The First Responders

Today's Hospitals Are the Fruit of Ancient Christianity

Many American churches have been criticized for their response to Covid-19. In Kentucky, for example, state troopers visited the parking lot of a church on Easter Sunday and placed notices on vehicle windshields saying that anyone who attended Easter services (against the rule of Gov. Andy Beshear) would have to self-quarantine for 14 days.¹ And the New York Times reported somewhat cheerfully on the Covid-19 death of a pastor who had continued to hold in-person worship services at his church.² States' lists of "essential services" that were permitted to stay open generally included liquor stores, marijuana dispensaries, and bicycle shops, while excluding churches and synagogues. The attitude reflected in these policies seems to be that Christianity is a problem in a time of illness, instead of a force for good.

But these same governing authorities might be surprised if they took the time to read some histories of modern medicine. In many ways, Christians have been at the forefront of caring for the ill. The Christian Medical Fellowship catalogues an impressive number of medical pioneers who also happened to be believers. Among them are Louis Pasteur, one of the fathers of germ theory and also of vaccination, and Joseph Lister, who applied his knowledge of germs and infections to surgical practice.³ But one of Christianity's greatest and most significant contributions to modern medicine is the development of hospitals.

Hospitals Rise with Christianity

There are only limited accounts of anything like a modern-day hospital existing before the rise of Christianity. For instance, there is evidence that physicians in the royal courts of Assyria and Babylonia may have cared for ill court singers in what might be described as "elementary hospitals." Similarly, in ancient Greece, nobles could visit the Asclepeia, complexes that grew up around temples to Asclepius, the Greek god of healing, and there be put into a period of sleep, and have their dreams analyzed afterward. But both of these early precursors were only for wealthy or noble-blooded persons.⁴

"While institutions providing some form of medical treatment existed in ancient Greece and Rome," one article summarizes, "neither of these cultures organized community care for the sick, poor, and needy. A radical change occurred in late Antiquity, with the rise of Christianity, which embraced charity as one of its basic doctrines."⁵ When Christianity became officially tolerated in the Roman Empire around a.d. 313, Christians began to establish places to care for the aged, the ill, the mentally disabled, and the poor.

The earliest hospitals, called xenodochia, were originally places for pilgrims or ecclesiastical messengers to stop and spend a night, but they eventually evolved into homes for the poor, the ill, and the physically or mentally disabled.⁶ These xenodochia were the predecessors of the modern hospital. So important were they that when the emperor Julian the Apostate (361-363) tried to revive a pagan culture, he found it necessary to emulate the Christians, and wrote to his high priest, "In every city establish xenodochia in order that strangers may profit by our benevolence."⁷

The Role of the Monasteries

Monasteries played a crucial role in the further development of formal places of caretaking. Particularly as the Roman Empire disintegrated, whole communities began to look to the monasteries as stable institutions where one might receive both spiritual and physical help. At first, monastery infirmaries were largely devoted to the care of sick monks, but in time they began also to house civilian patients, with wealthy Christian benefactors contributing to their care and local physicians lending aid.

By the middle of the sixth century hospitals had been established in both the Eastern and Western parts of the Roman Empire, many of them supported by various monarchs.⁸ Charlemagne even issued a decree that every cathedral built in his empire should have a school, a monastery, and a hospital adjoining it, underscoring the Christian duty to care for the weak, the ill, and the otherwise ignored or disregarded segments of society.

Perhaps one of the greatest moments for monasticism, as well as for its role in the development of hospitals, was the founding by St. Benedict of Nursia of his monastery and hospital at Montecassino, Italy, in 529. Care of the sick and poor is emphasized throughout the Rule of St. Benedict, but perhaps most significantly in Chapter 36, where St. Benedict writes:

Before all things and above all things, care is to be had of the sick, that they may be so served as if they were in very deed Christ, because He Himself said: "I have been sick and ye have visited Me" and "What ye have done to one from among these My little ones, ye have done to Me." . . . [T]hey must be patiently borne with, because from such is acquired more abundant merit. Therefore let the abbot take very great care that they suffer no neglect.

The Rule further specifies that the sick should be housed in separate cells with an appointed caretaker, receive regular bathing, and even be allowed meat to promote their strength and recovery. St. Benedict concludes, "Let the abbot take the greatest care that the sick be not neglected by the cellarers and the servitors." When the Rule became widespread as a guide for how monasteries should be run, so too did its specific admonitions regarding care of the ill.

Still Providing Care

Over the centuries, wealthy benefactors in large urban centers began to found hospitals. The Church and its monasteries were still highly involved, but the civil authorities also recognized the benefit of having formal hospitals. And so Christian dominance of the medical world began to give way. Yet even today, many hospitals still bear the names of saints, and many are still affiliated with a church body—a lasting testament to the continued influence of the Church in healthcare well into the 21st century.

Hospitals are but one example of the continued influence that Christianity has had upon healthcare. Christian institutions and churches also maintain clinics for the disadvantaged, pregnancy care centers for women who might otherwise seek abortion, and even healthcare sharing cooperatives (like Samaritan Ministries or Medi-Share) wherein Christians can literally help their brethren in need by sharing healthcare costs.

In all of these things, Chris­tianity has historically demonstrated its commitment to caring for both body and soul. As Christ admonished his disciples, "I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me" (Matt. 25:35-36a). During the Covid pandemic, many churches live-streamed their services, or offered communion in small groups, or held outdoor services, or did any number of other things to maintain the physical health of their members while also caring for their spiritual wellbeing. They are continuing the long, rich history of the Christian contribution to healthcare, and to hospitals in particular.

Notes
1. Louisville Courier Journal (April 12, 2020): courier-journal.com/story/news/2020/04/12/kentucky-churches-hold-in-person-easter-services-despite-order/5127260002.
2. New York Times (April 14, 2020): nytimes.com/2020/04/14/us/bishop-gerald-glenn-coronavirus.html.
3. "The Christian Contribution to Medicine," Christian Medical Fellowship, Triple Helix (Spring 2000): cmf.org.uk/resources/publications/content/?context=article&id=827.
4. F. P. Retief and L. Cilliers, "The evolution of hospitals from antiquity to the Renaissance," Acta Theologica Supplementum 7 (2005): ajol.info/index.php/actat/article/download/52575/41180/0.
5. Tatjana Buklijaš, "Medicine and Society in the Medieval Hospital," Croatian Medical Journal 49.2 (April 2008): ncbi.nlm.nih.gov/pmc/articles/PMC2359880.
6. Ibid., note 4.
7. Ibid., note 4.
8. Ibid., note 4.