History of Health Care: Transformation of the Hospital

Figure 1. Original building. Image: KGH Archive

The Main Building of the Kingston Hospital was built between 1833 and 1835, however due to lack of operating funds did not open until 1845, with incorporation in 1849 when a lay board was appointed. They had a mandate to operate the hospital as a charitable institution required to “supply necessities and relieve the condition of sick and destitute immigrants and other transients and the mariners of the lake” (Figure 1).

There were a dozen doctors in Kingston, at that time a community of 8,000. One physician per month provided free medical services at the Kingston Hospital. The initial staff included a housekeeper/nurse and her daughter as a helper, both of whom died caring for patients during the 1847 typhus epidemic. In 1851 a steward was appointed and in 1854 the staff included a matron, two male orderlies and the steward.

History of Health Care: Quarantine and Isolation

Before the nineteenth century, quarantine and isolation had been practiced in an effort to protect the community from contagious diseases such as plague and smallpox in the absence of specific treatment. Such diseases were considered contagious even though the cause and method of transmission were not known.

Two important developments occurred during the last half of the nineteenth century. An understanding of the cause and transmission of contagious disease occurred due to research leading to the germ theory. Government assumed increasing responsibility for the protection of the community from contagious diseases with legislation that established provincial and municipal Boards of Health.

Image from National Library of Medicine, http://www.nlm.nih.gov/exhibition/smallpox/sp_threat.html

A Brief History of Isolation and Infectious Disease

Drawing about the Cholera in Le Petit Journal, c. 1912

Contagious disease has challenged society throughout human history. Quarantine and isolation was practiced in response to the pandemics of bubonic plague and cholera, beginning in the Middle Ages. In the 18th and 19th centuries, smallpox led to smallpox hospitals in some large urban communities. At the same time, citizens lived with the fear of outbreaks of typhus, typhoid fever, diphtheria, scarlet fever and influenza. The effectiveness of isolation was often limited due to the lack of knowledge of the cause and transmission of these infectious diseases.

The germ theory of infectious disease was formulated during the second half of the 19th century. In the absence of specific treatment, isolation became the principle strategy to prevent the transmission of contagious disease. The Ontario Public Health Act in 1884 provided for the expropriation of land for isolation hospitals and required separate facilities for smallpox. Kingston established a Board of Health and created high standards of quarantine with a freestanding isolation hospital and the isolation of contagious disease in the home.