This order, also called the Order of Rhodes and more widely known as the Order of Malta, from the locations of its headquarters after it was forced to leave the Holy Land, is the oldest order of knighthood in existence, antedating even that of the Order of the Garter by more than two hundred years. It is also the most illustrious and meritorious of the religious military orders. Its origin goes back to the hospital for Christian pilgrims in Jerusalem, established in the first half of the 11th century by a group of merchantmen from Amalfi, Italy. When the crusaders captured Jerusalem in 1099 the hospital was headed by a layman named Gerard whose birthplace is variously given as Martiques in Provence, Amalfi in southern Italy and Tonco in Piedmont, all in line with the respective nationality of the historians who wrote his life.[4] This saintly man organized the hospital staff into a community of lay brothers for whom he drew up appropriate constitutions which were approved in 1113 by Pope Paschal II. The fraternity became known as the Hospitallers of St. John, after the patron saint of the church which was attached to the hospital. This patron was St. John the Almoner, Patriarch of Alexandria, who had provided the means for rebuilding the churches of the Resurrection and of Calvary in Jerusalem. Later the Hospitallers adopted the better known St. John the Baptist as their patron saint.

Whereas Gerard was the founder of the Order of St. John, his successor Raymond du Puy, a knight from Provence, became its organizer. While he was Master of the Hospital (1120-60), the community, although continuing its hospital work, began also to engage in services of a military character. The military duties consisted at first in providing armed protection for the sick and the poor and military escorts for the pilgrims. Soon the brotherhood took part in the defense of the Latin Kingdom of Jerusalem and in the battles against the Moslems and thus became a full-fledged military order. But the order never forsook its humble beginnings; its militarization only added a new objective to its activities, as expressed in the age-old motto: Obsequium pauperum et tuitio fidei—service of the poor and protection of the faith.

During the process of militarization three classes of brothers developed: the knights who led in the fighting and held most of the higher administrative functions at headquarters and in the other houses of the order; the chaplains who took care of the spiritual needs of the other members of the order and of the patients in the hospitals; the sergeants-at-arms, who were the serving brothers. In the beginning, persons not belonging to the military aristocracy or nobility could enter the class of knights, but as from Master Hugh Revel (1258-77) the rule was laid down that such as desired to be admitted as knights should prove nobility on both father’s and mother’s side. When occasionally a few knights were received into the order who were not fully qualified with regard to their armorial bearings, they were called Knights-of-Grace (admitted by favor) in contrast to the duly qualified members who were called Knights-of-Justice, a distinction which has prevailed until recently.

The number of professed knights was always quite limited, scarcely in excess of 500 or 600 knights. Since the order was essentially a lay organization, the number of professed priests always remained very small. The professed chaplains served mainly in the Convent, that is, the general headquarters of the order, and were therefore called Conventual Chaplains. The cura animarum in the houses outside the Convent was for the most part exercised by priests who did not belong to the order, but were engaged by the order according to its needs; since they were throughout the time of office under the jurisdiction of the grand master they were called Chaplains of Magistral Obedience.

The professed sergeants-at-arms assisted the knights; they were at first quite important and numerous but eventually almost completely faded out of the picture, being replaced by hired help. In fact, the knights employed a considerable number of men for all their enterprises, both charitable and military: physicians and other personnel in the hospital were engaged on a paid basis, the soldiers who formed the body of the order’s army were mercenary troops as were the sailors on their fleet in the days of Rhodes and Malta.

At the top of this hierarchical pyramid stood the Master. His official title, ever since the days of Blessed Gerard, was Master of the Hospital. Although often referred to, even in earlier days, as the Grand Master, he did not formally assume the latter title until 1489. After the order had settled on Malta, the Grand Master Alof de Wignacourt (1601-1622) was given the title of prince of the Holy Roman Empire by the Emperor and the Pope bestowed on him and his successors a rank equal to a Cardinal of the Holy Roman Church with the title of Eminence. Besides these sonorous titles, the grand master, like all other professed members of the order, also uses the religious title Frà (Brother) which is put before his baptismal name. To date there have been seventy-six grand masters.

The monastic habit of the order was a wide black cassock with a slit on each side for the arms. In the days of Blessed Gerard a plain white cross was sewn on the breast; Master Raymond introduced the eight-pointed white cross which has become the emblem of the order down to the present day. Since these bell-like cloaks were rather cumbersome in battle, Pope Innocent IV in 1248 granted the knights permission to wear a black surcoat over armour when on active service. Pope Alexander IV in 1259 changed the color of this tunic to red, with a plain white cross. The choir dress of the professed knights is even at present a black mantle with the Maltese cross and a very elaborate maniple.

The headquarters of the order, wherever they might be, in Jerusalem, Acre, Rhodes or Malta, were called the Convent. In its developed form this Convent consisted of the palace of the grand master, the living quarters of the knights and their assistants, the stables for the horses, the church and the hospital.

Even by modern standards the hospital in Jerusalem was quite large; Master Roger des Moulins in a letter of 1178 puts the number of patients at 950. According to the statutes of 1182, the medical staff consisted of four physicians and a number of male nurses. Special regulations were laid down concerning hygiene. A wise rule was that each patient, after admittance, should hand over his valuables to the hospital authorities so as to prevent protests and reclamations in case of loss or theft. A religious in charge registered all the belongings of a patient and gave them back after he was dismissed. The statutes of the hospital in Jerusalem served as a model for, and sometimes were literally copied by, other hospital organizations in the Middle Ages.[5]

In view of the fact that before the crusades hospitals in the more modern sense of the word hardly existed, the charity work of the Knights of St. John—and to a lesser extent that of the other orders founded in the Holy Land—has been hailed as a kind of innovation. Historians agree that the Hospitallers must be credited with having created the hospital in the organized sense.