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Most people would agree that the hospital functions as one of the 'first duties of an organized society' as a public service for those members of the community who are in need. In the thirteenth century, hospitals represented a nexus of exchange between church officials, the community, the needy, and the pious or ambitious individual. This book presents a survey that offers an overview of the role of the hospital in affairs of the urban community, suggesting how changes within that community were reflected in the activities of the hospital. It locates the rise of the hospital movement in northern Italy within the context of the changing religious, social, and political environment of the city-states. The book introduces the hospital's central function in the distribution and administration of charity. It illustrates how the hospital and other charitable organizations played a role in the appropriation of power and influence by urban citizens. A comprehensive investigation of twelfth and thirteenth century hospitals' foundational charters follows. The book then delves into a detailed description of the physical plant of the hospital, the daily life of individuals, and rules and statutes followed by its members. It considers the social composition of donors, workers, and recipients of hospital services. Jurisdictional disputes among the city leaders, the community, individual religious orders, ecclesiastical authorities, and larger political forces. Finally, the book explores the process of consolidation and bureaucratization of hospitals in the fifteenth century and the emergence of state control over social services.
. Soon, however, both Freudians and harried hospital bureaucrats put an end to the idea that work would help individuals overcome their symptoms and redirect their inner resources. And when the asylums were dismantled in the 1970s and 1980s, the politics of patient work helped move the process along. Few participants in these events could trace patient work as a thread that connected most major therapeutic changes, but hindsight allows us to see it as such. Acknowledgement The author thanks Ellen Dwyer for her comments on an earlier draft of this work. MAD0181_ERNST
member to the hospital’. 81 ‘Hospitalization became a middle-class survival strategy’ and lost its shame, Smith has suggested, seeing the cause as principally economic rather than due to advances in medical technology. 82 His overarching narrative is one of charitable institutions struggling financially and turning to the local state, who in turn looked to the central state, yet he also notes that in the 1930s financial need forced hospital