Historia de una infraestructura menguante: la crisis terminal del hospital rural al final del franquismo (1960-1975) / History of a dwindling infrastructure: the terminal crisis of the rural hospital at the end of Francoism (1960-1975)

Este artículo analiza la evolución de los hospitales rurales en España entre la segunda mitad del siglo XVIII y el final de la dictadura franquista, las décadas del «desarrollismo». En su primera parte explica las características de los hospitales rurales de aldeas y villas y las causas de su declive durante el siglo XIX en beneficio de los hospitales provinciales. Así mismo, el texto se aproxima a las condiciones de ejercicio de la medicina rural a lo largo del siglo XIX y las primeras décadas del XX (hasta la Guerra civil). En su segunda mitad, a partir del análisis de los Catálogos de hospitales correspondientes a los años 1963 y 1970, el artículo dibuja una panorámica de la asistencia hospitalaria en el mundo rural al final de la dictadura, pero aten-diendo también a las dinámicas específicas de cuatro regiones y a sus contrastes: Galicia, el País Vasco, La Mancha y Andalucía. Para una población, la rural, que fue la mayoritaria en España hasta entrada la segunda mitad del siglo XX, las décadas finales de la dictadura supusieron el tránsito definitivo de un modelo de asistencia sanitaria rural basado en la medicina liberal y en la beneficencia (pública y privada) a otro de medicina socializada y localización urbana (AU)

[Reminiscence of the "Relief Houses" that operated in rural Chile between 1931 and 1945]. / Recuerdo histórico de las "Casas de Socorro" que funcionaron en el Chile rural entre 1931 y 1945.

In June 1929, the medical charity inspectors (Isauro Torres and Enrique Laval M.) submitted to the Direction of the Institution a plan for the normalization of all hospitals, which was approved by the Central Board at its meeting on 19 July of that year. The plan was to phase in the hospital action from the First-aid Posts or "Relief Houses" to the large referral hospitals. The "Relief House" would become the initial phase of hospital organization, located in rural areas. Finally, we emphasize that the Relief Houses were establishments for preventive and curative medicine in rural areas.

La medicina rural a principios de siglo XX. A propósito de Martínez Saldise (1855-1937), socio de honor de la Sociedad de Pediatría de Madrid en 1927 / Rural medical practice at the beginning of the 20 th century. Martínez Saldise (1855-1937), honorary member of Paediatric Society of Madrid in 1927

INTRODUCCIÓN: En el centenario de la Sociedad de Pediatría de Madrid se quiere realizar un homenaje a la medicina rural de aquella época. Hay escasez documental sobre la historia de la medicina rural. El objetivo es describir el marco del ejercicio médico rural a finales del XIX y principios del XX en tanto que se desarrolla una revisión histórica biográfica de Manuel Martínez Saldise, que fue médico titular de Cazalegas (Toledo). En 1927 fue nombrado socio de honor por la Sociedad de Pediatría de Madrid. MATERIAL Y MÉTODOS: Búsqueda en repositorios de prensa digitalizada, portales web de historia de la medicina, pubmed, IME, archivos locales de diputaciones y colegio de médicos. Se revisó el archivo familiar con la colaboración de uno de sus descendientes. RESULTADOS: La contratación de los médicos rurales se realizaba por los ayuntamientos, el sueldo en gran parte dependía además del ejercicio privado, de las «igualas». Los médicos titulares participaban en las epidemias, en medicina legal, en las medidas de higiene; también tenían conflictos con alcaldes, caciques, con colegas y con el intrusismo. Se hace un resumen de aspectos biográficos y laborales de Manuel Martínez Saldise.comentarios:Los médicos rurales se entregaban a la sociedad de su época, ante los problemas que surgían, denunciaban las carencias de la administración local, dedicaban esfuerzos a su familia y a los más desfavorecidos

INTRODUCTION: On the centenary of the foundation of the Paediatrics Society of Madrid, a tribute is presented to rural medical practice of that time, although there are few documents on the history of rural medicine. The main objective is to describe the context of the rural medical practice in the late 19th and beginning 20th century, while presenting a historical biographical review of Manuel Martínez Saldise, who was medical specialist from Cazalegas (Toledo). He was appointed an Honorary Member by the Paediatrics Society of Madrid in 1927. MATERIAL AND METHODS: A search was carried out in repositories of digitized media, web portals of history of medicine, PubMed, IME files of local councils and medical colleges. The family archives were reviewed with the collaboration of his descendants. RESULTS: The hiring of rural doctors was carried out by the municipalities, and the salary largely depended on private practice as well as "retainers". Specialist physicians took part in epidemics, legal medicine, and in hygiene measures. They also had disputes with mayors, chiefs, with colleagues and with protectionism. A summary of the biography and occupational activity of Manuel Martínez Saldise is presented.comments: Rural doctors were subjected to the society of their time, with the issues that arose, denouncing the shortcomings of the local administrations, dedicated efforts to their family and the most disadvantaged

Charles Lucas and medical legislation in eighteenth century Ireland.

INTRODUCTION: Charles Lucas, apothecary, physician and MP, was instrumental in facilitating legislation in Ireland in 1765 that established a nationwide network of hospitals in Ireland. This legislation was unique in contemporary Europe, and by the end of the century, there was a hospital in every county in the country. MATERIALS AND METHODS: His work as an apothecary provided him with the knowledge to attempt to address the problems in the apothecaries' trade, and his 1741 pamphlet, Pharmacomastix, provided the framework for the 1761 Irish Apothecaries Act, which attempted to address these issues. It was, however, 1791 before nationwide regulation of the Irish apothecaries' trade was implemented following the establishment of the Apothecaries Hall, and this was 24 years before similar regulatory legislation was passed in Britain. Lucas sought enhanced regulation of the apothecaries' trade to provide better quality drugs and medicines for the general public, and he tried to ensure that untrained quacks did not practise as apothecaries, unbeknownst to their patients. He was aware that his proposals would meet with opposition, but he had the courage to pursue these without any element of personal gain. CONCLUSION: In medical terms, Charles Lucas was man ahead of his time.

Theatrical entertainments and kind words: nursing the insane in Western North Carolina, 1882-1907.

This paper argues that at the turn of the 19th century, nurses at the State Hospital in Morganton, North Carolina (now called Broughton Hospital) played critical roles in successfully implementing the best-known therapeutic methods of the time. They were also instrumental in developing the hospital's visibility and acceptance in rural western North Carolina. When the Hospital established its first nurse training school in 1895, this corps of first-generation western North Carolinians practising institutional nursing was highly esteemed in their field. Their skills not only served the community outside of the Hospital's walls, but were also sought out by other private and state asylums.

The rural hospital in Ecuador.

Over a period of twelve years, the author's vision of improving the health of rural Ecuadorians has evolved from an initial emphasis on primary health care to secondary care. The local community convinced him of the critical need for an efficiently managed, high-quality, and affordable rural secondary care hospital. Exploring a variety of funding options, the hospital ultimately achieved financial sustainability, principally through Ecuadorian public sources. Now, in partnership with the Ministry of Public Health (MOH), the rural hospital model that evolved in Pedro Vicente Maldonado is being adapted as a pilot project in an existing MOH rural hospital.

[Surgical dynasties and practices in northern Basque in the 18th century]. / Dynasties et pratiques chirurgicales en Pays Basque Nord au XVIIIème siècle.

In the XVIIIth century the sanitary practice in the Basque Country is confronted with the professional realities. On the one hand the ratio of sanitary Basque corps is more important than in some other countries. On the other hand there are more surgeons and midwives on the whole territory than physicians who are gathered in Bayonne and along the coast only. A kind of rural hospitalisation had been realized through the creation of the Barberaenea (Surgeon's Houses) which were numerous and afficient for the health service. Nevertheless in the Basque country the struggle against illness and death remained very unfavourable to the men like elsewhere.

'Why don't they get it?' Talk of medicine as science. St Luke's Hospital, Panniqtuuq, Baffin Island.

Using diaries, clinical notes and other sources, this contribution explores interactions between Dr J. A. Bildfell and Inuit at Panniqtuuq, Baffin Island, in 1933 and 1934. The article comprises a record of conflict, with two cultures colliding over the provision of health care. Scientific and technological advances in medicine were perceived by Bildfell as possessing the potential to address many of the problems diagnosed among Inuit. However, there was strong resistance to his practices. Bildfell was therefore caught between the promise and potential of his profession and a suppressed admiration for local belief-systems. The paper highlights Inuit resistance, particularly in relation to childbirth. In addition, Bildfell's writings are used to reveal how the construction of the 'other' can be understood as a heuristic device to explain antipathy to the introduction of western medicine. In the longer term, the latter imbedded itself into Qallunaat (non-Inuit)-Inuit relations. The paper also shows that colonial styles of rule are relevant to an appreciation of the foundation of post-colonial challenges to medical science and the consciousness that continues to follow professionals working in cross-cultural settings.

Blurring the boundaries of space: shaping nursing lives at the Red Cross outposts in Ontario, 1922-1945.

Historians and other scholars interested in the history of hospitals have investigated the links between medical architecture and the organization of space with the evolution of modern medicine. The transformation over time in the architectural for of medical institutions has tended to reflect developments in medical science and therapeutic efficiency as well as elements in the broader social climate. Some authors, however, have argued for the agency of structure and spatial organization, to consider that they are not just containers with which human activities take place, but which also actively construct or constitute social practices and relations. Most studies of this nature have centred on large medical buildings especially in urban areas, and have examined the impact of architectural arrangement in relation to administrators and architects, physicians and patients. Fe have considered the interconnections of form and space with nurses, despite the prominence of institutional nursing labour since the late 19th-century. The following discussion begins an exploration of these concepts within the rural environment. Between 1922 and 1984, the Ontario Division of the Canadian Red Cross Society administered an outpost program in which it operated small hospitals and nursing stations in isolated communities throughout the northern reaches of the province. This article will focus primarily o n the one-nurse stations that the Division managed during the interwar years and the nurses that it hired to staff them. The interior spatial organization of these outposts, which led in particular to their multiple functions as tiny hospitals, community health centres and nurses' homes, not only shaped both the professional practice and the social or private lives of the Red Cross nurses but also contributed to the diffusion of contemporary precepts in health and medical care throughout a remote population.

Rural community and health care interdependence: an historical, geographical study.

The relationships between rural health care and community development were examined over time, for the case-study area of Huron and Perth counties in Southwestern Ontario. The underlying premises were that an historical-geographic study could provide both a perspective on the development of rural health services and explore the interdependent relationship between rural community and health care. The research concentrated on examinations of the 2 key elements of rural health care, namely the rural practitioner and the community hospital. Detailed reconstruction revealed that, over time, both physicians and hospitals moved from a marginal to a central position and identity within the community, in parallel with the stages of community development in the 19th and 20th centuries, with hospitals emerging as major foci of rural sustainability. In the last 2 decades, the strength of the area's rural community health system was successfully marshalled to offset the potentially negative aspects of provincial health care restructuring. This reinforced both the perception and the reality of the interdependence of health services and communities in the predominantly rural area.

[Kedainiai Hospital - one of the oldest hospitals in the region]. / Kedainiu ligonine - viena seniausiu rajono ligoniniu.

The review presents the facts of the origination of hospitals in Lithuanian villages based on historical documents. This process took place within the occupation period of czarist Russia. The recurrence of epidemics of grave infections diseases, such as cholera, typhus and diphtheria was one of the most important reasons leading to the establishment of network of rural health care institutions. Free outpatient and inpatient treatment of rural population was introduced for the first time, however this was accomplished not in all small towns. Kedainiai is a very old town with interesting and unique history. The article reviews development of health care in Kedainiai within the period of Kaunas Province.