chapter  9
Alms and the Man
Hospital founders in Byzantium
ByPeregrine Horden
Pages 15

‘Pride and vanity have built more hospitals than all the Virtues together.’ 1 So wrote the Dutch physician Bernard de Mandeville in The Fable of the Bees (1714). He added:

Men are so tenacious of their Possessions, and Selfishness is so rivited in our nature, that whoever in any ways can conquer it shall have the Applause of the Publick. 2

Mandeville was composing his satire on the eve of the ‘voluntary hospital’ movement in his adopted England. Georgian propertied classes found in the voluntary hospital a way of dignifying their pride and vanity and mitigating their possessiveness. Their subscriptions to hospitals purchased not only the esteem of their peers but the right to nominate suitable deserving patients. It was seen as prudent to help such people get back to work. 3 It was a social obligation, a Christian duty, a loan to God – Proverbs 19.17, but with extra resonance in the early Georgian economy – a loan that would be repaid at Judgement Day. Not least, it was a pleasure. As the Gentleman’s Magazine put it in 1732, one year before Mandeville’s death, charity was ‘the most lasting, valuable and exquisite pleasure’. 4