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rules which he lays down for the practice of gymnastic exercise, his observations on the physical and moral education of children and youth, something in physiology, symptomatology, and general therapeutics, on the use of enemata, and on the abstraction of blood. He alludes, on the authority of Galen, to the partial or bent fracture of the long bones of children, a fact which appears to have escaped M. Malgaigne; who, in his history of surgery, has accredited the first description of this accident to Lanfranc, a surgeon of the thirteenth century.*


Hospitals and other Medical Institutions of Christianity.

Before the ultimate overthrow of the pagan institutions, while Christianity was hardly yet in the ascendant, the prelates and clergy were gradually acquiring the control of all that related to the physical and social welfare of their people. The religious and moral instruction of their flocks constituted but a portion of their duties. To them was also assigned the care of the orphan, the widow, the friendless, the needy, and the suffering; a duty which they sometimes performed in person, sometimes through the agency of special: officers of the church, or of the Benedictine and other monks. This custom appears to have originated with the local organization of the churches in the time of the apostles. It was still in use up to the period of the Decian persecution, A. D., 250; soon after which,

* Coccius, e Collectione. Niceta, p. 135. Malgaigne, Introduction, Euvres d'Ambroise Paré.

we find Cyprian, bishop of Carthage, charging Novatus, one of his presbyters, with the crime of appropriating to his own use the property which had been entrusted to him for the benefit of the poor and destitute of that diocese.* As yet, however, we have no notice of buildings, set apart by the church for charitable uses; nor is there reason to believe that any such existed either before or during the protracted periods of persecution, nor at any time prior to the accession of Constantine, who ruled from A. D. 306 till 337, and under whom Christianity first became the religion of the state.

The edict of this emperor for the closure of the Asclepions, as well as the other remaining temples of pagan worship, led at once to the establishment of hospitals and other charitable institutions under the auspices of the church. Constantine himself took an active part in providing the clergy with funds and every requisite for extending the institutions of the newly adopted religion of the empire;† and his mother, Helena, devoted all her energies to the founding of churches and benevolent institutions at Constantinople, as well as at Jerusalem and other places. The example set by this devout and influential woman was followed by those of her own sex, who had the means at their command in every part of the empire. During the succeeding reign, by order of Gallus Cæsar, the

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*See Introduction to Ecclesiastical History of Socrates. Bohn's edition, page ix.

Eusebius, book x., chapter vi., and elsewhere.

Theodoret, History of the Church, book i., chapter xviii.

elder brother of Julian, the groves of Daphne 'in the neighborhood of Antioch, once sacred to Apollo, were, in A. D. 357, dedicated to the church:* And, notwithstanding the subsequent opposition of Julian to this measure, the grounds within which had formerly stood the magnificent temple of Apollo Daphnæus, were occupied by an hospital. for the sick.t


Again, the emperor Valens presented the most beautiful lands in the neighborhood of Cæsarea to Archbishop Basil, for the benefit of the poor whose, bodies were affected with disease, as being those who there stood most in need of assistance. as early as A. D. 373, Basil had already' organized at Cæsarea an immense hospital called the Basilides, which Gregory Nazianzen thought worthy to be reckoned among the wonders of the world, so numerous were the poor and sick that came thither, and so admirable were the care and order with which they were served.§ The charge of the suffering within the walls of these new institutions, was not at first assigned to humble hands. The most illustrious ladies of the empire participated in these offices of mercy. At Constantinople, the empress, Flacilla, wife of the elder Theodosius, A. D. 380, was watching with solicitude over all those whose bodies were mutilated, or who had lost

* Select Works of the Emperor Julian, Duncombe's translation. London, 1784. Vol. i. p. 247, note.

Evagrius, Ecclesiastical History, book iv., chapter xxxv.

Theodoret, book iv., chapter xix. Bohn's edition, p. 177.

§ Ullman, Ecclesiastical History of the Fourth Century. See Westminster Rev., Oct. 1851, American edition; p..56.

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any of their limbs. She visited them at their own dwellings, waited upon them herself, and supplied their wants. She repaired with the same zeal to the public hospitals of the church, where she tended the sick, made ready their culinary utensils, tasted their broth, carried the dish to them, broke the bread, divided the meal, washed the cups, and performed for them all the offices which usually devolve upon servants.*

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In the Code of Justiniant we find a summary of the edicts issued by different emperors in relation to the charitable foundations, and the duties of the several officers in charge of them. The Orphanotrophi officiated as guardians to the orphans. The Xenodochi were commissioned to give accommodation to strangers, and travelers. It was at the Stranger's House that Ambrose, bishop of Milan,, received the emperor Theodosius, A. D. 390, on his visit of reconciliation to that prelate. The Brephotrophi had the care and protection of foundlings. The Ptochotrophi had charge of the poor; and the Nosocomi had the care and management of the sick. These several functionàries all belonged to the order of the clergy. But the Perabolani, who, to the number of six hundred, served under the bishop of Alexandria, and whose duty it was to

*Theodoret, book v., chapter xix.

+ Lib. i., Tit. iii., "De Episcopis et Clericis, et Orphanotrophis, et Xenodocis et Brephotrophis, Ptochotrophis et Ascetriis et Monachis, et Privilegiis eorum," &c. In reference to the Nosocomi see, also under the foregoing title, L. 42, §§, 6 and 9; and the notes of Cujacius on the third of the Nouvelle Constitutiones; and the edict of Honorius and Theodosius, A. D. 487, in reference to the Perabolani.

Theodoret, book v. chapter xviii. Bohn's edition, p. 221.

administer to the sick in time of pestilence, were uneducated laymen. Among the clerici or clergy, besides the prelates and officers already mentioned, were presbyters, archdeacons, deacons of either sex, sub-deacons, ascetriæ, or those appointed for religious meditation, readers of the Sacred Scriptures, exorcists, ostiarii or door-keepers, psaltæ or singers, and hermiæ,-monitors or expositors. These various functionaries received the appointments not by favor of their superiors, but by the voice of the people among whom they officiated.

The duties of the Nosocomi, or those in charge of the Nosocomia or hospitals, imposed upon them the necessity of familiarizing themselves in some measure with the principles of medicine, and in this way they were prepared to practice at large among the people. The regularly educated lay physicians were thus gradually deprived of many of their prerogatives, and supplanted by the clergy, who, in their united capacity of priest and physician, were afterwards for many ages almost the only practitioners of medicine. During this long period many of the higher clergy, as well as of the humbler members of the monastic order, were distinguished as writers and teachers of the healing art. One of the earliest of these, Nemesius, bishop of Emesa, the contemporary and friend of Basil and Gregory Nazianzen, flourished A. D. 380, and was the author of a work on the Nature of Man,* which is

* Nemesius Eme senus De Natura Hominis, Græce et Latine, 8vo.., Magdeburg, 1802.

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