Szpitale w Królestwie Polskim w XIX wieku:
Gespeichert in:
Beteilige Person: | |
---|---|
Format: | Buch |
Sprache: | Polnisch |
Veröffentlicht: |
Warszawa
Instytut Archeologii i Etnologii PAN
2008
|
Schriftenreihe: | Studia i Materiały z Historii Kultury Materialnej
72 |
Schlagwörter: | |
Links: | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017725241&sequence=000003&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017725241&sequence=000004&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA |
Beschreibung: | Zsfassung in engl. Sprache u.d.T.: Hospitals in the Kingdom of Poland in the 19th century |
Umfang: | 231 s., [1] k. tabl złoż. il. 24 cm |
ISBN: | 9788389499387 |
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Datensatz im Suchindex
_version_ | 1819381138342281216 |
---|---|
adam_text | SPIS TREŚCI
Wstęp
........................................................................................................... 7
Rozdział I
Organizacja szpitalnictwa
...................................................................... 15
Rozdział
II
Fundusze szpitalne
................................................................................. 36
Rozdział III
Budynki i wyposażenie szpitali
............................................................ 57
Rozdział
IV
Wyżywienie
............................................................................................ 105
Rozdział
V
Personel szpitalny
.................................................................................. 118
Zakończenie
................................................................................................. 137
Aneksy
Aneks
I.
Wykaz szpitali podległych Radzie Dobroczynności Publicz¬
nej z lat
1867
i
1897......................................................................... 142
Aneks
II.
Wykaz szpitali podległych Radzie Dobroczynności Publicz¬
nej z
1903
roku
.................................................................................. 147
Aneks III. Wykaz szpitali prywatnych z
1903
roku, nie pozostają¬
cych pod bezpośrednim zarządem Rad Dobroczynności Publicznej
... 150
Aneks
IV.
Wykaz nieruchomości stanowiących własność szpitali
w Królestwie Polskim w roku
1903................................................. 152
Aneks
V.
Wykaz dochodów szpitali w Królestwie Polskim z podzia¬
łem na kategorie
(1902
rok)
.............................................................. 155
Aneks
VI.
Wykaz effektów szpitalnych
............................................... 156
Aneks
VII.
Wykaz bielizny, pościeli i ubrania na
6
łóżek
................ 160
Aneks
VIII.
Inwentarz majątku Józefa
Wolfa
..................................... 163
Aneks
IX.
Wykaz szpitali w Królestwie Polskim
............................... 169
Bibiografia
................................................................................................... 188
Summary
...................................................................................................... 214
Spis rycin
.................................................................................................... 221
Indeks nazwisk
............................................................................................ 223
Indeks szpitali
............................................................................................. 229
Indeks instytucji
.......................................................................................... 232
Summary
HOSPITALS IN THE KINGDOM OF POLAND
IN THE 19TH CENTURY
The 19th century saw an unprecedented acceleration of changes in living
conditions. The speedy processes of civilization and modernization, the rapid
growth of the population, the urbanization, the technological revolutions and
the tremendous progress in science necessarily affected the everyday life, also
the life of the sick. All those factors changed the way of thinking about great
and trivial matters, about politics, culture and everyday life, and also about
hygiene and health. In this last domain there were changes not only in material
condition of hospitals, but also in the attitude of potential patients to the very
institution of hospital. This book focuses on the process of changes in the func¬
tioning of hospitals induced by the progress of civilization.
At the end of the 18th
с
Poland was partitioned by the three neighbouring
powers, Russia, Prussia and Austria. After this political catastrophe came
a period of relative stability, marked with the establishment of the Kingdom of
Poland, negotiated by the three occupants at the Congress of Vienna in
1815.
The so-called Congress Kingdom consisted of the territories acquired by Prus¬
sia in the
2nd
and
3rd
partition, which during the Napoleonic Wars had been
the Duchy of Warsaw
(1807-1815;
cf.
the map). The Kingdom was linked by
a personal union with the Russian Empire and was granted a constitution by
Tsar Alexander I to maintain appearances of its sovereignty, which Russia ne¬
ver respected. The administration of the Kingdom was formally independent,
but in practice it was entirely subordinated to the Russian government.
The discussion of the hospital system in the Kingdom of Poland will cover
the period from
1815
to the end of the 19th century. The starting point is obvio¬
us; the choice of the end point, however, can be disputed. Polish historians are
far from agreeing on when the 19th century really ended. Those that are inte¬
rested in political history assume that it lasted until the year
1914;
for social
historians the turning point was the
1905
revolution, while for those investiga¬
ting economical development
-
the year
1870,
the beginning of the second
technological revolution. For the present work the most important criterion is
the development of the hospital system, which resulted in the emergence of the
modern type of hospital at the turn of the 20th century.
215
The structure of the present book is determined by the subject of research.
I am primarily interested in material culture, therefore a large part of the book
focuses on issues related to that area. Chapter
1
discusses the legal regulations
affecting the work of hospitals and their staff, and surveys the hospitals wor¬
king in the Polish territories controlled by Russia in the period in question. At
the end of the 19th
с
in those territories there were
88
hospitals subordinated
to the Councils of Public Charity
{Rady Dobroczynności Publicznej),
special
institutions established by the tsarist government to control hospitals (see Ap¬
pendix II). This group included specialist hospitals, sanatoria and religious
hospitals. In addition to that, there were
21
factory hospitals and four privately
funded children s hospitals. Since
1817
hospitals were supervised by the Main
Supervisory Council
(Rada Główna Dozorcza),
subordinate to the Government
Committee of Domestic Affairs
(Komisja Rządowa Spraw Wewnętrznych).
In
the years
1818-1832
the Council managed the hospitals through various subor¬
dinate administrative institutions in a very inefficient and bureaucratic manner.
Only four new hospitals were founded in that period (see table II). In
1832
the
system was reformed and a new central institution, the Main Protective Coun¬
cil
(Rada Główna Opiekuńcza, RGO),
was established to supervise hospitals
and charity institutions. Each hospital, whether in Warsaw or in the provinces,
had its Individual Protective Council
(Rada Szczegółowa Opiekuńcza),
which
was responsible for the employment, the finances, the administration and the
standard of medical care. In
1842
a new law was passed to regulate the orga¬
nization and management of hospitals. This was one of the best laws in all the
three zones of the partitioned Poland, regulating almost all the aspects of the ;
functioning of hospitals. The law, consisting of over
300
pages, gave very
detailed instructions as to the number of employees and their duties, standards
.
of book-keeping, diets suitable for patients in various types of hospitals, disci¬
pline regulations, medical equipment and everyday items, as well as architec¬
tural and technical details concerning the buildings and their surroundings. The
work of the Main Protective Council and Individual Councils in the years
1832—
1870
greatly facilitated the development of the Polish hospital service. This
period saw the opening of
47
new hospitals and refurbishing of many old ones,
the introduction of regular medical care, the foundation of new specialized
institutions in Warsaw (e.g. gynaecological institutes and children s hospitals)
and the increasing specialization of hospital wards.
The hospital system was badly affected by the political repression after the
fall of the January Uprising in
1864.
The Main Supervisory Council and the
Individual Protective Councils were dissolved. The administrative reform of
1870
eradicated the last appearances of the Kingdom s independence. Like many
other institutions, hospitals were subordinated to the Russian Ministry of Do¬
mestic Affairs. The Ministry established province and county Councils of Pu¬
blic Charity
(Rady Dobroczynności Publicznej),
bureaucratic structures domi¬
nated by Russian officials, which hampered the development of hospitals. The
hospital service went into a slump. In
1867
the Kingdom had
7
beds for every
10 000
inhabitants and
3.3
bed for every
10 000
excluding Warsaw hospitals.
216
By
1902
those rates lowered to
5.8
and
2.6
respectively. The significant decre¬
ase resulted from the rapid growth of the Kingdom s population in the 1870s
and 1880s.
Chapter
2
describes the complicated financial position of hospitals. Their
condition was largely dependent on the real estate and capital owned, on owning
or not owning the premises used, on the charitable generosity of the local com¬
munity, on the number of patients to be attended and, due to the growing spe¬
cialization of hospitals, on the varying costs of treating different diseases. Fur¬
thermore, some hospitals had been working since the Middle Ages and by the
19th
с
had had a chance to accumulate substantial property due to donors
generosity, while others had just been founded and had to start from scratch.
Finally, due to the rapid progress of civilization, the organization of medical
care and the maintenance of hospitals turned out to require substantial support
from the state. As the Kingdom was not a sovereign state and the rules of
supporting hospitals by the tsarist government were not clearly regulated, ho¬
spitals were often badly underfinanced. The aforementioned law from
1842
regulated both the management of hospitals property and the distribution of
money provided by private donors and the government
(cf.
Appendix
5).
Ne¬
vertheless, the tsarist government often disregarded the wishes of private do¬
nors as to the use of their donations and thus discouraged the citizens from
charity work. In sum, it was the government that decided about the use of the
money, regardless of its source.
Chapter
3
Hospital buildings and equipment consists of two parts. Part
1
discusses the proposals and government regulations concerning the construc¬
tion and furnishing of city and provincial hospitals; part
2
is an attempt to
reconstruct the material side of the hospital service in the Kingdom of Poland.
In
1830
the tsarist authorities entrusted
Dr Adam
Rudziec-Rudnicki with
the task of unifying the regulations concerning hospital service issued in the
years
1815-1830.
In the same year
Rudnički
published his ideas of hospital
organization. He proposed that hospital buildings should be located in open
dry places with access to running water. He also outlined a model of hospital
for
1 000
patients, listing necessary fittings and equipment. His plan was never
implemented, which is not surprising, since in the 1830s a hospital was still
treated as a shelter for the poor.
Another important document was the aforementioned law concerning civil
hospitals in the Kingdom of Poland passed in
1842,
which is an excellent so¬
urce for researching the condition of medical institutions, since it regulated in
detail all the aspects of their functioning, from the classification of hospitals
according to medical specialization and religion, through the technical side
(lighting, heating, sewage etc.), to the detailed description of the rooms and
their furnishings. Importantly, the
1842
law reflected the contemporary know¬
ledge and developments in medical science and hygiene.
The second half of the 19th
с
saw the first pavilion hospitals. In
1872
Franciszek Tournelle,
a developer from Warsaw, wrote in the papers on the
advantages of this system, the most important of which was preventing
217
epidemics by separating patients suffering from various ailments. He also desi¬
gned a provincial hospital for
50
patients
(cf.
fig. 4a and 4b). The chapter
summarizes the heated press debate on that topic, which resulted in designing
village hospitals for ten and six patients
(cf.
fig.
6
and
7).
The aforementioned projects illustrate the evolution of the notion of hospi¬
tal from a huge dreary building to the pavilion system based on isolating pa¬
tients suffering from different diseases. Importantly, doctors, patients and re¬
formers gradually ceased to regard a hospital as a poorhouse, and began to
propagate the idea of a clinic, widely accessible both in the cities and in the
country.
A comparison of the above plans and models with reality has revealed the
direction of changes in the hospitals of the Kingdom. In the 1820s, before the
publication of Rudziec-Rudnicki s proposals, it was common to put two pa¬
tients in one bed, hospitals had no sanitary facilities, contagiously ill patients
were not isolated and surgical operations were performed in the wards. Later
the situation gradually improved, especially in Warsaw, starting with the selec¬
tion of patients and an adequate supply of beds, linen and tableware. In accor¬
dance with the
1842
law, newly built hospitals were equipped with central
heating, waterworks, ventilation and sanitary facilities. New buildings were
situated so as to utilize natural light most efficiently; they had gardens, sepa¬
rate admission rooms and operating theatres, often complying with the stan¬
dards set by the
1842
law
(cf.
fíg.
19).
In architectural terms the most impor¬
tant development was replacing a single building with a group of pavilions
making a campus; this arrangement, however, was only adopted in three new
hospitals in Warsaw, including the Infant Jesus Hospital
{Szpital Dzieciątka
Jezus),
built in
1901
(cf.
fig.
13
and
14).
Some old buildings were modernized in accordance with the postulated
norms, but this concerned mainly hospitals in big cities, while provincial ones
often lagged behind and failed to maintain basic hygienic standards. The afo¬
rementioned plans of founding small provincial clinics were not implemented.
The main problem was the overcrowding of hospitals, resulting from the incre¬
asing number of patients, particularly dangerous during epidemics. In addition
to that, provincial hospitals often lacked proper ventilation, heating and ligh¬
ting systems, sanitary facilities and separate wards for the contagiously ill. At
the turn of the 20th
с
some small hospitals (e.g. in
Łuków, Pułtusk, Grójec,
Łęczyca)
still had no separate operating rooms. Complaints about such defi¬
ciencies are evidenced in the case of hospitals in
Brzeziny, Zamość, Augustów,
Piotrków, Rawa and Ostrołęka.
The general condition of the hospitals in the Kingdom at the end of the
19th
с
was so poor and so difficult to improve despite physicians and archi¬
tects proposals because of the political situation. The Russian government was
not interested in improving health care in the occupied country and the situ¬
ation could not be significantly changed solely through the efforts of individu¬
als and the generosity of charitable donors. Actually then, the progress in
medical sciences and the knowledge about hygiene did not translate into the
218
everyday functioning of Polish hospitals, unlike in Western Europe, where
governments regarded improving health care as a way to strengthen their states.
The chapter on feeding the sick presents diets and menus served to various
categories of patients. The categorization was based on varied criteria; for
example in the 1830s the groups entitled to a full dietary portion included re¬
sidents of poorhouses, the mentally ill, pregnant women and wetnurses. Diffe¬
rent diets were suggested for people suffering from rheumatic and dermatolo-
gical ailments and for convalescents
(cf.
table VI). Patients with fever and newly
delivered mothers were to get half a portion, while paying patients
(cf.
table
VII)
were entitled to extra portions. The
1842
law divided patients into Chri¬
stians and Jews. Special diets, regardless of religion, were drawn up for the
mentally ill. To give an example, in the 1870s in the Evangelical hospital in
Warsaw the patients were divided into four categories, depending on the fees
for treatment. Each category had a separate diet, differing in both ingredients
and the size of portions.
The diet was generally very monotonous. It was based on cheap products,
mostly various kinds of groats, bread, potatoes, cabbage and beetroots. Meat
was usually boiled. From today s perspective it may be surprising that patients
were allowed vodka, wine and beer. More varied menu was available to pay¬
ing patients. In their diet we find beefsteaks, chicken, boiled beef with gravy
and flummery
(cf.
table
VIII
and IX).
In the 1880s the development of biology and medicine resulted in a new
idea of feeding patients, which in practice came down to introducing an
ŕ la
carte system. In Warsaw a special committee was formed to modernize patient
nutrition. The well-grounded proposals advanced by doctors, motivated by re¬
search and the experience of many European hospitals, in which introducing
better diet brought considerable advancement in treating many diseases, could
not be implemented until the end of the 19th
с
due to financial and admini¬
strative obstacles. Hospital lacked suitably large and well-equipped kitchens
and properly trained kitchen staff; the project was hampered by the general
resistance of the matter and aversion to innovations.
Chapter
5
discusses the earnings of hospital personnel, starting with the
official physicians employed by the tsarist government in the army and in the
civil administration. Their material standing was dependent on their position in
the administrative hierarchy. The lowest class in the provincial administration
were municipal physicians, who on the average earned
150
roubles per annum.
County physicians earned
375
roubles, while the Healthcare Inspector of the
Kingdom
600
roubles. Only some of the official physicians, holding the degree
of doctor of medicine and surgery or doctor of medicine and physician had
the right to private practice. The Kingdom s regulations recognized
14
medical
degrees; the abovementioned two were a proof of a thorough medical edu¬
cation.
The earnings of official physicians have been compared with doctors wor¬
king in private practice. Probate inventories indicate that the latter group was
quite well-off. For example, in
1830
the property of the Warsaw physician
Józef
219
Wolf was estimated at
3 474
roubles and the property of Anna
Adelt nee
Hun-
dyn, widow of
Dr Zygmunt
Adelt,
at
4 537
roubles. Also information from
biographical sources seems to confirm the relative affluence of those doctors
who due to their professional success or community work became public figu¬
res. For example Adam
Bogumil
Helbich
(1796-1881),
a renowned physician
from Warsaw, donated
4 500
roubles to a charity supporting doctors widows
and orphans. The same organization received
10 000
roubles from
Feliks Ja-
błonowski,
the head doctor of the Infant Jesus Hospital in Warsaw.
The data from probate inventories and bibliographical sources seem to con¬
tradict the aforementioned information on the very limited income of official
physicians. It should be stressed, however, that probate inventories and biogra¬
phies show individual cases. On the other hand, official physicians are not
necessarily representative of the whole community of doctors and we do not
know whether the modest official earnings were their sole income. Daily new¬
spapers and professional periodicals published information on the very low
revenues of provincial doctors. For instance, in the 1870s a doctor in the Je¬
wish hospital in
Kalisz
earned
75
roubles per annum. Like other intelligentsia
groups (scientists, journalists, lawyers, engineers), physicians were diversified
as to the financial standing. A doctor s situation could depend not only on
professional success but also on other circumstances, for example on an ad¬
vantageous marriage. The decisive factor, however, was the opportunity of pri¬
vate practice. There was a vital difference between practicing in a small town
or village, where very few people could afford to consult a physician, and in
a big city such as Warsaw,
Łódź
or even Lublin, which was then considered
a provincial town.
The chapter also discusses the duties and earnings of other hospital staff.
Sisters of Mercy, who took care of the patients, were in charge of the pharma¬
cy, larder, kitchen and laundry, and sometimes also did clerical work, earned
from
40
to
45
roubles per annum
η
addition to accommodation and food. Pa¬
ramedics, who took care of the sick when there was no doctor around, earned
from
30-90
roubles in the country to
225
roubles in Warsaw (the Infant Jesus
Hospital). Other personnel (cleaners, washerwomen, porters) earned on the
average
30
roubles (women) and
48
roubles (men) per annum, sometimes sup¬
plemented with full board and work clothes. The number of staff increased as
hospitals developed. This correlated with the increasing role of administrators,
who managed hospitals. For example, in the Infant Jesus Hospital in Warsaw,
the chief administrator earned
1 700
roubles per annum.
The hospital understood as a modern institution of medical care emerged
after a long and difficult process. In previous centuries, due to the state of
medical knowledge and the attitude to the sick, hospitals were mostly associa¬
ted with dying. It was only at the beginning of the 20th
с
that the hospital
began to function as a modem professional medical institution, thanks to the
advancement of bacteriology, anaesthesia and antiseptics.
West European examples show that the development and reform of the hospi¬
tal service in the 19th
с
were largely dependent on state support and closely
220
connected with the progress of civilization and economy induced by industria¬
lization. Despite the lack of sovereignty, the Kingdom of Poland was also mo¬
dernizing. Since the mid 19th
с
the population grew rapidly, especially in War¬
saw,
Łódź
and
Zagłębie Dąbrowskie,
which were important centres of metal,
textile and mining industry. Consequently, hospitals in the Kingdom were also
transformed, as in the West, although the process was understandably delayed,
as was in fact characteristic of the whole Central and Eastern Europe. My re¬
search indicates that at the forefront of reforms were Warsaw hospitals, which
were the first to specialize. Warsaw also had the first Ophthalmologic Institute,
venereal hospitals and the Gynaecological Institute. The first hospital for the
mentally ill was founded in
Tworki
in
1900.
In the period investigated the city hospitals in Warsaw,
Łódź,
Lublin or
Kalisz
were undoubtedly greatly transformed. Some of them adopted the pavi¬
lion system and both their premises and equipment matched the European stan¬
dards. Provincial hospitals, on the other hand, with few exceptions, were con¬
stantly underfinanced and could hardly undertake any serious reforms. Some
of them have not been transformed into fully-fledged medical institutions and
still functioned as poorhouses.
The political dependence of the Kingdom precluded any stable and consi¬
stent policy of the state in the area of medical reforms. Various valuable initia¬
tives were hampered by the lack of funds. There were no clear rules of go¬
vernment support for hospitals, which were treated instrumentally and forced,
especially after
1870,
to follow bureaucratically imposed models of financing
and management. One thing is certain, however. Throughout the 19th
с
most
hospitals in the Kingdom evolved from social welfare institutions into fully-
fledged institutions of medical care, which ceased to terrify the potential pa¬
tients. This was not an instantaneous achievement but a prolonged process,
which testifies both to the quality of medical sciences and the economic poten¬
tial of the Kingdom. The change in the functions of hospitals was induced by
the development of medicine, the increasing number of doctors and the chan¬
ging needs of potential patients, who required health care rather than social
welfare.
|
any_adam_object | 1 |
author | Mazur, Elżbieta |
author_GND | (DE-588)1285588037 |
author_facet | Mazur, Elżbieta |
author_role | aut |
author_sort | Mazur, Elżbieta |
author_variant | e m em |
building | Verbundindex |
bvnumber | BV035670972 |
contents | Bibliogr. s. [188]-213 |
ctrlnum | (OCoLC)297877105 (DE-599)BVBBV035670972 |
era | Geschichte gnd |
era_facet | Geschichte |
format | Book |
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geographic | Kongresspolen (DE-588)4437411-2 gnd |
geographic_facet | Kongresspolen |
id | DE-604.BV035670972 |
illustrated | Not Illustrated |
indexdate | 2024-12-20T13:40:17Z |
institution | BVB |
isbn | 9788389499387 |
language | Polish |
oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-017725241 |
oclc_num | 297877105 |
open_access_boolean | |
owner | DE-12 |
owner_facet | DE-12 |
physical | 231 s., [1] k. tabl złoż. il. 24 cm |
publishDate | 2008 |
publishDateSearch | 2008 |
publishDateSort | 2008 |
publisher | Instytut Archeologii i Etnologii PAN |
record_format | marc |
series | Studia i Materiały z Historii Kultury Materialnej |
series2 | Studia i Materiały z Historii Kultury Materialnej |
spellingShingle | Mazur, Elżbieta Szpitale w Królestwie Polskim w XIX wieku Studia i Materiały z Historii Kultury Materialnej Bibliogr. s. [188]-213 Krankenhaus (DE-588)4032786-3 gnd |
subject_GND | (DE-588)4032786-3 (DE-588)4437411-2 |
title | Szpitale w Królestwie Polskim w XIX wieku |
title_auth | Szpitale w Królestwie Polskim w XIX wieku |
title_exact_search | Szpitale w Królestwie Polskim w XIX wieku |
title_full | Szpitale w Królestwie Polskim w XIX wieku Elżbieta Mazur ; Instytut Archeologii i Etnologii Polskiej Akademii Nauk. Dawniej Instytut Historii Kultury Materialnej PAN. |
title_fullStr | Szpitale w Królestwie Polskim w XIX wieku Elżbieta Mazur ; Instytut Archeologii i Etnologii Polskiej Akademii Nauk. Dawniej Instytut Historii Kultury Materialnej PAN. |
title_full_unstemmed | Szpitale w Królestwie Polskim w XIX wieku Elżbieta Mazur ; Instytut Archeologii i Etnologii Polskiej Akademii Nauk. Dawniej Instytut Historii Kultury Materialnej PAN. |
title_short | Szpitale w Królestwie Polskim w XIX wieku |
title_sort | szpitale w krolestwie polskim w xix wieku |
topic | Krankenhaus (DE-588)4032786-3 gnd |
topic_facet | Krankenhaus Kongresspolen |
url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017725241&sequence=000003&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017725241&sequence=000004&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA |
volume_link | (DE-604)BV035919537 |
work_keys_str_mv | AT mazurelzbieta szpitalewkrolestwiepolskimwxixwieku |