At the onset of their article: “Managing a research hospital at the time of a global economics crisis: cruising between Scylla and Charybdis” Macchi and Pavan [1] cite the interesting paper published in this journal by Riva and Cesana [2] on evolution of the hospitals from ancient Greece to present. This article lacks an historical analysis of the architectural/structural elements that have marked hospital construction over the time. Indeed, hospital configuration has changed over the centuries together with the medical knowledge.