Reform and consolidation

Abstract

Chapter six traces the reform efforts of the fourteenth and fifteenth centuries, which eventually led to the consolidation of small independent hospitals into large civic institutions that became increasingly medicalized. Health boards created after the Black Death led to secularization of health care and poor relief. These social service institutions evolved over the early decades of the century and were a gradual response to the evolving needs and challenges of the population and the end of the communal era. This unification and institutionalization of civic oriented hospital care, resulted in one large Ospedale Maggiore, which was duplicated in towns and cities throughout Italy in the mid fifteenth century. It signified the end of the small, independent hospital movement that had so transformed the landscape of urban society earlier in the Middle Ages. The process of centralization that swept hospitals up in its wake was a universal feature of Italian state-formation in the age of the Renaissance