Tuesday, 26 May 2015

The Hospital, Rhodes

The Conventual Hospital was one of the most  important and impressive buildings on Rhodes. It was one of the major hospitals of the Mediterranean and remains the best preserved of the Order's hospitals. As recorded by the memorial inscription above the front entrance, work began on the 15th July 1440 and also that Grand Master Fra' Antonio Fluvian (1428-1437) (whose arms are held above by two angels carved in relief), donated 10 000 florins to the costs.

The imposing facade reflects the importance that the Order always regarded their duty towards the sick and the poor. The original doors of richly carved cypress  were removed in 1836 as a gift from the Ottoman sultan to King Louis Philippe 1 of France who had them hung in the Hall of the Crusades at Versailles. 



The entrance leads through a ribbed and cross vaulted passage into a large square courtyard surrounded by a two storeyed gallery with ribbed cross vaults on the ground floor and flat wooden ceilings on the upper level. This arrangement is said to have derived from Byzantine xenodochia (hospices), or caravanserei in which central courtyards are surrounded by arcaded two storey cloister as at Rhodes. Around the courtyard at ground level are vaulted storerooms. Access to those on the east and north sides are from the street outside and were rented out as shops to provide an income for the resident clergy. Access to the storerooms on the other two sides is from within the courtyard.


A wide stone staircase to the left of the entrance leads from the courtyard to the upper storey where the medical departments were located. On the north and west sides of the upper storey are small simple rooms, each with a fireplace, where ill brethren or other noble patients could be treated. (Unlike in the Holy Land, at Rhodes the Order did not maintain a separate establishment for sick brethren.)The entrance to the large hospital ward is on the upper gallery immediately above the entrance passage.


The Great Ward is 51m long and 12.5 m wide and divided down the length of the hall into two by a colonnade of octagonal stone pillars. The plain capitals are embellished with the heraldic device of the order of St John and of grand master d'Aubusson in alternation. Some of the original roof timbers survive on which are found the arms of the Hospital's founder Fluvian and also those of de Lastic and d'Aubusson. Along the two long sides of the ward are small vaulted cubicles built into the thickness of the walls; the result of concealed buttresses which served as privvies. Great wards such as this are based on the European hospitals, the hotels-Dieu. A large fireplace would have taken some of the chill away in the winter or more likely a provide a place for patients to huddle and feel some warmth in winter.

The great ward could probably accommodate 100 patients; each of whom had his own bed surrounded by a curtain and had his food served from a silver platter and slept at night between clean sheets. On admission a patient had to say confession and take Holy Communion and make their will in the presence of a chaplain and a scribe.


The Hospital was described by Czech pilgrim John Lord of Lobkowitz in 1493 when he and his servant were put up there and fed on white bread and wine:

        "That house, the Infirmary, is all built of cut stone and the inside is a straight square. and windows great and broad all around, that there is little wall between these windows: but one window next to the other, so that one may look into the house, and all of it is finely painted. Now the Master of Rhodes had endowed that house, that any man being Christian, of whatever lowly or great rank, who shall come there, if he be sick and ask it for God's sake, should at once be taken in; and there he is at once provided with medicine and other necessities, to wit food and drink and bedclothes. If an impatient person, he is given a room of his own; and if any lesser man, then there is a fine hall, and in it made beds in double row, and on some on them sick people are lying. And these beds are well made with clean white bedclothes, and on each bed there is a red cloth blanket, for there it is not as cold as (in Bohemia). And near each of these beds a door opens upon the balcony; and there too he has a privvy."

       "Also it is ordained that, each of the sick has a servant, that looks after him and serves him, whatever he needs. Also two doctors are ordained for this, sworn leeches, who look after the sick twice each day: once in the morning and once again in the evening. And there are these doctors having in the morning examined his water......

         "Further the same doctors write a paper, what sort of dish should be given him, and when; and there these officials appointed for this must so provide this, what time these doctors write and order it. And those things are entrusted to three men: one Knight of the Order and two clerks, all of them being on oath for this. Also at that time i saw the sick were served their meals in silver dishes, and they drink too from silver spoons. And none need pay anything for his stay there, except freely of his goodwill gives anything to the servant that has waited upon him."

The administration of the hospital was established on Rhodes in the form it would take until the loss of Malta. In 1440 the year that the construction of the hospital began, the Order issued a detailed set of statutes which were probably the first major revision of the Hospital's regulations since those of 1182. This and subsequent legislation controlled the inspection of stores, appointment of chaplains, confession and prayer, diet and clothing, precautions against fraud, alms and bequests. 

The Hospitaller of the Langue of France (magnus hospitalarius) was in overall charge, although he remained accountable to the Grand Master and the Council, and ultimately to the General Chapter for important decisions and for the confirmation in office of his subordinates. The Infirmarian, (infermarius) also from the Langue of France was in charge of the day to day running of the hospital. He received the patients, visited them in their beds and ensured that they received the treatment prescribed by the doctors. A scribe recorded the notes and also recorded the testimonial wishes of the sick.

The Order employed professional doctors who were expected to visit the wards twice a day and one of them had to be on duty at night. The doctors always attended the sick under the supervision of the infirmarian and eight brothers, one from each langue at the Convent. They were accompanied by a scribe who together with the infirmarian, noted down the doctors prescriptions and saw that they were properly observed. the hospital also employed two surgeons.

In 1445 the Master, somewhat exceptionally employed a Jewish doctor, Jacunda Gratiano, fiscius et professor actis medicine, to practice in the Conventual hospital after having taken an oath on the Jewish scriptures.

For their part the patients were not allowed to question the doctors decisions nor change their prescribed diet. Patients were also obliged to be silent, to desist from playing cards or dice and refrain from reading books not associated with the christian religion.

Besides those who were sick or ill the hospital also treated causalities of war. in 1445, following the Egyptian attack on Rhodes, certificates of mutilation were issued so that those who for example had had a hand amputated in the hospital would not be regarded as criminals.


Half way along the ward, opposite the door and above the main entrance below is the polygonal apse of the chapel. A chaplain, later the prior of the hospital, administered the sacraments and coordinated the religious life of the institution. Every morning the chaplains processed through the great ward and celebrated Mass before the altar in the small three sided Gothic chapel.

The chaplains were charged with administering holy Communion and the Last Rites to the sick and singing the Requiem Mass in the event of a death. Every evening at sunset the chaplains gathered in the great ward to recite the great prayer for 'Our lords the Sick.'

                               'Seigneurs Malades,
                                pries pour pais que Dieu la monde de ceil du terre.
                               Seigneurs Malades,
                               pries pour le fruit de la terre que Dieu le multiplie entelle
                               maniere que sancte eglise en sort serv ie et le people
                               soutenou.
                               Seigneurs Malades,
                               pries pour l'apostell de Rome et pour les cordennaus et pour les
                               patriaches et pour les arcevesques et pour les evesques et les
                               prelate...........'

They prayed too for all Christian kings, pilgrims, captives and benefactors. (The ancient custom  of parading the responsions in front of the sick had been discontinued by 1340.)
                                                  

A small door in the southern corner of the Great Ward leads into a second smaller chamber with a polygonal column in the middle, supporting two arches that in turn supports the wooden roof. It is thought that this room served as a refectory. 


      
There was a fully stocked pharmacy with an elaborate system for the storage and checking of the quality of the drugs and medicines. All poisons were kept under lock and key.


Pharmacy jars from Rhodes 
( St John's Gate, Clerkenwell)

Pharmacy jars bearing the arms of Grand Master Fra' Phillipe Villiers de l'Isle-Adam
(1521-1523)
(St John's Gate, Clerkenwell)

In addition to his responsibility for the Conventual Hospital the grand hospitaller was also head of those services that the Order provided for the poor, for widows and orphans and those struck by misfortune in general. Since the 12th century the office of the elemosinaruis looked after the homeless. The General Chapter of 1182 outlined measures that could be taken for the relief of the poor. Penniless newly weds for instance were given a gift on their wedding day and prisoners released from jail money to start a new life. The Hospital was to provide subsistence for thirty paupers including five clerics and that anyone who needed it was entitled to food, bread and wine three times a week. Every Saturday during Lent, thirteen paupers, including three clerics  were fed clothed and given a small sum of money. The elemosinarius also oversaw a team of workers who repair old shoes and clothes for the poor. The General Chapter of 1182 also decreed that orphans were to be brought up in the hospital.

The Order also provided a service responsible for measures promoting public health and the prevention of epidemics which were frequent and virulent in the Middle Ages. Domini sanitatis were set up in 1503. Two health commissioners, one Latin and one Greek wee elected annually to impose strict measures against the plague which included control of landings from shipping and on occasion forty days of isolation, segregation measures for lepers and measures to keep rubbish out of the sea.

 A second smaller entrance to the Hospital  leads from the Street of the Knights via a marble staircase to the upper storey. The original wooden doors were carved and bore the coat-of-arms of Grand Master Fra' Pierre d'Aubusson.  An inscription carved in the stone above the entrance states that Fra' Pierre Clouet, an official of the Order completed the hospital in 1489.


In spite of the great expense of maintaining such a magnificent establishment, the Conventual Hospital was of the greatest importance to the Order of St John not only as a religious obligation and source of ideological strength but also as a symbolic showpiece to impress visitors from the West who would take back with them the resulting image and in doing so helping to justify the Order's extensive possessions and privileges across Europe.