Life In A Medieval Hospital

0:00What do the words hospital, hotel,

0:02hostel, and hospice all have in common?

0:04They all refer to a place where you can

0:06stay for some amount of time. Now, these

0:09days you probably don't want to be

0:10staying at a hospital while you're

0:11traveling on vacation.

0:13Ideally, anyway. And that's because each

0:16of these terms in modern English means

0:17something different, something distinct.

0:20But that wasn't always the case. Each of

0:23these terms arise out of the Latin word

0:25hospitium, meaning the relationship

0:27between a host and a guest, hospitality.

0:31The connection brings us back to the

0:32Middle Ages and the medieval hospital,

0:34because medieval hospitals, hospitia,

0:37were not just hospitals in the modern

0:38sense. They were also hotels, hostels,

0:41and hospices all in one. On top of that,

0:44they were also almshouses, retirement

0:47homes, schools, student housing,

0:50churches, charities, orphanages, and so

0:53much more. The medieval hospital was

0:55such an incredibly important institution

0:57for so many people, especially those in

1:00cities and towns, but also for those in

1:01the countryside as well. But how did it

1:04all work? Sure, I just threw a bunch of

1:06words at you and said this is what they

1:07were, but what does that mean? What do

1:10you even do in a medieval hospital?

1:14>> [music]

1:22>> If we're going to talk about medieval

1:23hospitals, we have to recognize that

1:25these weren't hospitals in the modern

1:27sense. Today, a hospital is a place you

1:30go to if you're sick or injured or

1:32otherwise need medical attention. And

1:34although medieval hospitals were indeed

1:36places for the sick, they weren't

1:38exclusively so. In fact, it's rather

1:41difficult to give a simple definition

1:43for the medieval hospital because they

1:45were so many different things, and

1:47because so many hospitals had their own

1:49ways of defining and approaching their

1:51own roles. As the historian James

1:53Brodman puts it, quote, "So pervasive

1:56and diverse was the hospitaler

1:57phenomenon in the Middle Ages that it

2:00almost defies generalization.

2:02But almost only counts in horseshoes, so

2:04we're going to try anyway. Rather than

2:06being defined by the sick, as hospitals

2:08are today, medieval hospitals were

2:10defined more by the poor. Pauperes being

2:13the Latin term we often see in their

2:15charters and statues. And when I say

2:17poor, I don't necessarily mean a

2:19socioeconomic class here. Poor is more

2:22of a state of being in the medieval

2:24worldview, and it could be quite

2:26temporary. A knight who has fallen on

2:28hard times can be poor. So can a

2:30pilgrim, regardless of their background.

2:32Likewise, anyone who is sick would also

2:34be considered poor. The poor who were

2:37staying at hospitals were those in a

2:38state where they could use some help.

2:40Anyone who required some kind of care.

2:43In practice though, this was primarily

2:45those who we in the modern day would

2:47call the poor, since money, rank, and

2:50status often granted other kinds of

2:52support. But anyway, the domain of the

2:55hospital, what they were by and large

2:56for, was care for the poor.

2:59Sometimes that meant shelter, sometimes

3:01clothes or food, sometimes it was more

3:04involved like physical assistance in

3:06day-to-day activities, and sometimes

3:08hospitals provided a sense of belonging

3:10or community. As we'll discuss later,

3:12not every hospital did all of these

3:14things, or did them all in the same way.

3:17But some form of charitable care was

3:19what made a hospital a hospital, a house

3:22of hospitality.

3:23Something else which hospitals pretty

3:25much all shared was a highly religious

3:27character. The hospitals we're talking

3:29about here are those in medieval Latin

3:31Christendom, and so the religion in

3:33question is Catholic Christianity.

3:36Now, Christianity, since its origin, has

3:38placed a great deal of importance on

3:40charity and care for the poor. In the

3:42Gospel of Matthew, Jesus says of those

3:44that will inherit the kingdom of God,

3:45quote, "I was hungry and you gave me

3:48food. I was thirsty and you gave me

3:50something to drink. I was a stranger and

3:52you welcomed me. I was naked and you

3:55gave me clothing. I was sick and you

3:57took care of me. I was in prison and you

3:59visited me.

4:01Truly, I tell you, just as you did it to

4:03one of the least of these brothers and

4:04sisters of mine, you did it to me.

4:07This care for the poor and the meek is

4:09one of the things which helped

4:10Christianity spread so successfully

4:12amongst the urban lower classes of

4:13ancient Rome. And although Christian

4:16leadership tended to become more

4:17aristocratic, especially as Christianity

4:20became the official religion of the

4:21empire and its successors, many of them

4:23continued to place a great deal of

4:25importance on care for the poor. And

4:27these wealthier Christian leaders could

4:29often use that wealth to establish

4:31places where the poor could be cared

4:33for, which they started doing quite

4:34early on. A great example of this would

4:37be Caesarius of Arles, who was bishop of

4:39the city of Arles in the early 6th

4:41century, the very beginning of the early

4:43Middle Ages. Caesarius was a man known

4:46for his many charitable works, and one

4:48of those was to build a house for

4:49feeding and sheltering the city's poor.

4:52Another example of an early medieval

4:53hospital is the Hôtel-Dieu in Paris, one

4:56of the most famous medieval hospitals,

4:58which is still in use today, making it

5:00possibly the oldest continuously

5:02operated hospital in the world. Its

5:04foundation is traditionally attributed

5:06to Bishop Landry of Paris in 651, though

5:09the earliest written record of it comes

5:11from 829. Still pretty early. The

5:14attention to mutual care also made its

5:16way into Christian monasteries. In the

5:18rule he wrote for his monks at Monte

5:20Cassino, Benedict of Nursia included

5:22sections discussing the importance of

5:24taking care of their sick brothers. Sick

5:26monks would stay in a separate infirmary

5:28building where they could recover, and

5:30were allowed to eat meat, and eat and

5:33bathe more frequently. The rule even

5:35specifies that special care should be

5:36given to the needs of the sick, and that

5:38they should never be neglected. The Rule

5:41of Saint Benedict would become one of

5:42the most popular monastic rules in Latin

5:44Europe, and Benedictine monasteries

5:46would pop up all over the place. And

5:49even though monasteries were

5:50theoretically supposed to be

5:52self-contained and completely separate

5:54from the rest of society, so that monks

5:56could focus on a life devoted to God,

5:58in practice, the Christian emphasis on

6:00care for others meant that many of these

6:02monasteries wound up taking care of the

6:04sick poor from outside as well, often in

6:07a separate infirmary just for guests. It

6:10also helped that since monks were some

6:11of the most educated people in medieval

6:13Europe, and the rule of St. Benedict

6:15specifically calls for time to read and

6:17study, they also had some of the best

6:19medical knowledge of the day.

6:21But on top of medical care, many

6:24monasteries also had guest houses for

6:26travelers, and especially pilgrims, with

6:28pilgrim shelters popping up all along

6:30major pilgrimage routes, like in

6:32northern Spain along the road to

6:34Santiago de Compostela.

6:36But despite these earlier hospitals and

6:38infirmaries, the medieval hospital

6:40phenomenon would really come into its

6:42own in the latter half of the Middle

6:43Ages. Starting in the 11th century, and

6:46then really ramping up in the 12th and

6:4813th, hospital foundations exploded in

6:51number. People started establishing more

6:54hospitals than ever before, of every

6:56shape and kind. And by the late 1100s,

6:58hospitals started getting written

7:00statutes outlining their purpose and how

7:02they would be run. Some hospitals, in

7:04fact, probably most hospitals, were

7:07small buildings with a few staff who

7:09cared for a small number of people. Here

7:11the staff were typically salaried

7:13employees or volunteers. But

7:15unfortunately, very little evidence of

7:17them remains, so we don't always know a

7:20whole lot about them.

7:21Larger institutions were typically run

7:23by a religious community, men and women

7:26who often took religious vows of some

7:27kind and lived in common on the

7:29hospital's grounds. These communities

7:31usually numbered somewhere around 10 to

7:3314 people, though there could be more or

7:36fewer. For example, Paris's Hôtel-Dieu

7:39had a community numbering 63, an

7:41exceptionally large number for an

7:43exceptionally large hospital. These

7:45communities might be supported by hired

7:47help to clean linens or make repairs or

7:49whatnot, but it was not uncommon for

7:51these religious brothers and sisters to

7:53do these tasks themselves. In some

7:55hospitals, depending on the statute, the

7:57poor might also be considered a part of

7:59the overall community and be expected to

8:02help out as well. Pretty much every

8:04hospital also had at least one priest

8:06who attended to the spiritual needs of

8:08the poor. They might be members of the

8:10hospital's religious community or

8:12outside visitors.

8:13Priests heard confessions and celebrated

8:15mass at the chapel, which hospitals

8:17almost always had. In some cases, the

8:20hospital's chapel was effectively the

8:21main church of the parish and its priest

8:24was also the parish priest.

8:26The growing number of hospitals at this

8:28time was likely the result of several

8:29factors coming together in the High

8:31Middle Ages. For one, urbanism was

8:34growing. There were more and more towns

8:36and cities and those cities were getting

8:38larger. With that came urban poverty as

8:41people moved to cities to try and

8:42improve their lives, but in doing so cut

8:45themselves off from some of their

8:46traditional sources of support, family

8:49and village community. It also just

8:51generally concentrated the poor into a

8:53single area where they might otherwise

8:55be much more spread out. By the High

8:57Middle Ages, many people who were poor

8:59in the country would try to move to the

9:01city to try and find new opportunities,

9:03assuming doing so was possible.

9:06But on top of there being more poor

9:08people who could use hospitals, there

9:10were also increasing ideological

9:12influences for their founding and

9:13support as well. The concept of

9:15purgatory, a place where repentant

9:17sinners would go to work off or purge

9:19the residue of their sins before

9:21reaching heaven, was developing at this

9:23time. And since only the holiest of

9:25saints were pure enough to go straight

9:27to heaven after death, most people were

9:29going to spend some time in purgatory.

9:32Along with this came the idea that

9:33prayer and good works in life could help

9:35one get into heaven faster, and those

9:38good works included helping the poor

9:40both directly as the communities of

9:42brothers and sisters working in

9:44hospitals did, but also indirectly

9:46through donations to hospitals and other

9:48forms of support. Likewise, prayers for

9:51the dead would help them get through

9:52purgatory faster, and the prayers of the

9:55poor were thought to be especially

9:56powerful. So, donors and founders often

9:59supported hospitals with the explicit

10:01request that the religious community and

10:03the poor pray for them, with many

10:05donations being made in wills. Connected

10:08to this, we also see an increasing

10:09importance placed on pilgrimage, with

10:11pilgrimages also being a sort of

10:13pre-purgatory, skip the line, get in

10:15faster kind of deal, helping purge some

10:17of one's sins before death. But, since

10:20pilgrims were also amongst the poor,

10:22helping them was also a good deed, and

10:25we see lots more hospitals established

10:27to shelter pilgrims showing up at this

10:29time. In fact, the single largest

10:31hospital in the whole Latin Christian

10:33world in the Middle Ages was probably

10:35the Hospital of St. John in Jerusalem,

10:37which was the home base of the Order of

10:39St. John, sometimes called the Knights

10:41Hospitaller, until 1187.

10:44The Jerusalem Hospital was primarily a

10:46shelter for Christian pilgrims coming to

10:47Jerusalem, the most holy city in

10:49Christianity, and it's estimated to have

10:51been able to house over a thousand

10:53people. Most other hospitals housed

10:56fewer than a hundred.

10:58But, St. John in Jerusalem didn't only

11:00care for pilgrims. It took care of sick

11:02locals as well, including Muslims and

11:04Jews, by the way. And generally

11:06speaking, most hospitals were well,

11:09general, caring for all kinds of poor.

11:12However, few hospitals took in

11:14absolutely everyone. Some hospitals

11:17tended to provide care for those who

11:18would come and go, people with an

11:20illness which could be cured, people on

11:22death's door who needed palliative care

11:24for their final days, pilgrims who were

11:26coming and going, or people who needed a

11:28little bit of support while they got

11:30their lives back on track. These

11:32hospitals sought to help a large number

11:34of people. What they didn't want were

11:36people with chronic illnesses or

11:38disabilities who would take up beds and

11:40resources indefinitely, which could have

11:42been used to help countless others. On

11:45the other hand, you also had hospitals

11:47established specifically for these kinds

11:49of people. Hospitals for the blind, for

11:51example, who are not only chronic, but

11:53also require a special amount and kind

11:56of attention and assistance. One of the

11:58best-known hospitals for the blind was

12:00the Quinze-Vingts in Paris, founded by

12:02Louis the Ninth or Saint Louis, which

12:04remains a center for eye care to this

12:06day. Its name, literally 15-20s, refers

12:10to the 300 beds it originally had. The

12:13case was similar for hospitals for

12:15abandoned children and orphans, who

12:17sometimes weren't accepted at more

12:19general hospitals, though some statutes

12:21allow for the care of children whose

12:22parents died in the hospital.

12:25The care of children was thought to be

12:26particularly financially burdensome, as

12:29was the care for the elderly.

12:31Now, ideally in medieval society, the

12:33elderly would be cared for by their

12:35families, their children and

12:36grandchildren, or maybe their in-laws.

12:39But some families couldn't afford to

12:41take on this task, or weren't equipped

12:43to give their elder relatives the care

12:45they needed, or sometimes they just

12:46didn't get along. In these cases, a

12:49hospital was their best bet.

12:51Even if other resources were available,

12:53though, some people might have just

12:54preferred to retire in a hospital

12:56because they would have more support,

12:58and possibly because they felt some

13:00connection to it. It wasn't uncommon for

13:02donors to live out their last days in

13:04the places they supported throughout

13:05their lives, and some people gave a

13:07donation as a form of payment in order

13:09to retire there.

13:11These people are known as corrodions,

13:13and they weren't unique to hospitals.

13:15There were corrodions living in

13:17monasteries and other religious houses

13:18across medieval Christendom.

13:21In some hospitals, they even had special

13:22apartments away from the rest of the

13:24poor, and received special treatment.

13:27However, they were also sometimes

13:29considered to be a financial burden,

13:31especially if they lived a long time,

13:34and their donations didn't always cover

13:35the expenses of caring for them. So,

13:38some hospitals tried to forbid the

13:39practice, even as bishops and hospital

13:42founders might impose their friends and

13:43relatives on the hospitals without their

13:45approval. Of course, there was also the

13:48issue of the elderly who didn't have

13:50families, something which was especially

13:52the case with elderly priests. Now, some

13:55priests had a pension which they could

13:56live off of after they retired, but this

13:58was entirely dependent on the wealth of

14:00the particular parish in which they

14:02served, and many didn't have that kind

14:04of money. So, some wealthy bishops or

14:07priests from richer, usually urban,

14:09churches occasionally established

14:11hospitals for their poorer fellow

14:13clerics to retire in. Similar, though

14:15more transient, were students, who also

14:18varied greatly in their levels of

14:19wealth. Many towns with important

14:22schools and universities would end up

14:23with places dedicated to housing poor

14:25students who couldn't afford other

14:27lodgings, and some of these would

14:29develop into prominent university

14:31colleges. On top of that, some hospitals

14:34were important centers of education

14:35themselves. The Hospital of St.

14:37Bartholomew in London, for example, had

14:39a grammar school attached to it by the

14:4115th century. Although it was originally

14:43meant for the education of poor

14:45children, it eventually became so

14:47renowned that wealthier parents would

14:49pay to have their children taught there

14:50as well. You also had hospitals devoted

14:53to caring for pregnant women and single

14:55mothers. These hospitals may have been

14:58gender exclusive, but many hospitals

15:00housed both men and women, though

15:03statutes usually enforced gender

15:05segregation. In some, this meant that

15:07there were different buildings or wards

15:08for male and female residents to sleep

15:10or eat in, but many hospitals were just

15:13a single long hall. So, in these cases,

15:16men and women may have each been

15:17confined to one side, possibly with some

15:20kind of divider down the middle. Another

15:22kind of specialized hospital, and the

15:24last one that I want to mention, is the

15:26leprosarium, a hospital for people with

15:29leprosy.

15:30Now, there are a lot of misconceptions

15:32about medieval views about leprosy,

15:35including the idea that people with the

15:36disease were forced into leper colonies

15:38against their wills and controlled and

15:40isolated due to a fear of contagion.

15:43But, this idea is largely the result of

15:45speculation in the late 1800s, after the

15:48discovery of the bacterium that causes

15:50leprosy, or Hansen's disease as it's now

15:52often known.

15:54People noticed that leprosy wasn't a

15:55huge issue in Europe anymore, but was

15:57still spreading in other parts of the

15:59world. They theorized that Europe must

16:01have successfully dealt with leprosy in

16:03the Middle Ages by forcing people into

16:04leper colonies and basically

16:06quarantining them. This idea then

16:09colored most people's interpretations of

16:11medieval sources and led to all sorts of

16:13assumptions about medieval leper

16:14hospitals. And it's actually still a

16:16fairly prominent view, even amongst

16:18historians who don't study medieval

16:20medicine. It's only really in the last

16:22few decades that this picture has

16:24started to be challenged, for example,

16:26by Carole Rawcliffe in her works on

16:28medieval leprosy. The reality is that

16:31leprosaria were just another form of

16:33specialized hospital. Leprosy was a

16:35chronic illness, and those with leprosy

16:37needed special care, which is why many

16:40general hospitals didn't take them in,

16:42including them alongside children and

16:43the physically disabled. Medieval people

16:46did have some sense that people with

16:47leprosy could contaminate in some way,

16:50and some leprosarium statutes mention

16:52not allowing them into the kitchen or to

16:54touch water sources. But, the vast

16:56majority of their statutes look

16:58identical to those of any other

16:59hospital, with most not mentioning the

17:02disease at all. These leprosaria kept

17:04them separate from the outside world,

17:06not because they were being forcibly

17:07isolated, but because many of them

17:09included the leper as residents as

17:11members of their hospitals' religious

17:13community. They took vows, becoming

17:15religious brothers and sisters, and so

17:18the control over their lives was a part

17:20of their religious lifestyle, not

17:22because they had leprosy. In fact, if

17:24they broke the rules, the punishment was

17:26being kicked out, which is hardly a good

17:29quarantining policy. We have all kinds

17:31of evidence of people with leprosy

17:33living fairly normal lives in medieval

17:35towns and in the countryside. Those who

17:37joined leprosaria likely did so because

17:39it gave them a sense of community

17:41alongside others who had to endure the

17:43same things which they did. In fact, in

17:46many towns, the leper hospitals

17:47originated as independent leper

17:49communities which had formed on their

17:52own. On top of that, these hospitals

17:54provided care and were also a locus for

17:56donations. Joining such a community

17:59could therefore provide a degree of

18:00stability. The leprous were seen as the

18:03quintessential poor, sometimes said to

18:06be enduring purgatory on Earth, and so

18:08they were a popular choice for those who

18:10wished to make donations to the poor.

18:12But when we talk about hospital care in

18:14the Middle Ages, you might be wondering

18:15what that actually entailed. Well, as

18:18I've said several times by now, these

18:20weren't modern hospitals. And one thing

18:22that might strike many people as being

18:24rather odd is that most medieval

18:26hospitals didn't have any doctors. Now,

18:30the Middle Ages had physicians. These

18:32were men educated at medieval

18:33universities who studied medicine and

18:35medical theory. They were widely

18:38regarded as some of the greatest

18:39authorities on healing, but most of

18:41their work took place in the home. In

18:43fact, the strong connection between

18:44doctors and hospitals is a relatively

18:46new thing. Not everyone could afford to

18:49hire a physician at home, though,

18:51especially not the poor. So, some

18:53hospitals did get occasional visits as

18:55charitable efforts on the doctors' part,

18:57or they might hire some to come

18:58occasionally or when absolutely needed.

19:01But only a handful of hospitals had

19:03doctors as full-time staff, the Hospital

19:05of St. John in Jerusalem being one such

19:08known example. But to understand

19:10medieval hospital care, we also have to

19:13change our idea of medical care more

19:15generally. Although university

19:17physicians were frequently seen as the

19:18peak, medieval society had a medical

19:21marketplace and physicians didn't have

19:23the same dominance over medicine that

19:24they do today. The basic premises of

19:27medicine could be quite widely

19:28understood and many non-university

19:31trained healers still had access to all

19:33kinds of medical knowledge. They could

19:36have medical texts at their disposal

19:37which, around the same time as the

19:39explosion in number of hospitals, were

19:41increasingly being translated from Latin

19:43into vernacular languages like French,

19:46English, German, Italian, etc. This was

19:49especially the case with some of the

19:50most fundamental texts like the Isagoge,

19:52which introduced the basic principles of

19:54medicine. On top of that, there were all

19:56manner of vernacular healing traditions

19:58which were transmitted outside of

20:00universities and existed in parallel to

20:03intellectual medicine. Hospital carers

20:05could have been familiar with either and

20:07employed their own healing knowledge to

20:09help those in their care. And healing at

20:12the time wasn't just about prescribing

20:14specific drugs and medicines. It was

20:16about lifestyle, about what you ate and

20:19what you did. Many hospitals had gardens

20:21which had both herbs which could be used

20:23for curing illness, but also vegetables

20:26which were thought to be particularly

20:27healthful. In an essay on the subject,

20:29the historian Peregrine Horden looks at

20:31the hospital as a place where healing

20:33could take place through the regulation

20:34of the six non-naturals.

20:36In medieval medical theory, these were

20:38external influences on the body which

20:40could affect one's health: sleep and

20:43wakefulness, food and drink, excretion

20:45and retention, air and environment,

20:47exercise and rest, and mental state. As

20:50Horden rightly points out, the

20:52non-naturals were just as important in

20:53medieval medicine as drugs and surgery.

20:56And a hospital, a closed-off and

20:59controlled environment separate from

21:00normal life, was the perfect place to

21:02help regulate them to bring someone back

21:05to good health or improve their

21:07well-being in the case of those with

21:08chronic issues. Even just giving someone

21:11a bed to sleep on, a luxury which most

21:13people didn't have, could help improve

21:15someone's well-being. In some cases, the

21:18hospital was simply a place to rest and

21:20recover. And overall, even just having

21:23staff who were present and willing to

21:24assist you and care for you could make a

21:27big difference for the poor. Even those

21:29who were on the wealthier end of the

21:31spectrum might have had a hard time

21:33getting the care they needed from their

21:34families in their homes. And this may

21:36explain why we occasionally see burghers

21:38and even members of the lower nobility

21:41being cared for amongst the poor in

21:43hospitals. You even get merchants and

21:45other well-off travelers paying to stay

21:47in hospitals as guests. But something

21:50else which would seem like a big change

21:52from the modern hospital is just how

21:54religious the hospital's character was.

21:56Of course, as I've been mentioning this

21:58whole time, many hospitals were staffed

22:00by professed vowed religious

22:02communities. But even in hospitals where

22:04the staff were entirely hired labor and

22:06no one had taken any vows and there

22:08wasn't a rule prescribed, there was

22:10still a distinct religiousness to it.

22:13As I said previously, pretty much every

22:14hospital had a chapel attached and they

22:17also had priests who would say mass in

22:19those chapels. But the priests would

22:21also hear the confessions of those

22:22staying at the hospital. Many of their

22:25statutes required that this be the first

22:26thing done as soon as someone was

22:28admitted. Priests also needed to be

22:30there to provide extreme unction, the

22:32sacrament for those at the end of life.

22:35And they would also perform the rites

22:36for those who died in the hospital and

22:38were being buried in the cemetery. Many

22:40hospitals also had their religious

22:42community sing the divine office, a set

22:44of prayers performed at specific hours

22:46throughout the day. The statute of the

22:48hospital of Tonnerre, built by Margaret

22:50of Burgundy in 1293, even specifies that

22:53the chanters and choir boys need to be

22:55able to sing loudly enough that they

22:57could be heard throughout the infirmary

22:59hall. This focus on spiritual care,

23:01combined with a lack of physicians, has

23:04long led some to conclude that medieval

23:05hospitals were a place where spiritual

23:07healing was prioritized at the expense

23:10of physical healing. That they only

23:12really cared about the soul and not so

23:13much the body. But, not only does a lack

23:16of physicians not necessarily mean a

23:18lack of medicine, as we've already seen,

23:20but the dichotomy of spiritual versus

23:22physical health just wouldn't have made

23:24a whole lot of sense in the medieval

23:26worldview. The Middle Ages was full of

23:28stories of people who confessed their

23:29sins and were cured of all kinds of

23:31diseases, regardless of whether the

23:33disease itself was a direct result of

23:35sin.

23:36Guilt and sin weakened the body, and so

23:39spiritual healing could return it to

23:41strength. Additionally, the relics from

23:43saints, from which all kinds of

23:45miraculous healing stories emerged, were

23:47often brought into hospitals in the hope

23:49that they might help heal the sick. And

23:51some sick pilgrims stayed at hospitals

23:53as they visited saint shrines and

23:55awaited a miraculous cure. Even the

23:57regular mass could heal. It was seen as

23:59a miracle. Bread and wine turned into

24:01flesh and blood. So, experiencing that

24:04was also thought to have all kinds of

24:06miraculous potential. But, we don't even

24:08have to look at divine intervention to

24:10see how spiritual care fits into

24:12medieval medicine. One of Peregrine

24:14Horden's main points in the essay of his

24:16I mentioned before, was that spiritual

24:18care could easily fit into the

24:19non-natural category of mental state,

24:22which in Latin is accidentia animae,

24:25literally accidents of the soul. This

24:28was all about emotions and what we would

24:30today call psychological impacts on

24:32one's physical well-being. In the

24:34hospital setting, having the poor

24:36experience a highly sacred environment

24:38and be surrounded by religious ritual

24:40would have been a way to help raise

24:41their spirits and therefore their

24:43health. Horden notes that it's unlikely

24:45that every hospital made this explicit

24:47connection between the liturgy and the

24:49non-naturals, but the idea of healing

24:51being affected by one's environment and

24:53attitude was very widespread. And so,

24:56this connection may have been made even

24:58if unconsciously. We certainly get many

25:00mentions in medieval sources of

25:02spiritual care, which treats it like any

25:04other form of physical medicine. In a

25:07similar vein, we see many hospital

25:08statutes discuss the importance of

25:10ensuring that the staff has a pleasant

25:12demeanor towards the poor being housed.

25:14And the late medieval courtier and

25:16writer Christine de Pizan even suggested

25:18in her educational writings for women

25:20that a good princess should visit local

25:22hospitals, since such visits did wonders

25:25for the happiness and well-being of the

25:26poor. And on top of all these other

25:28types of spiritual and medicinal care,

25:30of course, you have the fact that

25:32hospitals provided food, shelter, and

25:34clothing to those in need. And some

25:36hospitals even provided food and

25:37clothing to those in the streets as

25:39well. Generally, any kind of charity

25:41that you can think of, a hospital could

25:43provide. We even hear of some of them

25:45ransoming slaves and prisoners, and

25:47sometimes even helping people pay off

25:49their debts. Of course, quality of care

25:52could vary depending on the hospital.

25:54Most hospitals were not big money makers

25:56and were incredibly dependent on regular

25:58support. So, that could have had a

26:00serious impact on the type of care

26:01available. Likewise, we do occasionally

26:04hear of corruption where hospital staff

26:06neglect the poor in their care and

26:08pocket donations to enrich themselves.

26:10But, this doesn't seem to have been a

26:11problem everywhere, as even the writings

26:13that denounce corrupt practices are sure

26:16to note that not all hospitals are like

26:18that. They were just pointing out those

26:20in need of serious reform. But, even

26:22beyond the care provided, life in a

26:24hospital would vary depending on where

26:26you were. Some hospitals allowed the

26:28poor in their care to come and go as

26:30they pleased, but most had some rules

26:32which needed to be followed. Oftentimes,

26:35the poor at a hospital were expected to

26:36adhere to a semi-religious lifestyle.

26:39They were often expected to remain

26:40chaste and participate in certain

26:42religious activities throughout the day,

26:44usually saying a certain number of

26:46prayers for the hospital's founder and

26:48benefactors. They also had curfews for

26:51being inside the hospital compound,

26:53which often had a wall surrounding it

26:54much like a monastery would, if they

26:56were allowed to go outside at all. They

26:58were also meant to eat communally with

27:00the rest of the poor and sometimes the

27:02staff, and they might be put to work

27:04during the day depending on their level

27:06of health. Again, this depends entirely

27:08on the specific hospital, and sometimes

27:10varied from person to person, as

27:12corrodions or paying guests were often

27:14given more freedom. In some hospitals,

27:17especially specialized ones like

27:19leprosaria where the poor lived

27:20long-term, they were also expected to

27:23take religious vows themselves. Which

27:25brings us to the religious communities

27:27operating many of these hospitals. When

27:30there was such a community, the hospital

27:31statute often spent more time discussing

27:34rules for the staff than anything else,

27:36which makes sense for a religious

27:38community.

27:39Sometimes, as was most often the case in

27:41France, those hospital communities could

27:43be fully independent entities, subject

27:46to the local bishop or in some cases the

27:48Pope himself. They might be governed

27:51exclusively by the discipline outlined

27:52in the statute. Though as time went on

27:55it became more and more common to impose

27:56a specific religious rule upon them.

27:59With some variation of the rule of Saint

28:01Augustine being the most common. Since

28:03it called for less isolation than

28:04something like the rule of Saint

28:05Benedict, which made it suitable for the

28:07active role of a hospital. At other

28:09times hospitals might be tied to a

28:11specific monastery. Usually when founded

28:14by them, making it essentially a

28:16daughter house. In this case the staff

28:19were typically monks or nuns from the

28:20mother house brought over to serve the

28:22poor. And finally there were some

28:24hospitals that were part of a wider

28:26association, which may or may not be a

28:28formal religious order. Some examples of

28:31these would be the Order of Saint John

28:33or Knights Hospitaler. And the Teutonic

28:35Order. Both of which had been hospital

28:38orders in the Crusader states before

28:40also taking on military

28:41responsibilities.

28:43But you also had purely hospital

28:44oriented orders like the Brotherhood of

28:46the Holy Spirit, the Trinitarians, or

28:49the Order of Saint Anthony, who

28:51specialized in hospitals for those

28:52suffering from Saint Anthony's fire, or

28:54what we today call ergotism. Hospitals

28:57could also vary greatly in their

28:58foundation, and the context of how and

29:01by whom the hospital was founded often

29:03had a big impact on all the other

29:05variations we've looked at across this

29:07video until now. We've already touched

29:09on a few different types of founders

29:11already. We've mentioned monasteries,

29:13religious orders, and even bishops. In

29:15the case of bishops in particular, it's

29:17notable that care for the local poor had

29:19for a long time been seen as the

29:21responsibility of a diocese's bishop,

29:24and so we often see bishops founding

29:26some of the first and often times

29:27largest and most important hospitals in

29:29many cities and towns. Their hospitals

29:32were also often general, since the

29:34bishop sought to help the poor

29:36generally. We also see hospitals founded

29:38by wealthy churches and individual

29:40priests, but the clergy didn't have a

29:42monopoly.

29:43Kings, queens, and nobles all founded

29:46important hospitals. I've already

29:48mentioned King Louis the ninth of France

29:49and Margaret of Burgundy, but of course

29:52they were not the only ones. Outside of

29:55the nobility, guilds and other lay

29:57associations also founded some in their

29:59names, as did wealthy burghers, like

30:02Folco Portinari, a banker and the father

30:05of Dante's muse Beatrice, who founded

30:07Florence's Hospital of Santa Maria Nuova

30:09in 1288, another medieval hospital which

30:12remains in use today. A hospital's

30:15founder often had a great deal of

30:16influence on its statute and therefore

30:18its type. They were also obviously an

30:21important financier for the hospital's

30:22establishment, and many hospitals were

30:25built on lands which were donated or

30:27purchased by the founder, or sometimes

30:29made out of buildings which they had

30:30owned and which were then repurposed.

30:33But hospitals needed lots of money in

30:35order to feed, clothe, and shelter the

30:37poor and staff, as well as maintain the

30:39buildings, beds, linens, and to purchase

30:41any number of other supplies. If the

30:44hospital was lucky, the founder or a

30:46later donor might grant it some lands

30:49from which it could then collect rents.

30:51Some hospitals were even granted

30:52seignorial rights and could therefore

30:54arbitrate in legal matters like a feudal

30:56lord. In either case, this would give

30:58them a regular income. Otherwise, the

31:01hospital would have to rely on regular

31:03donations, either of cash or of supplies

31:06directly, which could be unreliable and

31:08unstable. Some hospitals even had their

31:11poor go out during the day to beg, using

31:13that to pay for their meals.

31:15Some hospitals endured the test of time,

31:18lasting centuries, though they might

31:20change in character over the years,

31:22especially in the case of those that are

31:23still around. An exception though would

31:25be the Great St. Bernard Hospice in the

31:27Alps, which was founded in the 11th

31:29century and is still staffed by a

31:31community of canons regular who provide

31:34shelter for pilgrims and other travelers

31:36passing through. Other hospitals,

31:38however, lasted only decades before they

31:40were taken over by someone else or were

31:43otherwise abandoned.

31:46The medieval hospital was an incredibly

31:47important institution that touched

31:49practically everyone. For the lower

31:51classes, it was a source of potential

31:53support, a lifeline in a world where the

31:56future was never certain and your

31:58fortunes could change at any time. Even

32:00for those who were better off, there was

32:02no telling what fate the wheel of

32:04fortune had in store for you.

32:06Everyone had the potential to become

32:08poor in one sense or another. Some by

32:11fate, some voluntarily, as was the case

32:13for pilgrims. And for those with wealth

32:16enough to feel like they were possibly

32:17immune from that poverty, the

32:19expectation, some might even say

32:21requirement for them to be charitable,

32:23meant that they oftentimes found

32:25themselves closely tied to hospitals as

32:27well. Though it is notable that many

32:29donations were smaller and were made by

32:31those who may very well wind up in

32:33hospitals themselves one day. And of

32:36course, genuine religiosity could also

32:38be an influence on people's decisions.

32:41The hospital was a place for the poor to

32:42receive care, for the sick to recover,

32:45for pilgrims and travelers to rest, and

32:47so much more.

32:49It was a place for hospitality.

32:51Hospitium.

32:53Thank you all so much for watching.

32:55Remember that one like on this video

32:56equals one prayer, and one less year for

32:58me in purgatory. Sources, as usual, are

33:01in the description below. As for me,

33:04I'll see you next time.

33:07>> [music]

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