Judeo-Christian medical care in early Rome

In reference to medical history, Christianity must be seen, first, as a Jewish movement. Within a few centuries, root and branch had become hostile to each other, so it’s hard to bear in mind just how fundamentally Jewish the early Christians were. But around the time that Rome declared Christianity a legal religion, there was still relatively little cultural separation.

As mentioned before, I am leaning on Rodney Stark’s The Rise of Christianity for characterizing the 2nd and 3rd centuries. One of Stark’s major theses is that the early church remained culturally Jewish for a long time, and after it was no longer majority Jewish, it retained some of the culture.

It’s a relevant point for medicine because the Jews had a strong tradition of medical care. They focused on ordinary means of health care, such as food, water, washing, pain relief, and visits for encouragement. Certainly, all people believe in these things and practice them most of the time to some extent. The Jews were different in three ways.

First, the God of Israel commanded rituals (similar to Jupiter, Apollo, etc.) but also made it very clear that moral and even emotional commandments were more important. This was unlike any of the pagan polytheistic belief systems. There is no evolutionary progress from any other system to this one; it just appears in the timeline without precedent, and it asked things of people that they really preferred to neglect or avoid. One popular modern belief about religion is that it corresponds to people’s emotional needs, but the God of Israel doesn’t fit that framework very well.

Second, among these uncomfortable commandments was a categorical demand to value all life and consider all blood, the fluid of life, precious. By the time the Babylonian Talmud was being compiled, Jewish philosophers had realized the full implications of this commandment. It meant valuing not only the lives of your own family, but also the lives of strangers. It meant valuing the lives of the weak as well as the strong. It meant going out of your way and sustaining your own losses in order to protect the lives of people who might even intend harm to you. Jesus’ story of the Good Samaritan illustrates this Jewish value very well: the man he praises set aside the ritual commandments and instead endangered his own health and means to save a stranger’s life.

Third, because of this value system, more Jews put more thought into health care than most people did. Basic herbal knowledge and general diagnostic ability was considered part of a good education, so a randomly-chosen Jew was more likely to manage as doctor in a pinch than a randomly-chosen Roman. The first Hebrew medical book was written some time between 300 and 500; it was copied and circulated to promote greater medical awareness. This book emphasized cleanliness and care for the poor, as well as collecting and presenting the herbal lore of every region available to the writer.

So if you lived in Rome or Alexandria in the year 300, you would probably see different health care customs among the Jewish and Christian communities compared to the neighborhoods where pagan gods were still worshiped. Both Jews and Christians felt it their duty to take care of sick people who were unrelated to them or could not pay them.

To the Jewish focus on caring for the sick, Christians added a new aspect: they had a firm belief in the afterlife, and they also believed that they were commanded to put their own lives at risk freely. It was shameful for a Christian to shrink back from visiting or doctoring someone with a potentially infectious disease. That was considered pagan behavior, since it was acting like someone with no hope of heaven. It was denying Christ with your actions; it might mean losing your hope of salvation. Jesus had said directly, “he who saves his life shall lose it.”

When the Roman Empire was devastated by the plague of 251, many pagan Romans knew someone who was a Christian. Stark’s book argues that Christian survival rates were far above pagan rates, first for the simple reason that some epidemic victims can recover if they receive basic care. They were far more likely to receive this basic care, putting the caregivers at risk, if they were in Christian families or had Christian friends and neighbors. These survivors were highly likely to convert to Christianity as a result. So over a few years, with many more pagans dying, and many survivors converting, the Christian faith went from something like 2% to something like 10% or even 25% in some areas. Eventually, by 350, when the Roman government stopped trying to stamp out the new religion, it may have reached as high as 50%.

The medical care we assume today is clearly tightly connected to Judeo-Christian values. Around the world, Jews (in an ethnic sense) and Christians (not in an ethnic sense, but counted by how devout their beliefs are) give the lion’s share of the medical care. This was equally true in the Middle Ages, as we’ll see.

During the late Classical and early Medieval periods, Roman and Christian traditions fused so that people no longer distinguished them. By the time the Germanic tribes converted to Roman Christianity, the original role of Jews and Christians in creating medical care was forgotten, even if the roles continued. The scientific basis for medicine was Roman; the same Galen who fled Rome’s plague in 165 was taught in medieval medical schools without any awareness of the irony. Next, we’ll look at the Greco-Roman belief system.

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