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The article analyzes the institutional, political, and social circumstances which facilitated the creation of a public health and welfare system through the initiatives of monarchs in Portugal from the 16th to the 17th centuries and contributed to the formation of a modern State. Among the monarchs mentioned are Manuel Ier, King of Portugal, and Philippe II, King of Spain. The invention of a medical network and hospital reform and the creation and political function of Misericórdia confraternities are discussed.