Abstract
This chapter considers the rise of urban hospitals, their creation, their support, their administration, and their importance. Although still a religious institution, the medieval hospital transformed from a hospice and way station for pilgrims—as had been the case with the early monastery hospital—to a center for care of the urban poor and sick. Care was still overseen mostly by monks and nuns but greater public involvement, especially in administration, emerged. Moreover, the creation of the urban hospital was made possible through lay donations. The Peace of God Movements and the movements to live as Christ’s apostles spurred Christians from all levels of society to donate to an urban hospital focused on caritas in a manner akin to the Byzantine Basileias.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsNotes
- 1.
Edward Kealey, “Hospitals and Poor Relief, Western Europe,” in Dictionary of the Middle Ages , ed. Joseph Strayer (New York: Charles Scribner’s Sons, 1989), 6: 293.
- 2.
In addition, during the eleventh and twelfth centuries, much of Europe experienced widespread famine and disease, which generated greater need among the poor and sick. For example, the Chronicle of Sigebert of Gembloux [1126] “mentions ‘a great famine in Flanders and many paupers dead of hunger.’” See Mollat, The Poor in the Middle Ages , 60.
- 3.
Pierre de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 169–208.
- 4.
Mollat, The Poor in the Middle Ages , 87.
- 5.
Emily Jamroziak goes on to explain that these were probably located outside of the monastery. She also notes that “such institutions appeared to be a frequent fixture across Europe, but the relationship between ‘medical’ hospital and hospitals as shelters for the poor is much debated.” See Emily Jamroziak, The Cistercian Order in Medieval Europe: 1090–1500 (New York: Routledge, 2013), ebook.
- 6.
Gert Melville, The World of Medieval Monasticism: Its History and Forms of Life (Collegeville: Cistercian Publications Liturgical Press, 2012), 174.
- 7.
See especially, Lester K. Little, Religious Poverty and the Profit Economy in Medieval Europe (Ithaca: Cornell University Press, 1978).
- 8.
Kealey, “Hospitals and Poor Relief, Western European,” 6: 293.
- 9.
Augustinian Rule, chapter 5.
- 10.
Ibid.
- 11.
André Vauchez, The Spirituality of the Medieval West from the Eighth to the Twelfth Century, trans. Colette Friedlander (Kalamazoo: Cistercian Publications, 1993), 86.
- 12.
André Vauchez, The Spirituality of the Medieval West from the Eighth to the Twelfth Century, 130.
- 13.
Stephen D. White, Custom, Kinship, and Gifts to Saints: The Laudatio Parentum in Western France, 1050–1150 (Chapel Hill: The University of North Carolina Press, 1988), 155.
- 14.
White, Custom, Kinship, and Gifts to Saints, 29.
- 15.
Kealey, Medieval Medicus, 83.
- 16.
Mollat, The Poor in the Middle Ages , 95.
- 17.
For an alternative view, see R. I. Moore, who argues that “where money reigned supreme, the growing and increasingly menacing presence of the poor pointed to the necessity of providing for their control and, if necessary, their confinement or expulsion from the community.” R. I. Moore, The Formation of a Persecuting Society (Massachusetts: Blackwell, 1990), 106. Thus, it should not come as a surprise that many hospitals, especially leprosarium, were located outside the city walls. The hospital of Saint John, however, was an exception to this rule.
- 18.
The Hospital in History, Granshaw and Porter, 21.
- 19.
Clay, The Medieval Hospitals of England, 23. The so-called gentlefolk could move around as they pleased from ward to private room, where as those with plague or disease were limited to the confines of their ward. Money could buy privacy, and the elderly with means could use hospitals as a kind of retirement home.
- 20.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 112.
- 21.
Carole Rawcliffe, Medicine and Society in Later Medieval England (Phoenix Mill: Alan Sutton Publishing, 1995), 205.
- 22.
Rawcliffe, Medicine and Society in Later Medieval England, 205. Edward Kealey further notes that hospitals “could be centers for poor relief; clinics; dispensaries; homes for indigent students; hostels for travelers; leprosaria for people of all ages and classes; residences for the blind, the elderly, the mentally ill, and the orphaned; and the multi-department complexes with large professional staffs.” See Edward Kealey, “Hospitals and Poor Relief, Western Europe,” in Dictionary of the Middle Ages , ed. Joseph Strayer (New York: Charles Scribner’s Sons, 1989), 6: 294.
- 23.
The Hospital in History, Granshaw and Porter, 25.
- 24.
A range of hospitals existed in terms of authority. Some hospitals did not have a permanent altar or were not dependent on Episcopal authority. See de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 106.
- 25.
Clay, The Medieval Hospitals of England, 211.
- 26.
Ibid.
- 27.
See above for more on the Benedictine Rule, used in early medieval monastic hospitals, and the Augustinian Rule, used in later hospitals.
- 28.
Clay, The Medieval Hospitals of England, 194.
- 29.
Clay, The Medieval Hospitals of England, 194–195. Furthermore, “royal interest helped multiply the numbers of doctors, hospitals, and medical books, and this expansion gave health care a higher governmental priority than it might otherwise have enjoyed.” Kealey, Medieval Medicus, 25.
- 30.
James Brodman explains that one can get a sense of size from inventories. See Brodman, Charity and Religion, 62.
- 31.
The Hospital in History, Granshaw and Porter, 26. Although the most prevalent, the open-ward style was not the only one. Greek and Roman wards designed around an open courtyard did exist as discussed earlier. Many hospitals did indeed take this form, but even so, the open-ward system was by far the preferred choice. See Kealey, Medieval Medicus, 84.
- 32.
The open-ward system was “taken over from the monasteries, adapted, enlarged, refined, and eventually mass-produced. […] The form prevailed for nearly four centuries.” Thompson and Goldin, The Hospital: A Social and Architectural History, 20–21.
- 33.
The location of most of the early modern hospitals was next to or near a cathedral cloister, but in later periods, hospitals began to appear elsewhere. Because of the possibility of disease and contamination, some hospitals were built in undesirable areas, and typically the institutions were located outside city walls in order to contain disease. In other cases, especially in those of the leprosaria, the institutions were located along the rivers and waterways. Brodman, Charity and Welfare, 62. For more on leprosaria and the reaction of the public, see R. I. Moore, The Formation of a Persecuting Society, 42–56. Finally, to insure security, safety, and order, many hospitals were surrounded with a wall and a towered gate.
- 34.
Thompson and Goldin, The Hospital: A Social and Architectural History, 24.
- 35.
Such was the case of the hospital de Santa Cruz in Barcelona in the fifteenth century, which had four large halls that all opened into one another and into a large hall. See Thompson and Goldin, The Hospital: A Social and Architectural History, 30.
- 36.
Clay, The Medieval Hospitals of England, 158. Hospitals were often adorned with religious paintings and carvings in the chapels, often of patron saints and many had religious books and religious implements, such as plates and vestments. It should not come as a surprise that “many valuables fell a (sic.) prey to dishonest wardens.” Clay, The Medieval Hospitals of England, 164.
- 37.
Clay, The Medieval Hospitals of England, 158.
- 38.
Clay, The Medieval Hospitals of England, 176.
- 39.
Clay, The Medieval Hospitals of England, 172.
- 40.
The Hospital in History, Granshaw and Porter, 29.
- 41.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 193.
- 42.
Clay, The Medieval Hospitals of England, 197.
- 43.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 193–194.
- 44.
Clay, The Medieval Hospitals of England, 197.
- 45.
Clay, The Medieval Hospitals of England, 152.
- 46.
See Clay, The Medieval Hospitals of England, 154.
- 47.
The Hospital in History, Granshaw and Porter, 32.
- 48.
See Kealey, Medieval Medicus, 108–109.
- 49.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 112.
- 50.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège, 106.
- 51.
De Spiegeler notes that the power of the city in association with the hospital varied from city to city. de Spiegeler, Les Hôpitaux et l’Assistance à Liège, 122.
- 52.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège, 147.
- 53.
Ibid.
- 54.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 135.
- 55.
Kealey, “Hospitals and Poor Relief, Western Europe,” 6: 295.
- 56.
Clay, The Medieval Hospitals of England, 138.
- 57.
de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 133.
- 58.
Clay, The Medieval Hospitals of England, 149. In the case of Saint John’s hospital in Brussels, the masters and mistresses were brothers and sisters of the hospital community.
- 59.
The warden/master was drawn from the ranks of the brothers, and was also known as “prior, custos, keeper or rector.” Norman Moore, The History of St. Bartholomew’s Hospital, Vols. I and II (London: C. Arthur Pearson Limited, 1918), 288.
- 60.
Clay, The Medieval Hospitals of England, 150.
- 61.
Clay, The Medieval Hospitals of England, 151. Although a much later example, a fifteenth-century founder regulation displays some of these characteristics. It instructs that the master of Ewelme “must be an able and well-disposed person in body and soul, one who could counsel and exhort the poor men to their comfort and salvation. He had to conduct frequent services, and was warned to omit none—not even ‘for plesaunce of lorde or lady.’” Clay, The Medieval Hospitals of England, 151. In another example, we learn of a basic function of the master as the person responsible for overseeing the acquiring and purchasing cloths for the hospital: “William Hardel, Mayor of London in 1215–16, was witness of a charter of Alexander of Norfolk, in which he grants to St. Bartholomew’s Hospital, his house outside the gate of St. Paul’s, toward the sought and opposite the brewery of the cannons of St. Paul’s in the parish of St. Gregory. With its rent they are to buy the clothes necessary ‘in tulchia magna hospitalis’ for the poor staying there at night—according to the direction of the master.” Moore, The History of St. Bartholomew’s Hospital, 320–321.
- 62.
Kealey, Medieval Medicus, 104.
- 63.
Kealey, Medieval Medicus, 105.
- 64.
Edward Kealey provides a table of the known physicians in England from 500 to 1154. See Kealey, Medieval Medicus, 31.
- 65.
Brodman, Charity and Religion, 86.
- 66.
James Brodman explains that “by the thirteenth century, there [were] signs that medical care was being introduced into a few institutions. […] The Hospitaller Order of Saint John [was] particularly influential in this development because, as early as its statues of 1182, the order maintained four physicians at its large hospital in Jerusalem to diagnose disease and prescribe medicine.” Care such as this only arrived in Catalonia, Spain, by the end of the fourteenth century. Even so, “records of late medieval hospitals show that the sick comprised substantial proportions of the inmate population, indicating that the transformation of these institutions from mere shelters to facilities dispensing medical care was indeed well underway.” See Brodman, Charity and Religion, 93.
- 67.
The Augustinian Rule argued that “if the cause of a brother’s bodily pain is not apparent, you make take the word of God’s servant when he indicates what is giving him pain. But if it remains uncertain whether the remedy he likes is good for him, a doctor should be consulted.” The Rule of Saint Augustine .
- 68.
Brodman, Charity and Religion, 96.
- 69.
The Hospital in History, Granshaw and Porter, 31. Rarely did the leper or almshouses provide medical care. Also, the institutions specifically designed for travelers and pilgrims typically did not provide care. The Hospital in History, Granshaw and Porter, 24.
- 70.
Rawcliffe, Medicine and Society in Later Medieval England, 194.
- 71.
Sometimes it was left to him to deliver a sermon, so his role was both spiritual and administrative. When the traffic in indulgences began, the proctor became a “pardoner.” Clay, The Medieval Hospitals of England, 153.
- 72.
Moore, The History of St. Bartholomew’s Hospital, 378.
- 73.
Clay, The Medieval Hospitals of England, 155.
- 74.
Brodman, Charity and Religion, 50.
- 75.
Brodman, Charity and Religion, 51. There were times, however, obedience fell to the job of the warden: “On the next day but one after Hugh’s death the king committed to Brother Maurice, chaplain of the house of the Temple in London, the care and keeping of the Hospital of St. Bartholomew till the king with his justiciar should come to London and arrange more fully as to the ruling of the same, and the brethren and sisters of the hospital were commanded meantime to be attentive and obedient to the aforesaid Brother Maurice as to their warden.” Moore, The History of St. Bartholomew’s Hospital, 373.
- 76.
Brodman, Charity and Religion, 51. With so many duties, it should not come as a surprise that some hospitals were prosperous and others were not. Brodman, Charity and Religion, 53.
- 77.
Clay, The Medieval Hospitals of England, 17.
- 78.
See de Spiegeler, Les Hôpitaux et l’Assistance à Liège , 181; Moore, The History of St. Bartholomew’s Hospital, 339.
- 79.
Moore, The History of St. Bartholomew’s Hospital, 401–402.
- 80.
Clay, The Medieval Hospitals of England, 183–191.
- 81.
Brodman, Charity and Welfare, 64.
- 82.
Mollat, The Poor in the Middle Ages , 152.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2018 The Author(s)
About this chapter
Cite this chapter
Ziegler, T.A. (2018). High Medieval Charitable Institutions and Hospitals, c. 1000–1300 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_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-02056-9_4
Published:
Publisher Name: Palgrave Pivot, Cham
Print ISBN: 978-3-030-02055-2
Online ISBN: 978-3-030-02056-9
eBook Packages: Literature, Cultural and Media StudiesLiterature, Cultural and Media Studies (R0)