Focusing on one of the great London teaching hospitals, traditionally the pre-eminent site for medical education in England, E.A. Heaman traces the emergence of the modern scientific teaching hospital and the intellectual, social and political forces shaping it. Examining the social problems connected with health and the political debates around these problems at both the local parish level and on the national stage, Heaman explains how and why hospitals like St Mary's, originally charitable institutions for the poor, began to admit middle-class patients and eventually came under a national health insurance scheme. Heaman traces the appearance of research on the curriculum vitae of ambitious clinicians in the 1850s, the appointment of salaried scientists in the 1880s, the emergence of full-time clinical researchers in the early 1900s, and their gradually increasing influence over the teaching hospital. Carrying the analysis to the present day, she shows St Mary's growing participation in a developing medical public sphere that includes medical societies, a medical press, and granting agencies such as the Medical Research Council.