The history of Christian health care

Christians and Christian health care have made significant historical discoveries and contributions to the medical field. "Over two millennia, Christian doctors and nurses, inspired by the example and teaching of Jesus of Nazareth, have been at the forefront of efforts to alleviate human suffering, cure disease, and advance knowledge and understanding. Rosie Beal-Preston, in an article for the Christian Medical Fellowship Web site, examines how the Christian church has played a major role in developing and shaping the practice of medicine.

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The Hospital Movement

"Before Christianity emerged, there were several hospital-like centers in Buddhist regions. The ancient Greeks practiced a very simple form of medicine and Greek temples included places where the sick could sleep and receive help. The Romans are believed to have established some military hospitals. However, it was the Christians of the Roman Empire who began to change society's attitude to the sick, disabled and dying, by their radically different outlook."

"The Graeco-Roman world in which Christianity appeared was often cruel and inhumane. The weak and the sick were despised. Abortion, infanticide and poisoning were widely practiced. The doctor was often a sorcerer as well being a healer and the power to heal equally conferred the power to kill. Among the pagans of the classical world only the Hippocratic band of physicians had a different attitude to their fellow human beings. They swore oaths to heal and not to harm and to carry out their duty of care to the sick."

"However, it wasn't until Constantine granted the first Edict of Toleration in AD 311, that Christians were able to give public expression to their ethical convictions and undertake social reform. From the fourth-century to present times, Christians have been especially prominent in the planning and building of hospitals, as well as fundraising for them. Cities with significant Christian populations had already begun to change prevailing attitudes, and were already beginning to build hospices (guest houses for the sick and chronically disabled)."

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"Stories of Christian caring had enormous impact, even before Constantine's decree of toleration. Clement, a Christian leader in Rome at the end of the first century of the Christian era, records how the Christian community was already doing much to relieve the plight of poor widows. In the second century when plague hit the City of Carthage, pagan households threw sufferers onto the streets. The entire Christian community, personally led by their bishop, responded. They were seen on the streets, offering comfort and taking them into their own homes to be cared for. A few decades after Constantine, Julian, who came to power in AD 355, was the last Roman Emperor to try to re-institute paganism. In his Apology, Julian said that if the old religion wanted to succeed, it would need to care for people even better than the way Christians cared."

"As political freedom increased, so did Christian activity. The poor were fed and given free burial. Orphans and widows were protected and provided for. Elderly men and women, prisoners, sick slaves and other outcasts, especially the leprous, were cared for. These acts of generosity and compassion impressed many Roman writers and philosophers."

"In AD 369, St Basil of Caesarea founded a 300 bed hospital. This was the first large-scale hospital for the seriously ill and disabled. It cared for victims of the plague. There were hospices for the poor and aged isolation units, wards for travelers who were sick and a leprosy house. It was the first of many built by the Christian church."

"In the so-called Dark Ages (476-1000) rulers influenced by Christian principles encouraged building of hospitals. Charlemagne decreed that every cathedral should have a school, monastery and hospital attached. Members of the Benedictine Order dedicated themselves to the service of the seriously ill; to 'help them as would Christ'. Monastic hospitals were founded on this principle."

"In the later Middle Ages, in cities with large Christian populations, monks began to 'profess' medicine and care for the sick. Monastic infirmaries were expanded to accommodate more of the local population and even the surrounding areas. A Church ban on monks practicing outside their monasteries gave the impetus to the training of lay physicians. It was contended that this interfered with the spiritual duties of monks. So gradually cathedral cities began to provide more large public hospitals with the support of the city fathers and this moved medical care more into the secular domain."

"Nevertheless, expansion of health care by the secular authorities continued to be challenged and stimulated by the Church's example. Eventually there were few major cities or towns were without a hospital. And there were particular diseases, such as leprosy, where the Church, inspired by the example of Jesus who made a point to touch and heal these outcasts from society, took a lead. The Church built countless leprosy isolation hospitals. Even though actual medical knowledge was meager when compared to modern standards, the efforts of the Christian church nevertheless brought relief and mitigation of suffering to thousands of sick people. And perhaps just as importantly, it heralded a new, more humane attitude to the sick and elderly."

"In England suffering was caused when King Henry VIII suppressed the monasteries. The Reformation deprived many suffering and disabled people of their only means of support. Patients of hospitals like St. Thomas' and St. Bartholomew's, founded and run by monastic orders, were thrown onto the streets. The onus for health care was placed firmly on the City Fathers and municipalities were forced to pay more attention to the health problems of the community."

"It was not until the eighteenth century that the Christian hospital movement re-emerged. The religious revival sparked in England by the preaching of John Wesley and George Whitefield was part of an enormous unleashing of Christian energy throughout 'Enlightenment' Western Europe. It reminded Christians to remember the poor and needy in their midst. They came to understand afresh that bodies needed tending as much as souls."

"A new 'Age of Hospitals' began, with new institutions built by devout Christians for the 'sick poor', supported mainly by voluntary contributions. The influence of this new age was felt overseas as well as in England. Health care by Christians in continental Europe received a new impetus. The first hospitals in the New World were founded by Christian pioneers. Christians were at the forefront of the dispensary movement (the prototype of general practice), providing medical care for the urban poor in the congested areas of large cities."

"The altruism of these initiatives was severely tested when cholera and fever epidemics appeared. Larger hospitals often closed their doors for fear of infection. While wealthy physicians left the cities for their own safety, doctors and the staff of these small dispensaries, driven by Christian compassion, remained to care for the sick and dying. Christian philanthropists inspired setting up the London Fever Hospital to meet the desperate needs of those living without sanitation in overcrowded tenements. Christian inspiration continued to identify specific needs, leading to opening of specialist units: maternity and gynecology hospitals, and institutions for sick and deserted children. When the National Health Service took over most voluntary hospitals, it became clear just how indebted the community was to these hospitals and the Christian zeal and money that supported them over centuries."

Advance of medical knowledge

"As well as taking a leading role in caring for the sick, Christians also played very important part in the furtherment of medical knowledge. Together, Jews and Christians took the lead in collecting and copying manuscripts from all over Europe after the burning of the Great Library at Alexandria. This rescued much medical knowledge for the religiously tolerant Arabic Empire and for later generations."

"During the Dark Ages, Arabic medicine advanced considerably due to their access to these documents. In Europe, however, progress was comparatively slow. It was Christian thought that led to the formation of the Western universities. Founding of medical faculties was often due to Christian initiative. So too were attempts to raise standards of research and care."

During this period, the field of surgery saw most progress. Christians were among those advocating the need for cleanliness and less use of the cautery in treating wounds. Chauliac, the author of Chirugia Magna (Textbook of Surgery) was a priest and surgeon, who made many advances in orthopedics. He led by example, staying at his post to investigate the plague and treat its victims when many of his colleagues fled."

"In the Middle Ages there emerged a clash between those who relied dogmatically on ideas and theories passed on from Classical sources, and the new attitudes to research fostered by the growing influence of what is now called modern science. Christians such as Grosseteste, Bacon and Boyle encouraged experiment instead of simply relying on old traditions. The Royal Society was founded to encourage research, and the majority of its early members were Puritan or Anglican in origin. The discovery of printing (the first printed book in Europe was a Bible) and the Reformation sparked by Martin Luther were major forces in promoting intellectual liberty, and by the sixteenth century medical progress was advancing rapidly."

"Many very important discoveries in many medical fields were made by people who held a Christian commitment and there is not room to mention them all here: William Harvey (circulation), Jan Swammerdam (lymph vessels and red cells) and Niels Stensen (fibrils in muscle contraction) were all people of faith, while Albrecht von Haller, widely regarded as the founder of modern physiology and author of the first physiology textbook, was a devout believer; Abbe Spallanzani (digestion, reproductive physiology), Stephen Hales (haemostatics, urinary calculi and artificial ventilation), Marshall Hall (reflex nerve action) and Michael Foster (heart muscle contraction and founder of Journal of Physiology) were just some among many others."

"The same can be said of the advance of surgical techniques and practice. Ambroise Pare abandoned the horrific use of the cauterization to treat wounds and made many significant surgical discoveries and improvements. The Catholic Louis Pasteur's discovery of germs was a turning point in the understanding of infection. Lister (a Quaker) was the first to apply his discoveries to surgery, changing surgical practice forever. Davy and Faraday, who discovered and pioneered the use of anesthesia in surgery, were well known for their Christian faith, and the obstetrician James Simpson, a very humble believer, was the first to use ether and chloroform in midwifery. James Syme, an excellent pioneer Episcopalian surgeon, was among the first to use anesthesia and aseptic techniques together. William Halsted of Johns Hopkins pioneered many new operations and introduced many more aseptic practices (eg rubber gloves), while William Keen, a Baptist, was the first to successfully operate on a brain tumor."

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