The English Hospital: 1070-1570.

In around 1402 the gallows of the City of London were moved from Smithfield to Tyburn. This change meant that condemned criminals on their way to execution would pass the hospital of St. Giles in the Fields, Holborn. It became the custom for them to be allowed to pause and enjoy a last drink of ale at the hospital's gate, perhaps in reminiscence of the wine mixed with gall that Christ was offered at Golgotha. Medieval hospitals, we soon learn, performed a wide variety of functions beyond the overnight care of travelers, the sick, the poor, and the elderly. In that sense they provided much more than do modern hospitals, even though, in the sense that they mostly lacked medically-trained personnel, they also provided much less. Approached without anachronistic expectations, they thus present a complex history - one that has engaged both historians and antiquarians off and on since at least the eighteenth century. Contrary to the assertion of its publishers, the study now published by Nicholas Orme and Margaret Webster is not quite "the first general history of medieval and Tudor hospitals in eighty-five years": that claim does some injustice to Elizabeth Prescott's The English Medieval Hospital 1050-1640 (1992), a conspectus still useful for its architectural emphasis. But the book under review is certainly the most densely-documented survey that we are likely to have for some while. The work falls into two distinct sections. The first and longer, by Nicholas Orme, is partly a general narrative of hospital foundations from the Norman Conquest to the Reformation (with much attention given to leprosaria) and partly a set of analytical chapters covering hospitals' legal position, siting, functions (liturgical, pastoral, medical, educational), organization, inmates, and resources. The second section of the book narrows the focus to southwestern England and furnishes detailed gazetteers of the hospitals of Devon and Cornwall, in which counties the authors' joint research yields much fresh information. This is antiquarian history of the best sort. Each point in the first section is precisely and amply illustrated. In the gazetteers, facts are arrayed more for the sake of accuracy, completeness, and availability than for their contribution to the overall argument (the West Country does not yet seem to yield a picture that contrasts strongly with England as a whole).

This is also institutional history of a deliberately restricted kind. Wider ecclesiastical and social evidence is adduced briefly where needed; but the still more pertinent context of other sources of charity is explicitly omitted. The agenda for medievalist hospital historians seems obvious: to add further detail to the corpus so tellingly assembled here, not least through archaeology, and still more to integrate hospital history into that of philanthropy and health care of all kinds. Part of the latter task will be essayed in a forthcoming monograph by Marjorie Mcintosh on later medieval and Tudor England. Even when this appears, however, the work of Orme and Webster will remain the primary resource: a highly effective substitute for Rotha Mary Clay's classic Mediaeval Hospitals of England (1909, reprint 1966), and a worthy successor to the efforts of those antiquarian topographers who first put the subject on a secure footing.

PEREGRIN HORDEN Royal Holloway, University of London