Hospitals occupied an interesting position in the medieval West. As charitable institutions, they were expressions of Christian piety and ideals. Along with churches and monasteries, they were places devoted to the performance of Christian acts. Yet, while churches and monasteries occupied a clear place in canon law from the early centuries of the Church, hospitals did not. According to scholars over the past century, medieval canon law declared that hospitals were an ecclesiastical form which fell under the authority of bishops, governed akin to monasteries. Sethina Watson seeks to dispel this theory by putting forth the provocative thesis that medieval canon law did not claim hospitals as part of its jurisdiction. For Watson, “absence of law...is the phenomenon that define hospitals in law” (35). This is a study about how lawmakers approached an issue without legal inheritance or a place in law: “canon law without the canon” (29).

Watson adopts the medieval definition for “hospitals” or xenodochia which covers a broad array of welfare houses, including places for travelers, orphans, and the ill. Watson posits that the broad definition of hospitals was no accident but evidence that hospitals were not spelled-out in law. She suggests that hospitals would have been assigned a specific definition if they had been outlined in law, as they were in Byzantine law. This study focuses on local welfare houses, omitting the hospital communities of the military and Hospitaller orders because they were governed by canon law as religious orders. There was great variation in the operation and supervision of individual welfare houses, from individual charters to royal authorities. Indeed, one of the defining characteristics of hospitals was just how diverse they were in this regard.

Watson begins by dispelling notions that the major general councils of the twelfth and thirteenth centuries (i.e., the Lateran councils) created any legislation dealing with hospitals. She examines Lateran III and Lateran II to show that hospitals were not mentioned by either of these councils. Lateran IV did briefly mentioned hospitals in passing: c. 62 urged Christians to help the needy in hospitals. But it did not really provide a place for hospitals in law. Watson interprets the silence on hospitals in the councils as intentional. She suggests lawmakers recognized that hospitals outside the scope of canon law.

Turning from general Church councils in the High Middle Ages to councils in early medieval Francia, Watson notes that early medieval councils were eager to address hospitals. Councils used the terms hospitales and xenodochia interchangeably, though xendochia remained the preferred term until the twelfth century. She focuses on the councils of Orleans in 549 and Aachen in 816 because previous studies considered them to be the basis of Western law on hospitals. The council of Orleans forbade bishops from removing property of the royal hospital at Lyons and required priests to preserve its arrangements while the council of Aachen required dignitaries of major churches build a hospital for the poor and travelers. Watson argues that the council of Orleans only sought to legislate on the royal hospital at Lyons and that the council of Aachen only addressed the hospitals of clerics and nuns. A vast number of hospitals lay outside of the scope of these councils. Regardless of their intentions, neither council established law that defined hospitals.

Carolingian Lombardy produced more legislation dealing with hospitals than Francia, classifying them as Christian foundations. Capitularies were concerned with preserving the resources of hospitals, emphasizing good management and calling for the restoration of those that had fallen into ruin. The laws defined xendochia by its administration of resources and its charitable objectives. Lombard lawmakers seemingly only envisioned hospitals as creations of a founder/testator. The Lombard councils turned to testamentary law as a legal basis to protect hospitals, focusing on ensuring that the donor’s wishes were fulfilled in perpetuity. That meant property could not be alienated by administrators. When an administrator of a hospital failed in their duties, external authorities--such as royal agents or church dignitaries--could intervene. As such, hospitals were not given their own place in law, but rather treated as inheritable property.

Watson then argues that the legal origins of hospitals in the West are distinct from that of the East, taking aim at models which make a connection between the Corpus Iuris Civilis and Western hospital laws. The Corpus Iuris Civilis considered hospitals to be a matter of public or divine law because donors were (ostensibly) compelled by pious motives befitting Christians. It extended many of the protections enjoyed by churches to welfare houses and even differentiated between different types of welfare houses. However, the Corpus Iuris Civilis was almost unknown in the West from the sixth to the twelfth centuries. As a result, the West diverged. Watson shows that the only Western source in the Early Middle Ages which incorporated hospital laws from the Corpus Iuris Civilis--Abbot Ansegis’s Collectio capitularum--had no effect on Frankish law. Hospitals in the West did not receive substantial, individualized attention in the law. Rather, testamentary law subsumed them. In the West, the right of hospitals to endure was related to the donor’s right to assign property for charitable purposes. Seen from the view of testamentary law, defining different types of welfare houses was unimportant because what really mattered was the act of endowment and ensuring the donor’s wishes were carried out. In Watson’s view, Eastern and Western laws concerning hospitals are fundamentally different.

Turning back to the Carolingian era, Watson states that bishops in the eighth and ninth centuries neither inherited nor claimed that they had jurisdiction over hospitals because of their office. Nevertheless, they could gain jurisdiction over an individual hospital through various means, such as hospitals directly entrusted to the care of the bishop or hospitals held by monasteries since bishops were legally charged with supervising the monasteries in their diocese. Because bishops could not claim general jurisdiction over hospitals, Watson argues that councils and synods sought to “police” those who held the rights over hospitals rather than the hospitals themselves. The councils of Olona in 825 and Rome in 826 ordered bishops to admonish overseers of hospitals who failed to uphold the donor’s arrangements and demand restitution. Councils in Western Francia treated hospitals differently. The council of Meaux-Paris in 845/6 encouraged royal action to protect hospitals and discussed the abuse of hospitals in dramatic terms. Violators were called “murderers of the poor” and threatened with anathema. The council of Quierzy in 858 was the closest to claim episcopal jurisdiction over hospitals. The king was to order rectors of xenodochia to submit to their bishop and carry out their duties with his counsel. However, the council’s law regarding hospitals does not seem to have garnered much interest from other councils or collectors of law.

The twelfth and thirteenth centuries were an important time in the history of canon law, and for hospitals. Though Gratian’s Decretum referenced hospitals in seven chapters, it still did not give welfare houses a place in canon law. Watson argues that the two great radical thinkers of hospital law were Bernard of Pavia and Urban III. Bernard of Pavia provoked discussion amongst canonists when he defined hospitals as religious houses--and therefore under episcopal jurisdiction like monasteries and churches--since they were created by religious motives. Though his opinion was not accepted by other canonists, it spurred the rediscovery of Alexander III’s statement Si hospitalewhich declared that hospitals could be established without the approval of the bishop. Urban III’s decretal Ad Haec also sought to clarify the status of hospitals as ecclesiastical sites by defining them as material objects as opposed to sacred places. It said that those hospitals confirmed by a bishop must be held in perpetuity for their charitable purposes. Both ideas were included in the Decretals of Gregory IX.

Watson then reassesses the decrees of Paris (1213) and Rouen (1214) on hospitals. Though traditionally seen as the beginning of the application of written law to hospitals, Watson disagrees. The decrees promulgated by the council of Paris (the council of Rouen reiterated Paris’s precepts) argued that hospitals with adequate resources to support a common life should adopt a rule and live as religious. Traditionally historians have viewed Robert de Courson as the force behind this demand. Watson instead suggests Jacques de Vitry, Jean de Nivelles, and/or Jean de Liroux were the more likely sources because they were patrons of the early beguine movement, a movement which was associated with hospitals. She also suggests that hospital reform arose in Flanders and Brabant around 1200. Ultimately, the papal curia seems to have rejected the decrees advanced by Paris and Rouen because it did not fit with the two basic tenets concerning hospitals in canon law:Si hospitale and Ad haec.

Watson lastly discusses the decree Quia contingit (1317) created by the Council of Vienne. Quia contingit has been seen as the “Magna Carta of hospitals” and Watson also sees it as important. It stated that the patrons of hospitals which had fallen into ruin had a duty to reform their hospitals. Bishops or other local authorities were tasked with compelling the rectors of hospitals to fulfill their duties. It gave bishops the authority to intrude into the affairs of a neglected hospital. Yet it still acknowledged that hospitals did not fundamentally belong to the Church and that they existed under a variety of arrangements. Quia contingit became canon law’s defining statement on hospitals.

The appendix includes an edition of Alexander III’s lost decretal Ad Petitionem and Robert de Courson’s hospital decrees from 1213. Fragments of Ad Petitionem have already been published by Jaffé in Regesta pontifcum romanum. Watson’s edition is based on the Collectio Brugensis and supplemented by the Collectio Wigorniensis, Collectio Cheltenhamensis, and Appendix concilii Lateranensis. Watson’s editions of de Courson’s decrees from Paris and Rouen are based upon manuscripts, and she also includes English translations. These editions are useful for scholars interested in delving deeper into the texts. Watson must be commended for making texts in manuscripts available to a wider audience.

Watson is most effective at discussing individual sources, especially those concerning capitula and individual councils. For example, her discussion of the transmission of the decretal Ad Petitionem is wonderfully researched and shows just how much thought she has given to individual sources. She also suggests a new possible date for the council of Rheims in 1213 based on extensive and interesting research. Moreover, she continually provides new insights and interpretations of these sources which add new, interesting dimensions.

Seeking to avoid any idea of developmental teleology, Watson arranges the chapters analytically instead of chronologically. This results in a somewhat disjointed approach, especially in Part Two, where the Merovingians and Carolingians are discussed before a chapter on Byzantine and Roman law. Though there are some reasons for such an approach, it is an organizational technique which interrupts the flow of Watson’s argument. Indeed, a more chronological organization might have strengthened Watson’s argument by showing how hospitals never had a firm legal basis in Western Roman law, as well as how her argument fits into the historiography. It might also help readers because--for better or worse--readers are used to seeing a chronological organization in historical studies.

Watson is largely successful in arguing that hospitals were outside of canon law jurisdiction. Her thesis is quite compelling and seems more convincing than other theories. Yet one is still left with doubts on whether this constitutes an “absence of law” (35). Hospitals may not have received as much attention in law as churches or monasteries, yet councils did propagate legislation concerning them. Multiple councils treated hospitals as a part of testamentary law. Perhaps it is more a matter of how “law” is defined. Nevertheless, Watson does make an interesting and compelling argument for rethinking the traditional narratives of medieval hospitals in the medieval West.