Many contemporary saints’ lives, especially those of female saints, emphasize these women’s support of the poor and sick through the establishment of hospitals. The attachment of hospitals to monasteries continued to be an integral feature of Christian missionary activity, especially in the conversion of northern Europe.
Monasteries and Hospitals
The 6th century ‘Rule of Saint Benedict’, the founding document of the Benedictine Order of monks, envisioned the individual monastery as an extended household under the rule of an abbot and stipulated that it include a separate room set aside for the sick. There, Benedict directed, “They will be served as if they were Christ in person; for He Himself said, ‘I was sick, and you visited me’, and, ‘What you did for one of these least ones, you did for me’.” These well-known quotations from the gospel of Matthew were foundational to the medieval Christian rationale for the establishment of hospitals.
An extraordinary visualization of an ideal monastery complex, the Plan of Saint Gall, made in the 9th century, includes a separate cloister for the sick with its own chapel, refectory, store room, kitchen, bath house, special rooms for the critically ill and for bloodletting or surgery, as well as a garden of medicinal herbs. Even if the real monastery of Saint Gallen, now in Switzerland, never featured all of these amenities, the Plan reveals that this is the level of care which the community aspired to provide.
Need for Public Health Care
With the rapid urbanization of the medieval world, driven to no small degree by these monastic foundations, came the need for public health care and other social services on a larger and more variable scale. By the year 1000, both medical knowledge and the quality of accommodations for the sick in the eastern Roman Empire and the many Islamicate states had far surpassed that of Latin Europe. Baghdad, the capital of the Abbasid caliphate, had at least six hospitals, the first having been founded by Harun al-Rashid in the early 9th century, and affluent Muslim-ruled cities like Damascus and Córdoba were also major sites of medical experimentation and practice.
North of the Mediterranean, the great era of hospital foundations in Christendom was the 12th and 13th centuries, with much of that activity being linked to the founding of new religious orders, like the Cistercians and Franciscans, but also involving lay charitable institutions like confraternities and trade guilds, as well as municipal governments and aristocratic patrons.
As the historian Anne Lester has shown, with a special focus on the densely populated mercantile towns and seasonal fairs of Champagne, the building of hospitals, infirmaries, and hostels transformed not just cities but suburbs and rural areas to create what she calls “a new charitable landscape” featuring a variety of purpose-built or repurposed spaces to serve the needs of the indigent poor, sick travelers and pilgrims, or the chronically ill.
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Advertising Town’s Civic Values and Hospitality
Moreover, these spaces were not sequestered from their communities, but instead aligned with familiar public gathering places. Privately funded infirmaries or small hospitals, with just a handful of beds, were often established at or just inside the gates of a town, to serve the needs of visitors and also to advertise the town’s civic values and hospitality. In the center of town, a larger domus Dei or Hôtel-Dieu (a house or hostel of God) would be maintained by the citizens as a major monument to the community’s virtues and sound governance: these remain today in many northern European towns as hôtels de ville (town halls).
All of these foundations not only redrew the maps of towns but also reshaped their skylines and soundscapes, since most such institutions would have a bell with its own bell tower. And because hospitals needed to be maintained, as well as founded, these were multigenerational efforts that involved the cooperation of family and neighborhood networks over long periods of time.
In England, as in Flanders, the Low Countries, France, and other regions of northern and eastern Europe, the founding of new towns or the expansion of an existing urban footprint were processes usually accompanied by ambitious projects of public charity. As forms of urban government were created or strengthened, hospitals were both tools and expressions of communal power. They were also a means for encouraging tourism or pilgrimage to local churches.
At the same time, local lords also founded hospitals, not only on their seigneurial estates but also in major cities, as testaments to their wealth and charity. In all cases—whether ecclesiastical, municipal, or lordly—patrons strove to outdo one another in the size, comforts, and impressive architecture of the hospital building—one reason why a rather surprising number of medieval hospitals still survive, and some of them even continue to function as hospitals.
Common Questions about Hospitals in Medieval World
The 6th century Rule of Saint Benedict, the founding document of the Benedictine Order of monks, envisioned the individual monastery as an extended household under the rule of an abbot and stipulated that it include a separate room set aside for the sick.
Privately funded infirmaries or small hospitals, with just a handful of beds, were often established at or just inside the gates of a town, to serve the needs of visitors and also to advertise the town’s civic values and hospitality.
In the center of town, a large domus Dei or Hôtel-Dieu (a house or hostel of God) would be maintained by the citizens as a major monument to the community’s virtues and sound governance: these remain today in many northern European towns as hôtels de ville (town halls).