The Mediæval Hospitals of England by Rotha Mary Clay
CHAPTER X
3956 words | Chapter 70
THE HOUSEHOLD AND ITS MEMBERS
“_No more brethren or sisters shall be admitted than are necessary to
serve the infirm and to keep the goods of the house._” (St. John’s,
Nottingham.)
The hospital family varied widely in size and in the arrangement of its
component parts, but this chapter, like the preceding, is concerned
chiefly with the type of institution which had a definite organization.
The establishments for infected persons will first be considered.
(i) THE LEPER HOUSEHOLD
(a) _The Master._—“The guidance of souls is the art of arts,” says
St. Gregory: particularly difficult is the guidance of souls in
ailing bodies. Lanfranc realized that men of special gifts should be
selected for the care of his Harbledown lepers. He not only arranged to
supply all they might need on account of the nature of their illness,
but appointed men to fulfil this work “of whose skill, gentleness
and patience no one could have any doubt.” The Oxford statutes
ordained that the master be “a compassionate priest of good life and
conversation, who shall reside personally and shall celebrate mass
daily, humbly and devoutly.” He was required to visit the infirm, to
console them as far as possible, and confer upon them the Sacraments
of the Church.[88] The priest [p144] serving lepers was permitted to
dispense rites which did not pertain to other unbeneficed clergy; thus
the Bishop of London commanded the lepers’ chaplain at Ilford to hear
their confessions, to absolve the contrite, to administer the Eucharist
and Extreme Unction. The ideal man to fill the unpleasant post of
lepers’ guardian as pictured in foundation deeds and statutes was hard
to find: men of the type of St. Hugh and Father Damien—separated indeed
by seven centuries, but alike in devotion—are rare. Two Archbishops of
Canterbury witness to the scarcity in a deed referring to Harbledown
(1371, 1402). After stating that clergy are required to celebrate the
divine offices in St. Nicholas’ Church, the document declares:—
“It may be at present, and very likely will be in future, difficult
to find suitable stipendiary priests who shall be willing to have
intercourse in this way with the poor people, especially as some of
these poor are infected with leprosy; and this hospital was founded
especially for sick persons of this sort.”
The master might himself be a leper. An inquisition of 1223 showed
that at St. Leonard’s, Lancaster, it had formerly been customary for
the brethren to elect one of the lepers as master.[89] In 1342 the
prior of St. Bartholomew’s, Rochester, was a leper. The regulations
at Ilford provided for a leper-master and secular master, but those
of Dover merely said that the master may be a leper. Although the law
offered privileges to communities governed by a leper-warden (see p.
196), it does not appear to have been a common custom to appoint one.
In hospitals dependent upon a monastery, some monk was selected to
superintend the lazar-house.
(b) _The Staff._—It has been said that leper-hospitals [p145] were
“heavily staffed with ecclesiastics.” There were indeed three at
Lincoln, Ilford and Bolton to minister to ten or twelve men, but they
conducted the temporal as well as spiritual affairs of the society. At
Bolton, for example, the priests had to administer the manor which was
held by the hospital. It was more usual to have only one chaplain in a
household of thirteen. This was a favourite number, the figure being
regarded with reverence as suggestive of the sacred band of Christ and
His Apostles: “for thirteen is a convent as I guess,” writes Chaucer.
There were to be at Sherburn “five convents of lepers, that is of the
number of sixty-five at the least”; five priests ministered to them, of
whom one acted as confessor, and used also to visit the bedridden and
read the Gospel of the day to them.
The collection of alms also fell upon the staff, for as it was said at
Bridport “lepers cannot ask and gather for themselves.” The procurator
or proctor therefore transacted their business. It was ordained at
St. Bartholomew’s, Oxford, that the clerk serving in the chapel
should collect alms and rents and act as proctor. The staff sometimes
included other untainted persons. Two healthy brethren at this Oxford
leper-house were to be skilled agricultural labourers, able also to
make enclosures and cover houses.
(c) _Attendants._—Domestic and farm service was also done by paid
attendants. There were female-servants in the Sherburn leper-house,
who undertook laundry and other work, and one old woman cared for the
bedridden.
(d) _Leper Inmates._—Among the larger asylums, the approximate
accommodation was as follows:—Harbledown 100, Sherburn 65, St. Giles’,
London 40, St. Nicholas’, [p146] York 40, Thanington near Canterbury
25, Dover 20, Plymouth 20, Bodmin 19, Winchester 18. There were 13 beds
at Carlisle, Exeter, Gloucester, Reading, etc. In some towns there were
several small hospitals. Numbers were of course liable to fluctuation,
and often apply to a company of infected and healthy persons, as at St.
Nicholas’, York. “They used to have, and ought to have, forty brethren
and sisters, as well lepers as others; now they have thirty-two only.”
(1285.) By an inquisition taken in 1291, it was reported that a former
master had admitted thirty-six, of whom four were received _pro Deo_
because they were lepers, but the rest for money. The king commanded
that henceforth none should be received without special mandate,
inasmuch as the funds scarcely sufficed for the multitude already
maintained. The same abuse is noticeable a century earlier, for in
1164 Pope Alexander III forbade the patrons of St. James’, Thanington,
to admit into the sisterhood any who were not infected, for healthy
women had been importunately begging admission.[90] It was complained
in 1321, that St. Bartholomew’s, Oxford, was occupied by healthy and
sturdy men; and that at St. Leonard’s, Lancaster, there were six whole
and three lepers (1323). Both were originally intended solely for the
diseased, the inmates of St. Leonard’s being called by Henry III “our
lepers of Lancaster.”
It has been represented, as a proof that isolation was non-existent,
that lepers and untainted persons lived a common life, eating and
sleeping together. This was evidently not the case. The sheriff of
Lincoln received orders that at Holy Innocents’ “the chaplains and
brethren are to reside in one house, the lepers by [p147] themselves
and the sisters by themselves.”[91] The statutes at Ilford and Dover
give similar directions. The priests at Sherburn slept apart in a
chamber adjoining the church, but the Harbledown staff lacked such
accommodation until in 1371 it was ordained that they should henceforth
dwell in a clergy-house—“a home separate from the sick persons and near
to them.”
[Illustration: 24. SEAL OF THE LEPER-WOMEN OF WESTMINSTER]
When both sexes were admitted, they lived apart, a woman with the title
of prioress being selected to rule the female community. Some houses
were set apart for women, e.g. Alkmonton, Thanington, Bristol (St.
Mary Magdalene), Newbury (St. Mary Magdalene), Bury (St. Petronilla),
Woodstock, Clattercot, Hungerford, Arundel, Westminster, whilst one
left behind it the name of “Maiden” Bradley. It sometimes happened
that a married couple contracted the disease. A clerk smitten with
leprosy and his wife with the same infirmity were seeking admission
to St. Margaret’s, Huntingdon, in 1327. By the Ilford statutes, no
married man was admitted unless his wife also vowed chastity. On no
account was a married person received at Dover without the consent of
the party remaining _in seculo_, and then only upon similar conditions.
In this connection a passing reference may be made to the marriage
laws. Although by the laws of the Franks leprosy was a valid reason for
[p148] divorce, later Norman laws considered separation unjustifiable;
this latter was the attitude of the Church, which is given fully in
the Appendix to the Lateran Council of 1179.[92] Yet the pathos of the
leper’s lot is suggested by the declaration of Amicia, a woman of Kent
in 1254—that in truth at one time she had a certain Robert for husband,
but that now he had long been a leper and betook himself to a certain
religious house, to wit, the leper-hospital at Romney.[93]
For many reasons the leper-household was most difficult to control:
it is small wonder that abuses crept in. Men forcibly banished were
naturally loth to submit to rigorous discipline. They were persons
who would never have dreamed of the religious life save by pressure
of circumstances; moreover, the nature of their infirmity caused them
to suffer from bodily lassitude, irritability and a mental depression
bordering upon insanity; in the life of St. Francis is a description
of his ministry to a leper so froward, impious, abusive and ungrateful
that every one thought him possessed by an evil spirit. London lepers
were evidently not less refractory. From early days the city selected
two men as keepers and overseers at St. Giles’, the Loke and Hackney;
these officials, who were accustomed to visit the lazar-houses daily
and to chastise offenders, were granted exemption from inquests,
summonses, etc., on account of this “their meritorious labour, their
unpleasant and onerous occupation.” (1389.) The London edict of 1346
confirms the undoubted fact that lepers are specially tempted to a
loose life. Banished from the restraining influences of home and public
opinion, they [p149] were found in haunts of vice. The master of the
lazar-house had no means of enforcing control. If the leper escaped
and fell into evil habits none could prevent it: indeed, this did but
ensure the liberty he craved, for the ultimate punishment of inmates
was expulsion.
(ii) THE HOUSEHOLD OF THE INFIRMARY AND ALMSHOUSE
(a) _The Master_ or Warden, who was also known as prior, _custos_,
keeper or rector, was usually a priest, but occasionally a layman. One
of the early masters of St. Mark’s, Bristol, was a knight, Henry de
Gaunt, whose mailed effigy remains in the chapel. Crown hospitals were
often served by chaplains and clerks, but the appointment of “king’s
servants,” yeomen or knights, is noticeable during the fourteenth
century.
It is rarely recorded that the custodian of the sick was a physician,
but the absence of the title _medicus_ in no way proves that he and his
helpers were ignorant of medicine. In early days, indeed, it was only
the clergy, religious or secular, who were trained in the faculty, and
the master and his assistants must have acquired a certain intimacy
with disease; they would have a knowledge of the herbals, of the system
of letting blood, and other simple remedies. An important medical work,
_Breviarium Bartholomæi_, was written late in the fourteenth century by
John Mirfield of St. Bartholomew’s, Smithfield. He acknowledges that
it is a compilation for the benefit of those who could not afford to
buy the treatises whence it was derived; but he adds that part had been
personally communicated to him and was supported by the experience of
others. The fine manuscript copy in Pembroke [p150] College, Oxford,
includes a list of medical ingredients, herbs, etc.[94]
In some instances the warden _is_ described as a physician. When the
chaplain of St. John’s, Bridport, was incapacitated, Master John de
Brideport, physician, was deputed to act for him (1265). The Duke of
Lancaster presented his foreign doctor, Pascal de Bononja, to the
Preston hospital (1355). “Louis the physician,” who held St. Nicholas’,
Pontefract (1399–1401), may be identified with Louis Recouchez, king’s
physician, who was then appointed to the hospital at Westminster. It is
possible that visiting doctors and barber-surgeons attended hospitals.
In an inventory of Elsyng Spital a debt of xxxvij_s._ ij_d._ was due
to Robert the leech, and of x_s._ to Geoffrey the barber. One of the
inquiries at the Dissolution of religious houses was:—“Whether the
maister of the house doo use his brethren charitably when they be syke
and diseased; and whether, in tyme of their sykenes, he doo procure
unto them physicions.”
The duties—and temptations—of a warden are suggested by the “Articles
of Inquisition touching the Savoy” (1535). Not only was inquiry made
whether the master visited the poor at least twice a week, and the sick
twice daily, but also:—
“Whether he be mercifull, beningne and louyng to the poore; and not
skoymys [squeamish] or lothesome to uisite theym or to be among theym.
“Whether he or his ministers by his sufferance do take in suche as
they reken moste clene of the poore, and repell theym that they reken
most sore or deseased, for auoydyng of their owne lothesomenes or
contagion.” [p151]
[Illustration: _PLATE XVII._ GOD’S HOUSE, EWELME]
The qualifications and duties of the head of an almshouse are defined
in the minute regulations of fifteenth-century founders. The master
of Ewelme must be an able and well-disposed person in body and soul,
one who could counsel and exhort the poor men to their comfort and
salvation. He had to conduct frequent services, and was warned to omit
none—not even “for plesaunce of lorde or lady”—save “if he be let by
sekenesse or prechyng of the worde of God, or by visitacion of Fadyre
and modir.” The master of God’s House, Exeter, might not be absent
more than once or twice a year, his recess never exceeding three weeks
and three days. At Wells, a chaplain of commendable life, manners
and learning was sought—one “circumspect and expert in spiritual and
temporal things, and free from all infamous vice.” The ale-house
and hunting were forbidden to the warden of Heytesbury, as well as
“inhonest playes, as of the Dees, cartes or of the hande-ball.” He must
never be absent at night, nor for long by day, although it was lawful
for recreation to walk a mile or two at certain times. He had, indeed,
little leisure, for he conducted certain services both in the chapel
and parish church, and kept school, besides ruling the almshouse.
The model master did not exist only in the imagination of founders,
although he occurred rarely. Among good men who are not forgotten where
they fulfilled their duty, mention must be made of John de Campeden,
warden and benefactor of St. Cross. His friend William of Wykeham
placed him in charge of that despoiled and dilapidated institution. He
ruled wisely and spent large sums upon restoration. After a faithful
stewardship of twenty-eight years, his death occurred in 1410. His
memorial brass [p152] retains its place before the altar. The brasses
of several wardens are also preserved at Greatham.
(b) _The Staff: Brethren and Sisters._—These offices became in some
cases mere honorary posts; there was no salary attached to them, but
officials were supplied with food and clothing. The sisterships at St.
Katharine’s-near-the-Tower used to be given by the queen to her ladies.
Of the eight sisters at St. Leonard’s, York, some were workers (see
p. 154), but others lived apart from the rest in a place built for
them near the hospital, and were mere pensioners enjoying provision of
food, clothing, fuel and bedding. Unprotected women were often glad
to relinquish some little property by arrangement, and be settled for
life. “Brothers” might be priests, monks or lay-brethren. The staff
of St. John’s, Oxford, consisted of three Augustinian chaplains—one
being elected master—with six lay-brethren and six sisters. At Lechlade
two brothers distinguished for kindness and courtesy were selected to
exercise hospitality with charity and cheerfulness, and to watch over
the sick.[95] Of thirteen brethren at Kepier, six were chaplains, and
the rest acted as steward, keeper of the tannery, miller, etc. The
brethren of St. John’s, Ely, were forbidden to play with dice, or to be
present at such play, but were to give themselves to contemplation and
study of Scripture, one or two being deputed to wait upon the infirm.
Each lettered brother of St. Leonard’s, York, was directed to study at
his desk in the cloister two or three times a day.
The “proctor” was the financial agent of the community. He held
an important post, and had occasionally an official seal. It was
sometimes his duty to deliver a [p153] charity-sermon—“to preach and
to collect alms.” When the traffic in indulgences began, the proctor
became a “pardoner.” (See p. 189.) Spurious agents abounded, for the
post was lucrative. A man was arrested as feigning himself proctor of
St. Thomas’, Canterbury; another was convicted of receiving money,
beasts, legacies and goods ostensibly for that house.[96] The collector
received gifts in kind, and the following appeal was put forward by
St. John’s, Canterbury:—“if any one wishes to give . . . ring, brooch,
gold, silver, cows, heifer, sheep, lamb or calf, let him send and
deliver it to our proctor.” Sister Mariana Swetman was licensed to
collect alms on behalf of that hospital (1465), an interesting instance
of a woman virtually holding the office of proctor.
Ministering women have long laboured in our infirmaries for the
benefit of the sick, carrying on their works of mercy side by side
with men. “The lay sisters shall observe what we have above ordained
to be observed by the brethren, as far as befits their sex,” decreed
Archbishop Gray for St. John’s, Nottingham (1241). One of the men,
corresponding to the monastic _infirmarer_, was responsible for
the sick ward; thus a brother of Northallerton held the office of
_procurator infirmorum in lectulis_, whilst two sisters watched by the
sick, especially at night, and a third attended to household affairs.
At Bridgwater, women “not of gentle birth but still fit for the
purpose” assisted in nursing; they lodged in a chamber adjoining the
infirmary and were to be always careful and ready both by night [p154]
and day to help the sick and to minister to them in all things.
The work of women among the sick developed further during the fifteenth
century; they evidently took a prominent part in the management of
the larger infirmaries. A lady, corresponding perhaps to the matron
of to-day, was in authority at York. By a will of 1416, money was
bequeathed for distribution among the helpers and inmates of St.
Leonard’s at the discretion of Alice _materfamilias_. Long before
(1276) the officers had included not only a brother called Gamel
_de Firmaria_, but a sister named Ann _medica_;[97] and in 1385 the
principal sister was known as Matilda _la hus-wyf_.[98] In some
institutions there were already distinct ranks among nursing women. The
pious poet Gower remembers in his will (1408) the staff and patients of
four London hospitals; he leaves sums of money not only to the master
and priests of St. Thomas’, Southwark, but “to every sister professed”
and “to each of them who is a nurse of the sick.”
Woman’s sphere in hospital life was confined to work by the bedside and
domestic duties. Occasionally they were found to undertake what was not
fitting. The prior of Christchurch, Canterbury, made a visitation of
the daughter-hospital of St. James, Thanington, after which he issued a
deed of reformation (1414). A curious clause occurs in these statutes:—
“We command that no one of the sisters . . . or any other woman
soever while divine service is being celebrated in the chapel should
stand or sit in any way round or near the altars or should presume to
serve the priests celebrating the [p155] divine offices or saying the
canonical hours, since, according to the first foundation of the said
hospital its chaplains or priests ought to have a clerk who ought to
officiate in the aforesaid matters.”
In addition to regular brethren and sisters, there were
under-officials. The staff of the larger institutions included clerks
in minor orders, who assisted in worship and work. In almshouses where
there was no resident master, a trustworthy inmate held a semi-official
post. Thus at Donnington there were thirteen pensioners, and “one at
their head to be called God’s minister of the poor house.” When the
“tutor” at Croydon went out of doors, he ordained “oon of his fellawes
moost sadde [serious] and wise to occupy his occupacion for him till he
come ageyne.”
(c) _Attendants_, etc. Serving men and women were employed to wait
upon the infirm and upon the staff. Lanfranc ordered that the poor of
St. John’s, Canterbury, should have careful servants and guardians,
lest they should need anything. When the poll-tax was levied in Oxford
(1380), there were twelve servants, artisans and farm-labourers working
at St. John’s. In the immense establishment at York there were sixteen
male and female servants, besides a host of other stipendiaries—two
or three cooks, bakers, brewers, smiths and carters, a ferrywoman,
twelve boatmen, etc. Working-class officials called the “man harbenger”
and “woman harbenger” were employed to attend to beggars passing the
night at St. John’s, Sandwich. At the Maison Dieu, Dover, two women
made the beds, served the poor and washed their clothes. The position
of the female attendant in an almshouse is well described by the name
[p156] “sister-huswiff” used at Heytesbury. The ideal woman to hold
the post is pictured in the statutes of Higham Ferrers; of good name
and fame, quiet and honest, no brawler or chider, she should be “glad
to please every poor man to her power.” She had minute directions as to
housekeeping and other duties which would fill the day, and in illness
she must visit the patients at night. The keeper of the five married
couples at Ford’s hospital, Coventry, was required “to see them clean
kept in their persons and houses, and for dressing their meats, washing
of them, and ministering all things necessary to them.”
(d) _The Sick and Infirm._—Having described the officials, it will
be well to form some idea of the number of the infirm to whom they
ministered. The largest establishment of this kind was St. Leonard’s,
York; and at Easter 1370, there were 224 sick and poor in the
infirmary, besides 23 children in the orphanage. About the same time
there were 100 brothers and sisters at St. John’s, Canterbury. A large
number of patients were cared for in the London hospitals of St.
Bartholomew, St. Thomas and St. Mary. St. Giles’, Norwich, accommodated
30 poor besides 13 aged chaplains, and 40 persons were maintained
at Greatham. The majority of permanent homes were smaller, thirteen
beds being a usual number. Many hospitals were obliged to reduce the
number of patients as the revenues diminished. In the year 1333, St.
Bartholomew’s, Gloucester, supported 90 sick, lame, halt and blind; but
two centuries later Leland notes that it once maintained 52, but now
only 32.
Of pilgrim, patient and pensioner, little can be recorded. Temporary
inmates came and went, receiving refreshment and relief according to
their needs. Some of the resident [p157] poor were chronic invalids,
but others were not too infirm to help themselves and assist others.
The frequent attendance at prayers certainly gave the almsfolk constant
occupation, and they were required to be busy at worship or work. The
poor men of Croydon were charged “to occupy themsilf in praying and in
beding, in hering honest talking, or in labours with there bodies and
hands.” Inmates at Ewelme must be restful and peaceable, attending to
prayer, reading or work; their outdoor employment was to “kepe clene
the closter and the quadrate abowte the welle fro wedis and all odyr
unclennesse.” (Pl. XVII.) It was directed at Higham Ferrers that in
springtime each poor man should help to dig and dress the garden, or if
absent, give the dressers a penny a day. In the same way, at Sandwich,
an inmate’s allowance was stopped if he failed to render such service
as he could. Those brothers at Ewelme who were “holer in body, strenger
and mightier” were commanded to “fauer and soccour and diligently
minister to them that be seke and febill in all behofull tyme.
[p158]
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