The communes vied with kings, nobles, abbots, and citizens in the discharge of such duties. Hospices and hospitals were founded on every hand, either in deserted buildings, or in specially constructed edifices.

Refuges were also built on roads much frequented by pilgrims to shelter belated travellers, and hospices were constructed outside the walls and close to the city gates.

Pilgrimages were much in vogue in the Middle Ages, especially throughout the thirteenth and fourteenth centuries. The sanctuaries of St. Michael in Normandy, and of St. James of Compostella in Spain, were the most frequented. At the beginning of the thirteenth century a hospice was founded outside Paris, near the Porte St. Denis, which was dedicated to St. James. This hospice, with its chapel, was served by the confraternity of St. Jacques aux Pèlerins (St. James of Pilgrims), and offered gratuitous shelter each night to pilgrims bound for Paris. Its buildings covered two acres; they included a great hall of stone, vaulted on intersecting arches, and measuring some 132 feet by 36, for the accommodation of the sick.

In a file of accounts of the fifteenth century, concluding with an appeal for funds, it is stated that, for the convenience of pilgrims—y a lieu pour ce faire XVIIJ liz qui depuis le premier jour d'aoust MCCCLXVIIJ jusques au jour de Mons. S. Jacques et Christofle ensuivant on estés logés et hebergés en l'hospital de céans XVm VIc IIIIxxX pèlerins qui aloient et venoient au Mont Saint Michel et austres pèlerins. Et encore sont logés continuellement chascune nuict de XXXVI à XL povres pèlerins et austres povres, pourquoy le povre hospital est moult chargé et en grant nécessité de liz, de couvertures et de draps.[69]

In the first years of the fourteenth century several hundreds of hôtels dieu, hospitals, and lazar-houses received help from the King of France. St. Louis founded the Hospice des Quinze-Vingts for the blind, and in many towns hospitals were erected for the insane, the old, and the infirm, in addition to the usual lazar-houses. Special hospitals had already been established for women in labour, and a chapel was founded for their benefit in the crypt of the Ste. Chapelle of Paris, dedicated to Our Lady of Travail, of Tombelaine, in Normandy.[70]

[69] "Eighteen beds have been in use, and from the first day of August 1368 to the feast of SS. James and Christopher following (July 25, 1369) this hospital has lodged and sheltered 16,690 pilgrims journeying to or from St. Michael's Mount, besides others. And it has further given shelter each night to some thirty-six to forty poor pilgrims and other needy persons, whereby the poor hospital is heavily burdened and in sore straits for lack of beds, sheets, and blankets."—Ed. Corroyer, Description de l'Abbaye du Mont St. Michel et de ses Abords; Paris, 1877.

[70] Idem.