Sites of Health and Welfare Scheduling Selection Guide Summary

Sites of Health and Welfare Scheduling Selection Guide Summary Historic England’s scheduling selection guides help to define which archaeological sites are likely to meet the relevant tests for national designation and be included on the National Heritage List for England. For archaeological sites and monuments, they are divided into categories ranging from Agriculture to Utilities and complement the listing selection guides for buildings. Scheduling is applied only to sites of national importance, and even then only if it is the best means of protection. Only deliberately created structures, features and remains can be scheduled. The scheduling selection guides are supplemented by the Introductions to Heritage Assets which provide more detailed considerations of specific archaeological sites and monuments. This selection guide offers an overview of the sorts of archaeological monument or site associated with health and welfare which are likely to be deemed to have national importance, and for which of those scheduling may be appropriate. It aims to do two things: to set these within their historical context, and to give an introduction to the designation approaches employed. This document has been prepared by Listing Group. It is one is of a series of 18 documents. This edition published by Historic England July 2018. All images © Historic England unless otherwise stated. Please refer to this document as: Historic England 2018 Sites of Health and Welfare: Scheduling Selection Guide. Swindon. Historic England. HistoricEngland.org.uk/listing/selection-criteria/scheduling-selection/ Front cover The scheduled earthworks of the Hospital of St Mary and St Lazarus, Burton Lazars (Leicestershire), England’s most important leper hospital Contents Introduction .........................................1 1 Historical Summary .....................2 1.1 Prehistoric ...................................................2 1.2 Roman ...........................................................3 1.3 Anglo-Saxon and Medieval ..........................3 2 Overarching Considerations ........8 2.1 Scheduling and protection ........................8 2.2 Heritage assets and national importance ..9 2.3 Selection criteria ..........................................9 3 Specific Considerations .............10 3.1 Prehistoric .................................................10 3.2 Roman .........................................................10 3.3 Medieval .....................................................10 4 Select Bibliography ...................12 4.1 Roman .........................................................12 4.2 Medieval .....................................................12 5 Where to Get Advice ...................13 Acknowledgements ............................16 Introduction This selection guide offers an overview of the sorts of archaeological monument or site associated with health and welfare which are likely to be deemed to have national importance, and for which of those scheduling may be appropriate. It aims to do two things: to set these within their historical context, and to give an introduction to the designation approaches employed. A parallel Health and Welfare Buildings listing selection guide treats the selection of related buildings for listing. In order to gain a cohesive approach to archaeological and documentary evidence for archaeological designation, cross referencing the designation of health and welfare sites. Other with the Commemorative and Funerary and related topics include Roman baths (for which see Religion and Ritual post-AD 410 scheduling the Culture, Entertainment and Sport scheduling selection guides is necessary when considering selection guide. the significance of other palaeopathological, < < Contents 1 1 Historical Summary 1.1 Prehistoric it is reasonable to assume that some simple herbal remedies were also in use, but have not The evidence for prehistoric health and welfare survived in the archaeological record. Around sites is circumstantial. While it has been 40 trepanned skulls have been found in Britain. suggested that some Neolithic and later ritual A trepanned, but partly healed, skull found in sites such as Stonehenge have, in part, healing the Thames at Hammersmith, London, dates to functions, there is no clear evidence to support the Neolithic; another found on the foreshore at this claim. However, archaeological evidence Chelsea is mid-Bronze Age in date. It is possible indicates that trepanning (drilling a hole through that trepanning may have also had a ritual the skull to relieve pressure on the brain), purpose, with the skulls deposited as a rite or amputation and bone-setting were practised an offering after the death of the individual. in the British Isles from at least 10,000 BC, and Figure 1 Burnt Mound, Titlington Mount, Northumberland. A stream runs by the right side of the mound. A trough and several hearths evidenced the heating of water. 1 < < Contents 2 Evidence for prehistoric welfare sites is also retrieved from a burial at Wroxeter (Shropshire). inconclusive. A burnt mound comprises a kidney- Other artefacts, such as knives, tweezers and or oval-shaped mound of burnt stone, frequently so on may have also had a wholly or partial masked by turf, lying near to a watercourse. medical purpose. Burnt mounds tend to be concentrated in the midlands and southern England, but this may Civilian healthcare buildings are not clearly reflect intensity of archaeological survey and identified, however, although it has been examples outside of these areas have been suggested that the scheduled bath and temple found. Approximately 100 have been identified, complex at Lydney (Gloucestershire) may of which 15 sites are scheduled including clusters have also been a healing centre. The complex in Teesdale, County Durham and Birmingham. included a building with cubicles and ward-like The main phase of use spanned the Bronze Age accommodation, and votive offerings depicting (roughly 2300-850 BC), although earlier and later diseased body parts have been retrieved from examples are known. Excavations have revealed the site. The formal provision of medical care the principal features of burnt mounds as the in the Roman army is not entirely clear, but the mound itself (effectively a dump of burnt stones use of orderlies (casparii) and doctors (medici) interspersed with deposits of charcoal), a hearth is mentioned in altar inscriptions from the for heating these stones, and a water-tight trough Empire. Valetudinaria, or military hospitals, are or pit within close proximity to a source of water. referred to in written tablets from Vindolanda on At Swales Fen, Suffolk the trough was withy- Hadrians Wall. Also on the Wall, at Housesteads lined; other examples such as the burnt mound at Roman fort a building comprising wards arranged Titlington Mount in Northumberland (Fig 1) had around a central courtyard with a latrine, a small clay-lined troughs. The heated stones were clearly plunge bath and a possible operating theatre is dropped into the trough to heat the water. interpreted as a Valetudinaria. 1.2 Roman 1.3 Anglo-Saxon and Medieval Roman medicine was an amalgam of the Treatment of the sick, old and infirm in the Middle theories and practices derived from the Ages was largely the preserve of the church, and Etruscan, Egyptian and Greek traditions, and in particular of monasteries. Designation guidance based on the balance of the four humours on monastic infirmaries, as buildings within a established by Hippocrates. Historical and religious House, is to be found in the Religion documentary evidence for medical practice and Ritual post-AD 410 scheduling selection in this period is strong. Galen, for example, guide and Health and Welfare Buildings listing is probably the best known Roman epoch selection guide. This guide addresses secular, physician, whose practices and discoveries in archaeological sites. the second century continued to be referenced in the post-medieval period. Dioscorides Hospitals recorded 600 herbal remedies in his five-volume There is little evidence for hospitals in the De Materia Medica (AD 64), which continued to Anglo-Saxon period, and it has been thought be printed well into the Renaissance. that the majority were founded from the late eleventh century. However, excavations on Roman medical practices spread throughout the site of the former leper hospital at St Mary the Empire as attested by the discovery of Magdalen in Winchester (Hampshire) exposed Roman surgical equipment on English sites, for burials exhibiting evidence of leprosy which example, scalpels, forceps, saws and divination were radiocarbon-dated to between AD 960 and rods were found at a burial of about AD 50 near 1030. Artefacts from the site seem to support an Colchester (Essex), and a surgeon’s lancet was early, that is, pre-Conquest (1066), date for the < < Contents 3 hospital foundation. Other early examples date number of Maisons Dieu (see below) and small to the immediate post-Conquest period, when informal foundations is unknown, however, Archbishop Lanfranc established independent and additional examples continue to be hospitals such as that at Harbledown, outside discovered by the study of medieval wills. Canterbury (Kent). At the Dissolution a few hospitals escaped suppression or were refounded soon after, The post-Conquest period in England, as in while the majority became almshouses. Western Europe generally, saw the development of the hierarchical, educated, medical Within the class of medieval

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