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The Christian community and the world » The relationships of Christianity » Church and social welfare » Curing and caring for the sick » Healing the sick
The Christian church has responded to the matter of human illness both by caring for and healing the sick and by expressing concern for them. The practice of healing has retreated into the background in modern times, but healing played a decisive role in the success of the early church and was important in missionary apologetics. In the Gospels, Jesus appears as a healer of body and soul. The title “Christ the Physician” was the most popular name for the Lord in missionary preaching of the first centuries. Even the Apostles are characterized as healers. The Apologists of the 2nd to 4th century used numerous miraculous healings as arguments for the visible presence of the Holy Spirit in the church. The Fathers of the first centuries interpreted the entire sphere of charismatic life from the basic concepts that Christ is the physician, the church the hospital, the sacraments the medication, and orthodox theology the medicine chest against heresy. Ignatius of Antioch called the Eucharist the “medication that produces immortality.” Healing within the church began to retreat only in connection with the transformation of the church into a state church under Constantine and with the replacement of free charismatics by ecclesiastical officials.

The early basis for healing was generally a demonological interpretation of sickness: healing was often carried out as an exorcism—that is, a ceremonial liturgical adjuration of the demon that was supposed to cause the illness and its expulsion from the sick person. The development of exorcism is characteristic in that the office of the exorcist eventually became one of the lower levels of ordination, which led to the priesthood. During the Enlightenment in the 18th century, the practice of exorcisms within the Roman Catholic Church was suppressed.

In the Protestant churches, exorcism never completely vanished; in Pietistic circles exorcists such as Johann Christoph Blumhardt the Elder (1805–80) have appeared. With the motto “Jesus is Conquerer,” Blumhardt transformed his healing centre at Bad Boll in Germany, into an influential resource for international missionary work. His son, Christoph Friedrich Blumhardt (1842–1919), continued his father’s work and in sympathy with working-class needs entered politics as a member of the Württemberg Diet. Since the latter part of the 19th century, different groups of the Pentecostal and charismatic movements have revived the use of exorcistic rituals with great emphasis and—pointing to the power of the Holy Spirit—they claim the charisma of healing as one of the spiritual gifts granted the believing Christian. After the basic connection between healing of the body and healing of the soul and the psychogenic origin of many illnesses was acknowledged theologically and medically, different older churches, such as the Protestant Episcopal Church and even the Roman Catholic Church in the United States, have reinstituted healing services.

In terms of spiritual healing, one church has stood out in this respect. Mary Baker Eddy (1821–1910), the founder of Christian Science, referred particularly to healing through the Spirit as her special mission. Based on her experience of a successful healing from a serious illness by Phineas Quimby, a pupil of the German hypnotist Franz Mesmer, she wrote Science and Health with Key to the Scriptures and founded the Church of Christ, Scientist. According to the instructions of its founder, Christian Science today carries out a practice of “spiritual healing” throughout the world.

The Christian community and the world » The relationships of Christianity » Church and social welfare » Curing and caring for the sick » Care for the sick
In The Gospel According to Matthew, Jesus says to his Apostles, when the Son of Man comes in majesty to render final judgment on all of humankind, he will say to the chosen ones on his right hand: “I was sick and you visited me,” and to the condemned on his left hand: “I was sick and you did not visit me.” When the condemned ask the Lord when they saw him sick and did not visit him, they will receive the answer: “As you did it not to one of the least of these, you did it not to me.”

In the early church, the care of the sick was carried out by the deacons and widows under the leadership of the bishop. This service was not limited to members of the Christian congregation but was directed toward the larger community, particularly in times of pestilence and plague. Eusebius noted in his Ecclesiastical History that while the heathen fled the plague at Alexandria, “most of our brother-Christians showed unbounded love and loyalty” in caring for and frequently dying with the victims.

Beginning in the 4th century, the monasteries created a new institution, the hospital, and continued to care for the sick throughout the Middle Ages. The growing number of pilgrims to the Holy Land and the necessity of care of their numerous sick, who had fallen victim to the unfamiliar conditions of climate and life, led to knightly hospital orders, the most important of which was the Order of the Hospital of St. John of Jerusalem (later called the Knights of Malta), founded in the 11th century. The service for the sick, which was carried out by the knights alongside their military service for the protection of the pilgrims, was not elaborate.

In connection with the orders of mendicant friars, especially the Franciscans, civil hospital orders were formed. Even the hospital in Marburg, which was founded by St. Elizabeth of Hungary (1207–31) on the territory of the Knights of the Teutonic Order, was influenced by the spirit of St. Francis. Other hospitals were founded as autonomous institutions under the leadership or supervision of a bishop. The centralization of the different existing institutions became necessary with the growth of cities and was most frequently undertaken by city councils. The laity began to take over, but the spiritual and pastoral care of the patients remained a major concern.

In Protestant lands during the Reformation, medieval nursing institutions were adapted to new conditions. The church constitutions in the different territories of the Reformation stressed the duty of caring for the sick and gave suggestions for its adequate realization. The office of the deacon was supplemented by that of the deaconess. The Counter-Reformation brought a new impulse for caring for the sick in the Roman Catholic Church, insofar as special orders for nursing service were founded—e.g., the Daughters of Charity, a non-enclosed congregation of women devoted to the care of the sick and the poor, founded by Vincent de Paul, a notable charismatic healer. A great number of new orders came into existence and spread the spirit and institutions of ecclesiastical nursing care throughout the world as part of Roman Catholic world missions.

The Free churches led in the care of the sick in Protestant countries. Methodists, Baptists, and Quakers all had a great share in this development, founding numerous hospitals throughout the world and supplying them with willing male and female helpers. German Lutheranism was influenced by these developments. In 1823 Amalie Sieveking developed a sisterhood analogous to the Daughters of Charity and was active in caring for the cholera victims of the great Hamburg epidemic of 1831. She was an inspiration to Theodor Fliedner, who founded the first Protestant hospital in Kaiserswerth in 1836 and created at the same time the female diaconate, an order of nurses that soon found worldwide membership and recognition. Florence Nightingale received training at Kaiserswerth, which was an important model for modern nursing schools.

Church hospitals and ecclesiastical nursing care maintained a leading role in the 20th century, although along with the general political and social development of the 19th century the city or communal hospital was founded and overtook the church hospital.

The most impressive example of the universal spread of care for the sick was the founding of the Red Cross by the Swiss humanitarian Henri Dunant. The religious influence of Dunant’s pious parental home in Geneva and the shocking impression he received on the battlefield of Solferino in June 1859 led him to work out suggestions that—after difficult negotiations with representatives of numerous states—led to the conclusion of the “Geneva convention regarding the care and treatment in wartime of the wounded military personnel.” In the 20th century the activity of the Red Cross embraced not only the victims of military actions but also peace activity, which includes aid for the sick, for the handicapped, for the elderly and children, and for the victims of all types of disasters everywhere in the world.

The Christian community and the world » The relationships of Christianity » Church and social welfare » Care for widows and orphans
The Christian congregation has traditionally cared for the poor, the sick, widows, and orphans. The Letter of James says: “Religion that is pure and undefiled before God is this: to visit orphans and widows in their affliction.” Widows formed a special group in the congregations and were asked to help with nursing care and other service obligations as long as they did not need help and care themselves.

The church had founded orphanages during the 4th century, and the monasteries took over this task during the Middle Ages. They also fought against the practice of abandoning unwanted children and established foundling hospitals. In this area, as in others, a secularization of church institutions took place in connection with the spreading autonomy of the cities. In Protestant churches the establishment of orphanages was furthered systematically. In Holland almost every congregation had its own orphanage, which was sustained through the gifts of the members.

Following the wars of religion of the 17th century, the orphanages were reorganized pedagogically, notably by August Hermann Francke, who connected the orphanage in Glaucha, Germany, which he had founded, with a modern system of secondary schools. Francke’s orphanage became a model that was frequently imitated in England and also in North America. Another innovator was the Alsatian Lutheran pastor Johann Friedrich Oberlin (1740–1826), an exemplary proponent of comprehensive Christian caring and curing for the whole person and community. Responsible for a remote and barren area in the Vosges Mountains, Oberlin transformed the impoverished villages into prosperous communities. He led in establishing schools, roads, bridges, banks, stores, agricultural societies (with the introduction of potato cultivation), and industries. His nursery schools were imitated in many areas through “Oberlin Societies.” These efforts provided a significant contribution to the development of modern welfare, which in the 20th century was mainly the responsibility of state, communal, or humanitarian organizations but was still characterized strongly by its Christian roots.

Ernst Wilhelm Benz
Carter H. Lindberg

The Christian community and the world » The relationships of Christianity » Church and social welfare » Property, poverty, and the poor
The Christian community’s response to the questions of property, poverty, and the poor may be sketched in terms of four major perspectives, which have historically overlapped and sometimes coexisted in mutuality or contradiction. The first perspective, both chronologically and in continuing popularity, is personal charity. This was the predominant form of the church’s relationship to the poor from the 1st to the 16th century. The second perspective supplements the remedial work of personal charity by efforts for preventive welfare through structural changes in society. This concern to remove causes of poverty was clearly expressed in the Reformation but was soon submerged in the profound sociopolitical and economic changes of the time. The third perspective is a retreat into the charity models of the earlier Christian community. Because of the overwhelming effects of the process of secularization and the human misery caused by industrialization, the key to social welfare was expressed in the Pietist maxim that social change depended upon the conversion of individuals. The fourth perspective, present in churches of the modern period, envisions systemic social change to facilitate redistribution of the world’s wealth. Personal charity is not neglected, but the primary goal is to change the unjust structures of world society.

Augustine’s doctrine of charity became the heart of Christian thought and practice. Augustine portrayed the Christian pilgrimage toward the heavenly city by analogy to a traveler’s journey home. The city of God, humankind’s true home, is characterized by the love of God even to the contempt of self, whereas the earthly city is characterized by the love of self even to the contempt of God. It is the goal—not the journey—that is important. The world and its goods may be used for the journey, but if they are enjoyed they direct the traveler away from God to the earth. This imagery incorporates into Christian theology the great themes of pilgrimage, renunciation, alienation, and asceticism; and the biblical and early Christian suspicion of riches receives systematic theological articulation. Pride and covetousness are the major vices; humility and almsgiving are the major virtues; and poverty is endorsed as the favoured status for the Christian life.

This view did not, however, lead to a rejection of property and its importance for society. Although Gregory of Nazianzus (c. 330–c. 389) linked private property to the Fall, he understood that the abolition of private property would not cure sin. Property and wealth should be shared, not relinquished. Yet the paradox of 2 Corinthians 6:10 remained: How could a Christian be poor yet make many rich, have nothing yet possess everything? The answers given were communal property, charity to the needy, avoidance of avarice, and concentration upon heavenly treasure. The solutions of institutionalizing poverty in priesthood and monasticism, while rationalizing poverty as poverty of the spirit and material wealth as God’s provision for ministry, formed the basis for medieval care of the poor.

The most influential medieval thinker on the problem of property was Thomas Aquinas, who saw community of goods as rooted in natural law because it makes no distinction of possessions. The natural law of common use protects every person’s access to earthly goods and requires responsibility by everyone to provide for the needs of others. Private property, on the other hand, is rooted in positive law through human reason. Reason leads to the conclusion that the common good is served if everyone has disposition of his own property because there is more incentive to work, goods are more carefully used, and peace is better preserved when all are satisfied with what they have. Private property exists to serve the common good; thus, superfluous property is to be distributed as alms to the needy.

The other major effort to deal with property and poverty at this time was through rational direction and administration. As cities developed into political corporations, a new element entered welfare work: an organizing citizenry. Through their town councils, citizens claimed the authority to administer the ecclesiastical welfare work of hospitals and poor relief. The process was accelerated by the Reformers, whose theology undercut the medieval idealization of poverty. According to the Reformers, righteousness before God was by faith alone, and salvation was perceived as the foundation of life rather than its goal. Thus, the Reformation community found it difficult to rationalize the plight of the poor as a peculiar form of blessedness, and no salvific value either in being poor or in giving alms could be identified. When the Reformers turned to poor relief and social welfare, their new theological perspectives led them to raise questions of social justice and social structures. This was codified in Protestant church legislation in the “common chest,” which spread throughout Europe from its origin in Wittenberg. The common chest—funded by church endowments, offerings, and taxes—was the community’s financial resource for providing support to the poor, orphans, the aged, the unemployed, and the underemployed through subsidies, low-interest loans, and gifts.

In the 16th and 17th centuries Christian leaders, both Protestant and Roman Catholic, served the poor while ignoring the root causes of poverty. In the 18th and 19th centuries, however, the social institutions of Pietism, the Inner Mission, and European revival movements inspired social concern for the masses of people pauperized and proletarianized by industrialism. The Methodists in England undertook adult education, schooling, reform of prisons, abolition of slavery, and aid to alcoholics. Famous missions arose in Basel, London, and Paris. The Young Men’s Christian Association (YMCA; 1844), Young Women’s Christian Association (YWCA; 1855), and the Salvation Army (1865) were only some of the numerous charitable institutions and organizations created to alleviate modern ills. In 1848 Johann Wichern, founder of the Inner Mission, proclaimed that “love no less than faith is the church’s indispensable mark.”

Yet this Christian social concern hardly was aware of and rarely attempted to expose the origins of the social ills it strove to remedy. Wichern himself was aware that poverty is social, not natural, but his orientation, like that of others, was toward renewing society through evangelization. This attitude—that society is changed by changing the hearts of individuals—is still prevalent.

In the second half of the 20th century, however, the Christian community, especially in its ecumenical organizations, began to analyze the social problems of property and poverty from the standpoint of justice and the perspectives of the poor and oppressed. In 1970 the World Council of Churches (WCC) established the Commission for the Churches’ Participation in Development (CCPD). Initially involved in development programs and the provision of technical services, the CCPD focus shifted to the psychological and political character of the symbiosis of development and underdevelopment. This focus was endorsed at the 1975 WCC Assembly at Nairobi, Kenya, as “a liberating process aimed at justice, self-reliance and economic growth.” Other church bodies, such as the Lutheran World Federation and the World Alliance of Reformed Churches, shared this perspective. There was also the sense that the biblical themes of justice and liberation entail the creation of social structures to enhance human life, economic structures for the just distribution of goods, and political structures to promote participation and minimize dependence. This attitude is well reflected in liberation theology, which was popular in segments of the Roman Catholic Church from the 1970s to the 1990s. Seeking to apply the faith by aiding the poor and oppressed, primarily in developing countries, advocates of liberation theology established local “base camps” to study the Bible and to address the economic needs and political interests of poor communities.

The Christian community and the world » The relationships of Christianity » Church and social welfare » Pastoral care
Pastoral care has always been of special importance in the Christian community. The biographies of the great charismatic ministers, beginning with the Fathers of the Eastern Church and the Western Church, testify to surprising variations of this pastoral care. The principal interest of pastoral care—whether exercised by clergy or laity—is the personal welfare of persons who are hurt, troubled, alienated, or confused within. The historical expressions of pastoral care have focused on the predominant—but not exclusive—expressions of ultimate concern characteristic of the period in question. Ignatius, for example, addressed the terror of death when he termed the sacrament “the medicine of immortality”; Luther responded to the conscience tortured by guilt and uncertainty by proclaiming the free forgiveness of sin by grace alone, apart from human accomplishment; and the modern Christian community has utilized the insights of psychology and psychiatry in developing pastoral counseling and therapy responsive to modern anxieties. Fundamentally, however, pastoral care has always attempted to respond to the totality of human needs in every age in consonance with the words of Jesus Christ: “I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me” (Matthew 25:35–36).

One of the most important contributions to pastoral care after the New Testament was by Pope Gregory I the Great. His Pastoral Care, written after he became bishop of Rome in 590, was so influential that it became customary to present it to new bishops upon their ordination. This textbook of the medieval episcopate emphasized the role of the pastor as shepherd of souls.

The medieval institutionalization of pastoral care in the sacrament of penance led to certain deficits in practice: the exclusion of the laity by emphasis upon the central role of the priest and the distortion of its original spiritual purposes of prayer, repentance, and forgiveness of sins by the introduction of paid indulgences. The indulgence abuse sparked the Reformation critique of the sacrament of penance. This in turn led to the Reformers’ emphasis upon lay as well as clerical responsibility for pastoral care as expressed in their teaching of “the priesthood of all believers.” The Reformation insistence upon justification by grace alone shifted the burden of proof for salvation from human accomplishment to divine promise. By “letting God be God,” the Reformers claimed that persons were free to be human. This shift of theological focus, from an otherworldly achievement to a this-worldly trust in God, facilitated a renewed holistic awareness of human needs.

Carter H. Lindberg



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