Religious and Italian Renaissance hospitals
The Italian cities of Venice, Genoa, Florence and Milan had populations around 100,000 in the late-medieval period. With such concentrations of the poor and sick, it is no surprise that these cities also built some magnificent hospitals. Those of Florence were exceptional. Martin Luther praised them as regal buildings, providing the finest food and drink, learned physicians and clean beds. More than 50 different hospitals were active between the years 1000 and 1500. Florence, like many cities at the time, had a ratio of one hospital for every thousand inhabitants.
Religious confraternities took upon themselves the duty of charity, and some administered these early hospitals. Severe plague outbreaks spurred the foundation of hospitals. Unlike smaller institutions, those in major Italian cities had resident medical staff. Those in the urban centres offered care to the poor and sick. Most hospitals were established in suburban areas. The size of these hospitals varied from under ten beds to 230 at Santa Maria Nuova (founded 1288), the largest and most eminent. In the 1300s it had six visiting physicians, a surgeon and three junior staff members. Female patients were housed in separate wards and were cared for by women ‘skilled in surgery’. The majority of funds were spent on food; less than a tenth was spent on medicine. Only seven hospitals were dedicated to the sick.
Like all hospitals, these institutions found their finances were stretched during periods of crisis. During famines and the Black Death many early modern hospitals struggled to cope with the huge numbers of sick people. As a result, government subsidies were occasionally required. They were often inadequate. By the second half of the 1400s, many Italian city states began to found their own large institutions which rivalled those of Florence. Some city states also began to unite the many small hospitals in a centralised system of care for the sick and poor. Their designs have also been among the most influential hospital designs in the world.