The Basilias: A Detailed Summary

The Basilias: Not a Hospital but a Leprosarium

Introduction

Gregory of Nazianzus praised Basil's philanthropic institution, the Basilias, built around 372 AD near Cappadocian Caesarea.
Basil's project faced initial opposition, but it persisted due to Emperor Valens's land gift.
The Basilias became a renowned refuge for "ptochhoi" (the destitute poor).
No physical remains exist today, but it is a key site for understanding Christian philanthropy and hospitals in early Byzantium.
Modern studies often misinterpret the Basilias as a general hospital, expanding its scope beyond its original purpose.
Some historians describe it grandiosely as a "Vatican outside the city walls" or a "charitable multiplex."
One divided its activities into six areas: care for the poor, strangers, orphans, elderly, lepers, and the sick, claiming unprecedented scale.

The Basilias as a Leprosarium

The Basilias was not a general hospital or charitable multiplex but a monastic leprosarium.
It accommodated monks and lepers, each supporting the other.
Lepers were the central focus of its medical and philanthropic care.
This contradicts the notion of it serving the sick or destitute in general.
The institution's purpose was to address both practical and ideological considerations.
Basil aimed to appropriate the ideal of philanthropia and ameliorate ptocheia (loss of worldly prosperity).

Ptocheia and Philanthropia in Cappadocia

Ptocheia was understood as the loss of worldly prosperity, not just material destitution.
Philanthropia meant extending kindness to those who seemed undeserving.
Lepers symbolized ptocheia and tested the limits of philanthropia.
Basil sought to focus Christian philanthropy on the "fallen" – those humbled by changes in their circumstances.
These "fallen" individuals, even if rich, were deemed especially deserving of pity and institutional care.
Basil's priorities in the Basilias suggest a broader pattern in Christian philanthropy during the Roman world.

Byzantine Sources on the Basilias and Ptochotropheia

Gregory of Nazianzus exaggerated the scale of the Basilias in his funeral oration for Basil, possibly equating it with a heavenly Jerusalem.
Basil's letter to Helias describes a house of prayer with a residence for the "principal" (possibly a bishop or abbot) and "attendants of the divine" (possibly monks).
It also included refuges for travelers and those needing care due to infirmity, with physicians, workshops, and other facilities.
The term used to describe the facility for the infirm is vague, supporting interpretations ranging from general hospital to monastic complex.
Basil twice calls the facility a "ptochotropheion", meaning a place to nourish ptochoi.
It's key to understanding the institution's scope and purpose.

The Ptochotropheion

Epiphanius of Salamis explained that in Pontus, a "xenodocheion" (inn, lodging) is called a "ptochotropheion."
These establishments house and support "maimed invalids" (lelobemenous kai adynatous), specifically hospitals for lepers, not simply general hospitals.
The term "lelobemenous" became a euphemism for lepers during the fourth century, referring to those with disfiguring leprosy.
This term was possibly adopted from Josephus, who used it synonymously with "leprontes" for Jewish lepers in Egypt.
Greek Christian authorities reserved "lobe" and "lelobemenoi" for cases with loss of nose, feet, or hands.
The Basilias was likely an early leprosarium, supporting lepers and "making them reside" there.
Sebaste, the first stop from Caesarea to Pontus, had connections to Basil's ascetic training.

Further Evidence

Theodoret of Cyrrhus describes the Basilias as a place for paupers "maimed all over their bodies" (lelobemenoi).
He differentiates these refuges from church xenons for ordinary patients.
Sozomen calls Basil's facility a "refuge for ptochoi" (ptochon . . . katagogion), a phrase John Chrysostom used for a leprosarium outside Antioch.
Gregory of Nazianzus praises Basil for caring for lepers and freeing citizens from their awful sight, implying lepers were the project's sole beneficiaries.
Gregory the Priest's "Life of Gregory of Nazianzus" states Basil built immense houses with annual incomes, gathering all the region's infirm and calling the buildings "school-houses of ptochoi."
Gregory the Priest alone mentions how the Basilias was funded by securing pledges for annual contributions from wealthy donors, with its own name for their buildings: “phrontisteria… ptochon.”

Outside The City

All extant descriptions of Basil's Basilias indicate it was a leprosarium built to treat and sequester lepers.
Recognizing this explains why the Basilias was built outside the city, like later leprosaria, and why complaints arose during its construction, as with later leprosaria.
Firmus, bishop of Caesarea, asked a landowner to return ptochoi who had fled the Basilias, seeking freedom over its support and security.
Gregory of Nazianzus stated that Basil's philanthropy inspired others to emulate his work, leading to the disappearance of lepers in the region.
Basil mentions three more ptochotropheia in Cappadocia, likely leprosaria.
Later texts use "to ptochotropheion ton lelobemenon" to differentiate leper facilities from other ptochotropheia.

Physical Care

"Poor houses" provided long-term living and working spaces for physically disabled invalids, while xenodochia offered temporary shelter and beds for sick people to recover.

Previous Assumptions

Claims that the Basilias had a wide variety of beneficiaries are based on inferences from Basil's activities during a famine, his sermons, and monastic rules, not direct evidence.
There are assumptions that the Basilias cared for the elderly - based on basil's references to infirm people in ep94 - and that Crislip asserts that the poor were in the forefront of Basil's conception of Christian praxis and thus of his hospital, despite not seeing any evidence of it caring for the elderly.
It is assumed that the Basilias served as an orphanage based on references to orphans from Basil's, Basil's monastic rules.

Rejected Hypotheses

The famine of ca. 368–370 is often presumed to have inspired Basil's project, but it cannot be proven as fact.
There's no evidence that Basil's facility had the equipment for disaster relief/serving people in need.
Basil's letter to Helias, phrases "a refuge for strangers" built for "visitors on travel," more likely refers to guest rooms reserved for visiting travelers as a common feature for later monasteries.
Basil's monastic rule discourages stewards from giving monastery resources to wandering beggars.
Basil's letter to Bishop Amphilochius differentiates between giving "to the afflicted" versus giving to random beggars.
References to lepers are found in numerous Christian sources starting in the fourth and fifth centuries, with no evidence of a sudden surge.

Leprosy Spread?

Hansen's disease is less contagious than often believed, requiring prolonged direct contact.
After introduction to a region, the disease tends to sit and remain endemic at steady levels so long as poor sanitary conditions persist.
Asia Minor (as well as Egypt) was already a region in the Roman Empire where leprosy had become endemic well before the fourth century.
The presence of lepers was more visible with the struggle of church leaders to find their voice in late Roman politics with biblical ideology of social justice to legitimize a new mode of Christian leadership.
Leprosy from a theological perspective, being redefined as a "sacred disease" and treating leper's sermons as opportunities to communicate ideas about Christ's incarnation and the general goodness of God's mutable, material creation.
That leprosy not being contagious further supports these claims.

Phrontisteria

Gregory the hagiographer said Basil used when referring to his buildings for lepers: "phrontisteria. . . ptochon."
Assuming Basil built a hospital, but classical authors used the word to designate a place dedicated to advanced study or philosophical concentration, often meaning "monastery" instead.
Gregory of Nyssa explained the Basilias: Basil constructed a "tabernacle in the suburb,” where, through good instruction, he made the ptochoi in body become ptochoi in spirit; their poverty might become blessed for them, securing true kingdom. By speaking he formed God's tabernacle in each soul.
This makes the Basilias not just a leprosarium, but an assemblage of "phrontisteria . . . ptochon" inspired by poverty and dedicated to inmates' sanctification.
Basil's own notion for monastic communities resembles such a description.
Christian monasticism was a contemplative discipline or "philosophy" that used prayer and communal affection to foster humility in the soul and access to God.
He often uses phrases, “evangelical life,” “the life of endurance,” the poverty (ptocheia) called blessed by christ, and “the ptocheia for Christ's sake”, often standing foremost among those Jesus had intended by the phrase “ptochos in spirit.”In his view, monks stood foremost among those whom Jesus had meant by the phrase “ptochos in spirit."
Basil says when expounding upon the psalm, “not all ptocheia is to be praised, many are ptochoi in material circumstances and but are greedy but he is drawing toward him who has become a ptochos, for Gods sake."
The lord Himself founded and everything to blessedness in imitation and a model for his desciples.
Basil mentions “another group worthy of that name”, to anyone humbly accepts ptocheia like lazarus.
Basil probably meant Lazarus to stand figuratively for all afflicted people and helping them become, 'poor in spirit' was part of basil’s monastic program.

Penance

Symbiotic relationships between lepers and penitential monks became a standard motif in hagiography.
Palladius tells of Eulogius vowed to wash and feed a monk with his own hands and Daniel serving a leper to atone for Murry.
This emphasized physical afflictions, ostracism etc providing support for monks needing trials of their own.
john refers to monks attending the wounds of lepers.
We may assume those in attendant were also monks, and that's place was where monks could help ptochlo become “ptochol with spirit."

Definitions Of Poverty

Ancient Greek writers primarily use two words to describe poverty or people in a state of poverty: penia and ptocheia.
In comparison they have different etymological roots and significant conceptual differences.
To describe a lack of material resources penia was normally used, associated with toil.
To describe indigence/passivity, ptocheia was used, associated with cowering.
The New Testament, however, uses ptocheia/ptochol almost exclusively (38 out of 39 instances).

To Be Brought Low

Origen: “ptochos is someone who has fallen from wealth, while the penes earns his livelihood from toil,” using scriptures like, “the rich became ptochol” and “He Became a ptohos for our sake.