Kasalxonalar tarixi - History of hospitals

The kasalxonalar tarixi qadimgi davrlarda Yunoniston, Rim imperiyasi va Hindiston yarim orolidagi kasalxonalardan boshlanib, Asklepiy ibodatxonalari yilda qadimgi Yunoniston va keyin harbiy kasalxonalar yilda qadimgi Rim. Xristianlar davriga qadar hech qanday fuqarolik shifoxonasi mavjud emas edi.[1] IV asrning oxirlarida "ikkinchi tibbiy inqilob"[2] sharqda birinchi xristian shifoxonasining tashkil etilishi bilan sodir bo'ldi Vizantiya imperiyasi tomonidan Kesariya rayoni va bir necha o'n yilliklar ichida bunday kasalxonalar Vizantiya jamiyatida hamma joyda keng tarqaldi.[3] Kasalxonada rivojlanish va taraqqiyot davom etishi kerak edi Vizantiya, o'rta asrlar 5-asrdan 15-asrgacha bo'lgan Evropa va Islom jamiyatlari. In erta zamonaviy davr g'amxo'rlik va davolanish dunyoviy ishlarga o'tadi.[4]

Antik davr

Ning ko'rinishi Askleipion ning Kos, yunon Asklepieionning eng yaxshi saqlanib qolgan misoli.

Davolashni maqsad qilgan dastlabki hujjatlashtirilgan muassasalar qadimgi Misr ibodatxonalar. Yilda qadimiy tarix, kasalxonalar Gretsiyada, Rimda, Hindiston yarim orolida va Forsda hujjatlashtirilgan. Qadimgi madaniyatlarda din va tibbiyot bir-biriga bog'langan.[5]

Gretsiya

Yilda qadimgi Yunoniston, shifobaxsh xudoga bag'ishlangan ibodatxonalar Asklepius sifatida tanilgan Asclepieia (Qadimgi yunoncha: Tiεῖa, qo'shiq ayt. Asclepieion, Ἀσκληπioz), tibbiy maslahat, prognoz va davolash markazlari sifatida ishlagan.[6] Asclepeia davolanishga yordam beradigan ehtiyotkorlik bilan boshqariladigan joylarni taqdim etdi va davolash uchun yaratilgan muassasalarning bir nechta talablarini bajardi.[6] Rim nomi Æsculapius ostida unga orolda ibodatxona (miloddan avvalgi 291 yil) berilgan Tiber shunga o'xshash marosimlar o'tkazilgan Rimda.[7]

Ushbu ziyoratgohlarda bemorlar tush kabi uyqusiz uyqu holatiga kiradilar enkoimesis (chokmíz) behushlikdan farqli o'laroq, ular ham xudodan yo'l-yo'riq olishgan tushida.[8] Asclepeia davolanishga yordam beradigan ehtiyotkorlik bilan boshqariladigan joylarni taqdim etdi va davolash uchun yaratilgan muassasalarning bir nechta talablarini bajardi.[6] Asclepieion-da Epidaurus, miloddan avvalgi 350 yilga oid uchta katta marmar taxtalar ibodatxonaga muammo bilan kelgan va u erda to'kilgan 70 ga yaqin bemorlarning ismlari, voqealar tarixi, shikoyatlari va davolarini saqlaydi. Ro'yxatda keltirilgan ba'zi jarrohlik davolash usullari, masalan, qorin bo'shlig'ini ochish yoki shikastlanadigan begona moddalarni olib tashlash, bu etarli darajada haqiqatdir, ammo bemorni enkomeysis holatida, masalan, ko'knori kabi tinchlantiruvchi moddalar yordamida .[8] Asclepiusga sig'inishni Rimliklarga.

Rim imperiyasi

Qo'shimcha ma'lumotlar: Vizantiya tibbiyoti va O'rta asr tibbiyoti

The Rimliklarga deb nomlangan qurilgan binolar valetudinariya miloddan avvalgi 100-yillarda kasal qullar, gladiatorlar va askarlarni parvarish qilish uchun va ko'plari keyinchalik arxeologiya tomonidan aniqlangan. Ularning mavjudligi isbotlangan deb hisoblansa-da, ular ilgari o'ylanganidek keng tarqalganmi yoki yo'qmi degan shubha mavjud, chunki ularning ko'pchiligi saqlanib qolgan yozuvlar yoki tibbiy asbob-uskunalar topilmasi bilan emas, balki faqat bino qoldiqlari tartibiga qarab aniqlangan.[9]

Deklaratsiyasi Nasroniylik Rim imperiyasida qabul qilingan din sifatida parvarish qilishning kengayishiga olib keldi. Keyingi Nikeyaning birinchi kengashi milodiy 325 yilda har birida shifoxona qurilishi ibodathona shahar boshlandi. Eng qadimgi orasida shifokor tomonidan qurilganlar bor edi Avliyo Sampson yilda Konstantinopol va tomonidan Kesariya rayoni IV asrning oxirlarida zamonaviy Turkiyada. 5-asrning boshlarida shifoxona Vizantiya dunyosida xristianlarning sharqida hamma joyda tarqalgan edi,[3] bu Rim imperiyasining xristianlikgacha bo'lgan davridan boshlab, hech qanday fuqarolik shifoxonalari bo'lmagan davrdan keskin o'zgarish.[1] "Basilias" deb nomlangan, ikkinchisi shaharga o'xshardi va shifokorlar va hamshiralar uchun turar joy va turli toifadagi bemorlar uchun alohida binolarni o'z ichiga olgan.[10] Moxovlar uchun alohida bo'lim mavjud edi.[11] Ba'zi shifoxonalarda kutubxonalar va o'quv dasturlari olib borildi, shifokorlar tibbiy va farmakologik tadqiqotlarini qo'lyozmalarga yozdilar. Shunday qilib, bugungi kunda kasalxonani nazarda tutgan ma'noda statsionar tibbiy yordam, xristian rahm-shafqat va Vizantiya yangiliklari tomonidan ixtiro qilingan.[12] Vizantiya kasalxonasi xodimlari shu jumladan edi Bosh shifokor (archiatroi), kasbiy hamshiralar (gipourgoi) va buyurtmachilar (giperetay). XII asrga kelib, Konstantinopolda yaxshi tashkil etilgan ikkita shifoxona mavjud bo'lib, ularda erkaklar ham, ayollar ham bo'lgan shifokorlar ishladilar. Imkoniyatlar tarkibiga tizimli davolash protseduralari va turli kasalliklar bo'yicha ixtisoslashtirilgan bo'limlar kiritilgan.[13]

Hindiston qit'asi

Shuningdek qarang: Ayurveda

Kasallarni davolash uchun maxsus tashkil etilgan muassasalar ham erta paydo bo'lgan Hindiston qit'asi. Fa Sian, Hindiston bo'ylab sayohat qilgan xitoylik buddist rohib. 400 yilda, uning sayohatnomasida qayd etilgan[14] bu

Ning boshlari Vaishya (savdogar) oilalar (shimoliy Hindistonning barcha qirolliklari) shaharlarda xayriya va dori-darmon tarqatish uchun uylar tashkil qiladilar. Mamlakatdagi barcha kambag'al va qashshoqlar, etimlar, beva ayollar va farzandsiz erkaklar, nogironlar va nogironlar va kasal bo'lganlarning barchasi o'sha uylarga boradilar va har xil yordam bilan ta'minlanadilar va shifokorlar ularning kasalliklarini tekshiradilar. Ular o'zlari uchun zarur bo'lgan oziq-ovqat va dori-darmonlarni olishadi va o'zlarini qulay his qilishadi; va yaxshiroq bo'lganlarida, ular o'zlaridan ketishadi.

Tarixiy shahrida ikki ming yillik kasalxonaning xarobalari topilgan Anuradhapura Mihintale Shri-Lanka

Shri-Lanka

Sanskrit tilida saqlanib qolgan tibbiyot entsiklopediyasi - Carakasamhita (Compendium of Caraka ). Kasalxona binosini tavsiflovchi ushbu matn tibbiyot tarixchisi tomonidan yozilgan Dominik Vujastik miloddan avvalgi 100 yildan va milodiy 150 yilgacha bo'lgan davrga qadar.[15] Fa Sianning ta'rifi dunyoning istalgan nuqtasida fuqarolik shifoxonasi tizimining eng qadimgi ma'lumotlaridan biridir va ushbu dalillar, shuningdek, Karakaning klinika qanday qilib qurilishi va jihozlanishi kerakligi haqidagi tavsifi bilan Hindiston dunyoning birinchi qismi bo'lganligini ko'rsatmoqda. institutsional tibbiy ta'minotning uyushgan kosmopolit tizimini rivojlantirgan.[16]

Qirol Ashoka ko'plab ikkilamchi manbalar noto'g'ri kasalxonalarda tashkil etilgan deb aytishadi. Miloddan avvalgi 230 yil[17]

Ga ko'ra Mahavamsa, milodning VI asrida yozilgan Sinhalez qirolligining qadimiy xronikasi, Qirol Shri-Lankadan Pandukabxaya (miloddan avvalgi 437 yildan miloddan 367 yilgacha hukmronlik qilgan) mamlakatning turli hududlarida uy-joylar va kasalxonalar (Sivikasotti-Sala) qurilgan. Bu dunyodagi har qanday joyda kasallarni parvarish qilishga bag'ishlangan maxsus muassasalarimizdagi dastlabki hujjatli dalillar.[18][19] Mihintale Kasalxona dunyodagi eng qadimiy kasalxonadir.[20] In qadimiy kasalxonalar xarobalari Shri-Lanka hali Mihinteylda mavjud, Anuradhapura va Medirigiriya.[21] Kasalxonaning so'nggi arxeologik topilmalari Tissamaharama Milodiy I asrdan milodiy II asrga oid bo'lib, taniqli Mixintale va Polonnaruwa kasalxonalaridan 600-700 yil ilgari va Janubiy Osiyoda topilgan eng qadimgi orolda tibbiyot an'analarini ko'rsatib turibdi.[22]

5-asrdan 15-asrgacha

Asrlar davomida kasalxonaga oid taniqli maqolalar o'rnatildi (Vikipediyadagi maqolalar soni)
5-chi (1)6-chi (2)7-chi (1)8-chi (1)9-chi (1)10-chi (2)11-chi (2)12-chi (17)13-chi (14)14-chi (7)15-chi (15)

In O'rta asrlar muddat kasalxona sayohatchilar uchun mo'ljallangan yotoqxonalar, dispanserlar yomon yordam, yaradorlar uchun klinikalar va operatsiyalar, ko'rlar, cho'loqlar, qariyalar va ruhiy kasallar uchun uylar. Monastir shifoxonalarda terapevtik va ma'naviy ko'plab davolash usullari ishlab chiqildi.[23]

XIII asr davomida juda ko'p sonli kasalxonalar qurildi. The Italyancha shaharlar harakatning etakchilari bo'lgan. Milan o'ndan kam bo'lmagan kasalxonalar va Florensiya XIV asr oxirigacha o'ttizga yaqin kasalxonalar bo'lgan. Ulardan ba'zilari juda chiroyli binolar edi. Milanda umumiy kasalxonaning bir qismi loyihalashtirilgan Bramante va uning yana bir qismi Mikelanjelo. Sienna kasalxonasi, sharafiga qurilgan Sankt-Ketrin, shundan beri mashhur bo'lib kelgan. Evropada hamma joyda bu kasalxona harakati tarqaldi. Virchov, buyuk nemis patologi, kasalxonalar haqidagi maqolasida, Germaniyaning besh ming aholisi bo'lgan har bir shahri o'z kasalxonasiga ega ekanligini ko'rsatdi. U kasalxonadagi barcha harakatlarni kuzatib bordi Papa begunoh III Va Vircxov papachilikka moyil bo'lgan bo'lsa-da, bolalar va azob chekayotgan insoniyat uchun qilgan barcha ishlari uchun bu pontifikni juda yuqori maqtashdan tortinmadi.[24]

Kasalxonalar juda ko'p sonda paydo bo'la boshladi Frantsiya va Angliya. Keyingi Angliyaga frantsuz Norman bosqini, frantsuz ideallarining portlashi O'rta asrlarning ko'pgina monastirlari ziyoratchilar uchun xospitium yoki xospisni rivojlantirishga olib keldi. Bu kasalxona oxir-oqibat kasalxonaga aylandi, u erda turli xil rohiblar va oddiy yordamchilar kasal ziyoratchilarga va O'rta asrlar G'arbiy Evropasini azoblagan ko'plab balo va surunkali kasalliklarga jabrlanganlarga tibbiy yordam ko'rsatdilar. Benjamin Gordon kasalxonaning - biz bilganimizdek - frantsuz ixtirosi, ammo u dastlab izolyatsiya qilish uchun ishlab chiqarilgan degan nazariyani qo'llab-quvvatlaydi. moxovlar va o'lat qurbonlari, va keyinchalik keyinchalik ziyoratchilarga xizmat qilish uchun modifikatsiyadan o'tdilar.[25]

XII asrda rohib haqida yaxshi saqlanib qolganligi tufayli Eadmer Canterbury sobori, haqida juda yaxshi hisob bor Yepiskop Lanfrank Ushbu dastlabki kasalxonalarning namunalarini yaratish va saqlash maqsadi:

Ammo men uning ishini Kanterberi shahri devorlari tashqarisida kambag'allar uchun qilgan ishlarini tashlab qo'yish bilan yakunlamasligim kerak. Qisqacha aytganda, u har xil ehtiyojlar va qulayliklar uchun munosib va ​​mo'l-ko'l tosh uy qurdi. U asosiy binoni ikkiga bo'lib, bir qismini har xil zaifliklarga duchor bo'lgan erkaklar uchun, ikkinchisini sog'lig'i yomon ayollar uchun tayinladi. U shuningdek, ularning kiyimlari va kundalik ovqatlari uchun barcha choralarni ko'rish uchun vazirlar va vasiylarni tayinlab, ular uchun hech narsa kam bo'lmasligi kerak edi.[26]

Fors

The Gondishapur akademiyasi da kasalxona va tibbiy o'quv markazi bo'lgan Gundeshapur yilda Fors. Gundeshapur shahriga milodiy 271 yilda Sosoniylar shohi asos solgan Shopur I. Bu yirik shaharlardan biri edi Xuziston Fors imperiyasining viloyati, Eronda. Aholining katta foizi edi Suriyaliklar, ularning aksariyati nasroniylar edi. Hukmronligi ostida Xusrav I, yunonlarga boshpana berildi Nestorian nasroniy fors maktabi olimlarini o'z ichiga olgan faylasuflar Edessa (Urfa ) (shuningdek, Afina akademiyasi deb ataladi), xristian dinshunoslik va tibbiyot universiteti. Ushbu olimlar 529 yilda imperator Yustinian tomonidan akademiya yopilgandan so'ng Gundeshapurga yo'l olishdi. Ular tibbiyot fanlari bilan shug'ullanishgan va tibbiy matnlarning birinchi tarjima loyihalarini boshlashgan.[27] Ushbu tibbiyot xodimlarining Edessadan kelishi Gundeshapurdagi kasalxona va tibbiy markazning boshlanishini anglatadi.[28] Uning tarkibiga tibbiyot maktabi va shifoxona (bimariston ), farmakologiya laboratoriyasi, tarjima uyi, kutubxona va rasadxona.[29] Hindistonlik shifokorlar Gundeshapurdagi maktabga, ayniqsa tibbiyot tadqiqotchisi Mankaxga o'z hissalarini qo'shdilar. Keyinchalik islomiy istilodan so'ng, Manka va hindistonlik shifokor Susrutaning asarlari arab tiliga tarjima qilindi Bag'dod "s Donolik uyi.[30]

O'rta asr Islom kasalxonalari

Asosiy maqolalar: O'rta asr Islom olamidagi tibbiyot va Bimariston
Misrning Qohira shahridagi Qavalun majmuasiga kirish, u erda mashhur Qavalun kasalxonasi joylashgan.

Birinchi musulmon kasalxonasi moxov kasalligini saqlaydigan boshpana bo'lib, sakkizinchi asrning boshlarida qurilgan bo'lib, u erda bemorlar qamoqda, ammo ko'rlar singari oilalarini boqish uchun nafaqa bilan ta'minlangan.[31] Eng qadimgi umumiy kasalxona milodiy 805 yilda Bag'dodda Horun Ar-Rashid tomonidan qurilgan.[32][33] X asrga kelib, Bag'dodda yana beshta kasalxona bor edi Damashq XV asrga kelib oltita kasalxonaga ega edi Kordova yolg'iz 50 harbiy kasalxonaga ega edi, aksariyati faqat harbiylar uchun.[31] Ko'pchilik taniqli erta Islom kasalxonalari kabi nasroniylar yordami bilan tashkil etilgan Jibroil ibn Buxtishu dan Gundeshapur.[34][35] "Bimariston "" bimar "(kasal yoki kasal) va" stan "(joy) birikmasidir O'rta asr Islom olami, "bimaristan" so'zi kasallarni kutib oladigan, malakali xodimlar tomonidan parvarish qilinadigan va davolanadigan kasalxona muassasasini nazarda tutadi.

The Amerika Qo'shma Shtatlarining Milliy tibbiyot kutubxonasi mahsuloti sifatida kasalxonani kreditlaydi O'rta asr Islom tsivilizatsiyasi. Ba'zi monastirlar tomonidan ta'minlangan kambag'al va kasallarni davolash muassasalari bo'lgan zamonaviy xristian muassasalari bilan taqqoslaganda, Islom kasalxonasi yanada kengroq funktsiyalarga ega bo'lgan muassasa edi. Yilda Islom, moddiy ahvolidan qat'i nazar, kasallarni davolash uchun axloqiy talab mavjud edi. Islom shifoxonalari yirik, shahar tuzilmalariga moyil bo'lib, asosan dunyoviy muassasalar bo'lib, ko'pchilik erkaklar yoki ayollar, fuqarolik yoki harbiylar, bolalar yoki kattalar, boy yoki kambag'al, musulmon yoki musulmon bo'lmaganlar uchun ochiqdir. Islom kasalxonasi davolanish markazi, kasallik yoki baxtsiz hodisalardan so'ng tuzaladigan bemorlar uchun uy, aqldan ozganlar uchun boshpana va qariyalar va nogironlarni parvarish qilish uchun zarur bo'lgan qariyalar uyi sifatida bir qancha maqsadlarni ko'zlagan.[36]

Odatda shifoxona tizimli kasalliklar, jarrohlik va ortopediya kabi bo'limlarga bo'linib, turli xil ixtisoslarga ega bo'lgan katta kasalxonalar mavjud edi. "Tizimli kasalliklar" bugungi kunning deyarli ekvivalenti edi ichki kasalliklar va qo'shimcha ravishda isitma, yuqumli kasalliklar va ovqat hazm qilish muammolari kabi bo'limlarga bo'lingan. Har bir bo'limda mas'ul ofitser, raislik qiluvchi va nazorat qiluvchi mutaxassis bor edi. Kasalxonalarda ma'ruza teatrlari va kutubxonalar ham mavjud edi. Kasalxonalar xodimlari tarkibiga tozalikni tartibga soluvchi sanitariya inspektorlari va buxgalterlar va boshqa ma'muriy xodimlar kirgan.[31] Bog'doddagi kasalxonada yigirma beshta xodim shifokor ishlagan.[37] Kasalxonalarni odatda mutavalli (dekan) bo'lib xizmat qilgan bosh vrach bilan teng bo'lgan shayx saydalani deb nomlangan, tibbiy bo'lmagan ma'mur, bosh farmatsevt, tarkibida uch kishilik kengash boshqargan.[38] Tibbiy muassasalar har kuni an'anaviy ravishda yopilib turar edi, ammo X asrga kelib shifoxonalarni 24 soat ochiq holda ishlashga oid qonunlar qabul qilindi.[39]

Kamroq bo'lgan holatlarda shifokorlar ambulatoriya poliklinikalarida ishladilar. Shaharlarda, shuningdek, tez-tez gavjum jamoat joylarida joylashgan favqulodda vaziyatlarda shifokorlar tomonidan ish olib borilgan birinchi yordam markazlari mavjud edi, masalan, qurbonlar haqida g'amxo'rlik qilish uchun juma namozi uchun katta yig'ilishlar. Shuningdek, mintaqada shifokorlar va farmatsevtlar tomonidan ishlaydigan chekka aholi ehtiyojlarini qondirishi kerak bo'lgan ko'chma bo'linmalar mavjud edi. Vazir 'Ali ibn Iso ibn Jarax ibn Sobit Bog'dodning bosh vrachiga "qamoqxonalarda har kuni ularni tekshirishi kerak bo'lgan o'zlarining shifokorlari bo'lishi kerak" deb yozganidan so'ng, Bag'dod mahkumlar uchun alohida kasalxonaga ega bo'lganligi ham ma'lum bo'lgan. Misrda, Qohiraning janubi-g'arbiy qismida joylashgan birinchi kasalxona, parvarish qilingan birinchi hujjatlashtirilgan bino edi ruhiy kasalliklar birinchi islomiy esa psixiatriya kasalxonasi Bog'dodda 705 yilda ochilgan.[40][31]

Tibbiyot talabalari shifokorlarga hamroh bo'lib, bemorlarni parvarish qilishda ishtirok etishadi. Ushbu davrdagi kasalxonalar birinchi bo'lib shifokorlarni litsenziyalash uchun tibbiy diplom talab qilishgan.[41] Litsenziyalash testi viloyat hukumati tomonidan tayinlangan bosh shifokor tomonidan o'tkazildi. Sinov ikki bosqichdan iborat edi; birinchisi, nomzod nomzodga sertifikat, dastlabki tadqiqotlar yoki mavjud bo'lgan matnlarning sharhlarini sertifikat olishni istagan risola yozish, ularni xatolar uchun sinchkovlik bilan tekshirishga da'vat etilgan. Ikkinchi qadam, bosh tibbiyot xodimi bilan suhbatda savollarga javob berish edi. Shifokorlar belgilangan soatlarda ishladilar va tibbiyot xodimlarining ish haqi qonun bilan belgilandi. Xizmat ko'rsatish sifatini tartibga solish va hakamlik sudlari bilan bog'liq holda, agar bemor vafot etsa, ularning oilasi shifokorning ko'rsatmalarini bosh vrachga etkazadi, agar o'lim tabiiy ravishda yoki beparvolik bilan sodir bo'lsa, u holda oila bu ishni qiladimi? shifokor tomonidan tovon puli olish huquqiga ega bo'lish. Kasalxonalarda erkaklar va ayollar turar joylari bo'lgan, ba'zi shifoxonalarda faqat erkaklar va ayollar shifokori ishlaydigan boshqa kasalxonalar faqat ayollarni ko'rishgan.[31] Ayol shifokorlar tibbiyot bilan shug'ullangan bo'lsalar, ko'pchilik asosan e'tiborini qaratgan akusherlik.[42]

Kasalxonalarga pul to'lay olmayotgan bemorlarni chetga surish qonunda taqiqlangan edi.[39] Oxir-oqibat, xayriya fondlari deb nomlangan vaqflar kasalxonalarni, shuningdek maktablarni qo'llab-quvvatlash uchun tuzilgan.[39] Davlat byudjetining bir qismi kasalxonalarni saqlashga ham sarflandi.[31] Shifoxona xizmatlari barcha fuqarolar uchun bepul edi[39] va bemorlarga ba'zida kasalxonadan chiqqandan keyin tiklanishni qo'llab-quvvatlash uchun kichik miqdordagi stipendiya berilardi, ayrim shifokorlar vaqti-vaqti bilan to'lovlarni oladilar.[31] Misrning XIII asrdagi hokimi e'tiborga loyiq ehsonda Al Mansur Kalavun uchun poydevor tayinladi Qalavun kasalxonasi masjid va ibodatxonani, turli kasalliklar bo'yicha alohida bo'limlarni, shifokorlar uchun kutubxonani va dorixonani o'z ichiga oladi[43] va kasalxona bugungi kunda foydalanilmoqda oftalmologiya.[31] Qalavun kasalxonasi sobiq Fotimidlar saroyida joylashgan bo'lib, u 8000 kishiga mo'ljallangan edi.[44] "bu kuniga 4000 bemorga xizmat ko'rsatdi."[45] Vaqfda shunday deyilgan:

... Kasalxona, barcha bemorlar, erkaklar va ayollar, ular to'liq tiklanishigacha saqlanadi. Odamlar uzoq yoki yaqin bo'lishidan qat'i nazar, aholi yoki chet ellik bo'lishidan qat'i nazar, kuchli yoki kuchsiz, past yoki baland, boy yoki kambag'al, ish bilan ta'minlangan yoki ishsiz, ko'r yoki ko'zi ojiz, jismonan yoki ruhiy kasal bo'lgan, barcha xarajatlarni shifoxona o'z zimmasiga oladi. o'qigan yoki savodsiz. Ko'rib chiqish va to'lash shartlari mavjud emas, to'lovlarni to'lamaslik uchun hech kim e'tiroz bildirmaydi va hatto bilvosita shama qilmaydi.[43]

O'rta asr islom dunyosidagi birinchi, eng taniqli tabiblar X-XI asrlar davomida Ibn Sino, (yunoncha Avitsenna) va Al Razi (yunoncha: Rhazes) polimatlaridir.[46]

O'rta asr Evropa kasalxonalari

Cherkov Les Invalides kasalxonalar va katolik cherkovi o'rtasidagi odatda yaqin aloqani ko'rsatib, Parijda

Evropadagi O'rta asr shifoxonalari xuddi shunday uslubga amal qilgan Vizantiya. Ular tomonidan g'amxo'rlik ko'rsatiladigan diniy jamoalar bo'lgan rohiblar va rohibalar. Qadimgi frantsuzcha shifoxona atamasi otel-Dieu, "Xudoning yotoqxonasi". Ba'zilar monastirlarga biriktirilgan; boshqalar mustaqil bo'lib, o'zlarining vaqflariga, odatda mulklariga ega edilar, bu esa ularni qo'llab-quvvatlash uchun daromad keltirardi. Ba'zi kasalxonalar ko'p funktsional bo'lgan, boshqalari esa moxov kasalxonalari yoki kambag'allar uchun boshpana sifatida maxsus maqsadlar uchun tashkil etilgan. ziyoratchilar: hamma ham kasallarga g'amxo'rlik qilmaydi.

Miloddan avvalgi 529 yil St. Nursiya Benedikti (Milodiy 480-543), keyinchalik xristian avliyosi, g'arbiy asoschisi monastirizm va Sankt-Benedikt ordeni, bugun homiysi avliyo Evropaning birinchisi monastir Evropada (Monte Kassino ) orasidagi tepalikda Rim va Neapol, bu G'arb monastiri va O'rta asrlarda Evropaning yirik madaniy markazlaridan biri uchun namuna bo'ldi. Aziz Benedikt yozgan Sankt-Benediktning qoidasi bu kasallarga g'amxo'rlik qilish uchun axloqiy majburiyatlarni talab qildi.

Katolik tomonidan tashkil etilgan birinchi ispan kasalxonasi Visigot episkop Masona milodiy 580 yilda Merida, edi a ksenodoxium sayohatchilar uchun mehmonxona (asosan ziyoratchilar ziyoratgohi sifatida yaratilgan) Meridalik Eulaliya ) shuningdek, fuqarolar va mahalliy fermerlar uchun shifoxona. Kasalxonaning yordami bemorlar va mehmonlarni ovqatlantirish uchun fermer xo'jaliklaridan iborat edi. Pol Deakon bergan ma'lumotlardan bilib olamizki, ushbu shifoxona shifokorlar va hamshiralar bilan ta'minlangan bo'lib, ularning vazifasi kasallarni qaerda bo'lmasin "qul yoki ozod, nasroniy yoki yahudiy" kabi parvarish qilishni o'z ichiga olgan.[47]650 yilda "Otel-Dieu "Parijda topilgan,[48] u bugungi kunda ham faoliyat ko'rsatayotgan dunyo bo'ylab eng qadimgi kasalxona hisoblanadi.[49] Bu bemorlar va kambag'allarga xizmat ko'rsatadigan, boshpana, oziq-ovqat va tibbiy yordam ko'rsatadigan ko'p maqsadli muassasa edi.

8-asr oxiri va 9-asr boshlarida imperator Buyuk Karl o'z davridan oldin yaxshi qurilgan va buzilib ketgan kasalxonalarni vaqt talablariga binoan tiklashni buyurdi.[50] Keyinchalik u har bir sobor va monastirga kasalxonani biriktirishni buyurdi.[50]

10-asr davomida monastirlar kasalxonada ishlashning asosiy omiliga aylandi. 910 yilda tashkil etilgan taniqli Kluni ibodatxonasi butun Frantsiya va Germaniyada keng taqlid qilingan namunani ko'rsatdi. Dindorlar uchun shifoxonasidan tashqari, har bir monastirda shifoxonalar mavjud bo'lib, ularda eksternalar parvarish qilingan. Ular mas'ul edilar eleemosinarius, uning vazifalari, qoida bilan ehtiyotkorlik bilan belgilangan, tashrif buyuruvchi yoki bemor talab qilishi mumkin bo'lgan har qanday xizmatni o'z ichiga olgan.

Eleemosynarius mahallada kasal va muhtojlarni izlashga majbur bo'lganligi sababli, har bir monastir azob-uqubatlarni bartaraf etish markaziga aylandi. Bu borada diqqatga sazovor bo'lgan monastirlar orasida Pikardidagi Korbidagi Benediktinlar, Xirschau, Braunvayler, Doyts, Ilsenburg, Lizborn, Pram va Fulda ham bor edi; Arnsberg, Baumgarten, Eberbax, Himmenrode, Herrnalb, Volkenrod va Uolkenriddagi tsisteristlar.

Parijdagi Hotel-Dieu v. 1500. Nisbatan yaxshi bemorlar (o'ngda) og'ir kasallardan (chapda) ajratilgan.

Tomonidan qilingan ish kam samarali emas edi yepiskop ruhoniylari Axen (817, 836) kengashlarining intizomiy qarorlariga binoan, har bir kollegial cherkov bilan bog'liq holda shifoxonani saqlash kerakligini belgilab qo'ydi. Kanonlar shifoxonani qo'llab-quvvatlashga yordam berishlari kerak edi, va ularning sonidan biri mahbuslarga javobgar edi. Ushbu kasalxonalar shaharlarda joylashganligi sababli, ularga monastirlarga biriktirilganlarga qaraganda ko'proq talablar qo'yilgan. Ushbu harakatda episkop tabiiy ravishda etakchilikni o'z zimmasiga oldi, shu sababli asos solgan kasalxonalar Heribert (vafot 1021) yilda Kyoln, Godard (vafoti 1038) yilda Xildesxaym, Konrad (vafot 975) yilda Konstans va Ulrich (vafot 973) yilda Augsburg. Ammo boshqa cherkovlar ham shunga o'xshash ta'minotni amalga oshirdilar; shunday qilib Trier ning kasalxonalari Avliyo Maksimin, Avliyo Metyu, Avliyo Shimo'n va Seynt Jeyms o'zlari biriktirilgan cherkovlardan ularning ismlarini oldi. 1207–1577 yillarda Germaniyada bir yuz ellik beshta kasalxonalar tashkil etilgan.[51]

The Ospedeyl Magjiore, an'anaviy ravishda Ca 'Granda (ya'ni Katta Uy) deb nomlangan Milan, shimoliy Italiya, birinchi jamoat shifoxonalaridan birini joylashtirish uchun qurilgan, bu XV asrning eng yirik korxonasi. Tomonidan topshirilgan Franchesko Sforza 1456 yilda va tomonidan ishlab chiqilgan Antonio Filarete Lombardiyadagi Uyg'onish davri me'morchiligining birinchi namunalaridan biri.[52]

Normanlar 1066 yilda Angliyani zabt etganda o'zlarining shifoxona tizimini olib kelishdi. An'anaviy er egaligi va urf-odatlari bilan birlashib, yangi xayriya uylari mashhur bo'lib, ingliz monastirlari va frantsuz shifoxonalaridan ajralib turardi. Ular sadaqa va ba'zi dori-darmonlarni tarqatishdi va o'limdan keyin ma'naviy mukofotlarga umid bog'lagan zodagonlar va janoblar ularga saxiylik bilan yordam berishdi.[53]

Kechki o'rta asrlardagi Evropa kasalxonalari

1099 yilda (Malta ritsarlari) tashkil etilgan Quddusning Avliyo Ioann kasalxonasi ordeni - uning raisi sifatida - Muqaddas erga ziyoratchilar uchun shifoxonaning tashkil etilishi. Evropada Ispaniya shifoxonalari xastalikka g'amxo'rlik qilish orqali namoyon bo'lgan nasroniy fazilatining ayniqsa diqqatga sazovor namunalari bo'lib, odatda monastirga cherkov-cherkov konfiguratsiyasida biriktirilgan bo'lib, ko'pincha xoch shaklida qurilgan. Ushbu uslub XVI asrda portugaliyalik Xudoning Aziz Yuhanno kasalxonasini qurish kampaniyasida, Xudoning Yuhanno Aka-ukalari uchun Hospitaller ordeni asoschisi bo'lgan yuqori darajaga yetdi.[54]

Yaqinda Evropada ko'plab monastirlar tashkil topdi va hamma joyda Monte Kassino singari kasalxonalar mavjud edi. XI asrga kelib, ba'zi monastirlar o'zlarining tabiblarini tayyorlaydilar. Ideal holda, bunday shifokorlar barcha bemorlar va askarlarga, ularning mavqei va prognozi qanday bo'lishidan qat'i nazar, rahm-shafqat va xayriya ko'rsatgan davolovchi nasroniylashtirilgan idealni qo'llab-quvvatlaydi. VI-XII asrlarda benediktinlar bu turdagi ko'plab rohiblar jamoalarini tashkil qildilar. Keyinchalik, 12-13 asrlarda Benediktinlar buyrug'i bilan dastlab kasallar va yaradorlarga umumiy yordam ko'rsatish, so'ngra sifilizni davolash va yuqumli kasallik bilan kasallanganlarni ajratish uchun mustaqil kasalxonalar tarmog'i qurildi. Kasalxonalar harakati keyingi asrlarda Evropada tarqalib, 1287 yilda Yorkda 225 o'rinli shifoxona qurilgan va Florensiya, Parij, Milan, Siena va boshqa o'rta asrlarning yirik Evropa shaharlarida barpo etilgan yirik binolar.

Saksoniya davrida shimolda monastirlar, ruhoniylar va kasalxonalar asosan kambag'allarga xayriya joyi sifatida faoliyat ko'rsatgan. Keyin Norman fathi 1066 kasalxonalar avtonom, mustaqil muassasa deb topilgan. Ular sadaqa va ba'zi dori-darmonlarni tarqatishdi va o'limdan keyin ma'naviy mukofotlarga umid bog'lagan zodagonlar va janoblar saxiylik bilan berdilar.[55] Vaqt o'tishi bilan shifoxonalar ingliz monastirlari va Frantsiya kasalxonalaridan ajralib turadigan mashhur xayriya uylariga aylandi.

O'rta asr kasalxonalarining asosiy vazifasi Xudoga sig'inish edi. Ko'pgina shifoxonalarda bitta cherkov, kamida bitta ruhoniy va mahbuslar ibodat qilishda yordam berishlari kerak edi. Ibodat qilish g'amxo'rlikdan ko'ra ko'proq ustuvor vazifa bo'lib, shifoxona hayotining katta qismi edi va undan keyin ham Islohot. O'rta asr shifoxonalariga sig'inish kasallardan xalos bo'lish va kasallikdan qutulish imkoni bo'lmaganda ularning xalos bo'lishini ta'minlash uchun xizmat qilgan.[56][57]

Xarobalari Sent-Giles kasalxonasi (Buyuk kasalxona)
Sent-Leonard kasalxonasining xarobalari.

O'rta asr kasalxonalarining ikkinchi darajali vazifasi kambag'allarga, kasallarga va sayohatchilarga xayriya qilish edi. Kasalxonalar tomonidan beriladigan xayriya turli yo'llar bilan yuzaga keldi, shu jumladan zaiflarni uzoq muddatli saqlash, kasallarga o'rta muddatli yordam ko'rsatish, sayohatchilarga qisqa muddatli mehmondo'stlik va kambag'allarga muntazam ravishda sadaqa tarqatish.[56]:58 O'rta asr kasalxonalari orasida bu umumiy xayriya ishlari bo'lsa-da, xayriya darajasi o'zgaruvchan edi. Masalan, o'zlarini asosan diniy uy yoki mehmondo'stlik deb bilgan ba'zi muassasalar, qiyin sog'liqni saqlash ibodat qilishdan chalg'itishi mumkinligidan qo'rqib, kasallarni yoki o'lishni boshladilar. Biroq, boshqalar, masalan, Northallerton shahridagi Sent-Jeyms, Norvich shahridagi Sent-Giles kasalxonasi va Sent-Leonard kasalxonasi Yorkda, bemorlarga murojaat qilishlari kerakligi va "sog'lig'i yomon kirib kelganlarning hammasi tuzalguncha yoki vafot etguniga qadar turishiga ruxsat berilishi kerak" degan maxsus farmonlar mavjud edi.[56]:58[58]:23 Ushbu uchta kasalxonani o'rganish Evropaning o'rta asr kasalxonasida ovqatlanish, tibbiy yordam, tozalik va kundalik hayot haqida tushuncha beradi.

O'rta asr kasalxonalarining uchinchi vazifasi ta'lim va ta'limni qo'llab-quvvatlashdan iborat edi. Dastlab shifoxonalarda ruhoniylar va ruhoniylarning birodarlari savodxonlik va tarix bo'yicha ma'lumot olishgan; ammo, 13-asrga kelib, ba'zi kasalxonalar qashshoq o'g'il bolalar va yoshlarni o'qitishga kirishdilar. Ko'p o'tmay, kasalxonalar shifoxonadagi ibodatxonalarda yordam berish evaziga kasalxonadagi olimlarga oziq-ovqat va uy-joy bilan ta'minlay boshladilar.[56]:65

16-17 asrlar

XVI-XVII asrlarda mashhur shifoxonalar Vikipediyadagi maqolalari bilan

16-chi (18)17-chi (17)

Dastlabki zamonaviy Evropa

Shifokorga tashrif buyuradigan shifokor kasal kasalxonada, nemis o'yma 1682 yildan

Evropada O'rta asrlarda nasroniylik g'amxo'rligi kontseptsiyasi XVI-XVII asrlarda dunyoviy tushunchaga aylandi.[59] Ilohiyot muammo edi. Protestant islohotchilari katoliklarning boy odamlar yaxshi ishlar orqali Xudoning marhamatiga sazovor bo'lishlari va poklanishdan qutulishlari - xayriya tashkilotlariga xayriya mablag'lari berishlari va bemorlarning o'zlari azob-uqubatlar orqali inoyat olishlari mumkinligiga ishonishdi.[60]

Keyin monastirlarni tarqatib yuborish 1540 yilda King tomonidan Genri VIII cherkov kasalxonalarning yordamchisi bo'lishni to'satdan to'xtatdi va faqat fuqarolarning to'g'ridan-to'g'ri iltimosnomasi bilan London, kasalxonalar edi Sent-Bartolomeyniki, Sent-Tomasniki va Baytlahmdagi Sent-Meri (Bedlam) to'g'ridan-to'g'ri toj bilan ta'minlangan.[61] Aynan Sankt-Bartolomeyda bo'lgan Uilyam Xarvi 17-asrda qon aylanish tizimi bo'yicha tadqiqotlarini olib borgan, Percivall Pott va John Abernethy 18-asrda zamonaviy jarrohlikning muhim tamoyillarini ishlab chiqdi va Fenvich xonim 19-asrning oxirida hamshiralik kasbini rivojlantirish uchun harakat qildi.[62]

28 ta boshpana bor edi Shvetsiya boshida Islohot. Gustav Vasa ularni cherkov nazorati ostidan olib tashladi va rohiblar va rohibalarni chiqarib yubordi, ammo boshpana o'z mulklarini saqlab qolishlariga va mahalliy hukumat homiyligida o'z faoliyatini davom ettirishlariga imkon berdi.[63]

Evropaning ko'p qismida shahar hukumatlari 13-14 asrlarda tashkil etilgan kichik Muqaddas Ruh kasalxonalarini boshqargan. Ular kambag'allarga bepul oziq-ovqat va kiyim-kechak tarqatishdi, uysiz ayollar va bolalar uchun yordam berishdi va ba'zi tibbiy va hamshiralik yordamlarini berishdi. Ko'pchilik reyd paytida yopildi O'ttiz yillik urush (1618-48), bu o'ttiz yil davomida Germaniya va qo'shni hududlarning shahar va qishloqlarini vayron qilgan.

Ayni paytda, kabi katolik mamlakatlarida Frantsiya, boy oilalar kambag'allarga bepul tibbiy xizmat ko'rsatadigan konvensiyalar va monastirlarni moliyalashtirishni davom ettirdilar. Frantsuz amaliyotlariga xayriya ko'rsatmasi ta'sir ko'rsatdi, u kambag'allarga va kasallarga g'amxo'rlik qilishni katolik amaliyotining zaruriy qismi deb hisobladi. Emizuvchi rohibalar bemorlarni davolash uchun faqat shifokorlarning kuchiga va ularning dori-darmonlariga ishonishmagan; Eng muhimi, psixologik va jismoniy qulaylik, ovqatlanish, dam olish, poklik va ayniqsa ibodat qilish edi.[64]

Protestantlik yo'nalishlarida bemorlarga g'amxo'rlik qilishning diniy yo'nalishlariga emas, balki ilmiy jihatdan ko'proq e'tibor berildi va bu hamshiralikni kasb sifatida emas, balki kasb sifatida qarashga yordam berdi.[65] 1530 yildan keyin asosiy protestant cherkovlari tomonidan kasalxonalarning rivojlanishi kam bo'lgan.[66] Xorldagi Moraviyaliklar va Pietistlar kabi ba'zi kichik guruhlar shifoxonalarda, ayniqsa missionerlik ishlarida rol o'ynagan.[67]

Mustamlaka Amerika

Hospicio Cabañas yilda mustamlaka Amerikadagi eng katta kasalxona bo'lgan Gvadalaxara, Meksika

Amerikada tashkil etilgan birinchi kasalxona bu San-Nicolás de Bari kasalxonasi yilda Santo-Domingo, Distrito Nacional Dominika Respublikasi. Fray Nikolas de Ovando, 1502 yildan 1509 yilgacha Ispaniya gubernatori va mustamlakachi ma'muri tomonidan 1503 yil 29 dekabrda qurilishiga ruxsat berildi. Ushbu shifoxona aftidan cherkov tarkibiga kirgan. Uning qurilishining birinchi bosqichi 1519 yilda tugatilgan va u 1552 yilda qayta qurilgan.[68] 18-asrning o'rtalarida tashlab yuborilgan kasalxona hozirda uning yonida xarobalarda Santa-Mariya-la-Menor bazilikasi sobori Santo-Domingoda.

Konkistador Ernan Kortes Shimoliy Amerikadagi ikkita dastlabki kasalxonaga asos solgan: Immaculate Conception Hospital va Saint Lazarus Hospital. Qadimgi Immaculate Concepts edi, endi Xesus Nazarenoning kasalxonasi yilda Mexiko, kambag'allarga g'amxo'rlik qilish uchun 1524 yilda tashkil etilgan.[68]

Kvebekda katoliklar kasalxonalarni 1640-yillardan doimiy ravishda boshqarib turishgan; ular viloyat elitasidan rohibalarni jalb qildilar. Jeanne Mance (1606–73) Monreal shahridagi birinchi kasalxonaga asos solgan Hotel-Dieu-de-Montreal, 1645 yilda. 1657 yilda u o'zining uchta singlisini yolladi Aziz Jozefning diniy kasalxonalari va kasalxonani boshqarishda davom etdi. Ning jiyani tomonidan boshlangan loyiha Kardinal de Richelieu qirol tomonidan qirollik nizomi berilgan Lyudovik XIII va mustamlakachi shifokor tomonidan ishlaydi, Robert Giffard de Moncel.[69] Kvebek shahridagi umumiy kasalxona 1692 yilda ochilgan. Ular ko'pincha bezgak, dizenteriya va nafas olish yo'llari kasalliklarini davolashgan.[70]

18-asr

Shuningdek qarang: Turkum: 18-asrda tashkil etilgan kasalxonalar

Ta'siri ostida 18-asrda Ma'rifat davri, zamonaviy kasalxona paydo bo'ldi, u faqat tibbiy ehtiyojlarga xizmat qiladi va malakali shifokorlar va jarrohlar bilan ta'minlangan. Hamshiralar o'qimagan ishchilar edi. Maqsad bemorlarni davolashda zamonaviy usullardan foydalanish edi. Ular torroq tibbiy xizmatlar ko'rsatdilar va dunyoviy hokimiyat tomonidan tashkil etildi. Tibbiyot va yomon yordam o'rtasida aniqroq farq paydo bo'ldi. Kasalxonalarda o'tkir holatlar tobora ko'proq davolanmoqda va bemorlarning turli toifalari uchun alohida bo'limlar tashkil etildi.

1820 yil o'ymakorligi Yigit kasalxonasi yilda London 1724 yilda tashkil etilgan birinchi ixtiyoriy kasalxonalardan biri.

Ixtiyoriy kasalxonalar harakati 18-asrning boshlarida boshlandi, 1710 va 20-yillarda Londonda kasalxonalar tashkil etilgan, shu jumladan Vestminster kasalxonasi Tomonidan targ'ib qilingan (1719) xususiy bank C. Hoare va Co va Yigit kasalxonasi (1724) boy savdogarning vasiyatidan moliyalashtirilgan, Tomas Gay. Asrlar davomida Londonda va Britaniyaning boshqa shaharlarida boshqa kasalxonalar paydo bo'ldi, ularning ko'pchiligi xususiy obuna orqali to'lashdi. Londondagi Avliyo Bartolomey 1730 yilda qayta qurilgan va London kasalxonasi 1752 yilda ochilgan.

Ushbu shifoxonalar muassasa faoliyatida tub burilish yasagan; ular kasallarni parvarish qilishning asosiy joylaridan tibbiy innovatsiyalar va kashfiyotlar markaziga aylanib, kasallikning asosiy joyiga aylana boshladilar. ta'lim va istiqbolli amaliyotchilarni tayyorlash. Bu davrning eng buyuklari jarrohlar shifokorlar kasalxonalarda ishladilar va o'z bilimlarini o'tqazdilar.[71] Ular shuningdek, shunchaki boshpana uyi bo'lishdan, dori-darmon va kasallarni parvarish qilish bo'yicha murakkab muassasalarga aylandilar. The Charite King tomonidan 1710 yilda Berlinda tashkil etilgan Prussiyalik Frederik I vabo tarqalishiga javob sifatida.

Ixtiyoriy kasalxonalar tushunchasi ham tarqaldi Mustamlaka Amerika; The Bellevue kasalxonasi 1736 yilda ochilgan, Pensilvaniya kasalxonasi 1752 yilda, Nyu-York kasalxonasi 1771 yilda va Massachusets umumiy kasalxonasi 1811 yilda. Qachon Vena umumiy kasalxonasi 1784 yilda ochilgan (bir zumda dunyodagi eng katta kasalxonaga aylangan) shifokorlar asta-sekin eng muhim tadqiqot markazlaridan biriga aylanib ulgurgan yangi muassasaga ega bo'lishdi.[72]

Boshqa Ma'rifat davr xayriya yangiliklari dispanser bo'lgan; Bular kambag'allarni chiqaradi dorilar bepul. London dispanseri o'z eshiklarini 1696 yilda Britaniya imperiyasidagi birinchi shunday klinika sifatida ochgan. Ushbu g'oya 1770-yillarga qadar asta-sekin qo'lga kiritildi, shu vaqtgacha ko'plab bunday tashkilotlar paydo bo'la boshladi, shu jumladan Edinburg jamoat dispanseri (1776), Metropolitan dispanseri va xayriya jamg'armasi (1779) va Finsberi dispanseri (1780). Shuningdek, dispanserlar Nyu-Yorkda 1771, Filadelfiyada 1786 va Bostonda 1796 yillarda ochilgan.[73]

Evropa bo'ylab tibbiyot maktablari hali ham asosan ma'ruzalar va o'qishlarga tayanar edi. Oxirgi yili talabalar kafedralar orqali professorni kuzatib borish bilan cheklangan klinik tajribaga ega bo'lishadi. Laboratoriya ishi odatiy bo'lmagan va diseksiyalar qonuniy cheklovlar tufayli kamdan-kam hollarda bajarilgan kadavrlar. Aksariyat maktablar kichik edi va faqat Edinburg, Shotlandiya 11000 nafar bitiruvchilar bilan ko'plab bitiruvchilarni ishlab chiqarishdi.[74][75]

19-asr

Shuningdek qarang: Turkum: 19-asrda tashkil etilgan kasalxonalar

Ingliz shifokori Tomas Persival (1740-1804) tibbiy xulq-atvorning to'liq tizimini yozgan, Tibbiy axloq; yoki Shifokorlar va jarrohlarning kasbiy faoliyatiga moslashtirilgan institutlar va ko'rsatmalar to'g'risidagi kodeks (1803) ko'plab darsliklar uchun standart o'rnatgan.[76]

Kasalxona bo'limi Skutari qayerda Florens Nightingale zamonaviy kasalxonani qayta ishlashga yordam berdi va yordam berdi.

19-asr o'rtalarida kasalxonalar menejmenti byurokratik va ma'muriy yo'nalishlar bo'yicha qayta tashkil etilib, kasalxonalar va tibbiyot kasbi yanada professionallashdi. The Apotekalar to'g'risidagi qonun 1815 tibbiyot fakulteti talabalari kamida yarim yil davomida shifoxonada o'zlarining mashg'ulotlari davomida mashq qilishlari shart.[77] Ushbu professionalizatsiyaning misoli Charing Xoch kasalxonasi, 1818 yilda doktor tomonidan taqdim etilgan mablag'lar hisobidan 'G'arbiy London kasalxonasi va dispanseri' sifatida tashkil etilgan. Benjamin Golding. 1821 yilga kelib u yiliga 10 mingga yaqin bemorni davolagan va u yaqinroq joylarga ko'chirilgan Charing xoch Londonning markazida. Uning Charing Cross Hospital tibbiyot maktabi 1822 yilda ochilgan. U bir necha bor kengayib, 1866 yilda hamshiralar tarkibiga professional xodimlar qo'shildi.[78]

Reanimatsiya xonadan keyin yotoq travma zamonaviy kasalxonalarning yuqori texnik jihozlarini ko'rsatadigan aralashuv

Florens Nightingale zamonaviy kasbiga kashshof bo'lgan hamshiralik davomida Qrim urushi u rahm-shafqat, bemorlarni parvarish qilishga sodiqlik va g'ayratli va o'ychan kasalxonani boshqarish namunasini ko'rsatganida. Birinchi rasmiy opa-singillar tayyorlash dasturi - hamshiralar uchun Nightingale maktabi 1860 yilda ochilgan bo'lib, kasalxonalarda ishlash, kambag'allar bilan ishlash va o'qitish uchun hamshiralarni tayyorlash vazifasi qo'yilgan.[79]

Bulbul kasalxonani yaxshilash orqali shifoxonaning tabiatini isloh qilishda muhim rol o'ynadi sanitariya standartlar va kasalxonaning qiyofasini o'zgartirish bemorlar o'lishi kerak bo'lgan joydan, sog'ayish va davolanishga bag'ishlangan muassasaga. U shuningdek, muhimligini ta'kidladi statistik o'lchov berilgan aralashuvning muvaffaqiyat darajasini aniqlash uchun ma'muriy islohot kasalxonalarda.[80]

19-asrning o'rtalarida, Ikkinchi Vena tibbiyot maktabi kabi shifokorlarning hissasi bilan paydo bo'ldi Karl Freyherr fon Rokitanskiy, Yozef Shkoda, Ferdinand Ritter fon Hebra va Ignaz Filipp Semmelveys. Asosiy tibbiyot fani kengayib, ixtisoslashuvi rivojlandi. Bundan tashqari, dunyodagi birinchi dermatologiya, ko'z, shuningdek quloq, burun va tomoq klinikalari tashkil etilgan Vena.[81]

19-asrning oxiriga kelib, zamonaviy shifoxona turli xil davlat va xususiy shifoxona tizimlarining ko'payishi bilan shakllana boshladi. 1870-yillarga kelib kasalxonalar 3000 bemorni o'rtacha qabul qilish hajmini uch barobardan ko'proq oshirdi. Yilda Evropa qit'asi yangi kasalxonalar odatda qurilgan va ishlatilgan davlat mablag'lari. 20-asrning boshlarida hamshiralik Frantsiyada professional bo'ldi. O'sha paytda mamlakatdagi 1500 kasalxonani 15 ming kishi boshqargan rohibalar 200 dan ortiq vakillar diniy buyruqlar. 1900 yildan keyin hukumat siyosati dunyoviylashtirish davlat muassasalari va rolini kamaytirish Katolik cherkovi. Ushbu siyosiy maqsad antiqa muassasalarda tibbiy xizmatni yanada sifatli qilish zarurati bilan ziddiyatga keldi. Hukumat tasarrufidagi yangi hamshiralar maktablari nazorat rollariga tayinlangan dinsiz hamshiralar bo'lib chiqdi. Davomida Birinchi jahon urushi, chiqib ketish patriotic volunteers brought large numbers of untrained middle-class women into the military hospitals. They left when the war ended but the long-term effect was to heighten the prestige of nursing. In 1922 the government issued a national diploma for nursing.[82]

In the U.S., the number of hospitals reached 4400 in 1910, when they provided 420,000 beds.[83] These were operated by city, state and federal agencies, by churches, by stand-alone non-profits, and by foyda olish uchun korxonalar. All the major denominations built hospitals; the 541 Catholic ones (in 1915) were staffed primarily by unpaid nuns. The others sometimes had a small cadre of dikonessalar as staff.[84] Non-profit hospitals were supplemented by large davlat kasalxonalari in major cities and research hospitals often affiliated with a medical school. The largest public hospital system in America is the Nyu-York Sog'liqni saqlash va shifoxonalar korporatsiyasi o'z ichiga oladi Bellevue kasalxonasi, the oldest U.S. hospital, affiliated with Nyu-York universiteti tibbiyot maktabi.[85]

The Milliy sog'liqni saqlash xizmati, the principal provider of health care in Britain, was founded in 1948, and took control of nearly all the hospitals.[86]

Parij tibbiyoti

At the turn of the 19th century, Paris medicine played a significant role in shaping clinical medicine. New emphasis on physically examining the body led to methods such as perkussiya, inspection, palpation, auskultatsiya va otopsi.[87] The situation in Paris was particularly unique due to the fact that there was a very large concentration of medical professionals in a very small setting allowing for a large flow of ideas and the spread of innovation.[87] One of the innovations to come out of the Paris hospital setting was Laennec "s stetoskop. Weiner states that the widespread acceptance of the stethoscope would likely not have happened in any other setting, and the setting allowed for Laennec to pass on this technology to the eager medical community that had gathered there. This invention also brought even more attention to the Paris scene.[87]

Before the start of the 19th century, there were many problems existing within the French medical system. These problems were outlined by many seeking to reform hospitals including a contemporary surgeon Jacques Tenon in his book Memoirs on Paris Hospitals. Some of the problems Tenon drew attention to were the lack of space, the inability to separate patients based on the type of illness (including those that were contagious), and general sanitation problems.[88] Additionally, the secular revolution led to the nationalization of hospitals previously owned by the Catholic Church and led to a call for a hospital reform which actually pushed for the deinstitutionalization of medicine.[89] This contributed to the state of disarray Paris hospitals soon fell into which ultimately called for the establishment of a new hospital system outlined in the law of 1794. The law of 1794 played a significant part in revolutionizing Paris Medicine because it aimed to address some of the problems facing Paris Hospitals of the time.

First, the law of 1794 created three new schools in Paris, Montpellier, and Strasbour due to the lack of medical professionals available to treat a growing French army. It also gave physicians and surgeons equal status in the hospital environment, whereas previously physicians were regarded as intellectually superior.[89] This led to the integration of surgery into traditional medical education contributing to a new breed of doctors that focused on patologiya, anatomiya va diagnostika. The new focus on anatomy was further facilitated by this law because it ensured that medical students had enough bodies to dissect.[89] Additionally, pathological education was furthered by the increased use of autopsies to determine a patient's cause of death.[87] Lastly, the law of 1794 allocated funds for full-time salaried teachers in hospitals, as well as creating scholarships for medical students.[89] Overall, the law of 1794 contributed to the shift of medical teaching away from theory and towards practice and experience, all within a hospital setting. Hospitals became a center for learning and development of medical techniques, which was a departure from the previous notion of a hospital as an area that accepted people who needed help of any kind, ill or not.[90] This shift was consistent with much of the philosophy of the time, particularly the ideas of John Locke who preached that observation using ones senses was the best way to analyze and understand a phenomenon.[89] Foukalt, however, criticized this shift in his book Klinikaning tug'ilishi, stating that this shift took attention away from the patient and objectified patients, ultimately resulting in a loss of the patient's narrative. He argued that from this point forward, in the eyes of doctors, patients lost their humanity and became more like objects for inspection and examination.[91]

The next advancement in Paris medicine came with the creation of an examination system, that after 1803, was required for the licensing of all medical professions creating a uniform and centralized system of licensing.[89] This law also created another class of health professionals, mostly for those living outside of cities, who did not have to go through the licensing pricess but instead went through a simpler and shorter training process.[89]

Another area influenced by Paris hospitals was the development of specialties. The structure of a Paris hospital allowed physicians more freedom to pursue interests as well as providing the necessary resources.[87] An example of a physician who used this flexibility to conduct research is Phillipe Pinel who conducted a four-year study on the hospitalization and treatment of mentally-ill women within the Salpêtriére hospital. This was the first study ever done of this magnitude by a physician, and the Pinel was the first to realize that patients dealing with similar illnesses could be group together, compared, and classified.[87]

Protestant hospitals

Asosiy maqola: dekaness
Elizabeth Catherine Ferard, first deaconess of the Angliya cherkovi.

The Protestant cherkovlari reentered the health field in the 19th century, especially with the establishment of orders of women, called dikonessalar who dedicated themselves to nursing services. This movement began in Germany in 1836 when Teodor Flyedner and his wife opened the first deaconess motherhouse in Kaiserswerth Reynda. It became a model, and within half a century there were over 5,000 deaconesses in Europe. The Angliya cherkovi named its first deaconess in 1862. The North London Deaconess Institution trained deaconesses for other dioceses and some served overseas.[92]

Uilyam Passavant 1849 yilda Kayzersvertga tashrif buyurganidan so'ng AQShdagi Pitsburgga birinchi to'rtta dekonessani olib keldi. Ular Pitsburg kasalxonasida (hozirgi Passavant kasalxonasi) ishladilar.[93]

Amerika Methodists made medical services a priority from the 1850s. They began opening charitable institutions such as orphanages and old people's homes. In the 1880s, Methodists began opening hospitals in the United States, which served people of all religious beliefs. By 1895, 13 hospitals were in operation in major cities.[94]

Katolik kasalxonalari

In the 1840s–1880s era, Catholics in Philadelphia founded two hospitals, for the Irish and German Catholics. They depended on revenues from the paying sick, and became important health and welfare institutions in the Catholic community.[95] By 1900 the Catholics had set up hospitals in most major cities. In New York the Dominicans, Franciscans, Sisters of Charity, and other orders set up hospitals to care primarily for their own ethnic group. By the 1920s they were serving everyone in the neighborhood.[96] In smaller cities too the Catholics set up hospitals, such as St. Patrick Hospital in Missula, Montana. The Sisters of Providence opened it in 1873. It was in part funded by the county contract to care for the poor, and also operated a day school and a boarding school. The nuns provided nursing care especially for infectious diseases and traumatic injuries among the young, heavily male clientele. They also proselytized the patients to attract converts and restore lapsed Catholics back into the Church. They built a larger hospital in 1890.[97] Catholic hospitals were largely staffed by Catholic orders of nuns, and nursing students, until the population of nuns dropped sharply after the 1960s. The Catholic Hospital Association formed in 1915.[98][99]

Chinese hospitals

Shuningdek qarang: Xitoy tibbiyoti

Traditionally, Chinese medicine relied on small private clinics and individual healers until the middle of the 18th century when missionary hospitals operated by western churches were first established in China. 1870 yilda Tun Vax kasalxonasi became the first hospital to offer An'anaviy xitoy tibbiyoti. After the cultural revolution in 1949, most Chinese hospitals became public.[100][101]

20 va 21 asrlar

Shuningdek qarang: Category:Hospitals established in the 20th century va Category:Hospitals established in the 21st century

Yaxshilash Dori, medical technology, major worldwide pandemiya yilda 1918 va 2020, and management and consolidation of hospitals were the primary influences on hospitals during the 20th and 21st century.

Shuningdek qarang

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Qo'shimcha o'qish

Umumiy

  • Bowers, Barbara S. (2007). Medieval Hospital and Medical Practice. ISBN  075465110X.
  • Brockliss, Lawrence, and Colin Jones. "The Hospital in the Enlightenment," in The Medical World of Early Modern France (Oxford UP, 1997), pp. 671–729; covers France 1650–1800
  • Chaney, Edward (2000),"'Philanthropy in Italy': English Observations on Italian Hospitals 1545–1789", in: The Evolution of the Grand Tour: Anglo-Italian Cultural Relations since the Renaissance, 2-nashr. London, Routledge, 2000 yil. Google kitoblari
  • Davis, Adam J. The Medieval Economy of Salvation: Charity, Commerce and the Rise of the Hospital (Cornell Univ. Press, 2019)
  • Goldin, Grace (1975). Hospital: A Social and Architectural History. Yale U. P. (scholarly)
  • Goldin, Grace (1994). Work of Mercy: A Picture History of Hospitals., mashhur
  • Douglas Guthrie (1945). A History Of Medicine. BRAOU, Digital Library Of India. Thomas Nelson And Sons Ltd London.
  • Harrison, Mark, ed. (2008). From Western Medicine to Global Medicine: The Hospital Beyond the West.
  • Henderson, John, ed. (2007). The Impact of Hospitals 300–2000., 426 pages, 16 essays by scholars table of contents
  • Xenderson, Jon (2006). The Renaissance Hospital: Healing the Body and Healing the Soul.
  • Horden, Peregrine (2008). Hospitals and Healing From Antiquity to the Later Middle Ages.
  • Jones, Colin (1990). The Charitable Imperative: Hospitals and Nursing in Ancient Regime and Revolutionary France.
  • {cite book|author=Kisacky, Jeanne|title=Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870-1940|publisher=U of Pittsburgh Press|year=2017}}
  • McGrew, Roderick E., ed. (1985). Encyclopedia of Medical History.
  • Morelon, Régis and Roshdi Rashed, ed. (1996). Arab ilmi tarixi entsiklopediyasi.
  • Porter, Roy with Granshaw, Patricia, Lindsay (1989). Tarixdagi kasalxona. ISBN  978-0-415-00375-9.CS1 maint: bir nechta ism: mualliflar ro'yxati (havola)
  • Risse, Guenter B. (1999). Badanlarni tuzatish, jonlarni qutqarish: kasalxonalar tarixi. Oksford universiteti matbuoti. ISBN  0199748691., 752pp; world coverage parcha va matn qidirish
  • Scheutz, Martin, ed. (2009). Hospitals and Institutional Care in Medieval and Early Modern Europe.

Hamshiralik

  • Bullough, Vern L. and Bullough, Bonnie. The Care of the Sick: The Emergence of Modern Nursing (1978).
  • D'Antonio, Patrisiya. Amerika hamshirasi: bilim, vakolat va ish ma'nosi tarixi (2010), 272 pp parcha va matn qidirish
  • Davies, Celia, ed. Rewriting Nursing History (1980),
  • Dingwall, Robert, Anne Marie Rafferty, Charles Webster. An Introduction to the Social History of Nursing (Routledge, 1988)
  • Dok, Laviniya Lloyd. Hamshiralik ishining eng qadimgi davrlaridan to hozirgi kungacha bo'lgan qisqa tarixi (1920)to'liq matn onlayn; abbreviated version of M. Adelaide Nutting and Dock, Hamshiralik tarixi (4 vol 1907); vol 1 onlayn; vol 3 onlayn
  • Donahue, M. Patricia. Nursing, The Finest Art: An Illustrated History (3rd ed. 2010), includes over 400 illustrations; 416pp; parcha va matn qidirish
  • Usta, Juli va Joan E. Lina. Muhim tibbiyot hamshirasi: tarix (2000) parcha va matn qidirish
  • Hutchinson, John F. Champions of Charity: War and the Rise of the Red Cross (1996) 448 pp.
  • Judd, Deborah. Amerikalik hamshiralik tarixi: tendentsiyalar va davrlar (2009) 272pp parcha va matn qidirish
  • Lewenson, Sandra B., and Eleanor Krohn Herrmann. Capturing Nursing History: A Guide to Historical Methods in Research (2007)
  • Schultheiss, Katrin. Bodies and souls: politics and the professionalization of nursing in France, 1880–1922 (Harvard U.P., 2001) full text online at ACLS e-books
  • Snodgrass, Meri Ellen. Hamshiralik ishining tarixiy entsiklopediyasi (2004), 354 pp; qadim zamonlardan to hozirgi kungacha
  • Takahashi, Aya. Yapon hamshiralik kasbining rivojlanishi: G'arb ta'sirini qabul qilish va unga moslashish (Routledgecurzon, 2011) parcha va matn qidirish

Hospitals in Britain

  • Bostridge. Mark. Florens Nightingale: Belgini yaratish (2008)
  • Carruthers, G. Barry. History of Britain's Hospitals (2005) parcha va matn qidirish
  • Cherry, Stephen. Medical Services and the Hospital in Britain, 1860–1939 (1996) parcha va matn qidirish
  • Gorsky, Martin. "The British National Health Service 1948-2008: A Review of the Historiography," Tibbiyotning ijtimoiy tarixi, Dec 2008, Vol. 21 Issue 3, pp. 437–460
  • Helmstadter, Carol, and Judith Godden, eds. Nursing before Nightingale, 1815–1899 (Surrey, UK: Ashgate, 2011) 219 pp. on England
  • Nelson, Sioban, and Ann Marie Rafferty, eds. Notes on Nightingale: The Influence and Legacy of a Nursing Icon (2010) 172 pp.
  • Reinarz, Jonathan. "Health Care in Birmingham: The Birmingham Teaching Hospitals, 1779–1939" (Woodbridge: Boydell Press, 2009)
  • Sweet, Helen. "Establishing Connections, Restoring Relationships: Exploring the Historiography of Nursing in Britain," Jins va tarix, 2007 yil noyabr, jild 19 Issue 3, pp. 565–80

Hospitals in North America

  • Agnew, G. Harvey. Canadian Hospitals, 1920 to 1970, A Dramatic Half Century (University of Toronto Press, 1974)
  • Bonner, Tomas Nevill. Medicine in Chicago: 1850-1950 (1957). pp. 147–74
  • Connor, J. T. H. (1990). "Hospital History in Canada and the United States". Kanadalik tibbiyot tarixi byulleteni. 7 (1): 93–104. doi:10.3138/cbmh.7.1.93. PMID  11622358.
  • Crawford, D.S. "Bibliography of Histories of Canadian hospitals and schools of nursing".
  • D'Antonio, Patrisiya. Amerika hamshirasi: bilim, vakolat va ish ma'nosi tarixi (2010), 272 pp parcha va matn qidirish
  • Usta, Juli va Joan E. Lina. Muhim tibbiyot hamshirasi: tarix (2000) parcha va matn qidirish
  • Judd, Debora. Amerikalik hamshiralik tarixi: tendentsiyalar va davrlar (2009) 272 pp parcha va matn qidirish
  • Kalish, Filipp Artur va Beatris J. Kalish. Amerikalik hamshiralarning yutuqlari (1986 yil 2-nashr); kabi nomlangan Amerika hamshirasi: tarix (2003 yil 4-nashr), standart tarix
  • Reverbi, Syuzan M. Xizmatga buyurilgan: Amerika hamshirasi dilemmasi, 1850–1945 (1987) parcha va matn qidirish
  • Rozenberg, Charlz E. Begonalarga g'amxo'rlik: Amerikaning kasalxonalar tizimining paydo bo'lishi (1995) 1920 yilgacha bo'lgan tarix tarkib va ​​matnni qidirish
  • Rozner, Devid. Bir paytlar xayriya korxonasi: Bruklin va Nyu-Yorkdagi kasalxonalar va sog'liqni saqlash 1885–1915 (1982)
  • Starr, Pol. Amerika tibbiyotining ijtimoiy o'zgarishi: suveren kasbning ko'tarilishi va ulkan sanoatni yaratish (1984) parcha va matn qidirish
  • Stivens, bibariya. Kasallik va boylikda: Yigirmanchi asrdagi Amerika kasalxonalari (1999) parcha va matn qidirish; to'liq matn ACLS elektron kitoblarida
  • Vogel, Morris J. Zamonaviy kasalxonaning ixtirosi: Boston 1870-1930 (1980)
  • Wall, Barbra Mann. Ehtimol, tadbirkorlar: katolik opa-singillar va kasalxonalar bozori, 1865-1925 (2005)
  • Wall, Barbra Mann. Amerika katolik kasalxonalari: o'zgaruvchan asrlar va missiyalar (2010) parcha va matn qidirish