Sienese Hospitals Within and Beyond the City Walls

Sarah Loose Guerrero is an Assistant Professor of History at Brigham Young University in Utah, USA

In the later Middle Ages, the Ospedale di Santa Maria della Scala in Siena, Italy, was a force to be reckoned with. The hospital is the topic of the monograph by Sarah Loose Guerrero, who thus contributes to the study of charitable institutions and their socio-political roles in late medieval and early modern Italy. Focusing on one of Siena’s most important charitable institutions, the book examines its role within the city and across the countryside through its rural possessions. Guerrero builds on a well-established historiography, both on Italian Renaissance hospitals in general and on this institution in particular, yet her work brings a fresh point of view by emphasizing its rural patrimony and the ways in which it functioned as a bridge between urban and rural spheres, and by adopting a long-term perspective.[...]Sienese Hospitals is primarily a socio-political study rather than a history of medicine or patient care. It examines how the hospital functioned within broader urban and regional political frameworks. The concept of “geographies of power” serves as a central analytical lens, illustrating how Santa Maria della Scala’s influence extended far beyond the city walls. This decentralized power structure allowed the hospital to operate both as a civic institution and semiautonomous entity with its own governing mechanisms and as a wealthy landowner.One of the book’s key contributions is its detailed analysis of the hospital’s vast landholdings and the economic role these played in its operations.[...]Overall, Sienese Hospitals Within and Beyond the City Walls is an important and well-researched study that makes a significant contribution to the fields of socio-political history, economic history, and institutional history of health care. Guerrero effectively demonstrates how Santa Maria della Scala was a key player in Siena’s civic, economic, and political life. Her exploration adds an important dimension to our understanding of urban-rural interactions in Renaissance Italy. This book will be of great interest to scholars of medieval and early modern Italy, hospital history, and the broader study of geographies of power.

• IntroductionChapter 1: A Most Pious House: Charity and Power in the CityChapter 2: An Extended Family: Rural Charity and Power in the ContadoChapter 3: Spaces of Charity Beyond Siena’s Borders: The Spedali di FuoriChapter 4: Charity and Power in Crisis: Shifting DynamicsChapter 5: Power in the Granducato: Santa Maria della Scala and the Medici Grand DukesConclusionEpilogue: Santa Maria della Scala’s Spaces of Charity after 1600