The English Leper-houses.
The English charitable foundations, or hospitals of all kinds previous to the dissolution of the monasteries, including almshouses, infirmaries, Maisons Dieu and lazar-houses, amount to five hundred and nine in the index of Bishop Tanner’s Notitia Monastica. In the 1830 edition of the Monasticon Anglicanum, the latest recension of those immense volumes of antiquarian research, there are one hundred and four such foundations given, for which the original charters, or confirming charters, or reports of inquisitions, are known; and, besides these, there are about three hundred and sixty given in the section on “Additional Hospitals,” the existence and circumstances of which rest upon such evidence as casual mention in old documents, or entries in monastery annals, or surviving names and traditions of the locality. Our task is to discover, if we can, what share of this charitable provision in medieval England, embracing at least four hundred and sixty houses, was intended for the class of leprosi; what indications there are of the sort of patients reckoned leprosi; how many sick inmates the leper-houses had, absolutely as well as in proportion to their clerical staff; and how far those refuges were in request among the people, either from a natural desire to find a refuge or from the social pressure upon them to keep themselves out of the way.
It is clear that the endowed hospitals of medieval England were in no exclusive sense leper-hospitals, but a general provision, under religious discipline, for the infirm and sick poor, for infirm and ailing monks and clergy, and here or there for decayed gentlefolk. The earliest of them that is known, St Peter’s and St Leonard’s hospital at York, founded in 936 by king Athelstane, and enlarged more especially on its religious side by king Stephen, was a great establishment for the relief of the poor, with no reference to leprosy; it provided for no fewer than two hundred and six bedesmen, and was served by a master, thirteen brethren, four seculars, eight sisters, thirty choristers and six servitors. When Lanfranc, the first Norman archbishop of Canterbury, set about organising the charitable relief of his see in 1084, he endowed two hospitals, one for the sick and infirm poor in general, and the other for leprosi[166]. The former, St John Baptist’s hospital, was at the north gate, a commodious house of stone, for poor, infirm, lame or blind men and women. The latter was the hospital of Herbaldown, an erection of timber, in the woods of Blean about a mile from the west gate, for persons regia valetudine fluentibus (?), who are styled leprosi in a confirming charter of Henry II.[167] The charge of both these houses was given to the new priory of St Gregory, over against St John Baptist’s hospital, endowed with tithes for secular clergy. The leper-house at Herbaldown was divided between men and women; but in a later reign (Henry II.) a hospital entirely for women (twenty-five leprous sisters) was founded at Tannington, outside Canterbury, with a master, prioress and three priests. There was still a third hospital at Canterbury, St Lawrence’s, founded about 1137, for the relief of leprous monks or for the poor parents and relations of the monks of St Augustine’s.
London had two endowed leper-hospitals under ecclesiastical government, as well as certain spitals or refuges of comparatively late date. The hospital and chapel of St Giles in the Fields was founded, as we have seen, by Matilda, queen of Henry I., in 1101, and was commonly known for long after as Matilda’s hospital. It was built for forty leprosi, who may or may not all have lived in it; and it was supported in part by the voluntary contributions of the citizens collected by a proctor. Its staff was at first exceptionally small for the number of patients,—a chaplain, a clerk and a messenger; but as its endowments increased several other clerics and some matrons were added. By a king’s charter of 1208 (10th John), it was to receive sixty shillings annually. It is next heard of, in the Rolls of Parliament, in connexion with a petition of 1314-15 (8 Ed. II.), by the terms of which, and of the reply to it, we can see that there were then some lepers in the hospital but also patients of another kind. It is mentioned by Wendover, under the year 1222, as the scene of a trial of strength between the citizens and the comprovinciales extra urbem positos[168]: at that date it stood well in the country, probably near to where the church of St Giles now stands at the end of old High Holborn. The drawing of the hospital on the margin of Matthew Paris’s manuscript shows it as a house of stone, with a tower at the east end and a smaller one over the west porch, and with a chapel and a hall, but probably no dormitories for forty lepers[169].
The other endowed leper-house of the metropolis was the hospital of St James, in the fields beyond Westminster. It was of ancient date, and provided for fourteen female patients, who came somehow to be called the leprosae puellae[170], although youth is by no means specially associated with leprosy. This house grew rich, and supported eight brethren for the religious services of the sixteen patients[171].
It is usual to enumerate five, and sometimes six, other leper-hospitals, in the outskirts of London—at Kingsland or Hackney, in Kent Street, Southwark (the Lock), at Highgate, at Mile End, at Knightsbridge and at Hammersmith. But the earliest of these were founded in the reign of Edward III. (about 1346) at a time when the old ecclesiastical leper-houses were nearly empty of lepers. It would be misleading to include them among the medieval leper-houses proper, and I shall refer to them in a later part of this chapter.
The example of archbishop Lanfranc at Canterbury and of queen Matilda in London was soon followed by other founders and benefactors. The movement in favour of lepers—there was probably too real an occasion for it to call it a craze—gained much from the appearance on the scene of the Knights of the Order of St Lazarus of Jerusalem. Those knights were the most sentimental of the orders of chivalry, and probably not more reputable than the Templars or the main body of the Hospitallers from which they branched off. If we may judge of them by modern instances, they wanted to do some great thing, and to do it in the most theatrical way, with everybody looking on. What real services they may have rendered to the sick poor, leprous or other, there is little to show. The head-quarters of the order were at Jerusalem, the Grand Master and the Knights there being all leprosi—doubtless in a liberal sense of the term. We should be doing them no injustice if we take them to have been Crusaders so badly hit by their vices or their misfortunes as to be marked off into a separate order by a natural line. However, many others enlisted under the banner of St Lazarus who were not leprosi; these established themselves in various countries of Europe, acquired many manors and built fine houses[172]. In England their chief house was at Burton in Leicestershire; it was not by any means a great leper-hospital, but a Commandery or Preceptory for eight whole knights, with some provision for an uncertain number of poor brethren—the real Lazaruses who, like their prototype, would receive the crumbs from the high table. The house of Burton Lazars gradually swallowed up the lands of leper-hospitals elsewhere, as these passed into desuetude, and at the valuation of Henry VIII. it headed the list with an annual rental of £250. Their establishment in England dates from the early part of the twelfth century, and although the house at Burton appears to have been their only considerable possession, they are said, on vague evidence, to have enlisted many knights from England, and, curiously enough, still more from Scotland. A letter is extant by the celebrated schoolman, John of Salisbury, afterwards bishop of Chartres, written in the reign of Henry II. to a bishop of Salisbury, from which it would appear that the “Fratres Hospitales” were regarded with jealousy and dislike by the clerical profession; “rapiunt ut distribuant,” says the writer, as if there were something at once forced and forcible in their charities[173].
Coincidently with the appearance in England of the Knights of St Lazarus, we find the monasteries, and sometimes private benefactors among the nobility, beginning to make provision for lepers, either along with other deserving poor or in houses apart. After the hospitals at Canterbury and London (as well as an eleventh-century foundation at Northampton, which may or may not have been originally destined for leprosi), come the two leper-houses founded by the great abbey of St Albans. As these were probably as good instances as can be found, their history is worth following.
In the time of abbot Gregory (1119 to 1146), the hospital and church of St Julian was built on the London road, for six poor brethren (Lazares or pauperes Christi) governed by a master and four chaplains. The mastership of St Julian’s is twice mentioned in the abbey chronicles as a valuable piece of preferment. In 1254 the lands of the hospital were so heavily taxed, for the king and the pope, that the miselli, according to Matthew Paris, had barely the necessaries of life. But a century after, in 1350, the revenues were too large for its needs, and new statutes were made; the accommodation of its six beds was by no means in request, the number of inmates being never more than three, sometimes only two, and occasionally only one[174]. The fate of the other leper-house of St Albans abbey, that of St Mary de Pratis for women, is not less instructive. The date of its foundation is not known, but in 1254 it had a church and a hospital occupied by misellae[175]. A century later we hear of the house being shared between illiterate sisters and nuns. The former are not called lepers, but simply poor sisters; whatever they were, the nuns and they did not get on comfortably together, and the abbot restored harmony by turning the hospital into a nunnery pure and simple[176]. Similar was the history of one of the richest foundations of the kind, that of Mayden Bradley in Wiltshire. It was originally endowed shortly before or shortly after the accession of Henry II. (1135) by a noble family for an unstated number of poor women, generally assumed to have been leprosae, and for an unstated number of regular and secular clerics to perform the religious offices and manage the property. It had not existed long, however, when the bishop of Salisbury, in 1190, got the charter altered so as to assign the revenues to eight canons and—poor sisters, and so it continued until the valuation of Henry VIII., when it was found to be of considerable wealth. In like manner the hospital of St James, at Tannington near Canterbury, founded in the reign of Henry II. for twenty-five “leprous sisters,” was found, in the reign of Edward III. (1344), to contain no lepers, its “corrodies” being much sought after by needy gentlewomen[177].
Another foundation of Henry II.’s reign was the leper-hospital of St Mary Magdalen at Sponne, outside the walls of Coventry. It was founded by an Earl of Chester, who, having a certain leprous knight in his household, gave in pure alms for the health of his soul and the souls of his ancestors his chapel at Sponne with the site thereof, and half a carucate of land for the maintenance of such lepers as should happen to be in the town of Coventry. There was one priest to celebrate, and with him were wont to be also certain brethren or sisters together with the lepers, praying to God for the good estate of all their benefactors. “But clear it is,” says Dugdale, “that the monks shortly after appropriated it to their own use.” However, they were in time dispossessed by the Crown, to which the hospital belonged until the 14th of Edward IV[178].
One of the most typical as well as earliest foundations was the hospital of the Holy Innocents at Lincoln, endowed by Henry I. We owe our knowledge of its charter to an inquisition of Edward III. It was intended for ten leprosi, who were to be of the outcasts (de ejectibus) of the city of Lincoln, the presentation to be in the king’s gift or in that of the mayor or other good men of the city, and the administration of it by a master or warden, two chaplains and one clerk. In the space of two centuries from its foundation the character of its inmates had gradually changed. Edward III.’s commissioners found nine poor brethren or sisters in it; only one of them was leprosus, and he had obtained admission by a golden key; also the seven poor women had got in per viam pecuniam. In Henry VI.’s time provision was made for the possibility of lepers still requiring its shelter—quod absit, as the new charter said.
In the same reign (end of Henry I.) the hospital of St Peter was founded at Bury St Edmunds by abbot Anselm, for priests and others when they grew old and infirm, leprous or diseased. The other hospital at Bury, St Saviour’s, had no explicit reference to leprosy at all. It was founded by the famous abbot Samson about 1184, for a warden, twelve chaplain-priests, six clerks, twelve poor gentlemen, and twelve poor women. About a hundred years later the poor sisters had to go, in order to make room for old and infirm priests.
Sometime before his death in 1139, Thurstan, archbishop of York, founded a hospital at Ripon for the relief of “all the lepers in Richmondshire;” the provision was for eighteen patients, a chaplain and sisters. At an uncertain date afterwards the house was found to contain a master, two or three chaplains and some brethren, who are not styled leprosi; and from the inquisition of Edward III. we learn that its original destination had been for the relief as much of the poor as the leprous (tam pauperum quam leprosorum), and that there was no leprous person in it at the date of the inquisition.
The mixed character of hospitals commonly reckoned leper-hospitals is shown by several other instances. St Mary Magdalene’s at Lynn (1145) provided for a prior and twelve brethren or sisters, nine of whom were to be whole and three leprous. St Leonard’s at Lancaster (time of king John) was endowed for a master, a chaplain, and nine poor persons, three of them to be leprous. St Bartholomew’s at Oxford provided for a master, a clerk, two whole brethren and six infirm or leprous brethren; but the infirm or leprous brethren had all been changed into whole brethren by the time of Edward III[179]. So again the Normans’ spital at Norwich was found to be sheltering “seven whole sisters and seven half-sisters.”
The leper-hospital at Stourbridge, near Cambridge, was founded for lepers by king John, the one king in English history who cared greatly about his leprous subjects. It was committed to the charge of the burgesses of Cambridge, but it was shortly after seized by Hugo de Norwold, bishop of Ely, and within little more than fifty years from its foundation (7 Ed. I.) it was found that the bishop of Ely of that day was using it for some purposes of his own, but “was keeping no lepers in it, as he ought, and as the custom had been[180].”
The ostentatious patronage of lepers by king John, of which something more might be said, was preceded by a more important interposition on their behalf by the third Council of the Lateran in 1179 (Alexander III.). The position of leprosi in the community had clearly become anomalous, and one of the decrees of the Council was directed to setting it right. Lepers, who were “unable to live with sound persons, or to attend church with them, or to get buried in the same churchyard, or to have the ministrations of the proper priest,” were enjoined to have their own presbytery, church, and churchyard, and their lands were to be exempt from tithe[181]. Within two or three years of that decree, in or near 1181, we find a bishop of Durham, Hugh de Puiset, endowing the greatest of all the English leper-hospitals, at Sherburn, a mile or more outside the city of Durham. The bishop was a noted instance of the worldly ecclesiastic of his time. He was accused by the king of misappropriating money left by the archbishop of York, and his defence was that he had spent it on the blind, the deaf, the dumb, the leprous, and such like deserving objects[182]. William of Newburgh has left us his opinion of the bishop’s charity: it was a noble hospital lavishly provided for, “but with largess not quite honestly come by” (sed tamen ex parte minus honesta largitione[183]). The hospital of bishop Hugh, dedicated to the Saviour, the Blessed Virgin, St Lazarus, and his sisters Mary and Martha, still exists as Christ’s Hospital, a quadrangular building enclosing about an acre in a sunny valley to the south of the city, with a fine chapel, a great hall (of which the ancient raftered roof existed into the present century), a master’s lodge, and a low range of buildings on the west side of the square for the poor brethren, with their own modest hall in the middle of it. The original foundation was certainly on a princely scale, as things then went: it was for five “convents” of lepers, including in all sixty-five persons of both sexes, with a steward or guardian to be their own proper representative or protector, three priests, four attendant clerks, and a prior and prioress. We hear nothing more of the hospital for a century and a half, during which time it had doubtless been filled by a succession of poor brethren, or sick poor brethren, but whether leprous brethren, or even mainly leprous, may well be doubted after the recorded experiences of Ripon, Lincoln and Stourbridge. Its charter was confirmed by bishop Kellaw about 1311-1316; and in an ordinance of 1349 we still read, but not without a feeling of something forced and unreal, of the hospital ministering to the hunger, the thirst, the nakedness of the leprous, and to the other wants and miseries by which they are incessantly afflicted. But within ninety years of that time (1434) the real state of the case becomes apparent; the poor brethren had been neglected, and the estates so mismanaged or alienated to other uses, that new statutes were made reducing the number of inmates to thirteen poor brethren and two lepers, the latter being thrown in, “if they can be found in these parts,” in order to preserve the memory of the original foundation[184].
To these samples, which are also the chief instances of English leper-hospitals, may be added two or three more to bring out another side of the matter. In the cases already given, it has been seen that the provision for the clerical staff was either a very liberal one at first or became so in course of time. The hospitals, whether leprous or other, were for the most part dependencies of the abbeys, affording occupation and residence to so many more monks, just as if they had been “cells” of the abbey. The enormous disproportion of the clerical staff to the inmates of hospitals (not, however, leprous) is seen in the instances of St Giles’s at Norwich, St Saviour’s at Bury and St Cross at Winchester. The provision was about six for the poor and half-a-dozen for the monks. But even the purely nosocomial part of these charities was in not a few instances for the immediate relief of the monasteries themselves. St Bartholomew’s at Chatham, one of the earliest foundations usually counted among the leper-hospitals, was for sick or infirm monks. The hospital at Basingstoke, endowed by Merton College, Oxford, was for incurably sick fellows and scholars of Merton itself. The leper-hospital at Ilford in Essex was founded about 1180 by the rich abbey of Barking, for the leprous tenants and servants of the abbey, the provision being for a secular master, a leprous master, thirteen leprous brethren, two chaplains and a clerk. St Lawrence’s at Canterbury (1137) was for leprous monks or for the poor parents and relations of monks. St Peter’s at Bury St Edmunds, founded by abbot Anselm in the reign of Henry I., was for priests and others when they grew old, infirm, leprous, or diseased.
The instances which have been detailed in the last few pages, perhaps not without risk of tediousness, have not been chosen to give a colour to the view of medieval leprosy; they are a fair sample of the whole, and they include nearly all those leper-hospitals of which the charters or other authentic records are known[185]. It is possible by using every verbal reference to leprosy that may be found in connexion with all the five hundred or more medieval English hospitals in Bishop Tanner’s Notitia Monastica or in Dugdale’s Monasticon, to make out a list of over a hundred leper-hospitals of one kind or another. But there are probably not thirty of them for which the special destination of the charity is known from charters or inquisitions; and even these, as we have seen, were not all purely for lepers or even mainly for lepers. As to the rest of the list of one hundred, the connexion with leprosy is of the vaguest kind. Thus, four out of the five hospitals in Cornwall are called lazar-houses or leper-hospitals, but they were so called merely on the authority of antiquaries subsequent to the sixteenth century. The same criticism applies almost equally to the eight so-called leper-hospitals, out of a total of fourteen medieval hospitals of all kinds, in Devonshire. It is clear that “lazar-house” became an even more widely generic term than the terms lepra and leprosus themselves[186].
Thus our doubts as to the amount of true leprosy that once existed in England, and was provided for in the access of chivalrous sentiment that came upon Christendom in the twelfth and thirteenth centuries, tend to multiply in a compound ratio. We doubt whether many of the so-called leper-houses or lazar-houses in the list of one hundred, more or less, that may be compiled from the Monasticon, were not ordinary refuges for the sick and infirm poor, like the three or four hundred other religious charities of the country. We know that, in some instances of leper-hospitals with authentic charters, the provision for the leprous was in the proportion of one to three or four of non-leprous inmates. We know that as early as the end of the thirteenth century the leprosi were disappearing or getting displaced even from hospitals where the intentions of the founder were explicit. And lastly we doubt the homogeneity of the disease called lepra and of the class called leprosi.
As to the foundations of a later age they were no longer under ecclesiastical management, and they seem to have been mostly rude shelters on the outskirts of the larger towns. In 1316 a burgess of Rochester, who had sat in Parliament, left a house in Eastgate to be called St Katharine’s Spital, “for poor men of the city, leprous or otherwise diseased, impotent and poor”—or, in other words, a common almshouse. The remarkable ordinance of Edward III. in 1346, for the expulsion of lepers from London, seems to have been the occasion of the founding of two so-called lazar-houses, one in Kent Street, Southwark, called “the Loke[187],” and the other at Hackney or Kingsland. These are the only two mentioned in the subsequent orders to the porters of the City Gates in 1375; and as late as the reign of Henry VI. they are the only two, besides the ancient Matilda’s Hospital in St Giles’s Fields, to which bequests were made in the will of Ralph Holland, merchant taylor[188]. Another of the suburban leper-spitals was founded at Highgate by a citizen in 1468[189], and it is not until the reign of Henry VIII. that we hear of the spitals at Mile End, Knightsbridge and Hammersmith[190]. By that time leprosy had ceased to be heard of in England; but another disease, syphilis, had become exceedingly common; and it is known that those spitals, together with the older leper-hospitals, were used for the poorer victims of that disease. Stow is unable to give the exact date of any of these foundations except that at Highgate. He assumes that the others were all built on the occasion of the ordinance of 20 Edward III.; but it is probable that only two of them, the Lock and the Kingsland or Hackney spital were built at that time[191].
An early instance of a leper-spital or refuge apparently without ecclesiastical discipline is mentioned in a charter roll of 1207-8, in which king John grants to the leprosi of Bristol a croft outside the Laffard gate, whereon to reside under the king’s protection and to beg with impunity. On the roads leading to Norwich there were four such shelters, outside the gates of St Mary Magdalene, St Bennet, St Giles and St Stephen respectively; these houses were each under a keeper, and were supported by the alms of the townsfolk or of travellers; only one of the four is alleged to have had a chapel attached. The date of these is unknown, but they were probably late. On the roads leading from Lynn, there were three such erections, at Cowgate, Letchhythe and West Lynn, which are first mentioned in a will of 1432. These non-religious and unendowed leper-spitals were probably rude erections on the outskirts of the town, at the door of which, or on the roadside near, one or more lepers would sit and beg. The liberty of soliciting alms was one of their privileges, only they were not allowed to carry their importunity too far; hence the ordinance of most countries that the lepers were not to enter mills and bake-houses; and hence some ordinances of the Scots parliament limiting the excursions of the leper folk. One of the most considerable privileges to lepers was granted to the lepers of Shrewsbury in 1204 by king John, who did not lose the chance of earning a cheap reputation for Christian charity by his ostentatious patronage of the pauperes Christi: they were entitled to take a handful of corn or flour from all sacks exposed in Shrewsbury market.