The concept of the hospital has evolved over the centuries. In his history of the U.S. hospital system,
Charles Rosenberg writes that in the 18th century, the
last place any respectable person would want to find
themselves was in an “almshouse” – the predecessor to
the hospital.
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Almshouses housed the indigent,
orphaned, mildly criminal, and the sick for whom there
was no other place to go. Overcrowded, chaotic,
filthy and teeming with those considered to be
depraved, almshouses provided unwelcome company
for respectable citizens who were alone, ill and down
on their luck. For this reason, Benjamin Franklin
agreed to cofound the Pennsylvania Hospital in 1752,
the nation’s first hospital, to replace almshouses in
serving the “poor and deserved.”
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