But hospitals were most necessary in wild and desert parts, where human habitations were not to be expected; and particularly in woody mountainous districts, and on the banks of broad rivers, where travellers were stopped for the want of bridges, and collected together in great numbers. It is probable that many of these hospitals may have given rise to the villages which are still found in such situations.
Pope Adrian I. recommended to the notice of Charlemagne[1112] the hospitals built in the Alps; and in the year 855, the emperor Louis II. caused those situated on mountains to be visited and repaired[1113]. The ruins of many of these edifices still exist.
Towards the end of the eleventh century, brotherhoods, which undertook to provide for the wants of sick pilgrims, were formed in the Holy Land; and these became richer and more numerous as the crusades increased. It was not uncommon for opulent persons, when dying, to bequeathe their property to establishments in which they had found consolation and relief; and very often those who had experienced a cure gave their money and effects, or a considerable part of them, to some brotherhood, either in consequence of a vow, or in order to show their gratitude. On this account the hospitals in Palestine could be constructed on a larger scale, and provided with better accommodations, than any before seen in Europe. They were therefore considered as models; and princes and rich persons, on returning safe from their pilgrimages, caused similar ones to be established in their own countries. Many princes even brought with them to Europe members of these brotherhoods, which in the course of time were converted into orders of knighthood, that they might employ them in the erection of hospitals. Instances of this circumstance have been given by Möhsen, in his History of the Sciences in the Mark of Brandenburg, and these might be easily increased. In the same author may be seen an account of the establishment of houses for the reception of persons afflicted with cutaneous disorders, and of their conversion into pest-houses. I shall here only remark, that these inns and hospitals contributed, in no small degree, to facilitate the travelling of mercantile people, who in the infancy of trade, when the roads were insecure and no means of conveyance established, were obliged to accompany their merchandise themselves.
The assertion of Muratori, however, that the oldest hospitals were not properly established for sick travellers, but rather for the sound, is undoubtedly true; and it appears that hospitals, according to the meaning of the word at present, that is, such as were destined for the sick alone, were not introduced before the eleventh century. The above author quotes[1114] from the life of St. Lanfranc, who was archbishop of Canterbury in the year 1070, that he caused an hospital to be built there, and fitted up in such a manner, that one part of it was destined for sick men, and the other for sick women. It is probable, or rather almost certain, that this prelate formed the institution here mentioned after the model of those which he had seen in his native country, Italy. After this period similar establishments for the sick are mentioned in various other parts.
The first hospitals, at least in general, were built close to cathedrals or monasteries; and the bishops themselves had the inspection of them; but afterwards, either for the greater convenience or the want of leisure, when their occupations increased, they committed this charge to the deacons. In the course of time, when houses for the sick were erected by laymen, and entirely separate from monasteries, the bishops asserted their right, often confirmed to them by imperial as well as pontifical laws, of visiting these institutions. We find, however, that in later times they were deprived of this privilege by princes and sovereigns, either because they wished to omit no opportunity of lessening the power of the clergy, or because the latter had given reason to suspect that the incomes destined for the use of the hospitals were not always applied to the intended purpose. Instances are found also, where, by the letters of foundation, the whole management is consigned to the sovereign or the heirs of the founder. These institutions, however, have the appearance of ecclesiastical establishments, and still retain in many cases similar privileges. As such they are free from all taxes, are spared as much as possible in war, and enjoy the same rank as churches.
Of the internal œconomy of the oldest houses for the reception of the sick, no information, however, is to be found. It is not even known whether physicians and surgeons belonged to them, nor in what manner they were supplied with medicines. Apothecary shops were not then established; and those found in hospitals at present, are but of modern existence.
In the hospitals at Jerusalem the knights and brothers attended the sick themselves, bound up their wounds, and, in imitation of the Grecian heroes, Hercules, Achilles and others, acted as their physicians. Thus we find in Amadis, and other books of knight-errantry written in the middle ages, how much the knights exerted themselves to obtain the best balsamic mixtures, and that, in general, they dressed each other’s wounds. The well-known baume de commendeur is one of the oldest compositions of this kind, belonging to the times of knighthood.
Profound or extensive knowledge of medicine could not be expected among these knights, were we even unacquainted with the account given of their skill by Guy de Chauliac. This author, who wrote his book on the healing of wounds in the year 1363, mentions the different medical sects, and among these names the German knights as the fourth sect, who, he says, cured wounds by exorcism, beverages, oil, wool, and cabbage-leaves, and trusted to the belief that God had conferred a supernatural power upon words, plants, and stones[1115].
The oldest mention of physicians and surgeons, established in houses for the sick belonging to the order of Templars, is under the government of John de Lastic, who, in 1437, undertook the office of grand-master, and defined very exactly the duty of physician and surgeon[1116]. It however appears to me, as it does to Möhsen, that the hospitals had regular and learned physicians at a period much earlier.
But, as long as this was not the case, they could afford no instruction to young physicians in the theory or practice of their art, like our hospitals at present. We, however, find a very singular account in regard to Persia, where it is said that some Nestorian priests had an hospital adjacent to their monastery, together with an institute or school for young physicians, who under certain prescribed rules were allowed to visit the sick. This establishment was in a town called Gandisapora, or, as Professor Sprengel writes it, Dschandisabor, the medical school of which is not unfrequently mentioned after the seventh century. The pupils who were desirous of attending the hospital for their improvement, were first obliged to submit to a trial, and to read the psalms of David and the New Testament. Many of those who had here studied medicine attained to high ecclesiastical dignity, which is the more surprising as the rest of the Nestorian schools in the East pay attention only to theology, and prohibit the young clergy entirely from studying medicine[1117].