{"id":8193,"date":"2020-04-29T10:59:12","date_gmt":"2020-04-29T09:59:12","guid":{"rendered":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/?p=8193"},"modified":"2020-04-29T10:59:14","modified_gmt":"2020-04-29T09:59:14","slug":"hospitals-and-the-sick-then-and-now","status":"publish","type":"post","link":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/hospitals-and-the-sick-then-and-now\/","title":{"rendered":"Hospitals and the sick – then and now"},"content":{"rendered":"\n

As we are almost into May and lockdown measures are still in place, I thought this week I would take the blog back into the Middle Ages, which I\u2019m sure will surprise no one! Also, I expect a sizeable number of people will know that I have been researching hospitals in medieval England, especially in Kent, off and on for longer than I care to think about. Consequently, with the emphasis on the sterling work being undertaken by hospitals and care\/residential homes under the NHS banner at the moment, I thought a short piece on: who cared for the sick in medieval England \u2013 the role of the hospital, might be appropriate and of interest.<\/p>\n\n\n\n\n\n\n\n

I thought I would start with a quote from the Ancrene Riwle<\/em>, in part because anchoresses have always been part of Louise Wilkinson\u2019s modules on \u2018medieval women\u2019, but also because it nicely illustrates the medieval theological idea of the redemptive power of suffering for those who bore such tribulations with humility and fortitude: \u201cGod tests those he loves in the same way as the goldsmith refines gold in the furnace. The base metal vanishes completely, but the pure gold emerges truer and better than ever it was before\u2026 Sickness is your goldsmith, who, in the bliss of heaven adds gilding to your crown.\u201d Out of interest, if anyone has ever read\/seen the medieval \u2018morality\u2019 play Mankind<\/em>, the same idea is used there \u2013 if you haven\u2019t and you get the chance, do, it is brilliant fun. However, I guess I\u2019m biased because I taught it for over a decade as part of an early drama module.<\/p>\n\n\n\n

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Visiting the sick – from All Saints’ parish church, York<\/figcaption><\/figure>\n\n\n\n

Both the Ancrene Rewle<\/em> and Mankind<\/em>\nhighlight that the welfare of one\u2019s soul was of central importance to the\nmedieval Christian as s\/he sought to negotiate the perils on earth to achieve\nthe promises of heaven. Hence this dynamic relationship between body and soul\nmeant that the well-being of each was completely interlinked, but the soul took\nprecedence. For the founders, patrons and hospital benefactors of medieval\nChristendom, this relationship between care for the soul and care for the body\nwas at the heart of their charitable giving.<\/p>\n\n\n\n

Now the lives of medieval people in such things as Horrible Histories<\/em> is that they were nasty, brutish and short. While this is obviously a caricature, dearth, famine, disease and injury were all significant factors, a situation worsened in some ways from the coming of the Black Death and subsequent plague outbreaks, albeit generally survivors were better fed in the late Middle Ages. However, the fear of sudden and unexpected death which would not give time or opportunity to die in a state of grace led, in part, to the production of manuals concerning the art of dying well, the person enduring, even welcoming pain as a way of achieving spiritual redemption. Thus the death bed was largely the province of the priest rather than the physician, the last will and testament offering a final chance to engage in pious and charitable actions. <\/p>\n\n\n\n

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Maison Dieu or St Mary’s hospital for pilgrims, Ospringe [English Heritage]<\/figcaption><\/figure>\n\n\n\n

As I expect many of you know, contemporary ideas\nabout sickness stemmed from a combination of ideas from the ancient Greeks and\nthe early Church Fathers \u2013 disease as an imbalance of the four humours and St\nAugustine of Hippo\u2019s contention that none could escape suffering and death, the\nlegacy of Original Sin, to which was added an individual\u2019s extra load that was\ndue to his\/her inability to lead an exemplary Christian life. Consequently the\nsufferer should accept pain with humility, thereby avoiding the far worse\nordeal in purgatory. Now we shall never know how widely accepted such ideas\nwere and sleeping draughts of varying degrees of effectiveness were available\nfor those who could pay, but you do get examples such as Lady Margaret\nBeaufort, Henry VII\u2019s mother, who suffered terribly from arthritis but still\nspent hours on her knees praying as part of her pious way of life. <\/p>\n\n\n\n

Furthermore, Christ\u2019s healing miracles did mean\nthat the Church could reconcile its teaching about sin, disease and suffering\nwith the use of earthly medicine, although it must be allowed that often the\nsufferer was probably better off without such interventions by physicians or\nbarber-surgeons. Nevertheless, taking the idea of Christ the physician of\ndiseased souls, the Eucharist was thought of as having miraculous powers, even\nagainst earthly disease, and at Dijon, for example, the Host became the centre\nof a healing cult. Saints, too, could offer such miracles, and pilgrimage\nremained important throughout the Middle Ages. Adding to this, charitable acts,\nbased on the Seven Corporal Works of Mercy, of giving to the poor would not\nonly aid the recipient, but would please God and should make him more\ncompassionate towards the giver. One form of such alms giving was to support a\nhospital.<\/p>\n\n\n\n

Hospitals in medieval England came in a wide range of sizes, from the tiny hospital at Whitby where a leper lived by the bridge to the great hospital of St Leonard in York which, in the 14th<\/sup> century, housed 18 clerics, 30 choristers, 16 sisters and female servants, 10 corrodians, and between 144 and 240 poor-sick people. Furthermore, some hospitals only lasted for the life-time of a single person, whereas probably the first, at least from post the Norman Conquest, are still going strong, being Archbishop Lanfranc\u2019s twin institutions of St Nicholas\u2019 hospital for lepers at Harbledown and St John\u2019s for the poor and infirm, which is just outside the line of Canterbury\u2019s city wall. This means we shall probably never know just how many hospitals there were in medieval England, although I would suggest that there were over 30 in Kent alone. <\/p>\n\n\n\n

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St John’s hospital, Canterbury – 16th century gatehouse<\/figcaption><\/figure>\n\n\n\n

Now Professor Carole Rawcliffe has used two categories: those for lepers and those for non-lepers, but I prefer Professor Nicholas Orme\u2019s idea of distinguishing between earlier hospitals and later almshouses, with the addition of differentiating between Dr Patricia Cullum\u2019s small transient houses, which she calls late medieval \u2018Maisons Dieu\u2019, and those far better endowed where the almsfolk were the founder\u2019s bedesfolk. I also think it is worth separating those for the poor and infirm, and those for pilgrims (and other travellers). There are examples of these different categories in Kent, but for the purposes of the blog, I\u2019m just going to explore briefly the relatively small number nationally that took in the sick-poor. For most sick-poor people care came from family, friends and neighbours, not hospitals. By and large hospitals for the poor and infirm in England offered places for longer-term brothers and sisters, and if the sick-poor were admitted they either recovered and left, or died, in which case they would receive Christian burial. St John\u2019s hospital at Sandwich kept an old sheet specifically for that purpose. Possibly in part as a consequence of this different type of institution, England had nothing comparable to the extensive and more organised provision for the sick-poor in the Italian city states and other parts of continental Europe. Ok, we have already seen St Leonard\u2019s at York, but elsewhere it was not until the Tudors that more beds of this kind really became available: 180 beds at St Mary without Bishopsgate and at another London hospital, Henry VII\u2019s foundation at the Savoy which was intended to take in 100 poor men each night, preferably the sick, but not the leprous. In Kent (if we discount the hospitals that took in poor (and sick) pilgrims), probably the greatest provision for the sick-poor was at St John\u2019s, Sandwich, where the three chambers at the back of the hospital could accommodated at least eleven people. Although not all would have had a bed, there was a small bed next to the privy. \u00a0\u00a0<\/p>\n\n\n\n

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Christine Pikefish’s mazer bowl, St John’s hospital, Sandwich<\/figcaption><\/figure>\n\n\n\n

So what sort of people went into these hospitals? Some hospitals explicitly excluded groups such as cripples, the blind, the feeble, lunatics, pregnant women and other \u2018intolerable persons. Alternatively a few showed some degree of specialism, including St John the Baptist\u2019s hospital at Oxford that received casualty cases, St Mary Magdalen\u2019s hospital, Newcastle, that cared for victims of pestilence once the lepers had gone, while several London hospitals and a few in Kent specifically took in women in childbirth. For Kent, among these was Canterbury\u2019s third archiepiscopal hospital \u2013 St Thomas\u2019 that catered for poor (and sick pilgrims). London, too, offered provision for the insane, at a hospital near Charing Cross, as well as St Mary Bethlehem (Bedlam). <\/p>\n\n\n\n

Entry was frequently conditional on saying confession, and what might be termed this spiritual washing was at the Maison Dieu in Thetford accompanied by physical washing. In some of these hospitals at least, the beds for the sick-poor were aligned on either side of an infirmary hall, or \u2018nave\u2019, so that they might look into the chapel at the east end of the hall, whereby they would daily witness the elevation of the Host and hear the divine office. For example, such arrangements were at hospitals dedicated to St Mary at Chichester and Newark. However, Kentish examples are rare, the hospital for poor pilgrims at the Maison Dieu, Dover, having such a system. This lack of infirmary hall style hospitals in the county may in part be due to the absence of houses primarily or exclusively catering for the sick-poor, most hospitals accommodating lepers or the poor and infirm as the house\u2019s brothers and sisters. <\/p>\n\n\n\n

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St Mary’s or the Maison Dieu, Dover – pilgrim hospital<\/figcaption><\/figure>\n\n\n\n

While the primary care for the soul was the\njurisdiction of the hospital\u2019s priest brother(s), the sufferer\u2019s bodily needs\nwere in the hands of the hospital sisters, as well as female servants at the\nlarger houses. Probably many of the sisters were skilled in the use of herbs,\nbut the provision of better food and lodging, and general nursing care may have\nbeen more significant, although at possibly 3 to a bed contagion would have\nbeen an issue. Even though a few hospital accounts mention payment for medical\nservices and purchases from apothecaries, these are more likely to have been\nfor the brothers and sisters, not the sick-poor. Similarly, physicians\noccasionally held the mastership of a hospital, but most were sinecure\nappointments, and even where the master was resident, he would have gone\noutside the house to find his patients. Yet, and again perhaps to a degree in\nthe light of what was happening in Italy and elsewhere (Spain, France, the Low\nCountries, and central Europe), by the early 16th<\/sup> century things were\nstarting to change, but most of the few examples of barber-surgeons or\nphysicians working in hospitals relate to London.<\/p>\n\n\n\n

Consequently, just as today in terms of the\nCOVID-19 virus, nursing skills remain paramount, whether we are talking about\nhighly technical aspects or human empathy. Even though there have been considerable\ndifferences in what the term \u2018hospital\u2019 meant since the Middle Ages, as well as\nmajor culture changes, including differing belief systems, looking back into\nthe past offers some interesting comparisons. For medieval society was indeed\ndifferent compared to today; yet care for the sick continues to be paramount,\nwhether we are talking about provision in hospitals or in the community. Consequently,\nI wish everyone reading this and all of your families all the very best during\nthese difficult times.<\/p>\n","protected":false},"excerpt":{"rendered":"

As we are almost into May and lockdown measures are still in place, I thought this week I would take the blog back into the Middle Ages, which I\u2019m sure […]<\/p>\n","protected":false},"author":6665,"featured_media":8197,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[973,822,1001,5762,982,986,1142,1029,1],"tags":[7789,7785,3505,7822,1686,7817,3521,5201,4310,7794,7806,7790,4701,1014,7813,7818,7805,1133,7721,5170,7797],"class_list":["post-8193","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-academic","category-blog-posts","category-canterbury","category-heritage","category-kent","category-local-and-regional-history","category-london","category-middle-ages","category-uncategorised","tag-all-saints-york","tag-ancrene-rewle","tag-archbishop-lanfranc","tag-bedlam","tag-black-death","tag-dr-patricia-cullum","tag-harbledown","tag-maison-dieu-dover","tag-maison-dieu-ospringe","tag-mankind","tag-margaret-beaufort","tag-nhs","tag-professor-carole-rawcliffe","tag-professor-louise-wilkinson","tag-professor-nicholas-orme","tag-savoy-hospital","tag-st-augustine-of-hippo","tag-st-johns-hospital","tag-st-nicholas-hospital-canterbury","tag-whitby","tag-works-of-mercy"],"acf":[],"aioseo_notices":[],"authorName":"Sheila Sweetinburgh","featuredImage":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-content\/uploads\/sites\/445\/2020\/04\/AllSnts_sml.jpg","postExcerpt":"As we are almost into May and lockdown measures are still in place, I thought this week I would take the blog back into the Middle Ages, which I\u2019m sure […]","_links":{"self":[{"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/posts\/8193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/users\/6665"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/comments?post=8193"}],"version-history":[{"count":3,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/posts\/8193\/revisions"}],"predecessor-version":[{"id":8214,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/posts\/8193\/revisions\/8214"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/media\/8197"}],"wp:attachment":[{"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/media?parent=8193"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/categories?post=8193"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.canterbury.ac.uk\/kenthistory\/wp-json\/wp\/v2\/tags?post=8193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}