This history of St James's Hospital in Dublin traces its origins from the eighteenth century to the present day, with the authors arguing that developments in the past twenty years, including the construction of clinical and research institutes and centres of excellence, have placed the south Dublin hospital ‘among the leading European hospitals of the twenty-first century’. Chronological and narrative in style, the work focuses on important episodes in the history of the site: the Foundling Hospital, the South Dublin Union workhouse, and the foundation and development of the modern St James's Hospital, all on a site that is essentially a village within a less prosperous area of the city.

There is a strong emphasis on hospital events that are also key issues in Irish history. The impact of the Famine on the hospital is dealt with in one of the chapters that flows best, with intriguing details of how doctors struggled to cope with the crisis, and an outbreak of dysentery, even as the workhouse rapidly exceeded its 2,000 person capacity for the first time. The master had to ditch four tons of rotten potatoes and struggled to find a good substitute food, as the replacement bread, porridge and maize all caused the inmates gut complaints. Some 1,533 people died from ‘epidemic and contagious diseases’ in the South Dublin Union during the Famine.

Equally riveting is the story of the union's occupation during the 1916 Rising, under the command of Éamonn Ceannt and Cathal Brugha; Ceannt and his men marched in, cut the telephone wires, and demanded the keys from a bewildered porter, who had no idea a rebellion was taking place. A rather pleasing aspect of this book is a delicate eye for detail: here we are told that Áine Ceannt, wife of Éamonn, was the daughter of a ward mistress in the South Dublin Union and had lived in the grounds. In later chapters, the authors deal with the sensitive issues relating to the rationalisation of Dublin hospital resources, and the closure of smaller hospitals and the merger of their staff into the St James's complex.

Lavish illustration adds significantly to the reader's enjoyment of the book, with pictures of the first workhouse on the site (courtesy of the Irish Architectural Archive), portraits of key players in the institution's history, the return of paupers in the workhouse during the Famine, and various maps and architectural drawings of the site and buildings. It may be worthwhile, in this review, to draw the attention of medical historians to a forty-five page chronological table of appointments, retirements and significant events in the hospital's history since 1971, when the then minister for health, Erskine Childers, made an order establishing the board of St James's as a statutory body. This provides direction on trends in contemporary medicine which some may find useful.

This book is not written from the perspective of a historian of medicine examining innovations in the management of hospitals through the lens of changes in scientific understanding of disease and ensuing developments in the management of medical systems. It is written rather through the lens of the medical practitioner (Davis Coakley was a consultant physician at the hospital, and the authors combine this useful local knowledge with a keen sense of – and much acknowledged advice on – the broader historical context). For instance, the word ‘bacteriology’ – a key development in the history of disease – does not appear in the index. Another historian of medicine's perspective would result in a rather different book, even using the same resources. They might look more closely at contemporary influences on the developments in medical practice at St James's, or cast a wider net to set these changes in international contexts. But that would be to wish for a different book, rather than recognising the value of the book to hand, a very welcome, interesting and engaging resource for anyone interested in the history of medicine, in the history of hospital care, in the operations of workhouses, or in the social history of Dublin. It is a monumental history in two senses, both as a book in itself, and of an institution whose existence has been intricately interwoven with city life for hundreds of years.