Medieval Healthcare and the Rise of Charitable Institutions

The History of the Municipal Hospital

Tiffany A. Ziegler

• Publisher: Palgrave Pivot
• Year: 2018
• ISBN:
  9783030020569
• Topic: Literature
• Subtopic: Medieval & Early Modern Literary Criticism
• Index: Literature

Medieval Healthcare and the Rise of Charitable Institutions: The History of the Municipal Hospital examines the development of medievalinstitutions of care, beginning with a survey of the earliest known hospitalsin ancient times to the classical period, to the early Middle Ages, and finally to the explosion of hospitals in the twelfth and thirteenth centuries. For Western Christian medievalsocieties, institutional charity was a necessity set forth by the religion's dictums—care for the needy and sick was a tenant of the faith, leading to a unique partnership between Christianityand institutional care that would expand into the fledging hospitalsof the early Modern period. In this study, the hospitalof SaintJohn in Brusselsserves as an example of the developments. The institutionfollowed the pattern of the establishment of medieval charitable institutions in the high Middle Ages, but diverged to become anarchetype for later Christian hospitals.

© The Author(s) 2018

Tiffany A. ZieglerMedieval Healthcare and the Rise of Charitable InstitutionsThe New Middle Ageshttps://doi.org/10.1007/978-3-030-02056-9_1

Begin Abstract

1. Introduction

Tiffany A. Ziegler¹

(1)

Department of History, Midwestern State University, Wichita Falls, TX, USA

Tiffany A. Ziegler

Email: [email protected]

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.

Keywords

Hospital of Saint JohnHospitalsHealthcareDiseaseIllness Caritas

End Abstract

Introduction

One of contemporary society’s major concerns is healthcare; yet, healthcare is, and has always been, an age-old concept that has long plagued humankind. Queries often appear in today’s news: should healthcare be public or private? If public, which public entities should care for the health of individuals: the state, religious groups, others? Should healthcare be free? What exactly constitutes healthcare? While some of these questions are difficult to answer—governments struggle on a daily basis to come up with solutions—others might be addressed by looking to history. Interestingly, the question of public versus private care is not new and not limited to modern medicine; it was one of many of the same problems that afflicted peoples of medieval society when it came to healthcare. While we may not be able to fully understand our current system of healthcare through a study of the Middle Ages, a systematic study of medieval healthcare and charitable institutions in the high Middle Ages, primarily from the perspective of the hospital, is a good place to start to look for answers.

This book is a systematic study of medieval healthcare and the rise of charitable institutions with a focus on the high medieval hospital. The purpose of this work is to introduce the institution of the hospital and society’s obligation to care for those in need to a broad audience, as much of the work has previously been in the domain of specialists. Although the history of the hospital must begin with the rise of the first civilizations, which will be explored in the first chapters of this book, the history of the institution within its medieval context creates the basis for understanding the municipal hospital. The hospital of the Middle Ages, although analogous in many ways, took on a different character than their ancient predecessors and near eastern contemporaries: for Christian medieval societies, institutional charity was a necessity set forth by the religion’s dictums—care for the needy and sick was a tenant of the faith, leading to a unique partnership between Christianity and institutional care. This partnership created a distinctive Christian hospital that would expand throughout the Middle Ages into the fledging hospitals of the early Modern period and the predecessors of today’s institution.

The Development of the Medieval Municipal Hospital

The medieval municipal hospital developed thanks to a unique combination of events that transpired in the Middle Ages. Beginning, in the early Middle Ages, monasteries and monks provided care for those who were sick and injured; their institutions served as pseudo hospitals.¹ Although the main caregivers, monasteries were, by the twelfth century, overtaxed and burdened and could no longer support an increasing population in Europe.² By 1130, the Council of Clermont prohibited monks and clergy from practicing medicine. The high Middle Ages brought about a resurgence of trade and a blossoming of cities teaming with inhabitants: crowded in the confines of a city, the poor and sick became increasingly visible. For the first time since the fall of the Roman Empire, socially displaced poor and sick people began to plague the streets of European cities. These people were victims of the success of urbanization.³ Recently forced both into despair and the view of the public through the loss of personal ties that had been a hallmark of village society, the displaced poor and sick became constant reminders that with all its wonders, urbanization also brought serious problems. Without monasteries, to whom would the poor and sick turn?

During the twelfth and thirteenth centuries, urbanization created a wonderful predicament in the towns and cities of Europe. Towns blossomed, and in many places, village settlements exploded into formidable cities.⁴ While the immediate effects of urbanization included more croplands, better diets, increased trade and commerce, better learning, and an overall “renaissance,”⁵ the long-term benefits were not always immediately realized. In the transition, a watershed occurred: traditional early medieval society had been classified as a “tripartite society” of those who pray, fight, and work.⁶ The rise of cities, however, precipitated the growth of trade and commerce, and created professions for which the traditional divisions did not account, i.e., merchants and burghers.⁷ This new merchant-burgher class not only challenged the bounds of tripartite society and created a social upheaval, but also began to dictate a new set of social norms.⁸

As society moved from a land-based economy and barter society to a cash society, lands and rents once limited to only the upper nobility became available to lesser nobles, who were now able to participate in some of the more earmarked customs and traditions, especially in regard to land donations. Armed with lands and rents and motivated by the visible crowds of the sick and poor, an explosion in lay piety via land donations thus coincided with urban developments and provided much-needed help in the immediate period. Men and women alike sought out a life inspired by that of Christ Jesus and his Apostles (vita apostolica activa).⁹ They took to heart Jesus’ Sermon on the Mount, “Blessed of are the poor…,”¹⁰ while those who had provided care would find eternal salvation, thanks to the biblical dictum, “I was sick and you took care of me.”¹¹

Renewed care for the poor and sick continued to be an expression of Christ’s compassion for those too weak to care for themselves and was initially introduced to municipal areas with poor tables, confraternities, leprosaria, and monastic hospitals, which were created to feed, clothe, provide shelter for, and heal those in need. Although religious institutions were largely tied to the dissemination of goods and care, changes in society and the economy provided for greater lay participation, especially after monasteries were forbidden to provide medical care.

Subsequently, the urban center became a breeding ground for charitable and medicinal care,¹² especially in the thirteenth century with the rise in Mariological devotion. The thirteenth century witnessed increasing reliance on the Virgin Mary as the Mother of Mercy (mater misericordiae) and as an intercessor between Christ and sinners. This trend solidified the concept of love of neighbor as opposed to love of God. The suffering Christ was replaced with Christ on judgment day who would judge men and women. The average Christian could only hope to please this new Christ through the human and understanding Virgin Mary and through charitable care of one’s neighbors. Institutions—poor tables, confraternities, leprosaria, etc.—thus appeared throughout the bourgeoning cities. It was, however, the medieval hospital that became the ideal repository for the gifts of the concerned classes.

While civic and municipal hospitals arose all throughout Europe, one of the defining locations for the hospital movement was in the modern city of Brussels where a particular institution, the hospital of Saint John, arose to become an excellent example of the medieval municipal hospital. Brussels, specifically, and the Low Countries in general, were some of the first places to address the new urban issues systematically. By the twelfth century, Brussels had several hospitals, a leprosarium, poor tables, and even the remnants of monastic hospitals. While the existence of many institutions could seem like what has been called the “private” and “ad hoc nature of medieval charity,”¹³ it ...

Table of contents

• Cover
• Front Matter
• 1. Introduction
• Part I. The History of the Hospital
• Part II. Case Study of the Hospital of Saint John
• Part III. The Birth of the Municipal Hospital
• Back Matter