Part 12 (1/2)
Bridewell and Christ's Hospital, the other two of the inst.i.tutions long known as the five royal hospitals of London, were either actually founded or received a great stimulus and a thorough reorganization during the thirteenth century. In the succeeding centuries Bridewell {256} ceased to be a hospital and became a prison, while Christ's Hospital, though retaining its name, became a school. With some of these inst.i.tutions the name of Edward VI. has become a.s.sociated, but, as pointed out by Gairdner, the English historical writer, without any due warrant. Gairdner says in his History of the English Church in the Sixteenth Century, ”Edward has left a name in connection with charities and education which critical scholars find to be little justified by fact.” The supposed foundation of St. Thomas's Hospital, as he points out, was only the re-establishment of this inst.i.tution, ”and even when it was granted by Edward to the citizens of London, it was not without their paying for it.” Many inst.i.tutions, charitable and educational, had been destroyed by Henry VIII., and the crying need for them became so great under Edward's reign that the government was compelled to provide for their re-establishment.
It is no wonder, with all this activity of the hospital foundation movement, that Virchow should have been unstinted in his praise of the Pontiff and of the Church responsible for the great charity. He said: ”It may 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 fulness, but also to guide the life-giving stream 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.”
Even this was not all that he felt bound to say, and in his admiration he quite forgot the constant opposition he manifested toward the Papacy on all other occasions. This happened to be the one feature of Papal influence {257} and endeavor that he had investigated most thoroughly, and one is tempted to wonder if like investigation in other directions would not have shown him the error of prejudiced views he harbored with regard to other phases of the beneficent influence of the Popes in history. More knowledge is all that is needed, as a rule, to overcome all the anti-Papal prejudices founded on supposed historical grounds.
Indeed, Virchow's tribute to Pope Innocent III. as the initiator of all this humanitarian work is so frank and outspoken that, coming as it does from a man whose sympathies with the Papacy were well known to be the slightest, it deserves to be recalled in its completeness, in order that another factor for the vindication of Innocent's character may be better known. The great pathologist said: ”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 {258} 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.” [Footnote 31]
[Footnote 31: Virchow's article on the German hospitals is to be found in the second volume of his collection of essays on Public Medicine and the History of Epidemics, which is, unfortunately, not translated into English, so far as I know, but will have to be consulted in the original Gesammelte Abhandlungen aus dem Gebiete der Oeffentlichen Medicin und der Seuchenlehre von Rudolf Virchow, Berlin, 1879. August Hirschwald.]
The quotation from Virchow gives a good and quite comprehensive idea of the scope of these inst.i.tutions. The ailing of all kinds were received beneath their hospitable roof. In many cases the regulations for the reception of pregnant women and for the care of the foundlings are still extant, besides the hospital rules for the care of the various kinds of patients. The department set aside for the foundlings was in most places rather an allied inst.i.tution than an integral part of the hospital itself. While these were called findel or foundling houses in Germany, in Italy this harsh name was not used, but the inst.i.tutions were termed hospitals for the innocents, thus emphasizing the most pitiable feature of the cases of the little patients, and not branding them for life with a name that suggested their having been abandoned by those who should have cared for them.
The regulations for the admission and care of patients are interesting as showing how much these medieval inst.i.tutions tried to fulfill the ideal of hospital work. The people of the Middle Ages had not as yet suffered all {259} the disillusionments that come from the abuse of charity at the hands of those who least deserve help, and besides, the attendants at the hospitals were expected to do their work for its own sake and from the highest motives of Christian benevolence rather than for any lesser reward. At the beginning, at least, there seems to be no doubt that this lofty purpose was accomplished very satisfactorily; but men and women are only human, and after a time there was deterioration. Even Virchow, however, was so struck by the ideal conditions that existed in these early hospitals that he discussed the necessity for having in modern times hospital attendants with as unselfish motives as those of the medieval period. It seems worth while then to give some of the details of this supremely Christian management of hospital work.
In an article on the medieval hospitals in the Dublin Review for October, 1903, Elizabeth Speakman quotes from the statutes of various hospitals sufficient to show how the internal government of these charitable inst.i.tutions was regulated. There was always a porter at the main door, usually one of the Brothers or Sisters, who had the power to receive patients applying for admission. At certain places, however, it seems to have been necessary to inform the superior; and the statutes of the French Hospital at Angers say, that the prioress is to go herself without delay to receive patients or to send one of the Sisters for that purpose, ”not severe or hard, but kind of countenance.” At the same place the statutes say, ”the number of the sick is not to be defined, for the house is theirs, and so all indifferently shall be received as far as the resources of the house allow.”
From many of the hospitals members of the community were sent out from day to day to find out if there {260} were any lying sick who needed care and who should be sent to the hospital. They were expected also to pick up any of the infirm whom they might find along the streets and bring them to the hospital. The att.i.tude which the religious attendants at the hospitals were to a.s.sume toward the patients upon whom they wait is clearly stated. In nearly all of the French hospitals of the thirteenth century, at least, the statutes in this matter do not differ much from this specimen:
”When the patient arrives he shall be received thus: First, having confessed his sins to the priest, he shall be communicated religiously and afterward be carried to bed and treated there as our Lord, according to the resources of the house; each day, before the repast of the brethren, he shall be given food with charity, and each Sunday the epistle and gospel shall be read and aspersion with holy water made with procession.”
As is noted by Miss Speakman, all through the hospital statutes of these times the name of Masters or Lords is applied to the patients.
The expression in Old French is Les Seignors Malades. The ordinary name for hospital was Maison Dieu, which has been well translated ”G.o.d's Hostelry.” It is evident, then, though the origin of the phrase ”Our Lords the Poor,” as applied to hospital patients, has been said to be obscure, that it is only a re-echo of the scriptural expression, ”Whatsoever ye shall do, even to the least of these, behold ye do it unto Me.” A quotation which was emphasized in the old rule of St.
Benedict, promulgated for the treatment of those received into the hospitality of the Benedictine monasteries, ”All guests shall be received as Christ, who Himself has said, 'I was a stranger and ye took Me in.'”
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In modern times, the necessity for providing for patients whatever within reason they may long for has often been insisted on. It is curiously interesting to find a striking antic.i.p.ation of this very modern rule in the customs of these old-time hospitals. As a result of the att.i.tude of supreme good will toward patients, there is an injunction in many hospital statutes, that whatever the patient may desire, if it can be obtained and is not bad for him, shall be given to him until he is restored to health. The Knights Hospitalers of St.
John of Jerusalem followed the injunction so carefully and endeavored to satisfy even whims of their patients that might seem unreasonable to such an extent, that their conduct in the matter became proverbial and gave rise to at least one pretty legend, the hero of which is no less a personage than the famous Eastern Sultan of the later Crusade period.
”Saladin desiring to prove for himself this reputed indulgence of the knights to their patients, disguised himself as a pilgrim and was received among the sick in the hospital in Jerusalem. He refused all food, declaring that there was only one thing that he fancied, and that he knew they would not give him. On being pressed, he confessed that it was one of the feet of the horse of the Grand Master. The latter, on being acquainted with this fact, ordered that the n.o.ble animal should be killed and the sick stranger's desire satisfied. Saladin at this point, thinking the experiment had gone far enough, declared himself taken with a repugnance to it, so the animal was spared.”
Virchow studied very faithfully the management of these medieval hospitals, and was evidently quite impressed with the success with which difficulties had been {262} met and overcome. None knew better than he all the difficulties there were in hospital management, for during nearly fifty years he had been identified with many hospitals, from city charity inst.i.tutions to the various kinds needed for war and those erected in connection with universities for teaching purposes.
He had very little patience with religious formulas, and was indeed a typical agnostic. Notwithstanding this, he has been perfectly frank in confessing how much is accomplished by the religious management of the hospitals, and even did not hesitate to declare that if hospitals for the poor particularly, are to be successfully managed, there must be a change in the view-point of those who take up the work of hospital nursing, and the attendants must come from better social cla.s.ses than is at present the custom. (This is of course for Germany.)
The question as to whether secular or religious management of hospitals shall prevail has not been as yet absolutely decided, and this adds to the value of Virchow's opinion. No one knew better than he of the many sacrifices required if the patients are to be properly cared for. Himself, as I have said, utterly without religion, it is curious to see how he recognizes the benefit that religious motives confer upon the management of a hospital, and how much better the work is likely to be done by those who give themselves up to the care of the sick as a Christian duty. He says:
”The general hospital is the real purpose of our time, and anyone who takes up service in it must give himself up to it from the purest of humanitarian motives. The hospital attendant must, at least morally and spiritually, see in the patient only the helpless and suffering man, his brother and his neighbor; and in order to be able to {263} do this he must have a warm heart, an earnest devotion, and a true sense of duty. There is in reality scarcely any human occupation that brings so immediately with it its own reward, or in which the feeling of personal contentment comes from thorough accomplishment of purpose.
”But so far as the accomplishment of the task set one is concerned, the attendant in the hospital has ever and anon new demands made upon him and a new task imposed. One patient lies next the other, and when one departs another comes in his place.
”From day to day, from week to week, from year to year, always the same work, over and over again, only forever for new patients. This tires out the hospital attendant. Then the custom of seeing suffering weakens the enthusiasm and lessens the sense of duty.
There is need of a special stimulus in order to reawaken the old sympathy. Whence shall this be obtained--from religion or from some temporal reward? In trying to solve this problem we are standing before the most difficult problem of modern hospital management.
Before us lie the paths of religious and simple care for the sick.
We may say at once that the proper solution has not yet been found.
”It may be easy, from an impartial but one-sided view of the subject, to say that the feeling of duty, of devotion, even of sacrifice, is by no means necessarily dependent on the hope of religious reward, nor the expectation of material remuneration. Such a point of view, however, I may say at once, such a freedom of good will, such a warmth of sympathy from purely human motives as would be expected in these conditions, are only to be found in very unaccustomed goodness of {264} disposition, or an extent of ethical education such as cannot be found in most of those who give themselves at the present time to the services of the sick in the hospitals. If pure humanity is to be a motive, then other circles of society must be induced to take part in the care of the sick. Our training schools for nurses must teach very differently to what they do at present, if the care of the sick in munic.i.p.al hospitals shall compare favorably with that given them in religious inst.i.tutions.
Our hospitals must become transformed into true humanitarian inst.i.tutions.”
While some of this striking opinion of Virchow's was derived from personal experience with hospitals managed by religious, it must not be forgotten that such hospitals are rarer in Germany, at least in the north, than almost anywhere else in the world. His opportunities then were limited, and undoubtedly much of his favorable persuasions in this regard was founded on his investigation of conditions as he had learned to know them in the old-time hospitals of the later Middle Ages. The traditions as to the treatment of patients in these early times are such as to make us believe that hospital attendants did take their work seriously from a very lofty motive, and that while medicine and surgery were much less effective than in more modern times, the tender care of patients did as much as was possible to make inevitable suffering more bearable, and to keep the sight of painfully approaching death from being a source of discouragement and even of despair.