[Hospital infections in changing times]

It has already been known in ancient medicine that diseases with similar clinical picture can occur all at once at a certain place and under certain climatic conditions, and the Hippocratics dedicated a special book of their Hippocratic Scriptures to epidemics. The symptom complex of what is nowadays called "hospitalism", however, could only develop when the first hospitals were founded in early Christian cultures, which means social foundations, which were not at all hospitals like today, but social institutions for the old people, for pilgrims and--only in the third place--an asylum for poor, homeless, ill people. As well as in other places where large numbers of people are crowded together under poor hygienic conditions, e.g. in prisons or on overcrowded ships, in those overcrowded hospitals, which were called "Nosokomeion" in the Byzantine world and thus might well have been institutions where nursing of sick people was done, specific epidemic diseases occurred which were rarely found in individuals living in freedom or at their domiciles. Like all other epidemics, they were thought to be attributed to a miasma transported by the air and resulting from bad vapours, and it was for two milleniums that this remained the explanation for infectiosity. As in the hospitals before introduction of anti- and asepsis wound-healing per secundam, i.e. purulence, was regarded as normal and pus was called "Pus bonum and laudabile", which was thought to be the supposition for wound-healing and was the reason for the infernal stench which one could smell. One attributed the occurrence of miasma to this component. It was therefore attempted to combat the hospital infections by all means with desodorizing procedures, thus trying primarily to suppress the stench by frequent whitewashing of the rooms, spraying of vinegar, by burning powder and even using precious incense. On the other hand, various infectious diseases could easily be brought into those overcrowded hospitals, where often three up to six patients had to share one bed, so that still in 1865 no less a person than the famous Theodor Billroth (1829-1894) felt himself obliged to warn of the dangers of a stay in hospital. The danger of "hospitalism" or of "nosocomial infection" let the rich refrain from going into a hospital, until the progress in surgery, which was initiated by the introduction of narcosis, allowed surgical treatment only to be effected in hospitals.(ABSTRACT TRUNCATED AT 400 WORDS)