At the beginning of the Middle Ages sickness and suffering were in vogue, along with hair shirts, beds of broken stones, fasting, and flagellations, as among the recognized means of attaining eternal salvation. Visions of heaven kept the saints to their work till the right of sick people to be cared for was incidentally established. Such beautiful examples as St. Elizabeth of Hungary, unshrinking and tender, confirmed the value of holy deeds in place of holy meditations; then the crusades, filling Europe with poverty-stricken widows and orphans, gave rise to the Order of Beguines, lay sisters bound by no permanent vows, but simply pledged for the time being to serve the ailing and needy. This order was quickly rivaled by the semi-monastic Franciscans and Dominicans, till the rendering of bodily as well as spiritual aid had become an acknowledged function of the church, the gain to the nurse's soul being always coordinate with the amount of unpleasantness endured. Not satisfied with bathing his lepers, St. Francis sat with them at meat, eating out of their dishes; St. Hedwig washed the feet of those smitten with scurvy. Instinctively these great reformers felt the necessity of breaking down all reservations, all repulsions, in caring for anything so essentially odious as a diseased human body, and heaven as a perfectly sure reward would induce people to undergo the most indescribable disgusts. However different its expression, the wisdom of the world never materially changes, and our hospitals today feel compelled to put their pupils through a severe breaking in, to insure unquestioning acceptance of any horror with which the profession may legitimately confront them; but since nowadays it is not granted to every one to be happily certain of Paradise, some tangible earthly advantage may well be guaranteed the woman who undertakes a calling so taxing to mind and body.
In early times, English hospitals, like those of the Continent, were in the hands of religious orders, until the influence of the Reformation made them over to the mercies of convalescent patients or degraded nurses recruited from a class of women not good enough for ordinary domestic service. In 1546 St. Bartholomew's, previously a royal foundation, was given in charge by Henry VIII. to the Aldermen, Mayor, and Commonalty of the City of London, the new governing body binding themselves to establish upon the staff in three months "a matron and twelve women under her." From that time on, nursing in England was at a low ebb; arduous and ill paid, neither religious nor professional, it only attracted people who were quite unfit for any other occupation, often drunken and brutal, almost invariably inefficient. Particularly feeble paupers were considerately made night nurses, because the pittance so earned would enable them to buy better food than the ordinary workhouse fare.