I. Introduction
I started my scholarly work in the history of biblical interpretation, focusing on the Reformation. By comparing different interpretations of the Eucharist, I mapped out the formation of multiple confessions and the ways in which they turned to the early church fathers to draw lines of continuity in the history of Christianity. These variations of Christianity still exist today in the form of denominations, independent churches, or coalitions. Movements with any level of significance and longevity required much more than a single genius mind or a charismatic star but rather multiple leaders contributing to a common purpose. My study of these conflicts showed me that meaning-making happens in conversation with and even in conflict with others.
The enterprise of meaning-making continued to my next project. Why was the church important in the dynamics of an early modern society? How did the church support people in their communities? The history of poverty and the church’s responses to the poor emerged as a major contribution to social change, albeit it imperfectly, but nevertheless augmenting a limited government system. Both Catholics and Protestant cities worked to address poverty through some level of centralization of resources and coordination of its distribution. In places where religious change and social change coincided in the development of poor relief,Footnote 1 the repurposing of many monasteries and other religious buildings meant that traditional Catholic institutions that had provided services for the poor and sick were often dismantled as collateral damage. With many cities increasing legal restrictions on begging, Protestant leaders quickly recognized the need to develop poor relief institutions alongside the Protestant reform, usually in cooperation with the municipal government.
Religious reformers provided biblical interpretations to support care for the poor and sought to establish social institutions of poor relief. Acts of charity and care toward the most vulnerable were part of a long Christian tradition. The book of Hebrews says, “Do not forget to show hospitality to strangers, for by so doing some people have shown hospitality to angels without knowing it.”Footnote 2 The word, hospitality, comes from the Latin word, “hospes,” which means guest or stranger, where we get the words, “hospitable” and “hospital.” As in the Byzantine Orthodox and medieval Catholic traditions, Protestants conceived of poor relief and medical care as closely connected. The reformation of cities motivated greater access to medical care through the hiring of midwives, physicians, and surgeons for the poor. As Gary Ferngren notes, “the underlying basis for converting monasteries into large municipal hospitals was not to remove religious motivation from charity, but to create a Christian commonwealth that took upon itself the obligation to provide medical care for the destitute.”Footnote 3 Some narratives have portrayed early modern poor relief legislation as simply a political development promoted by city governments to establish completely secular state institutions. It is true that city ordinances mandated the transfer of church property to establish hospitals and schools, and that city officials implemented policy changes to address the problem of poverty in their towns. Yet if we dig a bit further, two factors become clear. First, the writers and creators of many city ordinances for poor relief were pastors. Why? Because poor relief often emerged as provisions and mandates in church ordinances. These church ordinances established the laws and guidelines for these poor relief institutions and included a measure of health care for the poor. Second, even in places where poor relief institutions preceded the Reformation, when the Reformation took hold, the pace of changes for poor relief increased dramatically.
When Luther’s colleague, Johannes Bugenhagen wrote to Luther to explain the progress of the Reformation in North German cities, he emphasized the organization of poor relief. In addition to religious and educational reforms, Bugenhagen highlighted that one of the definitive markers that the Reformation was taking hold was the establishment of poor relief institutions in the city.Footnote 4 In the 1528 Braunschweig church order, Bugenhagen condemned the practice of expelling sick people out of the city, since ignoring their care “would be worse than being a heathen.”Footnote 5 One development was to include some measure of medical care in the poor relief policies.
In the church order, Bugenhagen wrote: “The deacons of the poor chest from all parishes must build a house outside the city with many individual rooms for those who become ill with the plague. In this [plague] house, the deacons of the poor should arrange for as many male and female servants in a time of need as are needed and pay them. They will serve the needs of the sick. If the city does not want to provide for the needs of their men and women servants in a Christian manner, the deacons of the poor should supply them what they need with regard to food, drink, heat, bed linens, medicine, and so forth. All godly people should gladly give charitable gifts for this purpose.”Footnote 6 The deacons in the church helped to establish hospitals and hospices, which had a long-term effect on early modern healthcare. As religious leaders worked to organize charity into city institutions of poor relief, they sought to establish medical care for the indigent, often emphasizing the use of natural medicines. The religious value of charity and the work of poor relief institutions increased access to medicine, especially as leaders observed that healing the sick became a pathway for many people to work themselves out of poverty.
II. Religion and Medicine: Popularizing Medical Knowledge
The biblical narratives of Jesus’s miraculous healings meant that healing would be central to the history of Christianity. As in the ancient and medieval periods of Christianity, the ethical imperative for medical charity and care of sick people continued into the early modern period.Footnote 7 Lay healers, including hundreds of women were an integral part of healing and care for the poor in their local communities.
For example, Dorothea of Mansfeld (1493–1578), a German noblewoman combined both her religious faith and a commitment to charitable works for the poor who would gather in her castle garden. A steady stream of poor folks from the countryside would gather at her garden to receive her medical remedies. Since noblewomen often served as healers in the absence of a doctor. Dorothea used her healing talent as a “potent form of charity.”Footnote 8 Dorothea devoted herself to the healing arts by mastering the distillation of her aqua vita, (a distilled elixir) with ingredients from her herbal garden. During an epidemic in 1572, this elixir became her main remedy for the hordes of sick people streaming into her castle garden.Footnote 9 She saw her medical practice as her contribution to poor relief in her local context, namely by distributing medicine to the sick poor out of Christian love and by affirming that people’s healing were being augmented by God’s help.Footnote 10 Dorothea of Mansfeld’s widespread reputation even led her to impart medical advice to Martin Luther and Duke Moritz of Saxony. She maintained a general Christian ethic of care for one’s neighbor and chose to remain neutral in religious conflicts. Since Catholics and Protestants upheld the value of caring for the poor and the sick, Catholics and Protestants both claimed her as a representative of a model Christian noblewoman.
Yet based on some of Erasmus’ critique, Protestants articulated a theological shift that influenced cultural views of medicine. While some medical reforms were already underway by the beginning of the sixteenth century, concurrent religious intellectual reforms influenced the reform of medicine. Although Protestants maintained the power of prayer as part of healing, they tended to reject saints, relics, and pilgrimages as sources of healing. Luther emphasized faith as the human response to God’s gift of salvation and believed that spiritual healing had to precede bodily healing. Yet Luther’s theology of faith alone and its implications meant that Luther believed that only Christ could heal the root cause of sickness, (sin) not the saints. The link between sickness and sin did not disappear, but Luther made a distinction between active sins which one commits personally versus original sin that did not cause illness.Footnote 11 When suffering from kidney stones, he followed the physician’s instructions despite the pain. Luther saw medicine as a gift from God, who ultimately supplied healing through the use of medicine and competent experienced doctors.Footnote 12 Just as medicine could be a vehicle for God’s healing, Luther saw natural medicine as containing the power of the Word of God. Medicine worked when the Word of God bonded with it in a miraculous way. As an example of divine agency in the physical world, Luther viewed natural medicine as a means of divine revelation and healing power.Footnote 13 God’s ordained power was often channeled through the regular causal effects of created means, since the Word normally accomplished divine goals by working through created means.Footnote 14 Philip Melanchthon, Wittenberg reformer and younger colleague of Martin Luther, saw the human body as evidence of God’s handiwork and crucial for understanding the relationship between the body and the soul. Melanchthon reasoned that the knowledge of medicine for maintaining a healthy body was essential for preserving the health of the soul; hence anatomy became part of the curriculum for not only physicians or medical students but also for theologians, pastors, teachers, and arts students.Footnote 15
Religious reformers (mostly Protestant but also some Catholics) replaced saintly intercession for healing with a new emphasis on God as the ultimate healer who often provided through nature and natural medicines. They promoted positive attitudes about natural medicine as a form of piety, namely reliance on God and God’s created order. The belief that God provided either direct healing or the means for recovery in the divinely created world encouraged practitioners to examine healing properties of the natural world. Alongside Protestant preaching, a modified spiritual tone in plague writing emerged. In a 1519 pamphlet, the Swiss humanist, physician, and reformer, Joachim Vadianus (1484–1551) from St. Gallen omitted any intercession of the saints and appeals to St. Sebastian and St. Roch, which had been a common means of comfort in medieval plague pamphlets.Footnote 16 In 1519, Ulrich Zwingli, Zurich preacher and reformer, who had stayed in the city during a deadly plague outbreak to minister to the sick and dying in his congregation, contracted the plague and penned a song to record his outlook on illness. In his Pestlied (A Christian Song written by Ulrich Zwingli when he was attacked by the Pestilence), he called out directly to the Lord God in the opening lyrics, “Help, Lord God, help in this trouble!” and Christ for protection at the onset of illness.Footnote 17 Faced with suffering and mortality, he described a helplessness and yet countered it by seeking the Lord’s consolation and strength to fight and resist for him.Footnote 18 Because he came so near to death, Zwingli interpreted his recuperation as an opportunity to fulfill his purpose of preaching and teaching more boldly.Footnote 19 By 1519, appealing to the saints in times of illness had diminished for Protestants, although not disappeared, replaced with direct appeals to God’s grace and Christ’s mercy.
Based on Erik Heinrichs’s analysis of the wave of vernacular plague publications in the 1520s, German physicians and anonymous authors followed the trend of muting the saint’s role; even when printers reissued older texts, they removed references to the saints.Footnote 20 In muting the healing power of saints, believers lost one of the most accessible forms of comfort and healing. Although saints would return to plague literature after the Roman Catholic Church reaffirmed saintly intercession at the Council of Trent, nevertheless the concurrent movements of religious reform and medical reform resulted in another emerging source of solace and healing, namely natural medicine. This medicine, however, had to be accessible to become a real means of comfort.
Instead of “Paracelsus as the sole hero of German medical reform,” one could consider Martin Luther’s impact on medical reform as equally, if not more, far-reaching in terms of his broader influence on physicians’ writings.Footnote 21 Luther re-conceived of the God-human relationship in such a way that shaped the field of medicine. Luther’s plague sermon of 1527 (one of the most reprinted plague texts of the sixteenth century with nine editions in its first year and at least 30 reprints up to 1631) defined earthly medicine as “divine and necessary,” and provided the oft-cited justification of medicine from Ecclesiasticus 38, that “God created medicines for the benefit of humans and that the prudent do not neglect them.”Footnote 22 Luther also rejected the notion that a general poisoning of the atmosphere caused the Wittenberg plague of 1527 but rather argued that it originated with the level of local filth.Footnote 23 Against medieval precedent, Luther recommended that during the plague, Christians remain in their communities. While Luther made allowances for leaving, he argued that believers ought to show their trust in God and urged the city leaders to stay and serve the people.
Following the rejection of saints and sacramental’s avenues of divine healing, Luther supported the work of physicians and urged for towns to make provisions for the “maintenance of community houses and hospitals” where all the sick can be gathered for people to minister to them.Footnote 24 Luther recognized this charitable intention of previous generations through the establishment of many foundations, infirmaries, and hospitals so that “every citizen would not have to maintain a hospital in his own home.”Footnote 25 Luther expected city governments to play a major role in the establishment of poor relief and medical care while his view of neighborly love encouraged Christians to help such hospitals and contribute to their support.Footnote 26 But if there were no such institutions, Luther claimed, “each of us must be his neighbor’s nurse and hospital director in time of need.”Footnote 27
John Calvin’s 1541 Ecclesiastical Ordinances confirmed that illness often became an underlying cause of poverty and the ordinances prescribed the hiring of specific medical personnel, which was later codified in the civic Medical Ordinances (1569).Footnote 28 In his 1542 “Visitation to the Sick,” Calvin taught that ministers should give consolation to the sick and be a good example to others by giving relief to the afflicted.Footnote 29 The city of Geneva contracted a physician to care for the house poor and the poor in the city hospital. The city also contracted a surgeon and an assistant barber surgeon, to provide services for the poor and sick, especially during epidemics. In the following year (July 1543), the Genevan Small Council ordered that all medical personnel and all city ministers read about the plague remedies in the treatise of physician François Chappuis, who focused on remedies to help individuals avoid or cure the plague as well as notice signs for preventative measures.Footnote 30 Chappuis noted that many of the remedies he suggested, especially expensive medications, were not readily available to the poor. Instead of leaving the poor without any medication, he recommended a particular external topical medication (épithème) “for poor people.”Footnote 31 The hospital directors contracted with physicians, surgeons, apothecaries, and the city ministers to provide medical care for the poor at home, at the General Hospital, and at the auxiliary plague hospital.Footnote 32
Catholic and Protestant physicians articulated and incorporated religious views into their medical treatises. In response to the Reformation, some German physicians in their plague treaties encouraged Protestant rhetoric on medical and spiritual issues. The Protestant belief of the priesthood of all believers gave theoretical weight to the notion that believers could approach God directly and qualified lay scholars could interpret the Bible; this allowed physicians in Protestant regions to write works on the relationship between theology and medicine without facing persecution.Footnote 33 Heinrichs asserted that the Reformation marked an important turning point in printed plague literature such that Protestant perspectives appeared in vernacular medical literature by the end of the 1520s as physicians began to preach more often, drawing moral lessons from the plagues, condemning sin, joining religious debates, and urging moral improvement.Footnote 34 With the emergence of plague crises and increased attention to the plague’s contagious nature in the 1520s, public health concerns furthered the rise of the physicians’ authority within cities.Footnote 35
During the Reformation, the convergence of physicians and religious leaders addressing the plague and promoting social change “found a common cause in omitting saints from healing traditions and strengthening religious arguments for the use of natural medicine.”Footnote 36 Many medical texts simultaneously propagated religious views, whether Catholic, Protestant, or general Christian morals that would be acceptable for both. The combination of the Renaissance, Reformation, and vernacular print encouraged the German reform of plague advice by the mid-sixteenth century, flourishing in print and sales and connecting academic medicine with the local environmental and cultural context of German lands.Footnote 37
Physicians and healers had various motivations to publish their medical knowledge in the vernacular, but one common reason to popularize their knowledge was charity, partly as a Christian ethic and partly as a helping profession. Medical manuals and treatises sought to (1) teach simple remedies for affordable medicine and self-care, including personal hygiene and preventative care. In the first half of the sixteenth century, Hieronymus Brunschwig (1450–ca. 1512) was the name attached to one of the most popular general medical pamphlets of the era, Pharmacy for the Common Man (A Perfect Home-ish Apothecary) that compiled an array of recipes in a small compact home-medicine manual for cheap publication and easy transport. Published posthumously in Augsburg in 1529, this medical text, reprinted numerous times, emphasized the need for medical knowledge for the common people. The Pharmacy for the Common Man was among the most user-friendly pamphlets of the era since its recipes offered simple medicines made by boiling and distilling and its translation of the Latin notation used by physicians and pharmacists could guide the common reader.Footnote 38
The most common cures involved herbal treatments and the modification of certain behaviors (keeping limbs warm, eating certain foods, walking around, etc.). A treatment frequently prescribed was bloodletting, which indicated the era’s continued reliance on ancient medicinal practices. Yet there was a new emphasis linking cleanliness and healing. The author(s) also urged that every “physician or surgeon should investigate the cause of the disease [so that] they could treat the patients more effectively.”Footnote 39 This qualification seemed to distinguish physicians and established healers as those who could identify the cause of disease from the category of folk healers or quacks who tended to treat disease indiscriminately with a panacea or cure-all solution. Like many educated physicians who gave greater attention to the causes of disease, this author followed in the same vein, usually to find better treatment options. They would offer different treatments based on the cause of the disease. However, the author also seemed to advocate self-help whenever possible. After a remedy to address drunkenness, the author claimed that his instructions were meant so that people could “know how to help themselves.”Footnote 40 In the last part of the book, the author highlighted ways to cut costs in modified treatments, presumably for those who could not afford the more expensive regiments and ingredients or for rural populations that would not have access to a variety of ingredients. The Brunschwig medical manual, often reprinted, was meant for common people by taking into consideration the cost of making medicines and the desire for less expensive remedies.
Another reason to popularize their writings was (2) to teach and guide a view of humanity that included a deep connection between the bodily and spiritual. In the 1529 Pharmacy for the Common Man (drawing from the works of Hieronymous Brunschwig and Michael Puff von Schrick), the editor’s introductory sermon echoed Luther’s close correlation between medicine and the Word of God when he emphasized that medicine, after the Holy Scriptures, was the most precious, useful, and beneficial thing given to humankind.Footnote 41 Following a tradition of physicians since the medieval period when the influential Muslim physician Avicenna described medicine in divine terms, the link between natural medicine and divine healing powers “cannot be seen as a secularization of healing.”Footnote 42 Instead, healing and medicine would retain a spiritual dimension and an ongoing concern for both bodily and spiritual care.
While the general expectation might be that religious leaders emphasized the supernatural and the physicians emphasized the natural reasons and remedies, the early modern reality was more complicated because both pastors and physicians saw the supernatural and natural as integrated worlds. They did not see one as excluding the other but rather as coexisting realities. In other words, one would not choose either a spiritual or medical approach but embrace both since one could simultaneously confess their sins, strive to live an upright and moral life, be at peace with one’s neighbor, make use of medicine, and take measures to preserve one’s health.
In the middle of the sixteenth century, another influential work written by an Italian physician emerged and enjoyed reprinting for more than a century. The growth of publications in the books of secrets in the sixteenth century “opened up a burgeoning market for self-help manuals in medicine,” and while how-to books before this time generally were written for the middle and upper class, this new book of secrets communicated medical knowledge in a way that commoners could understand.Footnote 43 In 1555, a book of secrets, which I will refer to as Secreti (del reverendo donno Alessio piemontese), or A Collection of Seven and Fifty Receipts Good against the Plague appeared in print under a pseudonym, Alessio Piemontese, or Alexis of Piedmont, intended for non-elite audience. The pseudonym was meant to describe a “devout and learned man whose anguish over the condition of his soul led him, albeit reluctantly to publish his precious secrets, the product of his life’s labor, for the world’s benefit.”Footnote 44 Attributed to a doctor or group of doctors known as Alessio Piemontese, the author or editor described the purpose of this book as being for the benefit of poor people.Footnote 45 As this Collection gained best-seller status and international fame, it triggered an upsurge of books of secrets, multiple copycats, and resulted in 70 editions by the end of the century and translations into various European languages. By 1568, when the fourth (and last) part of the additional compilations to the Secreti came out, Alessio Piemontese was a legend whose name was “synonymous with medical and technical secrets” and representative of the ethics of openness, “especially attractive to common readers.”Footnote 46
Tracing the source for all the recipes is nearly impossible because they were compilations collected over the years from various sources, reshuffled, and redistributed in booklets. Based on the preface and Girolamo Ruscelli’s history of the Academia Segreta, some came from books and manuscripts now lost, while some came directly from empiricists, peasants, and women encountered through world travels.Footnote 47 Like a once carefully guarded secret recipe that have become widespread, collectors gathered these recipes initially for self-use but then for others, whether in the household or for broader consumption. The multiple origins and crowd-sourced compilations in such medical manuals made authorship variable and elusive, although the collector’s work was seen as equally valuable for the dissemination of knowledge.
In addition to charitable impulses, many sixteenth-century medical books highlighted the perspective of divine intervention as part of healing and the natural world as God’s providence for the cure of diseases. The Flemish Catholic physician Levinus Lemnius (1505–1568) described his purpose in writing his widely read Occulta naturae miracula, or Secret Miracles of Nature (1559) as to preserve the presence of God in nature. He praised philosophers for attempting to find natural causes, but added that the powers in nature, namely its “hidden essence and secret properties” proceed from God.Footnote 48
As physicians publicized their medical knowledge, some physicians and lay healers promoted religious reform or their versions of spiritual health, along with the idea that medicine was a way to understand God’s providence. Yet even as medical knowledge became more accessible, the impoverished still struggled to attain health. In response, physicians and lay women healers articulated their motivation to practice charity through their medicine. Poor relief institutions extended medical care to the poor and promoted the cultural turn toward native local herbs and plants as well as more affordable remedies. The charitable activity of religious reformers, physicians, and lay healers not only furthered the spread medical knowledge but also supported a modicum of healthcare for a wide range of people who could never afford a physician’s visit.
III. Conclusion: Why Does the History of Christianity Matter?
The history of medicine is incomplete without the history of Christianity. The efforts of so many people from ministers and deacons to physicians and surgeons, and women and folk healers helped in the meaning-making of charity and hospitality as they provided new ways of comfort and healing. Medicine and healing continue to be an integral part of Christian practice in places beyond early modern Europe.
Around the world, believers have devoted great energy to caring for others because of the Christian imperative to love their neighbor, especially in places of great poverty. In Korea, Chul-yeol Lee was a farmer, an elder in his church, and a lay healer. Since going to the hospital was too expensive for most farmers, Elder Lee provided medical care in his farming village for the sick with his acupuncture, a common form of Eastern medicine, as a way to help the poor who could not afford or reach a doctor’s services. Elder Lee would pray with his patient before he started the acupuncture. This type of work might seem like a simple act of charity. Yet in the context of mid-20th century Korea, these acts of medical charity demonstrate that healing and medicine have remained an indispensable part of the Christian identity.
Here is Elder Lee’s context. In 1945, only 2% of the Korean population was Christian and by 1950 about 8% were Christian at the start of the Korean War. During the Korean War, Communist forces targeted Christians and their churches. When my grandfather and his younger brother gathered for a church service, the North Korean Communist forces seized all who were gathered. His brother was the young dynamic pastor of the church, so he became a clear target. As is often in the case of war and the accompanying violence, he was tortured and brutally beaten to death. The rest were taken to the outskirts of town, tied together, and buried alive. Somehow my grandfather escaped, but not unscathed. They broke his leg so that he could not escape easily. By the time I met my grandfather, he always walked with a limp. My grandfather and his brother had embraced a Christian identity at a young age and his family paid a high price for choosing a minority religion. Even during the war, my grandfather continued to treat people with acupuncture, even as his broken leg never healed properly. He also made sure that the next generation, through my aunt and uncle would have the skill set to continue their acupuncture services for those who could not afford medical care in the US immigrant community. Whether in poor relief legislation, popularization of medical manuals, or lay healing for poor communities, Christians have stories to tell of being healed (even if partially) and being healers even in the most trying circumstances. This is why the history of Christianity matters, because Christians have contributed extensively to meaning making and cultural interpretation for so many communities around the world. Some stories come from a different perspective, some are still emerging, while some are still hidden, and waiting to be told. Let us keep telling the stories that people need to hear. Help others remember the ways that Christian communities contributed to the meaning-making of human lives. Write the histories that, in revealing its cultural breadth and impact, lead to greater understanding and inspire further study.
Acknowledgments
I am grateful for the Church History editors and the research supported by CMC’s Gould Center for Humanistic Studies, Dean’s Faculty Grant and the DeBakey Fellowship in the History of Medicine at the National Library of Medicine.
