Hospitals

Hospitals So called from the mediaeval hospitia, are now generally understood to be establishments intended for the reception of the poor the sick, or the infirm, where their spiritual and temporal wants are gratuitously ministered to. Though various provisions were made for the poor among the Greeks and Romans, and public largesses were distributed in many ways, hospitals were unknown. The true spirit of Christian charity, however, considers the most useless and abandoned characters as most in need of assistance, and imitates Christ in bestowing it upon them. The early Christians fed, not only their own poor, but also those of the heathen. Even Julian the Apostate praised their example in this respect. As soon as the early Christians were free to practice their religion openly, they commenced building charitable institutions, to which they gave various names, according to the character of their inmates: thus they had the Brephotrophium, or infant asylum; the Orpihanotrothium, or orphan asylum; the Nosocomium, or sick hospital; the Xenodochliun, or retreat for strangers, more particularly pilgrims. The latter was properly the hospital, or house of hospitality and in monasteries, that part of them which was reserved for the accommodation of visitors, and was divided into sections according to the classes of society to which the visitors belonged, was also so called (Du Cange, Gloss. s.v. Hospitale). These hospitals were soon found in all the large cities. Epiphanius says (Haeres. 75, No. 1): "The bishops, in their charity towards strangers, are in the habit of establishing institutions wherein they receive the maimed and the sick, providing them with such accommodations as their means will allow." They 'were generally in charge of the clergy (Constit. Apostol. I, 3:c. 19), though rich laymen would occasionally erect hospitals also, and wait on their inmates themselves, as did Pammachius of Porto, and Gallican of Ostia. The bishops were careful to have the poor properly buried, ransomed the prisoners of war, and often emancipated slaves. They often went so far as to sell the communion service, or the altar ornaments, to raise the means of accomplishing these charitable objects (Maurs des Chretiens, § 51). One of the most famous of these institutions was founded at Caesarea in the latter half of the 4th century. The next notable institution was that of St. Chrysostom, built at his own expense at Constantinople. There was also a very fine hospital at Rome, which was built by Fabiola, a Roman lady and friend of St. Jerome, who himself likewise built one at Bethlehem. The inmates of the hospitals in the early Church, very much like the practice of our own day, were divided according to sex. The male portion was placed under the charge of a deacon, and the women under the care of the deaconesses, who, according to Epiphanius (Exposit. fid. c. 17), rendered to persons of their sex whatever services their infirmity required. It was a rule for the deacons and deaconesses to seek for the unfortunate day by day, and to inform the bishops, who in turn, accompanied by a priest, visited the sick and needy of all classes (Augustine, De civit. Dei, I, 22 c. 8). The hospitals known as Nosocomia were really first instituted under Constantine. They were under the direct care of the bishop himself, and were, until the Middle Ages, oftentimes placed near or incorporated with their dwellings. But they must not be understood to have been, like the hospitals of our own day, one immense building. They consisted of a number of small cottages (dormunculke), each intended for a certain malady. Procopius (De aedif: Justinian. I, 1, c. 2; Hist. Byzant. 3), in speaking of an ancient valetudinarium which was re-established and enlarged by Justinian, says that the enlargement consisted in the addition of a certain number of small houses ("numero dormuncularum"), and of additional annual revenues ("annuo censu"). These numberless small houses, spread over a large area, gave to a hospital the appearance and extent of a village by itself. The nosocomia were also established in the West, but, unlike those of the East, they were confined to the houses of the bishops. Thus Augustine dined at the same table with the sick and poor to whom he afforded relief (Posidius, In ejus Vita, c. 23). After the downfall of the Roman Empire, we find no mention made of hospitals in Europe for several centuries. During that period the bishops generally took the whole care of the poor and the sick. The bishops' house was the refuge of the poor, the widows, the orphans, the sick, and the strangers; the care of receiving and entertaining them was, as we have already stated, always considered one of the chief duties of the clergy. Daring the troubled times which followed the downfall of the Carlovingian dynasty the poor were almost forsaken; gaunt famine stalked over Europe, and the clergy were hardly able to keep off starvation from their own doors. But in the 13th and 14th centuries, when contagious diseases were rife in Europe, hospitals were generally established in nearly all parts of the continent. Some were the fruit of private charity, others were established by the Church, and others by the state. They were usually under the direction of priests and monks, and in the course of time many abuses arose. In the progress of civilization both the condition and the management of such institutions were greatly improved. At the present day, no civilized country is without its hospitals, either endowed and supported by the government or by private charity. The Protestant Church of Germany has institutions of deaconesses, who especially devote themselves to the care of the sick in hospitals, and from Germany these institutions have spread to many other countries. There are also in many countries special schools for the training of nurses in hospitals. Among those who, in modern times, have exerted themselves for the improvement of the hospital service, Florence Nightingale is prominent. See Bergier, Dictionnaire de Theologie, s.v.; Martigny, Dict. des Antiquites Chret. p. 289 sq.; Aschbach, Kirchen-Lex. 3, 336 sq.; Leckey, History of Rationalism, 2, 263 sq.; Gosselin, Power of the Pope, 1, 120,222; Church of England Review, July, 1855; Low, The Charities of London (London 1850,12mo); Nightingale, Notes on Nursi., l (London 1859); Dieffenbach, Anleit. zur Krankenwartung (Berl.1832). SEE ALMIONER; SEE ALMS; SEE DEACONESSES; SEE FOUNDLING HOSPITALS; SEE ORPHAN ASYLUMS. (J. H.W.)