Hospitals, 1784 – Buildings Filled with Dreams

Surgeon Richard Selzer wrote:“Without dreams, a hospital is only a building. Listen to a building filled with dreams and you realize it is not merely a pile of stone and cut timber, but an interior filled with pain and relief. Such a place invites humanity to heroism.”

Today, a hospital generally means an institution providing healthcare with specialized staff and equipment, funded by the public sector, private companies, charities and other sources. Historically, hospitals were usually funded by religious institutions and philanthropic leaders. In ancient Egypt and Greece, various temples served as centers for medical advice and healing. 

• King Pandukabhaya of Sri Lanka (around 400 BC) ordered the establishment of inpatient facilities and a hospital.
• In India, King Ashoka (around 250 BC) established partial hospitals staffed by doctors and nurses. 
• In the sixth and seventh centuries, the Academy of Gundishapur in the Persian Empire became one of the first teaching hospitals, where physicians supervised many students. 
• In 325, the First Council of Nicaea recommended that the Church care for poor and sick people through hospitals built in every cathedral town. 

Saving Souls

Initially, hospitals aimed not only to relieve suffering and save lives but also to save souls.

Opened in 1784, Vienna General Hospital (VGH) became the world’s largest hospital at the time, with more than 2000 beds. It had departments for general illnesses, surgery, sexually transmitted diseases and infectious diseases. It also had a tower for people with psychological problems—then described as the insane—and a section for abandoned children. 

The German physician Johann Frank became an important figure in hospital history by encouraging accurate statistical recordkeeping. First published in 1779, “Complete System of Medical Policy” was his work on hygiene and public health. As director of VGH in 1795, Frank tried to prevent infections from spreading between patients. The oldest public hospital in the United States is Bellevue Hospital, founded in New York in 1736.

A Brief History of Hospitals in Turkey

In Anatolia, during the Seljuk period, hospitals were centers for medical education and care. One of the most important was Gevher Nesibe Sultan Darüşşifası, built in Kayseri in 1206. It operated in conjunction with a madrasa providing medical education.

During the Ottoman Empire, hospitals were called “darüşşifa” and were generally built alongside mosques and madrasas. They operated on religious and philanthropic principles and provided services free of charge. Ottoman hospitals generally employed physicians, surgeons, pharmacists and nurses. Fatih Darüşşifası, part of the Fatih Mosque and Complex in Istanbul, opened in 1470 and became one of the most important medical centers of its time.

Opened in 1557 in Istanbul, the Ottoman Empire’s capital, Haseki Sultan Darüşşifası has a surprising and interesting story. It was commissioned by Hürrem Sultan, wife of Sultan Süleyman the Magnificent, and bore her title “Haseki Sultan.” It became an important center of Ottoman medical services and one of Istanbul’s largest hospitals.

One interesting aspect of Haseki Sultan Darüşşifası was its emphasis on gynecology and childbirth services. It provided special departments for female patients and employed female doctors and midwives. This was striking for the time, when women’s participation in medical professions was generally uncommon.

Haseki Sultan Darüşşifası was also important for medical education and research. Some of the Ottoman Empire’s best physicians and students trained and worked there. It was a center for sharing medical knowledge and experience and learning and developing new treatments.

The Republic of Turkey brought greater emphasis on healthcare and modernization of hospitals. In the 1920s and 1930s, new hospital buildings influenced by Europe and America were constructed, and medical equipment was updated. Important steps were also taken in medical education and research. Gülhane Military Medical Academy (GATA) Hospital, Ankara Numune Hospital and Istanbul University Cerrahpaşa Medical Faculty Hospital were among the early hospitals of the republican era.

In the early years of the Turkish Republic, Mustafa Kemal Atatürk attached importance not only to developing hospitals and medical education but also to social services. During the War of Independence in Ankara, children needed protection because men had gone to the front and mothers were transporting ammunition. To meet this need, in 1921, Himaye-i Etfal (Child Protection Institution) was established, particularly to support orphans. Mustafa Kemal Atatürk took on the institution’s founding and protective role, emphasized children’s needs and requested public assistance. The Grand National Assembly of Turkey also supported it.

Besides giving gifts to many children and young people he met during visits and inspections, Atatürk requested in his will that Makbule, Afet, Sabiha Gökçen, Ülkü, Rukiye and Nebile receive monthly payments throughout their lives, and that assistance be provided for İsmet İnönü’s children’s higher education. During the First World War, he took Abdurrahim, an unaccompanied child from Van; Afife, an orphan girl from Bitlis; and Zehra, whom he met while visiting the Darüleytam orphanage in Kağıthane, Istanbul, under his care as adopted children. M. Kemal Atatürk continued to guide services for children by emphasizing their cause at every opportunity. On 17 October 1922, he addressed children welcoming him in Bursa as follows, explaining the kind of younger generation he wanted.

About the Article Illustration: King Louis XIV of France (1638-1715) launched a hospital project called Les Invalides in 1679 for elderly and sick soldiers. Its church highlights the historically close link between hospitals and religion.

Historical Figures Mentioned: Pandukabhaya (reigned 437 B.C.–367 B.C.), Ashoka (304 B.C.–232 B.C.), Johann Peter Frank (1745–1821), Mustafa Kemal Atatürk (1881–1938).

• Previous topic: Hunter’s Anatomy of the Pregnant Uterus, 1774
• Next topic: Lavoisier’s Respiration, 1784 – The Animal Machine