Caring for the sick

The oddest feature of medieval hospitals to the modern mind is that not all of them cared for the sick. Those that did might be selective. At Bridgwater:

No lepers, lunatics, or persons having the falling sickness or other contagious disease, and no pregnant women, or sucking infants, and no intolerable persons, even though they be poor and infirm, are to be admitted to the house; and if any such be admitted by mistake, they are to be expelled as soon as possible. And when the other poor and infirm persons have recovered they are to be let out without delay.

This last rule has a pleasingly optimistic ring. Treatment was limited and many who entered a hospital would leave it only for the grave. Yet recovery was envisaged.

There is little evidence that hospital inmates were attended by physicians or surgeons; what evidence there is appears mainly in the late medieval period. That pattern could simply reflect the paucity of records, particularly from earlier centuries. It seems that one of the sisters of St Leonard York was a physician in 1276. However we do not find hospital patrons making provision for medical attendance before the statutes of the great Savoy Hospital in London in 1524. The cost of medical care from outside practitioners was probably prohibitive for most smaller hospitals. Perhaps that was just as well. The medical panacea of the age was bleeding.

We have no hospital case books from the time. There are few clues to the training of staff. John Mirfield, a cleric of St Bartholomew London, wrote a medical compilation in the late fourteenth century - the Brevarium Bartholomei. He seems to have been widely read and took a sceptical view of the charms and incantations so prevalent in treatment. He dismissed the idea that a woman in labour could be helped by a having a prayer written out and strapped to her thigh.

Yet the concept of healing prayer was built into hospital life, and there was a deep belief in miracles. Partaking of the body and blood of Christ the healer in Holy Communion was thought to combat disease of the body and soul. Hospitals took seriously the need to provide spiritual comfort for those in death's shadow.

Hospital gardens could provide herbs for medicine as well as the pot. Excavations at St Mary Spital and at Soutra have found seeds of an impressive range of potentially medicinal plants. The difficulty lies in proving that they were used in medicine, if they were common in the wild or had other uses. So it is interesting that pipkins which could have been used to prepare medicines were found at St Mary Spital and a jar at Soutra with residues of hemp, opium poppy, rose, cedar and pine. No great leap of faith is needed to picture herbal remedies as the mainstay of hospital medicine.

In any case the helpless infirm would be more comfortable in a warm, clean hospital than in the hovels of the poor. A good diet and careful nursing amid an ordered serenity might achieve much.

Continued to Crisis of Care.