Historical Developments in NursingOne

Most people still think of nursing as only caring for the sick or assisting the doctor in care and treatment of patients. But it is more than that.

History shows that nursing always developed more rapidly in a society where women were given greater freedom and that it is also closely related to development in the medical science.

His life was simple. He lived close to nature and soon associated spiritual values to natural objects.

Prehistoric man believed that a thing in nature like tree or river had a spirit or soul. Such a religion is known as Animism.

The things in nature became friends or jobs according to main ability to control them. Water and trees were friends, while storms and poisonous plants were enemies.

This leads to a form of worship. They thanked friendly things for their help and tried to make peace with the unfriendly.

Diseases appeared to be associated with sorcery, magic, breaking a tatoo and bodily invasion by a spirit.

To get rid of these evil spirits dwelling in the body, the body had to be made unpleasant for them. Thus starving, beating and nauseous medicines were used. Loud noises, magic, trites and ceremonies and sudden fright were also tried.

If the evil spirit was thought to live in a special part of the body, holes were made to allow it to escape.

In the excavated graves of prehistoric man skulls with holes made by Trepanation have been found (Trepanation—cutting a circular hole with saw have been found).

The ‘medicine man’ was one who paid close attention to signs and symptoms and he knew what to do in some 3conditions. He attracted attention by wearing strange costumes, using magic words and queer procedures.

As his influence increased he took up the role of priest—Pretending to understand and control the forces of health and disease. In this role he was known as the ‘Priest-physician’. His word was law.

From the primitive man's belief in evil spirits they soon come to think that disease was caused by their failure to please the gods or by their sins.

This idea still exists, even among highly civilized intelligent people.

Nursing evolved as an initiative response to the desire to keep healthy as well as to provide comfort to the sick.

This was reflected in the caring, comforting nourishing, cleansing aspects to the patient.

Knowledges of these simple skills were passed down from generation to generation. Tenderness, concord, love and hope were expressed in the simple remedies. Thus, empirical practices in nursing evolved.

The causes of diseases he thought were the anger of gods invasion of the body by evil spirits and bad influences of stars and planets.

The medicine he practised consisted in pleasing gods by prayers, rituals and sacrifices, driving out evil spirits from the human body by noise or violence and using charms and amulets to protect himself against them.

Medicine was intermingled with superstition, religion, magic and witch craft. The practices of primitive medicine are still practised in many parts of ths over civilized world today.

In the most primitive setting, the nurturing efforts and independent role of the nurse in response to survival needs were directed toward keeping people healthy as well as comforting the sick resulting in empirical practice.

They had a well-developed system of writing. During this Sumerian Period, medicine changed from witchcraft to craft (Technique as hot applications). Sumerians wrote the prescription on day tablet.

So, the Babylonians believed that sin was the causes by anger of god.

The Parsees in India are discendants of the Persians. They believed in “evil spirit theory of disease”. Their holy book is called Avesta. This describes ceremonial rules of laws for birth and death.

After a persons death body was fastened to the roof of a special high tower called “Tower of silence”. The birds picked the flesh, bones, dropped to the pit below the tower.

Egyptian thought medicine was though to be divine origin.

One of the outstanding priest physician was “IMHOTEP” means who came up in peace. He was well-liked by people, because of his kindly personality and his success in healing the sick. Temples were centre of healing process.

The Egyptians believed in life after death. They developed an art of “Embalming and bandaging” (dead body to preserve it). Such as Embal body was known as “Mummy”. From these preserved body, the disease that existed at their time and the treatment has been gained.

Women in Egypt of high rank become priestesses in the temple. Some of them assisted the priestesss in casing for sick mother and daughter nursed the sick in their homes.

Egyptians—prohibited dissection of the dead body.7

Isolation keeping some diseased person separately, quarantine supporting the disease will be disappeared, we have tendencies to spread to others. So, they are kept separately, and reporting of communicable disease.

The high priest was “priest physician” and health inspector. Houses of hospitality, forerunner of inns, hotel and hospital. They practised excellent hospitality, visiting and caring for the sick was religious duty. A nurses role includes a midwifery.

The priest was the medical advisor and pharmacists. They practised sweatbath. The AZTECS were war like group ruling central America. They also practised sweatbath and human sacrifice to cure diseases.

They also believed diseases were caused by anger of God. Disease gift to the God were in the forms of “Effigy”.

The Incas also practised “sand painting” to cure the disease.

Sand painting, applied to the sense of right. Prayerful singing to the sense of hearing the sweet smelling herbs, to the sense of small, and the herbs to be eaten to the sense of taste, faith on the part of the patients. In addition to their technique, they also practised “Hydrotherapy” (bringing down the temp down) in to the healing ceremony.

Among the Chinese doctor “Sen lung was known as father of medicine in China and an authority of an internal medicine. The Chinese doctors practised “vaccination” as earlier 1000 BC. They used “sea weed” to cause thyroid conditions and chaul moogra oil for curing leprosy. As earlier as 13,000 AD physiotherapy was also used, as part of treatment. They recognised disease such as “Syphilis and Gonorrhoea”.

They also had halls, near to temple where the sick prayed for healing hygiene was important, bathing and wearing cloths were advised and practised. Tea drinking was an ancient precautions in China, against intestinal infections. The chinese believed when disease due to the evil spirits in the patients. Thus nursing was impossible and this faith also prevented the progress of medical progress.

King Ashoka, built monasteries and houses for travellers and hospitals for both men and animals.

Prevention of disease became the first important thing. Hygenic practices were adopted, i.e. people must wear clean clothes, should keep their nails cut and short. The women after delivery should live in rooms, which are clean and well ventilated. The nurses were usually men or old women.

Medical treatments included special diets, massage, bath, “Inunciation” (rubbing medicine on skin).

The uncleaned patients like delivered lady and dying patients were not allowed to come in the temple or remain throughout. In 1070 AD special buildings were erected for their patients. They were regarded as the first “Europeon hospitals”.

Prevention of diseases, dependend upon obedient to the natures law and this was the begining of scientific medicine. Hippocrate developed, ways of doing physical examinations and of taking histories. He stressed fresh-air cleanliness, good diet for health. He gave instructions about hot applications, poulitices cold sponging for fever.

Fluid for kidney diseases and mouth washes. He stressed loyalty to one's profession and responsibility for those depending on us. This is expressed in “Hippocratic OATH” used in medical schools today.

The “The CADUCEUS” is one of the gifts from Greek. It is composed of the staff intewined with serpents. This staff indicates the traveller, the intertwined serpents signify Rejuvenated, knowledge and wisdom. The Epics (tip) of the 11staff, are two wings of mercury (God of Greek) for speed, with which a physician should act.

Many instruments, similar to our modern surgical, scapel, forceps speculum were found.

Jesus Christ brought a new aspects that of Altruism (thoughtful interest in others).

Christianity tought that kindly service to humanity, without any hope or reward. Followers of Jesus Christ took upon themselves the care of sick and poor.

From early Christian Era, we have a continuous record of history of Nursing.

One of the outstanding early deconesses was Phoebe.14

Phoebe is known as the forerunner of modern public health nurse.

The deconesses order, disappeared after 4th century. Widows and virgins interested in religious works went to monasteries as nuns.

The Bishop home was too small to meet the demands of hospitality. So additional rooms and shelter were added. This was called xenodochia. In this all types of relief work was carried out, e.g. hospitals for the sick those with leprosy, home for strangers and orphans, aged and the travellers.

She made a public confession of her sins and gave her wealth and energies for the care of the sick and poor.

She turned her home into the first free Christian Hospital in Rome. She gathered the sicks from the streets and devoted her life to giving them nursing care.

When her husband died she entered Marcella's monastery and there she became a Christian. About 385 AD. She and her daughter, Eustochia, went to Palestine and settled in Bethlehem. Here she built hospices (place of shelter for travellers) and hospitals for the sick. She and her staff did the nursing. She established a monastery in Bethlehem and gathered a group of devoted women. After her death, in 404 AD her work was carried on by her daughter.

Barbonic tribes invaded Rome in 476 AD and brought about the final disorganization of society.

During, this time, the Roman armies were disbanded. Roads and bridges were destroyed. “Roter hands” crowded the high-ways, making travel unsafe. People's homes were destroyed or taken over by the Barbarians turning many homeless.

Roman authorities shifted the capital from Rome to Constantinople. Due to this change in the capital, many of the aristocracy left for constantinople.

Many of those who have to remain, turned to the Monastries for help and protection.

According to the self needs of the time. Three protective units developed:

Monasteries where priests or nuns lived. The monasteries increased in size and facilities and new rules were set up to meet the needs of changing society.

As time went on, many of the monks and nuns proved themselves to be exceptionally good organizers and administrators.

One outstanding monk was St. Benedict of Nursia. He encouraged all his neighbours whether Pagan or barbarians, to become Christians and to work together in hormony. He also built a monastery on a rocky mountain top between Rome and Naples called Monte casino. Monte casino grew to become one of the most efficient mediaeval monasteries. Here the Benedictine rule was developed to meet their needs. In addition to custo mary monastic vows of poverty, chastity and obedience vow of life long service was made. Men and 17women were allowed to live purposeful lives devoted to the kind of work they enjoyed. Men and women from all ranks and social classes were admitted to the Benedictine order. It became one of the most active organisations for social work.

As the monasteries became wealthier they gained more freedom and political power. When they were critized they made their rules stricter. Many lost interest in the work when their freedom was restricted. As a result between the 9th and 10th centuries the monasteries went into decline.

In feudalism the king owned all the land. He gave portions of the land to his favourite subjects who were barons, earls or knights. These grants of land were known as a fief or feud in Europe and a manor in England.

The Baron divided his land among many serfs who worked on the land in return for food, shelter and a form of protection. Since, there was no standing army the landlord might call on the serfs to leave the land and serve in his army when necessary. The serf had very little freedom. If the land was sold he became the serf of the new owner. Petty quarrels among the knight took place and kept the serfs from the land. This resulted in famine and disease.18

The training of the knight, which become known as “chivalry” stressed service to others, protection and defence of the weak. Every true knight came to believe that service to God came before service to his earthly lord, chivalry was the accepted code for living a good life.

In the guilds apprenticeship method of learning a skill was stressed higher standards of work encouraged, unethical practices were checked and social insurances including sickness insurances were followed.

This guild apprenticeship method have been followed in nursing and medical teaching for many years. Also the guild was the fore runner of the modern labour unions and professional organisations.

While so doing they learnt many things from other cultures and about medicine from the Greeks.

Islam did not allow surgery and dissection and so medicine did not progress. Mosleum women were absent in the care of the sick and were kept under ‘Purdha’.

Nursing at last had developed roots, purpose, direction and leadership.