Legal and Psychological Aspects of Christian Caregiving: Hospices in Medieval German Cities

Introduction

The Christian perception of caritas (active caregiving) originates with the New Testament: “Love your neighbor as yourself” (Mark 12:31). The Apostle Paul elaborated this concept in his Second Letter to the Corinthians: “Each one must do as he has made up his mind, not reluctantly or under compulsion, for God loves a cheerful giver” (2 Corinthians 9:7). Emperor Constantine (306-337 AD) first legitimized this central commandment and two centuries later Emperor Justinian (527-565 AD) sponsored it in the Corpus Juris Civilis (“Justinian Code”). This was an important step, as William Byrnes put it: “Christianity, an underdog religion that arguably had its biggest supporters among the underclass of Rome – the poor, the plebes and enslaved, had made an extraordinary impact upon the most powerful organism in Rome – the law” (William H. Byrnes IV, “Ancient Roman Munificence: The Development of the Practice and Law of Charity,” 57, 3, Rutgers Law Review, 1,043, 2004).

Caregiving was of course not new. Human beings have helped one another since time immemorial, but the Christian concept of active caregiving or conscious giving was newer. Earlier groups may have helped members in need, but the conscious act, often with the purpose of creating a positive afterlife, was newer.

General Considerations

This understanding of active neighborly giving stands in contrast to the previous Roman Republican and Imperial practice of munificence to enhance the donor’s standing in society rather than

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to help the poorest of the poor. Thus, donors had temples, buildings, baths, aqueducts, sewer systems, and roads built “to look good,” just as they hosted lavish parties to achieve the same goal (Byrnes; Andreas Thiel, The Romans in Germany [in German], 15^th ed., 2016; Karl-Wilhelm Weeber, Luxury in Ancient Rome [in German], 2003, esp. 89ff). They were interested in their standing and advancement in this life and not the one after it. Until the emperors took on the exclusive role of major donors, well-placed Romans gave back to advance their careers.

Justinian’s law recognized two types of donation: the donation realized during the life of the giver and the donation given upon death of the donor by will (Byrnes, “Munificence,” 1,098). The main concern for many was the salvation of their souls, which might be hurried along toward heaven via the impetus of charity in their last official act upon the earth. As the Church matured into the Middle Ages, such provisions were thought to be the essential purpose of the last will and were termed that which makes provision for the soul (Byrnes, “Munificence,” 1,104).

Christian charity elevated the active engagement for the well-being of neighbors and prayer as a way to gain a place in the afterlife with the angels surrounding God’s throne. This in various interpretations entered different parts of Europe in the post-Roman world. This legal contest underpinned more than 50 charitable institutions that emerged in the German-speaking cities in the 13^th century. (Some of the late Roman laws also guide charitable giving to this day.)

It should not astonish that hospices originated during some of the worst hunger events in Germany’s history and while several Crusades were underway. Monasteries already functioned as refuges of the poor and ill where brothers, not priests, aided them. As cities grew again, they too became places of refuge. People were starving in the countryside and often lost everything. Abandoned by their families during illness, there were men, women, and children without support and/or simply unable to provide for themselves. Whole flocks of starving and sick people moved or were chased from one village to another; sketches of the “undesirables” being evicted are still displayed in European museums. Sometimes they wandered into cities that offered potential hope. They lingered in front of churches and the homes of the wealthy, asking for donations and employment. Such persons were not the only ones taken in; in Hamburg, for example, pilgrims on their way to a holy site

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were also accepted.

Cities were dirty and unsafe, with chickens and pigs running about freely, canalization being nonexistent. Human waste intermixed with the animals’ waste. In 1986, my tour group to Central Asia overnighted three times in Samarkand. The odor of the open sewers woke us every morning around three; it was the most profound stench imaginable. In the Middle Ages, people probably did not even notice, but constantly choked and, if they could afford them, bought wooden elevators to attach to their shoes when in the streets.

Given these circumstances, how did they notice the poor, ill, and elderly? German cities of the first half of the 13^th century were relatively small; on average, they ranged from less than 2,000 to about 10,000. Cologne and Mainz were the exceptions, with the first at 50,000 and the second with 25,000 inhabitants. (Berlin, 1,200, 2,400; Lübeck, 1,200, 6,000; Nuremberg, 1,200, 10,000; Augsburg, 1,200, 12,000; Mainz, 1,200, 25,000; Cologne, 1,200, 50,000; Hamburg, 1,400, 8,000). Many residents recognized each other, even if they did not know one another, especially in their neighborhoods. An outsider would have stood out by facial features, attire, and unfamiliarity with usual urban behavior and areas to avoid.

Because this was the time of the crusades and not everyone could embark to the Middle East, the church argued that those who were left behind could fulfill their Christian obligation by engaging in charitable activity. Did the church ask well-off citizens “to notice” the destitute, sick, and old, or did they do so on their own? The story was often told that a wealthy donor, say a merchant or bishop, gave money and/or property to sponsor the erection of a facility for the poor, ill, or older persons (see G.W. Dittwer, The Holy Ghost Hospital and St. Clemens in Kaland [in German],1838). The psychological context was straightforward: to fund an institution to help others was an act of doing good and at the same time created a reward in heaven.

In some cases, wealthy families gave their holdings and worked in the facility in order to later in their lives take their place there as residents. In some other cases, they joined immediately and were given a small chamber and could thus sleep away from the rest of the residents who inhabited the common area. In this case, we would today tend to speak of privacy, but in the percep-

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tions of the time, the chambers indicated privilege. Yet another situation is the one in the Heilig-Geist-Hospital am Roten Tor in Augsburg, “well-situated investors who promised their holdings to the foundation after their deaths received their own chamber, while inhabitants who paid smaller amounts were placed in rooms with multiple occupancy” (Peter Lengle, Hospitals, Foundations and Brotherhoods: History of the City of Augsburg from Roman Times until Now [in German], 1985, 202-08). A similar example comes from the city of Montabaur. This matches the wealthier eating better food than the rest of the residents and sitting at the front of the long tables in the “assembly area.” Other reports even indicate that some of the wealthiest donors resided in private rooms with a cooking facility and their servants in attendance.

This elevation from the group had at least one other advantage. The institutions were run like monasteries or nunneries and being away from the routines once again meant privilege, but also some freedom for self-expression. Yet everyone, at least in Augsburg, beginning in the 1600s, received a warm bath eight times a year.

Uniformly, hospices were dedicated to the Holy Ghost and sometimes supervised and worked by brothers of religious orders, like Cistercians and Augustinians. Others who worked in these institutions were poor members who worked in the bakery, prostitutes in rehabilitation, etc., and others, mostly women, who felt the calling to work there. We have a specific example of community members working in a hospice from the Heiligen-Geist-Hospital in Rostock. It had working farms like other such institutions, two in this case, and small cubicles for the staff who worked in them.

However a person worked in the institution, they were engaged in caritas. Caritas meant not charity, as it might today, but active love of neighbor. The idea, too, was to help residents with their meaningful transition to the next life while making their lives easier in this one. It also meant that staff received no payment, except the belief that the elderly, poor, and ill needed their help as neighbors and that the reward would come in the afterlife.

Specific images of that afterlife could readily be called upon, like angels surrounding the throne of God, the father, and his son, with the Holy Ghost fluttering above. Images were also available in churches of purgatory, the cleansing by fire of lesser sins before entering heaven, and there are the images of devils in hell,

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tormenting evildoers falling from above onto their forks and other instruments of torture, fires burning everywhere. The Seven Deadly sins were a constant reminder of what awaited if one slid into one or more. The first part of Dante’s 14^th century epic poem, Inferno, and Bosch’s interpretation of hell, were far removed in time and this context, but the imagery was available long before then on the local level. (One of the best representations of popular imaginations stems from the Kreuzgang in Brixen/Bressanone of the 14^th century, then in a German-speaking area.)

Chapels and churches in or near Hospizes offered a point of reflection on the afterlife. One never knew, although indications were thought to have existed, when death would take them (Alicia Strobel, Dealing with Death and Dying in Medieval Monasteries [in German], 2017). Preparations for this inevitability were therefore necessary; prayer, confessions, fasting, good deeds, and tolerating the burdens of aging were part of it. It may appear almost cruel that, in a time of frequent food shortages and famines, residents of hospices fasted. Yet, if the few details of food intake in hospices, like the one in Basel that received 37,000 eggs a year, are any indication, then fasting was a distinct possibility. A difference today is also the lack of genuine help for the ailments of the elderly; neither hip replacements nor ibuprofen were available back then. Offering the burdens of aging for the greater glory of God, in imitation of Christ’s suffering, was thus for many a part of the preparatory activities. Although “cripples” were often shunned in public, in hospices, they could wander about safely.

No doubt, hospices provided a better situation for those accepted than hopelessly wandering the streets or not being cared for in advancing years, whether wealthy or poor. On average, hospices had 100-150 inhabitants, thus accommodating a respectable proportion of the population. (Augsburg’s facility by 1370 hosted 270 residents.) This is an especially meaningful number when one considers the residents’ high turnover rate. With a life expectancy of about 30-40 years, somewhat higher or lower depending on social placement, one could expect a resident to “move on” faster than is experienced today when life expectancy is much higher, about 81 in 2018 in Germany.

Having spent seven years in different monasteries and observing several facilities for elders here in Germany, I noticed the intense rivalries that disturb the peace in institutions like them and facilities for elders. The conflicts become visible in the placement

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at tables and the quality of food enhancing them every day. In the hospices, the residents ate at long tables, placed according to class. The wealthier inhabitants, those who had promised their fortune to the institution after their deaths, sat at the head of the tables and received three courses, including meat, bread, light beer, and dessert. Those who had promised less, the older and the poor, sat at the lower ends of the tables and generally received, like in Augsburg, soup meat or meat soup, oatmeal, bread, and light beer. Wealthy persons may well have washed the feet of a poor inhabitant, but quietly and openly be accused of exhibiting no more than a holier-than-thou attitude: “Just look at where they sit at the table!” It’s important to add, although international trade in foodstuffs, like beef from Hungary, was already flourishing, most meals originated with locally grown and produced items (Franz Schubert, Eating and Drinking, 109ff). This included bread, meat, eggs, some vegetables, and beer.

Food was sufficient and regular inside, especially in comparison to what the residents most likely would have eaten outside. Nevertheless, the outside world intruded. Schubert told of the emergence of table manners to inhibit some issues at tables (Schubert, Eating and Drinking, 80ff). He argued that they started in response to unique problems during various communal feasts and gradually spread from these to other eating situations. One oddity that had become less appealing was the passing of a wooden drinking vessel, as was the habit of less-well-placed persons reaching for bread that everyone needed to sop up soup and for better slices of meat or eggs from those better-placed at tables. As in monasteries, one of the residents, or brothers of the religious order, probably read from the Old or New Testament while the rest of the group ate.

Conclusion

Today we would most likely speak of the ill, poor, and older residents as having been traumatized before they entered a Hospiz and that they need or needed some form of counseling. But neither those who cared for them nor the residents saw the situation this way. They faced life stoically, and in the case of the older inhabitants, most likely looking forward to the next stage of their lives; that is, at best heaven, at worst purgatory. One is tempted to argue that the greater the travail while they lived in this phase, the greater the opportunities to show dignified acceptance to themselves and maybe others. Those who assisted the ill, poor, and older in the hospitals offered the love of the neighbor, not with the in-

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tent of being paid, but rewarded with the knowledge they were helping others, and seemed to ensure in the future that they would sit with the angels near the Trinity of Father, Son, and Holy Ghost. It is noteworthy that most of these hospices are still in existence today.

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