EARLY TYPES OF HOSPITALS DURING FIRST THREE CHRISTIAN CENTURIES

AND EARLY PERIOD*

ARISTOTELIS CHR. M.D. Associate Professor

of the History and Philosophy of Medicine, Medical School of Athens University

The of the early medical centers was dur-ing the first three centuries A.D. by pioneer physicians . Women doc-tors at the beginning, and men later, founded the early types of hospi-tals with personaI initiative. The function of the institutions first took place centers of adoratlon, caverns, inns, monasteries, and private houses. Later the Byzantine State cooperation wlth the Church organised the first real hospitals. The probable reasons for their establishment are the following: the social need of human beings to help one other and be cured together with others, according to the of the Great and Meletius Iatrosophista' ; the new Christian spirit of charity, hospitality and cure of body and soul of the patients, misfortunate persons and new faithful; the role of the person-al initiative and wills; the instltution of monasteries with hostels side for treatment of any iIl person; special circumstances provoking illness among many people such as epidemics, famine, persecutions, serious diseases such as leprosy and psychiatrlc mania; the small number of the scientific and miraculous physicians and the need of the multitude of patients for someone to stay near them for healing; the need for curing special social groups such as aged men, poor, pregnant women, orphans, widows, divorced women, lunatics; the existence of quackery, magic medicine and witchcraft wlthout the prin-ciples of medical science ; the organisation and administration for treatment by the State, Church and medical circles a real medical center.

* Paper given the 3511' International Symposium the History of Medicine, Cos, 2-8 Sept. 1996.

289 The Early Types of Hospitals

The pioneer and founder physicians are the foIlowing: The female doctors sisters Ss. Zenais and Philonilla (1st cen., commemorated 11 October) from Tarsus of Cilicia, relatives of the apostle Paul, worked

a cavern - hospital the area of the town2.18.19 Demetrias Greek Magnesia. They practised the art of medicine with charity, impro-visation and apostolic zeal. They were honoured with the title «friends of peace» because they were peace-Iovers, unmercenary and protec-tresses of medicine, who worked miracles2.17.19.

The woman doctor HermioneI7.20.2J (1st-2nd cen., commemorated 4 September) daughter of the Deacon Philip Caesarea of Palestine and studied the art of medicine3.20. After a long journey with her sister Eftychida17 .21 she went to Ephesus search of the apostle John, but didn't find him because of his assumption. this famous town, Hermione practised the art of medicine20 and founded the first

(<<publicum hospitium»f O a public hostel which is an early model of the later Byzantine xenon. It was more or less an infirmary, an asylum for the ill, poor and misfortunate. She practised the art of medicine a philanthropic way, encouraged and revigo-rated the multitude, that entered her initial inn-hospital. Hermione cured the diseases of the body and spirit with the invocation of Christ's Name. She was a virgin and and crowned a martyr physician. very deep old age she suffered many tortures by the emperors Trajan and Adrian, but she miraculously feIl asleep pe ace, as did her executioners, a before decapitation3.

The three saints Zenais, Philonilla and Hermione are the mercenary and miracle-worker doctors and they are the female pro-tectresses of medicine.

The physicians saints Cyrus and Joannes suffered martyrdom

the 3rd cen. trying to give courage to the young mother saint Atha-nasia and her daughters Theodote, Eudokia and Theoctiste, who had been imprisoned. Their memory is celebrated 31 Junuary and 28

a physician soldier from Edessa of Syria. Du ring a persecution they took refuge a monastery near the Arabian guJf. They offered healing for free to all patients at a sma]) hospitaJ of their monastery. They were thus ca])ed unmercenary and divine healers. Man's bad heredity of the passions was treated by the two doctors: «taking from divine grace the gift of miracles, you continuafIy work miracles cutting out afI

passions with your invisible surgical operation». their dismissal 11ymn they are honoured as «the great clinic of the wor d>> , «the doc-

1-2 19

290 Chr. Eftychiadis

tors of miracles and the healers of the patients, who illuminate the universe»4.

The doctor saint Diomedes (3rd cen., commemorated 16 August) was born Tarsus of studied medical science, was married and became the «best» physician, and humanist working

He accepted all patients his and laboratory Nicaea of Bithynia and cured them with «divine surgery» and the «cooperation of the Spirit». His nursing home was «a common labora-tory», «a clinic unsalaried» and «a most calm harbour». He offers

and benefits them «who recourse to him with faith»5. The saint and doctor Thallelaeus (3rd cen., commemorated 20

May) suffered martyrdom 284 A.D. of He practised the art of medicine Phoenicia of Lebanon «in his own house» a small infirmary. He carried upon his shoulders the sick

this nursing house, treated their wounds and considered the pains of the patients be his own pains. «The wise Thallelaeus» seIVed the

and without distinguishing between faithful or idolater. He is worthy as a «treasure of healing who donates the cure for free>}.

During the early Byzantine era (4th - 7th cen.) the cooperation between the State, Church, the private initiative and the medical circles was very fruitful. New imperial constitutions, canons of Ecumen-ical Synods, private and the medical legislation arranged the conditions of foundation, administration and the financial functioning of hospitals.

Justinian's medical legislation such as the Codex and Digesta define the conditions of establishment of a hospitaI by personal initia-tive or by behest. The could appoint the manager or the com-mittee of the hospital. Saint Constantine the Great regulates the schools and hospitals the instruction of the art of medicine by the physicians and professors8• Emperor Theodosius the Minor the duties of the assistants of the physicians, who were called parabo-lani, curing of the bodies of the patientsq

• accordance with Canon of the 4th Ecumenical Synod Chalcedon (451 A.D.) poorhouses and hospitals are founded by the Church J(). Novella Consti-tutio of Justinian governs the administration and financial function of the first hospitals. The income of the infirmaries results from dona-tions, Iegacies, loans, mortgages, buying and selling, financial

and grants I Especially for the taxation of the asylums and hospitals Theodosian Codex J2 and emperor Justin 1 13 don't deli-

The Early Types of Hospilals 291

ver them from the burden of any public tax. Emperor Heracleius (7th cen.) with his 23rd NoveJJa Constitutio l4 and a Canon of the Fourth Ecumenical Synod l5 deal with the erection of churches hospitals and the situation of the hospital's clergymen.

the West, according to saint Hieronymus, Fabiola (4th - 5th cen.), estab1ished the first «hospitaJium» Rome, and worked there as a nurse l l'. the Arabic world the first hospitals were erected mainly from the 8th century.

ConcIusion. The early types of hospitals were connected with p]aces of adoration, caverns, inns, monasteries, clinics and private houses. They were established during the three first Christian cen- turies for various reasons, first by female doctors, the saints and tectresses of medicine Zenais, PhiloniHa and Hermione. the early Byzantine era the institution and functioning of hospitals were regu- lated by the State, Church, private wills and medical legislation .

1. Melelii monachi ialrosophislac, 64, 1069-1309. 2. Menaion, ed. Phos, Alhens 1970, 10 (October), 108. 3. Menaion, 9 (Seplcmher), 62, 63. 4. The Great Horologion, ed. Saliveros, Alhens, 342, 405. 5. Menaion, 8 (Augusl), ]61, 173. 6. Religious and EIllical Encyclopaedia, ed. Marlinos, 7. 6, col. 102. 7. ed. G.E. Heimbach, Lingenlhal, ed. J. 5,

Alhens ]9J0-1911 . 5-1-7, 220 (Codex) 1.2 15. Corpus Juris CivtYis Justiniani, ed. Alberto el Mauricio, Lipsiae 1866, Pars 111, NoveIIas eI ConIinens

(Novella) 131, 10, 595. 5-2-2, 229, 230 11 (Oigesl,l) 18.1 41 . 3 9 5-3-1 1, 242

8. CorpusJuris Justiniani Codicis, 53, 666. Theodosiani ed. Th. Mommsen, Berolini 1905, Pars 3,3 (333 Sept. 27), 741.

9. Theodosialli Pars Poslerior, 2, 43 (418 Febr. 3), 851. 10. ed. r. - Alhens

1852-1859, ", 234, 235. J1. 3-1 -39, 167. Novella 123, cap. 23. Corpus Civilis, Novella 131, 595,

598,599. 22-]-76, 1075, 1076, (Codex) 4.21 17. 5-2-6, 233. Novella ]20, cap. 1,5,6. 5-3-17, 25__0..:.-. _

____ ..

13. NoveIIa 149 5(9) 6-3- 42, 273. ]4. Novclla 23 612) 3-2-2, 175. 15. Calloll 01' Ecumenical Synod, 235. 16. e r n 77, 22, 690-698. 17. u i e e ha e , Synaxariunl Ecclesiae Constantinopolitanae, Paris 1902, col.

129, 14. 18. a u s, alIerIum. 19. SIJnctorunl, 10m. 5, edit. Jo. Carnandel, Parisiis el Romae 1869,

502-509. 20. ActII SlIflcIorum, 10m. 2, apud Jo. Baplislam Albrizzi, Veneliis 1756, 185. 21. BoIIandiana, 10m. 72, Bruxelles 1954. 5, 10m. 77, Bruxelles 1959, 265.