I. ANCIENT AND MEDIEVAL. B. EARLY CHRISTIANITY

Christianity arose in Palestine during the first half of the first century c.e. among the followers of Jesus of Nazareth, called the Christ, who believed him to be the Messiah and the Son of God. Although the first followers were almost exclusively Jews, this new faith spread quickly through the Mediterranean basin and soon attracted many non-Jewish converts. For its first three centuries it remained a religion of a small but steadily growing minority. Officially declared a forbidden religion by the Roman imperial government, its adherents endured spasmodic persecutions that culminated in the Great Persecution (303–311). Emperor Constantine, a convert to Christianity, pronounced it a legal religion in 313; Emperor Theodosius I (379–395) declared it the official religion of the state and abolished the public practice of pagan religious rites.

This article covers the Christian religion from its origins to the fifth century. The sources for early Christianity are primarily literary: the New Testament, composed by followers of Jesus during the first century; and the patristic literature (the writings of early church leaders and theologians until the end of the fifth century). During this era, the beliefs and practices of the new faith were articulated and refined amid many controversies, particularly about the divinity of Christ and the nature of redemption. Gradually, a core of beliefs and a canon of literature predominated as orthodox and a church organization emerged that promoted these beliefs. By the late fifth century, orthodoxy had achieved its enduring form in doctrine and hierarchy, both of which differed in some respects between western Europe and the Byzantine culture of the East. At the same time, certain heterodox or heretical Christian groups existed peripherally. One of these, Arianism, became a powerful political and religious force.

Medical theories and practice in the varied milieu of Greek and Roman paganism were so religiously neutral that a discussion of classical medical ethics need pay relatively little attention to the subject of religion. Christianity, however, is fundamentally different in its most basic tenets and principles from the salient features of the religious pluralism in which it took root. Issues of health, sickness, healing, life, and death are so integral to Christian theology that two questions need to be addressed before anything meaningful can be said about early Christian medical ethics: (1) What was Christianity's theological understanding of illness? (2) Were the use and practice of medicine regarded as appropriate for Christians?

What was the theological understanding of illness? Patristic theology viewed physical health as a good but not an absolute good, and much less the supreme good. Physical health could even be an obstacle to the supreme good, which was spiritual health. The church fathers emphasized that the soul is infinitely more valuable than the body, and that care for the latter is not to conflict with care for the former. Yet the majority of the sources maintained that the body is to be reasonably cared for, since God has provided the means for its care. The church fathers saw health as a blessing from God, but since it was only a relative good, it could be an evil if given a higher priority than it deserved. Conversely, sickness could be a good thing. A survey of the writings of the church fathers reveals the firm conviction that Christians should rejoice in sickness as well as in health. Sickness can correct or restrain one from sin, refine, admonish, increase patience, reduce pride, cause one to be less self-reliant and more dependent upon God, and make one more mindful of eternity and one's own mortality, thus helping to wean one from the material to the spiritual, from the temporal to the eternal (Amundsen, 1982).

Sin lurked in the background of all conditions of suffering. Without sin there would be no suffering, because the fall of the first humans created by God, Adam and Eve, was the ultimate explanation for the miseries of the present. Sin, in this sense, was generic in the human race. When the church fathers identified personal sin as the cause of sickness, it was usually in the context of pastoral exhortations intended to comfort and correct rather than to foster guilt.

In the literature of the first several centuries of Christianity, three sources of disease or illness were identified: God, demons, and nature. They were not mutually exclusive. While there appears to have been a hesitancy to attribute disease directly to God, the more his sovereignty was stressed, the more he was viewed as either sending or permitting illness through demonic or natural instrumentality. The subject of disease causality in the early Christian literature is rife with confusion and interpretive problems, especially considering the perceived role of demons.

What was thought to cause disease in any given case greatly affected the choice of means of healing: spiritual/miraculous (e.g., prayer, the sacraments, exorcism, and, beginning in late antiquity, the cult of saints and relics); medical (drugs, dietetics, and surgery—typically administered by a physician); or magical (demonic or occult practices). The first two of these approaches were often combined, and sometimes magic was employed, although its use was consistently condemned in Christian literature. A Christian was to depend upon God. Sometimes the line of dependence was direct; at other times it included one or several intermediaries. The church itself (i.e., its clergy and sacraments) and the saints became variable parts of a chain of dependence to which a spiritual/miraculous healing model was essentially integral. A magical model offered an inherently incompatible, conflicting, and competing structure of dependence. A medical model was not necessarily either harmonious and compatible with the church's structure of dependence, or incompatible, conflicting, and competing with it.

Did the potential for tension between Christianity and medicine ever lead to a rejection of medicine? Some scholars have maintained that several church fathers were diametrically opposed to medicine in any form for Christians (e.g., Harnack; Frings; Schadewaldt). Most sources that have been thus interpreted have lately been shown not to be hostile to medicine per se (Amundsen, 1982; Temkin). Although more scholarly work remains to be done, it is unlikely that any patristic source will ultimately prove to have made a blanket condemnation of medicine. Nevertheless, some church fathers maintained that only those who lacked spirituality sufficient for them to be able to rely exclusively on divine healing should use medicine (e.g., Origen [ca. 184–ca. 253], Contra Celsum). Others practiced an asceticism that so glorified suffering and disease that they would not avail themselves of help from any source, although they did not deny the propriety of medicine for other Christians (Harvey; Amundsen, 1982).

Even if no patristic sources totally condemned medicine, the existence of those passages that have been thus interpreted, together with numerous cautionary statements about medicine made by other church fathers, demonstrates an uneasiness and a real potential for tension. Scholars like Adolf Harnack, Hermann-Josef Frings, Hans Schadewaldt, and Vivian Nutton, have advanced two possibly complementary theories to account for the supposedly unequivocal condemnation of medicine by some church fathers and the general uneasiness about Christians' using medicine expressed by others: (1) An early, conservative hostility against medicine was gradually ameliorated by a Hellenistic, liberalizing influence; (2) Christianity's supposed emphasis on, and ostensible promise of, miraculous physical healing was a constant, major obstacle to compatibility. Both views betray a misunderstanding of the nature of the inherent, and hence enduring, tensions and compatibilities between Christianity and medicine (Amundsen, 1982), and the second compounds the error by exaggerating the importance of miraculous healing in the propagation of the Gospel and in the Christian community, especially during the second and third centuries (Ferngren, 1992). Generally the patristic sources see medicine and physicians as God's gifts. Christianity inherited from Hellenistic Judaism an appreciation of Greek medicine that defined disease naturalistically while denying neither God's sovereignty nor his prerogative to intervene in mundane affairs. Nevertheless, the church fathers regarded as both sinful and foolish the use of physicians and medicine apart from faith in God and the failure to recognize that all healing, other than magical (demonic or occult), comes from God (Amundsen, 1982; Temkin).

The Ideal Physician of Early Christianity

The tension between Christianity and medicine was over-shadowed by their compatibility in one important sense: Jesus Christ was described as the great physician, the true physician, both the physician and the medication (Pease; Arbesmann; Schipperges, 1965; Temkin). Early Christian authors thus adopted and adapted a long-established tradition in classical literature that employed, in simile or metaphor, the idea of physicians as dedicated, unselfish, and compassionate preservers or restorers of health and, sometimes, inflicters of health-giving pain, always committed to the good of their patients. It was not uncommon for the term Hippocratic art to be used metonymously for the medical art, and Christian authors occasionally mention Hippocrates as an ethical ideal for the medical practitioner. Indeed, Christ was himself spoken of as being, "as it were, a spiritual Hippocrates" (Pease, p. 75), and it is to Hippocrates as the type of physician that Jerome (ca. 345–ca. 419), compares the Christian healer (In Ioanem Commentarii; cf. Epistle 125).

Early Christians found the "Hippocratic ideal" of decorum very appealing. Jerome wrote to a priest that it

is part of your duty to visit the sick, to be acquainted with people's households, with matrons, and with their children, and to be entrusted with the secrets of the great. Let it therefore be your duty to keep your tongue chaste as well as your eyes. Never discuss a woman's looks, nor let one house know what is going on in another. Hippocrates, before he will instruct his pupils, makes them take an oath and compels them to swear obedience to him. That oath exacts from them silence, and prescribes for them their language, gait, dress, and manners. How much greater an obligation is laid on us who have been entrusted with the healing of souls! (Epistle 52.15; see Temkin, p. 182)

In a collection of letters incorrectly attributed to Clement of Alexandria (ca. 150–ca. 220), there is a passage that reads, "We are to visit the sick … without guile or covetousness or noise or talkativeness or pride or any behavior alien to piety.… [I]nstead of using elegant phrases, neatly arranged and ordered … act frankly like men who have received the gift of healing from God, to God's glory" (De virginitate 1,112). This advice, which sounds as if it had been written for physicians, was intended for exorcists dealing with the demon-possessed. Every detail enunciated here, save for reference to piety and to God, is mentioned in the classical literature on medical etiquette, but one need not assume that the anonymous author of this letter was intentionally adopting principles of medical etiquette. Rather, the guidelines for conduct in both instances seem to be little more than practical etiquette for clergy as well as for physicians.

Compassion or philanthropy was the one feature of the "Hippocratic ideal" that the church fathers regarded as especially Christian. Origen writes that he followed "the method of a philanthropic physician who seeks the sick so that he may bring relief to them and strengthen them" (Contra Celsum 3.74). In demonstrating the superiority of Christianity to pagan philosophy, he says that "Plato and the other wise men of Greece, with their fine sayings, are like the physicians who confine their attention to the better classes and despise the common man while the disciples of Jesus carefully study to make provision for the great mass of men" (ibid., 7.60). It was in caring for common people, especially for the destitute and the poor, that physicians evinced a Christlike compassion. Augustine (354–430) regarded his friend, the physician Gennadius, as "a man of devout mind, kind and generous heart, and untiring compassion, as shown by his care of the poor" (Epistle 159). He frequently mentions physicians who, motivated by charity, asked no remuneration for their services but undertook the most desperate cases among the poor with no thought of receiving any recompense (e.g., Sermon 175).

Eusebius of Caesarea (ca. 265–ca. 339) writes that Christ, "like some excellent physician, in order to cure the [spiritually] sick, examines what is repulsive, handles sores, and reaps pain himself for the sufferings of others" (Ecclesiastical History 10.4.11). And Origen paraphrases a well-known Hippocratic aphorism that a physician "who sees terrible things and touches unpleasant wounds in order to heal the sick … does not wholly avoid the possibility that he may fall into the same plight" (Contra Celsum 4.15; see Temkin, pp. 141ff.). Physicians, according to Augustine, should always have their patients' cure at heart (Sermon 9), for the practice of medicine would be cruelty if physicians were only concerned about engaging in their art (In Psalmos). Gregory of Nyssa (ca. 335–394) began a letter to the physician Eustathius with the statement that, "Philanthropy is the way of life [epitedeuma, "one's business"] for all of you who practice the medical art" (although almost certainly written by Gregory of Nyssa, it is usually printed as Epistle 189 of his elder brother, Basil). While philanthropy was a highly desirable attribute for many pagan physicians, it is no exaggeration to say that Christianity made it an ethical obligation for Christian physicians (Temkin). Indeed, for some it became the chief motivating factor for the practice of medicine.

Hence it is not surprising that Christians adopted and adapted the so-called Hippocratic Oath at some time before the end of the period under consideration. Several manuscripts of an "Oath of Hippocrates insofar as a Christian may swear it" are extant (Jones, pp. 54f.). The Christian Oath omits the enigmatic prohibition of cutting for stone and makes more specific and definite the antiabortion statement. Where the pagan oath reads "Into whatsoever houses I enter, I shall do so to help the sick, keeping myself free from all intentional wrongdoing and harm," The Christian Oath has "Into whatsoever houses I enter, I will do so to help the sick, keeping myself free from all wrongdoing, both intentional and unintentional, tending to death or to injury." While one should not make too much of the addition of the promise to keep oneself free from even unintentional harm, it is reasonable to suggest that this concern, although not inconsistent with pagan medical ethics, is even more consonant with an early Christian ethics of respect for life that manifested itself not only in a condemnation of such practices as infanticide and suicide (including active euthanasia) but also in a philanthropy that was regarded as owed to the destitute and the ill.

Philanthropy

There is an enormous gap between pagan and Christian concepts of philanthropy. Christian philanthropy was an outgrowth of the Jewish insistence that love, mercy, and justice were attributes of God and were essential for true worship of God (e.g., Mic. 6: 6–8). Christian philanthropy was the expression of agape, an unlimited, freely given, sacrificial love that was not dependent on the worthiness of its object, since it was the manifestation of the very nature of God, who himself is agape (1 John 4:8). It was incumbent upon all Christians to extend care to the needy, especially to the sick. By late antiquity the care of the sick had become a highly organized activity under the supervision of the local bishop (Ferngren, 1988). Institutions that with some qualification may be called hospitals, were established and maintained beginning in the fourth century. The most famous of these was the nosokomeia or ptocheion of Basil, who was the bishop of Caesarea from 370 to 379 (Miller; Temkin). These institutions, as well as orphanages and homes for the care of the elderly and destitute, first arose after the legalization of Christianity, were distinctly Christian, and were a direct outgrowth of Christian philanthropy.

During various outbreaks of plague, Christians responded with spectacular daring in their attempts to succor the ill, both Christian and pagan. One particular group, on whom we have only scant information, were known as the parabalani ("reckless ones") because of the risks they faced by caring for plague victims (Philipsborn). Their zeal in the face of imminent danger was motivated in part by the belief that death thus incurred ranked with martyrdom (Eusebius, Ecclesiastical History). Christians were so well known for their care of the destitute that Julian the Apostate (r. 361–363), the only pagan emperor after the legalization of Christianity, complained that the "impious Galileans support not only their own poor but ours as well" (Epistle 22). Henry Sigerist did not overstate the case when he said that Christianity introduced "the most revolutionary and decisive change in the attitude of society toward the sick.… It became the duty of the Christian to attend to the sick and the poor of the community.… The social position of the sick man thus became fundamentally different from what it had been before. He assumed a preferential position which has been his ever since" (p. 69f.).

The Sanctity of Human Life

The Christian imperative to a practical philanthropy that extended to the poor and the sick was not solely a manifestation of Christian love but was ultimately articulated as a theology of respect for life, a principle of the sanctity of human life predicated on the concept of the imago Dei, the belief that every human being was formed in the image of God (Ferngren, 1987). By virtue of sharing the imago Dei, all human life was of value, and therefore was owed compassion and care. Specific condemnations of contraception, abortion, and infanticide, however, are not found in the New Testament. And when they first appear in Christian literature during the second century, they seem not to be predicated upon a developed concept of the imago Dei as the basis of human value. Rather, such condemnations appear in the context of broad and fervent denunciations of the most offensive sins to which Christians felt pagans were especially prone, such as gladiatorial shows and other exhibitions of extreme cruelty, and sexual immorality of an extravagantly imaginative variety.

The history of the treatment of contraception and abortion in the early church is rife with difficulties. First, the distinction between contraception and abortion, at least in the early stages of pregnancy, was blurred in both medical and popular perceptions (Noonan, 1966). The question of when human life begins was, and still is, hotly debated. Ancient embryology, although scientifically inaccurate, was more helpful than modern science in answering this question. Aristotle's theory of fetal succession of souls—nutritive, sensitive, rational—had a profound impact on patristic discussions of abortion. A fetus that is "fully formed" (a very imprecise concept) is "ensouled," that is, possesses a sensitive soul and is "animate" (an equally imprecise concept). One that is not "fully formed" is not "animate," in that it is not yet "ensouled" with a sensitive rather than a nutritive soul. The transition from a nutritive to a sensitive soul—that is, animation—is marked by "quickening," the first movement of the fetus, which ostensibly happens about the fortieth day with males and the ninetieth day with females.

Furthermore, Christian condemnations of contraception and abortion were based on two quite different principles. One is that contraception and abortion before "ensoulment" are essentially sexual sins but not the destruction of human life. The other is that contraception and abortion at any stage are indeed the destruction of human life. Both, of course, regarded abortion after "ensoulment" as homicide (Noonan, 1970; Connery; Gorman; Dombrowski). Some recent revisionist historians advance the argument that the early Christian community did not condemn abortion at any stage of fetal development until two factors conduced to condemning it: the desire to rely not only on evangelism to increase the Christian community but also on internal growth, and the developing contempt for women within the church that relegated them to the role of childbearers (e.g., Hoffmann). Such special pleading has little to commend it.

The Christian condemnation of infanticide, including exposure, however, was unequivocal and inclusive, counting the active or passive killing of any newborn, whether healthy, sickly, defective, or even grossly deformed, as the murder of one made in the image of God (Amundsen, 1987). Active euthanasia, except as it was condemned in the "Hippocratic oath insofar as a Christian may swear it," is not discussed in the sources, but must have been regarded as murder, especially given the early Christian community's attitude toward suicide. Although suicide was not included in the broad spectrum of sins of pagans that aroused the moral indignation of early Christians, it was condemned by numerous church fathers, beginning with Justin Martyr, who in the second century replied to the hypothetical question why Christians do not just kill themselves and save pagans the trouble, "If we do so, we shall be opposing the will of God" (2 Apology 4). At about the same time the anonymous Epistle to Diognetus states that Christians do not kill themselves because God has assigned them for an important purpose to a post that they must not abandon. Clement of Alexandria flatly states that suicide is not permitted for Christians (Stromateis). The anonymous Clementine Homilies, which reached their present form in the mid-fourth century, but were based on an original composed in the late second or early third century, assign to suicides a severe future punishment (Homily 12). Lactantius (ca. 240–320) condemns suicides as worse than homicides, since they not only commit violence against nature but are impious as well. Nothing, in his opinion, can be more wicked than suicide (Divine Institutes; Epitome 39). John Chrysostom (ca. 349–407) writes that all Christians justly regard suicide with horror, "for if it is base to destroy others, much more is it to destroy one's self" (Commentary on Galatians 1:4). His contemporaries Ambrose and Jerome also categorically condemn suicide, the former flatly stating that "Scripture forbids a Christian to lay hands on himself" (Concerning Virgins 3.7.32), and the latter that Christ will not receive the soul of a suicide (Letter 39). Both Ambrose and Jerome make one exception to their condemnation of suicide: when it is committed to preserve one's chastity.

Augustine's rejection of this one exception led him to engage in a thorough analysis of suicide in books I and XIX of his City of God. His argument against the permissibility of suicide is fivefold. First, Scripture neither commands it nor expressly permits it, either as a means of attaining immortality or as a way to avoid or escape any evil. Second, the Sixth Commandment of the Mosaic law, "Thou shalt not kill," must be understood to forbid it. Third, since individuals have no right on their own authority to kill even a person who justly deserves to die, those who kill themselves are homicides. Fourth, the act of suicide allows no opportunity for repentance. And fifth, suicide violates the foundational Christian principle of patient endurance of all that the sovereign Creator permits to befall humanity (Amundsen, 1989).

While the church fathers firmly held that death was not to be sought, they proclaimed that Christians should not fear physical death, since it would furnish them entry into the ineffable delights of heaven. Hence numerous patristic sources marveled at Christians who were afraid of dying, and especially at those who desperately clung to any hope of sustaining their lives when afflicted with seemingly hopeless illness. They viewed such conduct as tantamount to blasphemy, or at least as a sad contradiction of Christian values (Amundsen, 1989).

It was bad enough to stake one's futile hope of a temporary reprieve on physicians; but to resort to magic was even more reprehensible (Amundsen and Ferngren). For example, in the late fourth or early fifth century, John Chrysostom praised a mother who chose to allow her sick child to die rather than use amulets, although her ostensibly Christian friends had urged her to do so and she herself was confident that it could save her daughter's life (Homily 8 on Colossians). About 150 years later, the physician Alexander of Tralles employed quite different reasoning when he argued that it was sinful not to apply any remedy that might possibly save a patient's life, even amulets and incantations (Temkin). Alexander's attitude is interesting for three reasons. First, it demonstrates that magical remedies had already obtruded themselves into medicine. Second, it graphically illustrates a conflict of priorities between the physician and the theologian. And third, it is a very early, perhaps the earliest, hint of a physician's expressing a moral, indeed a religious, obligation to prolong life, in this case based on the reasoning that the supposedly greater sin of not doing all in one's power to save a patient was justifiably avoided by the lesser sin of using magical remedies.

Christianity developed a theological basis for the sanctity of human life, condemning contraception, abortion, infanticide (even of the sickly and deformed), suicide, and (by implication) active euthanasia. Although it did not embrace any sense of obligation to attempt to prolong life (nor did it until several centuries more had elapsed), its theology of sanctity of life did conduce to the reasoning of Alexander of Tralles that is described above, an attitude that grew even stronger during the Middle Ages.

Conclusion

In early Christian literature a reasonably clear, if not exhaustive, picture emerges of ideal physicians who were "Hippocratic" in their decorum and motivated by Christian philanthropy, and who so cherished the sanctity of human life that they would neither perform abortions nor assist in suicide, yet regarded desperate attempts to forestall death as inconsistent with ultimate Christian values. Nevertheless, such a description tells us nothing directly about the ethics of early Christian physicians except insofar as individual physicians may have agreed with and attempted to conform to such an ideal.

The ideal physician had been posited in classical antiquity, and that ideal included compassion as a desirable characteristic. However, agape—Christian love, which was the basis of philanthropy—was so central a tenet of Christian theology that it was applied to the physician as not merely a desirable but as an essential characteristic. The philanthropic basis of medical practice and the principle of the sanctity of human life became the hallmarks of Western medical ethics until modern times.

darrel w. amundsen (1995)

BIBLIOGRAPHY

Amundsen, Darrel W. 1982. "Medicine and Faith in Early Christianity." Bulletin of the History of Medicine 56(3): 326–350.

Amundsen, Darrel W. 1986. "The Early Christian Tradition." In Caring and Curing: Health and Medicine in the Western Religious Traditions, pp. 40–64, ed. Ronald L. Numbers and Darrel W. Amundsen. New York: Macmillan.

Amundsen, Darrel W. 1987. "Medicine and the Birth of Defective Children: Approaches of the Ancient World." In Euthanasia and the Newborn: Conflicts Regarding Saving Lives, pp. 3–22, ed. Richard C. McMillan, H. Tristram Engelhardt, Jr., and Stuart F. Spicker. Dordrecht, Netherlands: D. Reidel.

Amundsen, Darrel W. 1989. "Suicide and Early Christian Values." In Suicide and Euthanasia: Historical and ContemporaryThemes, pp. 77–153, ed. Baruch A. Brody. Dordrecht, Netherlands: Kluwer.

Amundsen, Darrel W., and Ferngren, Gary B. 1982. "Philanthropy in Medicine: Some Historical Perspectives." In Beneficence and Health Care, pp. 1–31, ed. Earl E. Shelp. Dordrecht, Netherlands: D. Reidel.

Arbesmann, Rudolph. 1954. "The Concept of 'Christus Medicus' in St. Augustine." Traditio 10: 1–28.

Connery, John R. 1977. Abortion: The Development of the Roman Catholic Perspective. Chicago: Loyola University Press.

D'Irsay, Stephen. 1927. "Patristic Medicine." Annals of Medical History 9(4): 364–378.

Dombrowski, Daniel A. 1988. "St. Augustine, Abortion, and Libido Crudelis." Journal of the History of Ideas 49(1): 151–156.

Ferngren, Gary B. 1987. "The Imago Dei and the Sanctity of Life: The Origins of an Idea." In Euthanasia and the Newborn: Conflicts Regarding Saving Lives, pp. 23–45, ed. Richard C. McMillan, H. Tristram Engelhardt, Jr., and Stuart F. Spicker. Dordrecht, Netherlands: D. Reidel.

Ferngren, Gary B. 1988. "The Organisation of the Care of the Sick in Early Christianity." In Actes: Proceedings of the XXX International Congress of the History of Medicine, pp. 192–198. Leverkusen, Germany: Vicom KG.

Ferngren, Gary B. 1992. "Early Christianity as a Religion of Healing." Bulletin of the History of Medicine 66(1): 1–15.

Frings, Hermann Josef. 1959. "Medizin und Arzt bei den griechischen Kirchenvätern bis Chrysostomos." Ph.D. diss., University of Bonn.

Gorman, Michael. 1982. Abortion and the Early Church: Christian, Jewish, and Pagan Attitudes in the Greco-Roman World. Downers Grove, Ill.: Intervarsity.

Harnack, Adolf. 1892. Die griechische Übersetzung des Apologeticus Tertullians Medizinisches aus der ältersten Kirchengeschichte. Texte und Untersuchungen zur Geschichte der altchristlichen Literatur, 8(4). Leipzig: J. C. Heinrichs.

Harvey, Susan Ashbrook. 1985. "Physicians and Ascetics in John of Ephesus: An Expedient Alliance." In Symposium on Byzantine Medicine, pp. 87–93, ed. John Scarborough. Dumbarton Oaks Papers, no. 38. Washington, D.C.: Dumbarton Oaks Library and Collection.

Hoffmann, R. Joseph. 1990. "Faith and Foeticide." Conscience: A Newsjournal of Prochoice Catholic Opinion 11(6): 1, 3–6.

Jones, William Henry Samuel. 1924. The Doctor's Oath: An Essay in the History of Medicine. Cambridge: Cambridge University Press.

Miller, Timothy S. 1985. The Birth of the Hospital in the Byzantine Empire. Baltimore: Johns Hopkins University Press.

Noonan, John T., Jr. 1966. Contraception: A History of Its Treatment by the Catholic Theologians and Canonists. Cambridge, MA: Harvard University Press.

Noonan, John T., Jr. 1970. "An Almost Absolute Value in History." In The Morality of Abortion: Legal and Historical Perspectives, pp. 1–59, ed. John T. Noonan, Jr. Cambridge, MA: Harvard University Press.

Nutton, Vivian. 1985. "From Galen to Alexander, Aspects of Medicine and Medical Practice in Late Antiquity." In Symposium on Byzantine Medicine, pp. 1–14, ed. John Scarborough. Dumbarton Oaks Papers, no. 38. Washington, D.C.: Dumbarton Oaks Library and Collection.

Pease, Arthur Stanley. 1914. "Medical Allusions in the Works of St. Jerome." Harvard Studies in Classical Philology 25: 73–86.

Philipsborn, Alexandre. 1950. "La compagnie d'ambulanciers 'parabalani' d'Alexandrie." Byzantion 20: 185–190.

Quasten, Johannes. 1950–1986. Patrology. 4 vols. Westminster, MD: Newman Press. Should be consulted for references to available texts and English translations.

Rengstorf, Karl Heinrich. 1953. Die Anfänge der Auseinandersetzung zwischen Christusglaube und Asklepiosfrömmigkeit. Münster: Aschendorff.

Schadewaldt, Hans. 1965. "Die Apologie der Heilkunst bei den Kirchenvätern." Veröffentlichungen der Internationalen Gesellschaft für Geschichte der Pharmazie 26: 115–130.

Schipperges, Heinrich. 1965. "Zur Tradition des 'Christus Medicus' in frühen Christentum und in der älteren Heilkunde." Arzt und Christ 11: 12–20.

Schipperges, Heinrich. 1990. "Krankheit IV. Alte Kirche." In vol. 19 of Theologische Realenzyklopädie, pp. 686–689, ed. Frank Schumann and Michael Wolter. Berlin: Walter de Gruyter.

Sigerist, Henry E. 1943. Civilization and Disease. Ithaca, NY: Cornell University Press.

Temkin, Owsei. 1991. Hippocrates in a World of Pagans and Christians. Baltimore: Johns Hopkins University Press.