Hospitals in medieval Scotland

Background

Close to one thousand Hospitals in England, Scotland, Wales and Ireland were founded during a period of six hundred years. To begin with the causes for the building of Hospitals across Europe and in Great Britain can be found in the Western Catholic Church’s teaching related to Charity and Piety together that of Purgatory. In practice the theologies of Charity, Piety and Purgatory supported each other. Piety had three related meanings. First the sense of showing compassion; second the religious sense of Godliness and devoutness; and third, the sense of duty and respect. Taken together these meanings for piety suggest “ a sense of compassion and respect driven by a religious duty ”. Similarly, poverty was seen as the normal condition of having few materials possessions or wealth. The nobility and Royalty had wealth and influence. It was “normal” for others to be “poor”. Poverty for many was close to a state of complete destitution. The Church taught that piety was a duty born in religious conviction. Also that poverty was not necessarily a fall from grace, rather it was an opportunity to follow the Christian teaching “Blessed are the merciful: for they shall obtain mercy....” (Matthew, 5:7) In this complex of supporting and contrasting theories Hospitals were built by the Church for multiple reasons. In Great Britain it was not until the Reformation in the sixteenth century that civic authorities had to face poverty, ageing and a revised approach to charity and piety by the Churches.

Hospitals in England and Wales

Before considering Scotland, the situation in England and Wales provides a relevant context.

Out of 952 Hospitals built, some 585 were still in existence when the records were collected at beginning of the “English” Reformation. In England The Great Hospital in Norwich and the Bedehouse in Ewelme are well documented. An important Hospital was amongst the Church buildings in York. Rotha Mary Clay provides the most definitive account of English Hospitals in the late nineteenth century. Care for the poor was not institutionalized by civic authorities until the middle of the nineteenth century. The Almshouse or Poorhouse can be seen as a development of the medieval Hospital.

Scotland

It is estimated that between 160 and 170 hospitals were built in Scotland. Based on Hall’s classification comparable figures to those above can be adduced for Scotland. The nineteenth century survey in Keith et al. lists only 28 hospitals. It must be assumed that Spottiswood was selective amongst the available records.

The data provided by Hall are based on the known date of building the hospital. A comprehensive database of places of worship (churches) provides information on ruined buildings including hospitals. The earliest hospital in Scotland was probably St Leonard’s in St Andrews, founded by Bishop Robert of St Andrews in 1144. This was both a hospice and traveller's inn. Another early development was a traveller's inn founded in North Berwick in about 1154. Up to 1400, as many as 60 hospitals were founded. Many of these hospitals also served as leper houses or leper colonies. Cowan & Easson together with Hall identify about twenty Leper Houses.

The best indicator of the remains or site of a Medieval hospital is the use of the phrase “spital” in place names. Across Scotland, the Ordnance Survey lists 58 places with the phrase “spital” in a place name.

The north east of Scotland

Listed below, in a summary table, are the recorded hospital sites in the north east of Scotland. Some of the locations remain uncertain. Details of the dates founded and "terminated" are provided where known. In some cases the designation (i.e. type) is a composite. Leper houses are included, as they may have had a dual purpose. The designation “Maison Dieu” is generally a description from land or map records. The term is usually synonymous with "bedehouse".

For details of the various sites and notes see Cowan & Easson.

Derek Hall provides some additional data. The table below shows the locations for north east Scotland and Dundee hospitals.

Hospitals in Old Aberdeen and Aberdeen

There are records for nine hospitals in Aberdeen and Old Aberdeen. Just before the Scottish Reformation, Bishop Gavin Dunbar founded St Mary’s Hospital (NJ 93838 08800) - also known as Bishop Dunbar's Hospital in 1531. Much earlier, a hospital for the sick and elderly, St Peters (NJ 94000 07600) was founded in 1179. The Aberdeen Leper House dates from 1333 (NS 59100 64430). See map on the right.

Types of hospital

It is impossible to provide an exact classification for Scottish hospitals. Cowan & Easson and Hall use differing terms. Many of these institutions were known simply as hospitals. The term “almshouse” or “poorhouse” was sometimes given to these institutions. In general hospitals were Church foundations. As such they served the elderly and provided care for the sick within Western Christian practice. Some would have had a primitive “hospital” function (in the modern sense) with an adjacent herbal or "physic" garden. Both men and women would have been admitted. In most cases it was elderly men. In addition, the Church instituted a class of hospital that was akin to a monastery. These sub-monastic hospitals (e.g. St Mary’s in Old Aberdeen – known as Bishop Dunbar’s Hospital) in addition to caring for the elderly provided a chantry function with bedesmen praying for the dead. (See Bede House, Old Aberdeen) As such they are sometimes known as “bede houses”. In addition leper houses served a specific function with regard to leprosy. Hospitals, in addition to providing care for the elderly and infirm, were places where pilgrims or travellers would rest. It is likely that such institutions would have provided spiritual aid to travellers. Travellers's "hospitals" would have been on or adjacent to what are now called "heritage routes". It is possible that some “traveller’s hospices” would have been akin to the chapels built at bridges to allow travellers to stop and offer prayers for their safe transit. It is likely that any Medieval hospital on or adjacent to such routes would have served several purposes.

Traveller’s inns

It would be expected that inns or hostels would be situated on roads and paths. Paths normally follow natural contours across hilly territory. North - south travel across the north east of Scotland have to traverse the Grampians and Cairngorms. Across these hills paths take advantage of gaps between hills, that is passes. There are some fourteen passes over what is sometimes called the Mounth. Recently the various paths and passes have been categorized in a project by the Scottish Rights of Way Society. These are: Causey or Cowie Mounth (Stonehaven to Aberdeen); Elsick Mounth (Stonehaven to Drum); Slug Road Stonehaven to Durris); Cryne Corse Mounth (Laurencekirk to Durris); Stock Mounth (Glenbervie to Strachan); Builg Mounth (Glenfarquhar to Bridge of Dye); Cairnamounth (Fettercairn to Kincardine o' Neil); Forest of Birse Mounth (Tarfside to Aboyne); Fir Mounth (Glen Esk to Glen Tanar); Mounth Keen (Invermarkie to Ballater); Capel Mounth (Glen Clova to Glen Muick); Tolmounth (Glen Clova to Glen Clunie); Monega Pass (Glen Isal to Glen Clunie); Cairnwell (Glen Shee to Braemar). (1928) provides nine crossings of the Mounth these passes are confined to the eastern ranges, especially the province of Mar. Fraser (1980) and Smith add additional routes. Additional passes extend westward towards Inverness and Nairn.

These paths had stopping places for travellers and as a result a number of the hospitals were located adjacent to or on these routes. In addition, where paths crossed rivers by bridges, fords or ferries, traveller’s inns were located. It is notable that the Mounth passes also linked Castles across the whole of Scotland. This is clearly shown in the north east. It appears that the location of Hospitals on Mounth paths (e.g. Kincardine O’Neil, Spital of Loch Muick and perhaps the hospital at Boat O’Brig on the River Spey) were associated with travellers between settlements and castles. Simpson (1928) provides a detailed analysis of the Castles of Mar and their association with Mounth paths. The Cairnnamount path links Castlehill, Kincardine O’Neil and Lumphanan castles. The Capel Mounth, after traversing Loch Muick, passes Kinord Castle and the Loch Davan Motte before running past Migvie Castle. A western branch of the Capel Mounth path passes Loch Callater – to the west of Loch Muick – to Kindrochit and Braemar castles before leading towards Corgarf Castle.

There is clear evidence that hospitals were built to accommodate travellers or pilgrims on these routes. Across Scotland there are in excess of 400 “heritage” roads/tracks/routes. Of these, there are 27 military roads (e.g. Ruthven Military Road, Grampian/ Aberdeenshire); 14 pilgrim's routes (e.g. St Duthac's Way, Moray); 20 coffin roads (e.g. The Monks' Road, in Fyfe); and 108 drove/drover roads (e.g. Moniaive to Sanquhar Drove Road, in Dumfreis and Galloway). In Grampian/ Aberdeenshire there are 16 heritage roads/tracks. Five Medieval roads are also considered as pilgrim roads and two (Causey Mounth and Firmounth) as drove roads.

Aberdeenshire and the Cairngorms

Eastern hospitals

Hall (2006) includes, in Aberdeenshire, the Hospital at Kincardine O’Neil (NO 59211 99644) which served the dual purpose of a Hospice and a Hostel for Travellers – see adjacent map.

The location close to the River Dee on the Cairn a Mounth road supports this classification. (see Kincardine O'Neil Hospital, Aberdeenshire) Of the many definite hospital sites, the evidence for Kincardine O’Neil being a traveller’s inn is most persuasive.

To the west of Kincardine O’Neil the Capel Mounth drover’s road led past Loch Muick and an eighteenth-century ruined hospital or traveller's inn. (NO 3074 8500). The earliest reference to it is found in estate papers.

" ....to “the sheallings called hospital haugh” allied to Braichlay, at the foot of the Glen, in 1709 (Instrument of Sasine In Favour of Isaac Fullerton, 1709, Invercauld Papers); and a sub-tack of 1754 which required the sub-tacksman to re-roof “the house in Spittall” (Sub-tack, Lewis Mackenzie to Donald Glass, 1754, Invercauld Papers).

Fraser (1931) writes:

" ...Easson states that its existence cannot be verified but Jervise says that, “... a religious house and hospice were early established at the Spital of Muick by the Bishop and Chapter of Aberdeen, and was superseded by a hostelry until about 1850 near the old site...”

Fraser mentions that “...extensive foundations of the Spital... near the loch... can still be seen...”

The Royal Commission on Ancient and Historic Monuments in Scotland provides recent archaeological evidence about the Spital of Glen Muick. In its Notes on archaeological work at Glen Muick RCAHMS repeats a claim made by Sheila Sedgwick that:

“.... The Spittal (Spittelhauche in 1600) was the highest place of abode in the Glen (Muick)... . It stood on the south side of the river, about a mile east of the loch. For generations it had been a hospice for drovers crossing the Capel Mounth to Glen Clova, and in medieval time monks ran a shelter there, to cater for travellers to and from the south by the Capel Mounth. The religious house there was under the auspices of the Bishop and Chapter of Aberdeen. In 1764 Donald Glass kept thirty sheep, twenty four lambs and a goat. Up until about 1880 the inn was a busy place. .....”

There appears to be a confusion by the authors of the report and Sedgwick with regard to the “ ... monks .. (and) .. the Bishop and Chapter of Aberdeen ...”.

There is no evidence of any hospital in this location run by a monastic order. It is probable that the Bishop of Aberdeen founded such an establishment. So far the specific charters from the Bishop of Aberdeen have not been identified. However, there is a charter from 1195x1197 that concerns:

...Matthew, bishop of Aberdeen, for Michael the clerk; at the presentation of Prior Gilbert de Vere and the rest of the Hospitallers in England, he has given and granted the churches of Glenmuick (ABD), and has canonically instituted him as parson in those churches, rendering to the house of the Hospitallers 9 marks...”

.

It is possible that this charter may have been misinterpreted. The “hospitallers” referred to above were the military order of the Knights of Saint John and Order of Saint John, the Knights Hospitaller.

This charter suggests that the Church at Glen Muick was “given” to the Hospitallers by Bishop Matthew (Kinnimund) of Aberdeen (1172-1199).

In recent times the Visitor’s Centre at the Loch Muick suggests that the hospital was founded in the 15th century and run as a traveller's inn for the comfort of travellers – akin to a motorway service station.

Sedgwick provides a detailed account (pp 107 to 116) of the building known as the “Spital” at Glen Muick from c1800. It clear that it served as an inn for drovers, agricultural workers and perhaps for smugglers. There is a possibility that in the last three centuries the building had two stories. The stones from the remains were probably used to build more recent buildings in the adjacent ”Teetaboutie”.

One final possibility is that this and other hospitals located on pilgrim routes or ancient drover’s roads were used by travellers might have had a similar religious function to bridge chapels where travellers “rested” and said prayers before continuing their journey.

On balance there is sufficient circumstantial evidence regarding the Hospital to believe that it did serve some function for those who travelled on the Capel Mounth route.

Western hospitals

Further west a drovers' road ran past the Spit(t)al of Glenshee towards the River Dee at Braemar. While the name "spit(t)al" is normally associated with a hospital, there is some evidence that in this case the term may have a Gaelic origin. The Royal Commission on the Ancient and Historic Monuments in Scotland (RCAHMS) suggests:

“ ... It is generally believed locally that “spit(t)al” is a corruption of the Gaelic word meaning - '.. narrow pass between the hills ..' and is not associated with a hospital. If this translation is correct the name Spittal fits the position perfectly....”.

An early reference to this hospital may be the ownership of a "station" or "house" at Glenshee by the Knights Hospitallers. J. Cuthbert Hadden (1910) says:

“.. the Knights Hospitallers had a station here and performed such services as are now discharged by the Monks of St Bernard on the Alps...”

This authors also suggests that during the 16th century, it was a shelter for "belated travellers" avoiding bands of wolves.

There are some inconclusive references to a hospital at the Spital of Cairnwell, some 5 miles to the north of the Spital of Glenshee. The earliest reference appears to be in an unpublished manuscript by Keith entitled “View of the Diocese of Aberdeen. This document is printed in “Collections for a History of the Shires of Aberdeen and Banff by the Spalding Club in 1843. It reads:

“ ...Ther was an Hospitall at Cairnwall, (called Shean-Spittal, or Old Hospital,) wher ther is a road over the Grampian hills. 'Tis said ther were several other such hospitals for poor travellers passing over Granzbin....”

.

It is likely that the site at Glenshee is confused with that at the Cairnwell Pass.

An interesting example of a Travellers' Inn may be one at the Boat O'Brig on the River Spey. (NJ 3185 5167) It is first recorded in 1232. There may have been a bridge over the Spey here from Roman times, known as Pons de Spey. The hospital belonged to the Chapter of Elgin Cathedral. There is an interesting charter from Muriel de Rothes, daughter of Peter de Pollock, in 1232, part of which reads in translation:

“ ... know all men present and to come, I have given and granted and by this my charter have confirmed the Hospital of Saint Nicholas ... to serve the maintenance of the poor ...”

An ancient Drove road, going north-east from Tomintoul approaches the Spey near Craigellachie about 6 miles from Boat O'Brig. The hospital may have accommodated travellers as well as paupers. The "Registrum Episcopatus Moraviensis" (1837) reports:

“ ... It appears to have been situated at the passage of the Spey, still called the Boat of Brigg, where a new bridge has been lately erected. The hospital of St Nicholas, erected close to the bridge, and endowed for the reception of travellers, is now probably no longer to be traced. It is said that some remains of the foundations of the ancient bridge were lately visible. The super structure was probably of wood....” (f.n. pIII)

Additional evidence for the use of the Hospital of St Nicholas is provided by Shaw, L and J. F. S. Gordon in The History of the Province of Moray.

”...At the beginning of the 13th century, Muriel de Pollock, daughter of Peter de Pollock, heiress of Rothes, bequeathed her estate of Inverorkil, or Inverlochtie, where a bridge was first built by her, for an Hospital to God, the blessed Virgin Mary, and S. Nicholas (the patron Saint of all who travel by water) for the reception of poor travellers. The wooden bridge existed at the Reformation, but having fallen into neglect and disrepair it was swept away by the Spey, and its place was supplied by a ferryboat, whence the spot was termed " Boat o' Brig." ...”

There are no traces of the Hospital of St Nicholas or the 13th-century bridge at present.

Scottish Borders

In the Scottish Borders, a clear example of a traveller’s inn is at Soutra Aisle (NT 45254 58409).

In this case, a drover’s road that ran north towards Edinburgh suggests a probable association. There were two main drover’s roads starting in Hawick and dividing at Jedburgh into an easterly and a westerly route north. The westerly route passed through Selkirk and adjacent to Soutra Isle Holy Trinity. – see adjacent map. It is probable that Dere Street(North) (Start NT 453 582; End NT 482 545) is the likely route. The RCAHMS records the evidence as:

“ ... Soutra Hospital is said to have been founded by Malcolm IV in 1164, for lodging travellers, but the foundation was probably somewhat earlier. In 1236, specific mention is made that the rule of St Augustine shall be observed, and it is called the house or hospital of the Holy Trinity. Reference to residents in the hospital are found up to 1583-4, but in the 17th C. , it is described as utterly ruined....”.

Leper houses / hospitals

It is normal to include leper hospitals, leper colonies or lazar-houses in any classification of Medieval Hospitals. Both Cowan & Easson and Hall identify buildings where those suffering from leprosy were looked after. Leprosy or Hansen’s Disease (lepra tuberculosa), may have come into Britain in the 4th century with Roman soldiers. The disease became a serious problem, north and south of the border, by the middle of the 11th century. By the late 16th century hospitals in Scotland were no longer considered necessary to care for lepers.

The origin of the Leper hospital draws on two contrasting aspects of the Christian theology of charity, firstly a conflict between “inclusion with care” and “exclusion with care”. Christian New Testament teaching emphasized the need for “inclusion with care”. Second, and in contrast, Third Council of the Lateran (1179) of the Medieval Western Christian Church subscribed to a policy of exclusion. The translation of Canon 23 of the Third Council of the Lateran makes it clear that “charity in exclusion” was the policy of the Bishops:

“...we decree, in accordance with apostolic charity, that wherever so many are gathered together under a common way of life that they are able to establish a church for themselves with a cemetery and rejoice in their own priest... let them take care, however, not to harm in any way the parochial rights of established churches. For we do not wish that what is granted them on the score of piety should result in harm to others...”

This was more in tune with an Old Testament Jewish tradition found in Deuteronomy.

In Old Testament Biblical times, leprosy was prevalent in Palestine. Not only was it looked upon as a divine punishment, but at all times the Hebrews believed it to be contagious and hereditary, hence it was considered as a cause of defilement and involved exclusion from the community. In his seminal work on leprosy, Sir James Simpson writes:

"...laws were enacted by Princes and Courts to arrest (lepsosy’s) diffusion, the Pope issued. Bulls with regard to the ecclesiastical separation and rights of the affected, a particular order of knighthood was instituted to watch over the sick, and leper hospitals or lazar-houses were everywhere instituted to receive the victims of the disease."

Often leper hospitals were sited on roads into and out of towns.

Many of the hospitals were civic foundations. Some were connected with cathedrals. The Elgin Leper House, founded in 1360, may have been under the supervision of Elgin Cathedral.

In Scotland leper houses were generally under the control of a “custos” (i.e. a guard) and sometimes a prior. Overall, records show that some 20 leper hospitals were built between 1200 and 1600. The sites are marked with an L on the adjacent map.

Bede houses

The term “bede house” is sometimes applied to poorhouses or almshouses. Strictly, the designation should only apply to hospitals where the male residents lived a sub-monastic life as bedesmen. That is, they followed Divine Office throughout the day and said or heard prayers for the dead. The term “bede” comes from the old root of “prayer”. It is likely that many of the hospitals built between the eleventh century and the Reformation in Scotland followed this practice. After the Reformation, residents of some hospitals were sometimes called bedesmen.

St Mary’s Hospital – known as Bishop Dunbar’s Hospital in Old Aberdeen – was a bede house. (NJ 93844 08795) It is likely that the almshouse at Newburgh, Aberdeenshire (NK 00000 25400) served as a bedehouse. In the foundation charter Alexander Comyn, 2nd Earl of Buchan writes:

“...nouerit uniuersitas vestra nos diuine caritatis intuitu et pro salute anime nostre et Isabelle comitisse sponse nostre et pro animabus antecessorum nostrorum et successorum nostrorum dedisse concessisse et hac presenti carta confirmasse sex pauperibus prebendariis apud nouum burgum in Buchane ... “

Translated:

“... (be it) known to all of you that we divine the sake of charity and for the salvation of our soul, and Isabella countess of our spouse, and for the souls of our ancestors and of our successors, have given, granted and by this present charter have confirmed to the six to the poor prebendaries with the new burgh and their successors in the same place for the sake of alms in the Buchan... “

The wording of the charter is typical for a hospital set up as a “chantry” to house “priests” to say prayers for the dead, in this case Alexander and Elizabeth (Isabella) de Quincy, his wife. Alexander died in 1289 and his wife in 1282. There are no remains of the hospital visible in the village of Newburgh. It is likely that any remains were covered by an inn in the 18th century.

It is believed that the Oyne Hospital in Aberdeenshire was a bedehouse. (NJ 69340 23580). The data provided by Hall (2006) lists six bedehouses. (See the table below.) This is a curious classification as many pre-Reformation hospitals would have had bedesmen saying prayers for the dead. Before the Reformation most hospitals would have been ordered on a religious regime, and as a result the term “bedesman” was self-evident in common parlance.

It is likely that Hall’s classification of almshouse or poorhouse would have contained hospitals that were bedehouses. St Mary's Wynd Hospital (1438) in Edinburgh (NT 2618 7354) was probably a bedehouse for women.

This hospital is also known as the Edinburgh Cistercian Convent.

It is possible that the hospital at Rathven (NJ 4433 6568) may have served as a bedehouse for some time. Cowan and Easson (p 153) say it was founded in 1224/6 by John Byseth for a “...Chaplain, seven lepers and a servant”. There is evidence that in the nineteenth century, this “hospital” served elderly men in a similar fashion to the bedehouse in Old Aberdeen.

"There is a Bede-House still in being, though in bad repair, and six bede-men on the establishment ; but none of them lives in the house. The nomination to a vacancy is in the gift of Lord Findlater, as proprietor of Rannes ; and the yearly income of the bede-men is as follows: from the lands of Rannes, every bede-man has half an acre of land during life, and one boll of oat-meal annually; from the lands of Findochtie, eight shillings, a penny and a farthing ; and from Freuchnie, formerly part of the lands of Rannes, one shilling, four pence and three farthings, making in all nine shillings and sixpence yearly." (The Statistical Account of Scotland, xiii. p, 412.)

Also:

"The Bede-House is still standing in the village of Rathven, and was very lately repaired: two of the six bede-men, who are still maintained on the establishment, at present live in the house." (The New Statistical Account of Scotland, xxxviii. p. 268.)

The bedehouse in Tarves (NJ 87491 30824) founded by William Forbes of Tolquhon in 1584 is post-Reformation but used the term “bedesmen” for four resident men. It is believed that:

“...in return for food clothing a stipend and lodging the poor men had to attend the local church to pray for the founder’s soul...”

This bedehouse is also known as “Boghouse”.

There are nine bedehouses identified across Scotland. (See adjacent map) Overall, the designation “bedehouse” is ambiguous. It appears that in common parlance the term “bedesman” was applied to any resident of almshouses, poor houses, maison-dieu and possibly former leper houses, or those supported by hospital trusts after the Scottish Reformation (1559/1560). The term may or may not have applied before the Reformation.

Summary

Medieval hospitals or “spitals” provide a record of the development of help for the poor, the sick and the widowed. Hospitals built between 1144 and c1650 highlight the many changes to the landscape, the settlements and the people who lived in Scotland. It is impossible to put a religious boundary around the period of hospital building as the social values developed pre-Reformation were continued for at least hundred years after 1559. The names of Hospitals record epidemics such as leprosy. Their locations give a clue to the way travellers, drovers and perhaps smugglers traversed the landscape. The foundation of sub-monastic bede houses highlights the importance of prayers for the dead and a belief in Purgatory in the pre-Reformation Catholic Church. Mortifications setting up hospitals etc. record the influence and wealth of the nobility and the Church. The remains of Medieval hospitals can still be seen. Their existence throws light on life in Scotland, England and Wales and Europe to this day.