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.