St. Basil's Houses of Healing (& Tolkien's)

How Orthodox Bishops and Saints Launched the World's First Hospital System

Icon from the 11th century AD depicts Saint Basil who lived c. 330 CE to 379 CE. Located in St. Sophia Cathedral, Kiev.

“[Basil] however it was, who took the lead in pressing upon those who were men, that they ought not to despise their fellowmen…Others have had their cooks, and splendid tables, and the devices and dainties of confectioners, and exquisite carriages, and soft, flowing robes; Basil’s care was for the sick, and the relief of their wounds, and the imitation of Christ, by cleansing leprosy, not by a word, but in deed.” —St. Gregory’s sermon at St. Basil’s funeral¹

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The Lord of the Rings and Christ as Healer-King

One my favorite chapters in The Lord of the Rings is called “The Houses of Healing” (see chapter 8, Book 5 in Return of The King) which reveals Aragorn gracefully healing the wounded from war. Tolkien reveals to us a figure who is not only a great Warrior-King who wields the sword and wins critical battles against the Dark Lord, but someone who is also humble of heart and a Healer-King who sings over the sick and nurses the injured back to life.

In this scene, King Aragorn cares for Faramir who has been wounded in battle (as well as wounded by his own father). Tolkien writes,

“Now Aragorn knelt beside Faramir, and held a hand upon his brow. And those that watched felt that some great struggle was going on. For Aragorn's face grew grey with weariness; and ever and anon he called the name of Faramir, but each time more faintly to their hearing, as if Aragorn himself was removed from them, and walked afar in some dark vale, calling for one that was lost… Then taking two leaves, he laid them on his hands and breathed on them, and then he crushed them, and straightway a living freshness filled the room, as if the air itself awoke and tingled, sparkling with joy…

Suddenly Faramir stirred, and he opened his eyes… 'My lord, you called me. I come. What does the king command?'

'Walk no more in the shadows, but awake!' said Aragorn. 'You are weary. Rest a while, and take food, and be ready when I return.'

'I will, lord,' said Faramir. 'For who would lie idle when the king has returned?'

'Farewell then for a while!' said Aragorn. 'I must go to others who need me.'

…Pippin heard Ioreth exclaim: ‘King! Did you hear that? What did I say? The hands of a healer, I said.' And soon the word had gone out from the House that the king was indeed come among them, and after war he brought healing; and the news ran through the City.”

Tolkien, of course, is giving us a fictional image of Christ who is both Christus Victor as well as Christus Medicus. In the Gospels, our Lord not only storms the gates of hell, casts out demons, and tramples down death with his own death, but he also goes around healing the sick and binding the hearts of the broken-hearted (Read the Messianic prophecy of Isaiah 61)² He is both the White Rider at war as well as the Great Physician healing in the trenches. In one of his homilies, St. John Chrysostom tells us that the Good Samaritan in the parable is Christ who uses soothing oil as well as stringent wine to bring us back to life. The oil “brings the comforting word, wine provides the astringent lotion, the instruction which brings concentration to the scattered mind.”

The Orthodox Medical Tradition

Icon of St. Hermione

Because the apostles and saints sought to imitate our Lord who touched the lepers, it should be no surprise to us that a hospital system arose from Christianity! Here are a list of saints that played a role in this tradition of medical care in the ancient world:

1. St. Luke the Evangelist, (1st century) who wrote our 3rd Gospel, no doubt followed in our Lord’s footsteps in preaching the good news of salvation, but also healing through his medical ministry as physician. Although the Scriptures do not record St. Luke treating someone, it is highly probable that he provided medical care for many Christians being rejected from society as well as non-Christians. It is also very likely that provided medical care for St. Paul when he had been beaten, scourged, and stoned on a number of occasions. The Book of Acts, written by St. Luke, records his adventures with St. Paul both on land and at sea as well as shipwreck!

2. St. Hermione of Ephesus, (1st/2nd century) one of the daughters of Philip the Deacon, likely started one of the first Christian medical clinics. Originally, she went in search of St. John the Apostle as an old man only to find out that he had died. St. Hermione then collaborated with other disciples “to purchase a home and established both a medical clinic as well as lodging (xenodochium) for the poor, the stranger, and the homeless.”³

3. St. Basil the Great (4th century) is attributed with fundraising and launching the first true hospital complex in the world with various wards organized to treat different types of illnesses. Although smaller clinics existed throughout the world, St. Basil’s hospital was certainly the first of its kind (see more on this story below).

4. St. John Chrysostom (4th/5th century) and others were inspired by St. Basil and launched hospitals of their own which spread throughout Christian lands. One biographer writes of him, “They never forgot his care for the poor and miserable, and that in his first year he had built a great hospital with the money he had saved in his household…” ⁴

5. St. Sampson the Hospitable (5th/6th century) founded a hospital which became the largest free clinic throughout the Roman Empire. Funded by Emperor St. Justinian the Great, it served the people of Constantinople for 600 years. This is the story of how Justinian first met St. Sampson: “When Emperor Justinian became ill, and his physicians were unable to provide any relief for him, Patriarch Menas suggested that he send for Sampson, who healed the Emperor. Justinian offered him gold and silver to show his gratitude, but the saint refused, saying that he had already given all his wealth away. Instead, he asked Justinian to build a hospice for travelers.”⁵

The Story of The Basileiad: The World’s First Hospital

Many historians agree that the first hospital system arose in Asia minor (in the region of Caesarea) and began with St. Basil the Great. Thomas Hyne writes,

“Was it truly the world’s first hospital? Historians have compared the Basiliad to other, prior institutions which cared for the sick.9 For example, the Roman valetudinaria and Asclepian Temples predated the Basiliad and certainly provided care for the sick. But were they truly hospitals? Per Andrew Crislip, a hospital must have three components: inpatient facilities, professional medical caregivers, and care given for free.13 Scattered throughout the empire, the Roman valetudinaria were complexes constructed to treat ill or wounded slaves and soldiers. These valetudinaria were financed by either wealthy slave owners or Roman legions, to keep the slaves working or soldiers fighting (respectively).5 But the facilities did not treat the poor, and they were hardly charitable in nature. Similarly, the Asclepian temples, dedicated to the Greco-Roman god of healing, are sometimes cited as potential predecessors for the Basiliad. But the medico-religious services provided in these Asclepian temples were not given for free: sacrifices or donations were expected.14 Furthermore, the Asclepian temples rarely employed professional physicians. Finally, they did not accept terminal cases: indeed, a patient dying inside of the hospital would have been seen as a ritual impurity.15 Thus, even the often-cited healthcare institutions which predated Basil did not perform the same functions that his Basiliad did. It seems that Basil started a new trend: soon after his death, similar Christian hospitals were sprouting up elsewhere in the Roman empire, and they had became commonplace within one century.9 For these reasons, historians have argued that “the hospital was, in origin and conception, a distinctively Christian institution.” (see full article on St. Basil’s Hospital in Hektoen International: A Journal of Medical Humanities).

So what inspired St. Basil to launch the first hospital complex or medical campus?

Plagues had been rolling through the Roman empire for centuries. When the Christians came along, they stayed in the cities to care for the sick while the pagans fled. This type of radical love of service and healing led many people to become Christians.

However, St. Basil no longer wanted to be ‘in emergency mode,’ but desired to build something more systematic that was open to all people. The ancient world before him mostly knew of medical clinics for soldiers or the wealthy elite. In the far east, some monasteries had little hospitals attached to care for their monks. What St. Basil envisioned was far greater than any of those models, and so he began fundraising for the first hospital campus. Although he found great support, he also experienced opposition from the elite and even the Emperor himself!⁶

Eventually his dream of a paradise for the poor was realized. At St. Basil’s funeral,  St. Gregory Nazianzus preached a sermon of this new reality:

“Go a little way outside the city to see a new city, the treasury of piety, a common treasure room of those who have possessions where superfluous wealth . . . is stored. . . . In this institution diseases are studied, misfortune made blessed, and sympathy put to the test.”⁷

Many children were made orphans from the plagues, and so St. Basil was inspired to build something that went beyond simply a hospital. In the middle of the campus, there was “a magnificent church, and around it there were structures, guest houses/hotels, schools, orphanages, homes for the poor, and the hospital itself.”⁸  The complex was completed in the year 372 AD, and there was nothing comparable to it the ancient world. He even began leading a medical department himself since he had “ seven diplomas of education—one of them being a diploma of medical education.”⁹

St. Basil added a ‘quarantine unit’ at his new hospital and, like so many other Christians, risked his health in caring for the lepers. He “bandaged and washed these patients, and not only that, he directly spent time with them, embraced them, seeing in everyone the Image of God.”¹⁰ In the ancient world, leprosy was an automatic death sentence, and in some ways, worse than death. Not only was it a slow march to the grave filled with physical suffering, but it was also extremely contagious, which meant that you could not be anywhere near your family and friends. You lost your job and livelihood. You lost your worshiping community. You were sent to go exist in a living hell outside of the city. Some Biblical scholars have conjectured that Lazarus died of leprosy and that he, Mary, and Martha were all living in a leper colony outside of Jerusalem, when Jesus befriended them and eventually brought his old friend back from the grave. Like Jesus, St. Basil saw this ‘place of the living dead’ outside of the city and transformed this desolate place into a paradise and a new city for all people.

St. Basil’s model of medical care truly changed the world. Many bishops throughout the Roman empire quickly implemented this hospital system and eventually, the whole world took notice and embraced this new vision for humanity.

St. Basil the Great, pray of us!

Prayer List

Please pray for my best friend’s niece, Addy, who is battling cancer for healing and peace.

Please pray for Karen, a young mother who is battling cancer for healing and peace.

Please pray for Geoff, a young father who is battling cancer for healing and peace.

1. https://hekint.org/2017/02/24/reconstructing-the-worlds-first-hospital-the-basiliad/

2. No doubt this discussion also connects to different atonement models where Christ not only defeats Satan in the ‘Harrowing of Hell’ but also heals human nature as St. Irenaeus describes in his recapitulation model and offers up ‘human nature made new’ to the Father as St. John Chrysostom describes.

3. https://www.goarch.org/-/st-hermione-home-2020

4. https://www.newadvent.org/cathen/08452b.htm

5. https://www.oca.org/saints/lives/2012/06/27/101828-saint-sampson-the-hospitable-of-constantinople

6. https://orthochristian.com/117122.html

7. https://christianhistoryinstitute.org/magazine/article/basils-house-of-healing

8. https://orthochristian.com/117122.html

9. https://orthochristian.com/117122.html

10. See https://orthochristian.com/117122.html