By John Cule
National Library of Wales journal, Vol.20:2 (1977)
Introduction: A hospital is not a place devoted only to the cure of disease. This is an idealistic view even if ‘cure’ is interpreted in its broadest sense of a course of medical treatment. Many modern hospitals, like the earlier ones, are designed in whole or in part for the loving care of the infirm in body or in mind, for whom alleviation of their lot is the most that can be expected. Any institution designed for the support of the elderly, the mentally defective or the physically crippled is in itself a hospital and has to take some provision for their health in the prophylaxis and treatment of intercurrent disease, as well as the care of the final illness. The custodians of such places, even without formal medical education, will develop practical medical and nursing skills.
In the natural history of hospitals, the beginnings are to be found in responses to needs manifested by those sections of the community for whom the State or the Church assumed a particular responsibility. The State learned to care for its soldiers, the Church for its monks and pilgrims. The wounded were given shelter and treatment; the sick monk was tended in his monastery. The pilgrim was likely to need at least first aid for the afflictions of the journey. In such social groups, the occasional but inevitable necessities of medical and nursing care could be anticipated by planning. The institutional care of the sick developed from such places, where at first a more general hospitality was given.
In a distinct class is the care prescribed by the State in the early Irish, Welsh and Saxon laws for individuals injured by criminal acts or sometimes by accident. For such, domiciliary care seems to have been the rule prior to the ninth century and possibly later. An individual citizen, when sick or wounded, was thus generally cared for in his own home. In later ages, the time came when the Church or the State provided a communal service for the needs of the population at large.