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 HOSPITALS

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HOSPITALS

chaplains was founded by Sir David Latimer, Senes- chal to Marian, Archbishop of Cashel (122-1-1238). In 1272 the hospital was joined to the Cistercian Abbey in the neighbourhood. In or near Dublin ample provision was made for the care of the sick. About 1220, Henry Loundres, Archbishop of Dublin, founded a hospital in honour of God and St. James in a place called the Steyne, near the city of Dub- lin, and endowed it with lands and revenues. The Priory of St. John Baptist was situated in St. Thomas Street, without the west gate of the city. About the end of the twelfth century, Ailred de Pal- mer founded a hospital here for the sick. In 1361, it appearing that the hospital supported 115 sick poor, King Edward III granted it the deodanda for twenty years. This grant was renewed in 1378 and in 1403. About 1500, Walter, Archbishop of Dublin, granted a void space of ground to build thereon a stone house for ten poor men. On 8 June, 1504, John Allen, then dean of St. Patrick's Cathedral, foumled the said hos- pital for sick poor, to be chosen princiiiully out of the families of Allen, Barret, Begge, Hill, Dillon, and Rodier, in the Dioceses of Meath and Duljlin; and to be faithful Catholics, of good fame, and honest con- versation; he assigned lands for their support and maintenance, and further endowed the hospital with a messuage in the town of Duleek, in the County of Meath (Archdall, " Monasticon Hibernicum", London, 1786). At the Reformation all these funds and cliari- ties became the property of the Protestant Church of Ireland.

The famines and pestilences which scourged these countries during the Middle Ages called into existence a considerable number of institutions, in particular the leper-houses. This name, however, was often given to hospitals which cared for ordinary patients as well as for those stricken with the plague. What was originally opened as a leper-house and, as a rule, endowed for that purpose, naturally became, as the epidemic subsided, a general hospital. There were some leper-hospitals in Ireland, but it is not easy to distinguish them in every case from general hospitals for the sick poor. Thus the hospital built by the monks of Innisfallen in 869 is merely called nosoco- mium although it is usually reckoned an early foun- dation for lepers in Ireland. A hospital at Water- ford was " confirmed to the poor" by the Benedictines in 1185. St. Stephen's in Dublin (1344) is specially named as the residence of the "poor lepers of the city", in a deed gift of about 1360-70; a locality of the city called Leper-hill was perhaps the site of an- other refuge. Lepers also may have been the occu- pants of the hospitals at Kilbixy in Westmeath (St. Bridget's), of St. Mary Magdalene's at Wexford (previous to 1408), of the house at "Hospital", Lis- more (1467), at Downpatrick, at Kilclief in County Down, at Cloyne, and of one or more of four old hospitals in or near Cork. The hospital at Galway built "for the poor of the town" about 1543, was not a leper-house, nor is there reason to take the old hospital at Dungarran as a foundation specially for lepers" (Creighton, "A History of Epidemics in Britain", Cambridge, 1891, p. 100).

Action of the Papacy. — Innumerable pontifical documents attest the interest and zeal of the popes in behalf of hospitals. The Holy See extends its favour and protection to the charitable undertakings of the faithful in order to ensure their success and to shield them again.st molestation from any source. It grants the hospital permission to have a chapel, a chaplain, and a cemetery of its own; exempts the hospital from episcopal jurisdiction, making it immediately subject to the Holy See; approves statutes, intervenes to correct abuses, defends the hospital's property rights, and compels the restitution of its holdings where these have been unjustly alienated or seized. In particular, the popes Jire liberal in granting indulgences, e. g. to

the founders and patrons, to those who pray in the hospital chapel or cemetery, to all who contribute when an appeal is made for the support of the hospital, and to all who lentl their services in nursing the sick (Lallemand, op. cit., Ill, 92 sq.; Uhlhorn, op. cit., II, 224).

Character of the Medieval Hospitals. — It is not possi- ble to give any account in detail that would accurately describe each and all these institutions; they differed too widely in size, equipment, and administration. The one common feature was the endeavour to do the best possilile for the sick vmtler given circumstances; this naturally brought about improvement, now in one respect now in another, as time went on. Certain fundamental requisites, however, were kept in view throughout the Middle Ages. Care was taken in many instances to secure a good location, the bank of a river being preferred: the Hotel-Dieu at Paris was on the Seine, Santo Spirito at Rome, on the Tiber, St. Francis at Prague, on the Moldau, the hospitals at Mainz and Constance, on the Rhine, that at Ratis- bon, on the Danube. In some cases, as at Fossanova and Beaune, a water-course passed beneath the build- ing. Many of the hospitals, particularly the smaller ones, were located in the central portion of the city or town within easy reach of the poorer classes. Others again, hke Santa Maria Nuova in Florence and a good number of the English hospitals, were built outside the city walls for the express purpose of providing better air for the inmates and of preventing the spread of infectious and contagious diseases of all kinds.

As regards construction, it should be noted that many of the hospitals accommodated but a small num- ber of patients (seven, fifteen, or twenty-five), the limit being usually determined by the founder or benefactor: in such cases a private dwelling sufficed or at most a building of modest dimensions. But where ampler endowment was provided the hospital was planned by able architects and constructed on a larger scale. The main ward at Santo Spirito, Rome, was 409 ft. in length by 40 ft. in width; at Tonnerre, 260 ft. by 60; at Angers, 195 ft. by 72; at Ghent, 180 ft. by 52; at Frankfort, 130 ft. by 40; at Chartres, 117 ft. by 42. In hospitals of this type, an abundant supply of light and air was furnished by large win- dows, the upper parts of which were immovable while the lower could be opened or closed. To these, in some cases (Santo Spirito, Rome), was added a cupola which rose from the middle of the ceiling and was supported by graceful columns. The interior was decorated with niches, paintings, and armorial bear- ings; in fact the same artistic skill that so richly adorned the churches was employed to beautify the hospital wards. The ho.spital at Siena "constitutes almost as striking a bit of architecture as any edifice of the period and contains a magnificent set of fres- coes, some of them of the fourteenth century, many others of later centuries" (Gardner, "Story of Siena", London, 1902). The hospital founded (1293) at Tonnerre in France by Margaret of Burgundy, a sister-in-law of St. Louis, combined many advantages. It was situated between the branches of a small stream, and its main ward, with arched ceiling of wood, was lighted by large pointed windows high up in the walls. At the level of the winilow sills, some twelve feet from the floor, a narrow gallery ran along the wall from which the vent ilat ion might be regulated and on which convalescent patients might walk or be seated in the sun. The beds were separated by low partitions which secured privacy but could be moved asitle so as to allow the patients to attend Mass said at an altar at the end of the ward. This arrangement of a chapel in connexion with the principal ward was adopted in many establishments ; but the alcove system was not so frequently met with, the beds being placed, as a rule, in several rgws in the one large open ball.