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PUBLIC
FINANCING

A Brief History of
Charitable Hospitals
in San Antonio

By J.J. Waller, MD

T he provision of medical care to the indigent and construction. The almshouse contained a room for the sick and in-
homeless has been the responsibility of various med- sane and a prison in the cellar for the unruly and obstinate. This
ical systems to various degrees for ages. Historically, was subsidized by public funds. The one room infirmary was the
seed from which grew the mighty medical complex of Bellevue.
the ancient Egyptians and Greeks had temples ded-
The Franciscan mission of San Antonio de Valero was established
icated to the treatment of both the successful levels of society as on the San Antonio River at San Antonio de Béxar in 1718 along with
a military presidio and a small civilian settlement. The mission increased
well as the poor. The Romans had scattered hospitals throughout over the decades building a chapel and houses for the local Indians to
live and work. The mission was not very successful, and it was secular-
the Empire to treat the military, freeman, and slaves. The declaration ized by the king of Spain in 1793. In 1803, the mission was occupied
by a Spanish military unit from “Alamo de Parras, Coahuila” from
of Christianity as an accepted religion in the empire drove an ex- whence the “Alamo” name appears to have come into general use.

pansion of the provision of care. After 325 CE, construction of a The first hospital in San Antonio was established on Oct. 19,
1805, in the Alamo by decree of the Spanish government. The
hospital in every cathedral town was begun with frequent separate Alamo was partially repaired from its deteriorated condition to pro-
vide a clean room housing six beds made of reeds (bamboo or cane
buildings for various classes of patients. stalks). The area’s only physician, a civil servant of the Spanish gov-
ernment, was commissioned to treat all the residents of the county,
Throughout the Middle Ages, primarily because of the numerous including the military, Native Americans residing in the various mis-
sions, and the civilian settlers. In addition to the physician, who was
Crusades, various religious and lay orders were established to pro- paid 30 pesos a month, there was one nurse, a male, who was paid
12 pesos a month, and a woman to do the cooking for the patients,
vide nursing care. Most of these initially arose as military orders to who was paid 8 pesos a month. The population of San Antonio at
that time was approximately 300.
combat the Muslims in the Holy land; however, the orders, in addi-
Due to the increasing number of patients, the governor had two
tion, founded nursing groups to care for the wounded and the many additional rooms in the Alamo repaired to house more patients and
to provide one as a pharmacy. He ordered the purchase of lumbar
pilgrims who became ill and destitute en route to the holy Christian to construct “30 beds fully equipped.” This was completed in 1807.
In 1809, the hospital instituted the smallpox vaccination for all mil-
shrines. One of the most famous was the Knights Hospitallers, also itary and civilian members of the community. It continued as a mil-
itary infirmary until 1821 when Mexico became a republic and funds
known as Order of Knights of the Hospital of Saint John of were no longer available to maintain the Alamo as a hospital.

Jerusalem, and later the Knights of Rhodes and Malta or the Sov- Of historical interest only, after the battle of the Alamo, and dur-
ing the years of the Republic, the Alamo remained deserted. In
ereign Military Order of Malta. Wherever they established a military

fortress, they also included a hospital to care for the sick and

wounded. One of these orders was the Order of St. Camillus. It

started the first ambulance service and initiated the sign of the Red

Cross, still in use today.

In the 18th century, in the Age of Enlightenment, the modern

hospital began to appear, having separate departments set up for

different categories of patients. The voluntary hospital movement

began in the early 18th century, forming early in England and being

financed by private enterprises such as banks or wealthy merchants.

The concept of voluntary hospitals also spread to colonial America.

Under British control in New York, a prominent almshouse was

constructed in 1736. It was a two-story wooden and brick structure

costing 80 pounds for building materials and 50 gallons of rum for

18 San Antonio Medicine • December 2017