Ah, another post inspired by a visit to the Franklin Institute, but more specifically by the man himself. One of his many accomplishments was cofounding Pennsylvania Hospital (1751), the first chartered hospital in what would become the United States (Cortez founded one in Mexico, in 1524. Canada got one in 1639). Philadelphia was established by William Penn in 1682. Ben's old hometown of Boston (estd 1630) didn't get their first hospital until 1811. To be fair, between 1700 and 1790, Boston merely doubled in size (to 18,000), while Philly grew by a factor of ten (to 42,000). These young cities were just finding their feet and trying to meet the needs of their burgeoning population, but hospitals seem like a no-brainer. People get sick, hurt. They need care. So, recognizing that the presence of hospitals was not as ubiquitous as I'd once imagined, I thought it best to do some digging.
The word 'hospital' derives from the Latin root hospes, or guest. A hospital, in its original use, is a guest-house. Hospitals in the medieval world might be multipurpose or serve one specific group: the sick, foundlings, orphans, the poor who were unable to work, the old, and poor or infirm pilgrims. All of these early institutions in Europe were staffed and organized by the Church (Catholic and Eastern Orthodox), with care provided by monks and nuns. Some of these institutions were connected to monasteries, but others were established independently and endowed with lands to support their operations (such donations were generally thought by rich Christians at the time to be 'get out of hell free' cards).
The general recognition of the importance of these institutions is clear, thanks to Charlemagne. During his reign, he decreed that all hospitals which had fallen into disrepair should be restored, and that there should be a hospital attached to each cathedral and monastery. It isn't until the 14th Century that the secular government directly supports any of these institutions (and only when forced to, since the protestants didn't believe you could buy your way into heaven, and later the king dissolved all the monasteries of England). In these institutions, all services were free to the poor (no self-respecting noble would go to one). The workers not only provided 24-hour care, but went into the community to seek out those in need. Financial support came not only from amongst the faithful, but from the clergy themselves, who were often required to give a portion of their incomes. Others took it upon themselves to donate food, wood, or other goods to support the hospitals.
It is the duty of housing and protecting pilgrims that allowed the evolution of some of these philanthropic Christian organizations into military orders. The Teutonic Order evolved under the walls of Acre. The Hospitallars were founded in Jerusalem, as were the Templars. The initial aim of these orders was to protect pilgrims on their way to the Holy Land, but we all know how that worked out. Like the Church itself, these organizations were richly endowed by the nobility. Individual members, being bound by vows of poverty (like all monks), couldn't do much with the donated wealth, so it fell to the control of the leadership. The military and financial power wielded by these organizations changed the face of European politics.
As trade increased and the medieval world began to open up again, hospitals began to be established in the revitalized cities (which had been on the decline since the Romans left). These new hospitals gave the best care they could afford, and were often established near running water or in close proximity to the poorer neighborhoods. It was not uncommon for them to be located outside of the city wall, so those suffering from illness could get away from 'evil vapors' and also decrease the risk of passing contagions along to others. Many of these hospitals accepted only small numbers of patients (7-25), but the Grand Hospital of Milan (opened 1445) often cared for 2,000 patients at a time. Multiple hospitals might be founded in a given city (Cologne had 16).
The Church in general has a pretty nasty reputation in the Medieval period, and for good reason, but it's important to remember that it did some good work as well. Certainly there were improprieties connected to some hospitals, they did fleece the rich to support themselves, plus that whole warrior/monk thing, but hospitals did provide valuable services to those in need, that we today view as essential. They took care of the orphans and the foundlings. They healed the sick. They protected people upon the road. While they certainly did not embody the entirety of the Christian ethos, they did plenty more for the common person than any other political organization of e day was willing to. The interesting question is, in your fantasy world, what group do you have that believes in mercy? Who will wash the feet of the unclean? What happens to the lepers?
Wiki - http://en.m.wikipedia.org/wiki/History_of_hospitals
Catholic Encyclopedia - http://www.newadvent.org/cathen/07480a.htm
Population data - http://wps.ablongman.com/wps/media/objects/244/250688/Appendix/12.pdf
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