Hospitals and Asylums

Renaissance hospitals and asylums provided spiritual and physical care, as well as limited medical care, to people with many different needs. The earlier "hospitals" of the Middle Ages were basically shelters for the poor and needy. They provided people with food and lodging, but they seldom offered specialized medical care. During the Renaissance, hospitals grew much larger and more advanced in their administration and use of medical treatment. This was particularly true in Italy, whose hospitals became the wonder of Europe.

A Community of Care. Traditional hospitals focused as much on spiritual care as on physical care. The earliest hospitals belonged to Roman Catholic monasteries, but during the 1300s laypeople* began to play a larger role in creating and running hospitals. Organizations such as guilds* and the religious groups called confraternities took charge, using members and their wives to perform such daily tasks as laundry and food preparation. They also hired a chief administrator to look after day-to-day business such as providing meals and supervising staff. A large part of the staff consisted of people staying in the hospital, who both gave and received care. A Catholic priest tended to the community's spiritual needs.

Despite the need for care, most communities had only one hospital for every thousand people. Of these hospitals, many were too small to serve the public adequately. Several had only one or two beds, while others had none at all. Some hospitals, however, received large monetary donations and became very wealthy. As a result, many even included banking among their services. As these hospitals gained wealth, political officials sought more control over them.

The Changing Face of Care. In the early 1400s governments began to merge, or consolidate, small hospitals to form larger ones. By creating one large hospital, authorities could pool resources to provide better care. In 1542, for example, Duke Cosimo I de' Medici merged hospitals in Tuscany (the region surrounding Florence) and placed them under the control of a group of government officials. These officials reviewed the hospitals' accounts and directed their excess funds to an orphanage in the capital.

As government authorities took greater control of hospitals, they developed a system to direct care more efficiently and to add more medical treatment. Small hospitals came into being to serve the needs of specific groups, such as people suffering from plague* or syphilis (a sexually transmitted disease). Caretakers in these facilities had more knowledge about particular diseases and were more likely to be paid than those in earlier hospitals. Patients received a complete program of care that included food, rest, exercise, herbal remedies, and sometimes new forms of treatment.

In the 1500s nonmedical hospitals also began catering to specific groups of people. Asylums provided shelter for orphans, widows, battered women, former prostitutes, and Jews converting to Christianity. Confraternities played a large role in running them, though the clergy came to dominate the field over time. Asylums used a strict discipline of work, education, and spiritual exercises to reform troubled individuals and help prepare them to reenter society. At times this discipline became a form of punishment, and some hospitals for the poor became little more than prisons.

Hospital buildings also changed during the Renaissance. The earliest hospitals had been similar in design to monasteries, with separate quarters for men and women, a common dining room, and living areas for the staff. Hospitals of the Renaissance became larger and grander, partly as a way for towns to show off their wealth. They also included classical* design elements, such as porticoes*, which were both useful and beautiful. One of the most impressive Renaissance hospitals was the Maggiore Hospital in Milan, Italy. This large facility included a complex sanitation system; storage for food, water, ice, and drugs; and separate living areas for upper-class patients.

(See alsoMedicine; Poverty and Charity. )

* laypeople

those who are not members of the clergy

* guild

association of craft and trade owners and workers that set standards for and represented the interests of its members

* plague

highly contagious and often fatal disease that wiped out much of Europe's population in the mid-1300s and reappeared periodically over the next three centuries; also known as the Black Death

* classical

in the tradition of ancient Greece and Rome

* portico

porch or walkway supported by regularly spaced columns