In the third decade of the twenty-first century, visitors to Rome on a whistlestop tour to take in the splendours of St Peter's Basilica are likely to miss the now unassuming-looking buildings comprising the Hospital of Santo Spirito in Sassia. The hospital, located just out of sight of the busy Via della Concilazione leading to Bernini's piazza, and a few minutes’ walk from the Basilica, is still active today in a modern building adjacent to the fifteenth-century complex. It is an institution with a documented history dating back to 1198, though its origins as an ecclesiastical institution are even older.1 The scope and function of what constituted a Hospital and similar charitable institutions at the time of the foundation of the Order of Santo Spirito and its hospital are, however, vastly different from their modern equivalents.

At the time of the Hospital's foundation and throughout the period with which this book is concerned, the separation of disciplines into science, religion, art and their subsidiary disciplines of biology, botany, music, philosophy and so on did not exist. A university-trained physician of the Renaissance would have had a thorough understanding of a wide range of topics embraced within ‘natural philosophy’, as well as music theory, rhetoric, logic and astronomy, all of which were included in grammar-school education. This study focuses in particular on the close relationship between religion and medicine – a relationship that is extremely complex, with roots reaching back to antiquity – and how music may be viewed as a point of triangulation between them.

In pre-Christian and non-Western contexts, temples were (and are) places where the sick sought relief through rituals, and shamans functioned as mediators between the spirit world and physical world for guidance in curing diseases. We know from ancient literature that music played a part in these healing practices. It should not be surprising that as Christian communities developed, their places of worship likewise became sanctuaries to which folk came to find cures for mental and physical illness.

Healing was a fundamental part of the activities of the followers of Jesus recounted in the New Testament and, according to the earliest defences of Christianity written by Justin Martyr, Tertullian, Origen and Irenaeus, contin-ued in the Christian communities of late antiquity up until around the Council of Nicaea.

The Ludlamshöhle Petition, February, 1824

The petition that Beethoven received was of indeterminate authorship, signed by thirty of Vienna's most prominent music lovers and dated simply as “Vienna, in February, 1824” (see Appendix B). It is long and written in the most flowery, convoluted, and self-important language possible. It declares that the signers are representatives of Vienna's wide circle of lovers of art, that they know that Beethoven has great new works that have not yet been heard, and that they hope that he will not allow these works to be performed elsewhere (implying Berlin or even London) until they have been heard in this, his second native city. With the exception of a half-dozen members of the nobility, including Prince Eduard Lichnowsky, Count Moritz Lichnowsky, and Count Moritz von Dietrichstein, most of the signers are wealthy (or at least prominent) lovers of music and theater, music dealers, government officials, and so on. With the exceptions of Carl Czerny, Anton Halm, and Abbé Stadler, no one in the list could be considered a professional musician.

Thanks to Beethoven's conversation books, we now know the document's origins. On May 1, 1824, Joseph Carl Bernard, the editor of the Wiener Zeitung, told Beethoven that the “letter” was “a product of the Ludlamshöhle” group, who met in “a beerhouse next to the Trattnerhof, where Castelli, Kuffner, Deinhardstein, Bäuerle, and many others congregated. They wanted to strike a blow against the Italians with it.” And sure enough, the poet and playwright Ignaz Castelli (1781–1862), poet Christoph Kuffner (1780–1846), and poet Johann Ludwig Deinhardstein (1794–1859) were among the signers. Earlier, on Tuesday, April 27, Schindler had told Beethoven that Carl Czerny had assured him that Stainer von Felsburg was the author, but the document's length and tone suggest that several hands had a role in drafting it.

Similarly, we can now be clearer about when it was delivered. On Wednesday, February 25, nephew Karl told Beethoven that there had been a visitor while he (Beethoven) was gone from his apartment. The implication was that the visitor had brought Beethoven an important message and was somewhat irritated at not finding the composer at home so he could deliver it personally.

Music therapy in the great wards of the Hospital reached across boundaries of status. The organist was the medium through which mere mortals, whether brothers of the Order or the sick poor, were enlivened by intangible intimations of the celestial. When it came to providing music in the church, it was a different matter, as the reformed liturgy had to be strictly observed. From the time of Urban VIII Barberini and throughout the seventeenth century, the Hospital of Santo Spirito, like all hospitals and churches in Rome, was subjected to the increasing scrutiny of Apostolic Visitations. Surviving documents indicate that conduct and procedures in various parts of the institution, from the dispensary to the church, were tightened. This chapter will consider papal attempts at control in general, before evaluating a decree from the mid-seventeenth century and a backward-looking eighteenth-century iteration of it.

Spada's Stato della Casa written in 1660 makes multiple references to Apostolic Visitations, and to the ways in which the institution had made changes to comply with instructions issued after such visits. The directives concerning the hospital were primarily targeted at ensuring that there were sufficient priests on hand to hear the confessions of patients, to teach them correct doctrine and to perform the last rites as and when necessary. Beyond that, the behaviour of the personnel caring for the sick was to measure up to the standards of Christian charity set out in the Rule of the Order of Santo Spirito. On the actual practice of medicine or the conduct of physicians, there is comparatively little, and most of it concerns standards of hygiene and dietary rules.

Paolo Zacchia was employed by the Hospital in the decade prior to Spada's incumbency (1648–1659), and presumably had to ensure these standards were met. Zacchia had by that stage in his career already published a significant number of books, including those on observing a Lenten diet without damaging one's health, and on ‘hypochondriac diseases’. The latter includes a chapter on the passions of the soul – a topic that remained important in medical practice.

Introduction

Algonquian Christians underwent two baptisms at the hands of English neighbours; the first in water and the second in fire. Water symbolically joined them with the English through identification with Christ. The flames of war consumed hopes of meaningful fellowship.

In 1673, Thomas Shepard Jr wrote to a minister in Scotland telling of the ‘success of the Gospel among the Indians’. They ‘celebrated’ the ordination of a native and communion ‘in the Indian Church’. The bilingual service featured long prayers ‘in the Indian tongue’ by one who preached on brotherly love from Hebrews 13:1. This fellowship was the fruit of John Eliot's missionary work. He planted ‘civil governement’ among Algonquians in 1650.1 Shepard appended correspondence from John Eliot to this 1673 letter sent across the Atlantic. Towards the end, Eliot wrote that ‘All the praying Indians have submitted themselves to the English government’. It was the western front of godly hegemony, and all seemed quiet. Accounts like this, though containing much truth, economically dispensed with less flattering details.

Algonquian Christians, like all followers of Christ, had a cross to bear. That cross was their English coreligionists. Two years after Shepard's optimistic letter, many English Christians treated Praying Indians as a fifth column. As Kristina Bross has shown, evidence of piety became symbols of perfidy; Praying Indians became ‘Preying Indians’. Christian Algonquians had no good options. Positioned between warring factions, they identified with both and were trusted by neither. They were attacked by English soldiers and mobs, forced to leave their Bibles and interned on Deer Island in the dead of winter. Another baptism, this time by fire, drove the communities apart. Some critics called these actions cruel, unchristian and counterproductive. Those who defended Praying Indians came under suspicion. The conflagration nearly engulfed Eliot and Shepard; though in very different ways. Englishmen violently targeted Eliot for defending Praying Indians. Shepard's trial looked more like a temptation.

While the English disarmed, starved and quarantined Christian Indians on Deer Island, some went further and plotted their extirpation. On 6 February 1676, a concerned citizen, Abram Hill, approached Thomas Shepard Jr with a proposition: ‘will you go with us to Deare Island to destroy the Indians’?

This book started from a simple question: what was Frescobaldi doing working in a hospital? While attempting to find the answer by exploring the administrative archive of the Ospedale di Santo Spirito in Sassia, I discovered a wealth of material about this complex institution that employed some of the most respected physicians of the time and was a centre of medical education, while at the same time, was driven by religious conviction to care for social outcasts – unwanted babies, orphans and the sick poor. Crucially, it employed musicians and used music created by leading figures in Roman musical circles.

The variety and chronology of the sources that include the buildings themselves, administrative materials and an archive, albeit dispersed, of music manuscripts, renders a linear account of them difficult. Several key documents are reports written to satisfy papal authorities that are essentially reflective and backward-looking. Further, internal decrees were iterative and in force for long periods of time. Information extracted from such documents had to be mapped onto documents of a more mundane nature such as meeting minutes and financial documents that offered a more objective chronology. For this reason, the story of music in the Hospital has to some extent had to be told backwards.

The book is structured in two parts. The first provides a background to the institution and its foundation, exploring the relationship between religion and medicine and the role of music in both, while also outlining what was accepted as medical fact in the early modern world. The second part draws on the rich, but non-linear, archival material. Chapter 4 uses financial and documentary evidence to reflect on Bernadino da Cirillo's impact at the Hospital. Chapters 5 and 6 are broadly thematic, dealing with music in the church and the hospital wards respectively, while Chapter 7 is complementary to both Chapters 5 and 6, using iterations and revisions of a decree issued in 1644 to frame a broad chronological span from 1752 back to the late sixteenth century.

Music and the passions were of as much interest to religious thinkers as they were to physicians. In his eloquent reflections on the nature of spirituality and music, Cobusson speaks of music as occupying a liminal space in which all assured and secure structures and boundaries of our existence are undermined. It is neither subject nor object but an ‘inbetweenness’ connecting body and soul, the divine and the human; a threshold that by definition is neither one thing nor the other, and therein lies its power or efficacy. The proximity of body, mind and soul is reflected in religious writings concerning the passions and music's capacity to act on them. These concerns are already evident in the late antique sources documenting the history of the Christian Church in the east and in the west.

Music in the Christian liturgy in the form of recitation, chanting and singing evolved in the same Christian societies of late antiquity responsible for the emergence of the hospital. The divisions between Christians who chose isolation in desert communities to focus on their own spirituality and those who set up monasteries in urban areas to minister to the local population are reflected in different rules of monastic living, expressed most clearly by the enclosed work of prayer of the Benedictines and the community-focused Augustinians. Viewed in this way, monasteries and hospitals are twins. The historical development of the hospital runs parallel with the development of the monastic Offices, and this close relationship between religion and medicine is entwined with music. Those ministering to the sick were also committed to a life of constant prayer and psalm singing.

The passions in religious thought

Late antique sources written by the Church Fathers active in the fourth century, such as Jerome, Basil of Caesarea, Augustine and Gregory of Nyssa were core to early modern religious education and therefore to the men who ran and worked in the Hospital of Santo Spirito. Many of these antique sources mention music in general terms, and psalmody in particular, and it is clear that the psalms, unlike readings, were sung. These sources also note the regularity of singing and its beauty, demonstrating an appreciation of the rhetorical power of psalm-ody and the ability of psalm singing to control the passions.