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Cadernos do Arquivo Municipal

versão On-line ISSN 2183-3176

Cadernos do Arquivo Municipal vol.ser2 no.19 Lisboa jun. 2023  Epub 30-Mar-2023 


Alberto, E. M., Silva, R. B. da, & Teixeira, A. (Eds.). (2021) . All Saints Royal Hospital: Lisbon and Public Health. Câmara Municipal de Lisboa; Santa Casa da Misericórdia de Lisboa

i University of Massachusetts Dartmouth, North Dartmouth, MA 02747, Massachusetts, United States of America.

All Saints Royal Hospital: Lisbon and Public Health, published in Lisbon, Portugal in 2021 by the Câmara Municipal de Lisboa and the Santa Casa da Misericórdia de Lisboa, is the first comprehensive historical volume to examine the broad context of the founding, operation, and legacy of the Portuguese capital’s - and indeed the nation’s - primary medical facility for treatment and teaching during the early modern era. The Todos-os-Santos Royal Hospital in cosmopolitan Lisbon, the principal port of a global empire, was a center of medical experimentation and instruction which, during the sixteenth, seventeenth, and eighteenth centuries, was more open to innovations of surgical technique and applied medicines than any other such facility in the country. The research project that produced this tome is part of the City of Lisbon’s admirable cultural policy to research, preserve, and disseminate the Portuguese capital’s cultural heritage.

As a work of integrated medical history focused on a single national facility of fundamental importance, this project is superb. The book describes healthcare methods and remedies used throughout the working life of the Hospital, from its founding until its tragic destruction during the earthquake of 1755. André Levy, translator of the present volume into English, has allowed for an exceptionally important text in the history of early modern medicine - one of the most significant published this past year - to be available to an international scholarly audience. Its availability in English translation will ensure its broad dissemination and appreciation beyond the Lusophone sphere.

How this key royal hospital rose to prominence from promising beginnings through exceptional efforts to become an influential keystone institution devoted to bettering healthcare conditions for crown subjects across Portugal is the subject of this long awaited, much anticipated work of scholarship. Through tracing this process, the reader gains a rich and intimate knowledge of public health concerns and reactive policies, as well as an understanding of technical medical practices, in the early modern European world.

The editors’ and contributors’ engaging, highly innovative analysis has resulted in a subtle, layered treatment providing a comprehensive exploration of the history of the Hospital, as well as its varied functions and their social impact, providing a much-needed window into Lisboetas’ lives in sixteenth- to eighteenth-century Portugal. Whether for a specialist or general student of medicine, women’s studies, or European history, the contributing scholars have produced a first-rate read, with thorough scholarly apparatus that illuminates the central but oft-neglected dimension of the public healthcare experience within early modern society.

This new publication opens with a broad introduction (17 pages), in which the coordinating editors provide indispensable context for the project, the Hospital, contemporary quotidian life in Lisbon, social influences, and professional activities surrounding the Todos-os-Santos institution. The core of the volume and research project contains five main divisions, each with its own topical focus: 1) “The City and the Building”; 2) “The Institution”; 3) “Assistance, Health, and Science”; 4) “Experiences and Daily Life” and 5) “Preserving Health in Lisbon”. Several of these sections are further divided into subsections, grouped to further define and refine the various analytical topics. Nearly sixty contributing authors have collaborated to produce the scholarly texts. The core argument is very creative: that the Todos-os-Santos Royal Hospital gave Portuguese people a space for agency in medical treatment that transcended in importance and innovation any other medical facility in the realm, expressed through the methods and healing substances available to them as residents in the commercial hub of a great global empire.

Section one leads the reader through a practical discussion of the Royal Hospital’s physical space in the urban fabric of Lisbon: issues such as the architecture and appearance of the building, its physical capacity, its water supply and associated gardens (a source for patient medicines and food), and the decoration of the edifice are discussed in the fifteen chapters included here. Section two offers a valuable investigation into the hospital’s institutional administrative structures and processes, from its medieval origins, responding to a need for public charitable medical assistance, to its final manifestation as an Enlightenment-era teaching hospital. The development of the Hospital’s governance, finances (revenue and expenses), cooperative collaborations with the Santa Casa da Misericórdia and other religious orders, and its relationship with the royal household all receive detailed explication in this section. In section three, the reader is provided a masterful exploration of practical contemporary medicine and sickness during the Hospital’s period of operation. In eighteen chapters, the contributing authors give a richly detailed examination of the diverse types of medicine and techniques used, the types of disease, injuries, and wounds treated, and of the demographic characteristics not only of patients, but also the Hospital functionaries. Next, the dozen chapters of section four provide much welcome insight into the quotidian experience of working for or being treated in the Royal Hospital. Topics covered here include the Hospital’s standard equipment and furnishings, its textiles and patient clothing, the supply of food and drink - all important aspects necessary to understand how this key medical institution operated. And finally, in section five, the analytical structure concludes with a powerful consideration of the Hospital’s institutional role as an instrument of public health - the main function for which it was created, from the perspective of the crown and royal government. Discussed here are the means by which functionaries of the Todos-os-Santos Royal Hospital attempted to control epidemics, regulate public health measures, institute quarantines, and contain leprosy. Taken together, these rich, varied components provide a rare and fascinating view into the world of medicine of early modern Portugal.

This cornucopia of diverse chapters provides very fertile ground for scholarly exploration. In historiographical terms, the authors have produced a highly innovative volume. With a clear, well defined argumentative structure and organization, the volume provides a highly readable and engaging treatment of the subject - medical care was a fundamental component of empire building necessary for understanding the historical success of the Portuguese global enterprize. This work is strongly supported by new primary source research, illustrated by ample examples of the lived experiences of patients and medical practitioners in the Portuguese capital city, and backed by a strong comprehensive knowledge of, and recourse to, the relevant secondary source historical literature. Further, the translator’s indispensable contribution for the English-language edition must be appreciated, given the complexity of rendering archaic medical terms and concepts into language that modern international readers will understand.

The authors have produced an impressively-sized book-length treatment (650 pages of text), which fills an extremely rich volume. Thus, this is an important innovative work of research and analysis for the fields of medical, social, and Portuguese history. Such a fresh line of inquiry has led to a remarkable new consideration of the fundamental dynamic relationship between medical professionals, the procurement of new healing substances that originated in various parts of the empire, and the sick or injured souls whom they looked after in Lisbon’s flagship royal hospital. The scholarship is impressive for its thorough documentation based generally on new research, and the narratives are well-integrated and skillfully recounted.

A large, well chosen, and edifying selection of color and black & white illustrations dispersed throughout the chapters compliment the text, including images of twentieth-century excavations of the Todos-os-Santos Hospital site, contemporary engravings or paintings of the edifice and surrounding buildings prior to the 1755 earthquake, and images pertinent to the medical history subject matter. All serve to draw the reader into the distant world this exceptional volume describes.

The book is incisively and innovatively argued with fresh evidence from Portuguese medical, municipal, religious, and secular institutional records. Most of this documentation is not known at all in English-language historiography - and in fact is relatively little used in Portuguese historical research. The documentation and source notations are generally very fine-grained, with strong primary source mining from unique archived manuscripts - rare evidence documenting the Portuguese medical establishment under the Old Regime. The authors have made excellent use of the surviving archival material, which is preserved in Lisbon in municipal records, at the National Archives, and the National Library. The surviving material is sufficient to provide a broad sampling of peoples’ lives and experiences with medical care in the Portuguese capital city during the period under study.

A thorough reading of the text, with particular attention to the footnotes and bibliography, leads this reviewer to conclude that the scholarship is indeed very sound, the research exhaustive, all of which establishes this work as the new benchmark reference volume on the Todos-os-Santos Hospital specifically, but also for early modern medical care as practiced in continental Portugal.

My expectation is that this innovative research work will be of broad interest to readers well beyond the volume’s stated focus. For numerous general readers with an interest in the social history of Lisbon, this volume will emerge as a highly readable and informative resource. For example, this is a work of history that has profound implications for those who study imperial exchanges in every corner of the globe - and not just in areas colonized by the Portuguese crown. The work will be of interest to scholars of many fields, including but not limited to urban studies; art and material culture; architecture; women’s studies; the evolution of city government; botanical studies; cross-cultural transfers of medicine; and religious history (especially studies of religious confraternities).

The writing is accessible for a popular audience as well as scholars. This is a book that could be assigned for graduate level coursework, as a supplementary text for a specialized undergraduate course, as a monthly selection for book clubs, for travellers on their way to Lisbon, or for the casual/general reader.

Making a complex historical text about medicine and hospital operations accessible to students in the twenty-first century is a most difficult task for any translator, yet André Levy’s clear facility with the highly specialized vocabulary of fifteenth- to eighteenth-century Portuguese medicine - which alternates between the technical terms of an incipient scientific revolution and profoundly colloquial vernacular expressions - has given us a wonderfully readable version that maintains the engaging character of the various authors’ original language.

This is a work of highly original, creative, and deeply insightful scholarship. I believe this book will emerge as a landmark work of historical analysis because of its skillful, novel use of rare, underutilized medical, municipal, and parish records to look into and describe the quotidian circumstances of treating persons for disease or injury in the Lusophone world, and the practical, crucial role that medical care of the capital city’s people played for empire building and national defense in the Portuguese sphere.

Bibliographic reference

Alberto, E. M., Silva, R. B. da, & Teixeira, A. (Eds.). (2021). All Saints Royal Hospital: Lisbon and Public Health. Câmara Municipal de Lisboa; Santa Casa da Misericórdia de Lisboa. [ Links ]

Received: December 09, 2022; Accepted: January 13, 2023

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