The Hospital Real de San Miguel of Guadalajara (1670-1742): a tithe-funded hospital, a jurisdictional lawsuit, and the handover that made it cost more
Guadalajara's royal hospital lived on a ninth and a half of the tithes of a whole bishopric. The cathedral chapter ran it until a crown attorney won it for the royal patronage in 1683; the audiencia then ran it through a salaried lay steward, with enslaved people nursing, five or six patients, and surpluses diverted to a college. In 1704 the city handed it to the Bethlemites: occupancy passed eighty and the surpluses vanished — which the chronicler argues measures improvement, not waste.
Why this wins its question: Colonial Spanish American hospitals are normally described by who founded them. This object describes one by how it was paid for, who was audited, and what changed when the operator changed — from the sheets of a 1742 chronicle written by a lawyer of the court that administered it. It names the revenue instrument (a ninth and a half of the tithes of the whole bishopric), the legal objection to concentrating it in the capital, and the royal answer of 1718 that upheld the concentration while obliging the cathedral to fund proven parish repairs. It prints the lawsuit that moved the hospital from the cathedral chapter to the royal patronage in 1683, and then prints what the royal patronage actually ran: a salaried lay steward, enslaved people doing the nursing, five or six patients, and ten thousand pesos of surplus diverted to build a Jesuit college. And it carries a passage almost nobody quotes — the 1742 argument that the hospital's costs rising and its surpluses vanishing after the Bethlemites took it over in 1704 is evidence of success, because the earlier low numbers measured the sick preferring to die at home rather than enter a hospital where the attendance was servile. That is a revealed-preference argument about health-service utilisation, made two hundred and eighty years ago, and it is made by the same man who records the slaves, the surpluses and the president who later forbade the order to move.
Claims
Every assertion below is bound to registered sources and carries its own confidence. Weight them; do not treat the page as uniformly authoritative.
The revenue base is named precisely and it is a tax on agricultural production, not alms. Page 399 records that the Hospital Real de San Miguel maintained itself from the noveno y medio — a ninth and a half — which is applied to hospitals out of the tithes in the erection of the churches. Page 400 sets out the legal difficulty this created, in the chronicler's own framing: that under law 23, title 16, book 1 of the Recopilacion and under constitution 31 of the erection of the churches, the three ninths of fabric and hospital were to be divided in each parish in proportion to the tithes of its own territory, and yet at Guadalajara the ninth and a half of all the tithes went to the one hospital of the capital. This is a real fiscal question about a real institution: whether an ecclesiastical levy earmarked for hospitals should be spread thin across every parish or concentrated where a hospital could actually be run.
The crown answered the question and the answer contains a safeguard. Page 400 records that someone had already raised the doubt and reported it to the king, that the reply given was that no single parish could maintain a hospital on its own ninth and a half and that it had therefore seemed fitting to apply it to the royal hospital of the capital, and that the ninth and a half of fabric was by custom applied to the mother church; and that in view of this the king ordered, on 27 June 1718, that the custom be observed, on the condition that if any of the parishes not served with its own ninth and a half should need repairs or other necessary works, the need being first proved, the cathedral church should contribute the sum required. A concentration of earmarked revenue, upheld, with an obligation on the beneficiary to compensate the parishes it was concentrated away from, contingent on proof of need.
Control of the hospital was litigated between the church and the crown, and the crown won it in court. Page 399 records that from its creation the hospital of San Miguel was administered by the cathedral chapter; that the fiscal came out for the royal patronage; that a prolix suit followed in the royal audiencia and was declared in the king's favour; and that when the bishop later tried to name an interim chaplain on the ground of immemorial possession of administering the hospital through the chapter, the audiencia opposed him and named its own, whereupon the aggrieved bishop reported it to the king and received the answer, by decree of 27 November 1683, that in point of justice the hospital stood declared of the royal patronage and that the nomination of the chaplain accordingly belonged to the president as vice-patron. The chaplain actually named, D. Andres de Guisar, served many years.
What the crown won it thereby acquired was an auditing problem, and the record of the audits is the most quantitative thing on these pages. Page 400 records that the accounts were to be taken from the steward by an oidor, that the oidor who did so was D. Juan de Bolivar, that the audit produced a surplus of five thousand pesos, and that these were not the first: on two earlier occasions ten thousand pesos of surplus had appeared, one ten thousand applied to the foundation of the Jesuit college and the other to the convent of Santa Maria de Gracia. Page 433 gives the same three episodes from the other side and adds the disposal of the five thousand: the king ordered on 24 August 1670 that the audiencia have them put out at interest to increase the hospital's revenues. Page 400 also records that the king asked, of ruego y encargo, that the ecclesiastical chapter not interfere, that jurisdiction over the administration was at first submitted to the viceroy, that the audiencia represented this as inconvenient for the distance, and that by a further decree of 8 October 1672 it was submitted to the president and audiencia alone.
Those surpluses are the indictment, and the chronicler — a lawyer of the very audiencia that was administering the place — prints it. Page 432 records that the Hospital Real de San Miguel stood in the charge of a salaried secular steward, put there by the audiencia, and with no attendance but that of some enslaved people who cared for the sick. Page 433 records that the king was informed of how badly the hospital was served, by some slaves and a mercenary steward, and ordered on 1 August 1703 that it be handed either to the order of San Juan de Dios or to the congregation of the brothers of San Hipolito. Page 433 also records that the hospital had only five or six patients and large surpluses left over from its revenues. A hospital funded from a tithe on a whole bishopric, nursed by enslaved people, holding five or six patients and returning ten thousand pesos of surplus to build a college, is what the royal patronage in fact produced here for some three decades, and this entry puts that on the record before it records the improvement.
The transfer happened before the crown's order arrived, and an epidemic forced it. Page 433 records that the royal resolution of 1703 did not reach Guadalajara for a long time because the seas were infested with enemies; that a general pestilence then struck; and that the city and the prelates of the religious orders moved the royal audiencia to write to the vice-prefect general of the Bethlemites at Mexico, Fr. Miguel de San Angel, asking for four or five religious to receive the hospital and take charge of curing the sick, in the meantime, until the king should determine and the plague abate. On 11 November 1704, with the licences of the royal audiencia and the city council then governing in a vacancy, and with the secular council and the prelates of the orders present, the administration was placed in the religious' hands. The chronicler adds that the city showed its common rejoicing in masques and dances, and that the order received the hospital with an account and reckoning, with few patients, the beds reaching only seven.
The crown's confirmation followed and turned on a point of institutional competence. Page 434 records that the king, informed a second time by the audiencia, the council and the prelates of the motives for the handover — which the city had begged the order to accept for the public utility, not only for the hospitality and the school it increased but for the greater lustre of the republic — had the supreme council examine the constitution of that religion; that it was found from the constitution that the institute extended not only to the assistance of convalescents, as had been understood when the first decree was despatched, but to the curing of all illnesses; and that in conformity with this the king ordered, on 30 June 1705, that under the rules of the royal patronage the hospital be handed to one of the three orders — San Juan de Dios, San Hipolito or Bethlehem — as should seem best to the viceroy of New Spain, with the agreement, communication or intelligence of the audiencia of Guadalajara. Page 434 records the decree received on 2 July 1706, the audiencia ordering the chamber notary to draw testimony of the proceedings and certify the state the hospital had been in when handed over and the state it was in now, the consultation of the viceroy, then the duke of Alburquerque, and his confirming what was already so well done.
The passage this entry exists for is an argument about how to read a rise in costs. Page 434 states the objection in its strongest form — that the hospital seems to have been better off before the religious had it, since before there were few patients and today there are more than eighty, in the year more than a thousand are cured, before the revenues were left over even when scarce and today they barely reach even though larger — and then answers it: "pero es engaño", because before, the sick preferred to die among their misfortunes rather than experience those of a hospital where the attendance was servile; today they are attended by servants, but faithful servants who, burning in charity, spend all the revenues on the comfort of the poor and by their good treatment attract many sick. Occupancy up from five or six to eighty, a thousand cured a year, surpluses gone: the chronicler's reading is that a hospital that returns money to the treasury is failing and one that spends its whole income is working, and that the earlier low numbers measured avoidance rather than health. That is a piece of institutional reasoning about revealed demand, written in 1742.
Two details of the new regime are worth keeping because they show what the order was thought to be for beyond nursing. Page 433 records that the religious did not wait for the sick to be brought but enquired where they were and went to carry them on their own shoulders; that they relieved the dying, shrouded and watched the dead and attended their burials; that they relieved the patients' children with alms and educated them in the school they maintained; and that the physician and surgeon were given by the religious a prompt account of the illnesses and of the effects observed from previous medicines, which the chronicler calls the surest indications for getting the treatment right. Page 432 records the endowment that made the school possible: D. Bartolome de Santibanez, the first to be excited to propose the foundation, left two thousand pesos in his will so that their interest should be distributed in ink and paper for the poor children whom the religious taught to read and write.
Royal patronage survived the handover as a continuing set of controls, and the chronicle enumerates them. Page 434 records that from then on the religious administered the hospital, that the presidents exercised the vice-patronage, that although the order by then had priests of its own it presented three approved by the ordinary from whom the president named the chaplain, that the president received the accounts the religious rendered of the administration and named an oidor to visit the hospital whenever he saw fit; and that because the religious had a public church, the sub-dean oidor received the key of its tabernacle on Maundy Thursday, the dean oidor receiving that of San Francisco where the audiencia attended the Holy Week offices, the president and city that of the cathedral, and all the justices of the jurisdictions those of their parishes, in recognition of the royal patronage. The keys are a ceremony, and they are also an annual re-assertion of who owns the building.
The city then used the same authority to stop the order doing what it wanted. Page 434 records the chronicler's argument that the hospital could have gone to San Juan de Dios but that this would have been a lack of skill in those who governed, because the San Juan de Dios house was a hospital of the poor maintained by the alms its religious begged, and the city preferred to keep two hospitals rather than consolidate the revenues and the sick into one — leaving the citizens free ground for their charity and the patients the consolation of changing wards. Page 492 records what this meant in practice for the Bethlemites: the president D. Tomas Teran de los Rios prevented them from building a new hospital, telling the king that a move from one place to another within the same city was not a foundation. The order that had rescued the hospital could not choose where to house it.
The limits of this entry, and the reason its confidences sit where they do. Everything above is read from pages 399, 400, 432, 433, 434 and 492 of the Mexico 1870 printing of a manuscript finished at Guadalajara in 1742; the manuscript was not seen and the editors' transcription is not tested here. The royal decrees of 1670, 1672, 1683, 1703, 1705 and 1718 are reported with the dates the chronicle gives them and have not been checked against any archive, none being reachable from this container. The occupancy figures — five or six before, more than eighty patients and more than a thousand cured a year after — are the chronicler's and no register is cited for them; he is an open partisan of the Bethlemites and a lawyer of the audiencia whose jurisdiction prevailed over the bishop's at every stage he narrates, and the object states both. Nothing here establishes mortality, the composition of the patients by caste or sex, what the ninth and a half was worth in pesos in any year, what happened to the enslaved people who had been nursing before 1704, or whether the cathedral ever paid a parish under the 1718 condition.