HOSMER, HARRIET GOODHUE (1830-1908), American sculptor, was born at Watertown, Massachussetts, on the 9th of October 1830. She early showed marked aptitude for modelling, and studied anatomy with her father, a physician, and afterwards at the St Louis Medical College. She then studied in Boston until 1852, when, with her friend Charlotte Cushman, she went to Rome, where from 1853 to 1860 she was the pupil of the English sculptor John Gibson. She lived in Rome until a few years before her death. There she was associated with Nathaniel Hawthorne, Thorwaldsen, Flaxman, Thackeray, George Eliot and George Sand; and she was frequently the guest of the Brownings at Casa Guidi, in Florence. Among her works are “Daphne” and “Medusa,” ideal heads (1853); “Puck” (1855), a spirited and graceful conception which she copied for the prince of Wales, the duke of Hamilton and others; “Oenone” (1855), her first life-sized figure, now in the St Louis Museum of Fine Arts; “Beatrice Cenci” (1857), for the Mercantile Library of St Louis; “Zenobia, Queen of Palmyra, in Chains” (1859), now in the Metropolitan Museum of Art, New York City; “A Sleeping Faun” (1867); “A Waking Faun”; a bronze statue of Thomas H. Benton (1868) for Lafayette Park, St Louis; bronze gates for the earl of Brownlow’s art gallery at Ashridge Hall; a Siren fountain for Lady Marian Alford; a fountain for Central Park, New York City; a monument to Abraham Lincoln; and, for the Columbian Exposition, Chicago, 1893, statues of the queen of Naples as the “heroine of Gaëta,” and of Queen Isabella of Spain. Miss Hosmer died at Watertown, Mass., on the 21st of February 1908.
HOSPICE (Lat. hospitium, entertainment, hospitality, inn, hospes, host), the name usually given to the homes of rest and refuge kept by religious houses for pilgrims and guests. The most famous hospices are those of the Great and Little St Bernard Passes in the Alps.
HOSPITAL (Lat. hospitalis, the adjective of hospes, host or guest), a term now in general use for institutions in which medical treatment is given to the sick or injured. The place where a guest was received, was in Lat. hospitium (Fr. hospice), but the terms hospitalis (sc. domus), hospitale (sc. cubiculum) and hospitalia (sc. cubicula) came into use in the same sense. Hence were derived on the one hand the Fr. hospital, hôpital, applied to establishments for temporary occupation by the sick for the purpose of medical treatment, and hospice to places for permanent occupation by the poor, infirm, incurable or insane; on the other, the form hôtel, which became restricted (except in the ease of hôtel-Dieu) to private or public dwelling-houses for ordinary occupation. In English, while “hostel” retained the earlier sense and “hotel” has become confined to that of a superior inn (q.v.), “hospital” was used both in the sense of a permanent retreat for the poor infirm or for the insane, and also for a regular institution for the temporary reception of sick cases; but modern usage has gradually restricted it mainly to the latter, other words, such as almshouse and asylum, being preferred in the former cases.
The Origin of Hospitals.—In spite of contrary opinions the germ of the hospital system may be seen in pre-Christian times (see [Charity and Charities]). Pinel goes so far as to declare that there were asylums distinctly set apart for the insane in the temples of Saturn in ancient Egypt. But this is probably an exaggeration, the real historical facts pointing to the existence of medical schools in connexion with the temples generally, to the knowledge that the priests possessed what medical science existed, and finally to the rite of “Incubation,” which involved the visit of sick persons to the temple, in the shade of which they slept, that the god might inform them by dreams of the treatment they ought to follow. The temples of Saturn are known to have existed some 4000 years before Christ; and that those temples were medical schools in their earliest form is beyond question. The reason why no records of these temples have survived is due to the fact that they were destroyed in a religious revolution which swept away the very name of Saturn from the monuments in the country. Professor Georg Ebers of Leipzig, whose possession of that important handbook of Egyptian medicine called the Papyrus Ebers constitutes him an authority, says the Heliopolis certainly had a clinic united to the temple. The temples of Dendera, Thebes and Memphis, are other examples. Those early medical works, the Books of Hermes, were preserved in the shrines. Patients coming to them paid contributions to the priests. The most famous temples in Greece for the cure of disease were those of Aesculapius at Cos and Trikka, while others at Rhodes, Cnidus, Pergamum and Epidaurus were less known but frequented. Thus it is clear that both in Egypt and in Greece the custom of laying the sick in the precincts of the temples was a national practice.
Alexandria again was a famous medical centre. Before describing the European growth of the hospital system in modern times, to which its development in the Roman Empire is the natural introduction, it will be well to dispose very briefly of the facts relating to the hospital system in the East. Harun al-Rashid (A.D. 763-809) attached a college to every mosque, and to that again a hospital. He placed at Bagdad an asylum for the insane open to all believers; and there was a large number of public infirmaries for the sick without payment in that city. Benjamin, the Jewish traveller, notes an efficient scheme for the reception of the sick in A.D. 1173, which had long been in existence. The Buddhists no less than the Mahommedans had their hospitals, and as early as 260 B.C. the emperor Asoka founded the many hospitals of which Hindustan could then boast. The one at Surat, made famous by travellers, and considered to have been built under the emperor’s second edict, is still in existence. These hospitals contained provision so extensive as to be quite comparable to modern institutions. In China the only records that remain are those of books of very early date dealing with the theory of medicine. To return to India, the hospitals of Asoka were swept away by a revival of Brahmanism, and a practical hiatus exists between the hospitals he introduced and those that were refounded by the British ascendancy. Hadrian’s reign contains the first notice of a military hospital in Rome. At the beginning of the Christian era we hear of the existence of open surgeries (of various price and reputation), the specialization of the medical profession, and the presence of women practitioners, often as obstetricians. Iatria, or tabernae-medicae, are described by Galen and Placetus: many towns built them at their own cost. These iatria attended almost entirely to out-patients, and the system of medicine fostered by them continued without much development down to the middle of the 18th century. It is to be noted that these out-patients paid reasonable fees. In Christian days no establishments were founded for the relief of the sick till the time of Constantine. A law of Justinian referring to various institutions connected with the church mentions among them the Nosocomia, which correspond to our idea of hospitals. In A.D. 370 Basil had one built for lepers at Caesarea. St Chrysostom founded a hospital at Constantinople. At Alexandria an order of 600 Parabolani attended to the sick, being chosen for the purpose for their experience by the prelate of the city (A.D. 416). Fabiola, a rich Roman lady, founded the first hospital at Rome possessed of a convalescent home in the country. She even became a nurse herself. St Augustine founded one at his see of Hippo. These Nosocomia fell indeed almost entirely into the hands of the church, which supported them by its revenues when necessary and controlled their administration. Salerno became famous as a school of medicine; its rosiest days were between A.D. 1000 and 1050. Frederick II. prescribed the course for students there, and founded a rival school at Naples. At this period the connexion between monasteries and hospitals becomes a marked one. The crusaders also created another bond between the church and hospital development, as the route they traversed was marked by such foundations. Lepers were some of the earliest patients for whom a specialized treatment was recognized, and in 1118 a leprosarium was built in London for isolation purposes. Russia seems the one country where the interconnexion of hospital and monastery was not to be observed. After the period already reached, the 13th century, hospitals became common enough to demand individual or at any rate national treatment.
History of the Hospital Movement.—We have now to consider the principles upon which the provision of the best form of medical care in hospitals can be secured for all classes of people. Though hospitals cannot be claimed as a direct result of Christianity, no doubt it softened the relations between men, and gradually tended to instil humanitarian views and to make them popular with the civilized peoples of the world. These principles, as civilization grew, education improved, and the tastes and requirements of the common people were developed, made men and women of many races realize that the treatment of disease in buildings set apart exclusively for the care of the sick was, in fact, a necessity in urban districts. The establishment of a hospital freed the streets of the abuses attendant upon beggars and other poor creatures, who made their ailments the chief ground of appeal for alms. As the knowledge of hygiene and of the doctrine of cleanliness and purity in regard not only to dwellings and towns, but also in relation to food of all descriptions, including water, became known and appreciated, hospitals were found to be of even greater importance, if that is possible, to the healthy in crowded communities, than to the sick. It took many centuries before sound hygiene really began to occupy the position of importance which it is now known to possess, not only in regard to the treatment and cure of disease, but to its prevention and eradication. So the history of the world shows, that, whereas a few of the larger towns in most countries contained hospitals of sorts, up to and including the middle ages, it was not until the commencement of the 18th century that inhabitants of important but relatively small towns of from 50,000 to 100,000 inhabitants began to provide themselves with a hospital for the care of the sick. Thus, twenty-three of the principal English counties appear to have had no general hospital prior to 1710, while London itself at that date, so far as the relief of the sick was concerned, was mainly, if not entirely, dependent upon St Bartholomew’s and St Thomas’s Hospitals. These facts are interesting to note, because we are enabled from them to deduce from recent events that hospital buildings in the past, though the planning of most of them was faulty to begin with and became more and more faulty as extensions were added to the original buildings, did in fact suffice to satisfy the requirements of the medical profession for nearly two centuries. In other words, under the old condition of affairs the life of a building devoted to the care of the sick might be considered as at least 150 years. To-day, under the conditions which modern science impose upon the management, probably few hospital buildings are likely to be regarded as efficient for the purpose of treating the sick for more than from 30 to 50 years.
The foregoing statement is based upon the history of British hospitals of importance throughout the country, but the same remark will apply in practice to hospital buildings almost everywhere throughout the world. In truth, hospitals have been more developed and improved in Great Britain than in other countries, though, since the last quarter of the 19th century, German scientists especially have added much to the efficiency of the accommodation for the sick, not only at hospitals but in private clinics, and many German ideas have been accepted and copied by other countries. In Great Britain hospitals for the treatment of general and special diseases are mainly maintained upon what is known as the voluntary system. On the European continent, hospitals as a rule are maintained by the state or municipalities, and this system is so fully developed in Sweden and elsewhere that a sound economical principle has been embroidered upon the hospital system, to the great physical and moral advantage of all classes of the community. The system referred to confers great benefits upon inhabitants in large towns by bringing the poor-law and voluntary institutions into more intimate association, although they may be managed by separate governing bodies. The plan pursued is to demand payment from all patients who are admitted to the hospital under a scale of charges divided into three or four grades. The first grade pays a substantial sum and obtains anything or everything the patient may care to have or to pay for, subject to the control of the medical attendant. The second pays much less, but a remunerative rate, for all they receive at the hospital; and the third and fourth classes are very poor people or paupers, who are paid for on a graduated scale by the poor-law authorities, or the communal government, or the municipality. Under this system well-to-do thrifty artisans and improvident paupers are all treated by one staff, controlled by one administration, and are located in immediate proximity to each other though in separate pavilions. We have no doubt, as the result of many years’ investigation and an accurate knowledge of the working of the system, that this is the true principle to enforce in providing adequate medical relief for large urban populations everywhere throughout the world. It should be accompanied by a system of government insurance, whereby all classes who desire to be thrifty may pay a small annual premium in the days of health, and secure adequate hospital treatment and care when ill. Provided that pay wings were added to the existing voluntary and municipal hospitals, it should be found that the relatively small annual premium of £3 per annum should enable the policyholders to defray the cost of medical treatment in a pay ward or at a consultation department of a great hospital as a matter of business. In the United States of America most large towns have great hospitals, usually known as city hospitals, administered and mainly supported by the municipality. Many such institutions have pay wards, but nowhere, so far as we have been able to discover, has the system of medical relief in its entirety been organized as yet upon the business system we have just referred to.