Earliest Hospitals and Tropical Medicine
The history of hospitals extends over 2500 years, shown by early documents and archaeological evidence. In many parts of the world there were healing centres where the nature of the treatment provided varied according to local social and cultural norms.
In early Greek and Roman times, such healing centres were attached to temples, and the treatment provided involved intervention of deities. One of the best known, going back to 6th century BCE, was at Epidaurus, said to be the birthplace of Asclepius, the god of healing who was the son of Apollo. It had mineral springs and 160 rooms for overnight guests, who communed with Asclepius through dreams for advice on the necessary treatment required for their healing. The centre was in use through the Hellenic and Roman periods, and, despite being sacked and looted by invaders, lasted until the 5th century CE, by which time it was a Christian institution.
Enkoimeterion or Abaton at Epidaurus
Another possible type of ancient healing centres where the treatment was part of religious ritual, was the Roman valetudinaria (ca. 100 BC) where care was provided for sick slaves, gladiators & soldiers. Archaeological evidence show foundations similar to the modern format for a hospital, but they were most likely housing for visitors to military camps, or even part of the barracks.
The earliest institutions providing medical services which were similar to hospital systems in present times, were most likely those found in the South Asian sub-continent. Texts show the building of a civic hospital between 100BCE and 150CE in India, where there was a well-organized system of institutionally-based medical provision.
In Sri Lanka, ancient chronicles, inscriptions on stone pillar markers, and archaeological excavations of stone foundations, show that there were hospitals attached to monasteries going back to about 4thC BCE. Mahawamsa, the ancient chronicle of Lanka, records that centres for providing medical services were built all over the island, around 2500 years ago, by the king who reigned at the time.
The best preserved foundations of an ancient hospital are those found at Mihintale in north-central Sri Lanka. The stone foundations here, which follow a similar pattern to other major sites, are nearly 70m in length and about 35m wide. The 9thC CE hospital complex is similar to present-day hospitals, with 31 rooms for patients, a consulting room/out-patients clinic, rooms for hot water baths, a medicinal stone bath/trough, and, possibly, a dispensary. (See map below)
Stone foundations of the ancient hospital at Mihintale, with stone medicinal bath in foreground.
Map of hospital complex at Mihintale