Marco Antonio Ayala-García
Many hospitals came and went during the three centuries of the American colonies. By the end of the sixteenth century some 128 hospitals were operating throughout the Americas, largely in response to the frequent outbreaks of disease in the territories. The Spanish Crown needed to promote the good health of their subjects, especially considering that the indigenous people represented the major labor force for the colonies.
The first hospital in the Americas was built by Fray Nicolás de Ovando from 1503 to 1508 in Hispaniola (Dominican Republic and Haiti). Named Hospital de San Nicolás de Bari (I), it was located in Santo Domingo de Guzmán. Its personnel included a medical director, an agent, an internist, a chaplain, and six servants.1 Nowadays, the remains of this facility are the silent witnesses of its past and of the attention of Spain to healthcare in the colonies.
At the end of the Mexico-Tenochtitlan Conquest, Hernán Cortés began the construction of the hospital known as “El de la limpia Concepción de Nuestra Señora,” at the place where he had first met Moctezuma. Starting in 1524 this hospital was known as Hospital de Jesús Nazareno (II). It was located at calle 20 de Noviembre No. 86, Colonia Centro, Mexico City, and was the first hospital in Mexico. Only European Spanish patients could receive care at this hospital, which was home to the earliest professional physicians coming to the Americas from Spain. In its early days, this hospital admitted about 400 patients annually, and it did not provide care for mental disorders or to patients suffering from syphilis or leprosy.2,3 This same facility currently provides care for an average of 5,000 patients per month.
Other hospital-like facilities were created later in order to provide care for native indigenous people, blacks, mulattoes, and to anybody who might require care. Such institutions belonged to brotherhoods, congregations, and other Christian groups that organized to serve, with the idea of pursuing the salvation of the soul. These institutions provided social services to those in need, including housing, food, and religious services. Occasionally these institutions had access to a physician, a nurse, or a traditional healer, allowing some degree of unified Hippocratic/Galenic medical practice to take place.3
In 1524 the Hospital de San Lázaro (III) was established by Hernán Cortés in Mexico City. It closed its doors in 1528, when Beltrán Nuño de Guzmán ordered its destruction, but was later reopened at a new site in 1572 by Dr. Pedro López.4
The fourth hospital in the Americas was Hospital de la Misericordia (IV), located in Old Guatemala. This facility was founded in November 22, 1527, by don Jorge de Alvarado, brother of the conquistador don Pedro de Alvarado. The hospital was destroyed by the mudslides that descended from a volcano known as Volcán de Agua on September 11, 1541, after a storm that lasted three days.5 In 1528, Fray Juan de Zumárraga established Hospital de San Juan de Ulúa (V), in Veracruz, Veracruz, which closed in 1539.6
In 1532 Fray Vasco de Quiroga created the Hospital de Santa Fe de los Altos (VI) in Mexico, D.F., which closed down in the nineteenth century. It is in this hospital that salaried physicians were hired for the first time in the Americas.6 In this same year Hospital Real de los Naturales (VII) was established by Fray Antonio de Bermul and Juan de Quemada, in Acámbaro, Guanajuato. This facility closed in the eighteenth century.7
In 1533, Fray Vasco de Quiroga opened the Hospital de Santa Fe de la Laguna (VIII) in Pátzcuaro, Michoacán, which stopped providing services in the nineteenth century.6 Then in 1534 Hospital Real de San José de los Naturales (IX) was established by Fray Pedro de Gante in México City. This hospital closed in 1822, and the building that used to house it disappeared in 1931.6 Also in 1534, Fray Juan de Zumárraga established Hospital Real de las Bubas (X) also known as del Amor de Dios, at Doctor Balmis 148, Colonia Doctores, Delegación Cuauhtémoc, Mexico City. This hospital merged in 1734 with Hospital de San Andrés and in February 5, 1910 was replaced by Hospital General de México, which operates to this day.6,8,9
To summarize this brief history, the first ten hospitals in the Americas were built over a thirty-one year period and were located between the northern latitudes of 14o34´ and 20o 17´ (Figure 1). The target population in this geographical area included about 3,500,000 indigenous natives, 30,000 whites, and 25,000 blacks, mulattoes, and people of mixed race.10 Only two hospitals are still currently operating: Hospital de Jesús Nazareno, which opened in 1524, and Hospital Real de las Bubas or del Amor de Dios, which eventually became Hospital General de México.
- Fajardo-Ortiz, Guillermo. 2006. “Profiles and remains of the first hospital in America: the Hospital San Nicolás de Bari, in Santo Domingo, Dominican Republic”, Gaceta Médica de México 142:75-77.
- Ruvalcaba, Patricia. 2009. “Hospital de Jesús: Casi 500 años de hitos”, Km. cero. Accessed November 20, 2013, http://guiadelcentrohistorico.com/sites/default/files/km0-15.pdf
- Rodríguez-Sala, María Luisa et al. 2005. Los cirujanos de hospitales de la Nueva España (siglo XVI y XVII): ¿miembros de un estamento profesional o de una comunidad científica? México, D.F. UNAM.
- Sánchez Uriarte, María del Carmen. 2010. “El Hospital de San Lázaro de la ciudad de México y los leprosos novohispanos durante la segunda mitad del siglo XVIII”, Estudios de Historia Novohispana 42:81-113.
- Houston, J. 2009. “Healthcare in Colonial Guatemala”, Revue. Accessed November 20, 2013, http://www.revuemag.com/2009/06/healthcare-in-colonial-guatemala/
- Villanueva, Luis Alberto. 2004. “El sistema hospitalario de la nueva España del siglo XVI. Un tema para la reflexión en el siglo (XXI) (2ª parte)”, Revista de la Facultad de Medicina de la UNAM 47:117-120.
- Fajardo-Ortiz, Guillermo, and Jorge M. Sánchez González. 2007. “Hospitales de Guanajuato una breve semblanza”, Calimed 13:88-105.
- Rodríguez Pérez, Martha Eugenia, and Ana Cecilia Rodríguez de Romo. 1999. “Asistencia médica e higiene ambiental en la Ciudad de México siglos XVI-XVIII”, Gaceta Médica de México 135: 189-198.
- Lobato Díaz, Emilio, and Francisco González de Cosío. 1990. Ensayo sobre la historia de la medicina en México durante el siglo XVI. México, D.F. UAQ.
- Jimeno, Esther et al. 1983. Nuestro Mundo Actual. Una Visión al Mundo, América y Costa Rica, San José, Costa Rica, Universidad Estatal a Distancia.
MARCO ANTONIO AYALA-GARCIA, PhD, is a physician specialized in general surgery, was trained in transplantation surgery in Murcia, Spain, and holds a professorship of clinical research as well as a doctorate in medical sciences. He has accrued 24 distinctions: 10 for his academic activities, 5 for his participation in altruistic activities, 4 for his professional practice, and has won 5 prizes in professional competitions. He has published 36 articles and 14 book chapters. He is currently an investigator of medical sciences in the Hospital Regional de Alta Especialidad del Bajio, and a surgeon for the Mexican Social Security Institute in Guanajuato, Mexico.