April 9, 2025 • 48 mins
When we think about the joys of modernity, perhaps one of the images that comes to mind is hospitals. But, believe it or not, hospitals were also a fundamental part of the medieval world. Catering to the sick, the poor, and the needy, hospitals were institutions many medieval people could rely on in their most desperate moments. This week, Danièle speaks with Sarah Loose Guerrero about what to expect at a medieval hospital, how institutions like the Ospedale di Santa Maria della Scala supported citizens from infancy to adulthood, and what hospital support looked like for both urban and rural communities.
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Episode Transcript
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Speaker 1 (00:15):
Hi everyone, and welcome to episode two hundred and eighty
six of the Medieval Podcast. I'm Danielle Sabalski, also known
as the five Minute Medievalist. When we think about the
joys of modernity, perhaps one of the images that comes
to mind is hospitals, places where people can come in
with some of life's biggest issues and be supported. Hospitals
(00:36):
are symbols of community and charity in action. But what
if I told you that hospitals were also a fundamental
part of the medieval world. Catering to the sick, the poor,
and the needy. Hospitals were institutions many medieval people could
rely on in their most desperate moments, both in urban
and in rural spaces. This week, I spoke with doctor
(00:58):
Sarah Luce Guerrero about medieval hospitals. Sarah is assistant professor
of history at Brigham Young University and the author of
several works on medieval charity, digital humanities, and Sienna's most
famous hospital. Her new book is Cienes Hospitals Within and
Beyond the City Walls, Charity and the Hospitalite di Santa
(01:18):
Maria dela Scala fourteen hundred to sixteen hundred Our conversation
on what to expect at a medieval hospital, how hospitals
like Santa Maria de la Scala supported the community from
infancy to adulthood, and what hospital support looked like for
rural communities is coming up right after this. Well, welcome
(01:40):
Sarah to talk about medieval hospitals, especially Sienna. It is
so nice to meet you and this is just such
an important and interesting topic, So thank you so much
for being on the podcast.
Speaker 2 (01:52):
Thank you for having me.
Speaker 1 (01:54):
So I think at the outset there might be people
who are listening to this and surprised that there were
hospitals at all in the Middle Ages. So can you
tell us a little bit about sort of how hospitals
started springing up and then we can talk more specifically
about Siena if that's more comfortable for you. But tell
us about hospitals how they started in the Middle Ages.
Speaker 2 (02:15):
Sure. So, the idea of a hospital actually comes from
the word for hospitality, right, And a lot of hospitals
start initially as just almost like inns where pilgrims or
travelers could come as they're making their way, you know,
from one destination to another and they need a place
(02:36):
to stay. These were institutions that offered sort of free
housing and shelter and food for travelers, for pilgrims, mostly
those who are going on a religious journey. And a
lot of times those pilgrims had problems, like they were sick,
or they had you know, broken sandals or something like
(02:58):
that right that needed to be fixed. And so these
institutions started to evolve into places that could take care
of people and could give them assistance. And charitable institutions
were seen by both the church and the lay people
as a great way to exercise their faith and their spirituality.
(03:20):
So you see a lot of people founding hospitals just
as part of their religious practice. And not all hospitals
served the same purpose. Some were dedicated to the treatment
of a specific group of people or a specific disease.
You find leprosy hospitals or foundling hospitals that only cared
(03:43):
for children. And then sometimes you get hospitals like the
one that I wrote about, which has multiple functions. It
had medical care, Foundling Care gave food daily to the poor.
So yeah, I would say by the thirteen hundreds, hospitals
are pretty well entrenched across Europe.
Speaker 1 (04:05):
Yes, I mean nowadays we have hospitals in every major
city and even in rural spots, which is something which
we're going to get to in a minute. But you
see in your work on hospitals and especially this one,
that hospitals are pretty much ubiquitous. We're seeing them everywhere.
Speaker 2 (04:22):
Yeah, pretty much everywhere. There's hospitals all the way from
the northern British Isles down through the Iberian Peninsula into Italy,
and even in the Byzantine and Islamic worlds, they had
charitable institutions that are equivalent to what we would think
of as a hospital. I think we tend to think
(04:44):
medical institution right away, and they do over time adapt
that function, but they also serve all of those other
functions as well, right of providing shelter, providing food, and care.
Speaker 1 (04:57):
So when we're talking about this as a charitable instant,
tution hospitals in general, and you're mentioning that this is
an aspect of people's faith, especially who's running the hospitals
in general.
Speaker 2 (05:08):
It kind of depends. Some hospitals are run by monasteries
or convents. Sometimes they're attached to a specific cathedral or church,
right and then they're administered by the cathedral canons, the
sort of clergy in charge of the church.
Speaker 3 (05:25):
Right.
Speaker 2 (05:26):
A lot of times, especially in France and Italy and Spain,
you have what we call confraternities that are lay religious organizations.
So the members are not clergy, but they volunteer to
sort of dedicate their lives to charitable service and they
(05:46):
then come and live and work in and run the hospitals,
and they depend on funding from donations and other places
like that to help keep the hospital running. So yeah,
sometimes it's just regular men and women who they might
not want to go all the way and join a
(06:07):
convent or become a monk, but they do want to
do something that they view as useful and an exercise
of their spirituality, and so this is a good option
for that.
Speaker 1 (06:20):
Yes. And one of the things that we are seeing
in the Middle Ages and really happening with the hospital
that you're looking at, is that people are donating to
the hospitals, like you're saying, but especially in their wills,
so like this is something that people found to be
not only a religious duty but sort of a civic
duty and making sure that they are funding these hospitals
(06:41):
so that they are taking care of the people of
the city.
Speaker 2 (06:44):
You're seeing this right, Oh, absolutely, especially in cases like
the hospital in Siena that I studied, it becomes such
an important institution within the city that the city government
eventually decides we want to have some control over this institution,
and so they end up having members who sit on
(07:06):
the hospital's governing board, and so, yeah, it becomes both
a civic and a religious institution.
Speaker 1 (07:13):
So let's dive into this specific example. We talked about
hospitals generally, but let's talk about this specific example because
I think that it is a good example from which
we can extrapolate more information. So tell us about the
hospital that you studied.
Speaker 2 (07:27):
Okay, So this hospital is called the hospitality Santa Maria
della Scala, or you can just say Santa Maria della
Scala for short, and it dates all the way back
to the late one thousands. That's when the first sort
of document that alludes to a hospital exists, and over
(07:49):
time it grew to not just shelter pilgrims, that was
its initial purpose, but they took in abandoned children, they
had medical infirm for men and women. The poor could
come daily and have bread distributed to them, and then
on certain feast days. They would throw feasts for the
poor six times throughout the year. And yeah, they performed
(08:14):
all of these services and the hospital just sort of
expanded and grew over time, largely thanks to like you
mentioned donations, Right, people, especially wealthy members of the city's aristocracy,
leaving large amounts of land or cash to the hospital.
Speaker 1 (08:34):
Right. And this hospital is staffed by people that are
called oblates. And this might be confusing if people have
read other stuff or learn more about monks, where oblates
are people who are brought to the monasteries, children brought
up there, and these oblades are different, right, tell us
about the old blates that are staffing this hospital.
Speaker 2 (08:52):
Yeah, most of the people who are oblates are adults.
They have lived their lives doing another profession and then
decided at some point that they want to not abandon that,
but sort of leave that behind and come live and
work at the hospital. So that process of oblation just
looked like agreeing to donate their land and property to
(09:14):
the hospital as they enter and become part of the
the hospital's family and live and work there. They did
also allow people to donate their property to the hospital
but still continue to live and work on their property.
So there's those kinds of oblates as well, who don't
necessarily come and live in the hospital building, but who
(09:36):
donate all of their profits and income to the hospital.
Speaker 1 (09:40):
It's a good option to have because if you're going
to live at the hospital, you give up everything. You
never get it back, So that's a big step to
be taking. So, you know, I might be the person
who is like, I'm just gonna stay on my land
and just work at the hospital.
Speaker 2 (09:54):
Right Yeah, And especially for people who lived outside of
the city, right you might not want to leave your
more rural lifestyle to come live in the busy, sometimes smelly, messy,
messy city. And then over time too, a lot of
the abandoned children, both boys and girls, who are raised
(10:15):
in the hospital, once they reach the age of adulthood,
a lot of them stay and live and work in
the hospital, and they join the hospital's confraternity, so they
get members from that track as well.
Speaker 1 (10:29):
I do want to come back around to the way
that the hospital is supporting children, because I think this
is one of the most fascinating parts about this work
that you've done. But I do want to stay on
how it's established first, because one of the things that
is important about your book is you're getting into how
this hospital of Santa Maria in the middle of Siena
is also working with satellites throughout this councer, I don't
(10:53):
want to say county, throughout the area around Sienna. So
how is it managing these places? What are they for?
Why does a hospital have satellites around the town.
Speaker 2 (11:05):
It's sort of the same way that you know monasteries,
especially by the late Middle Ages, they had this tradition
of owning land right that was given to them and
they were able to derive profit from that to help
run the monastery. It's the same idea for hospitals too.
People would donate land to the hospitals and then they
could choose either to sell that land or keep it
(11:29):
and work it to derive profit. And Santa Marie de
la Scala was so popular for whatever reason among the
Sienes that it eventually ended up having about a third
of the land in the territory that Siena controlled. It
was the largest land owner in Siena, which that's sort
(11:51):
of uncommon. Big hospitals do own a lot of land,
but this is sort of a unique situation and what
they did with that land was organized it into what
they called granchia. They're just little pockets where they had
a lot of land in one spot, so they would
establish sort of a central farmhouse on the bigger ones.
(12:14):
Those are fortified to protect them from bandits and people
wanting to steal crops and things, and then they would
send administrators out to live and work and run those farms.
And they had a whole system of transportation to bring
things back in and out of the city and moving
people and livestock and goods around. So they were really good,
(12:38):
especially by the sixteenth century, at sort of managing this
flow of things to keep the hospital functioning.
Speaker 1 (12:46):
I think that it's a familiar concept to have outlying
farms that are supplying things like monasteries and hospitals. But
you're finding that the granta are not just for farming.
They're also for supporting people in the way that hospitals
have always supported people, right.
Speaker 2 (13:03):
Yeah, a lot of the granchia, in fact, all except
for one or two of the very smallest, they all
had a hospital, like a small rural hospital on site.
And yeah, it was part of their obligation as part
of this institution to also offer services to people in
(13:25):
these rural areas, which is really really important if you
are in a very small community can't travel all the
way to the city necessarily, So yeah, it provided a
definite service. I mean, it's hard right with the Middle
Ages because we don't always have sources to tell us
all the things we want to know, but we know
(13:46):
there was a lot of informal charity that went on
right neighbors helping each other and things like that. But
this does provide evidence that there were often actual institutions
right places where people could go, and they were small,
some of them were only like two beds, but it
still provided that service, and they also did the other
(14:07):
things like providing bread daily to the poor and if
children were abandoned on the grancha, they would be sent
to the institution in Siena so that they could be
taking care of their So yeah, it did provide options
right for people in the countryside that they would otherwise
(14:28):
not have had. Well.
Speaker 1 (14:29):
I think this is such important work because it's one
of the questions that people have, like if something goes
wrong on your farm, what are you going to do?
Who are you who are you going to call?
Speaker 2 (14:38):
Right?
Speaker 1 (14:38):
And then you can go to the hospital. In some cases,
the hospital will be there for you. So my question
to you is, when places like Santa Maria del Scala
they're looking for places to expand into the countryside, how
are they deciding on these properties? Are they all donations?
Because there is an indication and you can correct me
(14:59):
if I'm wrong, it feels like there's an indication in
your book that sometimes they're picking the land because there's
already an established hospital. There is that, right, Yeah, that's right.
Speaker 2 (15:08):
So very early on in the twelve hundreds, the hospital
has land donated to it, and in those areas there's
already a hospital there or nearby. Right, So then as
they sort of built up a portfolio, I guess we
could say in modern turns, they could be a little
(15:30):
more picky about Okay, we had this random parcel of
land donated to us over here. We don't really own
anything over there, so we're going to sell that one
and try to acquire more land in this area where
we already have some property. But yes, some of the
initial properties that were given to them already had hospitals established,
(15:52):
and then in a few other spots land was donated
to them with the specific requirement that you can have
this land if you build a hospital. Right, So the
donors were also then thinking about I want to give
this land, but I want to make sure that they're
going to provide those services on this land, which is
(16:13):
just kind of neat.
Speaker 1 (16:14):
Yes, well, I think it's one of these things that
will blow up ideas of modernity, right. We think about
the modern system is where you have, you know, a
web of clinics or something like that. But this is
already happening in the thirteenth and the thirteenth century, the
fourteenth century, and this is a great example of it.
Speaker 2 (16:34):
Yeah, I mean, and they're establishing guidelines for how people
should be treated, for what they should do, how they
should receive individuals when they come to them, right, Like
we just I think you're right. We tend to have
this idea of especially the medieval passes, being very haphazard
and you know, sort of illogical, and that's not the
(16:55):
case at all. M M.
Speaker 1 (16:57):
And one of the things that I think makes a
great place one of the things that you get in
the book for having a series of clinics or smaller
hospitals satellite hospitals, is its place on roots for trade
for pilgrimage. Right.
Speaker 2 (17:12):
Yeah, So Siena is right along a major pilgrimage route,
the one that runs to Rome, which, of course, as
the seed of the Pope, right is one of the
big pilgrimage sites. And so that gave it the opportunity,
the hospital, the opportunity to sort of build on that
religious tourism is what scholars call it, right, this idea
(17:33):
that people are going to be constantly and consistently coming
along these roads, and if we have hospitals not just
in the cities, but sort of along the way, that
we can offer services to people.
Speaker 1 (17:47):
Yes, and that is what makes so much sense when
you look at. One of the things that you look
at in the book is some of the jobs that
are done by people in the Granta and a lot
of them are farmers, and a lot of them are shoemakers,
which makes sense if you're on the pilgrimage route, because
people are going to be blowing a sand, like you said,
while they're walking to Rome, They're going to need shoemakers.
(18:07):
And this is really really interesting in one of those
things that seems specific to a geographical region, right, in
other places, shoemakers might not be the second most popular trade.
Speaker 2 (18:19):
Right, And you know, there's all kinds of other workers
out there doing things that you might not expect to
find in a in a rural institution. There are especially
on the fortified farms, there are guys who are stonemasons
and their job is like make sure the buildings are maintained.
And there's household servants to help run the actual farms.
(18:40):
But then there's all kinds of servants to care for livestock.
And I'm saying servants, I should actually say employees because
they weren't servants. So yeah, there's all kinds of activity happening.
Speaker 1 (18:52):
Yes, And the idea of staff is one that I
want to get into with you as well, because you
Pollo quote early on in the book talking about the
staff for this across the territory owned by it. It's
thought of as a family. O. Can you tell us
about this because this is rare, I think rare in
the Middle Ages talking about your staff as being your family.
Maybe when we're talking about like grand staff a huge
(19:14):
number of people, So tell us about this.
Speaker 2 (19:17):
Yeah. So it's something that is maybe unique to hospitals
or charitable institutions, but it's quite common especially I know
in Italy. There's some cases of it in Spain as well.
I'm not sure about other places. But using this language
or rhetoric of family to describe the people who are
(19:40):
carrying out the day to day activities, that's how they
thought of it, that's how they describe it. In the records.
They consistently use the term familia to talk about everybody
that's part of the hospital, from the children who you know,
these abandoned children get the last name Skala, and the
hospital records were to them as sons and daughters. When
(20:02):
their daughters marry, when they find husbands for those who
want to marry, they refer to those husbands as sons
in law. Right, So they do have this very strong
at least rhetorically right. They think about it as a family,
and I think that's partially due to the fact that
it is a religious institution, right, and so they see
(20:25):
themselves as all bound together, engaged in this work to
glorify Mary and Christ and care for people.
Speaker 1 (20:35):
Yeah, it seems like almost a dream job if you
could get in with the hospital might be a dream
job in that at least, as you say in the paperwork,
it looks like they are supporting these farmers through good times,
through bad times, and maybe keeping families on like the
Stonemasons you were talking about, you tase some Stonemasons that
stayed on for a couple generations. Like this seems like
(20:59):
a great place to work.
Speaker 2 (21:01):
Right, Yeah, this, I think you're talking about Anyelo and
his sons. And yeah he he is there in the
records from when he was a young man up through
old age, and by the time he's older, he is
living in a home that he has rent free from
the hospital. Right, And to me, that just signals this
(21:23):
sort of appreciation for his long years of work. I mean,
I try not to be too idealistic to rose colored glasses. Right.
There is lots of evidence of them saying like this
sharecropper has, you know, broken the rules and he's irritating people.
So he's out right. So they're not always benevolent, but
(21:46):
there's plenty of evidence that kind of the prevailing attitude
was one of, yeah, we're going to we want to
take care of these people. We are a charitable institution.
That is our mission. We're going to try toole to that.
Speaker 1 (22:01):
Yes, I love that. It's nice. Again, you don't want
to go too far, And I'm always trying to hold
myself back from being too idealistic. But it's really nice
when you see examples of people being supported and cared for.
And of course one of the best examples is with children.
So tell us a little bit about how the hospital
cares for children. So there's an infant, it's left on
(22:22):
the doorstep of the hospital.
Speaker 2 (22:24):
What happens then, Yeah, so the infant would be taken
in and assigned to one of the women who ran
the orphanage. They didn't call it an orphanage. That's just
the modern term, right. It divided up into a section
for infants, and then once kids got to be about
(22:46):
five or six, they split the boys and the girls
because they received separate kinds of education and treatment. If
the infant was still needing to be fed, they hired
wet nurses. There were tons of wet nurses on the
payroll of the hospital. And there's lots of evidence not
just in this hospital, but hospitals and lots of other
(23:08):
places that very enterprising women would have an infant and
if they needed the income, they would abandon that infant
and then come to the hospital and say, hey, I've
had a baby, I can work as a wet nurse
and then get paid sometimes to feed their own infant,
which the hospital sees as fraud and wants to stop.
(23:28):
But that was an important component of taking care of
those children, right, was, especially if they're babies, making sure
that they're fed. They would stay with their wet nurse
until they were weaned about two years old, and then
they would come back to the hospital and they would
be cared for. You know, they had clothes, they had food,
They would be given an education for girls, right it's
(23:51):
mostly household education. For the boys, they would find apprenticeships,
and a lot of young boys ended up being sent
out to the farms that the hospital owned and starting out,
you know, just as a household assistant or a stable boy.
And then some of them from there go on to
(24:11):
eventually hire positions, some of them even I give the
example in the book of one named Giovanni, who ends
up being the head administrator of the hospital's biggest grancha.
So the hospital tried to use its resources to provide
careers and futures for these for these boys and girls.
(24:33):
If girls wanted to marry, the hospital would provide dowries
for them and find husbands. I mean, there's so much
that we could talk about. I don't know if there's
anything else that you want to specifically touch on, but.
Speaker 1 (24:45):
All the things, all the things we again, we can't pick.
We can't have two rosy picture because like, if you
look at things like in the deckenziean world, like the
fact that kids are being taken care of sounds great
until you actually look at it, right, can't be too rosy.
But it does look like there are children that are
sent out to the grancha and they basically have a
(25:07):
foster family. They grow up with the same people. It's
like they have a family of their own that they
are given by the hospital. And this just sounds fantastic
instead of them just being like left in an institution
to be bored, this seems like a great way to
keep things running in a way that is supportive of
(25:27):
children and also supportive of the hospital's mission.
Speaker 2 (25:32):
Right, I mean it does, and I was careful I
tried to point this out in the book, right, Like,
this does benefit the hospital in the long run. Right,
if they're getting these children to then stay and work
in the hospital, that's helpful for them, but it's also
helpful for the child who doesn't end up on the
streets without a place to live and without a career
(25:53):
or a future. Not everybody had a good experience, and
I wish the records were more clear on how they
decided which children to send to the countryside, which ones
got to stay in the city. There's really no indication
on how they made those determinations. But I do talk
about in the book a few times when you know,
(26:14):
there's an outbreak of plague and they start sending as
many children as they can out to the countryside, right
because they recognize if they stay in the city, the
chances of them getting sick and dying are higher.
Speaker 3 (26:26):
Right.
Speaker 2 (26:26):
So there are lots of little evidences like that that
they really do care and they do try their best
to take good care of these children.
Speaker 1 (26:36):
Yes, and I think you see that also in the
jobs the careers that they're training these children for, because
they're not just sending them out to be grunts all
the time. They're giving them apprenticeships that will help them rise.
And as you said, there is a few children that
you were able to trace then ended up being important
in the hospital administration. But this means that they were
(26:57):
trained to be literate and to have skills that they
could apply elsewhere. And I think this is also very
forward thinking of them, not just self serving, but serving
the children.
Speaker 2 (27:08):
Yeah. Absolutely, there's plenty of boys with the last name
Skala who end up being record keepers, and that, like
you said, tells us that they were taught to read
and write, to be literate, and having that kind of
educational opportunity was not uncommon, but it wasn't easy to have,
(27:29):
especially if you were from sort of a peasant or
lower class family, right, So it was an advantage that
they got.
Speaker 1 (27:39):
Yeah, And I think this is another thing that we
might maybe not expect from the Middle Ages. You might
just expect someone to take a child that has been
left behind and treat them as someone who's always going
to be left behind. But this is not what you're
seeing in the research, right.
Speaker 2 (27:55):
They are treated as important in the sense that there
taking care of right, rather than just leaving them out
to die. And there are large numbers of children being abandoned,
especially during the fourteenth, fifteenth, sixteenth centuries, which tells us
(28:16):
a lot of families were struggling economically and for them
to have the option of I have all these kids,
I can't take care of them, what can I do?
Speaker 3 (28:26):
Right?
Speaker 2 (28:26):
Instead of just literally abandoning them to the elements, they
could give them to an institution to be taken care of.
And we do know that some children were abandoned with
information about their family and parents. Sometimes it's not super common,
but they sometimes did come back when their economic situation
(28:48):
was better and take their children back. We also know
that more girls were abandoned than boys, which is something
most people would probably expect. Yeah, the hospital always has
close to double the number of girls to the boys,
So yeah, taking care of abandoned girls in particular was
(29:09):
a big part of what they did.
Speaker 1 (29:12):
Yeah, and even these girls are given skills so that
they're not just going to end up being at the
bottom of the heap. So obviously not shaming people who
are laundresses at this time, but giving them skills so
that they can apply them later. I think this is
again valuing girls even when there are double the amount
of girls, or giving them dowries. This is something that
(29:33):
they don't necessarily have to do, and we do see
it being self serving in some ways where they're like, right, well,
you marry this guy who's also on heart property, you know,
that'd be great, but they don't have to give them dowries.
This is something that they choose to do, and I
think that that's significant.
Speaker 2 (29:50):
Yeah, they spend a significant amount on dowries for girls
who want to get married, and it is sort of
a funny thing, right, because it is showing care for
the girls, and it also is a way for them
to again demonstrate charity and to show like we're fulfilling
our spiritual mission by providing for these children. So yeah,
(30:14):
there's always, as you well know, in the Middle Ages,
it's impossible to separate right the spiritual from the secular
or like we do in today's world. And so all
of these actions that they had taking care of the poor,
taking care of the sick who came to the hospital,
there's always a religious purpose behind those actions. So on
(30:39):
one level, it is that it is that they're caring
for them, but on another level, it's also that it's
fulfilling their charitable mandate.
Speaker 1 (30:48):
Yeah, and I mean, as you say, you can't really
separate these two things. Where if you are giving somebody skills,
that means they're not going to come back to the
hospital later, right, They're not going to end up being impoverished.
Hopefully things go well. I'm not going to end up
being impoverished and being someone that they have to continue
to serve. So it's one of those things where you
put in some effort and it benefits all of society.
(31:10):
And I think that people in the Middle Ages could
see that, could see the long term benefits of supporting
the community in ways that maybe some people don't see
these days.
Speaker 2 (31:21):
Right, absolutely, And I did find I have found a
few cases of girls who were raised by the hospital,
married and then were widowed and who came back and
lived and worked in the hospital after they were widowed,
which tells me potentially a couple of things. One is
that maybe they didn't have the financial means to take
(31:42):
care of themselves after their husband died, and so the
hospital was willing to say, yeah, come back, or they
wanted to return and sort of give time and efforts
to a process that they went through themselves. Right, either way,
I think that's a significant thing.
Speaker 1 (32:01):
Yes, I mean, you can't always ascribe a good reason
for coming back to an institution that right I grew
up and I mean maybe that's the only place to go.
But it also it also could speak to the fact
that their experience there was good and that they do
want to come back and as you say, contribute or
at least they feel safe there, which is something that
I think can be discounted either.
Speaker 2 (32:24):
Yeah, it's an opportunity. And there are all kinds of
research that has been done into various hospitals like this.
My PhD supervisor, he's a professor at the University of Toronto,
Nick Turpstra. He wrote a book called Lost Girls, and
it's about a hospital in Florence that cared for young girls.
(32:47):
And there's some great examples in there of you know,
this idea that these hospitals really could be a source
of like refuge. In that case, these girls were sexually
a used or physically abused domestic servants right who, once
they found themselves pregnant, were kicked out and end up
(33:07):
at this hospital. And this hospital actually tried to take
care of them and help them right instead of like
you said earlier, instead of shunning them or sort of
casting them out of society, they had a place to go.
Speaker 3 (33:21):
Mm hmm.
Speaker 1 (33:22):
And this is just so valuable and it is the
place where people I think have an interest in pursuing
more study of history, like what happens to the people
who live between the cracks, what happens to the people
who fall through the cracks. And so this is why
I think that the research that you're doing is so valuable,
because we want to know what happens to these people,
because these are real people.
Speaker 2 (33:44):
Yeah, thank you. It's one of the things that I love.
I mean, it is fun to study the aristocracy and
you know, get the stories about great kings and all
of that, but most people were not that, right, most
people didn't live that experience, and so trying to give
(34:05):
a voice or at least find the experience of people
who were everyday individuals, right the bulk of society is
it's tricky, but it's something that I try to do.
Speaker 1 (34:18):
Yeah, and it's valuable work. And like I say, I
think that's what people are interested in. So I'm hoping
there's lots of people listening to this episode right now
they're like, yes, this is what I'm looking for. Okay.
So we do need to kind of look at the
other side of the hospital, which is something that I
think is very familiar to us now, where you have
a hospital that's got all of these charitable things that
it's doing it's very valuable to the community and it's
(34:39):
also very involved. I see this with a lot of
hospitals with things like the arts community. So this particular hospital,
Santa Maria de las Gala, has a very deep involvement
in the arts community in Sienas. So can you tell
us about how that's going on.
Speaker 2 (34:54):
Yeah. So one of the things that the hospital does
is higher artists, and they usually hire local CeNSE artists
to decorate the hospital's church and chapel and the pilgrims hall,
which is where people who were in the infirmary would stay,
(35:15):
and these frescoes in the peligrin Io the Pilgrim's hall
in particular, they made some specific choices about what they
wanted to have depicted. One side of the room has
frescoes that depict the history of the hospital and the
other side depicts all of the charitable work the activities
that the hospital does. And then they also hired artists
(35:37):
to the facade of the hospital. Today it's just plain brick,
but at one time it was decorated by frescoes that
told the story of the Virgin Mary and her life,
because the hospital is of course dedicated to her. She's
the patron saint of Sienna, so makes sense that it
would be dedicated to Mary. So yeah, it was a
(35:58):
space that was not just unadorned, but they wanted to
have these representations of the institution itself and their own
identity as well as their patron saint. So yeah, they
provided work for artists, for lots of builders and bricklayers
and all kinds of people to help build the institution up.
Speaker 1 (36:20):
And it's one of these things that's another clever strategy
where you're supporting the community and you're also fundraising and
marketing at the same time because you're letting people know
that the hospital is there and what it provides.
Speaker 2 (36:35):
Yeah. Absolutely, and it's in a good location. It's right
across from the cathedral, which does help lend it some prominence.
But over time it gets the responsibility to host one
of the feasts day celebrations for Mary, and so there's
big processions in the piazza in front of the hospital.
The hospital purchases some relics of Mary all the way
(36:58):
from Byzantium bring those and they there's a little window
in the front of the hospital's facade where they would
hold the relics up for everyone to see during the
festival celebration. And yes, all of this is designed to
remind people we're here, we do important work. Give money
to us right, support us and cienes. Local c andes
(37:21):
preachers would often encourage people to donate. I opened the
first chapter of the book with a quote from Sam Bernardino,
who's a famous Dominican preacher from Sienna, and it was
from a sermon that he gave in the piazza in
front of the cathedral in the hospital, and he compares
the piazza to the face of the city. He says,
the cathedral's one eye and the hospital's the other eye,
(37:44):
like these two religious institutions are watching us, and so
we need to give charitably. And Saint Catherine of Siena,
we know, spent a lot of time working in this
hospital taking care of the sick. Joined the confraternity, but
she came daily to work there and there's a chapel
(38:04):
in the hospital dedicated to her. So yeah, it was
it was a place where a lot of civic and
religious energy was focused.
Speaker 1 (38:15):
I think that's another important thing, and it is it
does sound very modern where you have the fraternities that
are coming and they're using the hospital as a meeting place, like,
let's all meet at the hospital, and it's great. Again,
it's great marketing, right. It makes them look very charitable.
And it's interesting to have this building where there are
sick people, there are orphans, there are people who they
(38:36):
might pass on the street, and this is the place
where they're going to meet together to have their board meetings.
It's just fascinating to have this like at the center
of the community.
Speaker 3 (38:47):
Right.
Speaker 2 (38:48):
And there's my favorite confraternity that met in the hospital
is called it's actually dedicated to Saint Catherine Santa Cana
de la Notte, Saint Catherine of the Knight. The chapel
is painted like a Knight's it's really it's really cool.
But they dedicated themselves to helping the hospital bury the dead.
So any patients who died while they were in the
(39:10):
care of the hospital, these confraternity members would help take
care of the funerals those for those people, which I
just love that there is a bunch of lay men
who were like, well, I want to do something you know,
spiritual with my life, so I'll go help the hospital
bury the dead. Right.
Speaker 1 (39:29):
Yes, I love that, especially because I think these days,
you see that there seems to be there seems to
be I don't have any research on this, so don't
quote me, but like there seems to be less volunteering,
less volunteer work happening. And so it's interesting to see
people who from our standards, they have a tough life.
They're spending all their time working to make sure that
(39:49):
they can just put food on the table, and then
on top of that, they're volunteering to bury the dead.
This is significant, and I don't think it's I would
guess it's not complete. These spiritual but also just moral.
It feels like the right thing to do for these people.
And I say this only because not that I think
that people have no spirituality or that is vague or anything,
(40:10):
but I know I know from reading that people have
doubts as well. That's spirituality. Sure, it's complicated, right, So
this is the moral thing to do, the right thing
to do, and the way of building community that I
think is just super beautiful.
Speaker 2 (40:24):
Yeah, absolutely. I mean motivation is always something that's hard
to determine historically, right, Yeah, So yeah, I think there
were definitely going to be some people who were one
hundred percent spiritually dedicated, and others who maybe just saw
it as a more as a moral thing or like
they liked being part of this group that didn't important work,
(40:47):
and maybe they didn't have enough property or money to
donate that to the hospital, but they felt like I
can give time, right, I can give actual labor to help.
And without all of those things, this institution would not
have functioned. And the same goes very much for other hospitals,
especially those run by confraternities across Europe. I think it's
(41:13):
an odd, maybe odd thing for the modern people to understand, right,
that people would be willing to donate so much of
their life to doing these kinds of things.
Speaker 1 (41:23):
But they did. Yeah, it's just beautiful. I love to
see this kind of thing in history, and I think
that the two of us love to see beautiful things
in ye. Right, So as we wrap up, what is
one of your favorite things that you learned in doing
this research on this hospital or hospitals in general.
Speaker 2 (41:42):
Oh, that's such a good question. That's a hard one
to answer too. There's like really odd things because I
love you know those kinds of like, oh that's so strange, Yeah, I.
Speaker 1 (41:53):
Love that stuff.
Speaker 2 (41:54):
Or you know, there's things that are very beautiful. I mean,
one of my favorite frescoes and that cycle of paintings
is the care and Healing of the sick, and it's
it's got sort of a dramatic scene of the infirmary.
There's a patient who's been brought in and he has
a huge gash in his leg and it's like bleeding
onto the floor, and we tell the artists had fun
(42:16):
with this painting. But the two medical assistants who are
taking care of him are washing his feet, which might
seem like a strange thing to do, but that was
one of the things they did for everybody who came
into the infirmary. The first part of their treatment was
washing the feet, because it's what Christ did for his apostles, right,
(42:38):
So it's a it's a spiritual act in that sense,
and so I just I really like that little detail
in the painting. And then in the background there's two
doctors examining urine, which is something they did. They came
around every morning and saw all their patients and you know,
checked things like how's their urine looking. And then there's
(42:59):
a priest hearing confession. There's a cat and dog, so
you just get this scene of the activity and everyday
life of this hospital and infirmary, and it really brings
it to life for me. And like I said earlier,
I try not to be too idealistic about it, because
of course they want to represent the best of the
(43:20):
hospital in these paintings, but I just love how it
reflects that mission that they really tried to carry out.
Speaker 1 (43:29):
Yes, I found that picture very moving as well, and
so for people who are interested in seeing it, you
can find it in Sarah's book, along with all of
this other information about this particular hospital and medieval hospitals
in general. So thank you so much Sarah for coming
on and telling us about this. It's been fascinating.
Speaker 2 (43:47):
Thank you, Thank you so much. It was fun.
Speaker 1 (43:52):
To find out more about Sarah's work. You can visit
her faculty page at Brigham Young University. Her new book
is ci in These Hospitals within Beyond the City Walls
Charity and the Hospitale di Santa Maria della Scala fourteen
hundred to sixteen hundred. Before we go, here's Peter from
Medievalist dot net to tell us what's on the website.
(44:12):
What's going on? Peter?
Speaker 3 (44:13):
Hey, Hey, So we're working on a fairly big story
that's come out in the last week or so. And
if you're a US academic, you will know about the
National Endowment of the Humanities. You know, it's just kind
of a grant organization that helps museums and historical sites
around the country as well as help scholars with their work.
(44:37):
But thanks to the new Republican government and DOGE and
all that, that entire thing has been cut.
Speaker 1 (44:44):
Yeah, one of the many tragedies unfolding.
Speaker 3 (44:48):
Indeed, indeed, it had a budget of two hundred and
ten million dollars a year and it's been around since
nineteen sixty five, and it's supported a lot of medievalist
projects we can reported on over the years, like the
Middle English X series, a big digitization project from the
Heel Museum in Manuscript Library, the Caravans of Gold exhibition
(45:08):
that toured around North America talking about medieval Africa. They
all had funding from the any Age. So right now,
just trying to follow up on it and see how
other people have been affected, other medievalists, what might happen
out of it. So if you're a scholar and you
were relying on that money, this is a big blow.
Speaker 1 (45:27):
Absolutely absolutely. Our hearts go up to those people who
are counting on that, because grants like that don't just
allow these projects to be built, but allow the scholars
working on them to survive. And so this is a
big deal for a lot of people. So our hearts
are going out to those people as they try and
figure out what their next steps are.
Speaker 3 (45:47):
Well, I want to get to a lighter note. We
have a piece by Cleo Pisanu and she's the person
who created the Court Jester podcast where she shares stories
of Fabliau and many pieces of medieval literature, and so
she wrote a piece for us about why she's doing it,
why did she start it?
Speaker 1 (46:08):
Met her very briefly a few years ago at Leeds
and she was super enthusiastic and keen about things that
are hilarious from the medieval world. And so congratulations to
her on keeping this podcast going for her.
Speaker 3 (46:21):
Indeed, indeed check that out, but do check out her
podcast is called The Court Gesture.
Speaker 1 (46:26):
Awesome. Well, thanks Peter for stopping by and telling us
what's on the website.
Speaker 3 (46:30):
Thanks.
Speaker 1 (46:32):
In times like these, it's important to have reliable information
easily available to the public, So a huge thank you
goes out to each and every one of you whose
support makes my mission possible. Your Patreon donations are what
allows this podcast to continue, so if you're a patron,
feel free to pat yourself on the back for your
part in making the world a better informed place. If
(46:54):
Patreon is currently a stretch, Rust assured that letting the
ads play through without skipping them is also a contribution,
as is spreading the word. But if you're able to
kick in a dollar or two to keep the medieval
goodness coming, please visit patreon dot com slash medievalists to
get started for everything from Sienna to Vienna. Follow Medievalist
(47:15):
dot net on Instagram at medievalist net or blue sky
at Medievalists. You can find me Danielle Sebalski across social
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can find my books at all your favorite bookstores. Our
music is Beyond the Warriors by Geefrog. Thanks for listening
(47:36):
and have yourself an amazing day.
Hi everyone, and welcome to episode two hundred and eighty
six of the Medieval Podcast. I'm Danielle Sabalski, also known
as the five Minute Medievalist. When we think about the
joys of modernity, perhaps one of the images that comes
to mind is hospitals, places where people can come in
with some of life's biggest issues and be supported. Hospitals
(00:36):
are symbols of community and charity in action. But what
if I told you that hospitals were also a fundamental
part of the medieval world. Catering to the sick, the poor,
and the needy. Hospitals were institutions many medieval people could
rely on in their most desperate moments, both in urban
and in rural spaces. This week, I spoke with doctor
(00:58):
Sarah Luce Guerrero about medieval hospitals. Sarah is assistant professor
of history at Brigham Young University and the author of
several works on medieval charity, digital humanities, and Sienna's most
famous hospital. Her new book is Cienes Hospitals Within and
Beyond the City Walls, Charity and the Hospitalite di Santa
(01:18):
Maria dela Scala fourteen hundred to sixteen hundred Our conversation
on what to expect at a medieval hospital, how hospitals
like Santa Maria de la Scala supported the community from
infancy to adulthood, and what hospital support looked like for
rural communities is coming up right after this. Well, welcome
(01:40):
Sarah to talk about medieval hospitals, especially Sienna. It is
so nice to meet you and this is just such
an important and interesting topic, So thank you so much
for being on the podcast.
Speaker 2 (01:52):
Thank you for having me.
Speaker 1 (01:54):
So I think at the outset there might be people
who are listening to this and surprised that there were
hospitals at all in the Middle Ages. So can you
tell us a little bit about sort of how hospitals
started springing up and then we can talk more specifically
about Siena if that's more comfortable for you. But tell
us about hospitals how they started in the Middle Ages.
Speaker 2 (02:15):
Sure. So, the idea of a hospital actually comes from
the word for hospitality, right, And a lot of hospitals
start initially as just almost like inns where pilgrims or
travelers could come as they're making their way, you know,
from one destination to another and they need a place
(02:36):
to stay. These were institutions that offered sort of free
housing and shelter and food for travelers, for pilgrims, mostly
those who are going on a religious journey. And a
lot of times those pilgrims had problems, like they were sick,
or they had you know, broken sandals or something like
(02:58):
that right that needed to be fixed. And so these
institutions started to evolve into places that could take care
of people and could give them assistance. And charitable institutions
were seen by both the church and the lay people
as a great way to exercise their faith and their spirituality.
(03:20):
So you see a lot of people founding hospitals just
as part of their religious practice. And not all hospitals
served the same purpose. Some were dedicated to the treatment
of a specific group of people or a specific disease.
You find leprosy hospitals or foundling hospitals that only cared
(03:43):
for children. And then sometimes you get hospitals like the
one that I wrote about, which has multiple functions. It
had medical care, Foundling Care gave food daily to the poor.
So yeah, I would say by the thirteen hundreds, hospitals
are pretty well entrenched across Europe.
Speaker 1 (04:05):
Yes, I mean nowadays we have hospitals in every major
city and even in rural spots, which is something which
we're going to get to in a minute. But you
see in your work on hospitals and especially this one,
that hospitals are pretty much ubiquitous. We're seeing them everywhere.
Speaker 2 (04:22):
Yeah, pretty much everywhere. There's hospitals all the way from
the northern British Isles down through the Iberian Peninsula into Italy,
and even in the Byzantine and Islamic worlds, they had
charitable institutions that are equivalent to what we would think
of as a hospital. I think we tend to think
(04:44):
medical institution right away, and they do over time adapt
that function, but they also serve all of those other
functions as well, right of providing shelter, providing food, and care.
Speaker 1 (04:57):
So when we're talking about this as a charitable instant,
tution hospitals in general, and you're mentioning that this is
an aspect of people's faith, especially who's running the hospitals
in general.
Speaker 2 (05:08):
It kind of depends. Some hospitals are run by monasteries
or convents. Sometimes they're attached to a specific cathedral or church,
right and then they're administered by the cathedral canons, the
sort of clergy in charge of the church.
Speaker 3 (05:25):
Right.
Speaker 2 (05:26):
A lot of times, especially in France and Italy and Spain,
you have what we call confraternities that are lay religious organizations.
So the members are not clergy, but they volunteer to
sort of dedicate their lives to charitable service and they
(05:46):
then come and live and work in and run the hospitals,
and they depend on funding from donations and other places
like that to help keep the hospital running. So yeah,
sometimes it's just regular men and women who they might
not want to go all the way and join a
(06:07):
convent or become a monk, but they do want to
do something that they view as useful and an exercise
of their spirituality, and so this is a good option
for that.
Speaker 1 (06:20):
Yes. And one of the things that we are seeing
in the Middle Ages and really happening with the hospital
that you're looking at, is that people are donating to
the hospitals, like you're saying, but especially in their wills,
so like this is something that people found to be
not only a religious duty but sort of a civic
duty and making sure that they are funding these hospitals
(06:41):
so that they are taking care of the people of
the city.
Speaker 2 (06:44):
You're seeing this right, Oh, absolutely, especially in cases like
the hospital in Siena that I studied, it becomes such
an important institution within the city that the city government
eventually decides we want to have some control over this institution,
and so they end up having members who sit on
(07:06):
the hospital's governing board, and so, yeah, it becomes both
a civic and a religious institution.
Speaker 1 (07:13):
So let's dive into this specific example. We talked about
hospitals generally, but let's talk about this specific example because
I think that it is a good example from which
we can extrapolate more information. So tell us about the
hospital that you studied.
Speaker 2 (07:27):
Okay, So this hospital is called the hospitality Santa Maria
della Scala, or you can just say Santa Maria della
Scala for short, and it dates all the way back
to the late one thousands. That's when the first sort
of document that alludes to a hospital exists, and over
(07:49):
time it grew to not just shelter pilgrims, that was
its initial purpose, but they took in abandoned children, they
had medical infirm for men and women. The poor could
come daily and have bread distributed to them, and then
on certain feast days. They would throw feasts for the
poor six times throughout the year. And yeah, they performed
(08:14):
all of these services and the hospital just sort of
expanded and grew over time, largely thanks to like you
mentioned donations, Right, people, especially wealthy members of the city's aristocracy,
leaving large amounts of land or cash to the hospital.
Speaker 1 (08:34):
Right. And this hospital is staffed by people that are
called oblates. And this might be confusing if people have
read other stuff or learn more about monks, where oblates
are people who are brought to the monasteries, children brought
up there, and these oblades are different, right, tell us
about the old blates that are staffing this hospital.
Speaker 2 (08:52):
Yeah, most of the people who are oblates are adults.
They have lived their lives doing another profession and then
decided at some point that they want to not abandon that,
but sort of leave that behind and come live and
work at the hospital. So that process of oblation just
looked like agreeing to donate their land and property to
(09:14):
the hospital as they enter and become part of the
the hospital's family and live and work there. They did
also allow people to donate their property to the hospital
but still continue to live and work on their property.
So there's those kinds of oblates as well, who don't
necessarily come and live in the hospital building, but who
(09:36):
donate all of their profits and income to the hospital.
Speaker 1 (09:40):
It's a good option to have because if you're going
to live at the hospital, you give up everything. You
never get it back, So that's a big step to
be taking. So, you know, I might be the person
who is like, I'm just gonna stay on my land
and just work at the hospital.
Speaker 2 (09:54):
Right Yeah, And especially for people who lived outside of
the city, right you might not want to leave your
more rural lifestyle to come live in the busy, sometimes smelly, messy,
messy city. And then over time too, a lot of
the abandoned children, both boys and girls, who are raised
(10:15):
in the hospital, once they reach the age of adulthood,
a lot of them stay and live and work in
the hospital, and they join the hospital's confraternity, so they
get members from that track as well.
Speaker 1 (10:29):
I do want to come back around to the way
that the hospital is supporting children, because I think this
is one of the most fascinating parts about this work
that you've done. But I do want to stay on
how it's established first, because one of the things that
is important about your book is you're getting into how
this hospital of Santa Maria in the middle of Siena
is also working with satellites throughout this councer, I don't
(10:53):
want to say county, throughout the area around Sienna. So
how is it managing these places? What are they for?
Why does a hospital have satellites around the town.
Speaker 2 (11:05):
It's sort of the same way that you know monasteries,
especially by the late Middle Ages, they had this tradition
of owning land right that was given to them and
they were able to derive profit from that to help
run the monastery. It's the same idea for hospitals too.
People would donate land to the hospitals and then they
could choose either to sell that land or keep it
(11:29):
and work it to derive profit. And Santa Marie de
la Scala was so popular for whatever reason among the
Sienes that it eventually ended up having about a third
of the land in the territory that Siena controlled. It
was the largest land owner in Siena, which that's sort
(11:51):
of uncommon. Big hospitals do own a lot of land,
but this is sort of a unique situation and what
they did with that land was organized it into what
they called granchia. They're just little pockets where they had
a lot of land in one spot, so they would
establish sort of a central farmhouse on the bigger ones.
(12:14):
Those are fortified to protect them from bandits and people
wanting to steal crops and things, and then they would
send administrators out to live and work and run those farms.
And they had a whole system of transportation to bring
things back in and out of the city and moving
people and livestock and goods around. So they were really good,
(12:38):
especially by the sixteenth century, at sort of managing this
flow of things to keep the hospital functioning.
Speaker 1 (12:46):
I think that it's a familiar concept to have outlying
farms that are supplying things like monasteries and hospitals. But
you're finding that the granta are not just for farming.
They're also for supporting people in the way that hospitals
have always supported people, right.
Speaker 2 (13:03):
Yeah, a lot of the granchia, in fact, all except
for one or two of the very smallest, they all
had a hospital, like a small rural hospital on site.
And yeah, it was part of their obligation as part
of this institution to also offer services to people in
(13:25):
these rural areas, which is really really important if you
are in a very small community can't travel all the
way to the city necessarily, So yeah, it provided a
definite service. I mean, it's hard right with the Middle
Ages because we don't always have sources to tell us
all the things we want to know, but we know
(13:46):
there was a lot of informal charity that went on
right neighbors helping each other and things like that. But
this does provide evidence that there were often actual institutions
right places where people could go, and they were small,
some of them were only like two beds, but it
still provided that service, and they also did the other
(14:07):
things like providing bread daily to the poor and if
children were abandoned on the grancha, they would be sent
to the institution in Siena so that they could be
taking care of their So yeah, it did provide options
right for people in the countryside that they would otherwise
(14:28):
not have had. Well.
Speaker 1 (14:29):
I think this is such important work because it's one
of the questions that people have, like if something goes
wrong on your farm, what are you going to do?
Who are you who are you going to call?
Speaker 2 (14:38):
Right?
Speaker 1 (14:38):
And then you can go to the hospital. In some cases,
the hospital will be there for you. So my question
to you is, when places like Santa Maria del Scala
they're looking for places to expand into the countryside, how
are they deciding on these properties? Are they all donations?
Because there is an indication and you can correct me
(14:59):
if I'm wrong, it feels like there's an indication in
your book that sometimes they're picking the land because there's
already an established hospital. There is that, right, Yeah, that's right.
Speaker 2 (15:08):
So very early on in the twelve hundreds, the hospital
has land donated to it, and in those areas there's
already a hospital there or nearby. Right, So then as
they sort of built up a portfolio, I guess we
could say in modern turns, they could be a little
(15:30):
more picky about Okay, we had this random parcel of
land donated to us over here. We don't really own
anything over there, so we're going to sell that one
and try to acquire more land in this area where
we already have some property. But yes, some of the
initial properties that were given to them already had hospitals established,
(15:52):
and then in a few other spots land was donated
to them with the specific requirement that you can have
this land if you build a hospital. Right, So the
donors were also then thinking about I want to give
this land, but I want to make sure that they're
going to provide those services on this land, which is
(16:13):
just kind of neat.
Speaker 1 (16:14):
Yes, well, I think it's one of these things that
will blow up ideas of modernity, right. We think about
the modern system is where you have, you know, a
web of clinics or something like that. But this is
already happening in the thirteenth and the thirteenth century, the
fourteenth century, and this is a great example of it.
Speaker 2 (16:34):
Yeah, I mean, and they're establishing guidelines for how people
should be treated, for what they should do, how they
should receive individuals when they come to them, right, Like
we just I think you're right. We tend to have
this idea of especially the medieval passes, being very haphazard
and you know, sort of illogical, and that's not the
(16:55):
case at all. M M.
Speaker 1 (16:57):
And one of the things that I think makes a
great place one of the things that you get in
the book for having a series of clinics or smaller
hospitals satellite hospitals, is its place on roots for trade
for pilgrimage. Right.
Speaker 2 (17:12):
Yeah, So Siena is right along a major pilgrimage route,
the one that runs to Rome, which, of course, as
the seed of the Pope, right is one of the
big pilgrimage sites. And so that gave it the opportunity,
the hospital, the opportunity to sort of build on that
religious tourism is what scholars call it, right, this idea
(17:33):
that people are going to be constantly and consistently coming
along these roads, and if we have hospitals not just
in the cities, but sort of along the way, that
we can offer services to people.
Speaker 1 (17:47):
Yes, and that is what makes so much sense when
you look at. One of the things that you look
at in the book is some of the jobs that
are done by people in the Granta and a lot
of them are farmers, and a lot of them are shoemakers,
which makes sense if you're on the pilgrimage route, because
people are going to be blowing a sand, like you said,
while they're walking to Rome, They're going to need shoemakers.
(18:07):
And this is really really interesting in one of those
things that seems specific to a geographical region, right, in
other places, shoemakers might not be the second most popular trade.
Speaker 2 (18:19):
Right, And you know, there's all kinds of other workers
out there doing things that you might not expect to
find in a in a rural institution. There are especially
on the fortified farms, there are guys who are stonemasons
and their job is like make sure the buildings are maintained.
And there's household servants to help run the actual farms.
(18:40):
But then there's all kinds of servants to care for livestock.
And I'm saying servants, I should actually say employees because
they weren't servants. So yeah, there's all kinds of activity happening.
Speaker 1 (18:52):
Yes, And the idea of staff is one that I
want to get into with you as well, because you
Pollo quote early on in the book talking about the
staff for this across the territory owned by it. It's
thought of as a family. O. Can you tell us
about this because this is rare, I think rare in
the Middle Ages talking about your staff as being your family.
Maybe when we're talking about like grand staff a huge
(19:14):
number of people, So tell us about this.
Speaker 2 (19:17):
Yeah. So it's something that is maybe unique to hospitals
or charitable institutions, but it's quite common especially I know
in Italy. There's some cases of it in Spain as well.
I'm not sure about other places. But using this language
or rhetoric of family to describe the people who are
(19:40):
carrying out the day to day activities, that's how they
thought of it, that's how they describe it. In the records.
They consistently use the term familia to talk about everybody
that's part of the hospital, from the children who you know,
these abandoned children get the last name Skala, and the
hospital records were to them as sons and daughters. When
(20:02):
their daughters marry, when they find husbands for those who
want to marry, they refer to those husbands as sons
in law. Right, So they do have this very strong
at least rhetorically right. They think about it as a family,
and I think that's partially due to the fact that
it is a religious institution, right, and so they see
(20:25):
themselves as all bound together, engaged in this work to
glorify Mary and Christ and care for people.
Speaker 1 (20:35):
Yeah, it seems like almost a dream job if you
could get in with the hospital might be a dream
job in that at least, as you say in the paperwork,
it looks like they are supporting these farmers through good times,
through bad times, and maybe keeping families on like the
Stonemasons you were talking about, you tase some Stonemasons that
stayed on for a couple generations. Like this seems like
(20:59):
a great place to work.
Speaker 2 (21:01):
Right, Yeah, this, I think you're talking about Anyelo and
his sons. And yeah he he is there in the
records from when he was a young man up through
old age, and by the time he's older, he is
living in a home that he has rent free from
the hospital. Right, And to me, that just signals this
(21:23):
sort of appreciation for his long years of work. I mean,
I try not to be too idealistic to rose colored glasses. Right.
There is lots of evidence of them saying like this
sharecropper has, you know, broken the rules and he's irritating people.
So he's out right. So they're not always benevolent, but
(21:46):
there's plenty of evidence that kind of the prevailing attitude
was one of, yeah, we're going to we want to
take care of these people. We are a charitable institution.
That is our mission. We're going to try toole to that.
Speaker 1 (22:01):
Yes, I love that. It's nice. Again, you don't want
to go too far, And I'm always trying to hold
myself back from being too idealistic. But it's really nice
when you see examples of people being supported and cared for.
And of course one of the best examples is with children.
So tell us a little bit about how the hospital
cares for children. So there's an infant, it's left on
(22:22):
the doorstep of the hospital.
Speaker 2 (22:24):
What happens then, Yeah, so the infant would be taken
in and assigned to one of the women who ran
the orphanage. They didn't call it an orphanage. That's just
the modern term, right. It divided up into a section
for infants, and then once kids got to be about
(22:46):
five or six, they split the boys and the girls
because they received separate kinds of education and treatment. If
the infant was still needing to be fed, they hired
wet nurses. There were tons of wet nurses on the
payroll of the hospital. And there's lots of evidence not
just in this hospital, but hospitals and lots of other
(23:08):
places that very enterprising women would have an infant and
if they needed the income, they would abandon that infant
and then come to the hospital and say, hey, I've
had a baby, I can work as a wet nurse
and then get paid sometimes to feed their own infant,
which the hospital sees as fraud and wants to stop.
(23:28):
But that was an important component of taking care of
those children, right, was, especially if they're babies, making sure
that they're fed. They would stay with their wet nurse
until they were weaned about two years old, and then
they would come back to the hospital and they would
be cared for. You know, they had clothes, they had food,
They would be given an education for girls, right it's
(23:51):
mostly household education. For the boys, they would find apprenticeships,
and a lot of young boys ended up being sent
out to the farms that the hospital owned and starting out,
you know, just as a household assistant or a stable boy.
And then some of them from there go on to
(24:11):
eventually hire positions, some of them even I give the
example in the book of one named Giovanni, who ends
up being the head administrator of the hospital's biggest grancha.
So the hospital tried to use its resources to provide
careers and futures for these for these boys and girls.
(24:33):
If girls wanted to marry, the hospital would provide dowries
for them and find husbands. I mean, there's so much
that we could talk about. I don't know if there's
anything else that you want to specifically touch on, but.
Speaker 1 (24:45):
All the things, all the things we again, we can't pick.
We can't have two rosy picture because like, if you
look at things like in the deckenziean world, like the
fact that kids are being taken care of sounds great
until you actually look at it, right, can't be too rosy.
But it does look like there are children that are
sent out to the grancha and they basically have a
(25:07):
foster family. They grow up with the same people. It's
like they have a family of their own that they
are given by the hospital. And this just sounds fantastic
instead of them just being like left in an institution
to be bored, this seems like a great way to
keep things running in a way that is supportive of
(25:27):
children and also supportive of the hospital's mission.
Speaker 2 (25:32):
Right, I mean it does, and I was careful I
tried to point this out in the book, right, Like,
this does benefit the hospital in the long run. Right,
if they're getting these children to then stay and work
in the hospital, that's helpful for them, but it's also
helpful for the child who doesn't end up on the
streets without a place to live and without a career
(25:53):
or a future. Not everybody had a good experience, and
I wish the records were more clear on how they
decided which children to send to the countryside, which ones
got to stay in the city. There's really no indication
on how they made those determinations. But I do talk
about in the book a few times when you know,
(26:14):
there's an outbreak of plague and they start sending as
many children as they can out to the countryside, right
because they recognize if they stay in the city, the
chances of them getting sick and dying are higher.
Speaker 3 (26:26):
Right.
Speaker 2 (26:26):
So there are lots of little evidences like that that
they really do care and they do try their best
to take good care of these children.
Speaker 1 (26:36):
Yes, and I think you see that also in the
jobs the careers that they're training these children for, because
they're not just sending them out to be grunts all
the time. They're giving them apprenticeships that will help them rise.
And as you said, there is a few children that
you were able to trace then ended up being important
in the hospital administration. But this means that they were
(26:57):
trained to be literate and to have skills that they
could apply elsewhere. And I think this is also very
forward thinking of them, not just self serving, but serving
the children.
Speaker 2 (27:08):
Yeah. Absolutely, there's plenty of boys with the last name
Skala who end up being record keepers, and that, like
you said, tells us that they were taught to read
and write, to be literate, and having that kind of
educational opportunity was not uncommon, but it wasn't easy to have,
(27:29):
especially if you were from sort of a peasant or
lower class family, right, So it was an advantage that
they got.
Speaker 1 (27:39):
Yeah, And I think this is another thing that we
might maybe not expect from the Middle Ages. You might
just expect someone to take a child that has been
left behind and treat them as someone who's always going
to be left behind. But this is not what you're
seeing in the research, right.
Speaker 2 (27:55):
They are treated as important in the sense that there
taking care of right, rather than just leaving them out
to die. And there are large numbers of children being abandoned,
especially during the fourteenth, fifteenth, sixteenth centuries, which tells us
(28:16):
a lot of families were struggling economically and for them
to have the option of I have all these kids,
I can't take care of them, what can I do?
Speaker 3 (28:26):
Right?
Speaker 2 (28:26):
Instead of just literally abandoning them to the elements, they
could give them to an institution to be taken care of.
And we do know that some children were abandoned with
information about their family and parents. Sometimes it's not super common,
but they sometimes did come back when their economic situation
(28:48):
was better and take their children back. We also know
that more girls were abandoned than boys, which is something
most people would probably expect. Yeah, the hospital always has
close to double the number of girls to the boys,
So yeah, taking care of abandoned girls in particular was
(29:09):
a big part of what they did.
Speaker 1 (29:12):
Yeah, and even these girls are given skills so that
they're not just going to end up being at the
bottom of the heap. So obviously not shaming people who
are laundresses at this time, but giving them skills so
that they can apply them later. I think this is
again valuing girls even when there are double the amount
of girls, or giving them dowries. This is something that
(29:33):
they don't necessarily have to do, and we do see
it being self serving in some ways where they're like, right, well,
you marry this guy who's also on heart property, you know,
that'd be great, but they don't have to give them dowries.
This is something that they choose to do, and I
think that that's significant.
Speaker 2 (29:50):
Yeah, they spend a significant amount on dowries for girls
who want to get married, and it is sort of
a funny thing, right, because it is showing care for
the girls, and it also is a way for them
to again demonstrate charity and to show like we're fulfilling
our spiritual mission by providing for these children. So yeah,
(30:14):
there's always, as you well know, in the Middle Ages,
it's impossible to separate right the spiritual from the secular
or like we do in today's world. And so all
of these actions that they had taking care of the poor,
taking care of the sick who came to the hospital,
there's always a religious purpose behind those actions. So on
(30:39):
one level, it is that it is that they're caring
for them, but on another level, it's also that it's
fulfilling their charitable mandate.
Speaker 1 (30:48):
Yeah, and I mean, as you say, you can't really
separate these two things. Where if you are giving somebody skills,
that means they're not going to come back to the
hospital later, right, They're not going to end up being impoverished.
Hopefully things go well. I'm not going to end up
being impoverished and being someone that they have to continue
to serve. So it's one of those things where you
put in some effort and it benefits all of society.
(31:10):
And I think that people in the Middle Ages could
see that, could see the long term benefits of supporting
the community in ways that maybe some people don't see
these days.
Speaker 2 (31:21):
Right, absolutely, And I did find I have found a
few cases of girls who were raised by the hospital,
married and then were widowed and who came back and
lived and worked in the hospital after they were widowed,
which tells me potentially a couple of things. One is
that maybe they didn't have the financial means to take
(31:42):
care of themselves after their husband died, and so the
hospital was willing to say, yeah, come back, or they
wanted to return and sort of give time and efforts
to a process that they went through themselves. Right, either way,
I think that's a significant thing.
Speaker 1 (32:01):
Yes, I mean, you can't always ascribe a good reason
for coming back to an institution that right I grew
up and I mean maybe that's the only place to go.
But it also it also could speak to the fact
that their experience there was good and that they do
want to come back and as you say, contribute or
at least they feel safe there, which is something that
I think can be discounted either.
Speaker 2 (32:24):
Yeah, it's an opportunity. And there are all kinds of
research that has been done into various hospitals like this.
My PhD supervisor, he's a professor at the University of Toronto,
Nick Turpstra. He wrote a book called Lost Girls, and
it's about a hospital in Florence that cared for young girls.
(32:47):
And there's some great examples in there of you know,
this idea that these hospitals really could be a source
of like refuge. In that case, these girls were sexually
a used or physically abused domestic servants right who, once
they found themselves pregnant, were kicked out and end up
(33:07):
at this hospital. And this hospital actually tried to take
care of them and help them right instead of like
you said earlier, instead of shunning them or sort of
casting them out of society, they had a place to go.
Speaker 3 (33:21):
Mm hmm.
Speaker 1 (33:22):
And this is just so valuable and it is the
place where people I think have an interest in pursuing
more study of history, like what happens to the people
who live between the cracks, what happens to the people
who fall through the cracks. And so this is why
I think that the research that you're doing is so valuable,
because we want to know what happens to these people,
because these are real people.
Speaker 2 (33:44):
Yeah, thank you. It's one of the things that I love.
I mean, it is fun to study the aristocracy and
you know, get the stories about great kings and all
of that, but most people were not that, right, most
people didn't live that experience, and so trying to give
(34:05):
a voice or at least find the experience of people
who were everyday individuals, right the bulk of society is
it's tricky, but it's something that I try to do.
Speaker 1 (34:18):
Yeah, and it's valuable work. And like I say, I
think that's what people are interested in. So I'm hoping
there's lots of people listening to this episode right now
they're like, yes, this is what I'm looking for. Okay.
So we do need to kind of look at the
other side of the hospital, which is something that I
think is very familiar to us now, where you have
a hospital that's got all of these charitable things that
it's doing it's very valuable to the community and it's
(34:39):
also very involved. I see this with a lot of
hospitals with things like the arts community. So this particular hospital,
Santa Maria de las Gala, has a very deep involvement
in the arts community in Sienas. So can you tell
us about how that's going on.
Speaker 2 (34:54):
Yeah. So one of the things that the hospital does
is higher artists, and they usually hire local CeNSE artists
to decorate the hospital's church and chapel and the pilgrims hall,
which is where people who were in the infirmary would stay,
(35:15):
and these frescoes in the peligrin Io the Pilgrim's hall
in particular, they made some specific choices about what they
wanted to have depicted. One side of the room has
frescoes that depict the history of the hospital and the
other side depicts all of the charitable work the activities
that the hospital does. And then they also hired artists
(35:37):
to the facade of the hospital. Today it's just plain brick,
but at one time it was decorated by frescoes that
told the story of the Virgin Mary and her life,
because the hospital is of course dedicated to her. She's
the patron saint of Sienna, so makes sense that it
would be dedicated to Mary. So yeah, it was a
(35:58):
space that was not just unadorned, but they wanted to
have these representations of the institution itself and their own
identity as well as their patron saint. So yeah, they
provided work for artists, for lots of builders and bricklayers
and all kinds of people to help build the institution up.
Speaker 1 (36:20):
And it's one of these things that's another clever strategy
where you're supporting the community and you're also fundraising and
marketing at the same time because you're letting people know
that the hospital is there and what it provides.
Speaker 2 (36:35):
Yeah. Absolutely, and it's in a good location. It's right
across from the cathedral, which does help lend it some prominence.
But over time it gets the responsibility to host one
of the feasts day celebrations for Mary, and so there's
big processions in the piazza in front of the hospital.
The hospital purchases some relics of Mary all the way
(36:58):
from Byzantium bring those and they there's a little window
in the front of the hospital's facade where they would
hold the relics up for everyone to see during the
festival celebration. And yes, all of this is designed to
remind people we're here, we do important work. Give money
to us right, support us and cienes. Local c andes
(37:21):
preachers would often encourage people to donate. I opened the
first chapter of the book with a quote from Sam Bernardino,
who's a famous Dominican preacher from Sienna, and it was
from a sermon that he gave in the piazza in
front of the cathedral in the hospital, and he compares
the piazza to the face of the city. He says,
the cathedral's one eye and the hospital's the other eye,
(37:44):
like these two religious institutions are watching us, and so
we need to give charitably. And Saint Catherine of Siena,
we know, spent a lot of time working in this
hospital taking care of the sick. Joined the confraternity, but
she came daily to work there and there's a chapel
(38:04):
in the hospital dedicated to her. So yeah, it was
it was a place where a lot of civic and
religious energy was focused.
Speaker 1 (38:15):
I think that's another important thing, and it is it
does sound very modern where you have the fraternities that
are coming and they're using the hospital as a meeting place, like,
let's all meet at the hospital, and it's great. Again,
it's great marketing, right. It makes them look very charitable.
And it's interesting to have this building where there are
sick people, there are orphans, there are people who they
(38:36):
might pass on the street, and this is the place
where they're going to meet together to have their board meetings.
It's just fascinating to have this like at the center
of the community.
Speaker 3 (38:47):
Right.
Speaker 2 (38:48):
And there's my favorite confraternity that met in the hospital
is called it's actually dedicated to Saint Catherine Santa Cana
de la Notte, Saint Catherine of the Knight. The chapel
is painted like a Knight's it's really it's really cool.
But they dedicated themselves to helping the hospital bury the dead.
So any patients who died while they were in the
(39:10):
care of the hospital, these confraternity members would help take
care of the funerals those for those people, which I
just love that there is a bunch of lay men
who were like, well, I want to do something you know,
spiritual with my life, so I'll go help the hospital
bury the dead. Right.
Speaker 1 (39:29):
Yes, I love that, especially because I think these days,
you see that there seems to be there seems to
be I don't have any research on this, so don't
quote me, but like there seems to be less volunteering,
less volunteer work happening. And so it's interesting to see
people who from our standards, they have a tough life.
They're spending all their time working to make sure that
(39:49):
they can just put food on the table, and then
on top of that, they're volunteering to bury the dead.
This is significant, and I don't think it's I would
guess it's not complete. These spiritual but also just moral.
It feels like the right thing to do for these people.
And I say this only because not that I think
that people have no spirituality or that is vague or anything,
(40:10):
but I know I know from reading that people have
doubts as well. That's spirituality. Sure, it's complicated, right, So
this is the moral thing to do, the right thing
to do, and the way of building community that I
think is just super beautiful.
Speaker 2 (40:24):
Yeah, absolutely. I mean motivation is always something that's hard
to determine historically, right, Yeah, So yeah, I think there
were definitely going to be some people who were one
hundred percent spiritually dedicated, and others who maybe just saw
it as a more as a moral thing or like
they liked being part of this group that didn't important work,
(40:47):
and maybe they didn't have enough property or money to
donate that to the hospital, but they felt like I
can give time, right, I can give actual labor to help.
And without all of those things, this institution would not
have functioned. And the same goes very much for other hospitals,
especially those run by confraternities across Europe. I think it's
(41:13):
an odd, maybe odd thing for the modern people to understand, right,
that people would be willing to donate so much of
their life to doing these kinds of things.
Speaker 1 (41:23):
But they did. Yeah, it's just beautiful. I love to
see this kind of thing in history, and I think
that the two of us love to see beautiful things
in ye. Right, So as we wrap up, what is
one of your favorite things that you learned in doing
this research on this hospital or hospitals in general.
Speaker 2 (41:42):
Oh, that's such a good question. That's a hard one
to answer too. There's like really odd things because I
love you know those kinds of like, oh that's so strange, Yeah, I.
Speaker 1 (41:53):
Love that stuff.
Speaker 2 (41:54):
Or you know, there's things that are very beautiful. I mean,
one of my favorite frescoes and that cycle of paintings
is the care and Healing of the sick, and it's
it's got sort of a dramatic scene of the infirmary.
There's a patient who's been brought in and he has
a huge gash in his leg and it's like bleeding
onto the floor, and we tell the artists had fun
(42:16):
with this painting. But the two medical assistants who are
taking care of him are washing his feet, which might
seem like a strange thing to do, but that was
one of the things they did for everybody who came
into the infirmary. The first part of their treatment was
washing the feet, because it's what Christ did for his apostles, right,
(42:38):
So it's a it's a spiritual act in that sense,
and so I just I really like that little detail
in the painting. And then in the background there's two
doctors examining urine, which is something they did. They came
around every morning and saw all their patients and you know,
checked things like how's their urine looking. And then there's
(42:59):
a priest hearing confession. There's a cat and dog, so
you just get this scene of the activity and everyday
life of this hospital and infirmary, and it really brings
it to life for me. And like I said earlier,
I try not to be too idealistic about it, because
of course they want to represent the best of the
(43:20):
hospital in these paintings, but I just love how it
reflects that mission that they really tried to carry out.
Speaker 1 (43:29):
Yes, I found that picture very moving as well, and
so for people who are interested in seeing it, you
can find it in Sarah's book, along with all of
this other information about this particular hospital and medieval hospitals
in general. So thank you so much Sarah for coming
on and telling us about this. It's been fascinating.
Speaker 2 (43:47):
Thank you, Thank you so much. It was fun.
Speaker 1 (43:52):
To find out more about Sarah's work. You can visit
her faculty page at Brigham Young University. Her new book
is ci in These Hospitals within Beyond the City Walls
Charity and the Hospitale di Santa Maria della Scala fourteen
hundred to sixteen hundred. Before we go, here's Peter from
Medievalist dot net to tell us what's on the website.
(44:12):
What's going on? Peter?
Speaker 3 (44:13):
Hey, Hey, So we're working on a fairly big story
that's come out in the last week or so. And
if you're a US academic, you will know about the
National Endowment of the Humanities. You know, it's just kind
of a grant organization that helps museums and historical sites
around the country as well as help scholars with their work.
(44:37):
But thanks to the new Republican government and DOGE and
all that, that entire thing has been cut.
Speaker 1 (44:44):
Yeah, one of the many tragedies unfolding.
Speaker 3 (44:48):
Indeed, indeed, it had a budget of two hundred and
ten million dollars a year and it's been around since
nineteen sixty five, and it's supported a lot of medievalist
projects we can reported on over the years, like the
Middle English X series, a big digitization project from the
Heel Museum in Manuscript Library, the Caravans of Gold exhibition
(45:08):
that toured around North America talking about medieval Africa. They
all had funding from the any Age. So right now,
just trying to follow up on it and see how
other people have been affected, other medievalists, what might happen
out of it. So if you're a scholar and you
were relying on that money, this is a big blow.
Speaker 1 (45:27):
Absolutely absolutely. Our hearts go up to those people who
are counting on that, because grants like that don't just
allow these projects to be built, but allow the scholars
working on them to survive. And so this is a
big deal for a lot of people. So our hearts
are going out to those people as they try and
figure out what their next steps are.
Speaker 3 (45:47):
Well, I want to get to a lighter note. We
have a piece by Cleo Pisanu and she's the person
who created the Court Jester podcast where she shares stories
of Fabliau and many pieces of medieval literature, and so
she wrote a piece for us about why she's doing it,
why did she start it?
Speaker 1 (46:08):
Met her very briefly a few years ago at Leeds
and she was super enthusiastic and keen about things that
are hilarious from the medieval world. And so congratulations to
her on keeping this podcast going for her.
Speaker 3 (46:21):
Indeed, indeed check that out, but do check out her
podcast is called The Court Gesture.
Speaker 1 (46:26):
Awesome. Well, thanks Peter for stopping by and telling us
what's on the website.
Speaker 3 (46:30):
Thanks.
Speaker 1 (46:32):
In times like these, it's important to have reliable information
easily available to the public, So a huge thank you
goes out to each and every one of you whose
support makes my mission possible. Your Patreon donations are what
allows this podcast to continue, so if you're a patron,
feel free to pat yourself on the back for your
part in making the world a better informed place. If
(46:54):
Patreon is currently a stretch, Rust assured that letting the
ads play through without skipping them is also a contribution,
as is spreading the word. But if you're able to
kick in a dollar or two to keep the medieval
goodness coming, please visit patreon dot com slash medievalists to
get started for everything from Sienna to Vienna. Follow Medievalist
(47:15):
dot net on Instagram at medievalist net or blue sky
at Medievalists. You can find me Danielle Sebalski across social
media at fiven Medievalist or five Minute Medievalist, and you
can find my books at all your favorite bookstores. Our
music is Beyond the Warriors by Geefrog. Thanks for listening
(47:36):
and have yourself an amazing day.
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