Abstract
This chapter explores the history of the hospital, beginning with early man and ending with Late Antiquity, by providing a brief background as to how certain civilizations—the Egyptians, the Greeks, the Muslims, the Christians, and the Romans—dispensed early healthcare. Key to this chapter is the introduction of temples, the first pseudo hospital, where healing occurred through the supernatural powers of the gods, such as Imhotep and Apollo. “Temple incubation”—as it came to be known—set the stage for later hospital developments, while great medical advancements came with the works of Hippocrates, Galen, Avicenna, and Averroes. Finally, the chapter considers the important public role, or the lack thereof, that governments played in healthcare, as well as the introduction of Christianity .
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Notes
- 1.
Earliest written evidence dates to Mesopotamia and the world’s oldest medical document dates from 2100 BCE. It is a partial text of an ancient Sumerian clay tablet that was once buried among the debris at Nippur. For more information, see John L. Webb, “The Oldest Medical Document,” Bulletin of the Medical Library Association, Vol. 45, No. 1 (January 1957): 1–4. Other ancient texts include the Egyptian Papyri, discussed below.
- 2.
Evidence comes in a variety of forms, including writing and artistic renderings. Also included as evidence are skeletal remains, which prove to be difficult to discern. For example, one of the more controversial skeletal discoveries is an operation that was performed in the Stone Age was the trephining of skulls. Holes were made in the skull, often successfully, to produce a remedy of some sort. The reasons for why early ancestors used this practice or to what benefit it provided is not clear. The scholarly debate is divided into two camps: supernatural and natural. Paul Broca’s work provides the supernatural view that skulls were trephined in order to release “spirits” that caused headaches or even epilepsy. See Paul Broca, “Trépanation chez les Incas,” Bull Acad Méd (Paris) 32: 866–872; Paul Broca “Sur les Trépanations préhistoriques,” Bull Soc Anthrop 11: 461–463. Others, such as D. Woelfel, link trepanations to war and weapons, and thus favor a naturalistic view. See D. J. Woelfel, “Die Trepanation” (Anthropos, Bd. 20, 1925). For a more modern view, see Plinio Prioreschi, “Possible Reasons for Neolithic Skull Trephining,” Perspectives in Biology and Medicine, Vol. 34, No. 2 (Winter 1991): 296–303.
- 3.
Arthur Kleinman, Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine , and Psychiatry (Berkeley: University of California Press, 1980), 50. Also, public and private can certainly be substituted for public and private.
- 4.
Although both Egyptian and Mesopotamian civilizations had active practitioners and healthcare systems, Egypt became the model for the healthcare system adapted by the Greeks and subsequently the Romans, hence the focus on it here.
- 5.
For a description of the practices, see Diodorus Siculus, chapter 91–92, 311–317. Diodorus Siculus, Library of History, Vol. 1, chapters 91–92, 311–317. Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 6.
This is not to say that Egypt was the only ancient civilization to development medical treatments and healthcare systems. Similar accounts existed in Mesopotamia and even Central and South America. The emphasis placed here on Egypt is intentional as in the history of medicine a clear connection can be created from Egypt, to Greece, to Europe in the Middle Ages. India and China also developed sophisticated treatments and centers for care. The religious movement of Buddhism produced a number of hospitals, as Christianity later would. The type of medical treatments first practiced by groups like the Peruvians, the Mesopotamians, and the Egyptians has been termed “archaic medicine” by Owsei Temkin. Temkin argues that although there was progress in medieval treatments and practices, the ancient civilizations of the world still relied on the medicine of the primitives. Moreover, “supernaturalism” remained a key component. For more on Owsei Temkin and his ideas, see A Short History of Medicine, ed. Erwin H. Ackerknecht and Lisa Haushofer (Baltimore: John Hopkins University Press, 2016), 25–26.
- 7.
Charles Henry Oldfather, “General Introduction,” in Diodorus Siculus, Library of History, Vol. 1, No. viii, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 8.
Diodorus Siculus, Library of History, Vol. 1, chapter 82, 283, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 9.
“…eating alone will not keep a man well; he must also take exercise. For food and exercise, while possessing opposite qualities, yet work together to produce health.” Hippocrates of Cos, Regimen 1, 229, Loeb Classics Online, https://www.loebclassics.com/view/hippocrates_cos-regimen_i/1931/pb_LCL150.229.xml.
- 10.
Diodorus Siculus, Library of History, Vol. 1, chapter 82, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 11.
See “Code of Hammurabi,” The Avalon Project, http://avalon.law.yale.edu/subject_menus/hammenu.asp. It should be noted that the Mesopotamians were also well versed in medical care. Extant evidence survives in the form of medical treatises on cuneiform tablets. The largest of the treatises is the “Treatise of Medical Diagnosis and Prognoses,” composed on some forty tablets and dating to c. 1600 BCE. Medical treatment of the individual begins with diagnoses and then cures, starting with the head and ending with the toes. The rational order of prognoses and treatments was accompanied by rational care that parallels modern care. See René Labat, Traité akkadien de diagnostics et prognostics médicaux (Academie Internationale d’Historie des Sciences: Paris, 1951). Moreover, it was believed that the Gods created the illnesses, which were diagnosed by an ashipu. Important in the diagnosis was identification of which god was causing the illness. The ashipu could then administer spells and charms, but for more extensive treatment an asu, or physician was needed. See Hector Avalos, Illness and Health Care in the Ancient Near East: The Role of the Temple in Greece , Mesopotamia , and Israel (Atlanta: Scholar Press, 1995).
- 12.
Diodorus Siculus, Library of History, Vol. 1, chapter 82, 283, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 13.
For more on Egyptian papyri and diagnoses, see J. F. Nunn, Ancient Egyptian Medicine (Norman: University of Oklahoma Press, 1996).
- 14.
The Edwin Smith papyrus was published in 1930 by James Henry Breasted. See John Henry Breasted, The Edwin Smith Surgical Papyrus (Chicago: University of Chicago Press, 1930). For more on the Ebers Papyri, see P. W. Bryan, The Papyrus Ebers (London: Geoffrey Bles, 1930). Both manuscripts date from the Egyptian Middle Period.
- 15.
See more on disease in ancient cultures in Mummies, Disease, and Ancient Cultures, ed. Aiden and Eve Cockburn (Cambridge University Press: Cambridge, 1980).
- 16.
See Bryan, The Papyrus Ebers, 45.
- 17.
Ibid.
- 18.
Many of these titles come from the Famine Stela where Imhotep is identified. See P. Barguet, La stèle de la famine à Séhel, Vol. 34 (Institut français d´archaéologie orientale: Paris, 1953).
- 19.
The Edwin Smith papyrus has been attributed to Imhotep.
- 20.
Per Arthur Kleinman’s definition, Egypt qualified as having a healthcare system. See above and see Arthur Kleinman, Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine , and Psychiatry (Berkeley: University of California Press, 1980), 50.
- 21.
R. Hajar, “Learning Ancient Greek Medicine From Homer,” Heart Views, Vol. 3 (2002): 8.
- 22.
Timothy S. Miller, The Birth of the Hospital in the Byzantine Empire (Baltimore: The Johns Hopkins University Press, 1985, 1997), 31.
- 23.
As proof that Homer was in Egypt, Diodous speaks of “evidence, and especially the healing drink which brings forgetfulness of all past evils, which was given by Helen to Telemachus in the home of Menelaüs. For it is manifest that the poet had acquired exact knowledge of the “nepenthic” drug which he says Helen brought from Egyptian Thebes, given her by Polydamna the wife of Thon; for, they allege, even to this day the women of this city use this powerful remedy, and in ancient times, they say, a drug to cure anger and sorrow was discovered exclusively among the women of Diospolis; but Thebes and Diospolis, they add, are the same city.” Diodorus Siculus, Library of History, Vol. 1, chapter 97, 355, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 24.
Diodorus Siculus, Library of History, Vol. 1, chapter 69, 239, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html.
- 25.
Diodorus Siculus, Library of History, Vol. 1, chapter 96, 327, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html. Thales even received his medical training in Egypt.
- 26.
Diodorus preferred the accounts of Homer to those of Herodotus, arguing that Herodotus told “marvelous tales” simply to keep his readers entertained. See Diodorus Siculus, Library of History, Vol. 1, chapter 69, 241, Loeb Classics Online, http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1D*.html. Despite Diodorus’ opinion, Herodotus’ recordings should not be ignored.
- 27.
Herodotus, The History of Herodotus, Book II, trans. George Rawlinson, Online at http://classics.mit.edu/Herodotus/history.html.
- 28.
Ibid.
- 29.
Ibid.
- 30.
Herodotus, The History of Herodotus, Book II, trans. George Rawlinson, Online at http://classics.mit.edu/Herodotus/history.html.
- 31.
Despite his association with healing, Apollo was also the god of disease and plague.
- 32.
Avalos demonstrated his arguments in the cases of Greece (especially in connection with the Asclepius—see below), Mesopotamia, and Israel. See Hector Avalos, Illness and Health Care in the Ancient Near East: The Role of the Temple in Greece, Mesopotamia, and Israel (Atlanta: Scholar Press, 1995), especially 395, where Avalos discusses the Greek Asclieipion as representative of these three functions.
- 33.
Hippocrates was said to have worshipped Asclepius.
- 34.
For more on the Asclieipion or Asklepieia, see Miller, The Birth of the Hospital in the Byzantine Empire, 38–41. Often associated with Asclepius are his holy staff and snakes, the caduceus, which is used to this day to designate medical practitioners and places of care. The caduceus may have been a way to inject patients with a non-lethal dose of snake venom, demonstrating an advanced understanding of anti-venoms and medical instruments.
- 35.
Asclepius was not the only ‘god’ to have anatomical votives. In fact, “one of the main criteria for characterizing deities as healers is the discovery of pertinent material evidence in the shrines: inscriptions, medical instruments, and funerary and honorary votives with explicit references to illness and healing,” in addition to architectural remains and/or literary references. Both Apollo and Asclepius received a large number of votives. See A Companion to Science, Technology, and Medicine in Ancient Greece and Rome , Vol. I, ed. Georgia L. Irby (Oxford: Wiley Blackwell, 2016), 442. Moreover, see Hector Avalos for the use of these votives in petition, therapy and thanksgiving in Avalos, Illness and Health Care in the Ancient Near East: the Role of the Temple in Greece, Mesopotamia , and Israel.
- 36.
A Companion to Science, Technology, and Medicine in Ancient Greece and Rome , 442.
- 37.
Ibid.
- 38.
A school of medicine was located near by.
- 39.
Peter Barefoot explains that the peoples of the classical world used “locotherapy,” be it deliberate or unconscious. Locotheraphy, or attention to environment (earth, water, air, and sun), when building an asklepieion, was key in healing all kinds of maladies. He further argues that the “return to good health is not just a matter of medication or surgery, but the environment must play its part as well.” Barefoot argues that some modern hospitals have embraced the idea, but that others would do well to study and adopt the Greek methods. One hospital touted for doing so is Saint Bartholomew’s Hospital in London, which has roots in the medieval period. See Peter Barefoot, “Asklepieia: Ideas for Design Today,” in Health and Antiquity, ed. Helen King (Routledge: New York, 2005), 213–215.
- 40.
This, of course, contained the Hippocratic Oath: “I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant: To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else. I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.” The Hippocratic Oath: Text, Translation, and Interpretation, trans. Ludwig Edelstein (Baltimore: The Johns Hopkins Press, 1943), at http://guides.library.jhu.edu/c.php?g=202502&p=1335752, accessed 4 August 2016. See also, Albert R. Jonson, A Short History of Medical Ethics (Oxford: Oxford University Press, 2000), especially chapter 1 on “Hellenic, Hellenistic, and Roman Medicine.”
- 41.
Hakim Mohammed Said, Traditional Greco-Arabic and Modern Western Medicine: Conflict or Symbiosis? (Karachi: Hamdard Academy, 1975), 14–15, 20.
- 42.
Said, Traditional Greco-Arabic and Modern Western Medicine: Conflict or Symbiosis? 17–21.
- 43.
Ibid.
- 44.
For more on Roman medicine, see Plinio Prioreschi, A History of Medicine: Volume III, Roman Medicine (Omaha: Horatius Press, 1998).
- 45.
Albert R. Jonsen, A Short History of Medical Ethics (Oxford: Oxford University Press, 2000), 9.
- 46.
Jonsen, A Short History of Medical Ethics, 9.
- 47.
For more on Celsus, see Plinio Prioreschi, A History of Medicine: Volume III, Roman Medicine, 13.
- 48.
The text reads salutaris profession, which can mean beneficial profession or healing profession. See Jonsen, A Short History of Medical Ethics, 9.
- 49.
Galen, Method of Medicine, Books 1–4, ed. and trans. Ian Johnston and G. H. R. Horsley (Cambridge: Harvard University Press, 2011), xlii–xlviii.
- 50.
John D. Thompson and Grace Goldin, The Hospital: A Social and Architectural History (New Haven: Yale University Press, 1975), 5.
- 51.
For more on the military hospitals, the Valetudinaria, see Miller, The Birth of the Hospital in the Byzantine Empire, 38.
- 52.
For an example of this type of hospital, see the Vindonissa hospital in Windisch, Switzerland, which existed in the first century CE. It is a symmetrical building with a great hall in the middle and patient rooms that lined the corridors. For more information, see Thompson and Goldin, The Hospital: A Social and Architectural History, 5. Moreover, Roman hospitals also housed slaves and upper class citizens in their hospitals.
- 53.
For more on Roman medicine, see Prioreschi, A History of Medicine: Volume III, Roman Medicine.
- 54.
Gary Ferngren, “The Sick Poor and the Origins of Medical Charity,” at http://chreader.org/sick-poor-origins-medical-charity/, accessed 5 October 2017.
- 55.
Andrew T. Crislip, From Monastery to Hospital: Christian Monasticism & the Transformation of Health Care in Late Antiquity (Ann Arbor: University of Michigan Press, 2005), 124. See Cohn-Haft, Public Physicians, but his entire argument is based on single piece of evidence from the fifth century CE.
- 56.
Andrew T. Crislip, From Monastery to Hospital, 48.
- 57.
Islamic belief promotes an approach to illness that finds parallels in the ancient world. Just as Apollo was the god of healing and disease, so too is it believed that Allah provides both disease and cures. It is, indeed, only through Allah that disease can be cured: “And if Allah touches you with harm, none can remove it by He, and if He touches you with good, then He is Able to do all things.” Surah Al-AnAam, 6: 17 in IqraSense, Healing and Shifa: From Quran and Sunnah (USA: IqraSense, 2013), 14. This is very much a spiritual approach to cures. This is not to say that all approaches in Islam were spiritual. Later, a discussion of The Meadows of Gold proves the importance placed on scientific cures.
- 58.
National Library of Medicine, “Islamic Culture and the Medical Arts: Hospitals,” https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html, accessed 10 August 2016. The early structure of Christianity as a persecuted religion did not allow for such centralized care, while the xenophobic nature of the ‘healthcare system’ of the Roman Empire was not one to embrace the less fortunate. The transition from the Late Antiquity to the early Middle Ages marked a unique transformation in Christianity, society, culture, and healthcare. The lack of centralization, with the exception of the bureaucracy of the Christian church, made centralized healthcare difficult. As a result, healthcare was overseen by monks and monasteries. Developments that mimicked the Islamic system would have to wait for more urban environments.
- 59.
We will see later that this is paralleled in the hospital of Saint John in Brussels with the exception of the mental health services. Moreover, with the exception of the status of retirement home, most people who sought out care at the hospitals, Islamic and Saint John, were of modest means. The wealthy, in Islamic and Christian societies, would have received care at their homes and/or by court physicians. National Library of Medicine, “Islamic Culture and the Medical Arts: Hospitals,” https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html, accessed 10 August 2016.
- 60.
Bimaristan is derived from the Persian word, birmar, meaning ill person, while -stan denotes place or location, hence place of ill people. Maristan is a corrupted form of bimaristan. See National Library of Medicine, “Islamic Culture and the Medical Arts: Hospitals,” https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html, accessed 10 August 2016.
- 61.
This was the title that would inform later crusading hospitals in the East.
- 62.
Jundishapur was also home to a well-known center of learning.
- 63.
National Library of Medicine, “Islamic Culture and the Medical Arts: Hospitals,” https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html, accessed 10 August 2016.
- 64.
The first Christian hospital was founded at the end of the fourth century in Caesaraea in Cappadocia. See Jonsen, A Short History of Medical Ethics, 13.
- 65.
There are a number of sections that can be highlighted in this work, but key is a section titled, “Wathqid Discusses Medicine,” which details Islamic practices in medicine. See Masudi, The Meadows of Gold, ed. and trans. Paul Lunde and Caroline Stone (New York: Routledge, 2010).
- 66.
There is a direct connection between the birmaristans of the Middle East, and particularly of Jerusalem, to Brussels and the Hospital of Saint John. Those hospital connections help to create a link that solidifies transference of the idea of centralized care overseen by a governmental—albeit religious in some sense—from the East to the West. With the hospital of Saint John, that very transition occurred; it was initiated by Duke Godfrey but augmented by trade and civic centers, such as Brussels, which was located on a primary east–west trade route. Brussels was a second-generation Roman city that lost much of its Roman influence with the decline of the Empire. The shrinking of Roman Imperial and pagan influence meant the replacement with Christian institutions. The cities were reorganized—topography shifted to that of the church. It will be illustrated later that in Brussels, the dukes of Brabant and the Bishops of Cambrai, in addition to the city aldermen, vied for control as the socio/politico/religio leaders. This is evident in the rise of the hospital of Saint John, which again was borrowed largely from the East.
- 67.
This is not to say that peoples other than the Christians did not practice charity. As noted earlier, the Romans understood that clean and healthy citizens were happy citizens. Charity was, in fact, a central tenant of Islam as well.
- 68.
Mollat, The Poor in the Middle Ages , 38.
- 69.
Darrel Amundesen and Gary Ferngren, “Medicine and Religion: Pre-Christian Antiquity,” in Health/Medicine in the Faith Traditions, ed. Martin Marty (Philadelphia: Fortress Press, 1982), 88 in Andrew T. Crislip, From Monastery to Hospital: Christian Monasticism & the Transformation of Health Care in Late Antiquity (Ann Arbor: University of Michigan Press, 2005), 69.
- 70.
Henry E. Sigerist, “The Special Position of the Sick,” in Culture, Disease, and Healing, ed. David Landry (New York: Macmillan, 1977), 388–394, at 391 in Andrew T. Crislip, From Monastery to Hospital: Christian Monasticism & the Transformation of Health Care in Late Antiquity (Ann Arbor: University of Michigan Press, 2005), 69.
- 71.
Andrew T. Crislip, From Monastery to Hospital, 69.
- 72.
A Latin Dictionary, “caritas,” ed. Charlton Lewis and Charles Short (The Clarendon Press: Oxford University Press, 1962), 292. See use, for example, by Cicero and Cato.
- 73.
Lewis and Short, 292.
- 74.
Ibid.
- 75.
Peter Kwaniewski explains that caritas should be translated as “charity;” he argues, “the fact that for some people “charity” has come to mean nothing other than tossing a coin into a beggar’s cup is no reason to throw it out of theology where it occupies the queenliest of places; like many another beautiful but endangered species in the English language, it rather needs to be rescued and bred in captivity. For the scholastics, charity means nothing less than the very love which is God’s essence, the love that Christ manifested in his death on the cross.” Things like almsgiving are what Kwaniewski calls “charity’s effects.” See Peter Kwaniewski, in Thomas Aquinas, On Love and Charity: Readings from the Commentary on the Sentences of Peter Lombard, trans. Peter A. Kwaniewski, Thomas Bolin, and Joseph Bolin (Washington, DC: The Catholic University Press of America, 2008), xxii.
- 76.
See Frederick S. Paxton, Christianizing Death: The Creation of a Ritual Process in Early Medieval Europe (Cornell University Press, 1996), 27.
- 77.
James 5:14–15, RSV.
- 78.
James 5:16, RSV.
- 79.
The passage in James, however, like many in the Christian Bible, has multiple meanings, including both the literal prayer for healing the more spiritual idea that sickness, or sin, can be healed through prayer. Contextually, because James is not necessarily ‘sick’ but instead is fighting a spiritual battle, it is more likely that this passage is associated with spiritual healing. A similar situation occurs in Islam. Although there is an idea linked to physical care, belief and faith become components for true spiritual healing, or ruqyah: “And We send down of the Quran that which is healing and a mercy to those who believe.” Quran, Surah Al-Israa, 17:82 in IqraSense, Healing and Shifa: From Quran and Sunnah (USA: IqraSense, 2013), 20.
- 80.
Matthew 5:3, RSV.
- 81.
Matthew 25:36, RSV.
- 82.
Matthew 4:24, RSV.
- 83.
It is my interpretation that there are two different actions occurring: one is the casting out of demons and the other is the healing of the sick by anointing them. Most Greek versions of the text suggest a break in the two actions with a comma. This is seen in Scrivener’s Textus Receptus of 1894: “καὶ δαιμόνια πολλὰ ἐξέβαλλον, (sic.) καὶ ἤλειφον ἐλαίῳ πολλοὺς ἀρρώστους καὶ ἐθεράπευον.” The Stephanus Textus Receptus of 1550, however, does not have the delineation between the two actions: “καὶ δαιμόνια πολλὰ ἐξέβαλλον καὶ ἤλειφον ἐλαίῳ πολλοὺς ἀρρώστους καὶ ἐθεράπευον.” For Greek translations, see http://biblehub.com/texts/mark/6-13.htm.
- 84.
These ideas are based on Matthew 25:31–46 RSV, where Matthew lists the six virtues that Jesus will use on the Day of Judgment: “I was sick and you took care of me,” etc. To these six was added Tobit 1:17–19 RSV, which includes the burying of the dead. It is no coincidence that medieval monks practiced the seven corporal works of mercy. The monastery became a pseudo hospital for the sick in the Middle Ages. See below for more information.
- 85.
Andrew T. Crislip, From Monastery to Hospital, 54.
- 86.
Andrew T. Crislip, From Monastery to Hospital, 55. For more from Dionysius, see Eusebius.
- 87.
Sometimes, prevention is also included as an element of healthcare.
- 88.
Everett Ferguson, Backgrounds of Early Christianity (Grand Rapids: William B. Eerdmans, 1993), 540.
- 89.
Everett Ferguson, Backgrounds of Early Christianity , 540.
- 90.
There is a distinction, however, in how the two groups—Christians and Jews—approached care of the sick. According to Luke 13:10–17, for example, the chief rabbi of the synagogue criticizes Jesus for healing a woman. This issue is not in the care that he gives or she receives, but in the fact that he performed the act on the Sabbath. See Miller, The Birth of the Hospital in the Byzantine Empire, xvii. For more on Jewish charity, see Frank M. Loewenberg, From Charity to Social Justice (New Brunswick: Transaction Publishers, 2001); Gildas Hamel, Poverty and Charity in Roman Palestine: First Three Centuries, C.E., Near Eastern Studies 23 (Berkeley: University of California Press, 1990).
- 91.
There are even some modern arguments that Imhotep of Egypt was the biblical Joseph, which is key in making the connections between temple incubation and early hospitals.
- 92.
Quintus Septimius Florens Tertullianus was born in and probably spent the majority of his life in Carthage—a Phoenician settlement.
- 93.
Tertullian, Apology 39.1–6, in A. D. Lee, Pagans and Christians in Late Antiquity: A Sourcebook (New York: Routledge, 2000), 37–38.
- 94.
The Christian clubs were significantly different from Roman clubs and associations. Roman clubs included three types: economic (stationes), religious (cultores) and social (tenuiores). All three types had some sort of religious function, but paled in comparison to their Christian counterparts. Some emperors tolerated the associations while others called for their disbandment.
- 95.
Carter Lindberg, Love: A Brief History Through Western Christianity (Oxford: Blackwell, 2008); Carter Lindberg, Beyond Charity: Reformation Initiatives for the Poor (Minneapolis: Fortress Press, 1993), 44.
- 96.
Hippolytus, The Apostolic Tradition of Hippolytus, ed. Gregory Dix (London: SPCK, 1968), 57.
- 97.
Mollat, The Poor in the Middle Ages , 40.
- 98.
Clay, The Medieval Hospitals of England, 1.
- 99.
Ibid.
- 100.
Donald Snook, Jr., Hospitals: What They Are and How They Work (Maryland: Aspen Publishers, 1992), 3.
- 101.
For example, see Turmanin in Syria (on the main road from Antioch to Qalat-Siman) (475 CE)—it was built over the pillar upon which St. Simeon Stylites dwelled. See Thompson and Goldin, The Hospital: A Social and Architectural History, 7.
- 102.
There is not as great of a distinction between a pilgrim and a sick person as one might first believe. Thompson and Goldin note that “the definition of a pilgrim is more or less sick, he or she having undertaken a long journey as a form of penance.” Travel was difficult for people, both physically and mentally. There was a general need for nurses to care for and bandage feet from the roads. Thus, “for this reason the convent shelter [had to] be more than an inn, nursing care would necessarily be included in hospitality, and a hospice had to be part hospital.” See Thompson and Goldin, The Hospital: A Social and Architectural History, 7–8. Never is this truer than in the Christian Crusades of the eleventh and twelfth centuries. The establishment of the crusader hospitals, and even the order of the Hospitallers, is a combination of the house of hospitality and the more military-esque hospital of the Egyptians, Greeks, and Romans.
- 103.
Thompson and Goldin, The Hospital: A Social and Architectural History, 3–4.
- 104.
Documents from the First Council of Nicea [The First Ecumenical Council], Henry R. Percival, ed., The Seven Ecumenical Councils of the Undivided Church, Vol XIV of Nicene and Post Nicene Fathers, 2nd series, ed. Philip Schaff and Henry Wace (repr. Edinburgh: T&T Clark; Grand Rapids MI: Wm.B. Eerdmans, 1988). Fordham Internet Sourcebook, at http://sourcebooks.fordham.edu/halsall/basis/nicea1.txt, accessed 15 August 2016.
- 105.
Mollat, The Poor in the Middle Ages : An Essay in Social History, 19–20. This notion about the establishment of hospitals along roads is paramount when considering some of the developments highlighted in the previous chapter. Brussels arose along old Roman trade routes, and many of the cultural remnants of the new city were Roman in origin. The fact that Brussels came to embody so many hospitals in its medieval apex should not be a surprise given the fact that most hospitals formed along roads and in major cities.
- 106.
See Jonsen, A Short History of Medical Ethics, 13.
- 107.
Thompson and Goldin, The Hospital: A Social and Architectural History, 4–6.
- 108.
Peter Brown, Through the Eye of a Needle: Wealth, the Fall of Rome , and the Making of Christianity in the West 350–550 AD (Princeton: Princeton University Press, 2014), 68.
- 109.
Brown, Through the Eye of a Needle, 68.
- 110.
The Theodosian Code and Novels and the Sirmondian Constitutions, trans. Clyde Pharr (Princeton: Princeton University Press, 1980), 440–451.
- 111.
The Theodosian Code and Novels and the Sirmondian Constitutions, 440–451.
- 112.
Brown, Through the Eye of a Needle, 68.
- 113.
Brown, Through the Eye of a Needle, 70–71.
- 114.
Brown, Through the Eye of a Needle, 71.
- 115.
Ibid.
- 116.
Brown, Through the Eye of a Needle, 70.
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Ziegler, T.A. (2018). The Hospital in History, c. 3500 BCE–c. 500 CE. In: Medieval Healthcare and the Rise of Charitable Institutions. The New Middle Ages. Palgrave Pivot, Cham. https://doi.org/10.1007/978-3-030-02056-9_2
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