The date of foundation of the hospital, located near the church of San Martino, is traditionally considered to be 1090. In 1781 a project for remodelling the building, no longer adequate to the city’s needs, was approved. However, perhaps due to the unhealthy air of the selected site, too close to the Porta Lake, the work was postponed for years. The project for draining the lake, implemented under the reign of Elisa Baciocchi through the construction of cataracts at Cinquale (barrages designed to restrain and brake the flow of water) led to resumption of the work, and in 1819 the new building was inaugurated.

Its structure, specifically that of a hospital, was designed according to the principles, therapeutic and no longer merely those of relief, that were being successfully introduced into hospitals during the 18th century. These principles were clearly stated in the "Regulations of the venerable hospital of Massa under the protection of SS. Giacomo e Cristoforo" dating from 1843. In 1858 the hospital was equipped with such modern instruments and apparatus as the "speculum uteri", "eyeglasses with four lenses for ophthalmic diseases", machinery for sampling blood and setting broken bones.