Sheltering the needy

The gateway to the Hospital of St John the Baptist, Canterbury

Some one and a half thousand hospitals were founded in the British Isles in the Middle Ages. About a quarter were leperhouses. The rest are less easily classified. Many were multi-purpose charities which might feed the poor, care for the infirm and take in the stranger. Roughly 10% were hostels for pilgrims and other wayfarers. Only about 8% were intended specifically for the infirm. The major concern of most founders was the poor. Yet the distinction between the poor and the infirm could not be clear-cut. Poverty often sprang from a physical handicap or old age. So any hospital might have to deal with ailments, but its primary function was simpler. It saved lives with shelter, food and clothing. What could be more fundamental? So let us look first at how man's most basic needs were met.

Hospitals were designed for communal living. From the start a courtyard plan was popular. A gatehouse would lead into a quadrangle. Such a plan created a sheltered area, an enclosed world where inmates could be undisturbed. In the hospital they would eat together, pray together and share a dormitory. The model was monastic.

It also had echoes of family life. A manor house of the time might look quite similar, with hall, chapel and outbuildings arranged around a courtyard. A lord of the manor would eat and pray with his household. From cottage to castle there was little privacy in the early Middle Ages, so the lack of it in hospitals need cause no surprise.

The Great Hospital at Norwich from W.H. Godfrey, The English Alms-house (1955)St Giles (The Great Hospital) at Norwich has a decidedly monastic look. It has a cloister at its heart. In the mid-thirteenth century Bishop Walter Suffield decided to resite a parish church and add to it a retirement home for poor and decrepit chaplains of the diocese. The new institution would also provide a meal a day for a number of the poor, including several poor scholars. So the bishop neatly solved three problems at a stroke. As a clerical establishment giving out alms, St Giles sprang almost ready- made from the monastic tradition.

A few grand establishments had a double quadrangle - even more reminiscent of the monastic plan. In an abbey the cloister was the quiet centre of the contemplative life, while the great court beyond was the bustling hub of its practical support, with kitchen, bakehouse, brewhouse and workshops. In recent years excavations at Soutra in Scotland, St Leonard's, York and St Mary Spital, London have revealed how closely a house of care could mimic a house of prayer.

At the House of the Holy Trinity Soutra one courtyard held the chapel and staff quarters, while the kitchen and bakehouse were in a second courtyard. At St Leonard's it seems that one courtyard accommodated the hospital buildings and the other the church and clergy. Both houses were run by Augustinian canons. The Rule of St Augustine was a common choice for hospitals, being the most adaptable. Its followers were not strictly tied to the church and cloister. But a large hospital could afford to arrange some separation of the clergy. The lavishly-endowed Soutra was the largest hospital in Scotland in its heyday, while St Leonard's was its rival south of the border. The great hospital at York housed more staff and inmates than any other English medieval hospital.

We can follow the development of St Mary Spital thanks to an extensive study by the Museum of London Archaeology Service. This hospital too was run by Augustinian canons. The earliest buildings were the infirmary and chapel. As the hospital gained a special place in the hearts of Londoners, endowments fuelled its growth. A cloister was added which followed a monastic layout exactly, complete with chapter house, dormitory and refectory for the canons and lodgings for the prior. The original infirmary became part of the church, and a new infirmary was added beside it. Outbuildings spread out from this inner core and beyond lay a service court. The end result was an impressive complex.

A double quadrangle can still seen today at the Hospital of St Cross at Winchester. The outer gate leads into a small courtyard where the poor came daily to be fed in the Hundred Men's Hall. A grander gatehouse guards the large inner quadrangle. Knock on the door of the Porter's Lodge and you will receive the "wayfarer's dole" of free bread and ale. St Cross is the only British hospital still maintaining that tradition of hospitality to the poor pilgrim.

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