chapter  1
The World of the Hospital
Comparisons and continuities
ByPeregrine Horden
Pages 32

Vienna around the year 1780. 1 Anyone with a time machine and a desire to gain some vantage point on the long-term history of hospitals, but allowed just one period and place to visit, could make a far worse choice of venue. In this city with a population of over a quarter of a million people, some 1,000 hospital beds were available for the care of the sick and needy. They were distributed across a range of institutions that varied greatly in size and services. But most exemplified a tradition of Catholic charity that would have been instantly recognisable back in the Middle Ages. Under the Church’s aegis, though subsidised – inadequately – by the government, they offered shelter and nursing to poor immigrants, the homeless, the elderly, and the needy sick. There was the Bürgerspital, the oldest in the city, with 200 beds, founded in the thirteenth century. There was the Bäckenhäusel, which had been established as a lazaretto or plague house in 1656, a year in which the Viennese suffered very badly from plague. And there was the Great Poorhouse, dating from 1693. Reports of high institutional mortality, in these and a few other lesser establishments, did nothing to diminish their reputations as gateways to death. By the 1780s one-third of hospital patients were reckoned to have contracted the morbus Viennensis, the ‘Viennese disease’ of pulmonary tuberculosis.