In the twelfth century the Church itself drew monks back from the work of physicians, and it did so by dividing the work, not by rejecting it. Councils meeting in 1130, 1139, and 1163 issued decrees that, step by step, restricted the study and practice of medicine by monks and by canons living under a rule.

The first two decrees forbade monks and regular canons to leave their cloisters in order to study medicine or civil law for the sake of worldly gain. The third went further, forbidding religious to go out from their houses to attend lectures in these subjects at all. The concern behind all three was the same. The practice of medicine was drawing monks out of the cloister and into the world—onto the roads, into the houses of the wealthy, and into the handling of fees. A monk who sold his skill for money had stepped outside the poverty and enclosure he had vowed.

A second concern was surgery. The Church held that those who serve at the altar should not shed blood, a principle later summed up in the saying that the Church shrinks from blood. In the early thirteenth century this became an explicit rule, and clergy in major orders were forbidden any part of surgery that involved cutting or burning.

At the same time, the practice of medicine was finding a new home. In southern Italy a school of medicine had grown famous, and in northern Italy and beyond the first universities were taking shape, with faculties in which medicine was taught and licensed. Over the following generations the physician became a graduate of the schools, and the work of physicians passed from the monasteries to the universities and to the lay profession they trained.

None of this was a rejection of medicine. The councils did not say that the sick should go without physicians; they said that monks should not be the ones to practice for gain or to shed blood. The work was divided. The learned art went to those trained for it, and the monastery kept what was its own.

What remained was exactly the infirmarian’s office. No council restricted prayer at the bedside, the feeding and washing of the sick, the herb garden, the ordering of daily life, or the care of the dying. These stayed in the monastery, unchanged, for centuries. The line the Church drew in the twelfth century ran between the physician and the infirmarian, and both sides of it remained in honor.

That line is the historical ground of our own position. When we say that we do not examine the sick and that we are not physicians, we are not inventing a modern caution. We are keeping a division that the Church made for itself more than eight hundred years ago.

At IHS Bethlehem Church, we keep the line the Church drew in the twelfth century exactly where it was drawn. The practice of medicine belongs to physicians; nursing service—prayer, company at the bedside, the rule of life, the herb garden, the arts, and the care of the dying—belongs to the corporation.