Segregating the sexes
The monastic plan presented one problem. It was devised for single-sex communities. Some hospitals were single-sex, but most seem to have taken in both men and women and were staffed by brothers and sisters, aided by servants of both sexes.
Men and women could not be expected to share sleeping quarters. Yet both needed access to the chapel. Lanfranc's solution at St John's Hospital, Canterbury was a T-plan. There was a long infirmary range partitioned into two sections. The chapel was set at right angles to it, with entrances either side of the partition. A drawback of this plan was that the bed-ridden would be excluded from worship. Perhaps that is one reason why the Canterbury plan was not much copied.
A single range containing a connected infirmary and chapel proved far more popular. It gave the infirm a view of the altar when they most needed it. The Duke of Lancaster, as the patron of St Mary in the Newarke, Leicester, specified that all the patients lying in the nave of the hospital church should be able 'devoutly to behold the elevation of the Body of Christ'. St Mary Chichester is the sole survival in Britain of the open-plan medieval hospital in close to its original state. The aisles were later partitioned off into cells to give the almsfolk greater privacy, but if we mentally strip the panelling away, we can imagine the hospital in the thirteenth century.
But how could such a plan accommodate both men and women? One answer was an infirmary divided down the middle, as at St John, Winchester, where twin halls led to a shared chapel. Taking the process one step further, St Nicholas at Salisbury doubled the plan. It had two separate infirmaries with chapels.
Another approach was the double-decker infirmary. The best-known example is SS John the Baptist and John the Evangelist at Sherbourne, built in 1437. It housed women on the top floor and men beneath. The women could see mass from a gallery in the chapel, hidden from the men below. Sherbourne has been seen as a novel departure from previous hospital plans. Yet two-storey buildings were not beyond the scope of Norman builders and this arrangement would be an obvious solution for mixed infirmaries.
So were there earlier examples? Clues emerged from studies in the 1990s. The Lazar House Library at Norwich has already been mentioned. This Norman infirmary appears to have been two-storey, to judge by the placing of the windows. The hospital did house both men and women. Another mixed house was St Mary Spital in London. There excavators found that the new infirmary built around 1300 had such heavy buttressing and thick walls and piers that it was presumably two-storey.
Nursing sisters might even eat separately from their brethren in the larger houses. At St Giles Norwich and St Leonard York the master and brothers ate in the common hall, while the sisters ate in privacy.
Continue to Feeding the hungry.