Art on the wards: this richly documented account of hospitals in renaissance Florence makes clear their significance as centres for the patronage of architecture and art

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The Renaissance Hospital: Healing the Body and Healing the Soul

JOHN HENDERSON Yale University Press, 35/$60 [pounds sterling]

ISBN 9780300109955

Florence's foundling hospital, the Ospedale degli Innocenti in Piazza SS Annunziata, with its distinctive and influential arcaded loggia by Brunelleschi, is the most conspicuous example of a renaissance hospital to have survived in the city. Founded in 1419 by Francesco Dafini, the 'Merchant of Prato' memorialised by Iris Origo, and initially administered by the silk guild of Florence, this building performed its original function until 1875. It was only one of 42 hospitals functioning in Florence in the middle of the 15th century, and traces of them survive, notably the loggia of the hospital of S Matteo, now the Accademia di Belle Arti, on the corner of Piazza S Marco and via Ricasoli, and that of the hospital of S Paolo, facing towards S Maria Novella. The way in which these and other hospitals functioned within the social and spiritual life of the city is vividly brought to life in this well-researched study by John Henderson.

The earliest hospitals in Italy were intended to offer hospitality to pilgrims. S Mafia della Scala in Siena on the Via Francigena pilgrim route, and S Spirito near St Peter's in Rome were the major examples, and there were links with hospitals of the same name in Florence. The majority of Florence's hospitals were built on a small scale and with a specific condition or social group in mind, such as the leprosarium at S Eusebio or the hospital of S Maria degli Angeli, which provided six beds for members of the wool-carders guild, but after the Black Death in 1348 larger medical hospitals developed. As plague recurred, an isolation hospital--lazaretto--was established in Venice in 1426, but Florence had no such hospital until more than 50 years later. The pox led to the foundation of hospitals for the incurabili, and later hospitals for reformed prostitutes--convertite--were established.

Hospitals were frequently founded by rich individuals for the salvation of their souls. The largest to develop in Florence was at S Maria Nuova, founded by Folco Portinari in 1286. A hospital still functions on this site, although most of the original fabric has been swept away. The Portinari family were buried in the chapel of the mens' ward and maintained patronal rights until deprived of them by a Medici pope, Clement VII, in 1532. In the 15th century, as members of the family managed branches of the Medici bank in Florence, Milan and Bruges, they spent money on adorning their foundation. Major painters were engaged here: Domenico Veneziano, the young Piero della Francesca and Bicci di Lorenzo, and later Andrea del Castagno and Alessio Baldovinetti painted frescoes in the Cappella Maggiore of the hospital church of S Egidio. The loss of this fresco cycle, of the life of the Virgin, is one of the major lacunae in our appreciation of painting in the quattrocenta, but other works for S Egidio, by Lorenzo Monaco and Fra Angelico survive in the Uffizi, together with its famous altarpiece by Hugo van der Goes.

Although Henderson's concern is not primarily art history, he makes suggestions for further research in this field, notably illuminated liturgical books, and the design and construction of hospitals. He refers repeatedly to works of iconographic interest, notably a fresco by Domenico di Bartolo in the hospital in Siena, and the glazed terracotta reliefs by Andrea della Robbia on the facade of the Ospedale del Ceppo in Pistoia. He also dwells on a pictorial representation by Bicci di Lorenzo of Pope Martin v confirming the consecration of S Egidio in 1420. But he is not well served by the small grey illustrations in this book. A few colour plates would have been useful, especially as the text refers to colours in the works of art, illustrations of which are not easily available elsewhere.

The great strengths of this book lie in documentation and presentation. The author has undertaken extensive research in the archives of the hospitals of Florence gathered at S Mafia Nuova, as well as on tax returns, and uses information from contemporary inventories, wills and chronicles as well as ground-plans made in the 18th century before many of these institutions were suppressed. The plan of Ospedale Messer Bonifazio, founded by Bonifazio Lupi from Parma in 1377 in Via S Gallo and replaced by the Questura after the hospital dosed in 1886 is preserved in this way. A vast amount of new material is marshalled in a masterly fashion, and although some readers may find the reinforcement of points repetitive, the limpid prose is rather refreshing.

The hospital is seen as a space for social and spiritual interchange. Mass would be said daily at the altar in each ward, and the souls of the founders were remembered in the prayers of the sick, who ideally were treated with great care and respect, as their sufferings echoed those of Christ. Although 'everyone knows how dirty, smelly and disagreeable the sick are', those caring for the sick accrued spiritual benefit, many choosing to do such work, which gave them social security as well as the possibility 'to live in a pious place and lead an honest life in order to save their soul'. The lay-out of hospitals had monastic prototypes, as did the organisation of work with lay brothers and sisters. The lofty cruciform ward at S Maria Nuova, with an altar at the crossing, had dear ecclesiastical resonances. Physicians normally provided their services for a reduced fee, or no fee at all, for the good of their souls and enhanced social standing, while they made their money from rich private patients. Hospitals were essentially to care for the poor, for the curing of their souls as much as the curing of their bodies. But as the third section of this book makes dear, medicine and medical training were greatly advanced by exposure to so many different medical conditions. A high proportion of patients recovered from illnesses, and hospitals were not merely 'antechambers of death'.