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Art. 7.-ST BARTHOLOMEW'S HOSPITAL.

The History of St Bartholomew's Hospital. By Sir Norman Moore. Two vols. Pearson, 1918.

MORE than two hundred years after the foundation of St Bartholomew's Hospital, the master, brethren and sisters claimed exemption from the payment of taxes. Their endowment was considerable, but insufficient to meet the expense of 'the sick poor coming into the hospital until well from their diseases, pregnant women coming in till able to get up after childbirth, the sustenance of the children thus born in the hospital till seven years of age should their mothers die, as well as various chantries and the maintenance of other almsdeeds, and the sustenance of the master, brethren and sisters.' This familiar story comes from the middle of the 14th century, the period of Crécy and Poitiers. The hospital of St Bartholomew is nearly eight hundred years old. Since the year 1123 it has looked on to Smithfield. Although the ancient buildings have gone long since, and the early constitution was rudely broken at the Reformation, its unbroken record of service is a more intimate part of the life and history of London than is the story of the Tower of London. The Conqueror's white fortress stood by the river in 1123 as it stands in 1919; but it was never part of London and has long ceased to have a part in the life of England. The strength of the hospital lay in something more enduring than stone. The citizens whose ancestors had seen its beginnings outside the walls in the days of the first Henry, took its work to themselves in the days of Henry VIII; and under their protection it resumed its ministry to women labouring with child, sick persons and young children.

The splendid volumes which Sir Norman Moore has prepared as a gift to the hospital are an addition to the history of London and, less directly, to the history of medieval England. His is no perfunctory or laboured exercise. It is full, leisurely, informed by wide and gracious learning. Sir Norman Moore is an authority on the history of medicine and a Celtic scholar of distinction, but during the last thirty years of a busy

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professional life he has found time for this gradual compilation in honour of St Bartholomew's. When he resigned the office of Senior Physician at the end of 1911, he could write:

'I began my service in the hospital in 1872 as House Physician, and have ever since continued its servant as Casualty Physician, Warden of the College, Lecturer on Comparative Anatomy, Demonstrator of Morbid Anatomy, Lecturer on Pathology, Assistant Physician, Lecturer on the Principles and Practice of Medicine, and Physician.'

He is almost as familiar with the buildings and streets which once stood between Newgate and the bar of Smithfield as he is with the wards and offices of the existing hospital. He knows the history of each parcel of ground in the hospital's possession. He has not been content with long hours of study in the British Museum or among the muniments of St Paul's. He has traced he sites of forgotten London houses, and explored the Essex flats. He has made pilgrimages to places associated vith the memory of early benefactors. How delightful uch a study can be to a generous mind may be seen in he passage describing Sir Norman's visit to Beaumais, n Normandy :

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'Richard de Beaumes or de Belmeis, Bishop of London, ho aided Rahere [the Founder], was one of the great men of is time. He took his name from Beaumes, now Beaumais, few miles from Falaise in Normandy. Beaumais is a scatered village built on lands which slope down to the river ive; and on the higher ground stand the château, a buildg of the 16th century, and the church which was built rly in the 12th. .. Richard, Bishop of London, may ave said Mass in this very church; and in grateful memory him, as a benefactor of St Bartholomew's and of London, left a bough of spindle wood, gay with crimson fruit, by the tar when I visited Beaumais. The orchards in which the puses of the village are embedded were bright with rosy ples, and the cheerful note of the green woodpecker was ery now and then to be heard. A small corn-mill was orked by the Dive, the successor of that mentioned by rdericus Vitalis. In a farmhouse there were a few tables read for public meals. At one sat Agricola, whom I had en at work in the fields with his mother. At another my

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wife and I had breakfast. . . . The son of the house, a courteous and well-read man, waited upon us, and we talked of Beaumais and of the debt of gratitude which St Bartholomew's Hospital in London owed to Richard of Beaumais, the bishop who befriended our founder. "I knew," said the Norman, "that the lord of Beaumais had gone to the conquest of England with William, but that we had produced a Bishop of London was a detail of which I was ignorant.'

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The history of the Hospital of St Bartholomew is divided into two periods, each of four centuries, by its legal re-foundation in January 1547, as the House of the Poor in West Smithfield. The good citizens who persuaded Henry VIII to allow them to undertake the control of these ancient endowments had memories of the useful service rendered by the hospital to the community. They were, moreover, in some anxiety by reason of the lack of provision for the sick and vagabond poor in their streets. The new order imposed new civic obligations. And so, together with Christ's Hospital, St Thomas's and Bridewell, St Bartholomew's came under the direction of the Aldermen and Common Council of the City of London. The process of transfer lasted nearly ten years. At first the King preferred to revive the hospital on a limited foundation under the control of his own nominees. This unsatisfactory scheme lasted less than three years (1544-7), and gave way to the permanent administration based upon a covenant between King and citizens.

'The constitution under which the hospital is ruled to this day was established in 1547, and confirmed, with an alteration in but one important particular, in 1782. Most of the offices created by the Deed of Covenant of December 1546 and the letters patent of January 1547 exist at the present day. The treasurer, the almoners, the physician, the surgeon, the rentar, the steward, the matron and sisters, the porter bearing a figure of St Bartholomew on his staff of office, and the beadles with silver badges engraved with the hospital arms, are all parts of the present life of the hospital.' †

It would be easy to exaggerate the extent of the change. Municipal hospitals were common in mediæval

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imes, and it was natural for men of 'charitable intenons and business habits' to keep together the scattered ents of the well-known foundation and to apply to their ontrol the methods which they used in the administraion of their own affairs. The hospital had long ago haken off the authority of the neighbouring Priory of t Bartholomew and had shared in the civic as well as the religious life of London. That it should continue o do so was not remarkable. There was nothing abrupt the transition from the England of Henry V to the England of Oliver Cromwell. Against the background slow change, the dissolution of the monasteries, the urning of martyrs, the battle of Naseby, even the xecution of King Charles, seem anything but catasophic. For most people medieval is also Tudor England -a land of late domestic Gothic, panelled rooms, oak urniture, rich tapestries, of processions and quaint old ustoms; and one feels how easily the St Bartholomew's Henry's foundation, as it is described in the 'Order' sued by the Lord Mayor in 1552, might have survived, ke so many other medieval hospitals and almshouses, a charming relic of old England.

That St Bartholomew's has not merely survived, t grown into the noble institution described by Sir orman Moore, is due to causes of which Henry and the tizens could have foreseen as little as the original under. The condition of development was a succession governors willing to adapt the customs of the foundaon to meet the needs of a great city; but the growth the hospital was due to the unrelenting claims of the w learning. The hospital was inspired by men who uld give the best interpretation to the religious and aritable intentions of its founders, and worked for the vancement no less than the application of knowledge. was swept into the service of a movement as fiercely interested as any monastic order. The most interestg pages of Sir Norman Moore's book are those in which shows how St Bartholomew's shared in the advance medical science, and describes the travels of Caius and

See Miss Clay's 'Medieval Hospitals of England' (London, 1909). ne passages from Riley's 'Memorials of London,' quoted by Mr Coulton his 'Social Life in Britain' (pp. 502-6), suggest that in the 14th tury London possessed a sort of municipal medical service.

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Harvey and the efforts of Abernethy to organise the medical school.

Sir Norman Moore, however, fills the whole of his first volume and part of his second with the record of the hospital in medieval times, when St Bartholomew's near Smithfield was but one of many hospitals dedicated to this saint, and had no very distinctive rôle in the study of medicine or the service of the sick. This part of his book is primarily a contribution to the history of medieval London. With the exception of the Ordinances issued by the Bishop of London in 1316, there do not appear to be any details of distinctive interest regarding the daily life and administration of the hospital. It is rather surprising that more is not known of St Bartholo mew's as a medical centre during the Middle Ages. Before the end of the 12th century it had acquired some fame for its cures; and, as Sir Norman Moore has already pointed out in his lectures on the History of the Study of Medicine in the British Isles (London, 1908), John Mir field, in the latter part of the 14th century, wrote his 'Breviarium Bartholomei' in the neighbouring priory Mirfield had access to a good medical library, and may be presumed to have left at least some of his books to the priory which had given him shelter. But there is no evidence that the hospital encouraged learning or pos sessed a medical library of its own or, indeed, many other books.†

The legendary stories of early cures will be found in the Libe Fundacionis, of which Sir Norman Moore published the 15th-century English translation in 1886. He gives numerous quotations from it in the present work.

† John Cok, who compiled the cartulary in the early 15th century also copied various well-known theological treatises, hymns, etc., in MS. now in the British Museum (Add. MS. 10392). As Sir Norma Moore suggests, the works which he copied may have been in the hospita library, but it is more likely that they were in a neighbouring library The copy of Gratian's decretals, mentioned on p. 108 of the second volume surely belonged to the priory, and not to the hospital. A study of early medical manuscripts is required. Sir Norman Moore considers (1, 279) that in the early 13th century, Isidore of Seville was the only writer upon medical subjects with whom students would be familiar. Another favourite writer was Gariopondus of Salerno, who died in the middle of the 11th century, and compiled a Passionarium found in medieval catalogues. is frequently styled 'Passionarium Galeni,' and was printed at Lyons i 1526 under this title. Simon Bredon, a physician of the 14th century who was himself for a time master of a hospital in Maidstone, possessed

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