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Ivory, Tom

Hospitals and Infirmaries: The Social Archaeology and Architectural History of Care in Medieval Ireland

PhD Candidate: Tom Ivory
Supervisor: Porfessor Tadhg O'Keeffe

Funding: Irish Research Council Government of Ireland Postgraduate Scholar


The terms ‘hospital’ and ‘infirmary’ conjure up the concept of specialised medical care in the modern mind, but in the middle ages the role played by such institutions, especially hospitals, were as much about caring for the spiritual welfare of the ill, a care was predicated on the salvation of the immortal soul. The medieval hospital was also, it seems, a place where travellers could find a bed and a place to rest, whereas the medieval infirmary was more narrowly concerned with care of the ‘infirm’. According to A.Gwynn & R.N.Hadcock there may be as many as 215 institutions throughout the 32 counties (1970), of which only a small number have remains – but they have never been the subject of systematic archaeological attention.

The aims of this thesis are to create a database of such institutions, their founders and care communities, to analyse their locations relative to centres of medieval settlement, to record the physical remains, to analyse how they ‘worked’ as architectural spaces, and to place them within their international contexts.

Medieval hospitals preformed multiple functions, in many cases being no more than small hospices providing hospitality for the poor traveller or being 'lazar houses' or leper hospitals. Gwynn and Hadcock’s work suggests a degree of uncertainty about the category of ‘hospital’, and about their role in the medieval culture of care. Gerard Lee’s book, Leper Hospitals in Medieval Ireland (Dublin 1996), is informed transversely by a certainty about the existence of numerous Leper Hospitals which have added to the 215 identified by Gwynn and Hadcock. Elizabeth Prescott (1992) recognised ambiguity in references to hospital. At a conference in Glenstal Abbey in September 2014 entitled Soldiers of Christ: The Knights Hospitaller and the Knights Templar in Medieval Ireland and in the accompanying volume, a recurring theme was the uncertainty about the precise forms and functions of hospitals in medieval sources, or those by place names with as Lazer or Spittel/Spiddal elements. The context was the sites of the Knights Hospitaller, the monks that provided hospital care for pilgrims to the Holy Land, but it was recognised the definition of hospital was the core problem.

How reliable is the total of 215+ sites? What do the historical sources tell us about each place? As the central research question driving this proposal, what does the architecture tell us in those places where structures remain?

The objective is to reach a better understanding of how the sick and infirmed were treated and considered by the rest of society and how that may have changed as the religious climate changed over the period AD1169-1540.

The project aims to answer the following questions. The first two pertain to historical data and need to be answered as background, the second three are the core concerns of the thesis.

  1. What is the total number of sites that can be legitimately described as having hospitals in the middle ages? How many of these sites have physical remains?
  2. Given that care of the body was also care of the soul in the middle ages and that the Church was centrally involved in the culture of care, are there patterns in respect of religious communities? Were the communities located in areas of Anglo-Norman or Gaelic-Irish control, or both? What religious orders had infirmaries attached to their monasteries?
  3. How does the geography of hospitals relate to patterns of medieval settlement? Was there a tendency to have them outside town walls? Were the chapels in hospitals (as documented by Prescott 1992, 16-22 and Tadhg O’Keeffe, Medieval Irish Buildings, 1100-1600[ Dublin 2015], 179) sufficiently distant from other churches to have been parochial? Was there an Urban – Rural divide?
  4. What structures remain at the sites, and are there patterns in the structures and spaces of the architecture that are consistent with a function of care? Can we read ‘patient’ numbers from the sizes of the sites?
  5. How does the Irish evidence – architectural, topographical – relate to evidence overseas, especially in north-west Europe? Is there an origin for the form of the medieval hospital in Ireland and what or where informed that form?


Browne OSB, M. and Ó Clabaigh OSB, C. 2016. Soldiers of Christ: The Knights Templars and the Knights Hospitallers in Medieval Ireland. Dublin: Four Courts Press.

Gwynn, A. & Haddcock, R. N. 1988. Medieval Religious Houses: Ireland: with an appendix to early sites. 2nd ed. Dublin: Irish Academic Press Ltd.

Lee, G. A. 1996. Leper Hospitals in Medieval Ireland. Dublin: Four Court Press.

O'Keeffe, T. 2015. Medieval Irish Buildings, 1100-1600. Dublin: Four Courts Press.

Prescott, E. 1992. The English Medieval Hospital 1050-1640. London: Seaby.

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