The Cosmological Vision of St. Basil and the First Hospital


fr paul


Go forth a little way from the city, and behold the New City, the storehouse of piety,

the common treasury of the wealthy…where disease is regarded in a religious

light, and disaster is thought a blessing, and sympathy is put to the test.

~ St. Gregory of Nazianzus,

Funeral Oration for St. Basil the Great


By Subdeacon Joseph Magnus Frangipani

Five years after the First Council of Nicaea, in 330, Constantine the Great moved the capital of the Roman Empire to Byzantium, later known as Constantinople, and St. Basil the Great was born near the foot of an extinct volcano.[1]

Eusebius of Caesarea records that St. Basil’s family endured for Christ fires and swords and crucifixion, wild beasts, depths of sea and the hacking of legs and arms and eyes under Maximinus II but in all these things we are more than conquerors through Him who loved us.[2] We see here the distinguishing characteristic of St. Basil’s family is piety, the “common esteem of virtue” to which the saints ascend even today in Heaven.[3]

For instance, St. Basil’s father, son of St. Macrina the Elder, disciple of St. Gregory the Wonderworker, was a famous rhetorician in Pontus who, together with his wife St. Emmelia, the daughter of a martyr, raised nine children among the dry and arid mountains of Caesarea, Cappadocia, in Asia Minor.[4] At least five of these children are celebrated as saints, including St. Peter of Sebaste, a bishop who presided over the First Ecumenical Council; St. Naucratius, a hermit and fisherman; St. Macrina the Younger, renowned ascetic and Cappadocian Fathers Saints Basil and Gregory.


St. Basil, who we commemorate January 1st together with the Circumcision of our Lord and God and Savior Jesus Christ, lives true to the tradition of Christ the Physician at work in the hospital of the Church.[5] St. Gregory the Theologian, a friend St. Basil met while studying five years in Athens, praises St. Basil’s family for their “care of the poor, their hospitality toward strangers, their purity of soul achieved through austerity, the dedication of a portion of their goods to God.”[6]

Although the Cappadocian Fathers – brothers Saints Basil and Gregory of Nyssa and St. Gregory the Theologian – did not practice medicine, they had close ties to doctors and the medical discipline.[7] St. Gregory the Theologian’s younger brother, Kaisarios, studied medicine in Alexandria and was famous aiding the poor’s sick in Caesarea, likely working alongside St. Basil in his hospital during the famine; St. Gregory of Nyssa appealed to the history of medicine as an example of what God allows men to do when they work in harmony with Him and with one another, and St. Basil himself excelled in medicine during his studies in Greece.[8]


In fact, St. Basil plays a significant social and cosmological role in the early years of the world’s first hospitals. After his baptism in 357, St. Basil visited what are often referred to as the emergency rooms of the hospital of the Church – monastic communities – in Palestine, Syria, Egypt and Mesopotamia as he prayed to imitate ascetics who are “subdued by no natural necessity, ever keeping their soul’s purpose high and free in hunger and thirst, in cold and nakedness…as though living in a flesh that was not theirs.”[9]

What does St. Basil do after visiting these remarkable desert dwellers among the caves and crevices? He distributes his wealth to the involuntary poor and suffering and prays with and for them, a Godly virtue he emphasizes in the two monastic rules he composes for monks working in his Caesarean hospital that would “serve a great variety of needy people” equipping strangers with not only physical but spiritual bread.[10] St. Basil always saw a connection between body and soul, between noetic faith and physical movement and time and eternity.

St. Basil asks, “Is not time like this: that the past has vanished, the future is not yet with us, and the present, before we realize it, escapes our perception of it?”[11] What he’s saying here, what he’s hinting at, is that the body and soul are created in a fixed time and space but bound eternally together from that moment forward. Any separation is unnatural, as death is unnatural. And we see here St. Basil’s awareness not only of temporal and eternal time but time’s cessation. These contemplations are also contemplations of death.


The rules St. Basil draws up after visiting the desert monastics emphasize an understanding of time and mortality establishing for the first time in Asia Minor monasticism. St. Basil’s rules stress communion, unity, and wholeness which is the telos or goal of life, a telos mirrored in the rest of God’s creation through her seasons, lunar and solar cycles, migrations of butterflies and birds, and in the flow of time. Everything is connected.

And so you see, these monastic rules are cenobitic – communal – as opposed to the “selfish isolation” of idiorrhythmic living again emphasizing the Church’s vision of shared living following St. Paul’s command to pursue what makes for peace and for mutual upbuilding.[12]

With time and creation more and more in his heart and on his mind, St. Basil begins to “devote himself to the care of ‘a group of old people living together in poverty and infirmity’” to greater and greater degrees, tending his brothers and sisters echoing Christ when Who proclaims Behold, I make all things new.[13]

In 369 and 370, just a few years after St. Basil’s ordination to the priesthood by Bishop Eusebius, a “cruel and widespread” famine sucked Cappadocia of water, vital crops and livestock, challenging faith and hope in God through not only our perseverance – for in patience you have your souls, as St. Luke the Physician of our Church writes – but in nature – human nature and the natural world.[14]

Cows sat down and died. Children gathered at the water’s edge sipped mud. Clouds and birds disappeared over the brown skies. And two major figures in St. Basil’s life die during this tumultuous time: his mother, St. Emmelia, and his bishop, Eusebius. And Eusebius even dies in St. Basil’s arms, a comfort where so many in the world find trust and solace.

In the words of St. Gregory the Theologian, St. Basil was for Eusebius “a good advisor, a righteous representative, an expounder of the Word of God, a staff for the aged, a faithful support in internal matters, and an activist in external matters.”[15]


The famine blowing through Cappadocia uproots figs, carrots and cattle and proves devastating beyond measure. Many lost their faith, lost their lives, and lost their families.

What did St. Basil do?

He collected “all kinds of food helpful for relieving famine” and “had in view only one object: to win mercy by being merciful, and to acquire heavenly blessings by his distribution of grain here below.” And “his support of the needy” was displayed “more often in cases of spiritual want”: a telling point “for this,” continued friend St. Gregory, “is frequently a means of touching the soul and reducing it to subjection by kindness.”[16]

In providing good food from neighboring areas, warm shelter, dry clothing and all the services of the Church – which is important which dry clothing, warm food, medicine, Church services, communal living, – brotherhood – everything – was extremely rare then. So by making accessible to the poor this love of God St. Basil founded a very “large philanthropic institution…which he placed in care of a monastic community,” the very hospital his brother St. Gregory calls, a veritable city of piety, “the New City.”[17]


The New City was an icon of New Jerusalem, replete with spiritual and physical healing where the poor, aged, and crippled received new life. Challenging today’s erroneous presumptions of premodern institutions for the sick as overcrowded, cold and damp, infested with rats and unhealthy while providing little or no medical attention Byzantine hospitals – of note, St. Basil’s New City – attracted physicians and surgeons from all over the world who followed strict rules regarding hygiene, privacy, ventilation and heating following Christ’s command that in so far as you did this to one of the least of these brothers of Mine, you did unto Me.[18]

We’d never seen anything like this before: where the poor are taken care of alongside the sick, the traveling, the young, the old, the pious, the impious. Pilgrims tethered livestock and slept warm and full; the aged beheld faces of young tending their basic needs; sick bathed and were made well again by world-renowned physicians and herbalists; and everyone, every one, – and this is just so beautiful – benefited from a hug, kiss and ear from the attentive St. Basil the Great.

“To this world at last it was necessary to add a new world, both a school and training place where the souls of men should be taught and a home for beings destined to be born and to die.”[19] writes St. Basil, alluding to his New City.

And here, we see Christ again working through St. Basil’s friendship, loyalty and sacrifice toward all creation:[20]

“Listen, all inhospitable hearts, ye who shut your doors, whose house is never open either

in the winter or in the night to travelers. The solicitude of storks for their old would be

sufficient if our children would reflect upon it, to make them love their parents. Storks

surround their fallen, when old age makes his feathers drop off, warm him with their

wings, and provide abundantly for his support, and even in their flight they may help

him gently on each side upon their wings.”[21]

St. Basil’s spiritual, emotional and physical care for the poor, the sick and the dying brings to mind these holy words of St. James: and these are among my favorite lines of the Bible: pure and undefiled religion before God and the Father is this: to visit the orphans and widows in their trouble, and to keep oneself unspotted from the world.[22]

It’s worth reading again:

Pure and undefiled religion before God and the Father is this: to visit the orphans and widows in their trouble, and to keep oneself unspotted from the world.[23]

But the famine carried with it a deeper spiritual reminder for St. Basil, and it is probably best related through this verse, in St. Paul’s second letter to the Corinthians: Although our outer human being is perishing, the inner is renewed day by day.[24]

Because St. Basil knew, just as we Christians today know, we are more than body, we are more the soul – we are defined in the Light of Christ. And this is really interesting, because without the Light of Christ, Who is Love, Who is the Creator, Who is the Friend, so without His Light – His glory – His Uncreated Energies – we are undefinable. Our humanness remains without illumination, without clarity, without harmony. Without the goodness which belongs to God.

“I recognize two human beings, one the sense-perceptible, and one hidden under the

sense-perceptible, invisible, the inner human. Therefore we have an inner human being,

and we are somehow double, and it is truly said that we are that which is within. For I

am what concerns the inner human being, the outer things are not me but mine. For I am

not the hand, but I am the rational part of the soul. And the hand is a limb of the human

being. Therefore the body is an instrument of the human being, an instrument of the

soul, and the human being is principally the soul in itself.”[25]

A comprehension of this self, St. Basil reflects, “provides entirely sufficient guidance toward the concept of God” – now, St. Basil isn’t saying we’re good unto ourselves, that all we need is meditation closed off from communion with neighbor and with the Source of our neighbor, God – but a comprehension of this self leads us outside ourselves.

“If you are attentive to yourself, you will not need to trace your understanding of the

Fashioner from the structure of the universe, but in yourself, as if in a kind of small

ordered world, you will see the great wisdom of the Creator. Understand that God is

incorporeal from the incorporeal soul existing in you, not circumscribed by place…”[26]


Adam and Eve needed no clothes for coverings in paradise and only needed them after the Fall, after they partook from the tree too early, not fasting, but cutting themselves off from the will of God, from the Source of Life, thereby tasting sin – or separation – and it’s effects, which principally is death. But before the Fall, we gazed toward God without anxiety, without depression, without anxiety toward their bodies and St. Basil seems to recognize this nakedness in all of us and acts on behalf of the Church when he clothes, he feeds and administers the Sacraments, to Cappadocia’s famished.


Keeping the famine of Caesarea in mind while studying St. Basil’s works is important because we witness the macro- and microcosm of life and man. Serving simple but nourishing meals – “cauldrons of pea soup and our salted meats” – proclaiming the Gospel through action – St. Basil acknowledges the shortages of Cappadocia are his shortages, he sees his neighbor’s hunger is his own not only physically but spiritually, ontologically.[27] When I visited India six years ago, I tended to polio victims and lepers but their illnesses condemned me, because their leprosy reflects the leprosy of my heart. The stunted growth of Polio reflects my inadequacies. The whole of man suffers in the Fall.

We’re connected with distinctions.

It is unnatural to separate mortality from immortality. It is unnatural to separate man from God, as we see in the Moses’ account in Genesis. It was not God’s intention that we fall away from Him, but out of love He allows us to freely join or separate ourselves to Him. Otherwise, if He forces us to love Him, it isn’t love.


“You will finally discover that the world was not conceived by chance and without reason but for a useful end and for the great advantage of all beings, since it is really the school where reasonable souls exercise themselves, the training ground where they learn to know God.” writes St. Basil in the Hexaemeron, a narrative of the ‘Six Days’ of creation in Genesis delivered in 370, the same year, you may remember, Caesarea is scourged by unprecedented starvation and drought.[28]

What he’s talking about is that every particle of limestone, every elm leaf, every cat, every human being, has value. The other aspect we might consider here is that, pointing to creation as a training ground, St. Basil affirms that we aren’t made perfect – we’re made good – in the image and likeness of God – but we aren’t made perfect..rather, we’re made with the capacity for perfection. For deification, that through them you may become partakers of the divine nature.[29]


During this period St. Basil reaffirms for himself and the citizens of Cappadocia – in fact, for all of us today – he reaffirms the sanctity and goodness of creation and man’s place within it. He defends creation and man’s physical and spiritual dignity within it during the famine. By defending creation you defend it’s Creator.

“I want creation to penetrate you,” writes St. Basil, “with so much admiration that everywhere, wherever you may be, the least plant may bring to you the clear remembrance of the Creator.”[30]

This means the dandelion you step on outside.

As St. Porphyrios says, “The teleology of creation displays the greatness of God and His providence.”[31] This means the goal of creation is to display the variety of God’s goodness and His providence. So if we see ugliness and chaos in the mirror of creation we see ourselves, we’re projecting ourselves onto it. It’s reminds me, how often relationships with our father determine to greater or lesser degrees our relationship with God. Sometimes, the less our father is in our life, the less we see God’s love. The more we see God’s love, the more we perhaps understand and draw closer to one another. Again, communion between not only visible worlds – our own and other people’s – but communion between the tangible world and the intangible is key.


Through nature we approach – but don’t necessarily reach – a deeper understanding or experience of Christ. So in this way, nature is a visible ladder to the invisible things. St. Basil illustrates this complexity.

Flowers teach us with their fragrance of the love of God, scattering their fragrance and their beauty on sinners and the righteous. And in earth, wind, spirit and fire are patterns in which we see the workings of the Uncreated God. As. Basil says, “Earth, air, sky, water, day, night, all visible things, remind us of Who is our benefactor.”[32]

The bee, St. Basil writes,

“constructs its cells without injuring any one and without interfering with the goods of others. It gathers openly wax from the flowers with its mouth, drawing in the honey scattered over them like dew, and injects it into the hollow of its cells. Thus at first honey is liquid; time thickens it and gives it its sweetness.

“The book of Proverbs has given the bee the most honorable and the best praise by calling her wise and industrious. How much activity she exerts in gathering this precious nourishment, by which both kings and men of low degree are brought to health! How great is the art and cunning she displays in the construction of the store houses which are destined to receive the honey! After having spread the wax like a thin membrane, she distributes it in contiguous compartments which, weak though they are, by their number and by their mass, sustain the whole edifice.”[33]

So he calls Christians to emulate bees, bobbing one flower to the next, drawing forth honey, constructing homes, modes of being, and he calls us to participate in nature, not below or above it, but through and in.

He never rejects the body, never sees past the created world for the spiritual realm but sees the two inseparable, bound – despite the Fall – by God in the Incarnation, in Christ’s Divine and human wills, in flesh and spirit, death and resurrection, God and Man, everything is bound in the Mystery of Christ. During the famine of Caesarea with dust and blood blowing all over the place, St. Basil calls for a study of salvation – the salvation of the individual, but also of the whole human community.”[34]

Although priority is given to faith and Scripture, sources of the knowledge of God, of theoria – “to which every rational nature aspires” – sources of the knowledge of God are patterned throughout the natural world and in the supernatural world of the human heart.[35]

“Virtues exist in us also by nature, and the soul has affinity with them not by education, but by nature herself. We do not need lessons to hate illness, but by ourselves we repel what afflicts us, the soul has no need of a master to teach us to avoid vice. Now all vice is sickness of soul as virtue is its health.”[36]

Again, using the Church not as a court of law or a philosophical interest but as a hospital.

“Ponder how you were molded. Consider the workshop of nature.” asks St. Basil. Again, nature is seen as a workshop, as something changing, moving, teaching, instructing, and imbued with means of transmitting God’s energies. “The hand that received you is God’s…you are a vessel divinely molded, having come into being from God. Glorify your Creator.”[37]

We aren’t products of random mutations but purposefully crafted, bearing the image – we are the icon – of God, not by nature but by adoption, by God’s love. We experience this through the human heart, but whether we experience it and forget it or not, makes no difference to reality: we are God’s, and God is ours. He serves us, as we serve Him, for the Christian world is an anthropocentric world, allowing and calling us toward unending perfection in God.
In nature, Moses, author of Genesis, “took refuge in Ethiopia, living there far from former pursuits, and passing forty years in the contemplation of nature…finally…at the age of eighty, saw God.”[38] He didn’t see God’s essence, of course, but His energies, just as the disciples beheld God’s energies on Mount Tabor, witnessing His glory.

In nature, we receive a hidden ladder, a sort of forward-movement of the heart/mind by which we ascend to Christ in contemplation and prayer, in hesychia (stillness) and fasting. The animals participate in paradise with God, too, for were they not in Eden? One of many differences, however, is that for them, this ladder by which one eternally ascends is incomplete.


St. Basil points out how the animals are given instinct over reason, and actually, he says we can and should learn from this. For example, animals detect the coming seasons as Christians should anticipate eternity; animals walk bowed to the ground and men, naturally erect, ought set their sights on heaven, seeking “the hidden places of your own soul, and there you will learn that in the beginning God was.”[39]

Watching stars sail across the night sky we might think of Uncreated Light and reflect on it’s reflection within the heart of man. Tracing fingers through sap running over tree rings we might marvel at the rings of fingerprints on man’s hand and see God’s Hand at work in creation.

Or watching brown sparrows, musty buffalo and gray mice we might consider how they detect the coming seasons and thank God for this marvelous mystery, and anticipate with the animals a greater season, a season of coming paradise, and anticipate eternity whether it comes by the end of the world or the end of our world, at the end of our individual life here on earth.

So. If we see within ourselves a miniature universe, we can see the universe around us with the hidden eyes of the kingdom of God, in the human heart.[40]

“We must try to keep the mind in tranquility.” writes St. Basil. “For just as the eye which constantly shifts its gaze, not turning to the right or to the left, now incessantly peering up and down, cannot see distinctly what lies before it, but the sight must be fixed firmly on the object in view if one would make his vision of it clear, so too man’s mind when distracted by his countless worldly cares cannot focus itself distinctly on the truth.”[41]anthonythegreat

In other words, we must calm the stormy waters of life and our thoughts (which determine our life) like St. Peter by calling on the Name of Jesus, with the Prayer of the Heart. Seeing we also are surrounded with so great a cloud of witnesses, “the efforts of a single person are far from sufficient to grasp the great works of God. So, together, we devote all our modest talents to achieving that power in common.”[42]

Aloneness is a Christian impossibility.

I’ll say this again.

Aloneness is a Christian impossibility.

There’s a big difference between aloneness and loneliness. We may still be lonely, but God is never further than the breath He breathed into us.

Christ teaches us to bare one another’s burdens, to take up our cross, and it is through our long and jagged road up Golgotha that together with Him we are raised. It is from our cross – sickness, or pain, or grief,  whether it be high rent and a low-paying job, or someone’s left you, or you suffer an addiction, – whatever the cross is, this is where we view creation, this is how we see the world, and we must see it with Christ Who died on the cross to taste resurrection. It is dying on the cross that with us creation rises anew.

We’re connected. When Man fell, all of creation fell. So when man is deified, when he partakes of the divine nature, the divine energies of God, then he sees all of creation deified too. Animals have a clarity by which they see this sanctity which is why St. Seraphim of Sarov feeds bears from his palm, and Elder Paisios and Elijah are fed by ravens, and so on. Their personality isn’t obliterated, nor is their freewill stepped upon, but man and creation are lifted together.


St. Basil together with our Church affirms that creation was created instantaneously and from nothing, by God’s freewill as an act of love. And if creation is instantaneous so is death, but then so is our wedding banquet with our Lord.

Our race is the Christian race, and the finish line is unending. It is continuous perfection in God together with the saints. As Orthodox Christians, when we pray with St. Basil in his liturgy, “let us commit ourselves and one another and our whole life to Christ our God,” we ask forgiveness and sanctity for our souls and bodies. Soul and body together are sanctified, which is why in the Orthodox Church we have relics. Through Elisha’s bones God revives a dead man, and through another saint’s bones, a woman bears a child where before she was clinically infertile.

The body is molded from earth by the Hand of God and our soul made from His very breath, so the temple of our body has the fingerprint of God on it, the image and likeness of Jesus Christ, and if we follow our breath down into the heart we will see Him.P8280926

“Some have said that molded is said of the body while made is said of the soul.” writes St. Basil. “Probably the idea is not outside the truth…the Psalmist teaches the difference between making and molding when he says, Your hands made me and molded me. (God) made the inner human being, he molded the outer.”[43]


St. Basil knows an intelligent cause presided at the birth of the Universe for He experienced this ’cause’ throughout creation.[44] Man’s ontologicalhealing is in motion with creation, always fluid, always active and growing. Man is the unique locus of the cosmos.

Georges Florovsky quotes St. Maximus the Confessor affirming Ephesians 1:9: “By this Incarnation and by our age he has shown us for what purpose we were made and the greatest good will be of God towards us before the ages.”[45]

To those who maintain one ought only to rely on supernatural powers of God to banish suffering, Basil responds that the Creator works just as much through the visible world as He does through the unseen. Thus, God’s grace is evident in the healing power of medicine and it’s practitioners, including those in the early Byzantine hospital during and after the famine. In fact, such natural cures could lead to a greater awareness of God’s all present and omnipotent power.[46] St. Basil serves in the forefront of this theological process, together with his family still active in the hospital of the Church.

“I am going to lead you,” invites St. Basil, as much today as he did 1600 years ago, “like strangers, through the mysterious marvels of this great city of the universe…everywhere, in mystic language, history is sown with the dogmas of theology…”[47]

Glory to Jesus Christ.

Glory forever!



Works Cited



St. Basil of Caesarea. Nine Homilies of the Hexaemeron and the Letters. The Nicene and Post-Nicene

Fathers volume 8. Translated by Blomfield Jackson. Grand Rapids, Michigan: Eerdmans

Publishing Company, 1955.

_________________. On the Human Condition. Translated by Nonna Verna Harrison. Crestwood, New

York: St. Vladimir’s Seminary Press, 2005.

St. Gregory of Nazianzus. Funeral Oration on the Great S. Basil. The Fathers of the Church volume 22. Translated by Leo McCauley, John Sullivan, Martin McGuire and Roy Deferrari. New York,

New York: Fathers of the Church, Inc., 1953.

Florovsky, Georges. Creation and Redemption. Belmont, Massachusetts: Nordland Publishing

Company, 1976.

The Holy Bible, New King James Version.

Miller, Timothy. The Birth of the Hospital in the Byzantine Empire. Baltimore, Maryland: The Johns

Hopkins University Press, 1997.

Quasten, Johannes. Basil the Great. Patrology volume 3, The Golden Age of Greek Patristic Literature. Washington, D.C.: Spectrum Publishers, 1960.

Rousseau, Philip. Basil of Caesarea. Berkeley and Lose Angeles, California:

University of California Press, 1994.

Velimirovic, Nikolai. Prologue from Ochrid. Bimingham, England: Lazarica Press, 1985.



[1] Mount Erciyes

[2] Ecclesiastical History, VIII, 14 & Rom. 8:35-37

[3] St. Gregory of Nazianzus Oratio 43.4

[4] Rousseau 4

[5] Prologue from Ochrid January 1st

[6] Oratio 43.9

[7] Miller 57

[8] Ibid. 55 & 57

[9] Quasten, quoting St. Basil, 205

[10] Miller 87

[11] Hex. 1,6

[12] Introduction to Basil, Nicene and Post Nicene Fathers, volume 8 pg 20 & Rom. 14:19

[13] Rousseau, secondary quote St. Gregory of Nyssa, 76 & Rev. 22:5

[14] Introduction to Basil, Nicene and Post Nicene Fathers, volume 8, pg 21 & Luke 21:19

[15] St. Gregory of Nazianzus Oratio 43

[16] Ibid.

[17] Miller 85

[18] Miller 5 & Matt. 26:40

[19] Hex. 1.5

[20]    Quastern 222

[21] Hex. 8.5

[22] James 1:27

[23] James 1:27

[24] 2 Cor. 4:16

[25] Basil On the Human Condition 35-6

[26] Ibid. 104

[27] Rousseau 137

[28] Hex. 1.6

[29] 2 Peter 1:4

[30] Hex. 5.2, emphasis added

[31] Elder Porphyrios, Wounded by Love, 218

[32] Hex. 3.10

[33] Ibid. 8

[34] Rousseau 321

[35] Rousseau 323 quoting Basil’s Homily 334.7

[36] Hex. 9.4

[37] Human Condition 51

[38] Hex. 1

[39] Rousseau 324 quoting Basil’s Homily 343.4

[40] Hex. 6

[41] Basil’s Letter 2

[42] Heb. 12:1 & Rousseau 329 quoting Basil’s Homily 351

[43]    Basil On the Human Condition 50 & Ps. 118:73

[44] Hex. 1.2

[45] Florovsky 169

[46] Hex. 5 & Miller quoting Basil’s letters

[47] Ibid.6.2


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