Copyright © The Malta Historical Society, 2005.

Source: Melita Historica : Journal of the Malta Historical Society. 1(1953)2(111-112)

[p.111] Reviews 1953

EDGAR ERSKINE HUME: Medical Work of the Knights Hospitallers of Saint John of Jerusalem. Baltimore, John Hopkins Press, 1940. pp. xxii, 371.

Innumerable books have been written about the Order of the Knights Hospitallers of St John of Jerusalem, but curiously enough very little has been published with particular reference to the main object for which that Order was originally founded, i.e. the care of the sick. Any contribution to the literature of this important subject is welcomed, so long as it is carried out in a scientific manner. This book satisfies a long felt want.

Colonel Hume was well qualified to undertake this work. He was a distinguished Officer in the Medical Corps of the United States Army and saw much active service during the First World War. After that war he was engaged on relief work in Central Europe and spent some years on the Adriatic seaboard, where he became acquainted with the various branches and activities of the Sovereign Order in Rome. He became interested in the history of the Order, and was given facilities to search in the archives in Rome and in Malta. He gained the confidence of the Grand Council of the Order and in 1937 he was appointed by the Grand Master as Delegate of the Order to the International Congress of Military Medicine in Bucharest.

This book contains much material which is not, strictly speaking, descriptive of the medical work of the Knights. Apparently the author did not think it fit to separate the medical from the general activities of the Knights. His method is to describe the progress of the Order from its birth, and to emphasize its medical aspects. He dwells at great length on the description of the hospitals, and the rules and regulations governing their administration; he gives biographical notes on some of the outstanding doctors and administrators of the hospitals, but gives very little information about methods of treatment, clinical or surgical practice and precautionary measures.

The description of the Knights’ hospital in Rhodes is interesting and informative because that hospital is much less known than the one established later in Malta; however, the hospital in Rhodes was not open only for the treatment of patients, like the one in Malta.

Originally it was a Xenodochium and as such it provided care and treatment for the sick, gave shelter to the weary pilgrim and offered refuge to the maimed and the crippled.

In the book mention is made of a pathological condition which affects the hands and feet. The malady is sometimes known as St. John’s disease, Morbus Sancti Johannis, and used to be considered as a form of epilepsy. The author does not feel inclined to identify the disease as epilepsy, and he is quite right: most probably the condition was due to some form of avitaminosis which one would expect to find amongst poor pilgrims and destitute persons.

Some information is also given about the Public Health measures which the Order adopted in Rhodes and in Malta. The author mentions the “Domini Sanitatis” in relation with the creation of a Health Commission in Rhodes, but he does not make it clear that the commission created by Grand Master d’Aubusson (1503-1512) constituted a department of health in the true sense of the word and its Officers were called the “Domini Sanitatis.” [1]

The author likewise mentions regulations governing the burial of the dead, but he seems to be unaware of the fact that in 1780 the Grand Master had asked the Société Royale de Medicine of Paris to appoint a commission to study the question of inconvenience arising from the burials in parish churches in Malta. A very famous French doctor, Vicq D’Azyr, whose name is still met with in text books on anatomy, signed the report of the commission, which was published in 1781 and makes very interesting reading.

Reference is also made to the “Order’s medical men on the galleys of the fleet.” One would have liked the author to expand more fully on this important aspect of maritime health, but admittedly there are few sources from which to draw as regards sanitation on board the galleys of the Knights. The fate of the slaves chained to the rowing benches must have been pitiful and brutal according to modern ideas.

The book is divided into three sections or periods of which the last one is perhaps the [p.112] best as it deals very profusely with the work of mercy undertaken by the Order after its expulsion from Malta. It may be stated that following the loss of its territorial possession, the Order concentrated on the main scope for which it was originally founded, and rapidly expanded its hospital and nursing services. The author gives a detailed account of the organizations run by the Order for the benefit of suffering humanity in the various countries where Branches, Grand Priories and Associations have been established. The hospitaller activities of the Order assumed great importance during wars, disasters and epidemics; in peaceful years, too, the Knights Hospitallers never slackened in their efforts to benefit humankind; they have established clinics, out-patient departments, homes for the sick and medical schools.

It is interesting to read that the hospital built by the Order at Tantur in Jerusalem in 1873 was erected on the site which once had been granted to the Knights Hospitallers by King Baldwin of Jerusalem in 1110. One also reads with pleasure that a section of that hospital was reserved for the care and treatment of poor and undernourished babies; and it must have proved of great value in combating infant morbidity and mortality, so high in Palestine during the last century.

A great effort was made by the Order during the First World War. There were several groups of Knights at work, and soldiers on both sides were succoured. It is estimated that no less than 800,000 sick and wounded men were cared for by the several branches of the Hospitallers. The author describes in detail the various organizations of the Knights in belligerent countries and gives figures and estimates to show the good work performed. He also records the fact that Mussolini in 1923 had entrusted the Sovereign Order in Rome with the distribution of nearly 2,000,000 dollars for the assistance of refugees from Asia Minor. This was an event of international importance; but the author, perhaps intentionally, does not dwell on its political implications.

One of the main enterprises by the Order in modern times was the establishment in Ethiopia of a Leprosarium comprising a leper colony, a hospital and an institute for the study of leprosy. The author enlarges on the origin, planning and construction of the institution which, after a promising start, ended miserably with the end of Italian rule Ethiopia.

The author brings his narrative to the beginning of the Second World War and finishes his work with a chapter on the Venerable Order of St. John in England, mentioning the medical work undertaken by the English Order in Jerusalem and giving information on the St. John’s Ambulance Brigade and Association, which are connected with the Order and which gave sterling service during the last World War.

The book is well written and makes interesting reading; although it purports to describe the medical work of the Order, it is free from technical discussions, and appeals both to the professional and the lay reader. Perhaps the historical data in the book is more profuse than the mere medical material, but this fact widens the scope of the work and makes it more universally read. It is evident that when the author undertook his work he did not have in mind to produce a book of this size, but his research was so fruitful that he felt reluctant to discard material of general interest. In a letter which the author sent to me from Washington on the 10th April 1939 he wrote “the volume grew to greater length than I had anticipated, being now well over 300 pages.”

The author deserves credit for the pains taken to collect information from widespread sources; his references are various and comprehensive, they indicate the thoroughness of his endeavours to consult original records and to obtain information from various sources, but there are one or two books on the subject which must have escaped his attention, and as they may be useful to students, their mention would not be out of place here. They are:—

1. “L’Ordine di Malta e Le Scienze Mediche by Professor C. Fedeli—Pisa, Francesco Mariotti, 1913. p. 40.

2. Rapport Sur Plusieurs Questions Proposées à la Société Royale de Medicine, per M l’Ambassadeur de la Religion, e de part de Son Altesse Eminantissime Monseigneur le Grand Maitre.” Imprimé au depens de la Religion, Malte, 1781. This report was also translated into Italian by Giovanni Civenzio and published in Palermo, Reale Stamperia, 1782.

3. “Associazione Dir. Cav. Italiani del Sovrano Militare Ordine di Malta pel Servizio Sanitario in Guerra” (pamphlet). Roma, Fratelli Zampini, 1898.

[1] FEDELI: L'Ordine di Malta e le Scienze Mediche Imprimé au depens de la Religion, Malte, 1781.