for what they accomplished in times of emergency, famine, flood and epidemics, so that the institute would remind one in many ways of the Red Cross in the modern time. After some generations, when the Crusades were drawing to a close, the Hospitallers found it necessary to organize a military branch for the protection of pilgrims and of their convalescent patients on their way home. The word Knights was then added to Hospitallers as their title. This did not occur, however, until nearly a century and a half after they began their work. Both the men and women of the Order wore a rather striking costume with a white cross prominently dis played on the breast of it, so that they must have been conspicuous figures on the battlefield or near it, and there are traditions that both men and women in the Order served close to the lines. 'There was an immense outpouring of charity everywhere in Christian countries at this time, to enable these Orders to do their work, reminding the modern of our own suc cessful organization of war activities. The resulting good example had much to do with the magnificent development of hospitals throughout Europe which occurred almost im mediately after the end of the Crusades. With regard to this movement Virchow calls atten tion to all that the Popes did for hospital encouragement. He has words of highest praise for Pope Innocent III who did so much for the creation of an extensive hospital system in Christendom. The Pope wishing to have a model hospital in Rome, sent for Guy of Mont pellier (circa 1200), who, he was told, had organized the greatest hospital of the time in that city. Guy was commissioned to es lisp a model hospital in Rome and plann , the Santo Spirito in the Borgo not far from' the Vatican which existed until our time. The Pope commended this hospital to bishops when they officially visited Rome, and recom mended under conditions in which a recom mendation was a virtual command, the establishment of similar institutions in their dioceses. As a result, nearly every town of 5,000 inhabitants or more in France, England. Italy, Spain and Germany came to have its public hospital in the course of the next 200 years. Virchow notes over 150 in Germany. Many of these hospitals were beautiful build ings, and not a few of them in the more popu lous centres were constructed so as to fulfil the most modern requirements. They were as a rule of single story, rather high, with windows well up in the walls to avoid draughts; with galleries for convalescent patients to sit in the sun and for nurses' observation, running along just below the windows ; with tiled floors ; with a kitchen in a separate building and surrounded by beautiful gardens. The hospital site was often fixed on a stream of water, sometimes an artificial islet being created which insured Sow ing water all around the hospital, for coolness and refuse disposal. Some of the hospitals in the cities in the Middle Ages were among the most beautiful of their public buildings archi tecturally and their interiors were decorated by the great painters and sculptors of the time Some of these in a lofty spirit of charity gave their services for this purpose. Sometimes artists who had been patients painted pictures for the hospitals out of gratitude for their treatment. A noteworthy example is Saint Jean at Bruges, where Meinling's visited at a franc per person still give a revenue of thousands of dollars a year. Wards were often built cruciform with an altar at the crossing where Mass was said every morning which provided religious consolation for the patients' thoughts during the day. The windows wen often of beautiful stained glass with figure or Bible stories on them which occupied patients' minds.