Hospitals - Vinculum Information System Guide

Chronological span

The establishment of welfare institutions on Portuguese territory, founded by private individuals or associated with religious houses and confraternities, began in the twelfth century and continued throughout the following centuries¹. The hospital intended to receive patients and provide them continued medical care only emerged at the end of the Middle Ages, with the kings João II and Manuel I being responsible for founding royal hospitals as part of the reform of the kingdom’s pious institutions, the earliest example of which was Hospital de Todos os Santos in Lisbon². Authorised by the pope in 1479 and with the first stone of its building laid on 15 May 1492, it was already functioning in 1501 or 1502³. Endowed with a specialised medical staff and with a patrimony partly derived from the welfare institutions that preceded it⁴, the Hospital de Todos os Santos remained the model of a modern hospital in Portugal, even after the destruction of its facilities in 1755 and the consequent transfer of the people hospitalised there to the former Santo Antão College, with the consequent change of its name to Real Hospital de São José⁵.

Normative documents (main)

Regimento dos hospitais e albergarias de Évora, dated 12 May 1470⁶;
Regimento do Hospital de Todos os Santos, dated 1504⁷;
Regimento do Juiz dos Feitos das Misericórdia e Hospital de Todos-os-Santos, dated 18 December 1565, which details, among other aspects, the institution’s competences over the Hospital’s chantries⁸.
Ordenações Filipinas (c. 1604), with a specific title on the Juiz dos feitos of the Misericórdia and Hospital de Todos os Santos of Lisbon, corresponding to the aforementioned Regimento of 18 December 1565⁹.

Competences

General

The hospitals, hostels, mercearias, and leprosy hospitals were generally intended to provide assistance to travellers, abandoned children, and the indigent. The historiography on the subject has emphasised the connection of hospitals to longer-term care, perhaps with the possibility of medical care, whilst the hostels (albergarias) were intended for more temporary care²⁰. As from the sixteenth century, the foundation of royal hospitals consolidated the institution’s medical vocation, interrupting the medieval “spatial blurring between poor patients and pilgrims”²¹. In the case of the leprosy hospitals (gafarias), this hospitalisation became permanent, and these institutions functioned as places of internment for the contagious²². As for the mercearias, their primary vocation was the accommodation and maintenance of honourable men and women who had fallen into poverty, generally advanced in age, in exchange for the fulfilment of a set of obligations of suffrages for the souls²³.

On entails

Many hospitals had a specific space for worship (oratory and chapels), where liturgical ceremonies were held for the salvation of their beneficiaries’ souls²⁴.

Such institutions did not have the specific vocation of managing assets entailed in chantries and morgadios. However, with the hospital standardisation at the end of the fifteenth century and the beginning of the following one, some of the hospitals which evaded alienation became administrators of chantries, hospitals, and hostels which had become extinct in the meantime, such as the Espírito Santo Hospital in Santarém²⁵. The same process can be detected in the case of the “general hospitals” created in the meantime, with emphasis on the case of the Hospital de Todos os Santos in Lisbon.

The latter was entrusted (1) with the administration of chantries and the respective liturgical obligations, as well as receiving (2) the right to collect the value of unfulfilled pious legacies in the city and then archbishopric of Lisbon, which included the masses established when the chantries were founded:

Regarding the administration of chapels, in 1499 and in 1500 king Manuel granted the Hospital the possibility of annexing the chantries and confraternities located in the city of Lisbon, in its district and in the places of the comarca around the city, as long as the letter of foundation and the respective liturgical obligations were not known. In 1503, these donations were extended to the chantries, located in the same territory, which had no administrator²⁶. The resolution of the lawsuits concerning these chapels belonged to the jurisdiction of the ouvidor of the Hospital de Todos os Santos, until the right of oversight was passed on to the Misericórdia of Lisbon in 1564²⁷. Henceforth, the provedor and the irmãos of the latter had the right of preference in the administration of any chantry of royal provision in the city and district of Lisbon, while the cases over the chantries of the Hospital came to be settled by the judge (Juiz dos Feitos) of the Misericórdia and Hospital de Todos os Santos²⁸.
The Hospital de Todos os Santos received, in 1545, the right to collect unfulfilled pious legacies in the city of Lisbon that were not executed within the time prescribed by the testators, a concession extended to the entire diocese by disposition of Pope Clement VIII in 1598. Since the pontifical determinations were not complied with, the monarch sent a letter, dated 22 May 1685, to the provedores of the comarcas of the archbishopric of Lisbon, so that they would provide for the execution of the unfulfilled legacies that fell to the Hospital de Todos os Santos. In 1761, for this purpose, a regulation was drawn up for the execution of these legacies in the comarcas of Alenquer, Santarém, Setúbal, and Torres Vedras, the “four comarcas of the patriarchate”²⁹.

Institutional organisation and the roles of its agents with regard to entails

Institutional organisation

The welfare institutions had a simple structure, centred around a person responsible for their operation, generally designated as provedor, and a chaplain, obliged to satisfy the liturgical obligations in the interest of the founders and beneficiaries³⁵.

The “royal” hospitals, such as Hoapital de Todos os Santos in Lisbon, had a much more complex organisation, which is known in its general outlines³⁶.

The roles of its agents

Provedor of the Hospital de Todos os Santos
According to the Regimento das capelas e dos hospitais, albergarias e confrarias de Lisboa e do seu termo (1504), the provedor was responsible for drawing up a compromisso, which had to contain the declaration of all the hospitals, all the obligations of the chantries, and all the obligations of the merceeiros attached to the Hospital de Todos os Santos, according to the provisions of the existing compromissos (constitutions) for each of these institutions³⁷.

Likewise, he was responsible for auditing the accounts of the suspended administrators of the chantries attached to the Hospital³⁸.

Ouvidor of the Hospital de Todos os Santos
Until the abolition of this office, in 1564, it was up to the ouvidor of the Hospital de Todos os Santos to judge the cases concerning the chantries of the city and district of Lisbon³⁹.

Relations with other institutions with regard to entails

The hospitals could be administered by the king and by the royal councils—as seen in the most well-known cases of Lisbon, Porto, and Coimbra⁴⁰—and supervised by the provedores of the comarcas with regard to the appointment of their officials, their fiscal administration, and compliance with the associated pious obligations⁴¹.

The erection of a chapel or oratory in this type of institution was subject to the necessary episcopal authorisation⁴².