The Byzantine Empire Had Hospitals: What Were They Like?

The Romans were mostly known for their military might and the ability to conquer and pacify their neighbors for long periods of time. While they made significant strides in medicine as well, much of this work occurred on the battlefield during war. The Byzantine Empire took medicine off the field of battle and put it into the hands of the everyday citizen by constructing hospitals and advancing the science behind these treatments to the next level.

But of course Byzantine hospitals were much different than our own.

Technically, they weren’t for the public at large. Instead, churches created hospitals as a place where those who were destitute might go to find access to amenities that they couldn’t find anywhere else. Men and women were segregated. Historians believe that these humble beginnings paved the way to the hospitals that treat us today — even though archaeologists have yet to find physical evidence that this is the case.

Most of what we know is derived from texts.

The “first” hospital was supposedly put together by Leonitius of Antioch sometime between 344 and 358 AD. We know that they probably weren’t a means for anyone to recover from serious illness. Instead, they were probably more like Hospice care — a means to make the transition to death more comfortable for those living in poverty or migrants who were traveling from one place to the next when they fell ill. 

It wasn’t long before these organizations began to pop up all over the Byzantine Empire. Only a century later, they could be found among the ashes of the old Roman Empire (in the west) as well. Some scholars believe they had spread as far as Egypt and Syria.

The spread began to slow down by the sixth century. That’s because they were already a basic part of Byzantine society in many of the empire’s larger cities, offering medicine and shelter to their patients. Constantinople had more than a few. 

Byzantine physicians practiced Hippocratic principles when treating patients. That means they believed that the body was made up of four basic “humors.” These were blood, phlegm, black bile, and yellow bile; all were directly connected to the season of the year.

Diagnostic procedures more directly parallel the practices of today’s physicians. They would check pulse and breathing, analyze urine and excrement, and pay attention to speech patterns. These procedures are probably more complex than you might think. For example, John Zacharias Aktouarios was able to separate a person’s urine into at least eleven distinct components inside a vile. By analyzing those components, he was able to determine whether or not a person was suffering from infection. 

Although medicine made strides, it would be centuries before hospitals transitioned into larger, more organized institutions.

How Was The Byzantine Military Machine Structured?

The Byzantine Empire was the eastern half of the Roman Empire — and it survived for many centuries after the western half of the empire crumbled to dust. While most of us think of it as an entirely different entity — that perhaps the heart and soul of the Roman Empire was lost when Rome itself fell to both domestic and outside forces — it really wasn’t all that different in the beginning. Over time, though, it became a unique empire with a heart and soul all its own.

It’s military, for example, evolved quite differently than Rome’s did. 

The cataphracts (a word meaning completely armored) were heavy cavalry meant to check the military might of the Persians, who were devastating to Byzantine soldiers when encountered in the field. These soldiers were among the most disciplined that were fielded all the way through the High Middle Ages. Even the horse was heavily armored. Riders would carry a number of weapons, including lances, maces, or bow and arrow.

Although the cataphracts were the result of outside forces, the Byzantine military almost always included well-trained infantry men — which was the direct result of having been a part of the Roman Empire for so long before. Most of these men would carry a sword, axe, or spear. Some would arm themselves with lead-weighted darts called plumbata. They would wear a shield shaped like either an oval or triangle. Some would wear chain mail. Those of lesser means could be found equipped with leather armor. 

Around the twelfth century, Byzantine began including units of pronoiars, who were paid in land. Although they didn’t directly collect wages, part of their job was that of a glorified tax collector. Sometimes they kept some of the monies collected. Because of their power, they were considered somewhat like western knights. Although they were soldiers with a great number of expectations placed on them, they also had wealth and titles.

The akritoi soldiers were found along the Anatolian borders, although their initial appearance as part of the Byzantine military is not well documented. The akritoi were mostly Greek farmers. They mostly carried a bow and arrow or javelins. These light soldiers would be used for quick encounters to soften an enemy before the rest of the army swooped in, but they could also be trusted to act defensively.

In addition to a military of its own citizens, Byzantine relied heavily on units made up of mercenaries and foreign soldiers. Whereas the Western Roman Empire was known for quickly raising legions from within its own cities, it could be said that the Eastern Roman Empire was known for quickly raising new armies from within its own coffers. Byzantine was an empire of vast wealth — and it knew how to put that wealth to use.

Historical Fiction You Should Read If Interested In The Byzantine Empire

Not everyone can sit down to read through a fact-filled historical textbook. And that’s okay. Some authors of historical fiction have taken pains to make their stories as historically accurate as they possibly can. They also tend to point out when they took liberties to change certain historical events to better the plot. So which novels are best if you would like to learn more about the history of the Byzantine Empire?

Ben Kane. If you would like to start from the beginning — before the fall of the Western Roman Empire — then Ben Kane’s The Forgotten Legion series is a great place to begin. It tells the fictitious story of an actual legion that vanished after battle, but you learn a lot about the world during the first few centuries A.D. Kane has also written a number of interesting novels retelling the story of Hannibal’s attack on Rome.

Cecilia Holland. She has written quite a lot of historical fiction novels, but readers of Byzantine history might find The Angel and the Sword of particular interest. A young Spanish princess runs away only to fend off the Vikings during a siege on Paris. There are several references to the Byzantine Empire throughout Holland’s novels, and she visits the region several times.

Stephen R. Lawhead. His novel, Byzantium, follows a scribe living in an Irish Monastery who eventually travels to Byzantium with a number of monks. Learn about the city itself and the Golden Court.

Robert Graves. Those familiar with his work will recognize his love of mythology and history. Count Belisarius is one of his greatest achievements. It takes place beginning in the sixth century while the rest of the world is still struggling to rebuild after Rome fell. Belisarius was a general of Emperor Justinian, and Graves provides a wonderful picture of this long-forgotten time period.

Gordon Doherty. Strategos: Born in the Borderlands takes place beginning in 1046 A.D. during a period of time when the Byzantine Empire is on the brink of war. This story is set in Eastern Anatolia, where the Seljuk Sultanate routinely mounts incursions into the Empire. It’s a great option for those who want a grittier view of the era.

Tom Vetter. Call to Crusade (Siege Master #1) is set in 1070 during the First Holy Crusade and is told from the perspective of a knight who fights in the war for Jerusalem, among others — yet another war that the Byzantine Empire could not hope to avoid.

How Did The Residents Of The Byzantine Empire Prepare Their Food?

It should come as little surprise that the food you ate was highly dependent on the social class you belonged to in the Byzantine Empire. While the aristocracy was capable of paying cooks to prepare luxurious dishes and desserts three times a day — like syrup-soaked meats (many animals they had likely hunted themselves) and sweet cakes, the poor could not be expected to meet the same standards. 

Unsurprisingly, “poor” was the golden standard in society for most of the years during which the Byzantine Empire thrived. Few could expect to reach any manner of wealth, and there really was no middle class as we might recognize it today. 

Believe it or not, in the days of the Roman and Byzantine Empires, the poor were actually more likely to go out to eat. It was cheaper than dining in or cooking for yourself yourself. Local restaurants were small establishments called “tavernas,” where owners would often quickly and cheaply cook food by boiling. 

Fish sauce and fermented barley sauce were commonly used to make the meager offerings more palatable to the masses. They even had another product similar to our modern day version of soy sauce!

Thankfully, trade routes were well established in that part of the world and it was much easier to come by extra ingredients and different types of food. While much of it may have been bland fare provided to the poor, at the very least there was a bit of variety due to relationships built with the Persian and Arabic Empires. This is why modern day Balkans, Greek, and Turkish cuisine are so similar.

Many of the dishes we enjoy today — like baklava — are even thought to be descended from similar Ancient Byzantine recipes!

While meat was an uncommon ingredient for much of the Byzantine population (save for fish), there were a number of other staples in their diet. These included bread, fruit, nuts, eggs, legumes, olives, milk, and cheese. 

If you lived in the Byzantine region, you could be expected to drink a lot of wine, no matter your class or standing in life. Much of the food was cooked in wine or vinegar. If you were lucky enough to enjoy meat on occasion, then a common recipe was rabbit simmered in red wine with cloves, served with a dressing called “mytton” that was made from garlic, olive oil, and black olive paste.

Hen was often roasted inside a sealed clay pot (and an oven), that was filled with wine, bread crumbs, pepper, cloves, nutmeg, cinnamon, pine nuts, mushrooms, etc. 

Truth be told, some Byzantine recipes sound better than most of the things we eat today!

Why Did The Byzantine Empire Finally Fall To Outside Forces?

It’s a testament to Roman ingenuity that the eastern half of its empire persisted for about a thousand years after the western half crumbled. The Roman Empire as we know it fell for a number of reasons: most prominent among them was change from within. Many people believe that it fell into decline because of “barbarian” incursions from the north, but this is only a fragment of the truth.

Christianity breathed new life into the empire for a while, but it also destroyed the core values that had held the empire strong for so long. Eventually the first great melting pot experiment became a den of debauchery filled with ever-increasing racism, wealth inequality, greed, and religious persecution. (Sound familiar?) There were other factors, of course, but these were the primary contributions.

Even when the Western Roman Empire fell into decline and eventually disappeared, the Eastern Roman Empire (also known as the Byzantine Empire) continued to survive — with Christianity as its faith. Why?

Part of the power was derived from location. It was quite literally situated in the center of the known world, which left it as a crossroads for some of the greatest and most famous trade routes ever known. It’s economy and military stood above all others, and it was able to adapt to outside forces faster than the western half of the empire once did.

But all things come to an end. Change is the great constant, and times changed.

The Ottoman Turks finally destroyed the last remaining crumbs of the Byzantine Empire in 1453. How? Constantinople was sacked in 1204 during the Fourth Crusade, which led to a division of its assets. This was the beginning of the end, and it made the task of destroying what remained much easier for Byzantine’s enemies — and it had many of those.

During the 14th and 15th centuries, the remaining territories (which were separated into mere city-states) were slowly assimilated into the Ottoman Empire during a series of bloody wars. Even before the Ottoman invasions, the struggling Byzantine leftovers were subject to Serbian incursions after a civil war that left the empire’s people decimated. 

Constantine XI was emperor during the 1453 Ottoman siege of Constantinople, which pitted 80,000 Ottomans against a mere 7,000 Byzantine soldiers, many of whom were foreign. Constantine XI didn’t take the defeat lightly — he was last seen engaging in hand-to-hand combat after the city had already fallen. Believe it or not, Rome arguably survived as the “Third Rome” until it finally fell during the Russian Revolution in the early 1900s.

Wildfire in “Game of Thrones” Was Probably Inspired By A Byzantine Super Weapon

If you’ve read George R. R. Martin’s A Song of Ice and Fire or watched the immensely popular television adaptation Game of Thrones, then you’re probably familiar with a weapon used during the Battle of Blackwater Bay during the frenetic defense of King’s Landing. The recipe for wildfire is super secret, it’s green, it melts anything it touches, and it’s oh-so-beautiful on the big 4K television screens. Did you know it was most likely inspired by “Greek fire,” a powerful weapon used by the Byzantine Empire from around 672 AD?

Much like the Battle of Blackwater Bay, Greek fire was often used in naval warfare.

According to historical texts, Greek fire was discovered and first unleashed on unsuspecting Byzantine enemies when the Greeks were under siege in Constantinople. The fun part? Historians have no idea at all what Greek fire actually was or why it was so potent. It was described as an enduring stream of fire that could stay lit even on water (much like wildfire).

Some scientists even believe Greek fire was ignited on contact with water, which would mean its active ingredients were likely naphtha and quicklime. Historians credit this oddball super weapon for many crucial Byzantine victories that would change the course of history (one of them being the survival of Constantinople during a couple of Arab sieges, which means the Byzantine Empire wouldn’t even have survived without Greek fire).

Greek fire is the most popular nickname for the weapon in the modern era, but it has also gone by a number of others: Roman fire, sea fire, war fire, liquid fire, sticky fire, and manufactured fire (to name a few). Fire, fire, fire. They liked their new weapon, we’re sure.

There were a number of methods for the delivery of Greek fire over a given battlefield. On the ocean or during sieges, it might be funneled into and projected through a strong tube. Eventually a portable projector was invented as well. Can you imagine individual soldiers running around with ancient flamethrowers when all you had was a sword, shield, and heavy armor to defend yourself? Scary! Much like in Game of Thrones, Greek fire was also delivered using jars via catapult. Out on the ocean, cranes might drop Greek fire on the enemy from afar.

According to several (maybe reputable?) first-hand accounts, there was often a rushing and roaring sound whenever the fire was shot. Some sources also suggest that the Greek fire was heated using a furnace before it could be discharged at the enemy.

Though Greek Fire was a super weapon of sorts, that didn’t mean the Byzantines were invulnerable. The weapon’s range on the water was very limited, and it couldn’t be used effectively if the winds were blowing in the wrong direction or when the waves were choppy. A good tactician could use their undue influence and goad the Byzantines toward defeat.

Byzantine Emperor: Heraclius

Heraclius was the Emperor of the Byzantine Empire from 610 to 614. He made Greek the official Byzantine Language. He is known for his many military campaigns as the empire was being threatened on multiple frontiers. He successfully pushed the Persians out of Asia Minor in the Battle of Nineveh bringing peace between the two empires. However, that was short lived as he soon faced threats from Muslims losing Mesopotamia, Armenia, and Egypt. He also attempted to fix the schism in the Catholic Church but ultimately failed.

Despite ultimately losing territory, Heraclius is considered one of the greatest Roman rulers. He reduced corruption and reorganized the military. His most important legacy comes the recovery of “The True Cross” from the Persians. The True Cross is the remanents of the cross in which Jesus was sacrificed. Heraclius returned the cross to Jerusalem in 629 (or 630). He was labeled the first crusader. However historical accuracy of this tale has been widely debated amongst scholars claiming that the True Cross was lost and the cross that Heraclius brought back to Jerusalem was a mistake.

Heraclius was married twice, once to Fabia Eudokia and then to his niece Martina. He had two children with Fabia and then nine children with Martina. Two of his sons became Emperor – one from Fabia (Heraclius Constantine [Constantine III]) and one from Martina (Constantine Heraclius [Heraklonas]). When Heraclius was dying he left the empire to be ruled by both sons with Martina as Empress. In 641, 11-year-old Constans II, son of Constantine III took over as Emperor.

Everything You Didn’t Know About The Byzantine Empire

It’s one of the most successful empires in history, and yet there’s so much we don’t know about it. Or at least there’s so much that isn’t common knowledge, when it should be. The Byzantine Empire was strong, influential, and fascinating, and we should strive to learn as much about it as we can in order to understand how it rose and fell. Here are the facts you didn’t know about the Byzantine Empire.

  1. Historians only began to refer to it as the “Byzantine” Empire during the Renaissance, after the empire fell. In reality, it was simply the eastern half of the Roman Empire, which had split down the middle before the western half fell. In other words, the common notion that the Roman Empire collapsed in the fifth century AD is inherently false.

  2. The eastern half thrived for another thousands years–albeit under a different name imposed by historians later. It was the Roman Empire, however. Its residents called themselves Romans because they were Roman. So were the empire’s practices, principles, and traditions.

  3. Its name stems from an ancient Greek city called Byzantium after it was founded in 657 BC. Emperor Constantine I renamed the city Constantinople (because narcissism was always a thing) in 330 AD. It would become the new capital of the Eastern Roman Empire.

  4. The empire fell in 1453 when it was devastated by the Ottoman Empire. There’s always a bigger fish.

  5. The residents of the empire influenced modern cooking. They used rosemary to flavor lamb, and as far as we know they were the first to do so. They used saffron to cook as well.

  6. They paved the way for morbid obesity. Or the falling price of sugar did. The empire’s citizens definitely had a sweet tooth, and they loved rice pudding and a sugary dish called grouta. They used marmalade, jellies, fruit conserves, and rose sugar to make desserts just a little bit better.

  7. The diet was also made up of fish, which was easy to find. They ate caviar!

  8. They drank wine, but the beverage started to evolve to become more flavored. They even started to drink a number of beverages that led to the flavoring of alcoholic favorites today: absinthe and vermouth among them.

  9. They were the first to use eggplant, and citrus fruits like lemons and oranges in cooking.

Hierarchy Of Living In The Eastern Roman Empire

Society in the Eastern Roman Empire wasn’t as far-removed from our own as you might think. Sure, they had a class of rich and a class of poor. There were others who lived comfortably without the luxuries of the super-rich. These Romans had a different kind of government, but you might be surprised why they chose to be ruled the way they did.

Long before the Roman Empire split into east and western halves, it was a kingdom ruled by kings. The monarchy eventually toppled when its people stopped believing in a king’s ability to lead them. The kingdom evolved into a republic, in which certain kinds of citizens were allowed to vote. During one period, consuls held the highest authority but were only voted in for a year at a time, ensuring that no one could easily grasp too much power. To be called a king was a supreme insult.

When the Roman Empire split, emperors continued to rule in the East. Perhaps they weren’t so different from kings. Perhaps they were. In order to keep a dynasty up and running, each successive ruler had to prove legitimacy, and that was determined by ability. If an emperor couldn’t handle the job, down he went. Even plebeians and warriors were sometimes elevated to this position–and that’s all it was, a position–although it was rare.

This was a society in which you could potentially work your way up the ladder no matter who you were, even though it was as seemingly difficult or sometimes impossible as it is today. Anything was possible, but the point is that birth did not guarantee your place in the social hierarchy.

A great number of slaves were used to conduct all sorts of labor. Slaves might be sold to a cruel master or a generous one. It was even possible that a slave could be freed after years of service. Liberated slaves were often accepted as part of society.

At the very top of the social structure were the aristocrats and government officials. Below them were the wealthy merchants and some landowners. On the bottom rung were the poor. The clergy didn’t reside on the same social structure as everyone else, but they might be privy to privileges only enjoyed by those on the upper rungs of the ladder. It was a mostly respected profession like a criminal defense lawyer Miami.

A Brief Chronology of Important Events in the Byzantine Empire

Rome was sacked in the year 410 by the Visigoths and again in 455 by the Vandals. Its last emperor was deposed in the year 476. These events helped propel the rest of the world into a new age–a dark age–while the Roman Empire in the East continued to survive and even thrive at some points for another millenium.

In the five years between 532 and 537, the emperor Justinian had the Church of Hagia Sophia built. This church was a powerful symbol of the new empire that was formed. Justinian took the idea of a unified empire seriously, and he put a lot of effort into retaking land that had been lost when the western half collapsed under wave after wave of invasion. Unfortunately, this was also a period of Islamic expansion that threatened to unravel everything Justinian strived to achieve.

During the period between 610 and 641, the modern-day areas of Syria, Palestine, and Egypt were taken by Muslim invaders. By the 690s they had taken Byzantine in North Africa. From 717 through 718, Constantinople itself was under siege. The invasion failed, but it was an example that the Byzantine Empire was not invincible–even if it was a force with which to be reckoned.

Over the next centuries, the Roman church continued to gain power and influence. The Byzantine Empire was ruled by the Macedonian dynasty, founded by Basil I. This dynasty ruled from 867 until 1056 and ushered in the Macedonian Renaissance, which led to a transformational period for Christian artwork and scholarship in general.

The decline of this eastern empire began around 1050. This was the age of the Crusades, which tore through surrounding lands between 1096 and 1291. The Byzantines were smashed by Seljuk Turks in 1071, and then Constantinople was lost to Crusaders with the Fourth Crusade in 1204. It took nearly sixty years until Constantinople could be liberated, an event that occurred in 1261.

Constantinople finally fell for the last time in 1453 after a massive force of Ottoman Turks ruined the city with a barrage from heavy artillery and infantry. This would change everything. The city would be forced to live under new Islamic rule with unfamiliar Muslim laws. Christians were not allowed to own weapons, although they were not barred from practicing. The city was renamed Istanbul, and the rest is history!