Evolution of prototype architecture of palliative institutions before the XX century

Introduction. The architecture of medical institutions has undergone a complex and multifaceted path of development. A special branch of modern healthcare is considered to be palliative care, which was formed in the twentieth century, but the prototypes of palliative care institutions emerged long ago. The role and functions of modern palliative institutions for many centuries have been provided by orphanages, hospitals, convents, monasteries, hospitals, strange houses and others.

Materials and methods. Materials and methods of the study include methods of review, comparative analysis and synthesis on scientific, historical, art, literary sources and project materials related to the architecture of prototypes of palliative institutions.

Results. The paper shows the connection between the development of Christianity and the formation of the foundations of the palliative (hospice) movement. The prerequisites for the emergence and history of the development of prototypes of palliative institutions, their architectural solutions and features are considered here. The paper studies the transformation of the hospices main function over the centuries to the twentieth century.

Conclusions. The evolution of palliative care institutions has occurred throughout the life of mankind, sometimes intertwined with health care, but more often following its own path. The evolution of medical and palliative care institutions cannot be considered synonymous, as for many periods, especially as the effectiveness of medical care has developed, there has been a fundamental difference between “curable” and “incurable” patients, not in favour of the latter. The evolution of palliative care institutions is linked to the social history of care for the elderly and dying, to the level of cultural development of society, to its religious, humane and mystical beliefs. A significant and decisive contribution to the evolution of the palliative care movement has been made by the efforts of individuals and the dictates of their human and medical duty. Their resilience and humanity allowed this part of health care not to languish, but to open up and prove that if a person cannot be cured, it does not mean that he cannot be helped.

1. Klochko A.R. The history of development of hospices located within the boundaries of cities. Academia. Architecture and Construction. 2023; 4:43-50. DOI: 10.22337/2077-9038-2023-4-43-50. EDN BRSVHZ. (rus.).

2. Klochko A. Hospices in the infrastructure of the cities of the RF. Project Baikal. 2021; 18(70):162-168. DOI: 10.51461/projectbaikal.70.1908. EDN CTUQER. (rus.).

3. Ferngren G.B., Amundsen D.W. Medicine and Christianity in the Roman Empire: compatibilities and tensions. Aufstieg und Niedergang der römischen Welt II.37.3. Berlin, Walter de Gruyter, 1994.

4. Kotgirwar Y. Trends in Hospice Architecture. Seminar and Technical writing-II PA 494. 2019. DOI: 10.13140/RG.2.2.13285.65763

5. Retief F., Cilliers L. The influence of Christianity on medicine from Graeco-Roman times up to the Renaissance. Acta Theologica. 2010; 26(2). DOI: 10.4314/actat.v26i2.52579

6. Aiken L. et al. Hospital reform in new Europe. Moscow, The Whole world, 2002. EDN QLWWCV. (rus.).

7. Zakieva L.F. The analysis of the stages in development and formation of health care facilities. International Research Journal. 2016; 11-2(53):73-74. DOI: 10.18454/IRJ.2016.53.154. EDN XBDNXL. (rus.).

8. Brown P. The rise of Western Christendom. Oxford, Blackwell, 1997.

9. Cilliers L., Retief F. The evolution of the hospital from antiquity to the end of the middle ages. Curationis. 2002; 25(4). DOI: 10.4102/curationis.v25i4.80

10. Sigerist H.E. Civilization and disease. Ithaca, Ithaca Press, 1943.

11. Retief F., Cilliers L. Epidemics of the Roman Empire, 27 BC-AD 476. South African Medical Journal. 2000; 90(3).

12. Kirsch J.P. St. Fabiola. In The Catholic Encyclopedia. New York, Robert Appleton Company, 1909.

13. Aitken J.T., Fuller H.W.C., Johnson D. The influence of Christians in medicine. London, Intervarsity Press, 1984.

14. Major R.H. A history of medicine. Vol. 1. Spring-field, Charles Thomas, 1954.

15. Haggard H. From medicine man to doctor. History of the Science of Healing. Moscow, Centerpoligraf, 2012. EDN QMCFJF. (rus.).

16. Shulcheva-Dzharman O. Hospice: a shelter for the last journey. Syria, Rome, France, England, Russia. Living Water. 2014; 9. URL: http://aquaviva.ru/journal/khospis-priyut-dlya-otpravlyayushchegosya-v-poslednee-stranstvie-siriya-rim-frantsiya-angliya-rossiya (rus.).

17. Aries P. The Hour of Our Death — the Classic History of Western Attitudes Toward Death Over the Last One Thousand Years. New York, Knopf, 1981; 560-571.

18. Butler C., Erdman A. Hospital Planning. New York, F.W. Dodge corporation, 1946; 154.

19. Heathcote E. Architecture and Health. Architecture of Hope. 2015; 52-93.

20. Robert Twycross: “Palliative care is about quality of life”. Pallium: Palliative and Hospice Care. 2020; 2(7):51-56. EDN QPSKQB. (rus.).

21. Amin A. St. Christopher’s Hospice: A Space for the Dying. 2015. URL: https://cicelysaundersarchive.wordpress.com/2015/12/14/st-christophers-hospice-a-space-for-dying/#_ftn40

22. Kron J. Designing a better place to die. New York, 1978; 43-49.