The purpose of this work is to evaluate the activities developed at Santa Casa de Misericórdia de São Paulo as seen from the interweaving of the themes of the state, the philanthropy and health assistance. It is crucial to observe how changes in the understanding of the disease were important in turning the disease itself into a multiple question: simultaneously administrative, sanitary and scientific. From this standpoint one can see the start of the construction of Santa Casa‟ large hospital of clinics in 1878, finalized in 1885, as a milestone in directing the provision of medical care to the growing population of the state. Three points will define how the expansion of the service took place. The first one relates to the action of "paulista" philanthropy in order to provide preferential attention to the immigrant manpower. The second one refers to the setting up of a republican administration of heath. And finally the centrality of the body of the physicians who exerted a certain scientific hegemony.
Santa Casa de Misericórdia; São Paulo; History of Medicine
