Theme Hospital on modern computers

October 13, 2009 | categories: Gaming, Pcs

One of my favourite old games is Theme Hospital by Bullfrog. I still have my original disc, and play it a lot. It has a lot of charm, but it's not always simple to get running. So I'm writing up this guide on playing Theme Hospital on a modern PC. It has been re-released a couple of times, but my disc has both the Windows and DOS versions on the one disc.

First of all, if you are running a 32 bit version of Windows, have the Windows version, and have no intention of playing the multiplayer mode, just insert your disc and install away. It still runs perfectly up until XP. On Vista on my PC, I had to set the compatibility mode to Windows 95, and turn "Run as Administrator" on and it worked from then on. The same steps should work the same on Windows 7 32bit, but I don't have a computer running that to check. [EDIT: A friend informs me that it doesn't work on his Windows 7 32bit, but I still haven't tested for myself. Try the DOSbox instructions if it doesn't work for you]

If you have 32 bit Windows, and the Windows version, just play away.

If you want multiplayer, or you have the DOS version, things become more complex. For Vista, the IPX network protocol, which was used by Theme Hospital, along with many games of it's time has been removed. There is a hack to enable IPX in Vista, but it does not allow you to change the settings, and did not work for me. If you have XP or earlier, installing IPX to the Hamachi VPN software apparently works but I don't have access to a XP computer to test it.

The final option which I eventually resorted to using is to install Theme Hospital to DOSbox. This works on all Windows versions from 2000 up, and for Mac OS X and Linux aswell. Download and install DOSbox. Make a folder to store the files. I recommend you make it something easy to type such as C:\hospital on windows on /home/user/hospital on Linux/OSX. Then open up DOSbox. You will be presented with a DOS prompt. Type the following:


mount C "/home/user/hospital"
mount D "/media/cdrom" -t cdrom

Or Windows (replace E: with the actual drive letter of your CD rom drive)

mount C "C:\hospital"
mount D "E:\" -t cdrom

Next we need to install Theme Hospital to DOSbox. First, when your cursor is stuck in the DOSbox window (as happens later in the process), to get it out press Ctrl-F10. Now, in dosbox type:


This will open up the Theme Hospital DOS installer. Click the install button and let it install to C:\HOSPITAL (note: For windows users, this is equal to C:\hospital\HOSPITAL on the actual system). Then go to the configuration screen. Configure your sound card and music card. I found selecting Creative Sound Blaster Pro worked fine for me on Linux and Windows. I did have to turn my system volume up to full on Linux to hear it as the volume was stuck down low, however.

To avoid typing in the mount commands each time edit your configuration file. On Windows click the edit configuration file shortcut. If you are using Linux, you first have to issue the command CONFIG -writeconf dosbox.conf inside of DOSBox. Afterwards, the dosbox.conf file will be written to your home directory.

At the very end of the file, add the mount commands you entered before installing the game.

Afterwards click exit. The DOS version of theme hospital is now installed on DOSbox. If you want to play multiplayer, read on. Otherwise, you can stop now.

Edit your configuration file again and replace the line:




For each additional computer you wish to play it on, repeat the above process. Finally pick one computer as the host. On that computer start DOSbox and type the same instructions as startup last time, but add this before starting the game

ipxnet startserver ipxnet connect

Find the host's IP address. For internet play, try For local network play, check your network connections dialog.

Now on each client computer type the following (replace the with your host computer's IP address):

ipxnet connect

And start the game on all the computers, enter the network game screen and play away.

Some Final Notes

Gameplay performance on the same system was much better on Vista than it was on Linux. The game played perfectly under Vista, while under Linux the sound was noticeably choppy. Whether this  is a problem with DOSbox or with my computer's drivers is not certain.

I'm not sure if it is possible to play the Windows version against the DOS version. I have not tried.