Healing hospitality in the early church


This will be the last post from Guenter B.
Risse’s Mending Bodies, Saving Souls: A History of Hospitals (Oxford University Press, 1999). In these excerpts from chapter 2, “Christian Hospitality,” Risse sketches the events and ideas that shaped the church’s commitments to providing healing spaces in its earliest centuries.

[Page numbers listed at the beginning of each paragraph. To see other posts from Risse’s book, put his name in the search box near the top of the right column of this blog.]

69           “Late in the year 499, the ‘Blessed City’ of Edessa in southeastern Anatolia, with an estimated population of about 10,000, experienced a great crisis. Frequent wars in the surrounding countryside four years earlier had already destroyed entire villages and ruined the fields. This situation was blamed for an epidemic of boils and swellings during which many inhabitants apparently went blind. By the fall of the year 499, agricultural failures in the surrounding rural areas multiplied due to swarms of locusts devouring the remaining crops. As a result, a multitude of country refugees began streaming into the city. Wrote Joshua the Stylite in his chronicle (composed in 507 in Syriac): ‘And the sick who were in the villages, as well as the old men and boys and women and infants, and those who were tor-[70]tured by hunger, being unable to walk far and go to distant places, entered into the cities to get a livelihood from begging, and thus many villages and hamlets were left destitute of inhabitants . . . the pestilence came upon them in the places to which they went and even overtook those who entered Edessa.’’

70           “[T]he ancient city of Edessa near the Syrian desert . . . on the caravan route to Persia and India . . . had also been strongly influenced by Jewish settlers and their traditions, but Christianity had grown dramatically during the first centuries, rapidly gaining its first recruits from among the urban upper and middle classes of Greco-Roman society.”

70           “After the year 200 and even earlier, the Mediterranean region had been periodically afflicted by prolonged, severe draught, triggering repeated famines, and epidemics. Sickness became a source of constant anxiety in the ancient Near East. Perhaps as a result of frequent commercial contacts with the Far East over the Silk Road, two separate disease pools, East and West, came together, with grave consequences for the entire region. Even before the Antonine plague of 165 – 180, a considerable number of Roman urban centers had probably achieved a sufficient population density to sustain imported contagious diseases. Perennial sanitary problems contributed to the spread of infectious diseases and higher mortality. Ailments resembling smallpox, measles, and plague repeatedly decimated populations and paralyzed political and social life. Fueled by the famines, civil unrest, and extensive migrations from rural areas to urban centers, both endemic [belonging or native to a particular people or country] and epidemic [spreading in a locality where the disease is not permanently prevalent] diseases decisively contributed to the progressive demographic and economic decay of the people living in the Byzantine Empire.”

71           “Bishops such as Eusebius were aware that the simple provision of food, water, shelter, and nursing allowed some of the sick to recover instead of dying miserably in the streets, thus reducing mortality and strengthening civic morale. During the fourth century, the Church had acquired not only significant political power, but also resources to care for its poor. Leading converted provincial aristocrats promoted a new urban constitution centered on the Christian bishop and his clergy. [For details, see M. Yanagi, et al., Byzantium, trans. N. Fry, Secaucus, NJ, Chartwell Books, 1978.] Like other cities in the Eastern Roman Empire, Edessa adopted the social tenets of the new Christian welfare. According to the historian Sozomenos, [72] the local ecclesiastical authorities had already sponsored in 373 a shelter or guest house—a xenodocheion or xenon—for the needy in response to a severe famine. The establishment was placed under the leadership of a hermit, Ephraim the Syrian, who had come out of seclusion. These foundations mirrored developments elsewhere in the empire, inspired, in part, by the original availability of Jewish hostels for pilgrims throughout Palestine. Since ancient times, Edessa’s fame had been linked to the presence of several springs with alleged healing qualities, including one, the well of Job south of the city, functioning until Emperor Antoninus Pius’ time but now surrounded by shrines dedicated to the saints Cosmas and Damian, who were buried there.”

Around 420 AD, Rabbula founded a Nosokomeion, sick house:

72           “Rabbula . . . bishop of the city between 411 and 435, founded around 420 another institution nearby specifically devoted to the sick and dying poor, a so-called nosokomeion or sick house, with separate facilities for men and women. Here attendants and even physicians were actively engaged in caring functions. Nearby, another hostel, created around 450, sheltered several lepers.”

Back to 499: Infirmary attached to “great church” in Edessa:

When in November 499 “the pestilence had become worse,” and then “frost and ice affected the homeless,” with “the spectacle of crying children and infants in every street hovering over the bodies of their dead mothers,” the church acted: “At this point, two priests from Edessa’s main house of worship ‘established an infirmary among the buildings attached to the Great Church of Edessa. Those who were very ill used to go in and lie down there; and many bodies were found in the infirmary which they [73] buried.’ As the combination of foul weather, famine, and disease took its toll, Edessa’s summer and winter bathhouses, with their extensive colonnades, were also pressed into service. ‘The governor blocked up the gates of the colonnades attached to the winter bath and laid down in it straw and mats, and they used to sleep there, but it was not sufficient for them.”

73           “the leaders of the city . . . too established hostels, and many went in and found shelter in them. The Greek soldiers too set up places in which the sick slept, and charged themselves with their expenses.’ In spite of these measures, mortality remained high. The community expressed its solidarity by attending many of the funerals. Of those placed in the shelters and nursed, many still ‘died by a painful and melancholy death,’ although surrounded by those devoted to their care.”

The following draws from Stark, Rise of Christianity, 73 – 94, who himself draws, says Risse, from William H. McNeill, Plagues and Peoples:

73           “Christianity, which was well established in the cities of the Eastern Roman Empire by the time of the disaster at Edessa in 499, was well suited to a population beset by famine, disease, and social disorder. Capable as it was of providing not only an ideology of salvation, but also charity and material assistance to the homeless and poor, it satisfied the longing for relief, hope, and community experienced by the ethnically diverse and uprooted people of the eastern cities, including Greek natives, Roman conquerors, Hellenized Jewish immigrants, and traders from the Far East. Joining this religion ensured membership in a dedicated network of believers whose family values protected orphans and widows and whose nursing services were eagerly sought during earthquakes, fires, and epidemics. Christianity thus became the basis for a new social solidarity eminently suited to the periodic chaos afflicting the urban dwellers.” [cf., also, the Mennonite guy, Schneider or whatever, in the book from the Ancient Future Evangelical conference at Wheaton, 2006 or so]

73-4       “The result was the institutionalization of philanthropy and the creation of establishments to shelter and feed the poor, care for the sick, assist widows and the aged, and raise orphans. Building on the pagan concept of agape or love of God, Christians created a new vision of charity by equating their sufferings to the vicissitudes of Christ’s brief sojourn on earth. [K. H. Leven, “Athumia and philanthropia: Social reactions to plagues in late antiquity and early Byzantine society,” Clio Med 27 (1995) 393-407.] The mutual love between God and humans was distinct to Christian dogma [see Stark re “mercy” as virtue in Christianity vs. weakness in Pagan thought] and energized all actions aimed at assisting others. Instead of the reciprocal hospitality that had prevailed in ancient Greece and the family-oriented obligations of the Romans, Christianity adopted ancient Egyptian and Jewish models of social welfare that targeted particular social groups marginalized by poverty, sickness, and age. Jewish communities had [74] offered hostels to house the poor and sick travelers, and their healers were obligated to treat the sick poor. Houses were even set aside for lepers. Now Christians adopted similar responses to protect their own brethren.” [H. Koester and V. Limberis, “Christianity,” in Civilization of the Ancient Mediterranean, Greece, and Rome, ed. M. Grant and R. Kitzinger, New York, C. Scribner’s Sons, 1988, vol. 1, pp. 1047 – 73).]

74           “In Christian doctrine, God’s own sufferings provided both meaning and reassurance to the dispossessed. Agricultural failures and commercial downturns impoverished many Byzantine citizens, who suffered frequently from famine, warfare, and new diseases. At the same time, food shortages tended to benefit the rich landowners, who were not above profiteering by selling their grain at exorbitant prices. In effect, as in other Near Eastern civilizations, the rich grew richer while the poor became poorer. However, Christ’s power and promise to offer each person a heavenly existence in another life inhibited the greed of the rich while providing consolation and hope to those whose wretched earthly existence generated only despair. Once launched as a religious system. Christianity proved successful. A strong sense of group solidarity and voluntarism strengthened the religious commitment. The rewards of membership were tangible, mitigating social inequities and promising greater security to vulnerable sectors of the population.” [Peter Brown, Power and Persuasion in Late Antiquity: Towards a Christian Empire, Madison, Univ. of Wisconsin Press, 1992, 71 – 117.]

74           “From its earliest days, Christianity demanded that all of its adherents aid needy and sick people. In his vision of the Last Judgment, Christ had linked an obligation to visit the sick to the essential good works needed for salvation. The six acts of Christian mercy were based on the Scriptures, notably the Gospel of St. matthew, composed in Antioch. The original concept of a ‘visitation’ of the sick may have been designed to convey solidarity and empathy, thus helping the sick overcome their isolating experiences. As such, visitations presumed the existence of a home and some familiar caring context. They often included gifts, food, and the performance of informal caring chores. However, when extended to provide lodging and aid to strangers, the New Testament recommendations promoted the need for a special communal shelter and nursing services. [Good works may have improved the quality of life for Christians and even extended their life expectancy. See A. R. Burn, “Hic breve vivitur,” Past & Present 4 (1953); 2 – 31. For more information, see Raymond F. Collins, The Birth of the New Testament: The Origin and Development of the First Christian Generation, New York, Crossroad Pub. Co., 1993.]

74           “Based on scriptural injunctions, charitable Christian institutions were designed for such multiple functions as sheltering and feeding the poor, providing clothing, and performing other caring functions. Poorer members of a Christian congregation were to be cared for through voluntary and concerted efforts under the supervision of clerics and deacons. While committed to charity, however, early Christian communities also attempted to set limits to their endeavors and curb abuses. In a letter to the Thessalonians (2 Thess. 3:6 – 10), Paul warned his brethren about Christians who refused to work, urging churches to release quickly those who were not willing to participate. After all, poverty was a condition to be endured, not abused. Before offering material support, some Christian groups required strangers to present episcopal letters to verify their status as members of other communities. Less suspicion was displayed toward widows, orphans, and the sick.” [For a useful summary, see Darrel W. Amundsen, ‘Medicine and faith in early Christianity,’ Bulletin of the History of Medicine 56 (1982): 326 – 50, and his collection of articles in Medicine, Society and Faith in the Ancient and Medieval Worlds, Baltimore, Johns Hopkins Univ. Press, 1996.]

From chapter 2, “Christian Hospitality,” on medical ministry in the early church:

69           “Late in the year 499, the ‘Blessed City’ of Edessa in southeastern Anatolia, with an estimated population of about 10,000, experienced a great crisis. Frequent wars in the surrounding countryside four years earlier had already destroyed entire villages and ruined the fields. This situation was blamed for an epidemic of boils and swellings during which many inhabitants apparently went blind. By the fall of the year 499, agricultural failures in the surrounding rural areas multiplied due to swarms of locusts devouring the remaining crops. As a result, a multitude of country refugees began streaming into the city. Wrote Joshua the Stylite in his chronicle (composed in 507 in Syriac): ‘And the sick who were in the villages, as well as the old men and boys and women and infants, and those who were tor-[70]tured by hunger, being unable to walk far and go to distant places, entered into the cities to get a livelihood from begging, and thus many villages and hamlets were left destitute of inhabitants . . . the pestilence came upon them in the places to which they went and even overtook those who entered Edessa.’’

70           “[T]he ancient city of Edessa near the Syrian desert . . . on the caravan route to Persia and India . . . had also been strongly influenced by Jewish settlers and their traditions, but Christianity had grown dramatically during the first centuries, rapidly gaining its first recruits from among the urban upper and middle classes of Greco-Roman society.”

70           “After the year 200 and even earlier, the Mediterranean region had been periodically afflicted by prolonged, severe draught, triggering repeated famines, and epidemics. Sickness became a source of constant anxiety in the ancient Near East. Perhaps as a result of frequent commercial contacts with the Far East over the Silk Road, two separate disease pools, East and West, came together, with grave consequences for the entire region. Even before the Antonine plague of 165 – 180, a considerable number of Roman urban centers had probably achieved a sufficient population density to sustain imported contagious diseases. Perennial sanitary problems contributed to the spread of infectious diseases and higher mortality. Ailments resembling smallpox, measles, and plague repeatedly decimated populations and paralyzed political and social life. Fueled by the famines, civil unrest, and extensive migrations from rural areas to urban centers, both endemic [belonging or native to a particular people or country] and epidemic [spreading in a locality where the disease is not permanently prevalent] diseases decisively contributed to the progressive demographic and economic decay of the people living in the Byzantine Empire.”

71           “Bishops such as Eusebius were aware that the simple provision of food, water, shelter, and nursing allowed some of the sick to recover instead of dying miserably in the streets, thus reducing mortality and strengthening civic morale. During the fourth century, the Church had acquired not only significant political power, but also resources to care for its poor. Leading converted provincial aristocrats promoted a new urban constitution centered on the Christian bishop and his clergy. [For details, see M. Yanagi, et al., Byzantium, trans. N. Fry, Secaucus, NJ, Chartwell Books, 1978.] Like other cities in the Eastern Roman Empire, Edessa adopted the social tenets of the new Christian welfare. According to the historian Sozomenos, [72] the local ecclesiastical authorities had already sponsored in 373 a shelter or guest house—a xenodocheion or xenon—for the needy in response to a severe famine. The establishment was placed under the leadership of a hermit, Ephraim the Syrian, who had come out of seclusion. These foundations mirrored developments elsewhere in the empire, inspired, in part, by the original availability of Jewish hostels for pilgrims throughout Palestine. Since ancient times, Edessa’s fame had been linked to the presence of several springs with alleged healing qualities, including one, the well of Job south of the city, functioning until Emperor Antoninus Pius’ time but now surrounded by shrines dedicated to the saints Cosmas and Damian, who were buried there.”

Around 420 AD, Rabbula founded a Nosokomeion, sick house:

72           “Rabbula . . . bishop of the city between 411 and 435, founded around 420 another institution nearby specifically devoted to the sick and dying poor, a so-called nosokomeion or sick house, with separate facilities for men and women. Here attendants and even physicians were actively engaged in caring functions. Nearby, another hostel, created around 450, sheltered several lepers.”

Back to 499: Infirmary attached to “great church” in Edessa:

When in November 499 “the pestilence had become worse,” and then “frost and ice affected the homeless,” with “the spectacle of crying children and infants in every street hovering over the bodies of their dead mothers,” the church acted: “At this point, two priests from Edessa’s main house of worship ‘established an infirmary among the buildings attached to the Great Church of Edessa. Those who were very ill used to go in and lie down there; and many bodies were found in the infirmary which they [73] buried.’ As the combination of foul weather, famine, and disease took its toll, Edessa’s summer and winter bathhouses, with their extensive colonnades, were also pressed into service. ‘The governor blocked up the gates of the colonnades attached to the winter bath and laid down in it straw and mats, and they used to sleep there, but it was not sufficient for them.”

73           “the leaders of the city . . . too established hostels, and many went in and found shelter in them. The Greek soldiers too set up places in which the sick slept, and charged themselves with their expenses.’ In spite of these measures, mortality remained high. The community expressed its solidarity by attending many of the funerals. Of those placed in the shelters and nursed, many still ‘died by a painful and melancholy death,’ although surrounded by those devoted to their care.”

The following draws from Stark, Rise of Christianity, 73 – 94, who himself draws, says Risse, from William H. McNeill, Plagues and Peoples:

73           “Christianity, which was well established in the cities of the Eastern Roman Empire by the time of the disaster at Edessa in 499, was well suited to a population beset by famine, disease, and social disorder. Capable as it was of providing not only an ideology of salvation, but also charity and material assistance to the homeless and poor, it satisfied the longing for relief, hope, and community experienced by the ethnically diverse and uprooted people of the eastern cities, including Greek natives, Roman conquerors, Hellenized Jewish immigrants, and traders from the Far East. Joining this religion ensured membership in a dedicated network of believers whose family values protected orphans and widows and whose nursing services were eagerly sought during earthquakes, fires, and epidemics. Christianity thus became the basis for a new social solidarity eminently suited to the periodic chaos afflicting the urban dwellers.” [cf., also, the Mennonite guy, Schneider or whatever, in the book from the Ancient Future Evangelical conference at Wheaton, 2006 or so]

73-4       “The result was the institutionalization of philanthropy and the creation of establishments to shelter and feed the poor, care for the sick, assist widows and the aged, and raise orphans. Building on the pagan concept of agape or love of God, Christians created a new vision of charity by equating their sufferings to the vicissitudes of Christ’s brief sojourn on earth. [K. H. Leven, “Athumia and philanthropia: Social reactions to plagues in late antiquity and early Byzantine society,” Clio Med 27 (1995) 393-407.] The mutual love between God and humans was distinct to Christian dogma [see Stark re “mercy” as virtue in Christianity vs. weakness in Pagan thought] and energized all actions aimed at assisting others. Instead of the reciprocal hospitality that had prevailed in ancient Greece and the family-oriented obligations of the Romans, Christianity adopted ancient Egyptian and Jewish models of social welfare that targeted particular social groups marginalized by poverty, sickness, and age. Jewish communities had [74] offered hostels to house the poor and sick travelers, and their healers were obligated to treat the sick poor. Houses were even set aside for lepers. Now Christians adopted similar responses to protect their own brethren.” [H. Koester and V. Limberis, “Christianity,” in Civilization of the Ancient Mediterranean, Greece, and Rome, ed. M. Grant and R. Kitzinger, New York, C. Scribner’s Sons, 1988, vol. 1, pp. 1047 – 73).]

74           “In Christian doctrine, God’s own sufferings provided both meaning and reassurance to the dispossessed. Agricultural failures and commercial downturns impoverished many Byzantine citizens, who suffered frequently from famine, warfare, and new diseases. At the same time, food shortages tended to benefit the rich landowners, who were not above profiteering by selling their grain at exorbitant prices. In effect, as in other Near Eastern civilizations, the rich grew richer while the poor became poorer. However, Christ’s power and promise to offer each person a heavenly existence in another life inhibited the greed of the rich while providing consolation and hope to those whose wretched earthly existence generated only despair. Once launched as a religious system. Christianity proved successful. A strong sense of group solidarity and voluntarism strengthened the religious commitment. The rewards of membership were tangible, mitigating social inequities and promising greater security to vulnerable sectors of the population.” [Peter Brown, Power and Persuasion in Late Antiquity: Towards a Christian Empire, Madison, Univ. of Wisconsin Press, 1992, 71 – 117.]

74           “From its earliest days, Christianity demanded that all of its adherents aid needy and sick people. In his vision of the Last Judgment, Christ had linked an obligation to visit the sick to the essential good works needed for salvation. The six acts of Christian mercy were based on the Scriptures, notably the Gospel of St. matthew, composed in Antioch. The original concept of a ‘visitation’ of the sick may have been designed to convey solidarity and empathy, thus helping the sick overcome their isolating experiences. As such, visitations presumed the existence of a home and some familiar caring context. They often included gifts, food, and the performance of informal caring chores. However, when extended to provide lodging and aid to strangers, the New Testament recommendations promoted the need for a special communal shelter and nursing services. [Good works may have improved the quality of life for Christians and even extended their life expectancy. See A. R. Burn, “Hic breve vivitur,” Past & Present 4 (1953); 2 – 31. For more information, see Raymond F. Collins, The Birth of the New Testament: The Origin and Development of the First Christian Generation, New York, Crossroad Pub. Co., 1993.]

74           “Based on scriptural injunctions, charitable Christian institutions were designed for such multiple functions as sheltering and feeding the poor, providing clothing, and performing other caring functions. Poorer members of a Christian congregation were to be cared for through voluntary and concerted efforts under the supervision of clerics and deacons. While committed to charity, however, early Christian communities also attempted to set limits to their endeavors and curb abuses. In a letter to the Thessalonians (2 Thess. 3:6 – 10), Paul warned his brethren about Christians who refused to work, urging churches to release quickly those who were not willing to participate. After all, poverty was a condition to be endured, not abused. Before offering material support, some Christian groups required strangers to present episcopal letters to verify their status as members of other communities. Less suspicion was displayed toward widows, orphans, and the sick.” [For a useful summary, see Darrel W. Amundsen, ‘Medicine and faith in early Christianity,’ Bulletin of the History of Medicine 56 (1982): 326 – 50, and his collection of articles in Medicine, Society and Faith in the Ancient and Medieval Worlds, Baltimore, Johns Hopkins Univ. Press, 1996.]


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