Early Christian Era East and West

After the collapse of the Roman Empire, Western medicine experienced a period of retrenchment and decline. Healing became an important act of Christian charity, a divine gift freely provided within the framework of the new church and not restricted to professional physicians. Given this religious orientation, Christians healed through the confession of sins, prayer, the laying on of hands, exorcisms, and miracles, occasionally performed by saints or church fathers.

In Byzantium, the Christian magical-religious healing flourished side by side with the earlier rational Greco-Roman medicine in spite of frequent tensions, especially because physicians often exacted exorbitant payments for their services. Several of them, including Oribasius of the fourth century, Aetius of Amida and Alexander of Tralles of the sixth century, and Paul of Aegina of the seventh century, compiled and preserved ancient medical knowledge and with their writings made Galen the central medical authority for the next 500 years.

Faced with a growing population and adverse economic conditions, the early Christian church created a number of philanthropic institutions. The provision of shelter and food for the poor and for strangers was extended to several forms of health care in houses called xenones (hostels) and more specifically nosokomeia (places for the sick). Among the first was an inn built by Bishop Basil around 375 in Caesarea, which was apparently staffed by nurses and physicians. Two decades later similar institutions opened their doors in Constantinople, and thereafter such hospitals proliferated in other major commercial cities of the Byzantine Empire.

In western Europe, monks played an important role in Christian healing as well as in the collection and preservation of medical manuscripts. Whereas Augustinian monks lived a life of isolation and prayer, the followers of Benedict created working communities that cared for their sick brethren as well as visitors and transients. Monasteries such as the cloister of Monte Cassino, founded in 529, and the cathedral schools after the year 800 became heirs to fragments of classical medical knowledge. Many Benedictine monasteries - such as St. Gall (c. 820) - continued both a hospitale pauperum for pilgrims and an infirmarium for sick monks and novices. Monasteries were constructed along important roads or in surviving Roman towns, notably in southern France and Italy. Sick care was dispensed as part of the traditional Christian good works. By contrast, medical treatment under the supervision of physicians remained sporadic.

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