Tag: compassion

How Christians Built the First Hospitals (Matthew 25:40)

depiction of a hospital

In the 4th century, a kind bishop named Basil of Caesarea started a major change by creating the first real hospital, which turned informal care for the sick and poor into organized medical help. This important institution not only changed healthcare by providing systematic support but also set the stage for future hospitals, focusing on human dignity and well-being. Originally called the Basiliad (after Basil), it introduced a structured way of healthcare, allowing a variety of medical practices and granting everyone, regardless of their status, access to quality care. As a result, the Basiliad became a lasting example for hospitals today, shaping healthcare practices and inspiring future medical professionals to support those in need while promoting a broader sense of social responsibility in the community.

In this article, we shall explore how the visionary leadership of Basil not only addressed the immediate health concerns of the afflicted but also established an enduring ethic of social responsibility and communal care that echoes through history. His innovative approaches and compassionate initiatives created a network of support, fostering a sense of unity among the community members. In this context, God’s Story of Grace progressed by reintegrating the sick individuals into the well-being of the wider community. Healing came to be seen not merely as a person’s physical restoration but also as a profound social reconnection, further establishing within society the trinitarian image (Father, Son and Holy Spirit) of mutual interdependence and self-giving love.

The Dawn of an Institution: The Basiliad

Long before Basil, medical care was often limited to private homes for the wealthy or temples that excluded the terminally ill. This changed with Basil, a well-educated man and devout Christian, who was moved by the teachings of Jesus to serve the most vulnerable in society. In 369 AD, during a time of severe regional famine, he established a massive complex just outside Caesarea in Cappadocia (modern-day Turkey). He had already established soup kitchens, but he envisioned something greater: a massive complex, a “city outside the city,” dedicated to organized, compassionate care. It was his friend and fellow theologian, Gregory Nazianzus, who would call this revolutionary institution the Basiliad, after its inventor.

This wasn’t just a clinic; it was a “new city” of mercy. The Basiliad included:

  • Inpatient facilities: Wards specifically designed for the sick, the aged, and orphans, where patients receive comprehensive care and attention “around the clock.”
  • Professional medical care: A dedicated staff of physicians and nurses provided systematic treatment. Basil himself, defying social norms, bandaged the wounds of lepers, a deeply marginalized group at the time.
  • Holistic services: The complex also offered trade schools to teach occupants useful occupations, lodging for weary travelers, and spiritual care, aiming to heal the whole person—body, mind, and soul.
  • Charitable mission: Crucially, all care was provided for free, funded by church donations and challenging the self-interest prevalent in Roman society.

A Legacy Takes Root

Basil’s efforts were a radical departure from the norm and prompted a major shift in the understanding of social responsibility. He also played a key role in convincing Christians that medical science was a gift from God, not a pagan practice, thereby encouraging the integration of medical knowledge and Christian charity. Here is an excerpt from his work, Long Rules (Question 55), that captures this sentiment:

Each of the arts is God’s gift to us, remedying the deficiencies of nature… The same is true, also, of the medical art. Inasmuch as our body is susceptible to various hurts… the medical art has been vouchsafed to us by God, who directs our whole life, as a model for the cure of the soul, to guide us in the removal of what is superfluous and in the addition of what is lacking.

Basil saw medicine as one of many God-given natural means—like agriculture and weaving—intended to comfort and care for the body in a fallen world, not an act of human pride or a rejection of divine providence. 

Following his death in 379 A.D., the impact of the Basiliad was immediate and widespread.

  • Rapid Expansion: Within a century, inspired by Basil’s model, similar Christian hospitals became commonplace throughout the Byzantine world and the wider Roman Empire, significantly improving healthcare access for the less fortunate.1
  • Monastic Influence: Monasteries became centers of healing, with monks and nuns offering medical care and shelter, further embedding the hospital concept within the fabric of society.
  • Formalization of Care: Religious orders, such as the Knights Hospitaller2, later formalized this commitment, establishing hospitals across Europe and the Holy Land.

The spirit of the Basiliad, with its revolutionary combination of professional medicine, organized charity, and inpatient facilities for all, regardless of wealth, established the fundamental principles that guide modern hospitals today.

The Lasting Influence of Compassion

The Basiliad brought together the “voluntary poor” (monastics) and the “involuntary poor” (those in need) in a new kind of community that embodied Trinitarian principles of self-giving love and interdependence. This was seen in three ways:

It fostered an inclusive community. The complex included a hospital with professional staff who were dedicated to providing exceptional care to all patients, a home for the aged that offered warmth and companionship, an orphanage where the children received not just shelter but also love and education, a trade school that equipped individuals with valuable skills for their future, and guesthouses for travelers that provided comfortable accommodations and a welcoming atmosphere. This diversity of functions and residents living in close proximity mirrored the dynamic, ordered relationship of the Persons of the Trinity, illustrating how different roles and identities can coexist harmoniously while contributing to the greater good of the whole community.

It offered dignity to all. In an era where the sick, especially lepers, were outcasts, Basil personally embraced and cared for them, seeing the image of God in every suffering person. This radical affirmation of human dignity challenged the prevailing social hierarchy and emphasized the equal value of all people, just as all persons of the Trinity are of equal divinity and power.

It demonstrated love as action: The “New City” was centered around a magnificent church and focused on “love for humanity” (philanthropia). The entire structure was a physical manifestation of Christian charity, a social revolution that sought to make societal interaction reflect the harmonious, life-giving communion of the Trinity itself.

Final Thought

In essence, Basil, who was a great proponent and defender of the Trinity, put the doctrine into a concrete social blueprint, demonstrating that the nature of God as a communion of persons demands a human society characterized by communion, mutuality, and compassionate service to all members. Basil was used by God to make the words of Jesus an expanded reality:

Truly I tell you, whatever you did for one of the least of these brothers
and sisters of mine, you did for me.

Matthew 25:40

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  1. Around a century after St. Basil’s founding (c. 469 CE), hospitals inspired by his work began to spread throughout both the Eastern and Western Roman Empires. Examples of growth: The Eastern Roman Empire, under Emperor Justinian, saw the establishment of approximately 35 hospitals in Constantinople alone. Religious orders: The founding of dedicated religious orders, such as the Knights Hospitalers of Saint John, contributed to the growth of hospitals by formalizing the care of pilgrims and the sick.
  2. The order was originally a monastic and charitable one, providing care for the sick and poor, especially Christian pilgrims in the Holy Land. 

How Mercy and Compassion Became Universal Virtues (Acts 4:32-35)

God brought within the world a revolution of mercy and compassion where the dignity and value of each human being became recognized and responded to in a way that was largely foreign in the world.1 When the Holy Spirit entered into humanity at Pentecost the worth and dignity of people would be understood and embraced in much greater ways leading to a revolution of compassion and mercy. What this article will explore is looking at the suffering and life of the ancient world and how the advance of God’s Story of Grace brought an understanding of the alleviation of suffering through compassion at a greater level. Christianity developed a social network of communities of support and care that allowed mercy to spread and further shape the world to reflect the image of the Trinity–a world that would come closer to being able to express mutual and self-giving love.

Here is how it began.

The Holy Spirit Rebirths Compassion

After the Holy Spirit entered the 120 in the Upper Room (Acts 2:1-3), his power began to spread into communities where the new believers had a oneness, love and unity that reflected the mutual and self-giving love of the Father, Son and Holy Spirit. For those in their community (the church) who were suffering, the natural goal was to elevate their lives through material and practical support. This reality is first seen with measurable clarity soon after Pentecost:

32 All the believers were one in heart and mind. No one claimed that any of their possessions was their own, but they shared everything they had. 33 With great power the apostles continued to testify to the resurrection of the Lord Jesus. And God’s grace was so powerfully at work in them all 34 that there were no needy persons among them. For from time to time those who owned land or houses sold them, brought the money from the sales 35 and put it at the apostles’ feet, and it was distributed to anyone who had need. (Acts 4:32-35)

This is the first spark which would over time blaze into a spontaneous movement of compassion and relief leading to ongoing ministries of mercy around the world. This was desperately needed in the world the early Christians inhabited.

Life In the Ancient World

Overpopulation

The importance of mercy and compassion for the spread of God’s Story of Grace in the ancient world cannot be overstated. The Christian movement emerged mainly in urban areas which were densely populated. Having its start in Jerusalem it would later have central hubs in Antioch and then Rome. Jerusalem may have had 25,000 people. Antioch (the third largest city of the Roman Empire) had around 200,000. Rome, the largest city in the world, boasted around 450,000 inhabitants. Though cities then were less populated than today, they were significantly more dense. Cities of the first century had a population of 200 to 300 people per acre. That is tightly packed, especially when considering that overly populated cities like Calcutta have 100 to a 120 people per acre.

Housing and Sanitation

Because the cities in the Roman Empire were desirable places for many to live compared to rural areas, immigration mushroomed their size. As population density swelled, houses were tightly built together and not well constructed in many instances. Private houses were rare as people lived in the equivalent of apartments. The collapse of buildings was a regular fear. The only source of heat was wood or charcoal braziers.2 This made homes smoky, especially in the winter. To avoid asphyxiation homes were kept drafty. To make matters worse, to dispose of sewage waste most people used chamber pots and pit latrines. When pots were used they were emptied in nearby ditches which served as sewers. Not uncommonly people would dump their waste into the street. This meant that housing was often smoky, damp and smelly. With these types of conditions, people lived much of their lives in public places away from their homes.

Sickness and Disease

With the type of housing and sanitation conditions mentioned above, disease and sickness was not uncommon. According to Rodney Stark’s, The Triumph of Christianity, a recent analysis of decayed human fecal remains in ancient Jerusalem found an abundance of tapeworm and whipworm eggs signaling this to be a prevalent problem. Infectious diseases like malaria, dysentery, typhoid, and various intestinal ailments were rampant. This suffering was intensified by malnutrition and food shortages. Even Luke records this occurring during the days of Emperor Claudius:

One of them, named Agabus, stood up and through the Spirit predicted that a severe famine would spread over the entire Roman world. (This happened during the reign of Claudius.) (Acts 11:28)

Only the Strong Survive

There was not a lot of motivation to address the suffering on a large scale because in the pagan cultures, they possessed no basis for the concept of the dignity of human persons. Without such a belief, the right to live was granted or withheld by family or society almost at a whim. It was natural for some to hold that the strong were naturally to be dominant and the weak were rightly trampled. From this mindset, mercy was seen as a character defect and compassion a misguided emotion. Tom Holland in his book, Dominion, states that many in the ancient world made a positive virtue of discarding and abandoning the weak. Referring to the practice of casting aside unwanted babies, he writes:

Across the Roman world, wailing at the sides of roads or on rubbish tips, babies abandoned by their parents were a common sight. Others might be dropped down drains, there to perish in the hundreds. The odd eccentric philosopher aside, few had ever queried this practice. Indeed, there were cities who by ancient law had made a positive virtue of it: condemning to death deformed infants for the good of the state. Sparta, one of the most celebrated cities in Greece, had been the epitome of this policy, and Aristotle himself had lent it the full weight of his prestige. Girls in particular were liable to be winnowed ruthlessly. Those who were rescued from the wayside would invariably be raised as slaves. Brothels were full of women who, as infants, had been abandoned by their parents—

Describing the plight of the poor and suffering in the Roman world, Gary B. Ferngren, states in his article, A New Era in Roman Healthcare:

  1. The sick and elderly were routinely left to waste away.
  2. Unwanted children were often left to die of exposure.
  3. If a father determined that the family could not afford to feed another child, that child would be abandoned on the steps of a temple or in the public square.
  4. Defective newborns were routinely left to die of exposure.
  5. Female infants were exposed more often than males, because girls could not really support the family.
  6. The chronically ill were often seen everywhere in the streets, baths and forums of the Roman cities.

A Revolution In Care and Compassion

In the midst of all of this illness and squalor, the power of the Holy Spirit in the church began a revolution of compassion and mercy. The early church voluntarily pulled their resources and distributed them to those in need. (Acts 4:32-35) This was indeed revolutionary, but it was a revolution with good reason. Jesus spent much of his ministry alleviating the suffering of the sick and discipling others to do the same. (Luke 10:9, 25-37) He told his followers that in the day of judgement they would hear these words:

35 For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36 I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me….40 “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ (Mathew 25;35-36, 40)

The apostle James declares:

15 Suppose a brother or a sister is without clothes and daily food. 16 If one of you says to them, “Go in peace; keep warm and well fed,” but does nothing about their physical needs, what good is it?” (James 2:15-16)

The apostle John writes in a similar manner:

17 If anyone has material possessions and sees a brother or sister in need but has no pity on them, how can the love of God be in that person? 18 Dear children, let us not love with words or speech but with actions and in truth. (1 John 3:17-18)

Another way the New Testament church practiced compassion and mercy was their love (agape) feasts. (1 Corinthians 11: 17-22, Jude 1:12) It was a weekly meal of the church, surrounding the celebration of the Lord’s Supper, which afforded outcasts an opportunity to fellowship with more well off members of society as equals. This was a setting where social barriers were removed bringing dignity to people deprived of it. For many it supplied needed nourishment from hunger. This movement of compassion developed into extended networks of care for those hurting and in troubling situations. (1 Corinthians 16:1-3) This approach would evolve into an organized system of care for widows. (1 Timothy 5:3-16)

This spark led to a flame that over time turned into a blaze.

From A Flame to a Blaze

The church began a revolution of mercy and compassion which exists today. This work continued on in movement and growth. Here are a few examples:

  1. Within a couple of centuries the church in Rome ministered to 1,500 widows and others in need. It has been estimated that the Roman church spent annually 1,000,000 sesterces—an equivalent of several millions of dollars in today’s currency—on ­benevolent work. This is an astounding amount.
  2. Starting with the ministry of deacons3 (Acts 6:1-6, 1 Timothy 3:8-13), Christians had been developing infrastructure in their own churches to help the sick. This would grow into a deacon-led care in which churches offered care for the sick. Most who served in this way did not have professional training.

This revolution would grow to an ethic of universal care. The churches’ program of benevolent care expanded to even those who were not part of the church. An epidemic of possibly smallpox or measles began in AD 250 in Ethiopia and spread to Rome. It lasted 15 to 20 years, and at many points killing thousands a day. Public officials did nothing to prevent its spread or care for the sick. By AD 251 the plague swept into Carthage. Cyprian, a Christian leader in Carthage, called the city’s Christians to care for the diseased and suffering. He urged the rich to donate funds and the poor to volunteer their service for relief efforts. Cyprian made no distinction between believers and pagans. This marked a new chapter. For the first time, Christians extended their medical care to pagans as well as Christians.

In the first two centuries, the church is the only organization to systematically care for the poor and sick of society. This brought the expansion of God’s Story of Grace in that it further advanced an understanding of the world where even the least among society was offered greater dignity and care. This began a revolution that is still in operation today. That story continued to expand, and it will be told in later articles.
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  1. Israel was commanded toward compassion toward the poor and suffering. But this compassion was more civil than a cultural movement. Sometimes rulers would exercise relief toward their subjects, but this was never ongoing or widespread. In other cases there were grain laws to subsidize the poor with grain to stop social unrest.
  2. A pan or stand for holding lighted coals.
  3. Deacon is derived from the Greek word diakonos which means servant.