History The more you know

The origin of the hospital

All peoples have a medicine: there is Indian medicine, Chinese medicine, African medicine …

These are mostly mixtures of superstition and magical beliefs, cosmological visions of various kinds and empirical knowledge, born of some observation of reality. Michelangelo Peláez writes: “The most ancient medical practices were a mixture of empirical interventions, of which the real cause of efficacy or ineffectiveness was ignored, and of magic, which attributed the motive of pain and illness to mysterious external forces, dominated by procedures enigmatic reserved for some members of the tribe who, properly initiated, enjoyed special healing powers ”.

Medicine as the West knows it, was born in the Greek world, with Hippocrates and its school, in intimate connection with Greek philosophy: the “Hippocratic refusal of a divine intervention in the process of illness, and consequently the refusal of any therapeutic magic aimed at calming divine anger, coexists with the declared respect for divinity. The Hippocratic physician substitutes for divine justice, more or less obscure, an order of the universe, divine and natural, which gives an account of all diseases, including the evil called “sacred” (epilepsy), considered by contemporaries more divine of others. In Hippocrates, we observe an adaptation of the divine to the natural, in the sense that the divine manifests itself in the regularity of natural laws “(Pelàez).

One thing is medicine, however, another is the hospital: if the property of modern medicine, daughter of the Greek and the Christian ones, is being founded on rational research and on the reduction of goals (the doctor must look for to take care of the body, without forgetting that besides it, and together with it, there is the soul), the greatest novelty of the Christian contribution lies in the establishment of a place where the poor, the sick, the marginalized, the pilgrims, orphans, etc. find assistance and help. In the name of Christ, which had been, according to a common way of saying in the Middle Ages, infirmus et patiens (infirm and suffering).


The term hospital in the Middle Ages indicated a place destined to offer hospitality to those in need (domus ospitalis). The hospital, therefore, was not properly understood as a place of care for the sick as it is for us today. Only in the fifteenth century were hospitals founded that, like the Sant’Anna in Ferrara (1440) and the San Matteo in Pavia (1449), became places of care for the sick, that is hospitals in the sense that we give today to the word.

The main function of a hospital was to welcome pilgrims, especially those who were unable to pay for a bed in an inn. For this reason, hospitals were often found along the roads that led, from all over Europe, to the great pilgrimage destinations: Rome, Jerusalem, Santiago de Compostela, etc. There were hospitals in the cities, but also outside the walls, to allow pilgrims to find refuge even if they arrived late in the evening, when the city gates were closed.

In the Middle Ages, there are three types of hospitals: the “xenodochii” for foreigners, the “ptochi” for the poor and those for the sick, that is, poor people who had untreatable diseases or disabilities (blind, lame, etc.). Often, however, there are two or all three functions at the same hospital, offered in separate rooms.

Hospitals were religious institutions, often belonging to a monastery or a parish and lived on incomes produced by bequests of citizens and alms. They could not offer much: generally a bed or, more often, a straw mattress in a large common room. When they were not adjacent to a monastery or church, they had a chapel. Usually, the offer of food to the pilgrims was not foreseen, while for the poor and the sick each hospital behaved according to its possibilities.

In a document dated 16 January 1346, relating to the Hospital of Misericordia in Ivrea, we read: “Each patient is given food to eat according to the possibilities of the house and, when this is not possible, they are prepared with good beds … for the poor we do not give food every day, because, when they can walk, they go to beg and in the evening they return to their beds “. Furthermore, as far as the sick are concerned, we read: “when necessary, call the doctor to treat them”. This sentence is interesting because it helps to specify that even the hospital for the sick was not, as we understand it, a place of care, but only a place of assistance and the doctor was called only in case of need.

A bit different was the fate of the sick admitted to monasteries and abbeys hospitals because here there were monks who were experts in the collection and cultivation of medicinal herbs and in the preparation of medicines.

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