Hospitals, Hospices and Shelters for the Poor in Late Antiquity

by
Mark Alan Anderson
Dissertation Director: John Matthews
May 2012

Lochokomeion
The lochokomeion, a place for the care of birthing women, accounts for seven
institutions (Nos. 174-180). All attested lochokomeia were built in Alexandria in the
early seventh century by John Eleemon, the Ecumenical Patriarch of Alexandria.
Pregnant women were encouraged to give birth in johns lochokomeia. They were then
allowed to stay for a week with their infants and received a small sum of money upon their
departure. Our source does not state what kind of women made use of these shelters
but we may infer that these were mostly single women without family support.

p.35-36
All nosokomeia treated the sick with at
least minimal nursing care by definition. The same is true of the lochokomeia (places for
the care of birthing women) built by John Eleemon in seventh-century Alexandria (Nos.
174-180). While these women and their infants were not necessarily ill, they certainly
required medical care through the birthing process and immediately following. I have
also assigned M2 as the minimal medicalization level for hospitals and shelters dedicated
to sectors of the population even more vulnerable than the destitute poor and strangers:
those that cared for the elderly, infants, orphans and widows. Nursing care at M2
institutions included the provision of special food for the sick (No. 4). Regarding the
imὂὁὄὈἳὀἵἷΝ ὁἸΝ“mἷὄἷ”Ν hὁὅὂiἵἷΝ ἵἳὄἷΝiὀΝ ἵὁmὂἳὄiὅὁὀΝ ὋiὈhΝ ὈhἷΝmiὀiὅὈὄἳὈiὁὀὅΝ
ὁἸΝὈὄἳiὀἷἶΝ
physicians, modern studies have shown that the kind of hospice care known to have been
provided by Christians during outbreaks of plague in the early Roman Empire and by M2
hospitals and shelters to the general population during late antiquity could radicallyreduce the mortality rate
during such crises.122

In a larger number of cases payments were made to guests as part of a standard

operating procedure. John Eleemon gave one keration (a small coin) to healthy men and
two to women and orphans daily, most likely at some of the hospitals that he founded in
Alexandria (Nos. 168-171). John was also famous for establishing a network of seven
hospitals for birthing women (lochokomeia) throughout the city. In addition to up to
seven days of shelter and care the new mothers were given three coins (nomismata) each
upon discharge (Nos. 174-180).

174. Alexandria. Before 620 CE. Lochokomeion.

Une vie inédite de saint Jean l’Aumonier = Delehaye pg. 45. 􀨦π􀄲􀩹 􀈜􀈠􀈤􀈠􀈛􀈠􀈝􀄰ῖα
􀈛α􀄲􀩹
􀄯􀈚αφ􀈩􀈡􀈠υ􀈢 􀄲􀈩π􀈠υ􀈢 􀄲􀫋􀈢 π􀈩􀈜􀄰􀈦􀈢 􀨥􀄯􀈠􀈝􀈒􀄱α􀄲􀈠, 􀨥φ’􀨦􀈞􀩿 􀄲􀈠􀈪􀄲􀈦􀈞
􀨦􀈛α􀄱􀄲ῳ 􀨕􀈞􀩹 􀄲􀄰􀄱􀄱α􀈡􀈐􀈛􀈠􀈞􀄲α
􀈛􀈜􀈓􀈞α􀈢 􀨕φ􀈠􀈡􀈓􀄱α􀈢 􀨥􀄱􀄲􀈡􀈦􀈝􀈑􀈞α􀈢, 􀨥􀈞 α􀩈􀈢 􀨥φ’􀩖􀈜α􀈚􀈢 􀨦π􀄲􀩹 􀨲􀈝􀈑􀈡α􀈚􀈢
􀨦􀈛􀈐􀄱􀄲􀈘􀈞 􀈖υ􀈞αῖ􀈛α 􀄲􀈓􀈛􀄲􀈠υ􀄱α􀈞
􀄯􀈚α􀈦απα􀈪􀄰􀄱􀈙α􀈚 􀨥􀈙􀈑􀄱π􀈚􀄱􀄰􀈞, 􀄰􀩇􀈙’􀈠􀩡􀄲􀈦􀈢 􀄲􀈡􀈓􀄲􀈠􀈞 􀈞􀈠􀈝􀈓􀄱􀈝α􀄲􀈠􀈢
􀈜α􀈝􀈕􀈐􀈞􀈠υ􀄱α􀈞 􀈠􀩅􀈛α􀄯􀄰
π􀈠􀈡􀄰􀈪􀄰􀄱􀈙α􀈚.
An unedited Life of Saint John the Almsgiver. He [John] built seven hospitals for birthing
women [lochokomeia] at various places throughout the city, for each one he set up forty
separate beds, he declared that in each one a woman who gave birth could stay for up to
174. Alexandria. Before 620 CE. Lochokomeion.

Une vie inédite de saint Jean l’Aumonier = Delehaye pg. 45. έπτα ζκξκεκηεῖα εατα
δδαφσλκυμ τσπκυμ τημ πσζεπμ έδκηάσατκ, έφ’έθι τκττπθ έεαστῳ άθα τεσσαλΪεκθτα
εζέθαμ άφκλέσαμ έστλπηΫθαμ, έθ αϊμ έφ’δζαδμ έπτα ήηΫλαδμ έεΪστβθ ΰυθαῖεα
τέετκυσαθ δδαπαπατεσγαδ έγΫσπδσεθ, εiγ’κϋτπμ τλέτκθ θκηέσηατκμ ζαηίΪθκυσαθ κ'ίεαδε
πκλετεσγαδ.

An unedited Life of Saint John the Almsgiver. He [John] built seven hospitals for birthing
women [lochokomeia] at various places throughout the city, for each one he set up forty
separate beds, he declared that in each one a woman who gave birth could stay for up to
seven days, then they would receive three nomismata for the trip home.
seven days, then they would receive three nomismata for the trip home.p.72

.287
p Demetrios J. Constantelos

Byzantine Philanthropy – Part II

28 August 2016 https://pemptousia.com/2016/08/24184/

Other Institutions

In addition to the major institutions which we have investigated in the preceding pages we find
in Byzantine society other establishments for social services, either proleptic or therapeutic in
nature.

Reformatory Houses

Prostitution was one of the less flattering aspects of a Christian civilization such as the Byzantine.
Poverty, social conditions, economic considerations, and above all human nature contributed to
the existence of moral and legal outcasts in Byzantine society. Their fate was the same as it had
been in previous societies. William Lecky, the nineteenth-century historian of morals and ideas,
ably expressed the sentiments of all societies when he wrote that the prostitute is a figure
“certainly the most mournful, and in some respects the most awful . . . who counterfeits with a
cold heart the transports of affection, and submits herself as the passive instrument of lust; who
is scorned and insulted as the vilest of her sex. . . . She remains, while creeds and civilizations
rise and fall, the eternal priestess of humanity, blasted for the sins of the people.”

In Byzantine society, while some viewed the fallen woman as a means of entertainment, others
accepted her as a creature made after the “image and the likeness of God”; a human being who
deserves the compassion and love of society. Therefore unlike other social and religious
systems, Byzantine society adopted a rather charitable attitude toward the persons of
prostitutes, though the legislation of the State and the Church was severe against prostitution as
such. Bobert Byron rightly observes that “the story of the prostitute indicates the whole tenor of
Byzantine society. That society was one in which practice of the true Christian ideal was possible;
not of a tithe to the poor or the turning of the other cheek; but of the sympathy for others, of the
understanding of fellow-beings born of the Greek instinct to scatter the pretensions of one man
above another.”

In the Byzantine world much effort was exerted so that civil disabilities and stigmas were
removed from this class of women who had never met with sympathy before. A brilliant example
was set by the Empress Theodora. The illustrious wife of Justinian I was one of the most
beneficent empresses of the Byzantine Empire. Not only was she alert in exerting her influence
for the cause of justice where justice was at stake, but she initiated several measures to assist
miserable individuals of her own sex who had fallen prey to procurers and whoremongers. We
are told that she redeemed prostitutes from their masters by paying from her own purse. Once
she offered five nomismata to a whoremonger for each woman under his patronage. She not
only gave orders against procurers but when setting free certain such women, she gave one
nomisma to each one of them. Justinian followed her example.

Individuals of the monastic ranks considered it their duty to work for the moral restoration of
fallen women. We are told that St. Vitalios worked to secure many prostitutes’ repentance and to
return them to a life of morals and dignity. He not only visited houses of ill fame in order to
persuade prostitutes to abandon their ignoble profession, but he also prayed for their
repentance. The result of his moral crusade was that some abandoned their sinful work
altogether, others married and commenced a new life, and a third group, leaving the worldly life,
found refuge in monasteries.

We have two other instances of organized philanthropy toward fallen women, one in the sixth
and the other in the eleventh century. Procopios, who often exaggerates, writes that “there was
a throng of women in Byzantium who had carried on in brothels a business of lechery, not of
their own free will, but under force of lust.” To clean up the city, Justinian and Theodora
banished brothel-keepers and erected a special institution to provide the needs of the former
prostitutes.

It was through the efforts of Theodora that Justinian issued a special novel10 against procuring
and the exploitation of poor and minor girls. The novel, as well as the chronicler John Malalas,
indicate that unscrupulous procurers visited villages and country towns where they approached
poor families. Poverty pressed upon the unfortunate parents to sell their girls to pro curers, who
promised the girls shoes, clothes, and other necessities. However, when the girls were brought
to Constantinople, they were confined in dens and miserable houses for the practice of
prostitution. The money, of course, was collected by the masters.

The celebrated queen expressed her concern for fallen women in more concrete terms. There
was a neglected palace on the Euxine sea across from Constantinople. They converted it into a
convent named Metanoia or “Repentance” to serve as a refuge for fallen women who had
repented of their ignoble past. Procopios adds that more than five hundred of them were placed
in that institution, and that the illustrious sovereigns endowed it with a plentiful income.

The second such establishment was the work of the Emperor Michael IV (1034-41). Psellos writes
that after the days of pleasure had passed for Michael and Zoe, the emperor displayed much
piety and desired the salvation of his soul. The celebrated philosopher maintains that he is not
eulogizing Michael but that he is simply narrating events.
In his catalogue of Michael’s good deeds, Psellos includes “an edifice of enormous size and very
great beauty” which the Emperor Michael IV founded to house harlots who were ready to
reform. The Emperor had issued a proclamation which, in the words of Michael Psellos, “all
women who trafficked in their beauty, provided they were willing to renounce their trade and
live in luxury, were to find sanctuary in this building: they were to change their own clothes for
the habit of nuns, and all fear of poverty would be banished from their lives for ever. . . .
Thereupon a great swarm of prostitutes descended upon his refuge, relying on the Emperor’s
proclamation, and changed both their garments and their manner of life, a youthful band
enrolled in the service of God, as soldiers of virtue.”

It is not irrelevant to emphasize that because of the humane attitude and the religious
philosophy of the Byzantines toward repentant prostitutes, we find a number of saints among
them who previously had been great sinners. For the foundation of this policy the Byzantines
referred to the Scriptures. While the New Testament speaks caustically against fornication,
adultery, and sins of the flesh, the repentant sinner is always accepted by the Church. The
example was set by Christ himself. When the Scribes and the Pharisees brought before Him for
condemnation a woman taken in adultery, Christ uttered the now-famous words: “He that is
without sin among you, let him first cast a stone at her.” Elsewhere Jesus indicated that
repentant harlots go into the Kingdom of God before the priests and pretentious religious
individuals. One can easily discern how much this Christian philosophy influenced the Byzantines
toward the fallen woman.

Xenotapheia

Among the diverse philanthropic institutions in Byzantium we may classify also the
xenotapheion or the cemetery especially put aside for the burial of poor strangers or poor local
people. We do not know much about this tradition, but there is evidence that in Byzantium
either the Church, the State, or individual philanthropists undertook the expenses for the burial
of the poor and had special sections for them. In Constantinople such a cemetery was near the
cistern of Mocios.

On the part of the State we are told that the Empress Pulcheria, the wife of Marcianos (450-57)
was instrumental in the establishment of xenotapheia. Because the noun is in the plural one
wonders how many she had built. Both Theophanes and George Monachos imply that Pulcheria
had established more than one. Later in the eighth and early ninth century the Empress Irene
(797-802) is given credit for her measures toward the poor. Pseudo-Codinos must have had in
mind certain specific cemeteries for the poor and the strangers when he wrote that Irene
established ta xenotapheia.

Justinian’s legislation implies that the poor were afforded a free funeral and burial in a special
cemetery. Later in the tenth century Leo VI (886-912) issued a law concerning the shops of Hagia
Sophia. Much of this income was used for philanthropic purposes, including the funeral
expenses of the poor and perhaps of strangers who had died while visiting the capital.

Xenotapheia existed in other cities as well. There was one in the small city of Daphne outside of
Antioch. John Moschos, the source of this information, implies that the strangers were buried in
a somewhat different manner than the local citizenry. Perhaps the religious ceremony was
briefer than the ordinary one, the corpse was not washed, and the brief service was without
candles and incense. In a similar manner Saint Symeon the Salos (sixth century) was buried in a
xenotapheion.
The underlying philosophy for charity toward dead strangers and the poor is expressed by
Theodore the Studite. In a letter to the consul Thomas, Theodore emphasized that because of
love for God and man, God’s image and likeness, the monks of the cloister of the Studion and
himself had dedicated their services to those who either because of poverty or because they
were foreigners and had no relatives in the capital were left unattended even at death.

Homes for the blinds

We have seen that Byzantine hospitals included ophthalmological clinics, and among the
physicians there was an ophthalmologist or ophthalmicos iatros, Additional but insufficient evi-
dence indicates that the Byzantines had special institutions for the blind. In the narrations of the
“miracles” of St. Anastasios (+628) we read that a typhlocomion or home for the blind was in
Jerusalem. Considering the sympathy with which the Byzantine Church and society looked upon
the blind and the deformed, we may assume that the typhlocomeion in Jerusalem was not the
exception. The Church maintained the fifty-seventh apostolic canon by which anyone ridiculing a
blind, a deaf, or a lame man could suffer the penalty of excommunication. Accord ing to the
canonists Zonaras, Balsamon, and Aristenos, the canon implied that the blind and the crippled in
general deserved understanding and the philanthropic help of the community.

There must have been other philanthropic institutions of which we know very little or nothing,
such as parthenones and cherotropheia. Parthenones might have been orphanages or homes
for deserted girls. We find them in the fourth century as well as in the tenth and the fifteenth, in
Constantinople and in smaller cities. The cherotropheion, an institution perhaps for poor widows
found in the early Byzantine Empire, may not have survived after the fifth century, although
protection was extended to widows in Byzantium in later centuries as well.

Extracts from the book of Demetrios J. Constantelos, Byzantine Philanthropy and social welfare, c
1968.

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