The book's main question is: what were the attitudes of early Christians to medicine and

physicians? The question is addressed based on two guideline-questions: 1) what kind of healing
did Christians employ and 2) was it miraculous healing or healing by natural means (i.e.,
medicine)? (p. 1)

Pertanyaan yang dikemukakakan pada awal kekristenan mengenai pengobatan dan dokter
adalah :

1. Pengobatan sepertia apa yang dipercaya oleh umat kristen?

2. Apakah pengobatan mujizat atau pengobatan natural?

On chapters 2,3 and 4 Ferngren tries to prove that Christian medicine was an
appropriation of Greek, and Roman, knowledge and that, contrary to common view, they
accepted a naturalistic view of illness and health (i.e. demons as causation and exorcism as the
cure was not the only option and moreover it was not the dominant approach). Also, miraculous
and religious healing played a minor part.

Pada bab 2,3,4 ferngren mencoba membuktikan bahwa pengobatan kristen adalah
penyelarasan antara ilmu yunani dan romawi. Juga menerima pandangan natural mengenai
penyakit dan kesehatan (misalnya iblis adalah sebagai penyebab dan eksorsis adalah pengobatan
utama). Pengobatan dengan mujizat dan kepercayaan justru berperan sedikit.

The topic itself poses an immediate difficulty and that is the scarcity of sources. Not only
concerning Christian views on healing but also on Greek medicine sources. Vivian Nutton, a
researcher on Ancient Medicine that Ferngren refers to frequently in his work, as opposing to his
views, also considers the surviving sources of "fragmentary nature". (p. 2) This causes a serious
problem when one attempts to make sense out of them in order to make History. In order to
overcome this Ferngren recurs frequently to the Bible as main document perhaps because it is the
most reliable and non-fragmentary one.

Topik yang dibahas ini mengalami kesulitan karena sedikitnya sumber.

 On chapters 5 and 6 Ferngren dwells on the concept of philanthropy trying on one hand
to distinguish his meaning on the Graeco-Roman period and later on to early Christianity; on the
other hand showing that it was the understanding of the concept of philanthropy that has
established the ideological and theological background that led to the creation of the hospital
(4th Century CE.). Philanthropy started as the act of giving and benefiting those of your own
social status while in early Christianity it has extended to those from a lower social status'. This
meant that healing, and most importantly, care (p. 145) should be given to those in need. Firstly
because all men were equal and secondly because being ill was not a punishment or a possession,
it was rather an opportunity to restore one's spiritual connection with God (restoring your
physical health was secondary). This philantropic impulse, conducted by early Christians closely
associated with monastic orders, has inspired the creation of public institutions were the recovery
of health was aimed at. 

Ferngren always sustains his views making the most of the available data also exposing
others scholars' arguments -- sometimes agreeing and others not.

What one may question while reading the book is what the author felt the need to make
clear in Chapter 1 titled "Methods and Approach" where he establishes the concepts and states
his assumptions. For instance, Ferngren states that in the 5 th century b.C. "a new kind of
medicine arose in Greece that was based on the application of theory to disease as a means of
providing explanatory models". (p. 5) And this "medicine" is the knowledge that spread during
the Hellenistic period (323-330 BCE.) up to the Byzantine Empire (330-1453 CE.). This basic
idea guides the book and it may seem inconsequential.

But the consequence is that such concept of medicine eliminates several aspects of the
culture that are important to understand what "theory of disease" was in that context. Moreover it
seems to imply that these "explanatory models", as soon as they come to exist, were not in
contact with many other forms of conceiving illness and healing as they for sure were. By taking
such a statement as an assumption throughout the book we get what I think it is a biased view on
ancient medicine where one stands from a point of view that clearly states "to know", before
time, that medicine would become the dominant type of healing approach because it was
"scientifically" the most accurate one and that was somehow already implied since its early
beginnings.

This, I believe, it is a reductive perspective of the complexity of the understanding of

illness and healing in times when things were changing and new approaches were being taken,
not only motivated by events that were occurring in the Christian religion, but also by many
other cultural and social events (being war and territorial expansion two of them). Several
healing systems co-existed simultaneously during those times and none of them should be
neglected in favor of the most "scientific" one. Ferngren himself quotes Nutton that states that in
paganism (Graeco-Roman period) there was no tension in medicine but rather a striking
collaboration between priest and doctor while Christianity introduced new tensions into the
relationship between religion and medicine. (p. 146) He chooses to quote Nutton in order to
show that this is not so again recurring mostly to events related with the Christian movement and
the Bible. 

To sum it up, Ferngren's book is one that takes as a starting point the contemporary
concepts of religion and science and only then looks back on ancient history taking these as its
background. Though Ferngren is very accurate in his sources and detailed in his arguments this
perspective guides the whole rationale of the book which I think it offers a biased view on the
topic forcing it to fit a frame that did not exist in the Graeco-Roman world and during the early
days of Christianity.

Over two millennia, Christian doctors and nurses, inspired by the example and
teaching of Jesus of Nazareth, have been at the forefront of efforts to alleviate human
suffering, cure disease, and advance knowledge and understanding. Rosie Beal-Preston
examines how the Christian Church has played a major role in developing and shaping
the practice of Medicine.
Jesus of Nazareth taught: 'Whatever you did for one of the least of these brothers of
mine, you did for me.' (Matthew 25:40)

The hospital movement

 Before Christianity emerged, there were several hospital-like centres in Buddhist
regions. The ancient Greeks practised a very simple form of medicine and Greek temples
included places where the sick could sleep and receive help. The Romans are believed to
have established some military hospitals. However, it was the Christians of the Roman
Empire who began to change society's attitude to the sick, disabled and dying, by their
radically different outlook.

The Graeco-Roman world in which Christianity appeared was often cruel and
inhumane. The weak and the sick were despised. Abortion, infanticide and poisoning
were widely practised. The doctor was often a sorcerer as well being a healer and the
power to heal equally conferred the power to kill. Among the pagans of the classical
world only the Hippocratic band of physicians had a different attitude to their fellow
human beings. They swore oaths to heal and not to harm and to carry out their duty of
care to the sick.

However, it wasn't until Constantine granted the first Edict of Toleration in AD 311,
that Christians were able to give public expression to their ethical convictions and
undertake social reform. From the fourth-century to present times, Christians have been
especially prominent in the planning, siting and building of hospitals, as well as
fundraising for them. Cities with significant Christian populations had already begun to
change prevailing attitudes, and were already beginning to build hospices (guest houses
for the sick and chronically disabled).

Stories of Christian caring had enormous impact, even before Constantine's decree of
toleration. Clement, a Christian leader in Rome at the end of the first century of the
Christian era, records how the Christian community was already doing much to relieve
the plight of poor widows. In the second century when plague hit the City of Carthage,
pagan households threw sufferers onto the streets. The entire Christian community,
personally led by their bishop, responded. They were seen on the streets, offering comfort
and taking them into their own homes to be cared for. A few decades after Constantine,
Julian, who came to power in AD 355, was the last Roman Emperor to try to re-institute
paganism. In his Apology, Julian said that if the old religion wanted to succeed, it would
need to care for people even better than the way Christians cared.

As political freedom increased, so did Christian activity. The poor were fed and given
free burial. Orphans and widows were protected and provided for. Elderly men and
women, prisoners, sick slaves and other outcasts, especially the leprous, were cared for.
These acts of generosity and compassion impressed many Roman writers and
philosophers.

In AD 369, St Basil of Caesarea founded a 300 bed hospital. This was the first large-
scale hospital for the seriously ill and disabled. It cared for victims of the plague. There
were hospices for the poor and aged isolation units, wards for travellers who were sick
and a leprosy house. It was the first of many built by the Christian Church.

In the so-called Dark Ages (476-1000) rulers influenced by Christian principles

encouraged building of hospitals. Charlemagne decreed that every cathedral should have
a school, monastery and hospital attached. Members of the Benedictine Order dedicated
themselves to the service of the seriously ill; to 'help them as would Christ'. Monastic
hospitals were founded on this principle.

In the later Middle Ages, in cities with large Christian populations, monks began to
'profess' medicine and care for the sick. Monastic infirmaries were expanded to
accommodate more of the local population and even the surrounding areas. A Church ban
on monks practising outside their monasteries gave the impetus to the training of lay
physicians. It was contended that this interfered with the spiritual duties of monks. So
gradually cathedral cities began to provide more large public hospitals with the support of
the city fathers and this moved medical care more into the secular domain.

Nevertheless, expansion of health care by the secular authorities continued to be

challenged and stimulated by the Church's example. Eventually there were few major
cities or towns were without a hospital. And there were particular diseases, such as
leprosy, where the Church, inspired by the example of Jesus who made a point to touch
and heal these outcasts from society, took a lead. The Church built countless leprosy
isolation hospitals. Even though actual medical knowledge was meagre when compared
to modern standards, the efforts of the Christian Church nevertheless brought relief and
mitigation of suffering to thousands of sick people. And perhaps just as importantly, it
heralded a new, more humane attitude to the sick and elderly.

In England suffering was caused when King Henry VIII suppressed the monasteries.
The Reformation deprived many suffering and disabled people of their only means of
support. Patients of hospitals like St Thomas' and St Bartholomew's, founded and run by
monastic orders, were thrown onto the streets. The onus for health care was placed firmly
on the City Fathers and municipalities were forced to pay more attention to the health
problems of the community.

It was not until the eighteenth century that the Christian hospital movement re-
emerged. The religious revival sparked in England by the preaching of John Wesley and
George Whitefield was part of an enormous unleashing of Christian energy throughout
'Enlightenment' Western Europe. It reminded Christians to remember the poor and needy
in their midst. They came to understand afresh that bodies needed tending as much as
souls.

A new 'Age of Hospitals' began, with new institutions built by devout Christians for
the 'sick poor', supported mainly by voluntary contributions. The influence of this new
age was felt overseas as well as in England. Health care by Christians in continental
Europe received a new impetus. The first hospitals in the New World were founded by
Christian pioneers. Christians were at the forefront of the dispensary movement (the
prototype of general practice), providing medical care for the urban poor in the congested
areas of large cities.

The altruism of these initiatives was severely tested when cholera and fever
epidemics appeared. Larger hospitals often closed their doors for fear of infection. While
wealthy physicians left the cities for their own safety, doctors and the staff of these small
dispensaries, driven by Christian compassion, remained to care for the sick and dying.
Christian philanthropists inspired setting up the London Fever Hospital to meet the
desperate needs of those living without sanitation in overcrowded tenements. Christian
inspiration continued to identify specific needs, leading to opening of specialist units:
maternity and gynaecology hospitals, and institutions for sick and deserted children.
When the National Health Service took over most voluntary hospitals, it became clear
just how indebted the community was to these hospitals and the Christian zeal and money
that supported them over centuries.

Advance of medical knowledge

As well as taking a leading role in caring for the sick, Christians also played very
important part in the furtherment of medical knowledge. Together, Jews and Christians
took the lead in collecting and copying manuscripts from all over Europe after the
burning of the Great Library at Alexandria. This rescued much medical knowledge for
the religiously tolerant Arabic Empire and for later generations.

During the Dark Ages, Arabic medicine advanced considerably due to their access to
these documents. In Europe, however, progress was comparatively slow. It was Christian
thought that led to the formation of the Western universities. Founding of medical
faculties was often due to Christian initiative. So too were attempts to raise standards of
research and care.

During this period, the field of surgery saw most progress. Christians were among
those advocating the need for cleanliness and less use of the cautery in treating wounds.
Chauliac, the author of Chirugia Magna (Textbook of Surgery) was a priest and surgeon,
who made many advances in orthopaedics. He led by example, staying at his post to
investigate the plague and treat its victims when many of his colleagues fled.

In the Middle Ages there emerged a clash between those who relied dogmatically on
ideas and theories passed on from Classical sources, and the new attitudes to research
fostered by the growing influence of what is now called modern science. Christians such
as Grosseteste, Bacon and Boyle encouraged experiment instead of simply relying on old
traditions. The Royal Society was founded to encourage research, and the majority of its
early members were Puritan or Anglican in origin. The discovery of printing (the first
printed book in Europe was a Bible) and the Reformation sparked by Martin Luther were
major forces in promoting intellectual liberty, and by the sixteenth century medical
progress was advancing rapidly.

Many very important discoveries in many medical fields were made by people who
held a Christian commitment and there is not room to mention them all here: William
Harvey (circulation), Jan Swammerdam (lymph vessels and red cells) and Niels Stensen
(fibrils in muscle contraction) were all people of faith, while Albrecht von Haller, widely
regarded as the founder of modern physiology and author of the first physiology
textbook, was a devout believer; Abbe Spallanzani (digestion, reproductive physiology),
Stephen Hales (haemostatics, urinary calculi and artificial ventilation), Marshall Hall
(reflex nerve action) and Michael Foster (heart muscle contraction and founder of Journal
of Physiology) were just some among many others.

The same can be said of the advance of surgical techniques and practice. Ambroise
Pare abandoned the horrific use of the cautery to treat wounds and made many significant
surgical discoveries and improvements. The Catholic Louis Pasteur's discovery of germs
was a turning point in the understanding of infection. Lister (a Quaker) was the first to
apply his discoveries to surgery, changing surgical practice forever. Davy and Faraday,
who discovered and pioneered the use of anaesthesia in surgery, were well known for
their Christian faith, and the obstetrician James Simpson, a very humble believer, was the
first to use ether and chloroform in midwifery. James Syme, an excellent pioneer
Episcopalian surgeon, was among the first to use anaesthesia and aseptic techniques
together. William Halsted of Johns Hopkins pioneered many new operations and
introduced many more aseptic practices (eg rubber gloves), while William Keen, a
Baptist, was the first to successfully operate on a brain tumour.
 Clinical medicine and patient care
It is not surprising to find that, again, due to their commitment to love and serve those
weaker than themselves as Christ did, people of faith were at the forefront of advancing
standards of clinical medicine and patient care throughout the ages. Thomas Sydenham is
sometimes hailed as the 'English Hippocrates'. He stressed the importance of personal,
scientific observation and holistic care for patients, and he was one of the brave 'plague
doctors' who did not desert the sick and dying during the Great Plague of London.
Herman Boerhaave followed in Sydenham's footsteps, and was very influential in
pioneering modern clinical medicine, while William Osler taught all medical students to
base their attitudes and care for their patients on the standards laid down in the Bible.

Medical ethics
The Hippocratic ideal was expanded by doctors such as Thomas Browne
(seventeenth-century), a godly physician who was one of the first to write on medical
ethics and whole-person care. Thomas Percival, a zealous social reformer as well as a
physician of integrity, drew up the first professional code of ethics in the eighteenth-
century. From that time Christian thought has shaped much of the modern profession's
ethical conduct, promoting personal integrity, truthfulness and honesty.

Many early GPs were religious men, and non-believers often unconsciously
continued to follow the prevailing general principles of Christian ethics. Two devastating
world wars, followed by increasing secularisation and humanistic thought, combined with
rapidly advancing ability to perform new medical procedures, have brought about
unprecedented ethically uncertain situations. Bioengineering, genetics and surgery
urgently require new codes of ethics, and many of the current laws and suggestions by
regulatory bodies have been influenced by the Christian attitude and outlook.

Specialities
The Christian contribution to the many specialist branches of medicine is huge. There
is only room to mention a few, such as Laennec, a Catholic, who invented the
stethoscope. The emerging practice of orthopaedics was much enhanced by the Lutheran
Rosenstein's textbook on the subject, while the devout Underwood's Treatise on the
Diseases of Children became a classic. Still's disease was named after George Still of
King's College Hospital and Great Ormond Street Hospital, who was a Lutheran and a
vigorous supporter of Barnardo's homes. In the field of dermatology, Willan (who wrote
a history of Christ) was the first to classify skin diseases, while many Christian
clergymen-physicians such as Blackmore, Willis and Fox were pioneers in the of advance
of psychiatry. In the USA Daniel Drake, an Episcopalian, was among the first to study
geographical pathology, and WH Welch of the Johns Hopkins, was an outstanding
Christian pathologist who discovered the bacillus of gas gangrene. JY Simpson, Howard
Kelly and Ephraim McDowell, all devout believers, were towering figures in obstetrics
and gynaecology. Whilst most medical advances and discoveries have taken place in
hospitals, numerous general practitioners such as Sydenham, James Mackenzie and
Clement Gunn worked tirelessly in day-to-day practice, striving to embody the ideals of
Christianity in their ethics and care of their patients.

Public health, preventative medicine and epidemiology

Early on Christians realised the connection between health and hygiene. Girolamo
Fracastoro, a very versatile student in the sixteenth-century, began to investigate the
spread of contagious diseases. In the next century his work was continued by Thomas
Sydenham. Ministers advocated personal hygiene. It was John Wesley who said
'Cleanliness is, indeed, next to Godliness.' The social activism of the Quakers is well-
known, among them John Fothergill who campaigned to eliminate social wrongs on
grounds that they undermined the health of the people. Another Quaker, John Howard,
had a great concern for prisons, where overcrowding and typhus were rife, and
successfully promoted two prison reform Acts of Parliament. Edward Jenner, a devout
man, was responsible for the beginnings of immunology and in ridding the world of the
scourge of smallpox.

Social need
In the nineteenth-century, the Industrial Revolution had led a drift to the inner cities
and intense social needs among the poor. It was the Quakers, Evangelicals and
Methodists who in particular applied themselves vigorously to meeting these needs. A
nation wide movement of Christian missions to help the poor was founded. Huge sums of
money was raised by voluntary subscriptions. And armies of volunteers went to slum
areas to offer practical help. Attention was paid to the misfits of society, such as
drunkards, criminals and prostitutes, as well as homeless teenagers.

The Salvation Army, founded in 1865 by William Booth, provided much-needed

medical care in impoverished inner city areas and homes for women who had been
induced into prostitution. Unmarried mothers were cared for, and these projects have
spread all over the world. Great Ormond Street Hospital was founded by Charles West, a
Baptist, to meet the needs of sick children who were inadequately cared for by 'habitually
drunk (nurses) with easy-going, selfish indifference to their patients, and no knowledge
or skill of nursing.'

Dr Thomas Barnardo set up his children's homes after seeing the terrible plight of
thousands of hungry and homeless children in the East End. Inner city missions bringing
a combination of medical care and the gospel were set up. Christians were at the forefront
of temperance movements. Care for the blind and deaf were areas drawing direct
inspiration from Jesus. Use of Braille worldwide and schools for the deaf were pioneered
by evangelical Christians.

St Joseph's Hospice in Hackney, founded by the Sisters of Charity in 1905, was the
prototype of the modern hospice movement. Dame Cicely Saunders founded St
Christopher's Hospice in 1967, with the aim of providing as peaceful an atmosphere as
possible for those in their terminal illness, while offering an environment of Christian
love and support.

Developing world missions

Jesus commanded his followers to go and make disciples of all nations (Matthew
28:19), as well as exhorting them to love their neighbours as themselves. There have been
several waves of missionary work during two millennia, and in each case medical work
has played a key part.

Dr John Scudder was among the first Western missionaries of the modern era and in
1819 went to Ceylon. Among the best-known pioneer medical missionaries were David
Livingstone (Central Africa), Albert Schweitzer, a talented doctor, theologian and
musician, who devoted his life to people living in the remote forests of Gabon, and Albert
Cook, who founded Mengo Hospital in Uganda. William Wanless founded the Christian
Miraj Hospital in India, and Ida Scudder founded the world-famous Vellore Medical
College in the same country. Hudson Taylor spread the gospel and western medicine to
China and founded the China Inland Mission. Paul Brand pioneered missions to lepers.
Henry Holland and his team, working in the north-west frontier of the Indian sub-
continent, operated on hundreds of cataracts every day. Others have been influential in
the prevention of such diseases as malaria and tuberculosis.

Women doctors
There was a strong Christian element in the motivation of the pioneers of medical
education for women. Elizabeth Blackwell, the first woman doctor, was a Quaker, while
Elizabeth Garrett came from a very devout family. Ann Clark, another Quaker, was the
first woman surgeon and worked at the Women's Hospital and the Children's Hospital in
Birmingham. Sophia Jex-Blake, another devout Christian, founded the London School of
Medicine for Women, while Clara Swain was the first woman doctor to go overseas (to
Asia) as a medical missionary.

Nursing
Modern nursing owes much to Christian influences. Most nursing, like most
medicine, was carried out by monastic orders within their own hospitals for centuries. In
AD 650, a group of devout nuns volunteered to take care of the sick at the Hotel Dieu in
Paris, and most other nursing followed this pattern. In the seventeenth-century, a parish
priest shocked by the conditions in the poor quarters of Paris, set up a nursing order under
the name of Dames de Charite. Civic and secular authorities were somewhat slow to
recognise the need for paid, rather than voluntary nurses. In the nineteenth-century,
'modern nursing' was born, in no small measure due to the work of Elizabeth Fry and
Florence Nightingale. Their revolution in the practice of nursing included making it a
more socially acceptable pursuit for women. Florence Nightingale was deeply influenced
by a small Christian hospital at Kaiserswerth in Germany, run by 'deaconesses', a group
of Protestant women. Their response to biblical commands to care for the sick and
educate neglected children, provided the templates for modern daily hospital nursing.
Florence Nightingale encouraged better hygiene, improved standards and night-nursing,
as well as founding the first nursing school. Nurses gained professional status at the end
of the century, largely thanks to the work of Ethel Bedford Fenwick, with the majority of
nurses being inspired to serve by Christian ethics. Many missionary nurses such as
Mother Teresa and Emma Cushman have worked tirelessly, bringing hygiene and
Western medicine to the four corners of the globe.

A new allegiance
This article has aimed to present some of the enormous contribution the followers of
Christ have made to the science and practice of medicine. Christians have consistently
raised the social status of the weak, sick and handicapped and sought to love and care for
them to the utmost of their abilities. Christians have been pioneers among hospital
building and staffing, in research and ethics, in promoting increased standards of care,
and in immunology, public health and preventative medicine. They have carried Western
Medicine across the globe and improved the quality of life for countless millions of
people.

Christianity gives men and women a new perspective and allegiance; their lives are
spent in joyful grateful service of the God who has redeemed them and given them new
life. In many ways, Christianity and medicine are natural allies; medicine gives men and
women unique opportunities to express their faith in daily practical caring for others,
embodying the commands of Christ; 'whatever you did for one of the least of these
brothers of mine, you did for me.' (Matthew 25:40)
 According to historian Gary Ferngren in Medicine and Health Care in Early
Christianity:

The experience gained by the congregation-centered care of the sick over several
centuries gave early Christians the ability to create rapidly in the late fourth century a
network of efficiently functioning institutions that offered charitable medical care, first in
monastic infirmaries and later in the hospital.

The Protestant Revolution, the Endarkenment, the French Revolution, and its
intellectual descendants have brought abrupt and sometimes violent disruptions, if not a
complete end, to this vast charitable network in many places. Yes, “evil” religion and
“papism” had to be smashed and replaced by the “humanitarian” Animal Farm of the
Leviathan state. Ha, how “compassionate.” But I digress….

Now, am I suggesting that the U.S. return to the exact health care system of the early
Church? Of course not! This straw man entirely misses the point that I’m trying to
communicate here. I’m not suggesting a structure and system in itself but rather an
approach and a set of principles that need to be incorporated into the American health
care system. And the Christian churches, esp. the Catholic Church, need to recommit
themselves to their obligation to care for the indigent sick and need to take an active role
in articulating and promoting these Christian principles to everyone.

What are those principles?

Generally and most importantly, care for the physical needs of human beings do NOT
override Christian moral imperatives not to steal and commit violence, even from and
against the rich. Spiritual needs override any physical needs.
The health of the poor in one’s local community must be a pressing concern of all
Christians.
Care for the sick is an essential duty of local churches that should not be relinquished
to the nation-state.
 In general, care for the sick is not to be financed by state-coerced wealth
redistribution but by the patients themselves or charity.
However, to whom much is given, much is expected. The rich are morally obligated
to voluntarily direct their wealth to the health care of the poor, starting in their local
communities.
If the state is to assist in financing health care in any way (which I doubt is
necessary), it should be done as locally as possible, according to the Catholic moral
principle of subsidiarity.
Medicine today is vastly more accurate, comprehensive, sophisticated, technological,
and effective. That also means that, aside from higher costs caused by government
interference in the industry, health care is naturally more expensive now because it is so
much more valuable than it was centuries ago. But none of these facts change or
undermine the Christian principles I’ve laid out above. Politics itself has shown that more
than enough money can be raised through a well-organized solicitation of voluntary
donations.

The fact that modern medicine can treat so many maladies naturally and
psychologically creates more pressure to assure every sick person receives treatment. But
again, that pressure should not tempt us to stifle charity through state-enforced plunder.
That pressure belongs on us as individuals, esp. the rich, who must care for modern-day
Lazarus or face an eternal punishment.

It is an inverse relationship and a zero sum game between government control and
Christian charity. The former stifles the latter. Even if socialized medicine did work
better (it never does), it would do no good for us to gain all the bodily health in the world
yet become mortally and spiritually sick in the process.

Gary Ferngren’s excellent and thought-provoking work is an invitation to reconsider

some ideas about early Christianity and its relation to medicine that we have too long
taken for granted. His main arguments are the following: Christianity was not a religion
of healing, which means that Christ’s miracles did not aim to heal people (like
Asclepius), but were signs to attest his divine nature. Miraculous healing (and miracles in
general) was not common among Christians during the first to third centuries ce. A sick
Christian turned to physicians and not to magical–ritual-religious healing. Christian
theological and practical philanthropy led to non-medical care for the sick, poor and
distressed. With charity and organisation and money, Christianity led to organised (still
non-medical) urban health care.

Chapter 2 focuses on the approaches to Greek medicine and physicians of the second-
century apologists (Tertullian, Origen, Tatian and Arnobius) traditionally regarded as
hostile to medicine. Ferngren reassesses these attacks either as exceptions, or as referring
to particular cases, and by no means typically Christian. In favour of Christians’ high
valuation of medical practice he lists its popularity as an analogy for the healing of the
soul, together with the naturalistic aetiology of diseases probably shared by most sick
people, pagan or Christian. One could object that attributing an illness to natural causes
would not deter the sick person from turning to healing deities or other ritual healing
practices. Similarly, when it comes to the versatile and varied class of healing
professionals, turning to any of them does not always reflect the patient’s aetiology of his
own disease, but often depends on availability, the advice of others, the healer’s fame and
popularity, the patient’s financial means, or his possibilities of travel. What facilitated the
embrace of medicine by Christians, in Ferngren’s view, was the fact that, unlike Greek
philosophy, ‘medicine, like natural philosophy, could be detached from its pagan
framework with relative ease’ (p. 40). Chapter 3 emphatically argues against ‘the thesis
that early Christian sources ascribed all illness to demonic etiology’ (and substitutes for
the exaggeration all, the equally great exaggeration none). A valuable section on demons
follows, which distinguishes between demonic possession that requires exorcism, and
demon-caused illness that calls for healing. One could easily continue this line of thought
and posit a distinction between miraculous healing sought for naturally caused disease
and demon-caused illness.
 The key concept of Chapter 4 is that the New Testament miracles ‘represent the
external aspect of salvation, the physical manifestation of a new spiritual order’ (p. 65)
and are not to be viewed per se as healing miracles. Christians, however, were soon to
face the challenge put by successful pagan healing miracles. They had to come up with a
response and a valuation: ‘when claims of contemporary miraculous cures were put
forward in the second century, in debate between the followers of Jesus and those of
Asclepius, Christians discovered cures were abundant and whose claims were hard to
deny, let alone to match’ (pp. 70–1). The value of this observation is shown by the fact
that it accommodated different possible accounts. Ferngren’s is that Christians simply did
not consider healing important until the fourth century, but put considerable effort into
organised, non-professional, mostly palliative care of the sick. This attitude had a two-
fold basis: in Christian medical philanthropy (Chapter 5), which actively cared for the
sick, especially during plagues; and also outside the community of Christian worship.
The theological imperative behind this was the doctrine of the imago Dei: ‘every human
life has an absolute intrinsic value as a bearer of God’s image and as an eternal soul’;
while money, writes Ferngren, came from wealthy individuals, long before state
sponsorship began in 313. Christians’ long experience in medical charity prepared the
way for the eventual establishment of the first hospitals as faith institutions (Chapter 6).
Christians were able to organise themselves well for a large-scale charity activity, and
church communities soon created minor clerical orders to assist them, chosen for spiritual
rather than medical qualifications. In Ferngren’s words, the hospital was ‘in origin and
conception, a distinctively Christian institution, rooted in Christian concepts of charity
and philanthropy’. It had, as he sees it, no ancient precursors either in the sphere of
medical care, or in that of religious healing.

What may the reader feel is missing from Ferngren’s argument? The parallel world of
non-medical healing, undoubtedly a contemporary reality. But even if the reader
concentrates only on the medical side, and on the Christians’ appreciation of medicine, he
or she would naturally be curious about the process of adapting medical practice to the
needs of faith. How were Hippocratic and Galenic scientific medicine transmitted? How
did they become accepted and incorporated into the new Christian paideia, especially as
medicine, and the study of medicine, was after all a pagan art, with many of its
practitioners closely linked to Greek philosophy and to the fading late Antique pagan
intelligentsia?

The book is a challenge, in the best sense, and has an important place in the ongoing
dialogue between medical historians and Classical and New Testament scholars. In
addition to his scholarly qualities, Ferngren has a sympathetic approach and an engaging
ability to step back and see the object of research and the research itself as part of a larger
picture. ‘The modern age is a historical period like any other, limited in its perspective by
time and culture … Understanding that we, too, have historical and cultural limitations
forces us to view the past in a manner that is neither patronizing nor disparaging but
appreciative of the power of ideas and practices that we do not always share or fully
understand’ (p. 10).

Medicine and Health Care in Early Christianity

Gary B. Ferngren
Gary Ferngren's book title is the result of a compilation of several articles written
between 1982 and 2006. Though they have been merged, rewritten and partly adapted
and modified, as you read it there is a sense that each chapter (apart from the first and last
ones) has an individual structure. Although there is an effort to make the book result as a
hole there are themes that are recurring adding nothing new and arguments that one
would expect to be given, to defend a specific point, that never take place. Having said
this, it is important to clearly state that the author has an impressive knowledge of
bibliography on the subjects of Greece and Rome, Science and Religion, and Ancient
Medicine -- which are the author's research and teaching areas since 1970 at Oregon State
University (Department of History).

The book's main question is: what were the attitudes of early Christians to medicine
and physicians? The question is addressed based on two guideline-questions: 1) what
kind of healing did Christians employ and 2) was it miraculous healing or healing by
natural means (i.e., medicine)? (p. 1)

On chapters 2,3 and 4 Ferngren tries to prove that Christian medicine was an
appropriation of Greek, and Roman, knowledge and that, contrary to common view, they
accepted a naturalistic view of illness and health (i.e. demons as causation and exorcism
as the cure was not the only option and moreover it was not the dominant approach).
Also, miraculous and religious healing played a minor part.

The topic itself poses an immediate difficulty and that is the scarcity of sources. Not
only concerning Christian views on healing but also on Greek medicine sources. Vivian
Nutton, a researcher on Ancient Medicine that Ferngren refers to frequently in his work,
as opposing to his views, also considers the surviving sources of "fragmentary nature".
(p. 2) This causes a serious problem when one attempts to make sense out of them in
order to make History. In order to overcome this Ferngren recurs frequently to the Bible
as main document perhaps because it is the most reliable and non-fragmentary one.

On chapters 5 and 6 Ferngren dwells on the concept of philanthropy trying on one

hand to distinguish his meaning on the Graeco-Roman period and later on to early
Christianity; on the other hand showing that it was the understanding of the concept of
philanthropy that has established the ideological and theological background that led to
the creation of the hospital (4th Century CE.). Philanthropy started as the act of giving
and benefiting those of your own social status while in early Christianity it has extended
to those from a lower social status'. This meant that healing, and most importantly, care
(p. 145) should be given to those in need. Firstly because all men were equal and
secondly because being ill was not a punishment or a possession, it was rather an
opportunity to restore one's spiritual connection with God (restoring your physical health
was secondary). This philantropic impulse, conducted by early Christians closely
associated with monastic orders, has inspired the creation of public institutions were the
recovery of health was aimed at.
 Ferngren always sustains his views making the most of the available data also
exposing others scholars' arguments -- sometimes agreeing and others not.

What one may question while reading the book is what the author felt the need to
make clear in Chapter 1 titled "Methods and Approach" where he establishes the concepts
and states his assumptions. For instance, Ferngren states that in the 5th century b.C. "a
new kind of medicine arose in Greece that was based on the application of theory to
disease as a means of providing explanatory models". (p. 5) And this "medicine" is the
knowledge that spread during the Hellenistic period (323-330 BCE.) up to the Byzantine
Empire (330-1453 CE.). This basic idea guides the book and it may seem
inconsequential.

But the consequence is that such concept of medicine eliminates several aspects of
the culture that are important to understand what "theory of disease" was in that context.
Moreover it seems to imply that these "explanatory models", as soon as they come to
exist, were not in contact with many other forms of conceiving illness and healing as they
for sure were. By taking such a statement as an assumption throughout the book we get
what I think it is a biased view on ancient medicine where one stands from a point of
view that clearly states "to know", before time, that medicine would become the
dominant type of healing approach because it was "scientifically" the most accurate one
and that was somehow already implied since its early beginnings.

This, I believe, it is a reductive perspective of the complexity of the understanding of

illness and healing in times when things were changing and new approaches were being
taken, not only motivated by events that were occurring in the Christian religion, but also
by many other cultural and social events (being war and territorial expansion two of
them). Several healing systems co-existed simultaneously during those times and none of
them should be neglected in favor of the most "scientific" one. Ferngren himself quotes
Nutton that states that in paganism (Graeco-Roman period) there was no tension in
medicine but rather a striking collaboration between priest and doctor while Christianity
introduced new tensions into the relationship between religion and medicine. (p. 146) He
chooses to quote Nutton in order to show that this is not so again recurring mostly to
events related with the Christian movement and the Bible.

To sum it up, Ferngren's book is one that takes as a starting point the contemporary
concepts of religion and science and only then looks back on ancient history taking these
as its background. Though Ferngren is very accurate in his sources and detailed in his
arguments this perspective guides the whole rationale of the book which I think it offers a
biased view on the topic forcing it to fit a frame that did not exist in the Graeco-Roman
world and during the early days of Christianity.

As Christians join the rest of the country in jousting over the proposed changes to our
health care system, one significant fact should inform the Christian debate: modern health
care is a Christian invention. The reasons Christians developed the world's first health
care system—as opposed to simply medical practitioners—are as relevant today as they
were 2,000 years ago.

How and why early Christian health care came about is the subject of Gary Ferngren's
book Medicine and Health Care in Early Christianity. Ferngren, a professor of history at
Oregon State University, argues with his fellow academics who believe that early
Christians opposed medicine, thinking that all illness was caused by demons. Instead,
Ferngren says, "Christians of the first five centuries held views regarding the use of
medicine and the healing of disease that did not differ appreciably from those that were
widely taken for granted in the Graeco-Roman world."

Many of Ferngren's colleagues in this field of research must think that early
Christians believed demons brought on disease and that exorcism was the only cure.
Nothing else could explain the lengths he goes to—two-thirds of the book—debunking
the notion.

Medicine, as developed by the Greeks, was a naturalistic field. Doctors studied the
body, made observations, and practiced their art without appeal to Greek divinities. So
Christians had no reason to oppose its practice. They did, however, advise fellow
believers on how to use medicine. For example, some preachers taught that the truly
spiritual would forgo medical care, relying on prayer alone, but all taught that God heals
through the work of the physician. In addition, medical literature—a piece of classical
education—provided a wealth of metaphors and illustrations that educated Christian
preachers wove into their sermons.

Imago Dei and ancient health care

When an epidemic struck in the ancient world, pagan city officials offered gifts to the
gods but nothing for their suffering citizens. Even in healthy times, those who had no one
to care for them, or whose care placed too great a burden on the family, were left out to
die.

Christians found this intolerable, and they set about to take care of these people and
others similarly afflicted. They did so because, Ferngren writes, "Early Christian
philanthropy was informed by the theological concept of the imago Dei, that humans
were created in the image of God."

This led not only to a belief in the responsibility to aid others and the inherent worth
of every human being, but also to a belief in the sacredness of the body itself. "It was to
save the body that Christ took on flesh in the Incarnation. Not only the soul, which in
traditional pagan thought was eternal, but the composite of body and soul, which
constituted man, was to be resurrected."

The idea of imago Dei also led to a redefinition of the idea of the poor. Rights in a
city or society were given to members, and all members received benefits. Those outside
were offered none. Christianity, in addition to seeing all people as "neighbors," developed
a special consideration for the poor. Just as God demonstrated in the Incarnation his
solidarity with those who suffer, so the members of his "body" must demonstrate their
solidarity with the suffering poor.

The classical understanding of civic care for those who suffered "was not merely
insufficient to provide the motivation for private charity; it actively discouraged it,"
writes Ferngren. "Christianity, however, insisted that the love of God required the
spontaneous manifestation of personal charity toward one's brothers: one could not claim
to love God without loving his brother."

TABLE OF CONTENTS

Drawing on New Testament studies and recent scholarship on the expansion of the
Christian church, Gary B. Ferngren presents a comprehensive historical account of
medicine and medical philanthropy in the first five centuries of the Christian era.

Ferngren first describes how early Christians understood disease. He examines the
relationship of early Christian medicine to the natural and supernatural modes of healing
found in the Bible. Despite biblical accounts of demonic possession and miraculous
healing, Ferngren argues that early Christians generally accepted naturalistic assumptions
about disease and cared for the sick with medical knowledge gleaned from the Greeks
and Romans.
 Ferngren also explores the origins of medical philanthropy in the early Christian
church. Rather than viewing illness as punishment for sins, early Christians believed that
the sick deserved both medical assistance and compassion. Even as they were being
persecuted, Christians cared for the sick within and outside of their community. Their
long experience in medical charity led to the creation of the first hospitals, a singular
Christian contribution to health care.