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Cloister of the Palace of he Commander (S.XVI)


The Great Hall Hospital of the Holy Spirit Sassia     

Mª Teresa Miralles Sangro, Crispín Gigante Pérez, María Victoria Miranda Camarero
Teaching at the nursing departament. University of Alcalá, Madrid, Spain

Mailing Address: Mª Teresa Miralles Sangro. Departamento de Enfermería. Universidad de Alcalá. Carretera Madrid-Barcelona  Km 33, 28871 Madrid, España

Manuscript received by 3.04.2004
Manuscript accepted by 25.06.2004

Index de Enfermería [Index Enferm] 2004; 47:66-68 (original version in Spanish, printed issue)








How to cite this document



Miralles Sangro MT, Gigante Pérez C, Miranda Camarero MV. The Great Hall Hospital of the Holy Spirit Sassia. Index de Enfermería [Index Enferm] (digital edition) 2004; 47. In </index-enfermeria/47revista/47_english_66-68.php> Consulted






With these few words and using history as transmitter we will attempt to skim through the history of one of the most important hospitals originating in Medieval Europe; The Hospital of the Holy Spirit in Sassia. We point out the day-to-day life of patients and their nurses.  Both perceived suffering and caring as means to eternal salvation.  Together they lived there enduring institutionalised and medico-religious lives. These were the characteristics of the hospitals of the time until well into the XX century.








     The hospital complex of the Holy Spirit at Sassia is the most famous among the roman hospitals as it is also the host house of the Order of the Holy Spirit, and one of the hospitals with longest tradition in Europe. Located on the eastern side of the river Tiber, the hospital was built where once was the house of Agripina the Elder, wife of Germanic and mother of Caligula. The history of this hospital goes back to the year 727 when the king Ine of Sussex (County in Great Britain close to the English Channel) founds the "Schola Saxonum" (from where the word Sassia derives), close to the Vatican as an hospice or home for the English pilgrims that visited Rome to see the tomb of the apostle Saint Peter.Engraving of Philippe and Felix Benoist, 1843

A fire destroyed the complex until Marchionne Dárezzo rebuilt it in 1198 during the pontificate of Innocent III. The pope Innocent III established his pontifical authority over sovereigns and clerics. On the political sphere, the Pope Innocent became the virtual overlord of England (King John without land, who was excommunicated, had to submit to the power of the Pope and finally turned into his vassal), Portugal, Aragon, Castile, Denmark, Sweden, Poland, Hungary and Bulgaria. Within the Catholic Church, he fought against the abuse of Papal bulls and became an example of austerity. He supported the monastic movement and encouraged the foundation of mendicant orders.

The reconstruction of the Hospital of the Holy Spirit started in 1198 over the plot of land that belonged to the Schola Saxonum, which was English owned. Thus John without land had to give his permission. The architecture of the building was under the supervision of Marchionne d'Arezzo and its organization was regulated by the Liver Regulae, circa 1230. At the beginning, the hospital was called Saint Marie at Sassia. However over the time it would be named after the title of the Hospitable Order that ruled it, becoming also the central home of the order. Being a papal hospital, its importance and influence expanded all over Europe and many hospitals adopted the advocacy of the Holy Spirit, even if they had nothing to do with the order of this name or with the roman hospital.

Guido of Montpellier who had founded the secular1. Hospitable Order of the Holy Spirit in France, was the person in charge by Pope Innocent II of arranging the assistance and services provided in the Hospital. The architectonic centre of the building, as in all medieval hospital, is the "hall"2 . Under the concept of "hall" we understand a spacious area without inner divisions and with windows on the sides. Apart from other eventual annex rooms, the "hall" was the hospital itself, providing all its services under its roof. The idea of the hospital was to welcome all patients under the order's rules and with a sense of community. In this one room, they would be provided all the requisites for human life: life, food, sleep and mainly religious cult. Thus, this room had to meet the requirements to fulfill all the previous needs for life and with an altar as central point of the hall for divine cult. A main prerequisite of the medieval hospital was to be able to see and directly look at the altar from any point of the room.

Turnstile of the abandoned. (s.XV)Those hosted in the Hospital expend their time mostly in the great hall of the hospital. The beds were placed in line, first in parallel, and lately in right angle to the exterior walls so that there would be enough space in the center for a corridor. The sort of people that occupied the hall were poor, sick, elder and vulnerable people. The hospital hosted the lowest social strata.

The patients were separated by sex and eventually, also depending of their illnesses. By the end of the Middle Ages, there were about 300 beds, while the number of patients doubled it. Thus, sometimes there were three patients sharing the same bed3 . Due to the lack of therapeutic available resources, complete rest, heat (there were chimneys in the hall) and food (or at least salt) were the sort of medical care provided. The hygienic conditions were very limited, and this, combined with the number of patients sharing one bed, explains the high mortality rates at the hospital4.

Those who arrived at the Hospital aimed to make of it their permanent residence. Over the time the Hospital had to regularize the entry of beneficiaries. Thus, they would have to give the hospital some capital in advance or pay regularly a certain amount of money for their maintenance.

The hospital closed down in 1414. Two years later, the Pope Sixth IV pushed the renovation of the institution. In the year 1473 and having realized the great deterioration of the hospital (damaged, obsolete, tight and gloomy architecture; without ventilation system, and without a minimum comfort for the patients) Sixth VI made Baccio Pontelli and Giovanni de Gherarducci responsible for the renovation of the building in order to adapt it to the necessities of the patients.

Part of the renovation of the building was the introduction of a new element into the Hospital, an organ. The organ dates back to 1547 and was installed in the center of the Hall so that from its central position the sound would reach all the beds. The main object of the organ was its therapeutic functionality. By the time (XVI and XVII centuries) music was already considered an art capable of influencing the human spirit through the combination of sounds and silent5 . The medical corps was formed by doctors such as Giovanni Tiracorda, doctor of Clement X, Lancisi, Baglivi, and many other followers of the idea of the Pope Sixth IV.

The great octagonal bell tower that divides the hall in two also belongs to this late Renaissance period as well as the fresco paintings that portrait the history of the old hospital and the biography of the Franciscan Pope. It is still possible to see the cave of the abandon children with the turnstile to deposit the baby born.

Ever since, new destructions, demolitions and plundering have affected the old building, which has gone throughout different renovations and new transformations to improve the structure of the construction. Thus this great monumental complex of the Holy Spirit has 4 courtyards and holds in one of its galleries a unique baroque clock of 1827 with the shape of a cardinal's hat. There are also a convent, the church of Saint Peter (built on top of the ruins of the old building of Saint Mary), a pharmacy, the palace of the Commander (administrative section of the building), and the Lancisiana Library founded by the great philanthropic doctor Giovanni Maria Lancisi in the year 1711. There is also a museum, the Historic National Museum of Health Art inaugurated in the year 1933, that holds and splendid mock-up of the Great Hall of the Hospital of the Holy Spirit.


Hospital of the Holy Spirit in Saxia, engraving by G.B. Falda (s.XVII)1. La Cava AF. Lòrdine di S. Spirito precursore dellássistenza ospitaliera e sociale. en  Atti del Primo Congreso Europeo di storia ospitaliera.  Italia, Regio Emilia, 1962.  
2. Leistikow D.  Edificios hospitalarios en Europa durante diez siglos.  C.H. Boehringer Sohn. Ingelheim am Rhein, 1967.
3. Esposito A. Assistenza e organizzazione sanitaria nell'Ospedale di Santo Spirito tra XIII e XV secolo. Universitá La Sapienza, Roma, 2000.
4. Rodríguez Mateos MV. Los hospitales de Extremadura 1492-1700. Universidad de Extremadura y Junta de Extremadura. Cáceres, 2003.
5. Doménech Part J. Introducción al mundo de la música. Ediciones Daimon. Barcelona, 1980.

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