the first hospital -- 10/18/17

Today's selection -- from The First Thousand Years by Robert Louis Wilken. What may have been the first of what we now call hospitals was established in the fourth century CE by St. Basil of Caesarea (329-379 CE):

"Basil also took an interest in the sick and infirm. When he was a student at Athens, he had shown particular attentiveness in the study of medicine, not only in its practical side, but also in its theory and principles. He had gained enough experience to know, as he put it in one of his letters, that incompetent physicians often make people's illnesses worse. In one of his writings on the monastic life, The Longer Rule, he addressed the question as to whether relying on the 'art of medi­cine' is in keeping with Christian piety. Medicine, he wrote, like the know-how of a farmer or the skill of a weaver, is a gift of God. Because the body is susceptible to illness, God has given human beings the skills to heal illness. 'Just as we would have no need of the labor and toil of the farmer if we were living among the delights of paradise, so we would not require the art of medicine for healing if we were immune to disease.' The work of the physician who heals bodies redounds to the glory of God no less than the work of those who care for the soul. As the Lord used clay for healing (John 9:6), so also it is good that physicians use the things of the earth for the cure of bodily ills. ...

Icon of St. Basil the Great from the
St. Sophia Cathedral of Kiev

"Basil was familiar with the health care system that had arisen among the monas­tic communities [with their small infirmaries]. But when he became bishop he undertook a more ambitious project: to build a freestanding institution that would care for the sick as well as the needy. The new foundation, located on the outskirts of Caesarea, was a large com­plex that included medical facilities for the sick staffed with nurses and physicians, living space for the elderly and infirm, a hostel for travelers, a hospice for lepers who had been driven from the city because of disfigurement, a church and a monastery. According to Gregory, Basil cared for the lepers 'not only in word, but also in deed?' To support those who worked in the complex there were kitchens, refectories, baths, storehouses, and stables. So numerous were the buildings that Gregory Nazianzen called it a 'new city' in which 'disease' is treated by monks, 'misfor­tune' is a blessing, and 'compassion' is honored.

"Basil's institution was much more than a hospice or poorhouse. One writer says that it served those who are 'seriously ill' and 'especially in need of medical care.' Basil's friend Gregory Nazianzen says that it was designed to provide a place where the sick would be cared for by trained physicians schooled in the arts of medicine. It differed from poorhouses and other forms of medical care in several ways. First, it included facilities where patients could stay during the course of their treatment. Second, it engaged trained medical professionals, doctors and nurses, to diagnose and provide treatment for the patients. Finally, its services were provided free of charge. ...

"Of course an institution of this sort was expensive and stretched the resources of the Church. Basil's family was wealthy, well-connected, and respected in imperial and provincial circles, and the land the new foundation was built on was given to the Church by the emperor Valens. In a revealing passage in his history of the time, the fifth-century bishop Theodoret of Cyrrhus says that the emperor was so pleased with Basil's project that 'he gave him fine lands to care for the poor,' and adds 'be­cause they suffered serious bodily ailments and were particularly in need of care and cure [emphasis added].' But there remained a question as to whether the complex should be subject to taxation. Since the time of Constantine the churches had been granted exemptions from taxes, not only on the personal income of the clergy but also on land the churches owned. Yet the state expected something in return, and one way of justifying the exemption was to point to the church's social services, in particular caring for the poor.

"To make a case for government support of his new foundation, Basil wrote to the provincial governor Elias to remind him what his new institution provided to society and the scale of its activities. Not only did it employ physicians and nurses and their assistants, funds were needed for the upkeep of buildings for the staff and patients and stables to keep horses for travelers. Among the things he requested an exemption for, Basil mentions a 'house of prayer,' a residence for the bishop and clergy. The Church was no longer a private institution; its affairs were now inter­woven with the life of the society.

"The new foundation came to be known as the Basileias, after its founder, Basil. In a ninth-century manuscript it is pictured as a large oblong building surrounded by arched stoa, or covered walkways. Through the arches one can see Basil and Greg­ory Nazianzen ministering to the sick. The Basileias became the model for other hospital-like institutions in the Byzantine world."

with thanks to PM



Robert Louis Wilken


The First Thousand Years


Yale University Press


Copyright 2012 by Robert Louis Wilken


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