El Santo Hospital de Caridad de Ferrol a finales del Antiguo Régimen / The Holy Hospital of Charity of Ferrol at the end of the Ancien Régime

El Santo Hospital de Caridad nació en el Ferrol de finales del siglo XVIII, bajo los auspicios del gobierno municipal, con el fin de cubrir las necesidades asistenciales de una población en constante crecimiento, al amparo del desarrollo de sus arsenales. Su labor en materia hospitalaria se circunscribía, por lo general, a la población civil, siendo complementaria a la ofrecida a los aforados castrenses por el Real Hospital de Esteiro, dependiente de la Secretaría de Marina. A través del estudio de su rica documentación, se constata la relación existente entre la evolución de los ingresos y las dinámicas demográficas de la localidad, su carácter de centro de nivel medio en el contexto del noroeste peninsular o el indiscutible peso femenino en el conjunto general de asistidos. También, la información aportada por las fuentes muestra una estrecha vinculación entre la labor asistencial del centro y los sectores más desfavorecidos de la sociedad ferrolana, desde los denominados pobres de solemnidad hasta aquellos otros relacionados con las actividades artesanales, el servicio doméstico o los empleos de baja cualificación. A este respecto, llama poderosamente la atención, en el caso femenino, la utilización de este hospital como principal institución asistencial para las mujeres de los aforados castrenses, que quedaban al margen de la cobertura del Hospital de Esteiro. Asimismo, los excelentes registros ofrecen la posibilidad de medir el peso de los reingresos en el volumen general de asistencias, que no solían producirse en más de tres ocasiones, por causa de la intensa movilidad que caracterizaba a la capital de departamento (AU)

El Cuidado en los años 70 del siglo XX: Hospital Nuestra Señora de Gracia de Zaragoza / Care in the 70s of the twentieth century: Hospital Nuestra Señora de Gracia the Zaragoza

Introducción: El hospital Real y General de Nuestra Señora de Gracia de Zaragoza fue fundado en 1425 por Alfonso V El Magnánimo. Durante la primera mitad de Siglo XX la asistencia de enfermería, era realizada por las Hermanas de Caridad de Santa Ana y personal adyacente, mediante su tarea y ejemplaridad en el cuidado siempre al lado del enfermo. Objetivo: Exponer las condiciones de trabajo y cuidados realizados por las Hermanas de Caridad de Santa Ana en el Hospital Nuestra Señora de Gracia en los años setenta del siglo XX. Metodología: Se ha utilizado la metodología cualitativa, entrevistando a dos enfermeras Hermanas de la Caridad de Santa Ana y a dos auxiliares de enfermería que trabajaban en aquella época. Resultados: Se destaca la distribución del hospital, sobre todo las salas y la diferencia en la forma de cuidados en función de las necesidades de Virginia Henderson. Conclusiones: Se han encontrado similitudes con las formas de cuidado en otros hospitales en la década de los años setenta, no consiguen ser totalmente equiparables a los realizados por las Hermanas de la Caridad de Santa Ana en el Hospital Nuestra Señora de Gracia en el mismo espacio temporal, principalmente por la percepción de la salud-enfermedad para cada cultura o grupo social (AU)

Introduction: The Hospital Nuestra Señora de Gracia of Zaragoza was founded in 1425 by Alfonso V El Magnánimo. During the first half of the 20th century, nursing care was carried out by the Sisters of Charity of Santa Ana and adjacent personnel through their work and exemplary care always at the side of the patient. Objective: Expose the working and care conditions carried out by the Sisters of Charity of St. Anne at the Hospital Nuestra Señora de Gracia in the seventies of the twentieth century. Methodology: The qualitative methodology has been used, interviewing two nurses. Sisters of Charity of Santa Ana and nursing auxiliaries who worked at that time. Results: The distribution of the hospital is highlighted, especially the rooms and the difference in the way of care according to the needs of Virginia Henderson Conclusions: Similarities have been found with the forms of care in other hospitals in the seventies, they are not fully comparable to those carried out by the Sisters of Charity of Santa Ana in the Hospital Nuestra Señora de Gracia in the same temporary space, mainly due to the perception of health-disease for each culture or social group (AU)

'Tolerable Intolerance': Protestantism, Sectarianism and Voluntary Hospitals in Late-nineteenth-century London.

This article interrogates the complicated understanding of sectarianism in institutional cultures in late-nineteenth-century England through an examination of the practice of religion in the daily life of hospital wards in voluntary hospitals. Voluntary hospitals prided themselves on their identity as philanthropic institutions free from sectarian practices. The public accusation of sectarianism against University College Hospital triggered a series of responses that suggests that hospital practices reflected and reinforced an acceptable degree of 'tolerable intolerance'. The debates this incident prompted help us to interrogate the meaning of sectarianism in late nineteenth-century England. How was sectarianism understood? Why was it so important for voluntary institutions to appear free from sectarian influences? How did the responses to claims of sectarian attitudes influence the actions of the male governors, administrators and medical staff of voluntary hospitals? The contradictory meanings of sectarianism are examined in three interrelated themes: the patient, daily life on the wards and hospital funding. The broader debates that arose from the threat of 'sectarianism in hospital' uncovers the extent to which religious practices were ingrained in hospital spaces throughout England and remained so long afterwards. Despite the increasing medicalisation and secularisation of hospital spaces, religious practices and symbols were embedded in the daily life of voluntary hospitals.

Children in the London: Inpatient Care in a Voluntary General Hospital.

The presence of children in English voluntary hospitals during the eighteenth century has only recently come under academic scrutiny. This research examines the surviving admission records of the London Hospital, which consistently record inpatient ages, to illuminate the hospital stays of infant and child patients and examine the morbidity of children during the long eighteenth century. Traumatic cases were the most common category of admission. The proportion of trauma cases admitted to the London Hospital was higher than in provincial English child patient cohorts, potentially reflecting the differential risks faced by rural and urban children. In most cases of traumatic injury the inpatients stayed in hospital long enough for significant fracture healing to have occurred. Understanding the conditions surrounding children's admission to hospital, their length of stay, the result of their stay, and which medical issues drove their parents or guardians to seek medical attention for them are critical to illuminating the morbidity of children during the long eighteenth century.

Medicine as a Public Calling.

The debate over how to tame private medical spending tends to pit advocates of government-provided insurance--a single-payer scheme--against those who would prefer to harness market forces to hold down costs. When it is mentioned at all, the possibility of regulating the medical industry as a public utility is brusquely dismissed as anathema to the American regulatory tradition. This dismissiveness, however, rests on a failure to appreciate just how deeply the public utility model shaped health law in the twentieth century-- and how it continues to shape health law today. Closer economic regulation of the medical industry may or may not be prudent, but it is by no means incompatible with our governing institutions and political culture. Indeed, the durability of such regulation suggests that the modern embrace of market-based approaches in the medical industry may be more ephemeral than it seems.

Policy commercializing nonprofits in health: the history of a paradox from the 19th century to the ACA.

UNLABELLED: POLICY POINTS: Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector. This policy paradox persists during the implementation of the Affordable Care Act of 2010. CONTEXT: For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox. METHODS: This article explores the origin and persistence of the paradox using what many scholars call "interpretive social science." This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality. FINDINGS: A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness. CONCLUSIONS: The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox.

John Hughlings Jackson (1835-1911): An adornment to the London Hospital.

John Hughlings Jackson was associated with the London Hospital as a Lecturer and Physician for nearly 40 years while also on the staff at The National Hospital, Queen Square. His experience at the two hospitals was complementary; sometimes, a patient would be exchanged between the two hospitals. At the London Hospital, he was especially revered by students, colleagues and even by the House Governor, for his knowledge and his contributions to neurology. His ideas helped to resolve the chaotic contemporary understanding of neurological phenomena into a coherent whole, determining the direction of future neurological research in the following century. His life and work was supported and strengthened by the help and friendship of his colleagues at the London Hospital, especially Sir Jonathan Hutchinson.

The Scottish Women's Hospital at Royaumont, France 1914-1919.

In 1915, under the aegis of the French Red Cross, volunteer medical women from the Scottish Women's Hospital Service for Foreign Service established a hospital at Royaumont Abbey in France, to treat casualties of the First World War. By working as a team comprised of radiologists, bacteriologists and surgeons, they were able to combat gas gangrene and record remarkable results. The circumstances and the way in which the doctors were portrayed in France and Britain prevented them from actively promoting their results to gain wider acceptance. After the War, medical women lost their training and employment opportunities and many left the profession.

The Scottish Women's Hospitals for Foreign Service--the Girton and Newnham Unit, 1915-1918.

The Scottish Women's Hospitals for Foreign Service were established shortly after the outbreak of the First World War. Opportunities were limited for medical women prior to the war and during it they were unable to obtain a commission in the Royal Army Medical Corps, hence the formation of these voluntary all-women units. The Girton and Newnham Unit, under the leadership of Dr L McIlroy, served with distinction in France, Serbia and Greece, demonstrating clinical competence in the management of the emergency medical and surgical problems associated with warfare, areas usually off-limits to women doctors. They were severely tested but showed endurance and resilience in the running of their hospital in the most difficult of conditions.

La clausura femenina del Hospital de las Cinco Llagas de Sevilla en el Antiguo Régimen / O encerramento feminino do Hospital das Cinco Chagas de Sevilla no Antigo Regime / Women’s enclosure in the the Hospital of the Five Wounds in Sevilla in the Ancient Regime

El Hospital de las Cinco Llagas de Sevilla se creó para atender a enfermas pobres y a causa de la separación de los sexos se formó una enfermería femenina para el cuidado de estas mujeres. Las madres y doncellas de dote trabajaron en la llamada clausura femenina del Hospital de la Sangre durante más de tres siglos. De esta manera, este artículo estudia el tratamiento que se dio a las enfermerías femeninas de este hospital como si fuesen monasterios en reclusión, completamente separadas del resto del hospital y con acceso restringido a los varones fuesen legos o religiosos, con un torno y puerta de entrada al área de clausura femenina (AU)

The Hospital of the Five Wounds of the city of Seville was found to attend the poor patients and because of the separation of sexes was created a women’s infirmary to take care to those women. The «mothers» and «daughters» worked in the called women’s enclosure of the Hospital of the Five Wounds during more that three centuries. In this manner, this article studies about the treatment that was given to the feminine infirmaries of this hospital as if they were monasteries, completely separated from the rest of the hospital and with access restricted to the religious and laymen (AU)

O Hospital das Cinco Chagas de Sevilla foi criado para servir os doentes pobres e por causa da separação dos sexos foi formada uma enfermaria feminina para o cuidado destas mulheres. Mães e filhas de dote, trabalhado no fechamento feminino chamado «Hospital de la Sangre» por mais de três séculos. Assim, este artigo analisa o tratamento dado para a fêmea de enfermagem deste hospital, como se fossem mosteiros em reclusão, completamente separada do resto do hospital e com acesso restringido para os machos foram leigos ou religiosos, com um torno e a porta de entrada para a área de fechamento feminine (AU)

'These schemes will win for themselves the confidence of the people': irish independence, poor law reform and hospital provision.

This article examines hospital provision in Ireland during the early twentieth century. It examines attempts by the newly independent Irish Free State to reform and de-stigmatise medical relief in former workhouse infirmaries. Such reforms were designed to move away from nineteenth century welfare regimes which were underpinned by principles of deterrence. The reform initiated in independent Ireland - the first attempted break-up of the New Poor Law in Great Britain or Ireland - was partly successful. Many of the newly named County and District Hospitals provided solely for medical cases and managed to dissociate such health care provision from the relief of poverty. However, some hospitals continued to act as multifunctional institutions and provided for various categories including the sick, the aged and infirm, 'unmarried mothers' and 'harmless lunatics'. Such institutions often remained associated with the relief of poverty. This article also examines patient fee-payment and outlines how fresh terms of entitlement and means-testing were established. Such developments were even more pronounced in voluntary hospitals where the majority of patients made a financial contribution to their treatment. The article argues that the ability to pay at times determined the type of provision, either voluntary or rate-aided, available to the sick. However, it concludes that the clinical condition of patients often determined whether they entered a more prestigious voluntary hospital or the former workhouse. Although this article concentrates on two Irish case studies, County Kerry and Cork City; it is conceptualised within wider developments with particular reference to the British context.

O Hospital Aristides Maltez e o controle do câncer do colo do útero no Brasil / The Hospital Aristides Maltez and control of cervical cancer in Brazil

O Hospital Aristides Maltez (HAM) foi inaugurado em 1952 na cidade de Salvador (Bahia). O hospital era uma instituição filantrópica pertencente à Liga Baiana Contra o Câncer. Centro especializado no tratamento de variados tipos de câncer, o HAM tinha sua atenção voltada prioritariamente para os cânceres femininos, principalmente o câncer do colo do útero. A instituição tornou-se referência nas ações de controle da doença na Região Nordeste do Brasil. A proposta deste artigo é analisar o processo de criação e consolidação do hospital como espaço de tratamento, pesquisa e formação profissional, avaliando seu papel na rede de discussões e ações em relação ao câncer do colo do útero formada no país em meados do século XX. A instituição foi uma das pioneiras no processo de transição na utilização de ferramentas de diagnóstico e implementação de campanhas de controle do câncer da doença em municípios interioranos. (AU)

Hôtel-Dieu de París; orígenes y aparición de las primeras enfermeras religiosas de la historia / Hôtel-Dieu em Paris; origens e aparência das primeiras enfermeiras religiosas da história / Hôtel-Dieu in Paris; origins and appearance of the first religious nurses of the history

El objetivo del presente estudio es descubrir y dar a conocer la historia del Hôtel-Dieude Paris y la historia paralela al mismo de las Hermanas Agustinas, cuidadoras de los enfermos de dicho hospital. El método usado para llevar a cabo el estudio ha sido una amplia búsqueda bibliográfica, traducción, lectura, análisis y reflexión de los documentos encontrados. Las conclusiones de este estudio nos hablan de la dureza de la ocupación, de cómo podían llegar a tardar en formarse para ejercer plenamente, hasta, veintiséis años y de cómo estaban de delimitadas las funciones entre unos cuerpos y otros (AU)

The objective of the present study is to discover and disclose the history of the Hôtel-Dieu in Paris and, at the same time, the history of the Agustinian´s Sisters, nurses of the mentioned hospital. The methodology used to carry out the study was an extensive literature research, translation, reading, analysis and discussion of the documents we find during the research. The conclusions tell us about the difficulties of the occupation, about how long one-person could take to complete studies and to became fully professional in this area (up to 26years), and also talks about how the functions between some occupations and others was delimitated (AU)

O objectivo do presente estudo é descobrire divulgar a história do Hôtel-Dieu de Paris e paralelamente a história das Irmãs Agustinianas, enfermeiras do hospital mencionado. O método utilizado para levar a cabo o estudo foi uma ampla pesquisa bibliográfica, tradução, leitura, análise e reflexão dos documentos encontrados. As conclusões deste estudo nos falam da dureza da ocupação, de como podiam demorar a se formar para exercer plenamente a profissão até vinte e seis anos e de como estavam delimitadas as funções entre uns corpo se outros (AU)

The first lady almoner: the appointment, position, and findings of Miss Mary Stewart at the Royal Free Hospital, 1895-99.

This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed "appropriate" received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.

The general NFP hospital model.

Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: "Why is the general NFP community hospital the dominant model?" In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the "general NFP hospital" model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States.