Abstract
Before examining the history of the hospital and charitable institutions, it is first necessary to understand some key developments and terms. This introduction considers the important partnership between Christianity and institutional care, the rise of urbanization in the high Middle Ages and the problems it created, and the response—including the creation of hospitals—that popular Christian movements, such as the vita apostolica activa, brought. After a brief survey of the medieval hospital of Saint John in Brussels, I define the following terms: healthcare, disease, illness, hospitals, and caritas. The introduction concludes with a discussion of why historians must examine the hospital of Saint John in a greater history of charitable institutions.
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Notes
- 1.
The term pseudo hospital refers to those institutions that were designed for another purpose but still had or maintained a hospital. The monasteries of the early Middle Ages are prime examples of pseudo hospitals—they were monasteries first, while hospital care was one of many secondary obligations.
- 2.
Michel Mollat, The Poor in the Middle Ages : An Essay in Social History, trans. Arthur Goldhammer (New Haven: Yale University Press, 1986), 87.
- 3.
See especially, Lester K. Little, Religious Poverty and the Profit Economy in Medieval Europe (Ithaca: Cornell University Press, 1978).
- 4.
For more on the development of cities throughout Europe, see David Nicolas, The Growth of the Medieval City: From Late Antiquity to the Early Fourteenth Century (New York: Routledge, 1997, 2014), and for the region of Brussels, see Alexandre Henne et Alphonse Wauters, Histoire de la Ville de Bruxelles (Bruxelles, 1968); and Ernest Smith, The Story of Brussels (Didactic Press, Kindle Edition, 2014).
- 5.
See Charles Homer Haskins, The Renaissance of the Twelfth Century (Cambridge: Harvard University Press, 1927).
- 6.
Traditionally, this phrase is attributed to one of two sources. The first comes from Bishop Aldabero of Laon on 1027/31. The second author is Bishop Gerard I (1012–51), a canon of Cambrai on 1023/4 and the bishopric from which the hospital of Saint John would later receive its statutes. Within one hundred years, the social structure would fall into transformation, making the distinction of three classes void. For more on both men, see Giles Constable, Three Studies in Medieval Religious and Social Thought (Cambridge: Cambridge University Press, 1998), 283–284.
- 7.
See Georges Duby, The Early Growth of the European Economy: Warriors and Peasants from the Seventh to the Twelfth Century (Ithaca: Cornell University Press, 1978).
- 8.
See Henri Pirenne, Medieval Cities: Their Origins and the Revival of Trade, trans. Frank D. Halsey (Princeton: Princeton University Press, 1925, 1969, 1975).
- 9.
See, for more on the concept of vita apostolica activa, Little, Religious Poverty and the Profit Economy in Medieval Europe and Mollat, The Poor in the Middle Ages : An Essay in Social History. Although mendicants and laymen alike were encouraged to live a life like that of Christ Jesus or his apostles, they could also follow the apostolic example of women like Mary and Martha. For more on this notion, see Katherine Ludwig Jansen, The Making of the Magdalen: Preaching and Popular Devotion in the Later Middle Ages (Princeton: Princeton University Press, 2000). Many of the concepts outlined in these works have been nicely condensed by Adam J. Davis, “The Social and Religious Meanings of Charity in Medieval Europe,” History Compass, Vol. 12, No. 12 (December 2014): 935–950.
- 10.
Matthew 5:3 RSV.
- 11.
Matthew 25:36 RSV.
- 12.
The crisis of urbanization not only precipitated social and communal evolutions but also new social and institutional structures, many of which came as responses by local churchmen and nobles, in addition to burghers and merchants, to remedy the unforeseen urban problems. Several scholars have identified these trends in areas throughout Europe, including Edward J. Kealey in his social history of Anglo-Norman medicine in the twelfth century and Sharon Farmer in her study on the poor men and women of thirteenth- and fourteenth-century France. Edward J. Kealey, Medieval Medicus: A Social History of Anglo-Norman Medicine (Baltimore: The John Hopkins University Press, 1981). Sharon Farmer, Surviving Poverty in Medieval Paris : Gender, Ideology, and the Daily Lives of the Poor (Ithaca: Cornell University Press, 2002, 2005). While both these and other works demonstrate that significant advances are being made in the study of the poor and the institutions created for them after the crisis of urbanization, there are still many gaps in scholarship, including coverage of the Low Countries in general and twelfth- and thirteenth-century Brussels specifically.
- 13.
Sharon Farmer, “From Personal Charity to Centralised Poor Relief: The Evolution of Responses to the Poor in Paris, c. 1250–1600,” in Experiences of Charity, ed. Anne M. Scott (Burlington: Ashgate, 2015), 42.
- 14.
This is the title given in the introduction to the charter. The word used is burgensibus. What is meant by the translation is not bourgeoisie, but rather the townsmen, particularly those of aldermen status. This makes sense in the hospital’s later history, as the town aldermen played a particularly important role in the institution and its affairs. For more on Brussels’ aldermen, see Alphonse Wauters, “Les Plus Anciens Écevins de la ville de Bruxelles,” Annales de la Société d’Archéologie de Bruxelles: Mémoires, Rapports et Documents, tome 8 (Bruxelles, 1894).
- 15.
Cartulaire de l’Hôpital Saint-Jean de Bruxelles (Actes des XIIe et XIIIe Siècles), ed. Paul Bonenfant (Brussels: Palais des Académies, 1953), SJ 2, pp. 5–7. The original is lost.
- 16.
Cartulaire de l’Hôpital Saint-Jean, SJ 4, pp. 8–10. The original is lost. Duke Henry I (1165–1235), in order to encourage bequests and donors, drew up an exemption in 1195 from military obligations for those who would retire to the hospital. Retirees would be liable for their payments on their fiefs and could no longer engage in their secular trades or pursuits, while the hospital would inherit their estates.
- 17.
Cartulaire de l’Hôpital Saint-Jean, SJ 5, pp. 10–13. CPAS, SJ 4.
- 18.
“fratribus hospitalis Brucellensis.” Cartulaire de l’Hôpital Saint-Jean, SJ 6, pp. 13–14. CPAS, SJ 4.
- 19.
The sisters too are noted in the charters: a 1209 document addresses the “fraters et sorores hospitalis beati Johannis in Bruxella.” See Cartulaire de l’Hôpital Saint-Jean, SJ 7, pp. 15–16. The original is lost.
- 20.
Cartulaire de l’Hôpital Saint-Jean, SJ 10, pp. 19–25. The original is lost.
- 21.
A general hospital can be used to describe a large institution that often results for the consolidation of smaller institutions. Saint John hospital seems to fit this definition when one considers that it started as a confraternity, served the retirees of the community, and then eventually transitioned to care of all individuals in need. While not as large as some of its contemporaries, it was large enough to serve the needs of Brussels. Furthermore, a general hospital is one that is open to the public. Saint John hospital and Saint Pierre Leprosarium were the only institutions to serve this need in Brussels. For more on the size of the hospital, its inmate population, and more see Chapter 5 of this work.
- 22.
Care at the hospital included everything from administering basic treatments, to providing for children and orphans, to helping women in their laying in periods and during birth, to providing hospice care.
- 23.
Sometimes prevention is also included as an element of healthcare.
- 24.
Healthcare.gov, “Public Health Care,” accessed 19 September 2017 at https://www.healthcare.gov/glossary/public-health/.
- 25.
Kenneth M. Boyd, “Disease, Illness, Sickness, Health, Healing and Wholeness: Exploring Some Elusive Concepts,” Journal of Medical Ethics: Medical Humanities, Vol. 26 (2000): 9–17, here 9.
- 26.
Boyd, 10.
- 27.
Michel Foucault, The Birth of the Clinic: An Archeology of Medical Perception, trans. A. M. Sheridan Smith (New York: Vintage Books, 1973, 1994), 3–4.
- 28.
Léopold Lambert, The Funambulist, “Foucault Episode 6: Architecture and Discipline: The Hospital,” accessed 22 September 2017 at https://thefunambulistdotnet.wordpress.com/2012/06/29/foucault-episode-6-architecture-and-discipline-the-hospital/.
- 29.
Michel Foucault, “La politique de la santé au XVIIIe siècle,” in Les Machines à guérir, Aux origines de l’hôpital moderne; dossiers et documents (Paris: Institut de l’environnement, 1976), 11–21.
- 30.
Michel Foucault, “La politique de la santé au XVIIIe siècle.”
- 31.
Ibid.
- 32.
Space, Knowledge and Power: Foucault and Geography, eds. Jeremy W. Crampton and Stuart Elden (New York: Ashgate/Routledge, 2016), 144.
- 33.
Monica H. Green, Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-modern Gynaecology (Oxford: Oxford University Press, 2008), 12. See also Monica H. Green, “Gendering the History of Women’s Healthcare,” Gender & History, Vol. 20, No. 3 (2008): 487–518.
- 34.
Monica H. Green, “‘History of Medicine’ or ‘History of Health’,” Past and Future, No. 9 (Spring/Summer 2011): 7.
- 35.
Monica H. Green, Making Women’s Medicine Masculine, 7–8.
- 36.
Rotha Mary Clay, The Medieval Hospitals of England (London: Frank Cass, 1966), 1.
- 37.
Pierre de Spiegeler, Les Hôpitaux et l’Assistance à Liège (Xe-Xve Siècles): Aspects Institutionnels et Sociaux (Paris: Sociéte d’Edition “Les Belles Lettres,” 1987), 47.
- 38.
Lisa M. Bitel, Women in Early Medieval Europe 400–1100 (Cambridge: Cambridge University Press, 2002), 95.
- 39.
Rotha Mary Clay, The Medieval Hospitals of England, 15.
- 40.
Rotha Mary Clay, The Medieval Hospitals of England, 17.
- 41.
Rotha Mary Clay, The Medieval Hospitals of England, 23.
- 42.
Rotha Mary Clay, The Medieval Hospitals of England, 211.
- 43.
A Latin Dictionary, “caritas,” eds. Charlton Lewis and Charles Short (The Clarendon Press and Oxford University Press, 1962), 292. See use, for example, by Cicero and Cato.
- 44.
Lewis and Short, A Latin Dictionary, 292.
- 45.
Ibid.
- 46.
James William Brodman, Charity and Religion in Medieval Europe (Washington, DC: The Catholic University of America Press, 2009), 3.
- 47.
James Brodman, Charity and Religion in Medieval Europe, 2–3. According to James Brodman, “charity exhibits several characteristics. First of all, it implies an altruism toward humanity, or at least toward those within society who were regarded as vulnerable, degraded, or in serious material need. […] Secondly, the concern for others is motived by a spirit that has a religious character and no merely one designed to preserve a particular social order by, for example, pacifying the poor. […] Finally and significantly, medieval religious charity was highly fragmented an inchoate; it never coalesced into a coherent or cohesive organization.”
- 48.
The chapel was a major source of income to the hospital; many donors made contributions on the condition that masses would be celebrated for them. See Pierre de Spiegeler, Les Hôpitaux et l’Assistance à Liège, 193–194.
- 49.
Many hospitals offer alternative therapies, from acupuncture, to energy healing, to yoga studios.
- 50.
To say that a history of charitable institutions and/or hospitals in the Middle Ages does not exist would be a lie. There are several histories, but those histories do not reveal the whole picture, especially in regard to hospitals. James Brodman’s Charity and Religion in Medieval Europe has made a phenomenal contribution to the field, especially in the context of lay generosity, charitable institutions, and religious support by the papacy. Brodman places new emphasis on the active role of the laity, detailing lay involvement in various charitable institution—including the hospital of Saint John in one chapter. Paramount, however, to understanding the further development of charitable institutions into hospitals is the urban milieu. The changes undergone by the laity, as Brodman highlights, are religious in nature, so much so that he sees religion as the only basis for a coherent movement in medieval society. He describes society’s response to charity as “highly fragmented and inchoate” arguing that it “never coalesced into a coherent or cohesive organization;” charity tended to be localized. Brodman, Charity and Religion in Medieval Europe, 2–3. While I find the assessment of religious charity correct, the idea of a fragmented, incoherent concern for the poor ignores societal, economic, and urban structural evolution. Many scholars, such as Sharon Farmer described above, are turning to this idea, as it is within the multiple transitions that the centralized municipal hospital was born. Sharon Farmer, “From Personal Charity to Centralised Poor Relief: The Evolution of Responses to the Poor in Paris, c. 1250–1600,” in Experiences of Charity, ed. Anne M. Scott (Burlington: Ashgate, 2015), 42.
- 51.
It should be noted that the lack of attention does not equate to a lack of all scholarship on Saint John hospital. Studies do exist, but they are outdated. Paul Bonenfant’s work, from the 1920s to 1965, for example, has helped to bring light to the institution’s existence. His efforts included a 1953 cartulary on the hospital. Although an invaluable source, the cartulary is written in French and not readily available to the English-speaking world. Moreover, as a cartulary, it contains 278 charters related to the hospital, but it is not a history of the hospital. Such a history still needs to be deconstructed from the charters of the cartulary, as well as from the extant charters that I have examined within the archives of Brussels. This book, however, is not an updated reassessment of Bonenfant’s work; much more can be learned from this remarkable institution. An assessment of the hospital in its social-historical context—that is to say within the development of the medieval town of Brussels, within the growth of the bishopric of Cambrai, and within the increased lay concern for those less fortunate—shows that Saint John was at the center of many developments in medieval Brussels. There, Saint John’s became the municipal hospital. Extant records from the institution and city archives prove these developments. Other material is drawn from the lives and acts of the bishops of Cambrai, including their mutual training at the University of Paris, the statutes of hospitals both near and afar, and the documentary history of the many peoples involved with the hospital throughout the twelfth and thirteenth centuries.
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Ziegler, T.A. (2018). Introduction. 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_1
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