Sethina Watson’s monograph on the legal history of medieval hospitals is a deliberately provocative intervention in the long and fragmented historiography of this important institution. In the decades since John R. Guy observed that “Of the Writing of Hospital Histories There is No End,” such histories have multiplied, but they have most often been local or regional histories.1 Valuable comparative work has been achieved through collaborative projects, but a work such as Watson’s is still very welcome. A challenge of writing the history of medieval hospitals is that these were “indisputably local institutions […] at the intersection of faith and politics, ideals and practice.” (p. 8.) Moreover, hospitals for which we have extant records represent a fraction of the whole. Watson argues that medieval hospitals were significantly absent from canon law. In doing so, she argues against the view that these institutions were regarded as quasi-monastic.

Crucially, the monograph deals with hospitals in both canon law and secular legal traditions. On Hospitals departs from much historiography in its chronological focus: Watson sees the centuries of the early Middle Ages as being formative to legal vocabulary for and understandings of hospitals. Following the introduction and a chapter on ecumenical councils, she turns to legislation from 400–900. Part III, “Stalking the Borderlands (1100–1320),” reads the work of canonists and commentators as responding to the legal norms set by the earlier period. While ecclesiastical authorities saw hospitals as connected to their social and apostolic duties, Watson argues, these institutions were legally beyond their authority, and remained so despite scattered attempts to make hospitals subject to regulation alongside other categories of religious house.

Chapter 2, focusing on the Second, Third and Fourth Lateran Councils, works from the later to the earlier councils. This is typical of the book’s thoughtful organization, which reinforces the central argument about the importance of the early Middle Ages to the legal identity of medieval hospitals. Canon 26 of Lateran II (1139 CE) may be seen as relevant to hospitals managed by communities of women, which were perceived as insufficiently bound to the religious life. Lateran III’s famous Canon 23 concerns communities of the leprous. Watson argues that the canon does not address hospitals, and that it suggests a papal interest in addressing the needs of communities without overstepping the boundaries of law (pp. 41–52.) Similarly, she maintains, Lateran IV was used to exhort Christians to support hospitals with material contributions, but the council’s watershed in the organization of religious life “was not recognized as affecting” hospitals either by canonists or by bishops (pp. 39–40.) The hospital statutes that emerged in the wake of the council she characterizes as “quasi-religious” and “confounding in their diversity.” Regulation efforts by bishops, too, she sees as fundamentally disconnected from hospitals’ legal status.

While early medieval conciliar authors were interested in xenodochia and hospitalia, Watson asserts that these institutions remained “chaotically varied” in practice. In analyzing the much-cited councils of Orléans (549) and Aachen (816) she argues that Orléans merely copies regional hospital statutes, and does not mark an attempt to create norms in canon law concerning hospitals. Chapter 4 argues that Carolingian councils, in legislating for the reform of xenodochia, saw these institutions as amounting to gifts, and having their roots in the will of founders. This is what Watson presents at the core of medieval hospitals’ legal history: their placement under the disposition of individual Christians, as part of a charitable economy, not among the institutions of the church. Chapter 5 maintains that the basis for a fundamental divergence between Byzantine and western models for hospitals is found in Roman law and its adaptations. In arguing that the concept of welfare institutions moved – like the term xenodochia – westward from Byzantium, Watson echoes much older scholarship, but her conclusions back a novel argument. While the Corpus Iuris Civilis’ division of monasteries and charitable institutions did not translate into Western Europe, its legal framework, she suggests, still formed an important precedent. More decisively, law codes in both East and West treated hospitals as testamentary institutions.

Chapter 6 argues that episcopal attempts to negotiate authority over hospitals in the Carolingian period came from potestas, rather than ius; more, she maintains that although ninth-century councils grouped hospitals with religious institutions, no ecclesiastical authority was established over them (pp. 163–73.) Any association between pia loca and hospitals would come only in the classical period of canon law, covered in Chapter 7. Even then, Watson argues, canonists from Gratian onwards were largely disinterested in hospitals as a subject for legal definition. Watson also treats decretals as not having legal force; this is, at the very least, a complex question. Ernst Pitz’ classic monograph is not included in the bibliography; nor is more recent work by Hans-Joachim Schmidt and Gisela Drossbach, though much of Drossbach’s work is.2 Danica Summerlin’s monograph, which engages with conciliar decrees, decretals, and debates about the legal force of each, may have appeared too late to be considered.3

Chapter 8 argues, against a century of scholarship on hospitals, that the early thirteenth-century councils of Rouen and Paris were outliers without subsequent influence. Watson sees them, instead, as connected to the regional reform circles of Robert de Courson. Here Watson sees “new forms of religious life, based in hospitals and leper-house,” linked to the emergence of beguines (p. 285), and the attempts of legal scholars to find space for these “new” hospitals in canon law as ultimately unsuccessful. I see this conclusion as debatable. But this difference of interpretation comes back to a question of what sources can be used to write the legal history of hospitals in the medieval period. Moreover, Watson sees normative texts as more decisive in determining the parameters of religious identity than others have done.4

The final full chapter presents the Council of Vienne (1311/12) as the first ecumenical council to concern itself with hospital reform, rather than the result of a long century of debate concerning the privileges of hospitals as religious houses. Watson’s analysis of Vienne presents it as confirming legal consensus, identifying hospitals as charitable but not religious institutions, which the church might recognize and support, but made no claims to control. Watson sees the later medieval legal history of hospitals as a history of silence, before the Council of Trent’s matter-of-fact taking up of Vienne. This strikes me as curious in view of Thomas Frank’s study of the complex debates around hospitals’ legal status from the fourteenth to sixteenth centuries, which takes Vienne as a starting point.5

Watson begins her monograph with an allusion to the biblical image of the sheep and the goats, and concludes it with the claim that medieval hospitals illustrate the complexity of society and law in medieval Christendom, the church and the world never fully separate. Medieval hospitals themselves, as communities, are largely absent from the monograph, or at least on its edge. It is a provocative absence.

Notes:
1 John R. Guy, Of the Writing of Hospital Histories There Is No End, in: Bulletin of the History of Medicine 59 (1985), pp. 415-420.
2 Ernst Pitz, Papstreskript und Kaiserreskript im Mittelalter, Tübingen 1971; Gisela Drossbach / Hans-Joachim Schmidt (eds.), Zentrum und Netzwerk. Kirchliche Kommunikationen und Raumstrukturen im Mittelalter, Berlin 2008.
3 Danica Summerlin, The Canons of the Third Lateran Council of 1179, Their Origins and Reception, Cambridge 2019.
4 Cf. Charles de Miramon, Les 'donnés' au Moyen Âge. Une Forme de Vie Religieuse Laïque, v. 1180–v. 1500, Paris 1999.
5 Thomas Frank, Heilsame Wortgefechte. Reformen europäischer Hospitäler vom 14. bis 16. Jahrhundert, Berlin 2014.