Mending bodies, saving souls: a history of hospitals

Guenter Risse's Mending bodies, saving souls, more than a decade in the making, is a tour de force which matches considerable intellectual and historiographical ambition with humane and punctilious scholarship. Risse tells the relatively well-rehearsed story in a distinctive and highly appealing way which will provide pleasure as well as instruction to social, economic, cultural historians as well as to historians of medicine. Risse is best known for his superb analysis of the emergence of clinical medicine in eighteenth-century Edinburgh. That work was based upon extremely extensive archival research. If the present work sees him venturing fearlessly onto the seas of the longue duree, he has embarked with the same ferocious commitment to scholarship. Exhaustive primary research is out of the question in all sections (though it is clearly in evidence in all the sections dealing with the period from the eighteenth century to the present), but all parts of the volume are underpinned by an extraordinarily wide range of secondary sources (which the publishers, who have otherwise done Risse and his readers proud, have shamefully omitted to group together into a bibliography). The institutional genealogy of the hospital is well established, and Risse follows in well-worn tracks, stretching from the most ancient to the most modem of times. He begins the story with the temples of Asclepius in ancient Greece, Roman military infirmaries and early Christian xenodochia and ends it with the twenty-first-century hospital as biomedical showcase. This is a tale which has often been told in a traditional Whiggish fashion, charting the progress of medical triumphs. Risse keeps any such bland historiographical and medical certainties to a minimum: he has some wry reflections, for example, on commercial imperatives on contemporary hospitals, and these institutions' growing iatrogenic effects. Medical triumphalism is more generally kept at bay in two ways. First, Risse chooses a kind of snapshot structure in which lineal influences are underplayed, and in which emphasis is placed upon the hospital's relations to its broader social, economic and cultural niche. Second, he develops a bifocal approach (highlighted in his volume's title) which stresses the applicability of the term "hospital" to any institutional form which combines bodily care and cure with a concern for spiritual and/or psychological well-being. The ideal type of Risse's "hospital" is thus any collective institution in which are entwined and intertwined the double helix of bodily and mental care. This provides a sufficiently capacious analytical …