Medieval hospitals went by a variety of names, most of them rooted in religious charity rather than medical treatment. In France, they were called Hôtels-Dieu (“Houses of God”) or Maisons-Dieu (“God’s Houses”). In England and across much of Europe, common names included “spital” (a shortened form of “hospital”), “almshouse,” “bedehouse,” and “infirmary.” Many were simply named after the saint they were dedicated to, like the Hospital of St. Oswald or the Hospital of St. Nicholas. The word “hospital” itself comes from the Latin “hospitale,” meaning a place of hospitality for guests and strangers, and that meaning shaped what these institutions actually did.
The Names and What They Meant
The terminology varied by country, but the core idea was the same: these were places of shelter and charity, not clinics in the modern sense. In France, any medieval hospital could be called an Hôtel-Dieu. The name stuck so firmly that French hospitals with roots in the Middle Ages still carry it today. The most famous, the Hôtel-Dieu de Paris, was traditionally founded around 651 CE by Bishop Landry near Notre-Dame Cathedral to serve the poor, homeless, and pilgrims.
In England, the terms “hospital,” “almshouse,” and “bedehouse” were often used interchangeably. A bedehouse (from the Old English “bede,” meaning prayer) was a place where residents were expected to pray for the souls of their benefactors in exchange for shelter. Almshouses served a similar function, housing the elderly and poor. The oldest almshouse foundation still in existence is thought to be the Hospital of St. Oswald in Worcester, founded around 990 CE, where brothers would “minister to the sick, bury the dead, relieve the poor and give shelter to travellers who arrived after the city gates had closed at night.”
Within monasteries, the room or building set aside for treating sick monks was called the “infirmary,” from the Latin “infirmus” (weak or sick). This is one of the few medieval hospital terms that survived into modern use with roughly the same meaning. Another Latin term, “Domus Christi” (“House of Christ”), appeared across Europe for charitable hospitals run by religious orders.
What Medieval Hospitals Actually Did
The names hint at something important: medieval hospitals were not primarily places for medical treatment. They were institutions of Christian charity that provided food, shelter, and spiritual care to the poor, the elderly, pilgrims, and sometimes the sick. Healing the soul was considered at least as important as healing the body. Physicians often refused to treat patients who had not first made a confession, because purifying the soul from sin was seen as a prerequisite for physical recovery.
Many of these institutions housed only a few dozen people at a time. The Domus Christi in Dubrovnik, for instance, typically cared for around 30 patients and could not afford to employ physicians or surgeons. Instead, it relied on a barber (who performed minor surgical procedures like tooth extractions and wound care) and lower-level medical staff. Larger hospitals in cities might employ university-educated doctors, but this was the exception rather than the rule, especially before the 13th century.
By the mid-1500s, roughly 800 medieval hospitals were spread across England alone. Many of these were small, housing fewer than a dozen residents.
Monasteries as the First Hospitals
Before freestanding hospitals existed, monasteries filled the role. From the sixth century onward, the Rule of Saint Benedict required monks to care for the sick, and monasteries built dedicated infirmaries for that purpose. These facilities initially served sick monks and nuns but often extended care to lay residents and outside visitors as well.
Monastic medicine was built around the theory of humoral balance, the idea that health depended on keeping the body’s four fluids (blood, phlegm, yellow bile, black bile) in proper proportion. Monks practiced bloodletting and carefully regulated diets as preventive medicine. They also served as the primary keepers of medical texts, copying and preserving ancient Greek and Roman writings on health. Monasteries remained the most important sites for medical knowledge and care in Europe at least through the 13th century.
The Shift to City Hospitals
As European cities grew, hospitals gradually moved out of monasteries and into urban settings. Military religious orders like the Knights Hospitaller, founded during the Crusades, established hospitals specifically to treat wounded and sick soldiers, and their organizational model influenced civilian hospitals across Europe. City governments and wealthy merchants began founding their own institutions, independent of the Church.
These urban hospitals operated differently from their monastic predecessors. City-run hospitals employed university-trained physicians and were managed by priests or laymen under a bishop’s supervision, or sometimes by city officials directly. By the late medieval period, some cities required their physicians to make hospital rounds twice a day. Admission decisions, however, rested with hospital administrators, typically local aristocrats who selected which patients were “worthy” of treatment.
Craft guilds also entered the picture in the late 1500s, founding hospitals to care for their elderly and declining members. The benefactors behind these institutions ranged from kings and archbishops to ordinary merchants.
Famous Medieval Hospitals Still Standing
Several medieval hospitals survived the centuries. St. Bartholomew’s Hospital in London, founded in 1123 by Rahere, a courtier of Henry I, has provided continuous patient care on the same site for over 900 years, making it the longest-running hospital in England. It was originally established alongside the Priory of St. Bartholomew.
In France, notable examples from the Gothic period include the hospital at Angers (built between 1153 and 1184) and the hospital at Tonnerre (around 1300). These buildings featured large, open halls where patients lay in rows of beds, often with a chapel at one end so they could hear Mass from their sickbeds.
England’s dissolution of the monasteries in the 1530s and 1540s devastated the hospital system. Many of the roughly 800 medieval hospitals were sold off to private landowners or simply abandoned. The institutions that survived, like St. Bartholomew’s, did so because they were refounded under royal charter as secular institutions, severing their original ties to the Church.