Poverty, Disease, and Port Cities: Global Exchanges in Hospital Architecture during the Age of Exploration

Abstract

This dissertation examines the cross-cultural circulation of the cruciform design for hospitals as the early modern architectural response to charitable and urban crises, considering the emergence of the plan in Italy and its rapid dissemination during the Age of Exploration (1400-1700). Despite recent media attention on makeshift hospitals, refugee camps, and reconstruction efforts worldwide following natural disasters, wars, and pandemics, the urgency of devising architectural and urban responses to human crises associated with poverty, disease, and migration is not a new phenomenon. While today these issues are often addressed in isolation, during the early modern period, they factored into a broader, ‘ecological’ understanding of health that drove the construction of hospitals and shelters for the sick poor, enmeshing these institutions into larger social, public health, and environmental strategies.</DISS_para> <DISS_para>Using the cruciform design as a connecting thread, I investigate links among port cities in Italy, Iberia, and the New World as they struggled with unprecedented challenges in sanitation, poverty, and medical assistance. As a result of intensified contact and circulation, ports are ideal sites for a study of architectural and urban innovations targeting urban crises. My project employs sociologist Immanuel Wallerstein’s model of ‘world cities’ to construe early modern ports as globally-networked cities that actively imported the latest advancements to achieve cultural and political centrality. Moving away from a formalist analysis, I integrate the building fabric with the contexts that inflected its adaptations, considering the role of the cruciform design in hospitals whose architecture and infrastructure promoted medical and sanitary innovations in the building itself and surrounding urban area, including developments to facilitate the disposal of human waste and the removal of dead bodies. My study combines archival evidence, archaeological data, and architectural and urban plans with contemporary knowledge of public and environmental health. This interdisciplinary approach highlights why political authorities sought and re-interpreted the cruciform design, isolating the innovative aspects responsible for the fast spread of this typology across Europe and Latin America. </DISS_para> <DISS_para>My Introduction (Chapter 1) examines the development of the cruciform typology as a result of charitable reforms occurring in northern Italy in the mid-fifteenth century. Building on early modern medical knowledge, I introduce the innovations associated with the design and consider the role of Filarete’s Treatise on Architecture (ca. 1460-64) in the circulation of architectural concepts during the period. Chapter 2 addresses the Ospedale di Messer Gesù Cristo (1474) in Venice in a longer history of Venetian reform. More specifically, I investigate the change in the mission of the Ospedale, as well as its architecture, from the perspective of military and urban crises faced by the Republic in the late fifteenth century. My discussion expands to Iberia in Chapter 3, with a study of the Hospital Real de Todos-os-Santos (1492) in Lisbon, an institution commissioned by the Portuguese monarchy to solve Lisbon’s crises of social welfare and public health. In particular, this chapter analyzes the Portuguese adoption of foreign and local strategies in charitable reform and the architecture of the hospital in view of larger public health strategies. Chapter 4 centers on the Hospital de las Cinco Llagas (1503) in Seville, especially considering the upsurge of at-risk women in Seville due to Spain’s male-driven colonization endeavors in the New World. Investigating the move and expansion of the hospital in 1549, I demonstrate how the architecture of the institution balanced innovations with the necessity to guarantee the invisibility and isolation of the institution’s female patients. Finally, Chapter 5, which also serves as a conclusion, addresses the translation of the cruciform typology to the New World. I compare the adoption of the plan in the Hospital San Nicolás de Bari (1503), located in the Spanish colony of Santo Domingo, with the different strategies of the Portuguese monarchy in colonial Salvador as evidenced by the Hospital da Cidade (1549).</DISS_para> <DISS_para>This dissertation contributes to the field in three ways. First, I demonstrate the actual reasons for the cruciform plan’s success rather than assuming the ‘natural’ replication of an Italian design as has been traditional in scholarship centered on this topic. Second, my case studies show the mobility and circulation of scientific and technological knowledge across southern Europe and between the Old and New Worlds, innovatively recognizing the impact of this flux on the built and urban fabrics of early modern cities. Finally, by shifting the scholarly discourse from Italy to the agency of Iberian and New World patrons, my dissertation opens the field for contributions from the so-called historical periphery, promoting a global understanding of early modern architecture and urbanism.