page_title: Hospital
section_title: Early modern and Enlightenment Europe
hierarchical_section_title: Hospital / History / Early modern and Enlightenment Europe
caption_attribution_description: English: Ruinas del Hospital San Nicolás de Bari, Ciudad Colonial Santo Domingo
context_page_description: A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children's hospitals, seniors' hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment and certain disease categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received.
  A teaching hospital combines assistance to people with teaching to medical students and nurses. A medical facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments and specialist units such as cardiology.
context_section_description: In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one. In England, after the dissolution of the monasteries in 1540 by King Henry VIII, the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of London, were the hospitals St Bartholomew's, St Thomas's and St Mary of Bethlehem's (Bedlam) endowed directly by the crown; this was the first instance of secular support being provided for medical institutions.
  The voluntary hospital movement began in the early 18th century, with hospitals being founded in London by the 1720s, including Westminster Hospital (1719) promoted by the private bank C. Hoare & Co and Guy's Hospital (1724) funded from the bequest of the wealthy merchant, Thomas Guy.
  Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St Bartholomew's  in London was rebuilt from 1730 to 1759, and the London Hospital, Whitechapel, opened in 1752.
  These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centres of medical innovation and discovery and the principal place for the education and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at the hospitals. They also changed from being mere homes of refuge to being complex institutions for the provision of medicine and care for sick. The Charité was founded in Berlin in 1710 by King Frederick I of Prussia as a response to an outbreak of plague.
  The concept of voluntary hospitals also spread to Colonial America; the Bellevue Hospital opened in 1736 (as a workhouse, then later becoming a hospital); the Pennsylvania Hospital opened in 1752, New York Hospital in 1771, and Massachusetts General Hospital in 1811.
  When the Vienna General Hospital opened in 1784 (instantly becoming the world's largest hospital), physicians acquired a new facility that gradually developed into one of the most important research centres.
  Another Enlightenment era charitable innovation was the dispensary; these would issue the poor with medicines free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the British Empire. The idea was slow to catch on until the 1770s, when many such organisations began to appear, including the Public Dispensary of Edinburgh (1776), the Metropolitan Dispensary and Charitable Fund (1779) and the Finsbury Dispensary (1780). Dispensaries were also opened in New York 1771, Philadelphia 1786, and Boston 1796.
  The Royal Naval Hospital, Stonehouse, Plymouth, was a pioneer of hospital design in having "pavilions" to minimize the spread of infection. John Wesley visited in 1785, and commented "I never saw anything of the kind so complete; every part is so convenient, and so admirably neat. But there is nothing superfluous, and nothing purely ornamented, either within or without." This revolutionary design was made more widely known by John Howard, the philanthropist. In 1787 the French government sent two scholar administrators, Coulomb and Tenon, who had visited most of the hospitals in Europe. They were impressed and the "pavilion" design was copied in France and throughout Europe.
caption: Ruins of the Hospital San Nicolás de Bari in Santo Domingo, Dominican Republic, recognized by UNESCO for being the oldest hospital built in the Americas.[28][29] Built between 1514–1541.
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