Tag Archives: healthcare

Monks, illness, demons, and sin


Monastic hospitalFitting right into the modern Monty Python stereotype of medieval people as backward, ignorant, and superstitious is the assumption that especially the monks of the Middle Ages sought only supernatural explanations for things. Understanding that up to the 12th century, healthcare took place almost exclusively in the monasteries, we jump to the logical conclusion: such care couldn’t possibly have attended to the physical causes of illness. Didn’t those monks just believe that illness was caused either by demons or by the sins of the sick person? There’s a germ of truth here (pun intended), but the reality was quite different. That’s the subject of the next section of the hospitals chapter in my Getting Medieval with C S Lewis.

Monastic phase

The distinctly monastic flavor of healthcare during the Middle Ages – even when it was provided by lay orders like the Hospitallers – deserves a bit more probing. From the beginning, monasteries in the West took Benedict’s cue and made caring not only for ill monks but also for needy travelers one of their primary tasks. The “stranger” was always an object of monastic charity. This “rather broad category,” says medical historian Gunter Risse, included “jobless wanderers or drifters as well as errant knights, devout pilgrims, traveling scholars, and merchants. . . .”[1] Monastic care for the stranger and the ill was formalized in the 800s during Charlemagne’s reforms, as assemblies of abbots (leaders of monasteries) gathered to reform and standardize that aspect of monastic life. At that time many of the scattered church-sponsored hostels (xenodocheia) across the Holy Roman Empire were given “regula”—quasi-monastic rules, and “monasteries . . . assumed the greater role in dispensing welfare.”

Organized, ubiquitous, stable, pious: the monasteries of the West became sites of care and of medical learning. “Benedict’s original rule ordered that ‘for these sick brethren let there be assigned a special room and an attendant who is God-fearing, diligent, and solicitous.’ This monk or nun attending the sick—the infirmarius was usually selected because of personality and practical healing skills. The latter were acquired informally through experience, as well as through consultation of texts, medical manuscripts, and herbals available in the monastery’s library or elsewhere. . . . The infirmarius usually talked with patients and asked questions, checked on the food, compounded medicinal herbs, and comforted those in need. . . .”[2]

“A rudimentary practice of surgery (‘touching and cutting’) at the monastic infirmary was usually linked to the management of trauma, including lacerations, dislocations, and fractures. Although these were daily occurrences, the infirmarius may not have always been comfortable practicing surgery on his brothers, for it was always a source of considerable pain, bleeding, and infection. Complicated wounds or injuries may have forced some monks to request the services of more experienced local bonesetters or even barber surgeons. . . .”[3] Risse notes other popular healing practices of the Middle Ages that were integrated into the monastic medical routine, including herbology, bathing (not otherwise common!), preventive bloodletting, and diagnostic examination of pulse, urine, stool, and blood.

The mention of some of these “backward” medieval medical practices may raise another stereotype many have in their heads about the Middle Ages. Just as some still believe the fabrication that medieval people believed in a flat earth, some assume that medievals did not know, and were not interested in, the physical causes of illness. Instead, the story goes, they assumed all illness came from devilish or demonic sources, or, a variant, from some hidden sin in the sick person. Continue reading

From poorhouse to hospital – a medieval development


Basil

Basil (Photo credit: el_finco) Not actually Basil the Great, but the herb, which has been used since ancient times as an anti-inflammatory.

Here’s the next bit of the “hospitals chapter” in Getting Medieval with C S Lewis. It follows from this bit on Lewis, this introductory bit, and this description of the very first proto-hospitals in the earliest Christian church

Basil’s House of Healing

The hospital itself, it is generally agreed, begins to emerge in the fourth century from the compassion of a well-known monk—Basil, now called “the Great.” In setting the scene for this story, historian Timothy S. Miller reminds us that Lewis’s “two-edged” description of the faith (body affirming + spirit affirming) characterized monks as well as laypeople – in a way many moderns find surprising. Mentioning some of the monks’ more severe ascetic practices (for example, the unforgettable Simeon Stylites’ long stretches sitting atop a pole in the desert), Miller admits, “Their lifestyles of severe self-denial may seem to pull against the truth that God made us human beings and called us ‘very good’—bodies and all.”

“But,” continues, Miller, “if monastics really thought of the body as evil, then how is it that some of the greatest strides in the history of healthcare arose within monasticism? Monks cared for the ill in Benedictine monasteries, Franciscan leprosaria, the institutions of the monastic ‘hospitallers,’ the many hospitals of the Augustinians, and so on throughout the history of monasticism.” Basil started it all, and his story “decisively dispels” our “myths of body-hating monks.”[1] Continue reading

Birth of the hospital in the West – the first stirrings in the early church


The plague in Rome. Painting by Jules Elie Delaunay

The plague in Rome. Painting by Jules Elie Delaunay

Moving on in the “hospitals chapter” in my Getting Medieval with C S Lewis:

What does a distinctively Christian practice of mercy look like?

To see what a distinctively gospel-centered approach to care for the body looked like in the early and medieval church, we turn to a case study: the early development and medieval rise of the hospital

Early

What, then, did this distinctively Christian practice of mercy look like in the early and medieval church? A key case is that of the hospital. Before Christianity, there were no hospitals in the Roman Empire. Within a few centuries of Christ’s coming, an institution that would later develop into the hospital begin to emerge as a unique new form of religious philanthropy on the face of the earth.

Church parish networks

Before it did, however, there was plenty of Christian healing and helping going on—with healthcare usually happening in the context of needy members: widows, orphans, the poor. But it was happening in the church. Specifically, it was happening within parish networks. As a regular part of their worship, the earliest Christians gathered alms to be distributed by deacons for the help of those in need. By the mid 200s, the benevolence mission of the church had birthed a complex of minor clerical orders, and a report from Cornelius, bishop of Rome, in 251 described a strategic system that involved dividing the city into seven districts, with deacons and subdeacons appointed to care for the people in each one. Gary Ferngren relates that the Roman church in that day spent up to a million sesterces a year—a huge amount of money—in supporting and caring for 1,500 needy people. Continue reading