Post-classical history

Hospital, Order of the

The Order of the Hospital (also known as the Order of St. John, and later as the Knights of Rhodes and the Knights of Malta), was an international military religious order that originated in the city of Jerusalem before the First Crusade (1096-1099). Originally established as an order whose function was to provide hospital service, it gradually assumed military responsibilities and became involved in the defense and internal politics of the Frankish states of Outremer. At the same time, the order received European properties that were organized into langues (literally, “tongues”) that paid annual dues, called responsions, to the central convent.

The order moved its central convent and hospital to Acre (mod. ‘Akko, Israel) when Saladin captured Jerusalem in 1187. After the fall of Acre in 1291, the order briefly moved to Cyprus. By 1310 it had captured the island of Rhodes (mod. Rodos, Greece) from the Byzantines, and it became a naval power in the eastern Mediterranean, maintaining a fleet of galleys and garrisoning castles. On Rhodes the Hospitallers faced several major sieges, including two by the Mamlûks in 1440 and 1444 and two by the Ottomans in 1480 and 1522. The Hospitallers surrendered Rhodes to the Ottomans in 1522. In 1530 Charles V, Holy Roman Emperor and king of Spain, gave the order the island of Malta. The Hospitallers ruled Malta until 1798, when Grand Master Ferdinand von Hompesch surrendered the island to Napoleon Bonaparte. Subsequently the order briefly found refuge in Russia and in Italy. Today, the order is still sovereign and devoted to hospitaller activities, administering medical charities worldwide from its headquarters in Rome. It no longer has a military character.

Origins and Militarization

The Order of the Hospital began as a pilgrim’s hospice, established in the city of Jerusalem by merchants from the Italian city of Amalfi. The hospice was operated by a lay confraternity under the auspices of the Benedictine abbey of St. Mary of the Latins. The Hospitallers of St. John began receiving grants of lands and properties in Europe and Outremer after the conquest of Jerusalem in 1099 and were recognized as a separate order by Pope Paschal II in 1113. The first master, Gerard, died in 1120 and was succeeded by Raymond of Le Puy (1120-1158/1160), a French knight who had come to Jerusalem with the First Crusade (1096-1099). Raymond’s leadership shaped the order, and it was under his mastership that the Hospitallers began to assume military duties in addition to the care of pilgrims and the sick in their Jerusalem hospital. References to the Hospitallers as a primarily charitable institution appear in papal documents until the late twelfth century. However, it appears that the entry of Raymond and other former knights into the order, the need to police pilgrimage routes, and a new definition of the Christian knight as a lover of justice and defender of the weak, influenced by Bernard of Clairvaux’s De laude novae militiae ad milites Templi(1128), caused the Hospitallers to gradually assume military responsibilities.

Areas of activity of the Order of the Hospital in the Eastern Mediterrean region

Areas of activity of the Order of the Hospital in the Eastern Mediterrean region

By the end of the twelfth century, the Hospitallers, along with the Templars, provided military forces for the Christian states of Outremer and garrisoned frontier castles. They were granted their first castle, Bethgibelin (mod. Bet Guvrin, Israel), in 1136 by Fulk of Anjou, king of Jerusalem. In 1142/1144 Count Raymond II of Tripoli gave them the Krak des Chevaliers (mod. Hisn al-Akrād or Qal‘at al-Hisn, Syria). This castle and the castle of Margat (mod. Marqab, Syria, acquired in 1186) became major administrative centers with extensive domains that provided income for the order.

The early charters do not indicate whether Hospitallers initially garrisoned the castles themselves, and there is no definite reference to military personnel as members of the order before the middle of the twelfth century. Hospitallers did, however, serve in the armies of Outremer. Raymond of Le Puy fought in the army of Baldwin II of Jerusalem in 1128, and according to the chronicler William of Tyre, Hospitallers served at the siege of Ascalon (mod. Tel Ashqelon, Israel) in 1153. In Aragon, Hospitallers were present at Tortosa in 1148 and received the castle of Amposta in 1149. The order may have reexamined its military role following the resignation of the master Gilbert of Assailly (1163-1169/1170), who had encouraged King Amalric of Jerusalem in his unsuccessful invasion of Egypt and left the order in debt.

A Knight Brother of the Order of the Hospital, painting by Pinturicchio (1454-1513). (Bettmann/Corbis)

A Knight Brother of the Order of the Hospital, painting by Pinturicchio (1454-1513). (Bettmann/Corbis)

It is probable that the order initially followed the Rule of St. Benedict until the promulgation of its first rule, attributed to Raymond of Le Puy and strongly influenced by the Rule of St. Augustine. Subsequent masters augmented the rule with statutes approved by meetings of the chapter general of the order. By the 1170s these statutes had institutionalized the Hospitallers’ military duties. The 1206 statutes of Margat first describe the offices of knights and sergeants-at- arms, and by the 1270s knights held all the high offices in the order. The 1206 statutes also reveal the international structure of the order and were influential in shaping its development. At the end of the thirteenth century, William of St. Stephen compiled the customs of the order (called esgarts and usances), which were based upon decisions made at meetings of the chapter general. The statutes of the order were not compiled and organized until Guillaume Caoursin, the vice-chancellor, published the Stabilimentum in 1494.

The Hospitallers in Outremer (to 1291)

Under Roger of Les Moulins (1177-1187), the Hospitallers became more involved in the politics of the Frankish states of Outremer, particularly the succession of Guy of Lusignan and his wife Sibyl to the throne of Jerusalem in 1186. Roger, a supporter of the faction led by Count Raymond III of Tripoli, vied with Gerard of Ridefort, the master of the Temple, who supported the Lusignans. Roger was killed in May 1187, at the battle of the spring of Cresson, leaving the Hospitallers leaderless at the battle of Hattin (4 July 1187). There the order suffered considerable losses, and in the aftermath of the battle lost its castles of Bethgibelin and Belvoir (mod. Kokhav ha-Yarden, Israel), although Saladin did not attempt to besiege Margat and Krak des Chevaliers.

After Hattin, the Hospitallers and Templars became more important as military and political advisors to the Frankish rulers, and their Western resources became essential for the survival of European rule in Outremer. The Hospitallers received money and provisions from their Western priories in addition to income from their properties in Outremer and from their participation in the coastal sugar trade. They contributed substantially to the campaigns of the Third Crusade (1189-1192), serving as senior advisors to King Richard I of England.

The two major military religious orders also assumed some administrative responsibility in the kingdom of Jerusalem, which for much of the thirteenth century was ruled by a series of regents for an absentee monarchy. As Mamlûk power increased in the later part of the thirteenth century, the Hospitallers played an important role in making treaties with Egypt. Masters such as Hugh Revel actively acquired properties around the Krak des Chevaliers and adopted an aggressive policy against the Mamlûks. However, the Mamlûks took Krak des Chevaliers in 1271 and Margat in 1285. The Hospitallers left Outremer after the fall of Acre in May 1291, when the master, John of Villiers, was severely wounded during the city’s defense and was evacuated to Cyprus with the remains of the convent.

The Hospitallers on Rhodes (1310-1522) and Malta (1530-1798)

After the fall of Acre, there was some discussion in western Europe about combining or dissolving the Hospitallers and the Templars. The two biggest military religious orders had been criticized for their sometimes rancorous participation in the politics of Outremer and their apparent hesitancy to pursue the immediate recovery of the Holy Land. The Hospitallers’ establishment of their central convent and infirmary on Rhodes coincided with the dissolution of the Order of the Temple and the confiscation of its properties. Although there is no evidence that the Hospitallers planned for this eventuality, they avoided a fate similar to that of the Templars by removing their convent from any possible interference from European rulers.

From 1306 to 1310 the Hospitallers conquered the island of Rhodes (located off the southwestern coast of Anatolia) from the Byzantines. They subsequently acquired other islands and territories in the Dodecanese, notably Kos, Simi, Kastellorizo, and Bodrum. On Rhodes, although still subject to the authority of the pope, the order became a sovereign state and naval power involved in the politics of the eastern Mediterranean. The order entered into treaties with and collected tribute from Muslim potentates.

Individual popes, such as Innocent VI, pressured the order to move to the Anatolian mainland and fight against the Turks, under the threat of losing its lands to a new military religious order. These plans did not come to fruition, however, and Rhodes served as the base for several crusading expeditions in the fourteenth century. The Hospitallers participated in Pope Clement VI’s crusade to capture Smyrna (mod. Izmir, Turkey) in 1343-1349, and then contributed 3,000 florins a year to its defense until it was lost in 1402. In 1365 Rhodes was the staging place for the crusade of King Peter I of Cyprus against Alexandria in Egypt. The sack of Alexandria in October 1365 alarmed the master of the Hospital, Raymond Berengar, who feared that the Mamlûk sultan would retaliate by blockading Rhodes and Cyprus; this concern demonstrates the extent of Hospitaller reliance upon the mainland of the Near East for food and other supplies.

The Great Schism between rival popes in Rome and Avignon (1378-1417), combined with the order’s financial difficulties, prevented any military campaigns against the Turks, although the Hospitallers leased Morea in Greece from the Byzantines between 1376/1381 and 1404 and began construction of the castle of Bodrum on the mainland of southwestern Anatolia in 1404. The increasingMamlûk and Ottoman activity in the eastern Mediterranean in the fifteenth century caused the Hospitallers to update their fortifications. The Mamlûks attacked Rhodes and Kos in 1440, and Rhodes again in 1444. The Ottomans attacked the Morea in 1446, completing its conquest in 1460; in 1453 they captured Constantinople (mod. Istanbul, Turkey) and thus extinguished the Byzantine Empire. The Hospitallers assisted the Venetians when Sultan Mehmed II, the conqueror of Constantinople, besieged Venetian Negroponte (Euboia) in 1470, although the Venetians lost the island. Mehmed’s fleet unsuccessfully besieged Rhodes itself in 1480. Mehmed died the following year; when his son Bayezid II became sultan his other son, Cem (Djem), fled to the Hospitallers on Rhodes for sanctuary. Bayezid paid the Hospitallers an annual income to keep Cem hostage. After Cem’s death, hostilities resumed between the Hospitallers and the Ottomans. Grand Master Philippe de Villiers de l’Isle Adam surrendered Rhodes to the forces of Sultan Süleyman II in 1522.

Süleyman permitted the Hospitallers to withdraw from Rhodes with many of their possessions and archives. The order debated where to relocate the central convent; the French knights, who were in the majority, preferred France, which the Spanish knights opposed. Emperor Charles V offered the Hospitallers the island of Malta, together with the islands of Gozo and Comino, and Tripoli (mod.Tarābulus, Libya) in North Africa. The order considered his offer for some time before accepting it in 1530, noting Malta’s relative poverty, its fine harbor, and its importance for the defense of Sicily. Tripoli proved to be indefensible and was abandoned in 1551.

On Malta, the Hospitallers decided not to establish the convent in the city of Mdina, and settled initially in the village of Birgu on the Grand Harbour. There they defended the island against the forces of Süleyman II in the Great Siege of Malta, lasting from May to September 1565. This was the last great battle between Christians and the Ottomans in the Mediterranean until Lepanto in 1571. Even after Lepanto ended the threat of Ottoman fleets to western Europe, Hospitaller ships continued patrols against North African corsairs until 1798.

After the Great Siege, the grand master, Jean de la Valette, decided to build a city on the Sciberras peninsula jutting into the Grand Harbour. This city, named Valletta, was the first planned city in Europe. Behind its massive walls, the streets followed a grid plan; each house was required to have a cistern to enable the household to sit out a siege. The order also built a hospital (the Sacra Infermia), the conventual church, a palace for the grand master, and, in the late eighteenth century, the library. This structure, today the National Library of Malta, still contains the main archives of the order.

By the end of the eighteenth century, the order’s identification with the Ancien Régime, plus the loss of its properties resulting from the French Revolution, weakened its moral authority and financial resources. The last grand master on Malta, Ferdinand von Hompesch, surrendered the island to Napoleon Bonaparte and his fleet in 1798.

Structure and International Organization

As an exempt order of the church, the Hospitallers were under the direct jurisdiction of the pope. The head of the order was the master, who governed with the central convent through meetings of the chapter general. The extent of the master’s executive powers is unclear for the early period, although it appears he shared authority with the convent. The chapter general, which did not meet annually, acted as a court to decide disputes among members, issued licenses for travel, and discussed the military preparedness of the convent. Generally, the meetings took place at the location of the main hospital, although some were held in Rome, most notably in 1462. Attendance at the meetings of the chapter general consisted of the master, the senior members of the order, the order’s top officials, and two representatives from each province (Fr. langue). The master became known as the grand master in the fifteenth century, was given the status of a cardinal in the sixteenth century, and claimed princely rank by the eighteenth century. The chief officials of the order served as advisors to the master and formed part of his council at the central convent. The offices were those of the conventual prior, grand preceptor, hospitaller, marshal, admiral, turcopolier (originally the officer in charge of the Turcopoles, or light cavalry), draper, and treasurer. By the fourteenth century each of these offices was assigned to a specific langue, except for that of the conventual prior, who supervised the conventual chaplains.

The Hospitallers were a lay order whose members took vows of poverty, chastity, and obedience to the master. Serving brethren formed the majority of the members in the twelfth through fourteenth centuries and did most of the work in the hospital. Fighting men of free, but not necessarily knightly, birth served as brother sergeants. Conventual chaplains tended to the spiritual needs of members of the order. The knight brethren fought on behalf of the order, and by the mid-thirteenth century had attained higher status than the conventual chaplains. The office of the master was reserved to knights by 1262, and by 1270 knights held all the high offices of the order. By the sixteenth century, prospective knights had to produce proofs of noble birth for several generations (the number varying according to langue) before admittance to the order. Around this time the order created two ranks of knights: the knights of justice, who were of noble birth, and the knights of grace, nonnobles who performed service for the order. The knights of grace remained of lower status and could not hold high office in the order.

It is possible that in the twelfth century female members served in the hospital, although they were not mentioned in the Hospitaller rule. At the end of the twelfth century, cloistered female convents dependent on the order emerged. Of these, the most important was the convent of Sigena, founded in Aragon in 1187. The cloistered female Hospitallers neither fought nor served in the hospitals, although they contributed responsions to the main convent. There were also associate members (called donates): men and women who took vows of obedience and promised to join the order in the future. Confraters and consors gave an annual donation to the order and were promised care in their old age and a Christian burial in return.

The Hospitallers acquired property throughout those parts of Europe that belonged to the Latin Church. Initially, the first grants were in southern France and Iberia. In the aftermath of the Second Crusade (1147-1149), the order began to receive more donations elsewhere, particularly in the British Isles, France, Germany, and Italy. Eventually it also acquired property in Hungary, Bohemia-Moravia, Poland, and Scandinavia. The basic unit of Hospitaller property was the commandery, usually an estate with a small religious house attached. Serving brethrens and novice knights lived in the commandery, with a chaplain. By the fourteenth century, a knight who had served some time in the central convent and made at least three trips in the order’s galleys could be granted a commandery within his own province. He then administered the commandery and received a portion of its income.

Commanderies were grouped by region into priories, each headed by a prior. The oldest priory was the Priory of Saint-Gilles, founded circa 1115; the Priory of Aragon (later the Castellany of Amposta) was founded in 1149. By the late thirteenth century, the priories were grouped into langues, “tongues,” according to nationality. Initially there were seven langues: Saint-Gilles (or Provence), Auvergne, France, the Castellany of Amposta (Aragon), Italy, England (which included Ireland, Scotland, and Wales), and Germany (which included central and eastern Europe). These priories were enlarged when the Hospitallers acquired former Templar lands in France, Aragon, England, Scotland, and Brandenburg after the Templars’ dissolution in 1312. In 1462 the order created the langue of Castile-Portugal.

Each langue was headed by the conventual bailiff (pillier) who held one of the chief offices of the order and served as an advisor to the master. The office of grand preceptor, who functioned as the second-in-command, was traditionally held by the bailiff of Provence. The bailiff of France was the hospitaller, responsible for the infirmary. The bailiff of Auvergne was the marshal, the chief military officer of the order. The bailiff of Italy was the admiral, commanding the fleet of the order. The bailiff of England was the turcopolier, commanding the mounted native mercenary troops. This office was later assumed by the grand master when the English priory was dissolved in 1540. The bailiff of Aragon was the draper, an office that initially issued clothing, fabric, and alms, and later provisioned the order’s military forces. The bailiff of Germany was the treasurer, but when Germany was demoted to a province, the treasury was subordinated to the grand preceptor. When the new langue of Castile-Portugal was created in 1461, the office of chancellor was elevated to the council and became the bailiwick of the langue of Castile-Leôn. In addition to assuming responsibility for each of the chief offices of the order, each langue maintained and defended a portion of the town defenses of Rhodes and, later, Valletta.

The archival records from the Rhodian era reveal more information about the role of the langues in the organization of the order. Although the central convent had income from local revenues, first from the Hospitallers’ estates in Outremer, and then from coastal trade and the estates on Cyprus, the Western priories paid yearly responsions that subsidized the hospital, the necessities of the convent, and its defense. In times of emergency, the langues provided men, money, and materials for military campaigns. The langues also formed the basis for conventual life and administration. Knights were admitted to the order through their native langue, and, when in residence in Rhodes or Malta, lived in their langue’s own auberge (residence). The system by which bailiffs of the langues served as the chief officials of the order broke down during the Great Schism; between 1378 and 1409 local obedience in some langues to the Roman pope reduced the payment of responsions to the central convent, which obeyed the Avignon pope. During the fifteenth century, the order faced a severe financial crisis, and Pope Paul II had to call a meeting of the chapter general in Rome in 1462 to reform the statutes and to collect the responsions. The power of the grand master to collect responsions increased, thus improving the revenues of the main convent.

Medical Activities

The order maintained a hospital at the site of the central convent, allocating one-third of its yearly income from its European priories for its needs. The first hospital, in Jerusalem, was located in the Muristan, near the Church of the Holy Sepulchre. Recent archaeological excavations have revealed the true size and layout of the hospital complex in Acre. The infirmary buildings in Rhodes and Malta survive intact. The physical remains suggest that the hospitals of the order were large and able to accommodate many patients. Hospitaller concerns with hygiene and isolation of infectious diseases were influenced by the desire to provide luxuries for the sick, as well as by Greek and Muslim medical practices. The rule of the order referred to the patients as “our lords the sick,” illustrating the order’s precepts that the sick represented Christ, and that the Hospitallers served Christ by caring for them. In this spirit of hospitality, the statutes of the order dictated that patients should receive white bread and comfortable beds in addition to their spiritual care. The Hospitallers had separate wards for male and female patients, provided obstetric care, and made provisions for child and infant care within the hospitals. The order employed qualified physicians and surgeons to diagnose and care for the patients’ ailments. Serving brethren worked in the hospital, and chaplains attended to the patients’ spiritual health. In acknowledgment of their hospitaller duties, the chief officers of the convent, including the master, performed regular service in the infirmary on Rhodes and on Malta.

Masters of the Order of St. John



Jacques de Milly


Raymond of Le Puy


Pedro Raimondo Zacosta


Anger of Balben


Giovanni Bastista degli Orsini


Arnold of Comps


Pierre d’Aubusson


Gilbert of Assailly


Emery d’Amboise


Castus of Muralo


Guy de Blanchefort




Fabrizio del Carretto


Roger of Les Moulins


Philippe Villiers de l’Isle Adam


Armengarde of Aspe


Pierino del Ponte


Warner of Nablus


Didiers de St. Jalle


Geoffrey de Donjon


Juan de Omedes


Afonso of Portugal


Claude de la Sengle


Geoffrey Le Rat


Jean Parisot de la Valette


Garin of Montaigu


Pietro del Monte


Bernard of Thercy


Jean l’Evêque de la Cassière




Hugh Loubenx de Verdalle


Bertrand of Comps


Martin Garzes


Peter of Viellebride


Alof de Wignacort


William of Châteauneuf


Luiz Mendez de Vasconcellos


Hugh Revel


Antoine de Paule


Nicholas Lorgne


Jean Paul de Lascaris Castellar


John of Villiers


Martin de Redin


Odo of Pins


Annet de Clermont de Chattes Gessan


William of Villaret


Rafael Cotoner


Fulk of Villaret


Nicolas Cotoner


Hélion of Villeneuve


Gregorio Carafa


Deodat of Gozon


Adrien de Wignacort


Peter of Corneillan


Ramon Perellos y Roccaful


Roger of Les Pins


Marc’Antonio Zondadari


Raymond Berenger


Antonio Manoel de Vilhena


Robert of Juillac


Ramon Despuig


Juan Fernandez de Heredia


Emanuel Pinto de Fonseca


Philibert de Naillac


Francisco Ximenes de Texada


Antoni Fluvia


Emanuel de Rohan Polduc


Jean Bonpart de Lastic


Ferdinand von Hompesch


Source: Helen Nicholson, The Knights Hospitaller

Hospitallers and the Arts

The Hospitallers in Outremer were not noted patrons of the arts, although frescoes in their church at Abu Ghosh survive. On Rhodes, Master Juan Fernandez de Heredia was a noted humanist, with strong connections to the Avignon papacy and the king of Aragon. It was on Malta that the Hospitallers left a lasting artistic legacy, with the construction of the city of Valletta, and the patronage of the painters Caravaggio and Matteo Preti. The order’s most noted contributions were to the field of military architecture, particularly with the castles of Belvoir, Lindos, and Bodrum, the citadel of Rhodes, and the fortifications of Valletta.

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