David A. Howard’s work is a good study of the Royal Hospital for Indians during the eighteenth century. It should not claim to be more. The hospital was founded by royal decree in 1553, but the first century and a half of its existence is outlined in fewer than two pages of the introduction. The author used the very handy collection of documents from the hospital archive in the Instituto Nacional de Antropología e Historia in Mexico City, as well as other sources in the Mexican National Archive, and he notes that documentation for the period before the eighteenth century is very limited. But, since he (or his editor) chose to put a general title on the work, one can validly ask, where is the evidence of research in the Spanish archives to fill in some of the gaps in the earlier history of the institution?

The work is primarily a study of the administration of the hospital. Having been founded as a lay institution, it came under control of the Brothers of St. Hippolytus for a while (1702–48), and was then returned to lay administration and staff. Perhaps its outstanding contribution in general terms, besides the day-to-day care for the miserably poor, was that the first school for surgery in Mexico was founded there in 1770. During the struggle for independence, the hospital came on hard financial times and, lacking support from the new creole government, it closed its doors in 1822.