The University of Southampton

HIST6120 The Rise of the Modern Hospital (18th-19th Centuries)

Module Overview

Erwin Ackerknecht and many modern historians of medicine maintain that the modern hospital in the nineteenth century is a response to the emergence of medicine of observation through the work of the major clinical figures such as Pinel, Bichat, Corvisart, Laennec and others. This module aims to reassess this historiographical approach by examining the modern hospital at the intersection of medicine and state, science and power. It will introduce you to the genesis of the creation of the modern hospital by examining the development and transformation of the medical profession alongside the creation of modern states. Is the modern hospital the result of what is called “hospital medicine” or is it a consequence of change in the medical professionalization? Should we seek its origin in the military modernisation through successive conflicts from the nineteenth century all the way through the WWII rather than in the emergence of modern medicine? To what extent, is it the result of a new social order, socialisation of medical care and cure, the centralisation of medical service, medical professionalization and tightening control on the medics? In summary, is the modern hospital a medical or a social and political phenomenon? By examining the transformation of the medieval hospice in the eighteenth and nineteenth centuries, as well as the establishment of modern hospitals you will be invited to reflect on factors behind the rise of the modern hospital.

Aims and Objectives

Module Aims

Investigate the rise and development of hospitals ? Introduce you to different types of hospices and hospitals ? Examine the relationship between medicine and hospitals ? Study the impact of military conflicts in the reorganisation of hospital ? Explore historical debates around the transition from pre-modern to modern hospital ? Examine the impact of medical knowledge and practice in the transformation or disappearance of hospices ? Study the impact of hospital on doctor-patient relationship ? developed your skills in handling different kinds of primary source material; ? Familiarise you with the place occupied by modern hospital in the society ? Familiarise you with different approaches in the historiography of hospices


The core of the module is to examine the rise of modern hospitals as a result of the socio-political and medical transformations triggered by the Enlightenment. We will follow the changing balance between care and cure, the main components of hospital institutions in the light of the development of medical knowledge (from humoral medicine to anatomical pathology and biomedicine), and socio-political evolution. Through different case histories (such as the cancer hospitals in London), we will reflect on a complex, rather than linear, development of modern hospitals. In the white heat of scientific technology in the 1960s, death caused by cancer was considered a failure of medical knowledge and more invasive methods were developed. However, patients’ families questioned whether a few more weeks or months of life was worth the pain and suffering involved. Specialised hospices were created to provide care for dying patients and charitable funds are now directed not only to research on cancer, but also how to allay pain in hospices, where not only palliative care nurses but also nuns are in charge. Key issues examined in the module include the following: 1: The impact of the Reformation and Renaissance on hospices. 2: The influence of the Enlightenment on medicine and hospital organisation. 3: The Neo-Hippocratic, and anatomical pathological medicines and change in the structure and function of hospitals. 4: The French Revolution, its aftermath and medical reform (the case of Hôpital Lariboisier). 5: The epidemic of cholera in the nineteenth century and its impact on the reorganisation of hospital. 6: The impact of military modernisation on the modern hospital. 7: The impact of modern state and public health on the rise of the modern hospital.

Special Features

There might be a field trip to some hospitals in particular those which transformed from pre-modern hospice structure to modern organisation, for example, Winchester hospital.

Learning and Teaching

Teaching and learning methods

10 weekly double seminars led by student presentations and facilitated by the tutor. Attention will be paid in each seminar to identifying key scholarship and debates, as well as engaging with some primary source material in preparation for the research essay summative assessment. Teaching methods include: ? Seminar discussion ? Small-group discussion ? Source analysis ? Student presentations ? Student-led seminars Learning activities include: ? Preparation for class (including both required and independent, further reading of secondary material) ? Close reading of primary material: identification of significant themes and ability to place primary sources within their proper context ? Seminar discussion and debate

Completion of assessment task26
Preparation for scheduled sessions100
Total study time150

Resources & Reading list

Granshow & R. Porter The gift relation: philanthropy and provincial hospitals in eighteenth-century England. The Hospital in History. ,0 , pp. 149-178.

Roy Porter (1997). The Greatest Benefit of Mankind. 

Ann Richardson (2007). Life in a hospice: reflections on caring for the dying. 

David Clark (1993). Partners in care? : Hospices and health authorities. 

Michael Wright (2006). Victor Zorza: a life amid loss. 

Cicely Dame Saunders (2002). Cicely Saunders: founder of the hospice movement: selected letters 1959-1999. 

Roy Porter (2006). The Cambridge history of medicine. 

Barbara Greenall (1982). Development of the United Kingdom hospice movement, 1976-1981: as reflected in the growth of relevant literature, and investigating the information needs of hospice medical staff. 

Granshow & R. Porter Charity, Power, and patronage in eighteenth-century Italian hospitals: the case of Turin. The Hospital in History. ,0 , pp. 93-122.

American Catholic hospitals [electronic resource]: a century of changing markets and missions, New Brunswick.

John Mount (2001). Palliative care services for different ethnic groups: proceedings of a seminar held in December 2000. 

Jenifer Wilson-Barnett (1988). Nursing issues and research in terminal care. 

Erwin Ackerknecht (1967). Medicine at the Paris hospital 1794-1848. 

Pierre-Jean-Georges Cabanis. Observation on hospitals. 

Erwin Ackerknecht (2012). A Short History of Medicine. 

Patients and practitioners: lay perceptions of medicine in pre-industrial society [electronic resource].

Sarah Zarbock Goltzer (1993). Hospice care for children. 

Dorothy Porter and Roy Porter (1993). Doctors, politics and society: historical essays. 

Roy Porter (1995). Disease, medicine and society in England, 1550-1860. 

Paul Bridgen Hospitals, Geriatric Medicine, and the long-term Care of Elderly People 1946-1976. Social History of Medicine. ,14 , pp. 507-523.

Asylum on the hill: history of a healing landscape [electronic resource].





MethodPercentage contribution
Essay  (4000 words) 100%

Repeat Information

Repeat type: Internal & External


Costs associated with this module

Students are responsible for meeting the cost of essential textbooks, and of producing such essays, assignments, laboratory reports and dissertations as are required to fulfil the academic requirements for each programme of study.

In addition to this, students registered for this module typically also have to pay for:

Travel Costs for placements

No cost implication except for possible field trip. The costs vary according to the length of trip. We can anticipate this can be up to £40 if we visit, for example, St Thomas Hospital in London.

Please also ensure you read the section on additional costs in the University’s Fees, Charges and Expenses Regulations in the University Calendar available at

Share this module Facebook Google+ Twitter Weibo

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.