ABANDONED CHILDREN IN SIBENIK FOUNDLING HOUSE AT THE END OF THE 19th CENTURY / Napustena djeca u sibenskom nahodistu krajem 19. stoljeca

The Sibenik Foundling House was an institution that cared for abandoned children before their adoption. The paper analysed the accommodation capacities of the foundling house from 1886 to 1900, using registers of baptisms and deaths from the provincial hospital in Sibenik as the basis for the analysis. An analysis of the received children was conducted based on how they arrived at the site and the level of knowledge about their origin or identity. From 1886 to 1900, the Sibenik Foundling House received three hundred and seventy-eight abandoned children with a yearly average of 25.2 children. Two hundred and forty-three children were brought to the hospital by their mothers as newborns, and their identities were recorded in the baptism registers, constituting 60.15% of the total number of residents in the Foundling House. One hundred and six received infants were foundlings­children without known identity­comprising 26.24% of the total number of baptisms in the hospital. Twenty-nine children were born in the hospital and left by unmarried mothers in the care of the Foundling House, making up 7.18% of all entries in the register of baptisms. The monthly distribution of received children shows a balanced distribution. The mortality rate of these children in the Foundling House was 32.80%. Children who did not have names and surnames were given to them by the priest who baptised them.

El final del Hospital Rawson y la diáspora finochiettista. A 45 años de estos hechos / The end of the Rawson Hospital and the finochiettista diaspora. 45 years after these events

La Asociación Médica Argentina (AMA) reconoce el valor de la Escuela Quirúrgica de los hermanos Finochietto y por tal motivo efectúa un homenaje anual desde el año 2002. En este artículo se hace una breve reseña histórica del Hospital Rawson, donde se inició y desarrolló dicha escuela. Se resaltan dos hechos: por un lado, el término "diáspora finochiettista", porque la dispersión de los cirujanos fue obligada y tuvieron que abandonar su lugar de procedencia original, el Hospital Rawson y, por el otro, que dicho nosocomio nació y murió como consecuencia de movimientos políticos cívico-militares. (AU)

The Argentine Medical Association (AMA) recognizes the value of the Surgical School of the Finochietto brothers, and for this reason has paid an annual tribute since 2002. Tthis article provides a brief historical review of the Rawson Hospital, where the school was initiated and developed. Two facts are highlighted: on the one hand, the term "Finochiettista diaspora" because the dispersal of the surgeons was forced and they had to leave their original place of origin, the Rawson Hospital; and on the other hand, the fact that this hospital was born and died as a consequence of civil-military political movements. (AU)

Exposed and Abandoned. Origins of the Foundling Hospital.

Abandoning undesired newborn infants was a Roman form of family limitation. They were exposed or given to foster mothers. Christianization alleviated their lot when in 374 CE, Emperor Valentinian's law provided some protection. The Milan Foundling Hospital was established in 787 CE. When the Carolingian Empire fell apart during the 10th century, monastic networks (the Holy Spirit Order and Daughters of Charity) took over social support for the poor, the sick, and the insane. Foundling hospitals proliferated in Italy between the 13th and 15th centuries, in France during the 16th and 17th, and in Germany and Austria in the 18th century. Metropolitan hospices admitted thousands of infants each year. Most were not "found" exposed but were admitted anonymously via a revolving box or registered in an open office. Soon after admission, they were transported for foster care to wet nurses in villages. Sick infants, especially those suspected of suffering from syphilis, were denied the breast, and artificial feeding was tried with little success. Official death statistics were falsified by relating infant deaths not to admissions but to the total number of children cared for. Over 60% died during their first year of life, mostly from pre-admission problems such as malformation, hypothermia, and disease; from poor hygiene in overcrowded wards; and from artificial feeding. Although not intended for that purpose, the hospices became medical research institutions when in late 18th century, physicians and surgeons were employed by maternity and foundling hospitals.

El hospital y el enfoque de derechos / The hospital and rights approach

La pandemia por SARS-CoV-2 puso de forma abrupta al sistema de salud en la agenda pública. Evidenciando sus problemas y requiriendo acciones de emergencia para poder dar cuenta del desafío de responder social y sanitariamente a esta crisis. La respuesta hospitalaria fue el eje y centro de atención de la pandemia, casi con exclusividad. Relegando las otras posibilidades o dispositivos asistenciales, como el primer nivel de atención y la salud comunitaria. Por lo tanto, nos proponemos reflexionar sobre esta organización sanitaria, tan arraigada en el modelo médico social y el marco del enfoque de derechos. Definiremos el hospital, describiremos sus antecedentes, sus características y propondremos como repensarlo críticamente para aportar a su crecimiento en el marco del enfoque de derechos. La salud como derecho es el marco legal, político y teórico que proponemos para abordar esta reflexión y al hospital, tanto como singularidad histórica como pluralidad o multiplicidad de organizaciones en función de cada contexto donde se desarrolla, como una organización social y sanitaria que formar parte de un conjunto de organizaciones y políticas destinadas a garantizar ese derecho (AU)

The SARS-CoV-2 pandemic abruptly put the health system on the public agenda. Evidencing their problems and requiring emergency actions to be able to account for the challenge of responding socially and healthily to this crisis. The hospital response was the axis and center of attention of the pandemic, almost exclusively. Relegating the other possibilities or assistance devices, such as the first level of care and community health. Therefore, we intend to reflect on this health organization, so rooted in the social medical model and the framework of the rights approach. We will define the hospital, describe its background, its characteristics and propose how to rethink it critically to contribute to its growth within the framework of the rights approach. Health as a right is the legal, political and theoretical framework that we propose to address this reflection and the hospital, both as a historical singularity and as a plurality or multiplicity of organizations depending on each context where it is developed, as a social and health organization that is part of a set of organizations and policies aimed at guaranteeing that right (AU)

Pantokrator Monastery-Zeyrek Mosque: The Preserved Byzantine Hospital in Istanbul.

BACKGROUND: Istanbul, home to numerous historical treasures, houses one of the oldest fully constructed hospitals. METHODS: This 50-bed hospital was built in the early 12th century during the Byzantine period by Empress Irene of Hungary and her husband Emperor John II Komnenos inside one of the largest monasteries of its time. The monastery housed one of the first hospitals and schools of medicine and included a nursing home, ophthalmologic health center, library, and cemetery. After the Empress died, her husband continued to enlarge the complex to its current state. Soon after the fall of Constantinople in 1453, the complex was renamed after Zeyrek Mehmet, who was ordered by Fatih Sultan Mehmet (Mehmet II or Mehmed the Conqueror) to convert the monastery into a mosque, constructing a Fatih Medrese for a short period of time. The hospital, however, remained untouched, and its rooms were used for Koran lessons. The building was fully restored from 2009 to 2017 and is still used as a mosque today. We would like to introduce the Pantokrator Monastery, maybe the only remaining hospital of the Byzantine era. CONCLUSION: Although it was built in the 12th century, the monastery is still a modern facility meeting current standards.

[Environmental Care in Hospitals: Hygiene and Feminine Atmospheric Work]. / Umweltfürsorge im Krankenhaus: Hygienische Sauberkeit und die feminisierte Arbeit an der Atmosphäre.

Cleaning the floor, stripping the bed, arranging a bouquet of flowers-such tasks are essential to keeping a hospital room clean and creating a pleasant atmosphere. They usually fall under the purview of female* nurses, cleaning staff and housekeepers. In everyday hospital life, the demands for hygienic cleanliness commingle with the imperatives of economization, marketing logic, and attention to the affective and emotional needs of the actors in these rooms. Although the standards of clinical hygiene are based on medical knowledge, the division of labor and the demands for cleanliness at various hierarchical levels also reveal gendered and partly racialized ideas that point beyond the clinical context. This blending of imperatives in the hospital environment invites deeper consideration of the history of bacteriology: The logic and language of defense against infection in science and everyday life is also interwoven with social markers of difference.Drawing on the findings of an ethnography on cleanliness and cleaning work in hospitals, as well as a history of knowledge approach, the article links the question of (feminized) care for the environment with the question of the atmosphere of clinical rooms. In what ways, and to what effect, does scientific knowledge about medical hygiene also carry with it cultural and aesthetic perceptions of beautiful and pleasant cleanliness that reveal feminine connotations rooted in the nineteenth century?

[The potato in hospital nutrition as an approach to its introduction in the urban diet: the case of Vitoria (Alava, Spain)]. / La patata en la nutrición hospitalaria como aproximación a su introducción en la dieta urbana: el caso de Vitoria (Álava, España).

INTRODUCTION: Introduction: given the lack of historical documentary sources about the beginning of potato effective consumption in Vitoria (Alava, Spain), its introduction in the urban diet is estimated from cultivation and production data. This only allows asserting the introduction of the cultivation at the end of the 18th century, the recognition of two quantitative jumps during the Independence and First Carlist Wars, and that it was the second cultivation in quantity by 1857. Objective/method: from the hypothesis of a good correspondence between hospital diet and ordinary urban diet, evidenced in other studies for Vitoria, it is proposed to document the chronology of potato introduction in the urban diet from its analysis in the city hospital, as well as to contextualize concurrent historical events, through the review and analysis of primary and secondary documentary sources. Results: the hospital keeps a record of food acquisitions since 1743. The first purchase of potatoes was paid on September 17, 1834. Acquisitions continue in very variable quantities and dates, which are normalized from 1844. Contextually, there is a major subsistence crisis with cholera as the most immediate and necessary cause in synergy with the first carlist war and the devastation of crops in a summer storm. In 1854 the potato was established in the urban diet. Conclusions: the first acquisition of potatoes was made in September 1834 in the immediate context of cholera together with the carlist war and catastrophic weather effects.

INTRODUCCIÓN: Introducción: dada la carencia de fuentes documentales históricas sobre el inicio del consumo efectivo de patata en Vitoria (Álava, España), su introducción en la dieta urbana se estima a partir de los datos de cultivo y producción. Ello solo permite aseverar la introducción del cultivo a finales del siglo XVIII, el reconocimiento de dos saltos cuantitativos durante las guerras de independencia y primera carlista, y que era el segundo cultivo en cantidad en 1857. Objetivo/método: desde la hipótesis de una buena correspondencia entre la dieta hospitalaria y la dieta ordinaria urbana, evidenciada en otros estudios para Vitoria, se propone documentar la cronología de la introducción de la patata en la dieta urbana a partir de su análisis en el hospital de la ciudad, así como contextualizar los acontecimientos históricos concurrentes mediante la revisión y el análisis de fuentes documentales primarias y secundarias. Resultados: el hospital conserva el registro de alimentos adquiridos desde 1743. La primera compra de patatas se abona el 17 de septiembre de 1834. Se continúa con adquisiciones en cantidades y fechas muy variables que se normalizan a partir de 1844. Contextualmente, existe una crisis mayor de subsistencia con el cólera como causa más inmediata y necesaria en sinergia con la primera guerra carlista y la devastación de cultivos en una tormenta veraniega. En 1854 la patata está asentada en la dieta urbana. Conclusiones: la primera adquisición de patatas se realizó en septiembre de 1834 en el contexto inmediato del cólera junto a la guerra carlista y efectos catastróficos meteorológicos.

["Hypnotics" in the metropolis: Africans in the Colonial Hospital of Lisbon during the early twentieth century]. / "Hipnóticos" na metrópole: africanos no Hospital Colonial de Lisboa nas primeiras décadas do século XX.

At the start of the twentieth century, some Portuguese physicians traveled to Africa to study sleeping sickness (African trypanosomiasis). One was Ayres Kopke, a member of the first medical mission to Portuguese West Africa and professor at the School of Tropical Medicine. After returning to Lisbon, Kopke continued his research, which included observation of patients brought to the metropolis. Starting in 1903, health departments in the colonies were responsible for sending patients with certain exotic diseases to the Colonial Hospital of Lisbon. Based on documents from this hospital including photographs of patients (who at that time were called "hypnotics"), this article discusses the importance of human experiments in Lisbon for advances in tropical medicine during the colonial period.

No início do século XX, alguns médicos portugueses foram à África estudar a chamada doença do sono. Entre eles estava Ayres Kopke, membro da primeira missão médica à África Ocidental Portuguesa. De regresso a Lisboa, o professor da Escola de Medicina Tropical continuou suas pesquisas, inclusive por meio da observação de doentes trazidos para a metrópole. Desde 1903, as repartições de saúde nas colônias estavam incumbidas de enviar doentes com determinadas patologias exóticas para o Hospital Colonial de Lisboa. Com base em documentos desse hospital, incluindo fotografias dos doentes, então chamados de hipnóticos, o artigo aborda a importância das experiências com humanos na metrópole para o avanço da medicina tropical durante o colonialismo.

The Work of Oliver R. Avison in Comparison to that of Albert Schweitzer from a Post-Colonial Perspective.

Compared to Nobel Prize Laureate Albert Schweitzer, Oliver R. Avison is not well known. Seeking to achieve more international recognition for Avison, this article elaborates on Avison's work with hospital and educational institutions from a post-colonial perspective. Schweitzer and Avison each wrote their memoires in an autobiographical style, and this article deals primarily with those writings, which are published under the titles Out of My Life and Thought by Schweitzer and The Land of the Morning Calm by Avison. Schweitzer and Avison were contemporaries and worked in medical service in the colonial period. Thus, they have certain commonalities. However, this article will elaborate on how Avison approached his mission differently in order to promote sustainability, equality and subjectivity in his work. Avison carried out more than mere charity work, he also accomplished sustainable development of his hospital, as well as its affiliated educational institution. The current circumstances of Severance Hospital and Yonsei University in Korea, compared to that of the Albert Schweitzer Hospital in Lambaréné, are clear evidence of this. Avison's extraordinary missionary work did not reflect the more negative side effects of colonial heritage intertwined with mission work in the 19th Century. Avison's case should be better known as a model of ecumenical mission towards sustainable development.

[The Hospital Proletário in João Pessoa: limits and possibilities for worker healthcare (Paraíba, 1930s)]. / O Hospital Proletário João Pessoa: limites e possibilidades para a saúde do trabalhador (Paraíba, anos 1930).

We discuss the attempt to establish the Hospital Proletário in the capital of the state of Paraíba in the 1930s. To this end, we problematized the coverage in the newspaper A União on this episode. The involvement of different actors - workers, associations and physicians - reveals the emergence of a new way of thinking and implementing healthcare policies. According to the Vargas government's national construction plan, actions like this were intended to ensure healthy workers - ready for the market and useful for the country. Despite its failure, the hospital project provided evidence of the different concepts of worker health during the Vargas Era. We identified the concepts of "health interdependence," "social medicine," "regulated citizenship" and the "labor movement."

Discutimos a tentativa de organização do Hospital Proletário na capital da Paraíba nos anos 1930. Para tanto, problematizamos a cobertura do jornal A União sobre esse episódio. O envolvimento de diferentes atores ­ trabalhadores, associações e médicos ­ revela a emergência de uma nova forma de pensar e praticar as políticas de saúde. Conforme o projeto varguista de construção nacional, tais ações visavam à formação de trabalhadores saudáveis, aptos para o mercado e úteis para a nação. Apesar de seu fracasso, o projeto do hospital evidencia as diferentes concepções sobre a saúde dos trabalhadores na Era Vargas. Apropriamo-nos dos conceitos de "interdependência sanitária", "medicina social", "cidadania regulada" e "trabalhismo".

"Hipnóticos" na metrópole: africanos no Hospital Colonial de Lisboa nas primeiras décadas do século XX / "Hypnotics" in the metropolis: Africans in the Colonial Hospital of Lisbon during the early twentieth century

Resumo No início do século XX, alguns médicos portugueses foram à África estudar a chamada doença do sono. Entre eles estava Ayres Kopke, membro da primeira missão médica à África Ocidental Portuguesa. De regresso a Lisboa, o professor da Escola de Medicina Tropical continuou suas pesquisas, inclusive por meio da observação de doentes trazidos para a metrópole. Desde 1903, as repartições de saúde nas colônias estavam incumbidas de enviar doentes com determinadas patologias exóticas para o Hospital Colonial de Lisboa. Com base em documentos desse hospital, incluindo fotografias dos doentes, então chamados de hipnóticos, o artigo aborda a importância das experiências com humanos na metrópole para o avanço da medicina tropical durante o colonialismo.

Abstract At the start of the twentieth century, some Portuguese physicians traveled to Africa to study sleeping sickness (African trypanosomiasis). One was Ayres Kopke, a member of the first medical mission to Portuguese West Africa and professor at the School of Tropical Medicine. After returning to Lisbon, Kopke continued his research, which included observation of patients brought to the metropolis. Starting in 1903, health departments in the colonies were responsible for sending patients with certain exotic diseases to the Colonial Hospital of Lisbon. Based on documents from this hospital including photographs of patients (who at that time were called "hypnotics"), this article discusses the importance of human experiments in Lisbon for advances in tropical medicine during the colonial period.

Learning from the past in the COVID-19 era: rediscovery of quarantine, previous pandemics, origin of hospitals and national healthcare systems, and ethics in medicine.

After the dramatic coronavirus outbreak at the end of 2019 in Wuhan, Hubei province, China, on 11 March 2020, a pandemic was declared by the WHO. Most countries worldwide imposed a quarantine or lockdown to their citizens, in an attempt to prevent uncontrolled infection from spreading. Historically, quarantine is the 40-day period of forced isolation to prevent the spread of an infectious disease. In this educational paper, a historical overview from the sacred temples of ancient Greece-the cradle of medicine-to modern hospitals, along with the conceive of healthcare systems, is provided. A few foods for thought as to the conflict between ethics in medicine and shortage of personnel and financial resources in the coronavirus disease 2019 era are offered as well.

Hospital markets in the United States, 2007-2017.

BACKGROUND: U.S. hospital markets have undergone consolidation in recent decades with the growth of large "health systems," but little is known about the characteristics of systems, and whether certain geographic areas or service types (e.g. intensive care, obstetrics) have been differentially impacted by consolidation. METHODS: Using 2007-2017 American Hospital Association data, we characterized health systems and their growth, and determined how changes in hospital market structure have differentially affected specific service types and geographic areas. RESULTS: Despite a national trend of reduced hospital utilization, health systems grew larger during our study period. Hospital markets were already highly concentrated in 2007 and became even more concentrated between 2007 and 2017, across all service types that we measured. The least concentrated service was emergency department care, while intensive care and obstetrics were the most concentrated. As of 2017, 19.0% of markets - representing 11.2 million Americans - are served by only one hospital system. Concentrated markets are less populous, poorer areas and have lower physician supply than less concentrated markets. CONCLUSIONS: Hospital markets were highly concentrated in 2007 and have since become more concentrated in the subsequent decade. Hospital consolidation is a nationwide phenomenon, and is occurring across hospital service types. IMPLICATIONS: Antitrust alone may be insufficient to address high and increasing hospital market power. Decreasing barriers to entry may allow for more competition.

O Hospital Proletário João Pessoa: limites e possibilidades para a saúde do trabalhador (Paraíba, anos 1930) / The Hospital Proletário in João Pessoa: limits and possibilities for worker healthcare (Paraíba, 1930s)

Resumo Discutimos a tentativa de organização do Hospital Proletário na capital da Paraíba nos anos 1930. Para tanto, problematizamos a cobertura do jornal A União sobre esse episódio. O envolvimento de diferentes atores - trabalhadores, associações e médicos - revela a emergência de uma nova forma de pensar e praticar as políticas de saúde. Conforme o projeto varguista de construção nacional, tais ações visavam à formação de trabalhadores saudáveis, aptos para o mercado e úteis para a nação. Apesar de seu fracasso, o projeto do hospital evidencia as diferentes concepções sobre a saúde dos trabalhadores na Era Vargas. Apropriamo-nos dos conceitos de "interdependência sanitária", "medicina social", "cidadania regulada" e "trabalhismo".

Abstract We discuss the attempt to establish the Hospital Proletário in the capital of the state of Paraíba in the 1930s. To this end, we problematized the coverage in the newspaper A União on this episode. The involvement of different actors - workers, associations and physicians - reveals the emergence of a new way of thinking and implementing healthcare policies. According to the Vargas government's national construction plan, actions like this were intended to ensure healthy workers - ready for the market and useful for the country. Despite its failure, the hospital project provided evidence of the different concepts of worker health during the Vargas Era. We identified the concepts of "health interdependence," "social medicine," "regulated citizenship" and the "labor movement."

[Life and achievements of an hospital director: Enrico Ronzani]. / Ricordo di un direttore sanitario illuminato: Enrico Ronzani

The paper illustrates the life and the achievements of Enrico Ronzani, born in Padua and graduated in Medicine at the Bologna University. He directed the hospitals of Florence and the Ospedale Maggiore of Milan, promoting its growth until it became the seat of the Medical School promoted by Prof Mangiagalli, and he himself became Full Professor of Hygiene. In such a position he taught Hygiene also to Architets and Engineers, built the new Institute of Hygiene and helped to design and build the new great Hospital of Niguarda. But, most of all, he was successful in designing, promoting and officializing the job of the Hospital Directors, which was subsequently recognized by the law; and, publishing a series of books on the role of the modern hospitals, he prefigured their position in a web of medical institutions to include also those devoted to pre- and post-hospital assistance to the population. Practically he foresaw what was realized many years later through the creation of the Italian National Health Service (Law 833 of 1978).

La atención a la salud en Mesoamérica antes y después de 1519 / Health care in Mesoamerica before and after 1519

Resumen En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Abstract This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.