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Metonymy ( / m ɪ ˈ t ɒ n ɪ m i , m ɛ -/ ) is a figure of speech in which a concept is referred to by the name of something closely associated with that thing or concept.

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85-502: Lake Health , formerly Lake Hospital System, is a system of hospitals and health care facilities throughout Lake County , Cuyahoga County and Geauga County , Ohio , United States . Lake Health changed its name from Lake Hospital System on June 12, 2009. On April 16, 2021, the Lake Health system became part of University Hospitals . Download coordinates as: Concord Continuing Care - Concord Hospital A hospital

170-421: A chargemaster ; however, these prices may be lower for health care obtained within healthcare networks . Legislation requires hospitals to provide care to patients in life-threatening emergency situations regardless of the patient's ability to pay. Privately funded hospitals which admit uninsured patients in emergency situations incur direct financial losses, such as in the aftermath of Hurricane Katrina . As

255-626: A medical records department , release of information department , technical support , clinical engineering , facilities management, plant operations , dining services, and security departments. The COVID-19 pandemic stimulated the development of virtual wards across the British NHS . Patients are managed at home, monitoring their own oxygen levels using an oxygen saturation probe if necessary and supported by telephone. West Hertfordshire Hospitals NHS Trust managed around 1200 patients at home between March and June 2020 and planned to continue

340-468: A pharmacy , pathology , and radiology . Hospitals are typically funded by public funding , health organizations ( for-profit or nonprofit), health insurance companies, or charities, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders , or by charitable individuals and leaders. Hospitals are currently staffed by professional physicians, surgeons, nurses, and allied health practitioners . In

425-416: A production line . A teaching hospital delivers healthcare to patients as well as training to prospective medical professionals such as medical students and student nurses . It may be linked to a medical school or nursing school, and may be involved in medical research . Students may also observe clinical work in the hospital. Clinics generally provide only outpatient services, but some may have

510-401: A few inpatient beds and a limited range of services that may otherwise be found in typical hospitals. A hospital contains one or more wards that house hospital beds for inpatients . It may also have acute services such as an emergency department , operating theatre , and intensive care unit , as well as a range of medical specialty departments. A well-equipped hospital may be classified as

595-481: A few related medical specialties . Subtypes include rehabilitation hospitals , children's hospitals , seniors' ( geriatric ) hospitals, long-term acute care facilities , and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital ), cancer treatment , certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. In Germany , specialised hospitals are called Fachkrankenhaus ; an example

680-608: A hospital bed, but be considered outpatient and "under observation" if not formally admitted. In the U.S., inpatient stays are covered under Medicare Part A, but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to additional coinsurance costs. In 2013, the Center for Medicare and Medicaid Services (CMS) introduced a "two-midnight" rule for inpatient admissions, intended to reduce an increasing number of long-term "observation" stays being used for reimbursement. This rule

765-449: A hospital just for diagnosis , treatment, or therapy and then leave (" outpatients ") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months (" inpatients "). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are often described as clinics . The best-known type of hospital

850-719: A hospital; Pennsylvania Hospital in Philadelphia opened in 1752, New York Hospital , now Weill Cornell Medical Center in New York City opened in 1771, and Massachusetts General Hospital in Boston opened in 1811. When the Vienna General Hospital opened in 1784 as the world's largest hospital, physicians acquired a new facility that gradually developed into one of the most important research centers. Another Enlightenment era charitable innovation

935-437: A new domain (a conversation). Thus, metaphors work by presenting a target set of meanings and using them to suggest a similarity between items, actions, or events in two domains, whereas metonymy calls up or references a specific domain (here, removing items from the sea). Sometimes, metaphor and metonymy may both be at work in the same figure of speech, or one could interpret a phrase metaphorically or metonymically. For example,

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1020-495: A particularly important provider of healthcare to uninsured patients and patients with Medi-Cal (which is California's Medicaid program, serving low-income persons, some senior citizens , persons with disabilities , children in foster care , and pregnant women). In 2012, district hospitals provided $ 54 million in uncompensated care in California. A specialty hospital is primarily and exclusively dedicated to one or

1105-973: A phenomenon known as international healthcare accreditation , by groups such as Accreditation Canada in Canada , the Joint Commission in the U.S., the Trent Accreditation Scheme in Great Britain , and the Haute Autorité de santé (HAS) in France . In England , hospitals are monitored by the Care Quality Commission . In 2020, they turned their attention to hospital food standards after seven patient deaths from listeria linked to pre-packaged sandwiches and salads in 2019, saying "Nutrition and hydration

1190-618: A result, Dutch architectural historian Cor Wagenaar has called many hospitals: Metonymy The words metonymy and metonym come from Ancient Greek μετωνυμία ( metōnumía )  'a change of name'; from μετά ( metá )  'after, post, beyond' and -ωνυμία ( -ōnumía ) , a suffix that names figures of speech, from ὄνυμα ( ónuma ) or ὄνομα ( ónoma )  'name'. Metonymy and related figures of speech are common in everyday speech and writing. Synecdoche and metalepsis are considered specific types of metonymy. Polysemy ,

1275-462: A significantly greater number of patients. It has 3,000 beds and performs 3,000 paediatric cardiac operations annually, the largest number in the world for such a facility. Surgeons are paid on a fixed salary instead of per operation, thus when the number of procedures increases, the hospital is able to take advantage of economies of scale and reduce its cost per procedure. Each specialist may also become more efficient by working on one procedure like

1360-411: A trauma center. They may also have other services such as a hospital pharmacy , radiology , pathology , and medical laboratories . Some hospitals have outpatient departments such as behavioral health services, dentistry , and rehabilitation services . A hospital may also have a department of nursing , headed by a chief nursing officer or director of nursing . This department is responsible for

1445-468: Is Fachkrankenhaus Coswig (thoracic surgery). In India, specialty hospitals are known as super-specialty hospitals and are distinguished from multispecialty hospitals which are composed of several specialties. Specialised hospitals can help reduce health care costs compared to general hospitals. For example, Narayana Health 's cardiac unit in Bangalore specialises in cardiac surgery and allows for

1530-476: Is a "metonymy of a metonymy". Many cases of polysemy originate as metonyms: for example, "chicken" means the meat as well as the animal; "crown" for the object, as well as the institution. Metonymy works by the contiguity (association) between two concepts, whereas the term "metaphor" is based upon their analogous similarity. When people use metonymy, they do not typically wish to transfer qualities from one referent to another as they do with metaphor. There

1615-943: Is a healthcare institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers , rehabilitation hospitals , children's hospitals , geriatric hospitals, and hospitals for specific medical needs, such as psychiatric hospitals for psychiatric treatment and other disease-specific categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on

1700-820: Is a metonym for the state in all its aspects. In recent Israeli usage, the term "Balfour" came to refer to the Israeli Prime Minister 's residence, located on Balfour Street in Jerusalem, to all the streets around it where demonstrations frequently take place, and also to the Prime Minister and his family who live in the residence. Western culture studied poetic language and deemed it to be rhetoric . A. Al-Sharafi supports this concept in his book Textual Metonymy , "Greek rhetorical scholarship at one time became entirely poetic scholarship." Philosophers and rhetoricians thought that metaphors were

1785-405: Is no physical link between a language and a bird. The reason the metaphors "phoenix" and "cuckoo" are used is that on the one hand hybridic "Israeli" is based on Hebrew , which, like a phoenix, rises from the ashes; and on the other hand, hybridic "Israeli" is based on Yiddish , which like a cuckoo, lays its egg in the nest of another bird, tricking it to believe that it is its own egg. Furthermore,

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1870-440: Is nothing press-like about reporters or crown-like about a monarch, but "the press" and "the crown" are both common metonyms. Some uses of figurative language may be understood as both metonymy and metaphor; for example, the relationship between "a crown" and a "king" could be interpreted metaphorically (i.e., the king, like his gold crown, could be seemingly stiff yet ultimately malleable, over-ornate, and consistently immobile). In

1955-493: Is part of a patient's recovery." The World Health Organization reported in 2011 that being admitted to a hospital was far riskier than flying. Globally, the chance of a patient being subject to a treatment error in a hospital was about 10%, and the chance of death resulting from an error was about one in 300. according to Liam Donaldson . 7% of hospitalised patients in developed countries, and 10% in developing countries, acquire at least one health care-associated infection . In

2040-400: Is the domain of metonymy. In contrast, the metaphorical phrase "fishing for information" transfers the concept of fishing into a new domain. If someone is "fishing" for information, we do not imagine that the person is anywhere near the ocean; rather, we transpose elements of the action of fishing (waiting, hoping to catch something that cannot be seen, probing, and most importantly, trying) into

2125-545: Is the general hospital, also known as an acute-care hospital. These facilities handle many kinds of disease and injury, and normally have an emergency department (sometimes known as "accident & emergency") or trauma center to deal with immediate and urgent threats to health. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States and Canada, have their own ambulance service. A district hospital typically

2210-432: Is the major health care facility in its region, with large numbers of beds for intensive care , critical care , and long-term care. In California, "district hospital" refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of hospital beds in many local communities. Even today, district hospitals are the sole public hospitals in 19 of California's counties, and are

2295-584: The Mahavamsa , the ancient chronicle of Sinhalese royalty, written in the sixth century AD, King Pandukabhaya of Sri Lanka (r. 437–367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala). A hospital and medical training center also existed at Gundeshapur , a major city in southwest of the Sassanid Persian Empire founded in AD 271 by Shapur I . In ancient Greece , temples dedicated to

2380-570: The Latin hospes , signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By metonymy , the Latin word then came to mean a guest-chamber, guest's lodging, an inn . Hospes is thus the root for the English words host (where

2465-559: The Porte . A place (or places) can represent an entire industry. For instance: Wall Street , used metonymically, can stand for the entire U.S. financial and corporate banking sector ; K Street for Washington, D.C.'s lobbying industry or lobbying in the United States in general; Hollywood for the U.S. film industry , and the people associated with it; Broadway for the American commercial theatrical industry ; Madison Avenue for

2550-633: The Prime Minister of Spain , and Vatican for the pope , Holy See and Roman Curia . Other names of addresses or locations can become convenient shorthand names in international diplomacy , allowing commentators and insiders to refer impersonally and succinctly to foreign ministries with impressive and imposing names as (for example) the Quai d'Orsay , the Wilhelmstrasse , the Kremlin , and

2635-856: The U.S. State Department , Langley for the Central Intelligence Agency , Quantico for either the Federal Bureau of Investigation academy and forensic laboratory or the Marine Corps base of the same name , Zhongnanhai for the leadership of the Chinese Communist Party , Malacañang for the President of the Philippines , their advisers and Office of the President , "La Moncloa" for

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2720-737: The government of Kenya , the Kremlin for the Russian presidency, Chausseestraße and Pullach for the German Federal Intelligence Service , Number 10 , Downing Street or Whitehall for the prime minister of the United Kingdom and the UK civil service , the White House and Capitol Hill for the executive and legislative branches, respectively, of the United States federal government, Foggy Bottom for

2805-495: The p was dropped for convenience of pronunciation) hospitality , hospice , hostel, and hotel . The latter modern word derives from Latin via the Old French romance word hostel , which developed a silent s , which letter was eventually removed from the word, the loss of which is signified by a circumflex in the modern French word hôtel . The German word Spital shares similar roots. Some patients go to

2890-555: The 1970s and have since expanded rapidly across the United States. The Catholic Church is the largest non-government provider of health careservices in the world. It has around 18,000 clinics, 16,000 homes for the elderly and those with special needs, and 5,500 hospitals, with 65 percent of them located in developing countries. In 2010, the Church's Pontifical Council for the Pastoral Care of Health Care Workers said that

2975-534: The American advertising industry; and Silicon Valley for the American technology industry. The High Street (of which there are over 5,000 in Britain) is a term commonly used to refer to the entire British retail sector. Common nouns and phrases can also be metonyms: " red tape " can stand for bureaucracy , whether or not that bureaucracy uses actual red tape to bind documents. In Commonwealth realms , The Crown

3060-598: The Church manages 26% of the world's health care facilities. Modern hospitals derive funding from a variety of sources. They may be funded by private payment and health insurance or public expenditure , charitable donations . In the United Kingdom , the National Health Service delivers health care to legal residents funded by the state "free at the point of delivery", and emergency care free to anyone regardless of nationality or status. Due to

3145-685: The French government sent two scholar administrators, Coulomb and Tenon , who had visited most of the hospitals in Europe. They were impressed and the "pavilion" design was copied in France and throughout Europe. English physician Thomas Percival (1740–1804) wrote a comprehensive system of medical conduct, Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons (1803) that set

3230-534: The Islamic world was built in 805 in Baghdad by Harun Al-Rashid . By the 10th century, Baghdad had five more hospitals, while Damascus had six hospitals by the 15th century, and Córdoba alone had 50 major hospitals, many exclusively for the military, by the end of the 15th century. The Islamic bimaristan served as a center of medical treatment, as well nursing home and lunatic asylum . It typically treated

3315-594: The Roman population, were occasionally privately built in extremely wealthy Roman households located in the countryside for that family, although this practice seems to have ended in 80 AD. The declaration of Christianity as an accepted religion in the Roman Empire drove an expansion of the provision of care. Following the First Council of Nicaea in AD 325 construction of a hospital in every cathedral town

3400-407: The U.S., 1.7 million infections are acquired in hospital each year, leading to 100,000 deaths, figures much worse than in Europe where there were 4.5 million infections and 37,000 deaths. Modern hospital buildings are designed to minimise the effort of medical personnel and the possibility of contamination while maximising the efficiency of the whole system. Travel time for personnel within

3485-449: The administration of professional nursing practice, research , and policy for the hospital. Many units have both a nursing and a medical director that serve as administrators for their respective disciplines within that unit. For example, within an intensive care nursery, a medical director is responsible for physicians and medical care, while the nursing manager is responsible for all the nurses and nursing care. Support units may include

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3570-466: The average length of stay, time to service, patient satisfaction, physician performance, patient readmission rate, inpatient mortality rate, and case mix index . In the United States , the number of hospitalizations grew to its peak in 1981 with 171 admissions per 1,000 Americans and 6,933 hospitals. This trend subsequently reversed, with the rate of hospitalization falling by more than 10% and

3655-404: The birth of specialised medicine. By the late 19th and early 20th centuries, medical advancements such as anesthesia and sterile techniques that could make surgery less risky, and the availability of more advanced diagnostic devices such as X-rays , continued to make hospitals a more attractive option for treatment. Modern hospitals measure various efficiency metrics such as occupancy rates,

3740-628: The capacity for a word or phrase to have multiple meanings, sometimes results from relations of metonymy. Both metonymy and metaphor involve the substitution of one term for another. In metaphor, this substitution is based on some specific analogy between two things, whereas in metonymy the substitution is based on some understood association or contiguity . American literary theorist Kenneth Burke considers metonymy as one of four "master tropes ": metaphor , metonymy, synecdoche , and irony . He discusses them in particular ways in his book A Grammar of Motives . Whereas Roman Jakobson argued that

3825-563: The concepts they express." Some artists have used actual words as metonyms in their paintings. For example, Miró 's 1925 painting "Photo: This is the Color of My Dreams" has the word "photo" to represent the image of his dreams. This painting comes from a series of paintings called peintures-poésies (paintings-poems) which reflect Miró's interest in dreams and the subconscious and the relationship of words, images, and thoughts. Picasso , in his 1911 painting "Pipe Rack and Still Life on Table" inserts

3910-584: The crown; this was the first instance of secular support being provided for medical institutions. In 1682, Charles II founded the Royal Hospital Chelsea as a retirement home for old soldiers known as Chelsea Pensioners , an instance of the use of the word "hospital" to mean an almshouse . Ten years later, Mary II founded the Royal Hospital for Seamen, Greenwich , with the same purpose. The voluntary hospital movement began in

3995-459: The early 18th century, with hospitals being founded in London by the 1720s, including Westminster Hospital (1719) promoted by the private bank C. Hoare & Co and Guy's Hospital (1724) funded from the bequest of the wealthy merchant, Thomas Guy . Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St Bartholomew's in London

4080-423: The extent that one will be used in place of another." Cicero viewed metonymy as more of a stylish rhetorical method and described it as being based on words, but motivated by style. Metonymy became important in French structuralism through the work of Roman Jakobson . In his 1956 essay "The Metaphoric and Metonymic Poles", Jakobson relates metonymy to the linguistic practice of [syntagmatic] combination and to

4165-460: The fundamental dichotomy in trope was between metaphor and metonymy, Burke argues that the fundamental dichotomy is between irony and synecdoche, which he also describes as the dichotomy between dialectic and representation, or again between reduction and perspective. In addition to its use in everyday speech, metonymy is a figure of speech in some poetry and in much rhetoric . Greek and Latin scholars of rhetoric made significant contributions to

4250-489: The healer-god Asclepius , known as Asclepeion functioned as centers of medical advice, prognosis, and healing. The Asclepeia spread to the Roman Empire . While public healthcare was non-existent in the Roman Empire, military hospitals called valetudinaria did exist stationed in military barracks and would serve the soldiers and slaves within the fort. Evidence exists that some civilian hospitals, while unavailable to

4335-517: The hospital and the transportation of patients between units is facilitated and minimised. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design. However, many hospitals, even those considered "modern", are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As

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4420-543: The hospitals. They also changed from being mere homes of refuge to being complex institutions for the provision and advancement of medicine and care for sick. The Charité was founded in Berlin in 1710 by King Frederick I of Prussia as a response to an outbreak of plague. Voluntary hospitals also spread to Colonial America ; Bellevue Hospital in New York City opened in 1736, first as a workhouse and then later as

4505-409: The literary practice of realism . He explains: The primacy of the metaphoric process in the literary schools of Romanticism and symbolism has been repeatedly acknowledged, but it is still insufficiently realized that it is the predominance of metonymy which underlies and actually predetermines the so-called 'realistic' trend, which belongs to an intermediary stage between the decline of Romanticism and

4590-417: The medieval concept of Christian care evolved during the 16th and 17th centuries into a secular one. In England , after the dissolution of the monasteries in 1540 by King Henry VIII , the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of London, were the hospitals St Bartholomew's , St Thomas's and St Mary of Bethlehem's (Bedlam) endowed directly by

4675-430: The metaphor "magpie" is employed because, according to Zuckermann, hybridic "Israeli" displays the characteristics of a magpie, "stealing" from languages such as Arabic and English . Two examples using the term "fishing" help clarify the distinction. The phrase "to fish pearls" uses metonymy, drawing from "fishing" the idea of taking things from the ocean. What is carried across from "fishing fish" to "fishing pearls"

4760-424: The modern hospital was beginning to take shape with a proliferation of a variety of public and private hospital systems. By the 1870s, hospitals had more than trebled their original average intake of 3,000 patients. In continental Europe the new hospitals generally were built and run from public funds. The National Health Service , the principal provider of health care in the United Kingdom, was founded in 1948. During

4845-543: The modern profession of nursing during the Crimean War when she set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration. The first official nurses' training programme, the Nightingale School for Nurses, was opened in 1860, with the mission of training nurses to work in hospitals, to work with the poor and to teach. Nightingale was instrumental in reforming

4930-399: The nature of the hospital, by improving sanitation standards and changing the image of the hospital from a place the sick would go to die, to an institution devoted to recuperation and healing. She also emphasised the importance of statistical measurement for determining the success rate of a given intervention and pushed for administrative reform at hospitals. By the late 19th century,

5015-444: The need for hospitals to prioritise their limited resources, there is a tendency in countries with such systems for 'waiting lists' for non-crucial treatment, so those who can afford it may take out private health care to access treatment more quickly. In the United States , hospitals typically operate privately and in some cases on a for-profit basis, such as HCA Healthcare . The list of procedures and their prices are billed with

5100-558: The nineteenth century, the Second Viennese Medical School emerged with the contributions of physicians such as Carl Freiherr von Rokitansky , Josef Škoda , Ferdinand Ritter von Hebra , and Ignaz Philipp Semmelweis . Basic medical science expanded and specialisation advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna , being considered as

5185-460: The number of US hospitals shrinking from 6,933 in 1981 to 5,534 in 2016. Occupancy rates also dropped from 77% in 1980 to 60% in 2013. Among the reasons for this are the increasing availability of more complex care elsewhere such as at home or the physicians' offices and also the less therapeutic and more life-threatening image of the hospitals in the eyes of the public. In the US, a patient may sleep in

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5270-438: The object meant, but not called by its own name." The author describes the process of metonymy to us saying that we first figure out what a word means. We then figure out that word's relationship with other words. We understand and then call the word by a name that it is associated with. "Perceived as such then metonymy will be a figure of speech in which there is a process of abstracting a relation of proximity between two words to

5355-536: The original meaning of the word, hospitals were original "places of hospitality", and this meaning is still preserved in the names of some institutions such as the Royal Hospital Chelsea , established in 1681 as a retirement and nursing home for veteran soldiers. During the Middle Ages, hospitals served different functions from modern institutions in that they were almshouses for the poor, hostels for pilgrims , or hospital schools. The word "hospital" comes from

5440-593: The past, however, this work was usually performed by the members of founding religious orders or by volunteers . However, there are various Catholic religious orders, such as the Alexians and the Bon Secours Sisters that still focus on hospital ministry in the late 1990s, as well as several other Christian denominations, including the Methodists and Lutherans, which run hospitals. In accordance with

5525-400: The phrase " lend me your ear " could be analyzed in a number of ways. One could imagine the following interpretations: It is difficult to say which analysis above most closely represents the way a listener interprets the expression, and it is possible that different listeners analyse the phrase in different ways, or even in different ways at different times. Regardless, all three analyses yield

5610-454: The phrase "lands belonging to the crown", the word "crown" is a metonymy . The reason is that monarchs by and large indeed wear a crown, physically. In other words, there is a pre-existent link between "crown" and "monarchy". On the other hand, when Ghil'ad Zuckermann argues that the Israeli language is a "phoenicuckoo cross with some magpie characteristics", he is using metaphors . There

5695-406: The poor, as the rich would have been treated in their own homes. Hospitals in this era were the first to require medical licenses for doctors, and compensation for negligence could be made. Hospitals were forbidden by law to turn away patients who were unable to pay. These hospitals were financially supported by waqfs , as well as state funds. In India, public hospitals existed at least since

5780-453: The primary figurative language used in rhetoric. Metaphors served as a better means to attract the audience's attention because the audience had to read between the lines in order to get an understanding of what the speaker was trying to say. Others did not think of metonymy as a good rhetorical method because metonymy did not involve symbolism. Al-Sharafi explains, "This is why they undermined practical and purely referential discourse because it

5865-412: The quality of health care has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this matter. Independent external assessment of quality is one of the most powerful ways to assess this aspect of health care, and hospital accreditation is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries,

5950-517: The reign of Firuz Shah Tughlaq in the 14th century. The Mughal emperor Jahangir in the 17th century established hospitals in large cities at government expense with records showing salaries and grants for medicine being paid for by the government. In China, during the Song dynasty , the state began to take on social welfare functions previously provided by Buddhist monasteries and instituted public hospitals, hospices and dispensaries . In Europe

6035-444: The rise of symbolism and is opposed to both. Following the path of contiguous relationships, the realistic author metonymically digresses from the plot to the atmosphere and from the characters to the setting in space and time. He is fond of synecdochic details. In the scene of Anna Karenina 's suicide Tolstoy's artistic attention is focused on the heroine's handbag; and in War and Peace

6120-591: The same interpretation. Thus, metaphor and metonymy, though different in their mechanism, work together seamlessly. Here are some broad kinds of relationships where metonymy is frequently used: A place is often used as a metonym for a government or other official institutions, for example, Brussels for the institutions of the European Union , The Hague for the International Court of Justice or International Criminal Court , Nairobi for

6205-432: The sole locally accessible hospital within nine additional counties in which one or more other hospitals are present at a substantial distance from a local community. Twenty-eight of California's rural hospitals and 20 of its critical-access hospitals are district hospitals. They are formed by local municipalities, have boards that are individually elected by their local communities, and exist to serve local needs. They are

6290-470: The sources of income received. A teaching hospital combines assistance to people with teaching to health science students and auxiliary healthcare students. A health science facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and urgent care ) and specialist units such as cardiology . Some hospitals have outpatient departments and some have chronic treatment units. Common support units include

6375-402: The standard for many textbooks. In the mid-19th century, hospitals and the medical profession became more professionalised, with a reorganisation of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practise for at least half a year at a hospital as part of their training. Florence Nightingale pioneered

6460-433: The study of metonymy. Metonymy takes many different forms. Synecdoche uses a part to refer to the whole, or the whole to refer to the part. Metalepsis uses a familiar word or a phrase in a new context. For example, "lead foot" may describe a fast driver; lead is proverbially heavy, and a foot exerting more pressure on the accelerator causes a vehicle to go faster (in this context unduly so). The figure of speech

6545-680: The subject-matter." In other words, Isocrates proposes here that metaphor is a distinctive feature of poetic language because it conveys the experience of the world afresh and provides a kind of defamiliarisation in the way the citizens perceive the world. Democritus described metonymy by saying, "Metonymy, that is the fact that words and meaning change." Aristotle discussed different definitions of metaphor, regarding one type as what we know to be metonymy today. Latin scholars also had an influence on metonymy. The treatise Rhetorica ad Herennium states metonymy as, "the figure which draws from an object closely akin or associated an expression suggesting

6630-545: The synecdoches "hair on the upper lip" or "bare shoulders" are used by the same writer to stand for the female characters to whom these features belong. Jakobson's theories were important for Claude Lévi-Strauss , Roland Barthes , Jacques Lacan , and others. Dreams can use metonyms. Metonyms can also be wordless. For example, Roman Jakobson argued that cubist art relied heavily on nonlinguistic metonyms, while surrealist art relied more on metaphors. Lakoff and Turner argued that all words are metonyms: "Words stand for

6715-559: The system after COVID-19, initially for respiratory patients. Mersey Care NHS Foundation Trust started a COVID Oximetry@Home service in April 2020. This enables them to monitor more than 5000 patients a day in their own homes. The technology allows nurses, carers, or patients to record and monitor vital signs such as blood oxygen levels. In early India , Fa Xian , a Chinese Buddhist monk who travelled across India c.  AD 400 , recorded examples of healing institutions. According to

6800-426: Was a pioneer of hospital design in having "pavilions" to minimize the spread of infection. John Wesley visited in 1785, and commented "I never saw anything of the kind so complete; every part is so convenient, and so admirably neat. But there is nothing superfluous, and nothing purely ornamented, either within or without." This revolutionary design was made more widely known by John Howard , the philanthropist. In 1787

6885-463: Was begun, including among the earliest hospitals by Saint Sampson in Constantinople and by Basil, bishop of Caesarea in modern-day Turkey. By the twelfth century, Constantinople had two well-organised hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialised wards for various diseases. The earliest general hospital in

6970-410: Was later dropped in 2018. In 2016 and 2017, healthcare reform and a continued decline in admissions resulted in US hospital-based healthcare systems performing poorly financially. Microhospitals, with bed capacities of between eight and fifty, are expanding in the United States. Similarly, freestanding emergency rooms, which transfer patients that require inpatient care to hospitals, were popularised in

7055-529: Was rebuilt from 1730 to 1759, and the London Hospital, Whitechapel, opened in 1752. These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centers of medical innovation and discovery and the principal place for the education and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at

7140-440: Was seen as banal and not containing anything new, strange or shocking." Greek scholars contributed to the definition of metonymy. For example, Isocrates worked to define the difference between poetic language and non-poetic language by saying that, "Prose writers are handicapped in this regard because their discourse has to conform to the forms and terms used by the citizens and to those arguments which are precise and relevant to

7225-889: Was the dispensary; these would issue the poor with medicines free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the British Empire . The idea was slow to catch on until the 1770s, when many such organisations began to appear, including the Public Dispensary of Edinburgh (1776), the Metropolitan Dispensary and Charitable Fund (1779) and the Finsbury Dispensary (1780). Dispensaries were also opened in New York 1771, Philadelphia 1786, and Boston 1796. The Royal Naval Hospital, Stonehouse , Plymouth ,

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