Viollet le Duc, in his “Dictionary of Architecture,” has given a picture of the interior of one of these medieval hospitals, that of Tonnerre in France, erected by Marguerite of Bourgogne, the sister of St. Louis, in 1293, which we reproduce here. Mr. Arthur Dillon, discussing this hospital from the standpoint of an architect, says:
“It was an admirable hospital in every way, and it is doubtful if we to-day surpass it. It was isolated, the ward was separated from the other buildings, it had the advantages we so often lose of being but one story high, and more space was given to each patient than we can now afford.
“The ventilation by the great windows and ventilators in the ceiling was excellent; it was cheerfully lighted, and the arrangement of the gallery shielded the patients from dazzling light and from draughts from the windows, and afforded an easy means of supervision; while the division by the roofless, low partitions isolated the sick, and obviated the depression that comes from the sight of others in pain.
“It was, moreover, in great contrast to the cheerless white wards of to-day. The vaulted ceiling was very beautiful; the woodwork was richly carved, and the great windows over the altars were filled with coloured glass. Altogether, it was one of the best examples of the best period of Gothic architecture.”
The hospital ward itself was 55 feet wide and 270 feet long and had a high arched ceiling of wood. The Princess herself lived in a separate building, connected with the hospital by a covered passage. The kitchen and storehouse for provisions were also in separate buildings. The whole hospital plant was placed between the branches of a small stream conducted around it, which served to temper the atmosphere, and was a source of water supply at one end of the grounds and helped in the disposal of sewage from the other end.
A hospital of the Holy Ghost which may be taken as the type of such structures is still standing at Lübeck in Germany, and was, like the hospital at Tonnerre, also built during the thirteenth century. It was erected as the result of the movement initiated by Pope Innocent’s foundation of the Santo Spirito at Rome. The picture of this, in my “Thirteenth Century,” will serve to show what Holy Ghost hospitals in important cities at least were like. Lübeck was one of the rich Hansa towns in the thirteenth century, but there were many others of equal importance, or very nearly so, and all of these towns were rivals in the architectural adornment of their municipalities, and particularly in the erection of cathedrals, town halls, guild halls, and other buildings for the use of citizens.
The older portion of the Hospital of St. Jean at Bruges also gives an excellent idea of a later medieval hospital as it was constructed in a populous commercial town. Bruges, almost needless to say, was one of the most important cities of Europe in the fourteenth century. The Hospital of St. Jean, then, was built, like the cathedral and churches and the town hall, so as to be worthy of the city’s prestige. The older part, which is now used for a storeroom, has the characteristics of the best medieval hospitals. The ward was one story in height, the windows were large, high in the walls, and the canals that flowed around the hospital made pleasant vistas for the patient, while the gardens attached were eminently suitable for convalescents. The phases of hospital building down the centuries can be studied at St. Jean, and, strange as it may seem, the oldest portion of the hospital, that of the medieval period, provided the most light and air for the patients and the best opportunity for thorough cleansing, as well as for occupation of the patients’ minds with details of the construction that were visible from any part of the ward.
The hospitals of the Middle Ages are particularly interesting, because they represent a solution of the social problems other than merely the relief of pain and suffering, or the care of the needy who have none to care for them. They represent a ready, constantly near opportunity for the better-to-do classes to exercise charity toward those who needed it most. The hospitals were always in the busiest portions of the towns, and were often visited by the citizens, both men and women. Dr. John S. Billings, in his description of “The Johns Hopkins Hospital” (Baltimore, 1890), touched upon this spirit of the hospital movement of the Middle Ages in a very appropriate way when he said:
“When the medieval priest established in each great city of France a Hotel Dieu, a place for God’s hospitality, it was in the interest of charity as he understood it, including both the helping of the sick poor, and the affording of those who were neither sick nor poor an opportunity and a stimulus to help their fellow-men; and doubtless the cause of humanity and religion was advanced more by the effect on the givers than on the receivers.”
A rather significant historical detail with regard to medieval hospitals is the foundation of a special order to take care of the hospitals in which St. Anthony’s Fire, or what we know as erysipelas, was treated. Apparently this indicated the recognition of the contagiousness of this disease by the medieval people. Pope Honorius III. approved the foundation of an order of nurses particularly devoted to the care of patients suffering from this affection. Other religious congregations for the same works seem to have been established. We did not recognize the contagiousness of the disease until the last generation. Undoubtedly these special foundations made it possible to control many of the epidemics of erysipelas that used to make surgical care in our hospitals in the modern time such a difficult matter. Even as late as our Civil War here in America, erysipelas was the special dread of the hospital surgeon. Oliver Wendell Holmes pointed out that erysipelas might readily be carried to the parturient woman with the production of child-bed fever. It is interesting to realize, then, the attempt of the medieval period to segregate the disease.