Christian doctors and nurses, inspired by the example and teaching of Jesus, have been at the forefront of efforts to alleviate human suffering, cure disease, and advance knowledge and understanding.

the hospital movement

Before Christianity, there were several hospital-like centres in Buddhist regions. The ancient Greeks practised a very simple form of medicine. The Romans are believed to have established some military hospitals. However, by their radically different outlook, it was Christians who began to change society's attitude towards the sick, disabled and dying.

The Graeco-Roman world was often cruel and inhumane. The weak and the sick were despised. Abortion, infanticide and poisoning were widely practised. The doctor was often also a sorcerer, and the power to heal equally conferred the power to kill. Among the pagans of the classical world, only the Hippocratic band of physicians had a different attitude — they swore an oath to heal and not to harm, and to carry out their duty of care to the sick.

However, it wasn't until the 'conversion' of Constantine that Christians were publicly able to express ethical convictions and undertake social reform. Even before that, stories of Christians caring for people had an enormous impact. In the second century, when the plague hit the city of Carthage, pagan households threw sufferers onto the streets. The entire Christian community responded. They were seen on the streets, offering comfort and taking them into their own homes to be cared for. After Constantine, Julian, who came to power in AD 355, was the last Roman Emperor who tried to reinstitute paganism. In his Apology, Julian said that if the old religion wanted to succeed, it would need to care for people even better than the way Christians cared.

As political freedom increased, so did Christian activity. The poor were fed and given a free burial. Orphans and widows were protected and provided for. Elderly men and women, prisoners, sick slaves and other outcasts, especially the leprous, were cared for. These acts of generosity and compassion impressed many Roman writers and philosophers.

In AD 369, St Basil of Caesarea founded a 300 bed hospital. This was the first large-scale hospital for the seriously ill and disabled. It cared for victims of the plague and was the first of many built by the Church.

In the so-called Dark Ages (AD 476-1000) rulers influenced by Christian principles encouraged the building of hospitals. Charlemagne decreed that every cathedral should have a school, monastery and hospital attached. Members of the Benedictine Order dedicated themselves to the service of the seriously ill; to 'help them as would Christ'. Monastic hospitals were founded on this principle.

In the later Middle Ages, monks began to 'profess' medicine and care for the sick. Monastic infirmaries were expanded to accommodate more of the local population. A Church ban on monks practising outside their monasteries gave the impetus to the training of lay physicians. It was contended that this interfered with the spiritual duties of monks. So, gradually, with the support of the city fathers, more cathedral cities began to provide large public hospitals. This moved medical care towards the secular domain.

Nevertheless, expansion of healthcare continued to be stimulated by the Church's example. Eventually, there were few major cities or towns without a hospital. And there were particular diseases where the Church took a lead. Leprosy is an example of this. In England, Henry VIII's suppression of the monasteries caused great suffering. Patients from hospitals that were founded and run by monastic orders were thrown onto the streets. The onus for healthcare was placed firmly on the city fathers, and municipalities were forced to pay more attention to the health problems of the community.

It was not until the 18th century that the Christian hospital movement re-emerged. Christian revival, sparked in England by the preaching of John Wesley and George Whitefield, was part of an enormous unleashing of Christian energy throughout the 'enlightenment' of Western Europe. It reminded Christians to remember the poor and needy in their midst. They came to understand afresh that bodies needed tending as much as souls.

A new 'age of hospitals' began, with new institutions built by devout Christians for the 'sick poor', supported mainly by voluntary contributions. Christians were at the forefront of the dispensary movement (the prototype of general practice), providing medical care for the urban poor.

The altruism of these initiatives was severely tested when cholera and fever epidemics appeared. Larger hospitals often closed their doors for fear of infection. While wealthy physicians often left the cities for their own safety, doctors and the staff of these small dispensaries, driven by Christian compassion, continued to care for the sick and dying. Christians identified specific needs, which led to the opening of specialist units: maternity and gynaecology hospitals, and institutions for sick and deserted children. When the National Health Service eventually took over most voluntary hospitals, it became clear just how indebted the community was to these hospitals, and the Christians that supported them over centuries.

advance of medical knowledge

Together, Jews and Christians took the lead in collecting and copying manuscripts from all over Europe after the burning of the great library in Alexandria. This rescued much medical knowledge for the religiously-tolerant Arabic Empire, and for later generations.

During the Dark Ages, Arabic medicine advanced considerably due to their access to these documents. In Europe, however, progress was comparatively slow. It was Christian thought that led to the formation of Western universities. Founding of medical faculties was often due to Christian initiative. So too were attempts to raise standards of research and care.

In the Middle Ages, a clash emerged between those who relied dogmatically on ideas passed down from classical sources and new attitudes to research, fostered by the growing influence of what is now called modern science. The Royal Society was founded to encourage research, and the majority of its early members were Puritan or Anglican in origin. The invention of the printing press and the reformation were major forces in promoting intellectual liberty. By the 16th century medical progress was advancing rapidly.

clinical medicine and patient care

Throughout the ages, their commitment to love and serve those weaker than themselves, as Christ did, placed Christians at the forefront of advancing standards of clinical medicine and patient care.

Christian doctor Thomas Sydenham is sometimes hailed as the 'English Hippocrates'. He stressed the importance of personal scientific observation and holistic care for patients. He was also one of the brave 'plague doctors' who did not desert the sick and dying during the Great Plague. Others followed in Sydenham's footsteps. Dr Herman Boerhaave was influential in pioneering modern clinical medicine, while Dr William Osler taught all medical students to base their attitudes and care for their patients on biblical standards.

public health, preventative medicine and epidemiology

Early on, Christians realised the connection between health and hygiene. Girolamo Fracastoro, a very versatile student in the 16th century, began to investigate the spread of contagious diseases. In the next century his work was continued by Dr Thomas Sydenham. Ministers also advocated personal hygiene. It was John Wesley who said 'Cleanliness is, indeed, next to godliness.' John Howard had a great concern for prisons, where overcrowding and typhus were rife, and successfully promoted two prison reform acts of Parliament. Edward Jenner, a devout man, was responsible for the beginnings of immunology and ridding the world of smallpox.

social need

In the 19th century, the Industrial Revolution led to a drift towards the inner cities, with intense social needs among the poor. A nationwide movement of Christian missions to help the poor was founded. Huge sums of money were raised and volunteers went to slum areas to offer practical help. The Salvation Army, founded by William Booth in 1865, provided much-needed medical care in impoverished inner city areas and homes for women forced into prostitution. Dr Thomas Barnardo set up a children's home after seeing the terrible plight of thousands of hungry and homeless children in the East End of London.

In 1967, Dame Cicely Saunders founded St Christopher's Hospice, with the aim of providing, as far as possible, a peaceful atmosphere for those with terminal illnesses, while offering an environment of Christian love and support.

developing world missions

Jesus commanded his followers to go and make disciples of all nations, (4) (and exhorted them to love their neighbours as themselves). There have been several waves of missionary work across two millennia with medical work playing a key part.

Dr John Scudder was one of the first Western missionaries of the modern era. In 1819, he went to Ceylon (modern day Sri Lanka). Among the best-known pioneer medical missionaries were Dr David Livingstone (Central Africa), Dr Albert Schweitzer (who devoted his life to people living in the remote forests of Gabon) and Dr Albert Cook (who founded Mengo Hospital in Uganda). Dr Ida Scudder founded the world-famous Vellore Medical College in India. Dr Henry Holland and his team, working along the north-western frontier of the Indian sub-continent, operated on hundreds of cataracts every day.

nursing

Similarly, modern nursing owes much to Christian influences. For centuries the majority of nursing, like most medicine, was carried out by monastic orders in their own hospitals. In AD 650, a group of devout nuns volunteered to take care of the sick in Paris, and most other nursing followed this pattern. In the 19th century, 'modern nursing' was born, in no small measure due to the work of Elizabeth Fry and Florence Nightingale. Fry was deeply influenced by a small Christian hospital at Kaiserswerth in Germany, run by 'deaconesses', a group of Protestant women. Their response to biblical commands to care for the sick and educate neglected children provided the template for modern daily hospital nursing. Nightingale encouraged better hygiene, improved standards and night-nursing, and also founded the first nursing school. Many missionary nurses such as Mother Teresa and Emma Cushman worked tirelessly, bringing hygiene and Western medicine to the four corners of the globe.

a new allegiance

Christianity gives men and women a new perspective and allegiance; their lives are spent in joyful, grateful service of the God who has redeemed them. In many ways, Christianity and medicine are natural allies; medicine offers people unique opportunities to express their faith in practical caring for others, embodying the command of Christ: 'whatever you did for one of the least of these brothers of mine, you did for me'. (5)

Rosie Knowles is a GP in Sheffield

1. Aitken JT, Fuller HWC, Johnson D. The Influence of Christians in Medicine. London: CMF, 1984

2. Hanks G. 70 Great Christians, The Story of the Christian Church. Christian Focus Publications, 1988

3. Wyatt J. Matters of Life and Death. London & Leicester: IVP/CMF, 1998

4. Matthew 28:19-20

5. Matthew 25:40