Humanitarian Charity in History: Christian Beneficence for Public Health

by Brenda Llewellyn Ihssen¹

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Religion and healthcare are ‘having a moment;’ they have long been partners, but this relationship has not always been public in a society that might prefer to see them as contradictory. While the AIDS crisis and 9/11 increased acceptance and visibility of faith-based partnerships in public health, COVID-19 further pushed the religion and healthcare liaison into the national spotlight, with open discourse about religious views on medical testing, vaccine development, public health expectations, and social responsibilities. Everyone had something to say, historically accurate or not. Yet in the dominant Christianity practiced in the United States, often it seems that Dolly Parton is the best representative of Christian charity since Jesus. It is clear that those who seek to relegate care for those in need to governmental systems either are unaware of the historical roots and complex nuances of what is commonly called Christian ‘charity,’ or they are ignoring altogether its deep historical links to health and health care delivery. This essay looks back at those links to help us understand the legacies of approaches, values, and practices that continue to influence communities and public health thinking today.

There are a variety of terms for early Christian philanthropic activity. The most frequently used were euergesia (performing an act of kindness) and eleutheriotes (demonstration of divine liberality). Jesus and his followers inherited notions of philanthropy from Hebrew scriptures, and the Jesus movement had engaged in wealth redistribution from the start. Theologians writing to wealthier converts are sometimes ambiguous,² but affirmed renunciation, distribution of wealth, and the alleviation of debt. Both New Testament and early Christian texts unequivocally denounce money as dangerous,³ even putting at risk one’s eternal salvation. Jesus’ view of to the hungry, the ill, and the poor, and his demonstration of love for God and neighbour (by fiscal divestment to the poor) was an operating principle for early Christian social groups,⁴ supported by various New Testament epistles. It was several centuries before theologians extolled charitable relief for all regardless of beliefs⁵ —but it is fair to say that Jesus’ activity for the most part transcended gender, status, and racial identity.⁶

Early Christian communities cultivated virtues to assist Christian and non-Christian⁷ households, and provided indiscriminate public aid in times of social, medical, and economic crises. They show synergies with pre-Christian ‘classical’ Hellenistic ideals of hospitality and love of one’s neighbour,⁸ as well as varying degrees of government support beginning in the fourth century CE. Christians emerged as civic representatives of social welfare and philanthropy. Distribution motives did not always fit our modern views of ‘social justice,’⁹ but in the context of the tools of their day—letters, sermons, canon law, and the lives of saints — charity distribution to benefit public health was understood to reflect an ethical, pious Christian life. Theological concepts like salvation, atonement, and the body of Christ, identified the poor, ill, aged, anguished, and enslaved as pious opportunities for giving. The practice of these values resulted in new approaches to assets management, the concept of investments, views about the roles of the poor and unhealthy in society, new models of healthcare, and attention to the way that charity bound donors and recipients together toward a vision of healthy society in this life and salvation in the next. Church law and leadership ideals compelled those now in power— bishops and abbots—to apply charitable philanthropy in ways that included—but were not limited to—direct medical care for the needy.

Context

Charity is never independent of historical context. In Christian history, imperial politics and government attitudes toward funding religious institutions has shaped philanthropy, including healthcare-related charity. As charity was channeled through a centralized church, voluntary generosity¹⁰ was replaced with organized and controlled programs.¹¹ These included building and maintaining hospitals, hospices, and homes for the aged,¹² the orphaned, the poor, the blind, the weary, the dying, and even the dead.¹³ Distribution of care to this new constituency reflected a shift in social classifications, a shift well worth remembering in light of headlines today: on housing crises, on mental health crises, or on the next wave in the opioid overdose crisis across the United States.

The Institution of Charity

Asked what makes a good religious leader, the city of Alexandria’s fifth-century bishop, Cyril, replied, “The gift of prophetic visions is of no use to a bishop, compared with giving to those in need.”¹⁴ By Cyril’s day, philanthropy had become a way of life for ordinary Christians, and not just bishops. The moral obligation to give alms to the church put goods into reliable circulation as charity. Ecclesiastical lists and sermons witness to registers for distributing money for public healthcare. The works of the Patriarch John the Almsgiver (6th-7th century) and Patriarch Tarasios of Constantinople (8th-9th century) testify to the thousands of clergy, women, men, and children who received charity in various forms: shelter, clothing, money, food, and healthcare. Economy and theology were tightly connected and socially transformative, as care for others became, in time, care for an “everbroadening circle of recipients,” each understood as the body of Christ.¹⁵

Institutions varied in what they focused on. The municipal poor might turn to a variety of services from bishops and urban monasteries, while rural monasteries tended to focus on pilgrims,¹⁶ offering food, clothing, shelter, and money. Some regulated “earned” charity,¹⁷ while others built rules for giving into their daily work practices. The fourteenth-century Typikon of Theodora Synadene for the Convent of the Mother of God Bebaia Elpis in Constantinople,¹⁸ for instance, says that the nuns worked not only for their own “flight from the vanities of this world,” but also to be able to “ ‘give to those in need’ [Eph. 4.28] in accordance with the commandment of the apostle.”¹⁹ The nuns were also expected to distribute the remains of their daily meal to “those who are driven by starvation and harsh and grievous famine to come to your gate every day.”²⁰

By renouncing their wealth, Christians were encouraged to emulate the divine benevolence of the supreme giver of gifts, but alms distribution was not necessarily the same as being divinely ‘charitable.’ The Vision of Kaioumos tells of a rich man named Philentolos who, during his lifetime, was equally committed to charity and dishonorable activities. There was lively debate after he died, over whether his charity was enough to ensure salvation. It likely pleased some of his critics when the hermit Kaioumos had a vision that Philentolos was in neither heaven nor hell, but rather was spending his eternity with unbaptized children.²¹ The subtlety would not be lost on a seventh-century audience, but it is worth affirming here: Philentolos’ good works were not nearly good enough to outweigh any “dishonorable activities,” leaving him stuck forever in an uncomfortable limbo, rather than enjoying the rewards of paradise.

Conclusion

These stories remind modern audiences that religion is never divorced from other social systems such as politics, economics, and healthcare. The laws, sermons, letters, monastic Rules, and saints’ lives of pre-modern Christian texts clearly link charity with eschatological hope, but a hope that benefited all parties in the present in diverse and distinct ways. For these writers, charity prevented greed and hoarding even as it promised immediate relief to communities and individuals in need. Inherited from Israelite, Hellenic, Rabbinic, and Roman philosophies of philanthropy, Christian charity, as a duty of care and as an expression and physical manifestation of theology, engaged full societal participation in a divine economy of faith and action.

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NOTES

1. _{This is a slightly modified version of an essay in Public Health, Religion, and Spirituality Bulletin Fall 2023, Issue 9, pp. 3–8 [Online 13 Oct. 2023, Article A046 · ISSN 2689-7024] https://publichealthrs.org/a046/. It is republished with the permission of the author.} ↩︎
2. _{Ecclesiasticus cautions for careful giving, 12.1-7, resulting in all kinds of justifications about giving, such as in Gregory the Great, Liber regulae pastoralis (20.21): “Let the alms sweat in thy hand.” In Millard Schumaker, Sharing Without Reckoning (Waterloo, CA: Wilfried Laurier University Press, 1992): 33.} ↩︎
3. _{Money as the ‘root of all evil,’ leading to poverty, scarcity, unhappiness, and an incentive for evil. See, for ex.: Ex 23:8; Dt 10:17; Dt. 27:25; Prov 14:31; Eccl 5:10; Matt 16:26; Matt 19:16-30; Matt 26:15; Mark 10:23-27; Luke 12.16- 21; Luke 16.19-31; Luke 16:13; 1 Tim 6.10.} ↩︎
4. _{Justin Martyr, 1 Apol. 14; 67.6; Tertullian, Apol. 39.5.} ↩︎
5. _{Leo, serm. 10.4 (CCL 138:43): “Dum ergo tempus habemus, sic ait Apostolus, operemur quod bonum est ad omnes maxime autem ad domesticos fidei,” in Neil, “Models of Gift Giving,” 236, n.45.} ↩︎
6. _{The Syrophoenician woman of Mark 7:24–30, notwithstanding.} ↩︎
7. _{Paul Veyne, Bread and Circuses: Historical Sociology and Political Pluralism, trans. B. Pearce (London: Penguin books): 19; Bruce W. Winter, Seek the Welfare of the City: Christians as Benefactors and Citizens (Grand Rapids, MI and Carlisle Cumbria: Eerdmans, 1994): 19.} ↩︎
8. _{“Philanthropy, from the Greek philanthrōpia-that is philein ton anthropon, to love the human person began as a theocentric concept and it was first used by the tragedian Aeschylos.” Demetrios J. Constantelos, “Origins of Christian Orthodox Diakonia: Christian Orthodox Philanthropy in Church History,” The Greek Orthodox Theological Review, Vol. 52, No. 1-4 (2007): 2; Demetrios J. Constantelos, Byzantine Philanthropy and Social Welfare (Rutgers State University Press, 1968), 3-17; G. Mussies, “Greek as a Vehicle of Early Christianity,” New Testament Studies, Vol. 29 (1983), 356- 69; Rhee, Loving the Poor, Saving the Rich, 14-27.} ↩︎
9. _{Holman, God Knows There’s Need, 11; also “Problems in Approaching Poverty,” Pauline Allen and Silke Sitzler, in Pauline Allen, Bronwen Neil, Wendy Mayer, eds., Preaching Poverty in Antiquity: Perceptions and Realities (Leipzig, DE: Evangelische Verlagsanstalt, 2009): 21-28.} ↩︎
10. _{Kahlos, Religious Dissent in Late Antiquity, 161-62. A. R. Hands, Charities and Social Aid in Greece and Rome (Cornell University Press: 1968): 62-76; Countryman, The Rich Christian in the Church, 103-107. Garrison, in Redemptive Almsgiving, writes that “within the broadly classified popular morality of the Graeco-Roman tradition, we find no specific exhortations to the rich that they should give to the poor.” Garrison, Redemptive Almsgiving, 41.} ↩︎
11. _{Cyprian of Carthage; Julian the Apostate.} ↩︎
12. _{Charlotte Roueché, “Caring for the elderly: creating a new concept and practice,” in Dionysios Stathakopoulos, ed., The Kindness of Strangers: Charity in the Pre-Modern Mediterranean (London, UK: Centre for Hellenic studies, 2007): 21-36.} ↩︎
13. _{Constantelos, Byzantine Philanthropy and Social Welfare, 88-110; 152-84; 185-22; 222-40; 241-56; 257-69; 275-76; 270-72; 274-75, respectively. See also, J. Herrin, “Ideals of Charity, Realities of Welfare: The Philanthropic Activity of the Byzantine Church,” in R. Morris, ed., Church and People in Byzantium (Birmingham, 1990): 302-06.} ↩︎
14. _{W.E. Crum, Der Papyruscodex saec. Vivii der Pillippsbibliothek in Cheltenham, Schriften der Wissenschaftlichen Gesellschaft in Strassburg 18 (Strassburg: K.J. Trubner, 1915), pp. 9.15 (Coptic) and 61 (trans.). Teodosiana, Studia Ephemeredis Augustinianum 58 (Rome: Institutum Pontificium Augustinianum, 1997), pp. 16-35; in Brown, Poverty and Leadership, 45.} ↩︎
15. _{Matthew 25.31-46. This passage will be used consistently by patristic authors to reinforce ethical behavior. See, for example, Gregory of Nyssa, In illud: Quatenus uni ex his fecistis mihi fecistis; On the Love of the Poor (GNO 9.1:111- 27), trans. Holman, The Hungry are Dying, 200-201, and Rudolph Brändle “This Sweetest Passage: Matthew 25:31- 46 and Assistance to the Poor in the Homilies of John Chrysostom,” in S.R. Holman, Wealth and Poverty in Early Church and Society (2008), 127-39. Rudolph Brändle, Matth. 25,31-46 im Werk des Johannes Chrysostomos (Tübingen, Mohr Siebeck, 1979). For a treatment of the reception history of this passage, see Eric R. Severson, The Least of These: Selected Readings in Christian History (Eugene, OR: Cascade Books, 2007).} ↩︎
16. _{Herrin, “Ideals of Charity,” 303; Holman, The Hungry are Dying, 64-98; Claudia Rapp, Holy Bishops in Late Antiquity: The Nature of Christian Leadership in an Age of Transition (University of California Press, 2013): 215-34.} ↩︎
17. _{See, for example, an early version of this in Nitria: “He [the guest] stays here all the time, even if for a period of two or three years. They allow a guest to remain at leisure for one week; from then on he must help in the garden, bakery, or kitchen.” Palladius, “7. The Monks of Nitria,” in Palladius, The Lausiac History of Palladius, trans. Robert T. Meyer (Mahwah, NJ: Paulist Press, 1964): 40- 41.} ↩︎
18. _{Theodora Synadene, Typikon of Theodora Synadene for the Convent of the Mother of God Bebaia Elpis in Constantinople in Thomas, Hero, eds., Byzantine Monastic Foundation Documents a Complete Translation of the Surviving Founders’ Typika and Testaments, trans. Talbot, 1512-78.} ↩︎
19. _{Synadene, Typikon of Theodora Synadene, trans. Talbot, [95], 1551.} ↩︎
20. _{Synadene, Typikon of Theodora Synadene, trans. Talbot, [89], 1549. One of the outstanding features of this series of translations is the cross-referencing of the typica; Talbot notes that the daily distribution is similar to (28) Pantokrator [11], (29) Kosmosoteira [6], (32) Mamas [13], (33) Heliou Bomon [13], and (58) Menoikeion [7]. In the Document Notes of Synadene, Typikon of Theodora Synadene, trans. Talbot, 1578.} ↩︎
21. _{F. Halkin, “La Vision de Kaioumos et le sort éternel de previous hit Philentolos next hit Olympiou,” AB 63 (1945): 56– 64.} ↩︎

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Dr. Brenda Llewellyn Ihssen is Professor of Early and Mediæval Christian History at Pacific Lutheran University (USA). Her scholarship explores themes of social ethics in patristic and Byzantine literature. Send her mail.