The Hospital Brothers of Saint Anthony

In 1095 CE, Gaston of Valloire (or of Dauphiné) founded a religious order, sanctioned by Pope Urban II (who also called for the First Crusade that same year). It was named for St. Anthony the Great, by whose intercession Gaston believed his son had been cured of the disease that then came to be known as St. Anthony's fire.

Gaston and his son built a hospital near the Church of St. Anthony at Saint-Didier de la Mothe, which was administered by the new order, the Hospital Brothers of St. Anthony. It was dedicated to caring for victims of St. Anthony's fire, which was the cause of frequent epidemics.*

The Hospital Brothers were laymen, and though they cared for the poor and sick who came to visit the shrine with relics of St. Anthony at the nearby church, they did not always get along with the community of Benedictines who tended the church and shrine.

The Hospital Brothers wore black with a a blue Tau ("T") cross. The Tau cross was affiliated with St. Anthony, but we are not sure why. He was not executed on one, as some suggest (he died in his bed). One theory is that he had a T-shaped staff on which he would rest. The laymen eventually evolved into a monastic order with the blessing of Pope Honorius III (who also sanctioned the Dominicans) in 1218; 30 years later they adopted the Rule of St. Augustine and were declared canons regular by Pope Boniface VIII.

Now the "Antonines" were a fully-fledged "rival order" to the nearby Benedictines; each group felt they had primary responsibility for the relics of Anthony. Hostilities arose until the pope gave custody of the shrine to the Antonines and sent the Benedictines to Montmajour Abbey, 130 miles away.

The success of the hospital motivated them to expand. By the 15th century there were 370 hospitals in France, Spain, Italy, and Germany run by the Order of St. Anthony. They were caring for many illnesses, including the Black Death. Their popularity declined after the Reformation, especially when the link was discovered between St. Anthony's fire and ergot, after which incidents of the disease fell sharply. Their donations and influence dwindled, and in 1777 they were subsumed into the Knights of Malta. The last hospital, in Hochst, Germany (see illustration), was closed in 1803. In Memmingen, Germany, you can see a museum to the Order, on the site of one of their hospitals that was opened in 1214.

The man who first sanctioned the Order and called for the First Crusade, Urban II, did a lot more in his decade as pope. Let's dig into his career tomorrow.

*For those who don't like to click links, St. Anthony's fire was caused by ergotism, although some of the symptoms could also be the result of erysipelas.

Ergot Poisoning

The term "ergot" refers to a group of fungi that grow on rye and other grains. The illustration shows a stalk of wheat with a growth that is part of the life cycle of the fungus Claviceps purpurea, the chief source of ergot. The fungus produces alkaloids that, when consumed by mammals, produces ergotism, or ergot poisoning.

There are two main symptoms of ergotism. There are convulsive symptoms that range from mild such as headaches, nausea, diarrhea, and vomiting, to severe: spasms, mania, and psychosis. There is also a set of gangrenous symptoms because of the vasoconstrictive nature of ergot: loss of circulation in the fingers and toes that can lead to loss of the fingers and toes themselves.

Ergot could also affect the nervous system and make the sufferer feel sensations on the skin without any external source. In the Middle Ages this was called St. Anthony's Fire.

Although ergot could infect other grains, rye was the likeliest source in the Middle Ages. Rye was considered a less desirable grain for bread than wheat, and was therefore the grain of the poor—which covered most of the agricultural population. Grains infected with ergot are darkened. Ergot-infected grains in a bushel of wheat would stand out from their color and could easily be picked out. The darker rye would more easily hide the infected grains, especially once it was ground into flour.

Medieval doctors had no cure, and so people turned to divine intervention. The 12th-century chronicler Geoffroy du Breuil recorded outbreaks in the Limousin region of France, where cures were attributed to Saint Martial. An outbreak in Paris in 1129 was cured by relics of St. Genevieve.

Ergot's life-cycle starts in the ground. The spores that produce ergot can survive for one year, and cannot germinate if buried more than an inch below the surface. As it turns out, simple crop rotation, that puts a non-grain crop in a field that held a grain, can cause the ergot present to die out without a host. Also, this post (from almost exactly 10 years ago) explains how the mouldboard plow was better at turning over the heavy soil of Europe, which could help to bury the spores deep enough to prevent germination.

In the words of the sixteenth-century physician Paracelsus. “All things are poison, and nothing is without poison: the dose alone makes a thing not poison.” Claviceps purpurea has produced other compounds thanks to modern science. Ergotamine, for instance, is used for the treatment of migraines because of its vasoconstrictive ability. The drug LSD was synthesized in 1938 from lysergic acid, which is derived from ergotamine.

Because a cure was attributed to St. Anthony, a hospital was founded in his name to treat others. Let me tell you tomorrow about the Hospital Brothers of Saint Anthony. See you then.

Ergot Poisoning

When the relics of St. Geneviève were paraded through there streets of Paris in 1129 during an outbreak of St. Anthony's fire, they seemed to work. The truth is, however, that St. Anthony's fire could abate as suddenly as it arrived, so coincidence might have figured in the miraculous cure. But what was (is) St. Anthony's Fire? Modern researchers put their money on ergotism, or ergot poisoning.

Ergot is a fungus— Claviceps purpurea—that grows on certain grains, especially rye. The early symptoms may not cause too much alarm: fatigue, nausea, diarrhea. Later, it can lead to convulsions. It becomes St. Anthony's Fire when the fungus causes the blood vessels in the outer extremities to constrict. The arms and legs do not get blood and oxygen and therefore develop gangrene. At that stage, amputation (or a miracle) is the only recourse. While the limbs were dying, the sensation of burning was intense, hence the reference to "fire." So why "St. Anthony"?

The Order of Hospitallers of St. Anthony founded hospitals to treat the disease. There was plenty of work to do. St. Anthony's Fire was a problem waiting to happen as soon as stored grain started getting moldy.

Ergot was known at some point: the black growth on the rye was studied. In 1582, a German doctor used small doses to produce contractions in pregnant women. In the 20th century, ergotamine was developed to help with migraines and cluster headaches.

Tomorrow I'll talk a little more about medieval hospitals and cures.

St. Anthony's Fire

Victims of ergotism by Peter Bruegel

Diagnosing medieval diseases has its difficulties. Modern research must rely on accurate recording of symptoms and knowledge of potential causes. And yet, we manage to estimate the likeliest causes of the ailments of long-gone centuries.

Geoffroy du Breuil of Vigeois was a Benedictine who recorded events from 994-1184 in his Chroniques. He mentions preparations for the First Crusade and the Cathar heresy. He also talks about an outbreak in France of an illness that caused rampant gangrene. This is believed to be a case of St. Anthony's Fire.

St. Anthony's Fire was so-called because it was most successfully treated by monks of the Order of St. Anthony. The order was founded in 1095 by Gaston of Valloire and his son, because the son had been cured from the symptoms by the relics of Saint Anthony the Great. The symptoms of St. Anthony's Fire were not only gangrene that caused limbs to fall off but also convulsions, diarrhea, psychosis, headaches, nausea, vomiting, and an uncontrollable itching feeling.

Now we equate St. Anthony's Fire with ergotism, caused by the fungus Claviceps purpurea which infects rye, barley, and other grains. Ergotism also explains a plague in 857, mentioned in the Annales Xantenses. It is also a proposed explanation for anecdotes of bewitchment found in the Middle Ages and later, including in Puritan New England.