The charity and the care: the origin and evolution of hospitals

Background: The hospital is considered as one of the founding elements of modern medicine. Such an institution, originally born to be a center for housing the sick and the poor, has provided with a place to improve the medical knowledge and to educate new generations of nurses and physicians. This paper wants to remind the meaning and the development of the hospital institution in the western world. Methods: The first part of this work analyzed the evolution of hospital, using a classical historiographical approach. In the second part, the history of the "Ospedale Maggiore" in Milan was used as a paradigm to describe the evolution of hospital from the Renaissance to nowadays through a "microhistorical approach". Results: The origins of the public hospital are evidenced in early Christian age, when the Christian message led people to assist the sick and the poor and to establish centers for such interventions, initially in the house of the bishop, then in monasteries and, finally, in autonomous buildings (the hospitals). These institutions were economically supported by the donations of wealthy philanthropists. Since the nineteenth century the hospitals have changed their organization and functions, but have continued to associate the charity and the care. Conclusion: Christian charity and the lay culture originated from it may be rightly credited not only as the founding element of ancient hospitals, but also as the virtue which has made possible for the development of medicine, as we know it. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.