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Early hospitals may have had their origins from temple institutions in ancient Egypt and Mesopotamia. In both these cultures, temples and priests, who also performed healing duties, may have used part of the temple compounds as areas for patients to be healed for a variety of diseases and sicknesses. <ref>For more on early temple-based healing and patient care in the ancient world, including Egypt and Mesopotamia, see: Griffin, D. J. (Ed.). (2011). <i>Hospitals: what What they are and how they work How They Work</i> (4th ed). Sudbury, MAass: Jones & Bartlett Learning.</ref> Early surgical practice is also recorded, mostly likely by the 3rd millennium BCE and became more common by the 2nd millennium BCE. In both Egypt and Mesopotamia, doctors likely performed surgery dealing with c-section and removal of boils. <ref>McIntosh, J. (2005). <i>Ancient Mesopotamia: new perspectivesNew Perspectives</i>. Santa Barbara, Calif: ABC-CLIO, pg. 275.</ref>

More complicated surgery may have been practiced; however, the limitation of not having anesthesia and infection would have made surgery at times very dangerous. What these early hospitals, or institutions, indicate is that as cities and urban areas emerged, it was clear that large populations also made it easy for sickness to spread. Hospitals and healing of common diseases, infections and even surgery became a major necessity at the dawn of urbanism. Similar to ancient Egypt and Mesopotamia, ancient Greece also had gods devoted to healing. The god Asclepius and his cult may have functioned similarly to healing gods and practices in Egypt and Mesopotamia, where the temples could have been used as areas for people to come and receive a form of healthcare, including medicine and surgery in cases. <ref>For more on Asclepius, see: Edelstein, E. J. L., & Edelstein, L. (1998). <i>Asclepius: collection Collection and interpretation Interpretation of the testimonies Testimonies </i> (Johns Hopkins paperbacks ed). Baltimore, Md: Johns Hopkins University Press.</ref>

Among early healthcare facilities, the Achaemenid Persians in the late 6th century and 5th centuries BCE may have established something comparable to a teaching hospital in Egypt and other places. <ref>For more on Achaemenid hospitals, see: Shoja, M. M., & Tubbs, R. S. (2007). <i>The history History of anatomy Anatomy in Persia. Journal of Anatomy</i>, 210(4), 359–378.</ref> In the Roman period, structures known as <i> valetudinaria </i>, which were likely secular facilities devoted to health care of soldiers, gladiators, and even potentially others. In the Christian period, by the late 4th century CE, there were edicts to now build dedicated hospitals. This was largely motivated by Christian interests in healing in relation to religious practices and following New Testament teaching on healing. The hospital in Constantinople and Caesarea in Turkey are among the first known. Little is known about these structures but they likely indicate a type of healthcare facility for the masses.<ref>For more on Roman period medical facilities, see: Israelowich, I. (2015). <i>Patients and healers Healers in the High Roman Empire</i>. Baltimore: Johns Hopkins University Press.</ref>

Perhaps the first true teaching hospital known to us, the Academy of Gondishapu, was established by the Sassanid Persians by the 5th century CE. Groups of medical scholars, who also came from the Byzantine Empire as Christian refugees because they were Nestorian Christians, banned by the emperor in Constantinople, came to Gundeshapur in Southwest Iran. They helped found an academy that had devoted medical facilities not only for healing and practice of surgery but the academy began to be developed and dedicated to education. It is here that concepts of anatomy were developed and scholarships akin to medical science developed in conjunction with dedicated medical facilities. By the 6th and 7th centuries CE, the institution likely became the most important medical center in the world. The academy attracted physicians from much of the ancient world, including from India and China. Medical students now were required to work closely with their educators and became apprenticed in the practice while working in the hospital. <ref>For more on the Academy of Gondishapu, see: Frye, R. N., & Arberry, A. J. (Eds.). (2007). <i>The Cambridge history History of Iran</i>. Vol. 4: The period from the Arab invasion to the Saljuqs (Repr). Cambridge: Cambridge Univ. Press.</ref>

At this time, the concept of medical records for patients was developed, where doctors would record patient information and results of treatments as they visited patients before and after treatment. Surgery was practiced in theaters where medical students would observe and medical books were also written about surgical practice and anatomy (Figure 1). The development of the pharmacy, first established by Middle East doctors as a separate science, evolved in the 9th century CE as a department that was also affiliated with hospitals and medical departments. What this development recognized is the importance of pharmacology as a separate science requiring specialised knowledge that worked along with doctors.<ref>For more on the development of Medieval Middle East hospitals, see: Ragab, A. (2015). <i>The medieval Mideval Islamic hospitalHospital: medicineMedicine, religionReligion, and charityCharity</i>. New York, NY: Cambridge University Press.</ref>.

In Europe, hospitals were even more closely tied to religious institutions and the Catholic church. Monks and priests would often work these institutions, where they had to train in medicine and religious knowledge. In fact, the relationship of hospitals and the Catholic church has continued to this day. However, what created more secular hospitals was the Protestant Reformation. During the Reformation, hospitals that were once supported by the Catholic church lost their support. In England, the loss of support for hospitals led many citizens to often demand that the government begin to take control of these institutions. This began the process of government-supported and eventually private hospitals. Soon, hospital care began to be different between Catholic and more Protestant states. The Protestant hospitals gradually became more secular in the approach to medicine and healthcare, where the beginnings of nursing as a separate branch of healthcare in hospitals began to develop by the late 16th and 17th centuries. <ref>For more on the development of hospitals in late Medieval Europe and early Modern Europe, see: Lindemann, M. (2010). <i>Medicine and society Society in early modern Early Modern Europe </i> (2nd ed). Cambridge: Cambridge University Press.</ref>

It was during the 18th century that Europe had begun adopting something already practiced in the Middle East for centuries, which was making hospitals teaching institutions and allowing them to become places of innovation as well as care. However, practical anatomy was still rarely taught in medical colleges that were developing, even though this had already been in practice in the Middle East for some time. <ref>For more on hospitals during the Age of Enlightenment in Europe, see: Cunningham, A., & French, R. K. (Eds.). (1990). <i>The Medical enlightenment Enlightenment of the eighteenth centuryEighteenth Century</i>. Cambridge [England] ; New York: Cambridge University Press.</ref>

During the 19th century, hospital care was now expanding rapidly and Protestant denominations, similar to the Catholic Church before, had begun sponsoring and supporting hospitals. Although forms of nursing had been around for centuries, it was generally less formal and often not professional in its utilization in hospitals. It was during the Crimean War that Florence Nightingale wrote her influential book <i>Notes on Nursing</i> that helped develop nursing into a profession. She utilized money raised to establish a training school at St. Thomas' Hospital in London, making that hospital to be the first to formally train nurses. Throughout the 1860s, nursing training programs were improved and professionalized, with nursing being offered as professional training in newly established and older hospitals. During subsequent wars in the 1870-1880s, field hospitals staffed by professionally trained nurses had dramatically improved the chances for soldiers being saved from battlefield injuries.<ref>For more on nursing and its development, see: Hawkins, S. (2010). <i>Nursing and women’s labour Women’s Labour in the nineteenth centuryNineteenth Century: the quest The Quest for independenceIndependence</i>. London ; New York: Routledge.</ref>