Middle Ages Folder


The Catholic Church and Healing
James J Walsh


Part 1


For nineteen hundred years the Catholic Church has been in intimate relation with the healing of mankind, body and soul. The Church has been a consistent and persistent patron of medicine, and the records of that patronage are available for those who are interested in the subject. It is easy to understand, then, how hard it has been to try to compress the story of the Church’s relations to healing into a brief sketch of this kind. I have here set down only the most important facts, the high lights of medical development down the centuries. Anyone who hopes to understand even a little the role of the Catholic Church has played in relieving suffering must consult large works, of which there are many available and to which this little book may serve as an introduction.



Fortunately in recent years there has come a far-reaching development of interest in medical history, and this has been followed by an equally significant accumulation of information. Until the end of the nineteenth century it was rather the custom to think of physicians and surgeons of the olden times as knowing almost nothing about medicine and surgery as they have developed in our day, but the more we have come to know of old-time medicine the more surprise there has medicine and surgery that are to be found even many centuries ago. Our ancestors could think in medicine as in most other departments of human interest, and they did so. With most of what has been accomplished in medicine the Church has been very closely associated. Ecclesiastics been at the number of anticipations of our modern brought about the eradication of leprosy. This revealed the significance of contagion and the possibility of the prevention of disease by quarantine—facts hidden from the Greeks. They applied the knowledge thus acquired to other problems of disease with distinct success. If the Church’s influence had secured nothing more than this in medicine, it would have been a wonderful triumph. That was, however, only a single item of many medical and surgical advances.


Monasteries preserved medical traditions and supplied drugs from the monastery gardens. The Church’s influence can be traced in the development of surgery and anatomy as well as in hospitals and asylums for the insane and medical teaching, so that there is scarcely a phase of medicine that is not deeply indebted to the Catholic Church. The story of it all I have tried to tell briefly here.




As Christ Himself went about healing as well as preaching, it was only to be expected that the Church founded by Him should be interested in the sick and those in need. Miracles of healing were the proofs of the divine mission of the Messiah Himself, and these continued at the hands of the apostles as a demonstration that the spirit of the Messiah was still with them. The most interesting feature of the Church’s relation to medicine in the early days is to be found in the fact that Luke, who wrote the third gospel but who also wrote the Acts of the Apostles, was a physician. In the early days of the so-called Higher Criticism of the Bible, serious doubts were thrown on the truth of this tradition of St. Luke’s being a physician, but the most recent reexamination of the documents makes it perfectly clear that Luke was beyond all doubt a physician. Sir William Ramsay, in his Luke the Physician and Other Studies in the History of Religion, (1) demonstrates clearly that Luke was a physician; and Harnack, the well-known German student of biblical subjects, confirmed this in his volume, Luke the Physician. (2).



As Harnack said, “Jesus appeared the great physician and healer. All the evangelists say this of Him; hence it is not surprising that one of them has set this phase of His ministry in the foreground and has regarded it as the most important.” He points out that, in Luke:


The description of particular cases of disease shows distinct traces of medical diagnosis and scientific knowledge. The language even where questions of medicine are not touched upon is colored by medical phraseology and where the author speaks as an eyewitness medical traits are especially and prominently apparent.



All this makes it very clear that the author was a physician; but, besides, it furnishes very definite evidence that the miracles of Christ were not merely mental healings, but that they were real exercises of His divine power—for Luke brings out the fact very clearly in a number of cases that the patients were suffering from true organic disease which could have been cured only by supernatural power.


Nothing demonstrates better than this fact the providential elements in the writings of the account of the life of the Lord and His miracles. A Greek physician of the scholarly tradition of Greek medicine from Hippocrates to Galen, providing in the very first generation of Christianity medical certification for the healings of the Lord, constitutes the best possible testimony for future ages to the reality and significance of these healings as evidence for His divinity.



Professor Adolph Harnack, already mentioned, began his career in the study of Christian antiquities with a monograph, Medical Features of Early Christianity, (3) in which he has gathered a large amount of information with regard to the relations of the Church and the medical profession. He mentions altogether some sixteen physicians who reached distinction in the early stage of Christianity. Some of these were priests and some of them bishops; as, Theodoros of Laodicea; Eusebius, bishop of Rome; Basilios, bishop of Laodicea; and at least one, Hierakas, was the founder of a religious order. The first Christian physicians came mainly from Syria as might be expected, for here the old Greek medical traditions were alive and active.



Among the early Greek physicians were Cosmas and Damien, physicians who were martyred in the persecution of Diocletian and who have been chosen as the patrons of the medical profession.  The Emperor Justinian erected a famous church, dedicated to them, which became the scene of pilgrimages. Christian medical organizations of various kinds, colleges, medical societies and the like, have ever since been named after them. Some idea of the interest of ecclesiastics in medical affairs may be gathered from a letter of Bishop Theodoret of Cyrus, directed to the prefect of the city, when he was about to leave the place. He wrote: (4)



When I took up the Bishopric of Cyrus I made every effort to bring in from all sides the arts that could be useful to the people. I succeeded in persuading skilled physicians to take up their residence here. Among these is a very pious priest, Peter, who practises medicine with great skill, and is well known for his care for the people. Now that I am about to leave the city, some of those who came at my invitation are preparing also to go. Peter seems resolved to do this. I appeal to your highness, therefore, in order to commend him to your special care. He handles patients with great skill and brings about many cures.



The first distinguished Christian physician in the history of medicine was Aetius of Amida, whose writings have become a classic. His medical studies were made at Alexandria; and having attracted attention by his medical learning and skill, he became physician to the emperors at Byzantium probably beginning with Justinian. He mentions Christian mysteries and appeals to the name of the Savior and the martyrs. He is distinctly scientific in his treatment of medical subjects and he is much richer in pathology, the scientific basis of medicine, than most of the older writers. Gurlt, the well-known German historian of surgery, says that Aetius treats pathology much more extensively than even Paul of Aegineta who is one of the most important of the medical writers of that time. Aetius says a great deal about drugs but he also treats of other remedial measures, dietetic, manipulative and surgical. He used venesection, cupping, leeches and the like, and his fourth and fifth books take up hygiene and special dietics. Aetius’s treatment of such subjects as goiter, varicose veins and of the tonsils, which are to be removed if hypertrophied, is so modern in some ways as to be very striking.

Aerius was thoroughly appreciated by his contemporaries, and his writings were faithfully preserved through all the vicissitudes of the times down to the introduction of printing, in spite of the time and labor required for making copies. The monastic scribes made no mistake in perpetuating his works. As soon as he appeared in print he received a hearty welcome. At the time of the Renaissance Aetius came to be very much thought of. Cornelius (Agrippa) declared that the early Christian physician’s work contained all that could be found in such writers as Galen and Oribasius and Paul of Aegina and even more. In his time, the early eighteenth century, Boerhaave declared that the works of Aetius are of as much importance to the physician as were the Pandects of Justinian for lawyers.



Even more important than Aetius was his colleague of the next century, Alexander of Tralles. His father was a physician as was also a brother, Dioscorus. Altogether, four of his brothers reached such distinction in their life work that their names have come down to us through nearly fifteen hundred years. The eldest of them was Anthemios, the builder of the great church of Santa Sophia in Constantinople. A second brother was Metrodoros, a distinguished grammarian, and a third was a prominent jurist in Constantinople. The careers of this family make it rather clear that conditions were very much the same in Asia Minor as regards the relations between the Church and education and science as they are at the present time. It might be expected that the brother of the man who designed Santa Sophia would not be without distinction in anything that he applied himself to. Alexander wandered throughout the known world of his time, Italy, Gaul, Spain and Africa, everywhere gathering medical knowledge and medical experience.



Then he settled down in Rome where he seems to have been a teacher of medicine, and some of the books we have from him are in the form of academic lectures. He seems to have made a great success in Rome; and he lived to be past eighty, dying probably during the first decade of the seventh century. His writings are very much valued at the present rime and modern German authorities on the history of medicine insist that he was not only a man of wide information but thoughtful and discriminating, and it is very evident that he made careful observations for himself. It is surprising to find in how many ways he has anticipated the conclusions of modern science with regard to the treatment of such affections as epilepsy, hemorrhage from the lungs, and other difficult therapeutic problems. For cough he recommended the careful use of opium, but also the breathing of Steam impregnated with various ethereal resins. For consumption he recommended an abundance of milk with a nutritious diet as digestible as possible, and advised, as a good auxiliary, change of air, a sea voyage or a stay at a watering place. The more one knows of these early medical traditions in Christian times, the more one thinks of them.



The influence of the Church in the early Middle Ages was exerted very happily for the development of the science of healing as well as for the exercise of charity. The old Greek tradition of medicine which we are coming to appreciate more and more in our day was fostered, and the works of the early Christian physicians closely in touch with it were preserved by the copyists in the monasteries; and after the invention of printing they exerted a great deal of influence at the time of the Renaissance. I have mentioned the striking examples among these early Christian physicians, who were to be most appreciated a thousand years later, but there were a number of others who might have been given place here if space had permitted. Their names and something of what they did for medicine and surgery will be found in my volume Old Time Makers of Medicine. (5).

(1)        New York, Armstrong & Sons, 1908.

(2)        New York, Putnam. 1909.

(3)        Medicinisches aus der aeltesten Kirchen-Geschichte, Leipzig, 1902.

(4)        Puschmann, Vol. I., p. 494.

(5)        Fordham University Press, N.Y., 1911. [Available on this website].




The hospital in our modern sense of the term, as an institution in which the ailing poor are cared for, is entirely owed to Christianity. Under the Greeks and the Romans there were hospitals for slaves and for soldiers but not for the poor. Originally the word meant “guest house” and only later came to be limited to ailing guests. In the early days of Christianity the deacons and deaconesses cared for the ailing in their own homes, but the Church also provided special quarters for those who had none. Often the bishop’s house provided a refuge for those who had no place to go, and one of the corporal works of mercy was “to harbor the harborless.” Sometimes, as we have seen, the bishops were themselves physicians. During the first centuries of Christianity none of these charitable works could be carried out openly because of the danger of persecution. There is no doubt, however, that in spite of this much was done for the benefit of the ailing poor.



Just as soon after the battle of the Milvian Bridge as the Church was free to engage in public works, hospitals became one of the features of Church life. Basil, the great Greek father of the Church, might well be taken as the incarnation of the spirit of Christianity at the time. His greatest work was the hospital established at the gates of Caesarea which became so large an institution with so many buildings for its different departments that it was called “New Town.” Gregory of Nazianzen, Basil’s friend, said of this hospital which had been called, after Basil, the Basilias, “It would be reckoned among the miracles of the world so numerous were the poor and sick that came hither and so admirable was the care and order with which they were served.”



Before the gates of Caesarea called by Basil out of nothing rose a new city devoted to works of charity and to nursing the sick. Well built and furnished houses stood on both sides of streets, symmetrically laid about the Church and contained the rooms for the sick and infirm of every variety who were entrusted to the care of doctors and nurses.

Another early hospital in the east was that founded by St. John Chrysostom at Constantinople (about 400) and which is mentioned by Palladius. It is said to have been commodious with many buildings and “well supplied with physicians and attendants for the sick— and cooks.”


Western Christianity was Just as enthusiastic in its establishment of hospitals as the East. In 390, under the guidance of St. Jerome, Fabiola, daughter of the ancient patrician family of the Fabii, built the first general public hospital in Rome. Jerome speaks of this as a nosocomium, a name which indicates that it was a place for the care of the ailing and not merely for the poor and helpless. Paula, who did so much to help St. Jerome in his translations of the prophets, was a close friend of Fabiola, and was deeply interested in hospital work. On the road to Bethlehem, when she lived in the Holy Land, Paula built hospices for pilgrims and hospitals for the sick in which she herself and her staff of dependents served untiringly. Lecky says she also established a hospital in Jerusalem. The buildings she erected were low and plain; but it were better, she said, to spend money on the poor than on fine buildings. Miss Nutting and Miss Dock, from whose History of Nursing I have taken many of these details, give a very full account of these early hospitals, in Italy and the Orient, that were attended by Roman matrons.



After reading the account of these hospital developments and the story of the care for the ailing poor in the history of the time, it is easy to understand that Julian the Apostate, when he tried to restore the old Olympic religion, wrote to Arsacius, high priest of Galatia, directing him to build a hospital in his city to be supported out of public revenues. He wished, as he said, to rival the good work of the Christians who cared for the pagans as well as their own and were thus winning the hearts of the people. Every phase of need for the ailing poor was provided for in Basil’s hospitals. Basil’s example of Christian charity, social service, and prevention as well as the healing of disease proved contagious.



Hospitals containing features similar to his were founded at Alexandria, at Ephesus and at Constantinople. St. John Chrysostom built one in the fourth century and others followed shortly. St. Pulcheria, sister of Theodosius II, founded a number of hospitals and refuges for the poor. Early in the sixth century Sampson founded a hospital near the Church of St. Sophia. Justinian built other hospitals. Du Cange (1) enumerates no less than thirty-five hospitals in the eastern imperial capital.



The development of the hospital movement through out Christianity in the Middle Ages is very well illustrated by the story of hospital foundations in the distant west of Europe—in England. Miss Clay in her volume on The Medieval Hospitals in England says:


It will surprise many to learn that—apart from actual monasteries and priories, there existed upwards of 750 of such charitable institutions in medieval England. To appreciate the relative magnitude of this number it must be remembered that the total population was smaller than that of London at the present day. The fact proves the clergy and laity were battling bravely with social problems. Miss Clay has given details with regard to a great many of these English medieval hospitals and has shown how important some of them were, though many of them were but small foundations. She has brought out very well how much private benevolence did in organizing for the care of the ailing poor, always turning to the Church and the religious for the carrying out of their good wishes while the benefactors were still alive and particularly after their death. There were many men like Dick Whittington of cat fame, “the model merchant of the Middle Ages,” who were liberal benefactors of the hospital work of their time.



A great new impetus for the building and organization of hospitals came with the Crusaders. The beginning of this movement developed, however, before the Crusades. Shortly before the year 1000, the feeling developed in many minds that the millennium might mark the end of the world. As a consequence a wave of religious fervor spread over Europe, and thousands of Christians made pilgrimages to the Holy Land. These pilgrimages continued during the following century. Jerusalem was then in the possession of the Moslems, and a great many of these pilgrims suffered severely Some of them were robbed by bandits, some were injured in accidents by the way, others fell ill, many of them died.



Some of the pilgrims, wealthier than others, bethought them to organize hospitals for the care of the ailing and destitute, and about the middle of the eleventh century rich merchants of Amalfi established at Jerusalem two hospitals, one under the patronage of St. John the Almoner and the other under that of St. Mary Magdalen. One of these was for men and the other for women. No distinction of sea was made, however, and ailing Mussulmans were cared for as well as the footsore Christian pilgrims and the ailing palmers who so much needed care.



There gradually came into existence two nursing orders which developed into the Knights Hospitalers of St. John of Jerusalem and the nursing order of St. Mary Magdalen which came after a time to be known as the female branch of the order of St. John of Jerusalem. When the Crusades broke out, they were ready to take up the great task of caring for the injured and ailing crusaders. The male nursing order found after a time that often, in the midst of their work of caring for the wounded on the battlefield, they were attacked by the Mussulman enemy, and so they organized a fighting branch of the order for their protection. After a time this fighting branch, the Knights Hospitalers, became even more important than the nursing branch, but always the duty of nursing continued to be an obligation on the order.



The nursing sisters came to be very well known, and the great heart of Europe went out to them in their work. Very soon they were given valuable endowments for their work in the shape of properties in many parts of Europe, the title to which was handed over to them and the rentals for which were regularly sent them. After the Crusades when they were dispersed over Europe, they continued to take care of the sick and injured, and besides that they devoted themselves to the care of the needy in times of social emergencies —as after earthquakes or fires or during epidemics. The Teutonic Knights, who from the first had both nursing and military duties and were mainly occupied in the crusade against the pagan Teutons in eastern Germany, came into existence later. Their importance can be best appreciated from the fact that one of the grand masters of the Teutonic Knights, a traitor to his trust, was the ancestor of the house of Hohenzollern, the recent kings of Prussia.



The great stimulus to hospital building came, however, in the thirteenth century. Pope Innocent III summoned Guy or Guido of Montpellier (France), who was said to have organized the best-conducted hospital of the time in his home city, to Rome to build a model hospital there. This was just about the beginning of the thirteenth century. That hospital—which with many restorations continued to function as a hospital until some ten years ago—was the old Santo Spirito in the Borgo not far from the Vatican. When bishops from all over the Christian world came at regular intervals for their visit ad limina to the Holy See, Pope Innocent called their special attention to this hospital and suggested that they should have one organized as far as possible like it in their dioceses. The result was a great outburst of hospital building everywhere throughout Europe. Many hospitals were built in Italy itself, but also in France and Spain and in Germany and England.


Virchow, the great German pathologist who was also deeply interested in the history of hospitals and of medicine, was enthusiastic in his admiration of Pope Innocent III for what he had accomplished by this means. Virchow said that there was scarcely a town of 5000 inhabitants in Germany that did not have its hospital as the result of the stimulus afforded by the Pope. He said: It must be recognized and admitted that it was reserved for the Roman Catholic Church and above all for Innocent III not only to open the bourse of Christian charity and mercy in all its fullness but also to guide the life-giving scream into every branch of human life in an ordered manner. For this reason alone the interest in this man and in this time will never die out. Virchow’s further tribute to Pope Innocent which is to be found in the second volume of his collection of essays, Public Medicine and the History of Epidemics” (2) gives the key to the spread of the hospital movement throughout Europe at this time.



The beginning of the history of all of these German hospitals is connected with the name of that Pope who made the boldest and farthest-reaching attempt to gather the sum of human interests into the organization of the Catholic Church. The hospitals of the Holy Ghost were one of the many means by which Innocent III thought to hold humanity to the Holy See. And surely it was one of the most effective. Was it not calculated to create the most profound impression to see how the mighty Pope, who humbled emperors and deposed kings, who was the unrelenting adversary of the Albigenses, turned his eyes sympathetically upon the poor and sick, sought the helpless and the neglected upon the streets, and saved the illegitimate children from death in the waters!



There is something at once conciliating and fascinating in the fact, that at the very time when the fourth crusade was inaugurated through his influence, the thought of founding a great organization of an essentially humane character, which was eventually to extend throughout all Christendom, was also taking form in his soul; and that in the same year (1204) in which the new Latin Empire was founded in Constantinople, the newly erected hospital of the Holy Spirit, by the old bridge on the other side of the Tiber, was blessed and dedicated as the future centre of this organization. These hospitals were usually staffed so far as nursing was concerned by members of the Order of the Holy Ghost, men and women. The men took charge of the male wards, the women of the female wards.




These hospitals of the Holy Ghost were famous for the order and cleanliness preserved in them. Many of the buildings erected for them were very beautiful, mainly because it was the custom of that time to consider that public buildings should be architectural monuments. The thirteenth century was the day of the great Gothic cathedrals and of the wonderful town halls and guildhalls as well as chapter houses and monastery buildings. Some of the hospitals erected in the thirteenth century were more beautiful than any that were built afterward until the twentieth century came with its great new hospital movement which has multiplied the number of our hospitals here in America fifty times in scarcely more than as many years.



Our movement has been entirely secular mainly under the influence of the medical profession who were awakened to the necessity for clean new hospital buildings if they were to be enabled to do the aseptic surgery which has meant so much for the saving of human life and suffering since Lister’s time. The old hospital movement was entirely ecclesiastical, and yet seven centuries after it stands comparison with ours.



Many of the hospitals were built by private beneficence, and some of the great noble families considered it a privilege to have their names associated with the inundation of hospitals. Virchow has dwelt especially on the many German hospitals erected by the families of which Elizabeth of Hungary was but one of the many ornaments because of their devotion to what we call social service. King Louis of France, as might have been expected from his kindly spirit of thoughtfulness for others, encouraged the building of hospitals in his dominions. This is one of the reasons why the name of saint is attached to his appellation as king of France. His sister Marguerite of Bourgogne built a model hospital of its kind, the picture and description of which are to be found in Viollet le Duc’s well-known Encyclopedia of Architecture.



A copy of this, a picture of a hospital ward of the thirteenth century, may be seen in my volume. The Thirteenth Greatest of Centuries. [Editor: See elsewhere on this site] Mr. Arthur Dillon, a New York architect, describing this hospital that was built by Marguerite of Bourgogne says of it: “It was an admirable hospital in every way, and it is doubtful if we to-day surpass it.”



Certain special hospitals deserve mention. A scourge of hospitals in the older times and indeed down almost to our own day was erysipelas. When it attacked surgical patients, it was nearly always fatal. In the latter Middle Ages special hospitals were founded for erysipelas, or “St. Anthony’s fire” as it was called, and by thus segregating these patients prevented infection and saved many lives and much suffering.


Hospitals continued to progress until the religious revolt in the sixteenth century. Luther, on a visit to Italy before his apostasy from the Church, praises the Roman hospitals and above all the fact that women of the better classes made it a rule to visit them at regular intervals and devote themselves to hospital work of various kinds. The confiscation of the old Catholic foundations at the time of the Reformation, so called, ruined a great many hospitals. The new doctrine of salvation by faith alone without good works took away much of the incentive to beneficence. Even Luther confessed more than once that under the papacy generous provision had been made for all classes of suffering, while among his own followers no one was interested in the maintenance of the sick and the poor.



The story of St. Camillus de Lellis illustrates the vitality of the Church during the century of the Reformation. While the reformers were spreading the doctrine of salvation by faith alone and the uselessness of good works in religion, this converted gambler who had been many years a soldier became the founder of an association of male nurses, priests and brothers wearing as the distinctive badge of their vocation the red cross for the first time in history (1586).



At first they visited the hospitals and made the lot of the patients easier by distributing many delicacies to them and above all bringing them consolation, carrying messages to friends, and the like. Then they realized the necessity for taking care of the poor in their homes and became real servants of the sick. After a time they took charge of hospitals and accomplished an immense amount of good. They were founded in Rome in 1585, and a branch house was established in Naples in 1588. Other houses followed in Florence, Bologna, Ferrara, Messina, Palermo, Nola—not to mention less important places.



They were asked to take charge of the Ospedale Maggiore in Genoa, one of the most important hospitals in Italy. Such small places as Bacchianico, the native town of Camillus, as well as other of the smaller cities of Italy received branches of the new nursing order. By the time of Camillus’s death (1614), less than thirty years after the original foundation, there were many hundreds of members of the order doing excellent work. In most places they organized an auxiliary among the people which was intended, however, not alone for the collection of funds but also for real personal service for the ailing poor under the direction of the religious. Many of the best people took on themselves the obligation of visiting the sick in the hospitals and alleviating their condition in every way.



This practice has been continued in Italy ever since, and the all important reason why Italian hospitals did not degenerate to anything like the same degree that is true in the English-speaking countries was that the visits of the well-to-do kept the hospitals to much better regard for the welfare of their patients. The Servants of the Sick were of particular service in times of epidemics and these were ever so much more frequent three hundred years ago and when catastrophes of one kind or another—floods, earthquakes, fires—required special skilled care for the sufferers from them. They also went as war nurses with the army and anticipated, in Italy, the work which the International Red Cross has been doing for the world during the past two generations since its foundation.

(1)        Historia Byzantina, II, “Constantinopolis Christiana.”

(2)        Gesammelte Abbandlungen aus dem Gebiete der Oeffentlichen

Medicin und der Seuchenlehre von Rudolf Virchow, August Hirschwald, Berlin, 1879





The greatest triumph both for scientific medicine itself and for the health of the people during the Middle Ages was the eradication of leprosy—which in the course of time had become an epidemic folk disease— by the method of isolation practiced with the approval and by the instigation of the Church authorities. As Professor Sudhoff, the greatest of living historians of medicine, declared in his Essays in the History of Medicine: (1).



“The leaders of the Church derived from the instructions given to the Jewish priesthood of the old dispensation, the impulse and even the obligation to carry out similar procedures. ... As a result, the idea of contagion now gradually became the motive power in the development of an entire system of preventive measures, at first limited to lepers and persons suspected of leprosy.”



After a time, however, the idea of prevention of the spread of disease by segregation came to be accepted for other affections besides leprosy, and this meant much in limiting the diffusion of contagious disease, especially in the crowded quarters of the cities of the Middle Ages. But the story of this is reserved for the following chapter. It is often said that leprosy spread throughout Europe after the Crusades. Long before this, indeed in the very early Middle Ages, leprosy had begun to be diffused along the littoral of the Mediterranean, and the shore regions of Spain and Gaul became infected with leprosy through coastwise traffic. Already in the sixth century, as Sudhoff points out, the disease had attained such frequency in the interior of southern Gaul that its suppression was of pressing moment. This led the Supreme Council of Lyons in 583 to react to the situation with an edict putting rigid limitations upon the free movement of lepers through the country.



In the East, even before this, there had been recognition of the danger and institution of the measures for segregation necessary to prevent the spread of the disease. It is from the East that leprosy spread along the coast regions of the Mediterranean first in the eastern part and later in the west, and it is but fair to recognize with Sudhoff that the measures which led to its eradication originated there also, the earliest impetus to their diffusion coming from St. Basil and his great hospital at Caesarea.



The recognition of the presence of leprosy led to the gradual development of compulsory regulations to prevent the spread of the disease. The lepers, for instance, were not allowed to go barefoot on public highways, they could not touch any articles laid out for sale even with the gloves which they were required to wear—an anticipation of our modem surgical employment of gloves to prevent infection—and any thing they touched must be bought and paid for. Some badge of warning had to be worn on their clothes so as to make people approaching them know that they were lepers. For persons approaching them unawares the leper had to make known his presence by blowing a horn or shaking a rattle which he was required by law to carry with him for that purpose. Whenever anyone addressed them they must stand facing the wind for contagion was supposed to spread not only by actual contact, mediate or immediate as we think now and as the word indicates, but was supposed also to be carried on the air from person to person and from place to place.



Even as regards attendance at church, strict segregation regulations were enforced. Whenever lepers were admitted to general religious services, as in a parish church, they had to enter by doors reserved particularly for them and they had to confine themselves to particularly designated places which isolated them. These portions allotted to the lepers were often separated from the body of the church by high partitions and sometimes permitted a view of the altar only through narrow slits. There are churches in England at which the lepers were expected to attend Mass, but they were required to remain outside of the church. There was only a small slit provided for vision of the altar and it was through this that they received Communion. So as to avoid even a slight chance of communicating their disease in the practice of their religion, in many of the leper houses there were special chapels and churches for them in the leper colonies which were usually situated down stream in relation to nearby inhabited localities. Lepers were required to live in these institutions and to observe all due precautions that would prevent contact with people who were not suffering from the disease. All lepers were committed to these institutions. Neither nobility nor family ties nor wealth nor political influence could dispense lepers from confinement to leper institutions once the disease had declared itself. There must have been an immense amount of hardship involved in this tearing away of people from their homes and friends; but there seemed no other way to secure the community from the danger which the spread of the disease involved, and so the regulations were enforced. The Church was the most prominent factor in the establishment of these leper segregation regulations and the consequent gradual elimination of the disease which took place. The influence of the Church made the leper colonies, however, very different from what most people think them to have been. A leper colony in the Middle Ages was often a very interesting institution. Some distance outside of the town, down stream from it, a traveler would notice on a hillside a group of little houses with shade trees and fruit trees around them and greensward and flowers, a church in the midst of them, all of it presenting a picturesque and even beautiful scene. This would be the leper colony. Lepers were not absolutely confined to these, but when with permit they traveled out of them, they were required as we have seen to observe very rigid regulations as to contact with others.  There was very definitely the “open-door system” which made existence very different from the prison-like immurement for life that most people assume to have been enforced on lepers.



Distinguished people, kings and queens and the higher nobility, archbishops, bishops and abbots, as well as men of high political status, who passed these leper colonies usually made presents to them so that the inmates might enjoy a special feast day at the expense of the passing traveler. Men like Louis IX of France made it a rule when passing to greet the lepers personally in spite of the dread of the disease which had developed as the result of the insistence on segregation. It was only to be expected that St. Francis of Assist would, as we hear of him, stop to greet the lepers, and this is true of a great many of the medieval saints. It is rather surprising to find how many of the important personages of the time turned aside when they were on a journey to bring some consolation to the hearts of the lepers.



Usually these passers-by asked for the special prayers of the lepers and recommended intentions to them, that is asked them to pray that certain of the desires of the hearts of their benefactors should be fulfilled. There was an almost universal feeling among the people of the time that the prayers of the lepers, if they were patient under their affliction, were likely to find special favor before the throne of God. It was recalled that He had said, “Whom the Lord loveth, He chasteneth;” and as these poor mortals certainly were chastened, they must be for that reason particularly close to the Lord. Hence the confidence with which men and women came to apply for the prayers of the lepers and their persuasion that whatever they did for these poor victims of disease had an especial significance as charity.


The lepers themselves came to recognize this feeling of almost reverence for them and to appreciate it properly so that after a time there developed in them a certain sense of having a special mission in life. They lost the feeling that they were abandoned by God and man and just had to live out a hard life until the end. This was very different from what most people in the modern time, who do not appreciate the real conditions, would be tempted to think. After a time many a leper began to feel that his suffering had given him a special place in the world as a sort of intermediary between God and His people. Their suffering brought them closer to the Lord and the hope was near that their prayers were more acceptable to Him if their suffering was borne in patience.



In spite of the impression to the contrary that is almost inevitable as a result of these conditions, the lepers came to enjoy after a time a certain satisfaction and happiness in life. As a consequence of the impetus to resistive vitality given by this hopeful state of mind in the midst of favorable surroundings in the country air and with good feeling, not a few of the lepers came to improve in health to such an extent that after careful examination which showed that no signs of the disease were left, they were permitted to mingle with the general population once more. There is no doubt that many cases declared to be leprosy were not genuine leprosy but represented some of the other chronic skin diseases mistaken for leprosy; but there was an immense amount of true leprosy, and the method of handling the disease worked out under the auspices of the medieval churchmen, stimulated as they were by the regulations of the Old Testament, led to its eradication.



As we know now, the cure of leprosy is not impossible and the disease has certain pathological relations to tuberculosis which makes it reasonably clear that fresh air and good food and a hopeful state of mind would do a great deal for milder cases. Leper inspections developed into a definite medical specialty so as to insure proper recognition of the actual conditions present in these cured cases. “The regular examination of all suspects or carriers,” as Sudhoff says, “first at the hands of the superintendent of the leper colony, the ‘masters’ of these organizations, later by specially appointed physicians and surgeons, by the corporate association of physicians in cities and by the medical faculties,” made a very definite accumulation of information with regard to the disease. This inspection having its origin in religious rites has this curious trait, that it started with the least easily transmissible of all chronic infections which thus became the chosen herald of the doctrine of contagion.


After the conquest of leprosy men were ready to believe in the possibility of eradicating other   diseases and proceeded to do it.

(1)       New York, 1926

Part 2

Published by: The ChurchinHistory Information Centre


This version: 23rd March 2008

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