Nursing in the Eastern Roman (‘Byzantine’) Empire

Byzantine care constitutes a unique example not only for the medieval period but also for the whole of human history and civilization. The Byzantine period is specifically of interest for its approach to social welfare and organized care for the sick, the elderly, mothers, and children. There were innumerable hostelries, Xenones (hospitals), nursing homes, leper homes, maternity hospitals, and infant and children’s centers that not only cared for the sick and the suffering but also taught medicine and health care.

Nursing care was administered mostly by nuns and monks as a form of prayer and as an expression of love and worship of God. On this basis, nursing developed into a calling and a sacred service. Nursing was practiced as a form of contemplation; nurses were expected to see God in the person of the patient.

Selected writings from the 8th and 12th century A.D. show the philosophy of patient care in Byzantine period. A passage from the writings of Theodore Stoudites describes nursing in this perspective. Theodore Stoudites, born in 759, in Constantinople, which included a hospital, dedicated the following iambus, “To the Nurse”:

“It is a sacred thing to bear the load of the sick. Since you are honored with this sacred privilege, my son, do struggle warmly and eagerly in the accomplishment of your duty. Early in the morning, first, visit and care for your bedridden patients, heat them mainly by your words, later serve them their appropriate diet in good manner and kind talking. Don’t neglect the patient, because he is a member of Christ. If you care for your patient with zest and promptitude, you will be greatly rewarded by receiving the divine light, and heaven’s inheritance.”

Writings by Anna Comnena are representative of the care the sick and disabled received at that time. Anna Comnena (1083-1148), daughter of the Emperor Alexius I Comnenos, was a famous historian who had “an unusual interest and gift for medical matters.” Anna Comnena is considered “the first woman historian,” and has been characterized as a “great historian.” She gives a picture of patient care, likely using a metaphor from the Book of Job, during her father’s dynasty:

“I, myself have seen an old woman, being served by a young lady, a blind man directed by a man with healthy sight, a crippled person transported by a healthy person, an armless man guided by other men, orphan babies carried in the arms of others unrelated to them, mothers, and paralytics being cared by robust people.”

Professional nurses were employed beginning at the end of the 4th century AD. Men were called hypourgoi and women, hypourgisses. Nurses were also called nosokomoi, and their assistants, paranosokomoi. The term Nosokomos was also used for the administrative director of the hospital. These were people with high social status.

In addition, Gregorios Theologos, in his sixth letter, provides a detailed description of the duties of a nurse.

The fact that nursing evolved as a form of loving care during the Byzantium is easy to explain. Philanthropy and the duty to care for the sick, the poor, and the needy were features of Christianity. Jesus Christ was referred to as “Christus Medicus” (Christ the physician, who, taking pity, heals us through his own body and blood with the medicine of life).

Byzantine hospitals and other philanthropic institutions were mostly annexed to monasteries, and they were kept up by donations from emperors and other eminent persons. Hospitals were so well organized that they can be compared with contemporary ones. Major hospitals of Byzantium included the following: Sampson’s hostelry, the Basilicas in Cappadocia, established by St. Basil, which included a number of hospitals, leper homes, poor houses, and other institutions, Pantocrator’s Monastery hostelry, and St. Irene’s hostelry. Byzantine hospitals were mainly for the poor. There were, however, some exceptions. The Emperor Justinian was hospitalized in the Samson Xenon (6th c. AD), and the Emperor Alexios in the Xenon of Magana (12th c. AD).

In Byzantine hospitals, patients were cared for with humanity. The Typikon of the Xenon of Theotokou of the Evergetidos in Constantinople (7th c AD) notes:

“We must care about the food, the drinking and the other needs of the patients…the doctors should visit the patients every day and look after them wholeheartedly”.

In the Typikon of Theotokou Eleousas in Stroubitsa of Skopia (11th c AD), the following words are found:

“You should console the needy and treat the patients at your best. You should behave to all with kindness. You should also treat the invalid at your best. You should not make fun of the feeble-minded. And kick out the fear from your soul.”

(Source: “The meaning of the nursing in Byzantium”, by Kourkouta L. et al.)

Research-Selection for NovoScriptorium: Anastasius Philoponus