“Behold at Southwark an ancient spital, built of old to entertain the poor, has been entirely reduced to cinders and ashes.”
Thus wrote Peter de Rupibus, Bishop of Winchester, of St Thomas’ Hospital, following a terrible fire in AD 1212.The fire began on London Bridge where it trapped crowds of Londoners, over 3000 of whom were reported to have perished.The hospital was already described as `ancient’ and was part of the priory of St Mary Overie.The priory was founded by Bishop Giffard of Winchester in 1106, but legend suggests origins in the Dark Ages as a nunnery founded by the love-lorn daughter of a Thames ferryman.
St Thomas Becket
The hospital was probably founded with the priory, but following the canonisation of Thomas Becket in1173 it was named or renamed after London’s favourite Saint.
A Monastic Staff
The early medieval hospital was staffed by a mixed order of Augustinian monks and nuns.The Augustinians were an outward looking order that gave a high priority to public service,and were responsible for founding both of London’s oldest surviving hospitals: St. Bartholomew’s (1123) and St. Thomas’. The hospitals were created for the benefit of the general public,originally more as places of general hospitality, from which the word is derived.
The original hospital appears to have stood close to the priory church, now Southwark Cathedral. In 1215, it moved to the east side of Long Southwark, now Borough High Street, where the air was said to be sweeter. It was to remain o
n this site until 1862.
St Thomas Becket and the Canterbury Pilgrims
“It happened that season that one day in Southwark, at the Tabard, as I lay ready to go on pilgrimage and start for Canterbury, most devout at heart, at night there came into that hostelry some nine and twenty in a company of sundry folk happening then to fall in fellowship, and they were pilgrims all that towards Canterbury meant to ride.”
-Prologue of The Canterbury Tales by Geoffrey Chaucer, translated by N. Coghill.
A Healing Saint
In medieval health care terms, the dedication of the hospital to St Thomas Becket was a major advantage. He was an extremely popular saint, who was attributed with miraculous healing powers and born a Londoner (1118). St Thomas was murdered in Canterbury Cathedral in 1170 and canonised 3 years later. Many of the early pilgrims to his tomb may have stayed at the hospital before they began their journey from the chapel, dedicated to the martyr, on the newly-built London Bridge. In the more commercial later middle ages, pilgrims spent the night in inns, such as the nearby Tabard Inn chosen by Chaucer (on the site of Talbot Yard, off Borough High Street). Perhaps co-incidentally there was a medieval monument in St Thomas’ to a certain Richard Chaucer.
Health Care at Medieval St Thomas’
Documentary evidence is scanty, but we know that medieval St Thomas’s performed three important functions. Hospitality was given to poor travellers and pilgrims, a home was provided for the destitute and aged, and the sick were nursed. The emphasis however was generally on ‘hospitality’ rather than on medical intervention.
In the early 15th Century Richard (Dick) Whittington extended the range of medical services provided by `Thomas Spital … an ospytalyte’ and made donations for poor men and women to make `a new chamber with 8 beds for young women that had done amiss, in trust of a good amendment.’ . He commanded `that all things that happened in that chamber should be kept secret … for he would not shame no young woman in no wise, for it might be cause of their letting (hindering) of their marriage.’
Funds were provided by charitable donations. Following the fire of 1212 all those who contributed to the rebuilding were granted 20 days remittance of penance. Subsequently, donors were given the right to participate in services in the Priory. Generous donations, it was thought, would speed the supplicant through purgatory to heaven. One medieval donation came from Alice de Bregerake who donated her property to the hospital in return for a yearly rent of a rose. She wrote: `Know all men, present and future, that I, Alice de Bregerake, moved by divine piety and for the welfare of my soul, as well as of those of my ancestors, have given … to St Thomas the Martyr .. property … for free and perpetual charitable uses; rendering therefore to me and to my heirs yearly, one rose on the feast of St John.’
Some aged people secured their future by giving over their lands in return for sheltered accommodation in the hospital. For others, shelter in a monastery was a reward for past service; the poets Geoffrey Chaucer and John Gower both spent their last years in a cloister: Chaucer at Westminster Abbey and Gower in the priory of St Mary Overie. John Gower was a benefactor to the associated hospital of St Thomas’s. In 1408, he left 40 shillings to the Master, 6s 8d to each of three brethren, 3s 4d to the professed sisters, 1s 8d to each nurse and 12d to each patient. If other fund-raising sources failed, the monks could, as those at St Thomas’s did in 1348, secure a licence to beg for alms.
Staff numbers at the hospital were low, in keeping with Augustinian practice. There appear to have been three brothers in Holy orders under a master with three professed sisters. The number of patients probably did not exceed 40 during this period. We have no clear evidence of conditions in the hospital, but they would probably have been considered reasonable for the times, with each new patient washed, deloused and issued with clean sheets. Upon discharge their clothes would be returned, laundered and repaired.
Patients would have received good food and kind nursing, but would have had to share beds with other patients (a common practice throughout medieval society).
Beds would have been basic, although probably at least as good as the patients were used to at home. Feather and flock mattresses were not common until Tudor times. Unfortunately, no records of payments to physicians or for medical supplies appear to exist to help elucidate the hospital regime.