From the earliest period Christian teachers had championed the cause of the poor and afflicted, and had upheld the sanctity of human life as such, whether in the aged, the crippled, or the unborn. Moreover the Church throughout ministered to poverty by almsgiving, and looked upon the destitute as having a special claim on her care. At two distinct periods in history these self-imposed duties were specially requisite—at the breaking up of the Roman Empire, and at the collapse of the feudal system. For under the Roman social system slavery had been a safeguard against vagrancy, but when slavery was discontinued the class of homeless outcasts became numerous. And again under the feudal system men belonged to the soil they were born on, but in proportion as serfdom ceased, beggars, and especially the diseased, increased to a great extent. In both instances efforts to stay the consequent evils to society were made by all professing Christians, but the attitudes of the 5th and the 12th centuries have distinct points of difference which it is well to bear in mind.
Glancing back along the vistas of time to the 5th century we find Severin bishop of Noricum († 482) instituting a regular and far-reaching system of charitable relief which has been described by his disciple Eugippius[761]. In connection with Magnericus of Trier († 596), the famous opposer of idolatrous practices, the newly-developed virtues of this period are thus summed up by his biographer, the monk Eberwein († 1047)[762]: ‘With him (Magnericus) the hungry found bread, the traveller found shelter, the naked found clothing, the weary found rest, and the stranger found hopefulness.’ We see that the efforts of these men were directed to ministering to poverty but not to disease, for the prevalent attitude of Christian society towards disease continued for some centuries strongly self-preservative. The poor were fed, but the diseased were shunned, especially those who were visibly disfigured, and who included the vast class of those who from the 11th century were currently spoken of as lepers (leprosi).
The homogeneity of the disease lepra in this application has been called into question, and it has been shown that the ‘lepers’ of the Middle Ages included those suffering from cutaneous eruption brought on by St Anthony’s fire, from gangrene of the limbs, such as comes through protracted use of bread containing rye spurred or diseased with ergot, and from other diseases which produce visible disfigurement. Scant provision was made for such people during early Christian ages, and lepers were numbered among social outcasts, not from fear of contagion—that was a comparatively late idea—but simply from a wish on the part of society to be spared a sorry sight. The diseased member of a family was a visible burden to his relations, and finding himself despised and shunned by his associates he took refuge with outlaws, who herded together and lived in a state of filth, misery and moral degradation terrible to recall.
It is in the treatment of these unfortunate people that the 12th century witnessed a revolution. The efforts of a few large-souled individuals overcame the general disgust felt towards disease, the restraints of a more barbarous age were broken through, the way to deal with the evil was pointed out, and gradually its mitigation was accomplished. The task these people set themselves, as so often happens in the course of social reform, absorbed them so entirely that they thought no sacrifice too great when it was a question of carrying out their ideas. It seems therefore rather gratuitous on the part of the modern scientist to say that a ‘halo of morbid exaggeration surrounded the idea of leprosy in the mediaeval religious mind. We live in a time of saner and better proportioned sentiment,’ etc.[763] In point of fact an evil is removed only by putting it for a time into strong relief, when it comes to be rightly dealt with and so is gradually checked. In early Christian times nothing was done for diseased people and lepers, but in the 12th and 13th centuries first individuals, then the masses, became interested in them. It mattered little that vagrants of the worst kind felt encouraged to call themselves lepers because as such they could excite more pity, could gain admission into hospitals, or were allowed to solicit alms under royal patronage. The movement once set going in the right direction steadily did its work: and the class of lepers so prominent in the 11th and 12th centuries were rapidly disappearing by the end of the 13th[764].
From the earliest period monasteries and church centres offered some alleviation for the sick and distressed, but their resources were at first intended for the relief of those who belonged to the settlement. The peaceful pursuits and regular occupations of the monk naturally prolonged his term of life, and as Christianity set great store by a peaceful and happy death, when feebleness and sickness crept on the member of a convent he was relieved from his duties and tended in an outhouse by a brother told off for the purpose. The guest-house of the settlement, called hospitalis, generally stood near this outhouse for the sick, but sometimes it was identical with it, and the pilgrims and travellers who were ill were nursed with the convent inmates. While these combined houses for guests and invalids, attached to convents, were numerous from the first, the foundation of shelters intended primarily for strangers took place comparatively late. Among them must be numbered the shelters designated as hospitals (hospitales), founded in outlying districts for the reception of pilgrims (pro susceptione peregrinorum) such as the Pope urged Karl the Great († 814) to keep up in the Alps[765]. Pilgrims were always an object of solicitude to the Church, and it was in their interest that the earliest independent road-side shelters and hospitals in cities were founded. These shelters and hospitals often consisted of no more than the protection of a roof, and the proctor, or brothers and sisters who voluntarily took charge of the house, secured the needful sustenance for themselves and those seeking their aid by going about begging.
The impulse to found these rests or hospitals naturally emanated from Rome, from a very early date the site of pilgrimages, but a new impulse was given to the movement by the foundation of two important guest-houses at Jerusalem in the 11th century, when that city also was a frequent resort of pilgrims. Of these two guest-houses or hospitals[766], one was intended for men and placed under the management of men, the other was for women and placed under the management of women. They were arranged according to an elaborate system which is interesting in many ways. The men were divided into three classes—the knights who looked after the interests of the house, the priests who attended to the sick, and the lay-brothers who assisted in the same work. The knights formed themselves into the religious order of St John, from the name of the church near which their headquarters lay. Similarly the women’s house, which was near the chapel of St Mary Magdalen, consisted of ladies, nuns and lay servants. The fact that St John and St Mary Magdalen were so often adopted as patron saints of similar houses elsewhere was due to the chance connection of these saints with the hospitals at Jerusalem.
Looking after pilgrims and nursing the sick constituted the chief work of the order at Jerusalem, but after the conquest of that city in 1187, when the knights removed to Malta and the ladies to Spain, the care of those not belonging to their body ceased to hold the foremost place. But the existence of the hospitals at Jerusalem and the attention they had attracted in the different countries of Europe, where grants of land had been made for their support, indirectly stimulated efforts in favour of the foundation of similar shelters or hospitals.
The first idea of independent hospitals came into England from Rome, when Archbishop Lanfranc († 1089), a native of Italy, founded two hospitals in the true sense of the word, one inside, one outside Canterbury. The one situated inside the city walls is described by the historian Eadmer († 1124) in the following terms[767]. ‘He divided it into two parts; men who were sick in various ways inhabited the one, women the other part. He gave to them clothes of his own and daily sustenance; and ordered that there should be servants and masters who were to take care they should want nothing; the men had no access to the women, nor the women to the men.’ A chapel was built on the other side of the way and given into the care of canons, who were to attend to the spiritual needs of the sick and to see to their burial after death.
The other hospital founded by Lanfranc was at Herbaltown, in the woods of Blean, a mile away from Canterbury; it was for those who were afflicted with scrofula (regia valetudine fluentibus), and who at a later date, in the confirming charter of Henry II, are styled lepers (leprosi)[768].
These accounts of Lanfranc’s foundations are especially interesting as they give us some of the earliest well-authenticated indications of a changed attitude towards lepers, and anticipate the efforts made in their behalf in the 12th century by the founders of the orders of combined canons and nuns, and in the 13th century by a number of women who on this account are numbered among the saints. These women, as we shall see, not only felt interested in these unfortunate beings but unhesitatingly tended them with their own hands. They knew nothing of the disgust usually felt towards wretchedness and poverty, and found their life’s happiness in vanquishing sordidness and filth. In the eyes of some of their contemporaries they were chiefly bent on seeking sorry sights and coveting painful experiences, but, apart from the appreciation they found among those to whom they directly ministered, others were generous enough to recognise the heroism of their efforts.