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 HOSPITALS

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HOSPITALS

superior, to that which was found in the oriental nations. Both Greeks and Romans regarded disease as a curse inflicted by supernatural powers and rather sought to propitiate the malevolent deity than to organize the work of relief. On the other hand the virtue of hospitality was quite generally insisted on; and this trait, as will presently appear, holds a promi- nent place in Christian charity.

Early Christian Times. — Christ Himself gave His followers the example of caring for the sick by the numerous miracles He wrought to heal various forms of disease including the most loathsome, leprosy. He also charged His Apostles in explicit terms to heal the sick (Luke, x, 9) and promised to those who should believe in Him that they would have power over disease (Mark, xvi, IS). Among the "many wonders and signs done by the Apostles in Jerusalem" was the restoration of the lame man (Acts, iii, 2-8), of the pal- sied iEneas (ix, 33, 34), and of the cripple at Lystra (xiv, 7, 9), besides the larger numljcr whom the shadow of St. Peter delivered from their infirmities (v, 15, 16). St. Paul enumerates among the cliarismata (q. v.) the "grace of healing" (I Cor., xii, 9), and St. James (v, 14, 15) admonishes the faithful in ca.se of sickness to bring in the priests of the Church and let them pray over the sick man " and the prayer of faith shall save him." The Sacrament of Extreme Unction was in- stituted not only for the spiritual benefit of the sick but also for the restoration of their botlily health. Like the other works of Christian charity, the care of the sick was from the beginning a .sacred duty for each of the faithful, but it devolved in a special way upon the bishops, presbyters, and deacons. The same ministrations that brought relief to the poor naturally included provision for the sick who were visited in their homes. This was especially the ca.se during the epidemics that raged in different parts of the Roman Empire, such as that at Carthage in 252 (St. Cyprian, "De mortalitate", XIV, in Migne, P. L., IV, 591-593; "S. Cypriani Vita" in " Acta SS.", 14 Sept.), and that at Alexandria in 268 (Eusebius, "Hist. Eccl.", VII, xxii; "Acta SS.", VI, 726). Valuable assistance was also rendered by physicians, slaves, or freedmen, who had become Christians and who like Cosmas and Da- mian were no less solicitous for the souls than for the physical needs and bodily comfort and well-being of their patients.

Another characteristic of Christian charity was the obligation and practice of hospitality (Rom., xii, 13; Heb., xiii, 2; I Peter, iv, 9; III Ep." St. John). The bishop in particular must be "given to hospitalitj'" (I Tim., iii, 2). The Christian, therefore, in going from place to place, was welcomed in the houses of the brethren; but like hospitality was extended to the pagan visitor as well. Clement of Rome praises the Corinthians for their hospitality (Ep. ad. Cor., c. i) and Dionysius of Corinth for the same reason gives credit to the Romans (Eusebius, "Hist. Eccl.", iv, 23). The bishop's house above all others was open to the traveller who not only found food and shelter there but was provided in case of need with the means to continue his journey. In some cases the bishop was also a physician so that medical attention was provided for those of his guests who needed it (Har- nack, " Medicinisches aus d. altesten Kirchengesch." in "Texte u. Untersuchungen" VIII, Leipzig, 1892). The sick were also cared for in the valctudinaria of the wealthier Christians who in the spirit of charity extended hospitality to those who could not be accom- modated in the bishop's house. There was thus from the earliest times a well organized system of providing for the various forms of suffering; but it was necessa- rily limited and dependent on private endeavour so long as the Christians were under the ban of a hostile State. Until persecution ceased, an institution of a public character such as our modern hospital was out of the question. It is certain that after the conver- VII.— 31

sion of Constantine, the Christians profited by their larger liberty to provide for the sick by means of hospitals. But various motives and causes have been assigned to explain the development from private care of the sick to the institutional work of the hospital (Uhlhorn, I, 317 sq.). It was not, at any rate, due to a slackening of charity as has been asserted (Moreau-Christophe, "Du probleme de la misere", II, 236; III, 527), but rather to the rapid in- crease in the number of C'hristians and to the spread of poverty under new economic conditions. To meet these demands, a different kind of organization was required, and this, in conformity with the prevalent tendency to give all work for the common weal an institutional character, led to the organization and founding of hospitals.

When and where the first hospital was estabhshed is a matter of dispute. According to some authorities (e. g. Ratzinger, p. 141), St. Zoticus built one at Con- stantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenotlochium in each city to be sup- ported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Clhristians who cared for the pagans as well as for their own. A splendid in- stance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Ca;sarea in Cappadocia (369). This "Ba.silias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, work- shops and industrial .schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Ba.silii"; Or. fun. "In Basil.", P. G., XXXVI, 578-579). St. Basil's example was followed throughout the East: at Alexandria by St. John the Almsgiver (610); at Ephesus by the bishop, Brassi- anus; at Constantinople by St. John Chrysostom and others, notaljly St. Pulcheria, sister of Theodosius II, who founded "multa publica hospitum et pauperum domicilia" i. e. many homes for strangers and for the poor (Acta SS., XLIII). In the .same city, St. Samson early in the sixth century, founded a hospital near the church of St. Sophia (Procopius, " De tedif . Justiniani", I, c. 2) ; this was destroyed but was restored under Justinian who also built other hospitals in Constan- tinople. Du Cange (Ilistoria Byzantina, II, " Con- stantinopolis Christiana") enumerates 35 establish- ments of the kind in this city alone. Among the later foundations in Constantinople, the most notable were the orphanotrophium established by Alexius I (1081- 1118), and the hospital of the Forty Martvrs by Isaac 11(1185-1195).

"The fact that the first hospitals were founded in the East accounts for the use, even in the West, of names derived from the Greek to designate the main purpose of each institution. Of the terms most frequently met with the Nusocomium was for the sick; the Bre- photrophium for foundlings; the Orphanotrophium for orphans; the Ptochium for the poor who were un- able to work; the Gerontochium for the aged; the Xenodochium for poor or infirm pilgrims. The same institution often ministered to various needs; the strict differentiation implied by these names was brought about gradually. In the West, the earliest foundation was that of Fabiola at Rome about 400. "She first of all", says St. Jerome, "established a nosocomium to gather in the sick from the streets and