Engraving showing St. Barthomew’s hospital in London as it stood in 1720.
7 January 2021
The English word hospital is a good example of the interplay between English, Latin, and French in the medieval period and how England during that period was, at least among the upper classes, a tri-lingual nation. It also shows the cultural interplay and exchange between predominately Christian Europe and the Muslim world during the medieval period. Hospital comes to us from the Latin hospitalis, a guest house or guest bedroom. As such it is related to hospitality. The word’s association with curing, or at least caring for, the sick and injured occurs rather early, but the sense of the word specifically meaning an institution dedicated to medicine and health doesn’t appear until the start of the early modern period.
We see the Latin hospitalis being used in England during the Old English period. For example, sometime prior to 796 C.E., Alcuin wrote to Eanbald, the archbishop of York:
Consideret quoque tua diligentissima in elemosinis pietas ubi xenodochia, id est hospitalia, fieri iubeas, in quibus sit cotidiana pauperum et peregrinorum susceptio, et ex nostris substantiis habeant.
(Let him consider also your most diligent piety in alms, where you have commanded there to be established waystations, i.e., hospitals, in which there should be the daily reception of paupers and pilgrims, and they should have [means/substance] from our resources.)
But while speakers of Latin knew the word, it was not borrowed into Old English, quite possibly because hosp in Old English meant disgrace or shame. Instead, Old English continued to use native words like inn and gyst-hof.
In the quotation above we see a slight expansion of the traditional meaning of the Latin hospitalis from a guest house or chamber to that of an inn or hostel that had started a century earlier in Rome. In the seventh century, Pope Gregory I had ordered one of the first and the most famous of these hospitals to be founded in Jerusalem for use by Christian pilgrims to that city. But at first it had no association with sick or injured.
In Baghdad in the ninth century, a system of bimaristans (Arabic بِيْمَارِسْتَان) began to care for lepers, eventually becoming places to care for the aged, infirm, and ill throughout the Muslim world. The quarter of Jerusalem which housed the Christian hospital would become known as the Muristan from the bimaristan located there. Pilgrims to Jerusalem would bring back knowledge of the system of bimaristans to Europe. And following the First Crusade (1096–99), in 1120 Raymond de Puy, the head of the order of Knights Hospitallers, expanded the hospital in Jerusalem that had been founded by Gregory centuries before, allowing it to care for the ill based on the Muslim model.
La vie de saint Thomas Becket (The Life of St. Thomas Becket) was penned a few years after Becket’s death, sometime before 1176. And this Anglo-Norman text uses the word hospital to refer to the leprosarium that had been founded c. 1084 by Lanfranc, the archbishop of Canterbury. This leprosarium was in Hambledown, Kent, near Canterbury (now part of that city). Following the murder of Becket, King Henry II enlarged the leprosarium and expanded it to include an alms house for the poor:
Juste Cantorbire unt leprus un hospital,
U mult i ad malades, degez e plains de mal.(Near Canterbury lepers, outcast and full of illness, have a hospital, where many there have sicknesses.)
And:
E a un hospital, bien dons liwes de la,
A herberchier les povres, li reis ne s’ublia:
Kar de rente a cel liu par au cent sols dona.(The king did not forget to give refuge to the poor with a hospital, an easy distance from the place: for he gave one hundred shillings for the rent for this place for a year.)
England during this period was trilingual, with the aristocracy speaking both French and English, and the clergy adding Latin to the mix. So, while we don’t have English-language examples of hospital from this period, the word probably would have been familiar to those who only spoke English as well.
But we don’t see hospital appear in English for another century or so. The poem Richard Coer de Lyon, written sometime before 1300, makes reference to the hospital in Jerusalem:
The kynge of Fraunce, without wene,
Lay in the cyté of Messene,
And Kynge Rycharde without the wall,
Under the house of the Hospytall.
And shortly later, c. 1300, the life of Becket in the South English Legendary references the hospital near Canterbury:
He com aȝen þulke hous · as þis Gilberd inne was
And sein Thomas was suþþe þerinne ibore · gracious was þat cas
Þat is nou an ospital · irered of sein Thomas(He came again to this house, as this Gilbert was within
And Saint Thomas was then brought inside, gracious was that situation,
That is now a hospital, established because of Saint Thomas.)
Still, during this period, hospitals, while they might incidentally care for lepers or those who were otherwise ill, aged, or infirm, were not dedicated to their care, remaining primarily almshouses or temporary lodgings for travelers.
It isn’t until the mid sixteenth century that we see hospital being used to refer to an institution dedicated solely to medical care. In 1546, Henry VIII re-endowed the old monastic Hospital of Saint Bartholomew in London, providing funds to provide medical care for one hundred indigent people. This is reflected in the preface to the The Ordre of the Hospital of S. Bartholomewes, published in 1552:
It is better knowen by reaporte vnto the nombre, then weyghed in effect almoste to any, that for the relief of the sore and sicke of the citie of London, It pleased the Kinges Maiestie, of famous memorie, Henry London poor and the eight (father to this our moste drad souereigne sick, lorde nowe reignyng) to erecte an hospitall in West Smithfield, for the continual relief & help of an .C. patients, sore and diseased.
That’s how a traveler’s waystation or hostel became a hospital.
Sources:
Alcuin. “Epistola ad Enbadum archiepiscopum.” Two Alcuin Letter Books. Colin Chase, ed. Toronto: Pontifical Institute of Mediaeval Studes, 1975, 69. HathiTrust Digital Archive.
Dictionary of Old English: A to I. Toronto: University of Toronto, 2018.
Guernes de Pont-Sainte-Maxence. La vie de saint Thomas Becket. Emmanuel Walberg, ed. Lund, Sweden: C.W.K. Gleerup, 1922, 200. HathiTrust Digital Archive.
Larkin, Peter, ed. Richard Coer de Lyon. TEAMS Middle English Text Series. 2015, lines 1765–68.
Mill, Anna Jean and Charlotte D’Evelyn, eds. “St. Thomas A Becket.” The South English Legendary, vol. 2 of 2. Early English Text Society, 236. London: Oxford UP, 1956, lines 82–84, 613.
Oxford English Dictionary, second edition, 1989, s.v. hospital, n.
“Preface.” The Ordre of the Hospital of S. Bartholomewes in West Smythfielde in London. London: R. Grafton, 1552, A.2r–v. Early English Books Online (EEBO).
Image credit: Benjamin Cole, 1720, Wellcome Collection Gallery; used under a Creative Commons Attribution 4.0 International license.
Thanks to Jessica Lockhart and Suzanne Akbari for assistance in the translations. Any errors are mine alone.