The Renaissance Hospital: Healing the Body and Healing the Soul (review)

John Henderson's richly informative study of Tuscan and especially Florentine hospitals pays equal attention to the civic, the religious, and the medical aspects of these institutions. Grounded in many years of archival research, the book is also notably attentive to the surviving material remains, art, and iconography of the premodern hospitals of Florence, of which the largest and most famous was S. Maria Nuova. Although the focus is on hospitals in Florence, comparisons with other hospitals in Italy and elsewhere in Europe illuminate the discussion. In its combination of social and religious history, sensitivity to art and material culture, and depth of archival scholarship, The Renaissance Hospital is a worthy successor to Henderson's earlier Piety and Charity in Renaissance Florence (1994, 1997), as well as a distinguished contribution to the growing body of recent, and revisionist, literature on medieval and early modern hospitals.

The book is divided into three parts. In the first, the author traces the history of hospital foundations in Florence from 1000 to 1550, showing both that the most active period for hospital foundation beginning in the mid-thirteenth century was linked to population growth, and that in Florence — unlike parts of Northern Europe — hospitals continued to be established in the later fourteenth and fifteenth centuries despite population decline. Hospitals of different types served a variety of different groups (pilgrims, the old, destitute women, etc.), but increasingly the emphasis turned to the care, and medical treatment, of the sick poor — a development that, Henderson argues, was partly a result of increasing awareness on the part of civic authorities of the problems of urban disease in a period of recurrent epidemics, first of plague and later of the so-called French Disease. In the two centuries following the mid-fourteenth century pandemic all new hospital foundations in Florence were the bequest of charitable individuals, but the civic government also oversaw hospitals, perceiving them as socially useful institutions both for assisting and for controlling the poor. Yet Henderson stresses that governmental authority, including even the more far-reaching regulations introduced by the Medici dukes, was as likely — or more likely — to be protective as exploitative, while the number, size, and facilities of Florence's hospitals, and the beauty of their buildings, became a source of frequently expressed civic pride.

A principal thesis of this book, in line with other recent scholarship, is that the history of Renaissance hospitals can by no means be described simply in terms of secularization. In the second part, Henderson shows the central role of religion in Florentine hospitals — in the hospital church or chapel (with a detailed account of the architecture, art, iconography, and ceremonial of St. Egidio, the church associated with Santa Maria Nuova); in the presence of cloisters as integral parts of hospitals; in wards provided with altars and religious art; and in the life of the nursing community, whose social background, conditions of service, and activities are traced in a chapter of exceptional interest. Henderson remarks that "surviving contracts . . . suggest the distinctions between patient, nurse and resident were far from clear cut" (188).

The final section of the book deals with physical healing. A chapter on medical practitioners shows that all categories of medical practitioner — physicians, surgeons, and empirics — worked in hospitals. But hospital service did indeed, as contemporaries claimed, attract well-known elite physicians, even though their hospital fees were not high (for these men such fees were only one source of income among many). In the following chapter on the patients, Henderson has drawn on surviving hospital death registers and other sources to assemble substantial information about mortality rates (relatively low), turnover (high), and the occupations, social status, place of origin, and reported reasons for admission of patients, who he estimates might have amounted to about nine percent of the city's population in any one year in the early sixteenth...