g. The Works of Charity => Hospitality

"Hospitality holds the highest rank among all works of piety and humanity. All Christian peoples agree with that because hospitality includes all other virtues. It must be practised and respected by all men of good will - especially by those who carry the honourable name of a Knight Hospitaller. Therefore we must not devote ourselves to any other task with more dedication than to this very task the Order has got its name from."

History proofs that these words of Vertôt were not an empty formula in the Order of St. John but were filled with life in the practical service.

The Hospitality of the Order of St. John roots in a profound spirituality, which we dealt with above, and it is one of its elements. Hospitality is service to the Poor of the Lord. The Grand Masters of the Order call themselves "servant of the Poor of our Lord Jesus Christ" or "Servant of the poor Sick" and the Brethren are called Servants of the Poor. This attitude seems quite strange, especially as humility is commonly not associated with the factual life of knights. We must take into consideration though that the knights usually were very submissive and devout to their superiors. The crusaders considered Christ their supreme superior whom they finally served. Christ identified himself with the lowly: "The righteous will then answer him, 'When, Lord, did we ever see you hungry and feed you, or thirsty and give you a drink? When did we ever see you a stranger and welcome you in our homes, or naked and clothe you? When did we ever see you sick or in prison, and visit you? ' The King will reply, 'I tell you, whenever you did this for one of the least important of these brothers of mine, you did it for me!'" (Mt. 25.37-40). Serving the hungry, thirsty, estranged, naked, sick or imprisoned therefore means serving Christ and that is exactly what the knights were up to. Therefore it is the very consequence of their faith and their ideals of chivalry to serve the poor as their Lords.

The practical connection between the spiritual and the physical service to the poor is evident in the fact that the Brethren of St. John did not restrict their service to the physical welfare of the sick, but that they were also concerned about their spiritual wellbeing.

Therefore they used to have an altar for saying Holy Mass right in the wards.

Later on St. John's Hospitals were often built as double story churches, whereas the sick lay on the first floor and could look down from their beds to the ground floor and thus have audio-visual contact with the events on the altar of the church.

This custom has continued until today, e.g. in a carriage of a hospital train of the Italian Association from World War I (1914-18),

or in a more recent hospital in Rome, San Giacomo in Augusta, where the Order of Malta once maintained a ward. The pictures were taken at a Grandmaster's visit there. The hospital was in operation until 2008.

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This connection is already obvious in the oldest seal of the Order, which symbolises the interior of the Hospital. A sick person lies in the bed with his face turned aside. The "Eternal Light" is suspended (hanging down) from a dome in the background, it reminds the Sick of Christ's presence in the Sacrament of the Altar. The swinging censer symbolises the prayers of the Brethren for the convalescence of the sick.

The Rule and the Statutes obviously proof what an even for our days exemplary well organised system of charity was being run by the Order of St. John already in the first 88 years of its existence. Moreover it did not restrict itself to its main task of nursing, but it also includes services like baby care, care for abandoned children, welfare aid, e.g. by material help for poor bridal couples, other poor people or discharged prisoners, or food aid for the Poor. A St. John's Hospital thus represented much more than just a hospital or a hospice (the latter was in those days not defined as a home for terminally ill, but purely as accommodation for guests, e.g. pilgrims. The Latin word hospitium means just "house for guests"). I would therefore like to call the Hospital of Jerusalem a comprehensive institution of Charity Care. This may not only be understood qualitatively but also quantitatively.

The priest Johannes Wizburgensis (John of Würzburg/Germany) reports in AD 1170 on his travel in AD 1135 to Jerusalem and the Holy Land. He writes about St. Hospital in Jerusalem: "Over against the Church of the Holy Sepulchre, on the opposite side of the way towards the south, is a beautiful church built in honor of John the Baptist, annexed to which is a hospital, wherein in various rooms is collected together an enormous multitude of sick people. Both men and women. Who are tended and restored to health daily at very great expense. When I was there I learned from the report of the serving brothers  themselves that the whole number of these sick people amounted to two thousand, of whom sometimes in the course of one day and night more than fifty are carried out dead, while many other fresh ones keep continually arriving. What more can I say? The same house supplies as many people outside it with victuals as it does those inside, in addition to the boundless charity which it daily bestowed upon poor people who beg their bread from door to door and do not lodge in the house, so that the whole sum of its expenses can surely never be calculated even by the managers and stewards thereof. In addition to all these moneys expended upon the sick and upon other poor people, this same house also maintains in its various castles many persons trained to all kinds of military exercises for the defence of the land of the Christians against the invasion of the Saracens."

Roger de Moulins reports in AD 1177, that after the Battle of Tell Diezer (Ramlé) 750 wounded soldiers were admitted to the hospital which was already accommodating 900 other sick people.

Another pilgrim to Jerusalem, Theodericus, who visited the Hospital about AD 1172, counted 1000 beds.

We also know that the hospital made no difference in where the people seeking help came from when admitting the sick. This fact explains a certain gentlemen's agreement from the enemies of Christianity towards the hospital, especially in the 11th century.

Zwehl praises this fact by writing: "The honour to have been the first ones to tackle the accommodation and nursing of sick people of every kind and origin in a larger scale is to be credited to the Hospitallers." It is another exceptional quality, that every sick person had his own bed in the St. John's Hospitals, which was in those times really unusual. The Hospitality of the Order of St. John represented all in all a remarkable progress in the occidental medieval Care for the Sick.

[Frederick Barbarossa and Richard Lionheart]

Frederick I Barbarossa calls the achievements of the Order "invaluable works of mercy" and
Richard Lionheart calls the "most holy hospital of Jerusalem magnificent in works of piety".

Pope Alexander III. calls the Brethren "steadfast champions of Christ" in his bull "Quanto maior" from March 9, 1160.

A most valuable contribution to the research of the early history of the Order of St. John was made by Berthold Count of Waldstein-Wartenberg's book "Die Vasallen Christi" in 1988. He discovered a report of an unknown German monk, who he thinks might be identical with John of Würzburg or Theodericus, in the Bavarian State Library, Munich (Germany) [CML 4620 f. 132 b - 139b]. The author reports, that he had been inside the walls of Jerusalem before the conquest of the Crusaders and that he himself had been admitted to the Hospital. The charity work which he experienced there was quite a contrast to the worldly life in the city itself. This encouraged him to write a tract on charity, which contains an elaborate description of the nursing care of the Order of St. John. He did not want to bother the doctors and nurses with the many questions a reporter usually asks. Therefore he just wrote down what he observed, which makes his report even more valuable. The reporter is obviously not able to distinguish between knights and serving brothers and he also mixes up their titles. He probably has not known the statutes either, although his report is in going with the prescriptions of the hospital regulations, which just reveals, that the brethren of the Order observed their Rule.

According to him the hospital admitted sick people of all nations, ranks and classes, men and women, Christians and Non-Christians. Every sick person, no matter what sex or religion he or she belonged to, was considered a neighbour of Christ, who had to be admitted and nursed. The Hospital is called the "Palace of the Sick" and consequently belongs to them. For the sick the best was just good enough. Therefore the hospital may also have employed oriental doctors, which encouraged the local people even more to come to the Hospital for treatment.

If sick people could not come to the hospital by their own means, the serving brothers of the hospital went to their home and transported them carefully to the hospital. There was even a kind of ambulance service, which accompanied the crusaders on their way. Even full time employed surgeons belonged to that service, who erected tents or canopies on the battle fields, where the casualties were brought to and even their mounts, which were then used to transport the wounded to the hospital. If those were not sufficient the brethren had to put their own pack animals to the patients' disposal, thus showing that they only had lent those from their Lords, the sick, anyway.

As soon as the sick had arrived in the hospital the porter had to receive and treat them like Lords. They were first brought to a priest, were they could confess their sins and receive as the first food, the "remedy of heavenly medicine", i.e. Holy Communion. (This practise the Order had adopted from the Medical School of Salerno). Thereafter the sick were brought to the ward.

The Hospital was divided into eleven wards, which were obviously segregated according to the kind of sickness or injury of the patients. One ward had between 90 and 180 beds. Every ward was catered for by a special nursing team consisting of twelve nurses who were subject to a master. The women's ward, mainly serving as a maternity ward, was situated in a separate building. Waldstein-Wartenberg (Vasallen Christi) assumes it may have been situated in the western wing of the hospital adjacent to the Maria Latina Maior Convent. The nurses there may originally have belonged to St. Magdalene's Convent and later have become nuns of the Order of St. John.

The beds were big and covered with a bedspread and a linen sheet and feather cushions, so that the sick did neither "have to suffer from the roughness of the shaggy blankets nor through the hardness of the bed". The private clothing of the sick was secured in sealed bags and they were provided with coats, furs and shoes, so that they neither had to suffer from the coldness of the marble floor nor that they would make themselves dirty. (cf. 2 HO 2).

The nurses had to prepare the beds, to straighten the blankets and to loosen the cushions. They had to be of assistance to the sick in every respect, to cover them, to set them up and to support them in walking. Their hands were washed and dried with a towel as often as necessary. When it was time for meals a "tablecloth" was put on top of their beds. Bread was distributed in special baskets. Every sick person got his own loaf of bread, to avoid giving an unequal share. To intensify the appetite of the sick, even the sort of bread was changed frequently, so that no aversion would develop. The food for the sick was usually prepared in the monastery kitchen, where they cooked beef and mutton on Tuesdays and Thursdays, whereas Mondays, Wednesdays, Fridays and Saturdays flummery was cooked. The members of the Order, knights, serving brothers and sisters served the food to the sick and got afterwards exactly the same food. The nurses had to watch that the food was well prepared and of good quality. When the quality of the food was poor or the sick did not have a good appetite, the nurses had to make a note of that fact and they had to see to it, that the patients got supplementary food like chicken, doves, partridges, lamb, bucks, at times also eggs or fish. The nursing staff had to buy regularly pomegranates, pears, plums, chestnuts, almonds, grapes, dried figs and vegetables like lettuce, chicory, turnips, parsley, celery, cucumber, pumpkin, sweet melons etc. The treasury of the Order provided every ward with a budget of 20 to 30 Solidi per week for such additional food. The doctors of the hospital prescribed which patients had to get a special diet. Generally forbidden for all patients were beans, lintels, sea-onions (?), moray eels, meat from mother pigs, every smoked meat, biltong or fat meat or innards.

Certain Brethren had the special task to wash the head and trim the beard of every patient. They had to wash the feet and clean the soles with a pumice stone every Monday and Thursday. They had to go through all the wards during food distribution and sprinkle everybody with water and apply incense. This was done by burning Thyrus wood, the so-called oriental tree of life. This general oriental custom was supposed to disinfect, but chased away the insects in any case.

"Because doctors have learnt a lot and have practical knowledge," our reporter concludes, "the community of the Order entrusts the practical healing to the experience of science, that the sick might not be deprived from what is possible to man." The number and knowledge of learned European doctors was not very considerable. Therefore Jews, Arabs, Armenians and Syrians were recruited as doctors. The doctors visited the wards every morning and evening. They were accompanied by two nurses. One of them had to get the medicines, the other one had to hold the urinal (urine analysis played a central role in medical examination in those days) and write down the prescriptions.

The hospital employed also barbers (village quacks), which were recommended by the doctors. It was their task to bleed the patients according to the prescriptions of the doctors. {The medieval conception of patho-physiology ascribed many sickness to an imbalance of what they considered the four body liquids, blood (Latin: sanguis), phlegm (Greek: flegma [phlegma]), bile (Greek: colh [chole] means also anger and rage) and black bile (Greek: melaina colh [melaina chole]), which had its effect even in the mood of a person. If there was too much blood, the person is sanguine; too much phlegm makes him phlegmatic; too much bile causes one to be choleric and too much black bile makes a melancholic. To interfere with such an imbalance, e.g. through bleeding somebody was considered a necessary medical treatment.}

To the very surprise of the contemporary witness terminally ill patients were nursed with the same care as those who had a good prognosis.

At dusk the day shift ended and two brothers per ward took over night shift. The brothers had to light three to four lamps in the ward "in order to prevent the sick from illusions, errors and dubiousness." One of the brothers had to go round with a candle in the left and a wine jar in the right hand and call out dearly to them: "You Lords, wine from God." Whoever wanted to drink had to be served. The other brother did the same with a jug of water calling out: "You Lords, water from God." When all had quenched their thirst, both came with a copper full of warm water calling: "Warm water, in God's name." It was their task to wash the sick and they used to do it "without force, but mild persuasion". Afterwards they just had to walk around in the ward continuously to watch even those sick who were asleep. Those who were uncovered had to be covered, who was lying uncomfortably, had to be repositioned. In case of necessity the priest had to be called and the deceased had to be removed.

Our reporter does not mention that the priests had to pray daily after dark with the patients. In a prayer text from the 12. century the "Lords Sick" were asked to pray for peace, the fruits of the earth, the pope, the cardinals, the patriarch of Jerusalem, the delegates, archbishops and bishops, for the Master of the Order and the Holy Land, the brothers of the Order, the kings of England etc., for all pilgrims, benefactors, the prisoners of war in the hands of the Saracens, for the Sick, the donates and the Sisters, who work in the hospital, for the spiritual and financial supporters, and finally for their own parents. It seems strange, that the sick were asked to pray, but they were believed to be closer to Christ and therefore their prayers were considered more effective. After the brothers had prayed the nocturne, all brothers on night duty met to form a procession by candlelight. Together they proceeded through all wards and could notice "if one of the wardens was careless or disorderly or even antagonistic to this task." Afterwards they elected a brother from among themselves, who had to supervise them. This brother continuously walked through all wards and kept an eye on the guards, that nobody fell asleep, was careless or even behaved improperly when nursing the sick. If he discovered any mistake in the care, he amended this mistake immediately, but he was entitled to sentence the careless guard with flagellation, which was executed on the following day. Such severe punishment was imposed on those, who maltreated the sick in words and deeds. Who did so repeatedly was immediately suspended from service and replaced by another brother. The evildoer was sentenced by the Hospitaller or his deputy, who had jurisdiction over all nursing and medical staff, to imprisonment of 40 days at water and bread.

Our reporter also mentions a hospital for women, which is situated in a separate building. His description is quite short, presumably he had no access to the department. He calls the nurses "Mothers of St. John" and nuns. They are most probably Nuns of the Order of St. John evolving from St. Magdalene's Convent. The female hospital was mainly a maternity ward. The delivering mothers got warm baths and all what they needed for their body hygiene. The commissioner of the hospital provides napkins for the newly born children which were laid into a cradle next to their mother. There was only an exception made, if the mother was poor, very ill or negligent with the infant because of her "stepmotherly harshness". In such cases the child was passed on to a wet nurse. As soon as the mother's condition had improved, the child was returned not later than a fortnight after birth. If the mother was not in a position to raise her child because of poverty, the master of the hospital visited her and arranged the transfer of the child to a foster mother. That happened quite often, as our reporter writes about up to one thousand children, who had to be supported by the hospital at the yearly cost of twelve talents each.

The earliest description of the first hospital of the Sovereign Military Order of St John of Jerusalem of Rhodes and of Malta

Blessed Gérard
This page is part of the publication: Blessed Gérard and his "everlasting brotherhood": The Order of St. John of Jerusalem

This page was last updated on Friday, 22 July 2016 19:02:28


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