Salus Infirmorum - The infirmary of the Military Order of Our Lord Jesus Christ in Tomar
Since the country's foundation, the main activity of convents and monasteries has been care practice: treat soul and body in accordance with their religious principles - charity towards others, providing care to the poor and sick.
Treatment was a mixture of science, faith and mysticism that often included the use of home remedies, relics of saints and amulets.
Patients assisted in this Royal Convent were mainly resident friars, visitors, knights and pilgrims who stopped here on their way to Santiago de Compostela. In Tomar, the Mercy House has provided these services from as early as the 16th century taking on the functions of small hospitals with varied functions such as hospices and leper hospitals.
The treatment area consisted of a number of cells, an apothecary shop and a small chapel, in addition to lodgings for doctors and nurses in the north-eastern part of the building. With easy access to road, close to both the Portaria Real and the hostel, it was connected to the convent, but far away enough to allow isolation of patients with infectious diseases. There was also a recovery area which faced a herbal garden of medicinal and aromatic plants.
All the materials used in the infirmary were strictly selected, the Convent's provost being in charge of providing everything needed to treat the sick.
The clinical staff consisted of a carefully selected, good-natured and charitable religious nurse, who took care of the patients with love and total dedication, making the necessary rounds and sleeping next to them. He was aided by an apprentice or assistant, convert or novice, who thus received training.
The hygiene of the bed, the infirmary space (including ventilation and disinfection) and all linen - washed separately from that of the rest of the convent - was also the nurse's responsibility, with the aid of servants, slaves or converts.
According to the rules in force in royal hospitals, and based on the rules of procedure of the Hospital de Todos os Santos, in Lisbon, the nurse had to know how to read and write to better interpret and comply with the requirements of the physician/doctor.
The doctor visited patients twice a day, morning and afternoon, accompanied by the Prior or his designee, the nurse, the apothecary and the surgeon, as evidenced by 18th century documentation, supported by practices in place in other convents. The physician measured pulse rates, performed palpations, took temperatures, observed urine and feces, diagnosing the disease through outward visible signs.
The priest-nurse followed medical prescriptions which included remedy therapeutics, treatments such as enemas or bloodletting (phlebotomy) - hygiene, baths, diet ... All this was noted down on a plastered board so that there were no mistakes.
The apothecary, also religious, had to be curious and experienced. He prepared compositions as prescribed by the physician in accordance with available manuals and, except for usual ointments and powders, all preparations were dependent on the prelate's permission. Difficult or unknown preparations were bought from outside apothecary shops.
The surgeon extracted teeth, took care of wounds and ulcers, performed amputations and even healed dislocations, though many times this could be performed by the bonesetter, the precursor of the orthopaedist. With no academic training required, surgery unlike medicine was considered almost a mechanical craft because it dealt with human anatomy, an activity regarded as unworthy by physicians.
The barber, in addition to his customary tasks, performed bloodletting using suckers and leeches. This therapy has, for a long time, been the most widely used technique to cure the evils. It was learned in an empirical way from masters and only in the 16th century was it regulated by examination after two years' experience.
From the tuition fees paid by knights, convent friars and novices (after having taken the religious habit and professed their vows) it can be concluded that, in the early 19th century, there were two physicians, one surgeon, two barbers, one general practitioner, one apothecary or apothecary assistant serving in the convent; the first two being the highest-paid professionals, after the First Prior.
Many of the most famous physicians of the 17th and 18th centuries were professed knights of the Order of Christ such as João Curvo Semedo, physician of the Royal House, who contributed to popularise chemical medicines.