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Lecture 4

HMED 3075 Lecture 4: The Rise of the Modern Hospital
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Department
History of Medicine
Course Code
HMED 3075
Professor
Tobbell D

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HMED 3075 Lecture Notes on 9/26/2016:
Lecture: The Rise of the Modern Hospital
Reading: Joel Howell, “The changing meaning of urinanalysis.”
Traditional Institution: 1800-1850
1800: only two hospitals: Pennsylvania hospital and New York hospital
Most people treated at home by female care givers
Nicer hospitals, needed a medical examination to determine if you would be
admitted to the hospital. Also considered social class and respectability for
treatment.
Hospitals played small role in provision of medical care
Patients
oInsance, indigent, dependent, permanently incapacitated
oSeparate wards for sick patients
oMinority of paying patients
o“last resort” option of hospital. Most wanted to be treated at home
Limited relationship to medical education. Training often wasn’t done in a hospital
1873: 178 hospitals
New York hospital in 1810:
Hospital growth, 1850-1875: The expanding population
oUrbanization
1800, 6% lived in cities: 1860, 20%
Poor urban health: overcrowding, poor sanitation, epidemics
oImmigration
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Description
HMED 3075 Lecture Notes on 9/26/2016: Lecture: The Rise of the Modern Hospital Reading: Joel Howell, “The changing meaning of urinanalysis.”  Traditional Institution: 1800-1850  1800: only two hospitals: Pennsylvania hospital and New York hospital  Most people treated at home by female care givers  Nicer hospitals, needed a medical examination to determine if you would be admitted to the hospital. Also considered social class and respectability for treatment.  Hospitals played small role in provision of medical care  Patients o Insance, indigent, dependent, permanently incapacitated o Separate wards for sick patients o Minority of paying patients o “last resort” option of hospital. Most wanted to be treated at home  Limited relationship to medical education. Training often wasn’t done in a hospital  1873: 178 hospitals  New York hospital in 1810:  Hospital growth, 1850-1875: The expanding population o Urbanization  1800, 6% lived in cities: 1860, 20%  Poor urban health: overcrowding, poor sanitation, epidemics o Immigration  1860 census: > 4 million immigrants o Industrialization  Industrial hospitals  Efficient care of workers  Hospital reform, 1865-1875: Minimizing Hospital Infection o Well-designed ventilation and heating systems o Placement of windows and beds o Sufficient space between patients o Separate wards for surgical patients  The Hospital Transforming, 1875-1900 o Transformation of hospital surgery  Aseptic surgery (1880’s+): sterile tools, techniques, and procedures. Increased safety of hospital surgery o New definitions of disease  Specificity of disease  Germ theory  > identify and treat the disease o New clinical and laboratory technologies  Ex. stethoscope (1870s)  Clinical pathology laboratory (1890s) Talked about by Joel Howell o Hospitals and medical careers
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