JaHR  vol. 4  no.

7  2013

Review article

nadezhda amudzhieva*, Pavel tsvetkov**

The cult of saints-healers – an alternative

and opposition to the official medicine in
medieval Bulgaria

aBStRact

Medieval Bulgarian medicine from the iX-Xv c. was characterized by the low occurrence
of medical services, by their inaccessibility, as well as by the widespread disappointment in
learned physicians. This led to the search for alternative healing practices. different means
and methods were developed for filling up the deficit of healthcare services:
• Self-treatment and self-proclaimed healers,
• Healing through sacred objects,
• Faith in saints and their relics.
evidence of the existence of a Bulgarian tradition of healing practices can be found in the
considerable number of medical medieval works of utilitarian application, such as manuals,
intended to be used by both – healers and patients.
Pagan practices of worshipping magic items were transformed into the worship of objects of
religious function – the cross, the Scriptures, holy water, holy oil, icons, etc., to which miracu-
lous healing and saving powers were attributed.
The cult of saints is highly utilitarian and focuses on the meeting of health care needs. Thus a
parallel between self-proclaimed healers and saints was drawn, as saints were also believed to
have been able to cure the faithful through god’s power. This cult has two aspects:
• their supernatural powers, which the Saints had while still alive and
• the miracles, associated with their relics.
in the primitive medieval health care system, primary medical practice was not entrusted to
the medical professionals, but to the saints-healers and their relics. Seeking assistance and
treatment from them was also a way to deny scientific medicine.

* correspondence address: nadezhda amudzhieva, Medical University – varna "Prof. dr. Paraskev Stoyanov", 55
"Prof. Marin drinov" Str., 9002 varna, Bulgaria, e-mail: [email protected]
** correspondence address: Pavel tsvetkov, Medical University – varna "Prof. dr. Paraskev Stoyanov", 55 "Prof.
Marin drinov" Str., 9002 varna, Bulgaria, e-mail: [email protected]

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european medicine has its roots in the pagan societies of ancient greece and Rome,
and combines science with ethics and deontology. its natural continuation is the
medicine of Byzantium, which, based on the achievements of the old schools and
the accumulated experience, as well as the new findings, developed the clinical prac-
tice, pharmacology and pharmacognosy. There it does not only build upon ancient
medical science, but also adds to it the concept of christian charity.

Medicine in Medieval Bulgaria

Because of the fact that from the viii century onwards Bulgarians were neighbors
and often subjects of Byzantium, they entered in a continually deepening cultural
interaction with the empire, in a cultural diffusion, which not later than in the Xii
century combined them in a single cultural community.1 Byzantine influence can be
seen in every aspect of medieval Bulgarian culture, including the development of
medicine. That influence is the main reason why the ancient achievements accepted
by Byzantine medicine also found their way in the old Bulgarian medical science of
the iX–Xv c. period.
John exarch’s Shestodnev from the end of the iX century is an example of the good
knowledge of the Byzantine and Medieval literature in Medieval Bulgaria. His
broad knowledge of many ancient scientific authorities, many of whom are doctors2
far exceeds his main source – Basil the great’s Shestodnev. Since most of the names
cited were not present in the source, it is obvious that they had been drawn from
other Byzantine authors. The description of the human body had been derived from
aristotle’s animal History, based on a Byzantine compilation, put together by the
monk Meletius. John exarch added to it his own thoughts, quoted Plato, men-
tioned the famous Hellenistic doctor alkmey Krotonidis of vi Bc.3
The old Bulgarian translation of the Byzantine compilation galen’s Reflections on
the teachings of Hippocrates, is another example of the penetration of antique sci-
entific models in Medieval Bulgaria.4 a huge number of references to ancient and
medieval doctors can be found in the Hilandar Medical code.5
worship of ancient art and values, and their reception in the christianized culture
of the Byzantine community manifested in the inclusion of many eminent authori-

1 dmitrij Obolenski, vizantijskata obshtnost, Sofia 2001, p. 361- 386

2
Joan exarch, Schestodnev, Sofia 2000
3 čvetan Krǎstanov and ivan dujchev, estestvoznanieto v Srednovekovna Bǎlgaria (sbornik s istoricheski izvori),
Sofia 1954, p.571
4
Stara Bǎlgarska literatura, vol. v, estestvoznanie, p. 516–525
5
Mincho georgiev, ibid, p. 20-21

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ties on ancient thought, including doctors, in church painting. The portraits of

aristophanes, diogenes, Socrates, aristotle, galen, Plato, Plutarch, Thucydides, So-
lon, Pythagoras, Homer, etc. were widely spread in the orthodox Byzantine world,
including many locations in Bulgarian lands. images of pagan sages can be seen in
the frescoes in the refectory of Bachkovski Monastery, in the women’s section of the
church of the nativity of christ in arbanasi6, in the Boboshevo Monastery, etc.
although these frescoes mentioned are from a later period - Xvii c., undoubtedly
similar images, found in different places, independently of one another, are based
on the centuries-old tradition in icon-painting models of the post-Byzantine world,
which we cannot trace further back, because of the lack of earlier models. The inclu-
sion of ancient philosophers, writers and scientists in church paintings is done in
recognition of the significance of their activity, as well as their moral qualities. Their
depiction with halos in many of those paintings puts them on an equal footing with
the saints.
The establishment of christianity also enriches the moral concept of medicine. The
age’s moral behest – love thy neighbor – was added to the ethical norms of the age
of Hippocrates. it was this command to offer help to all who might need it, that
turned into a catalyst for the development of medicine and healthcare.

Medical Care and Hospitals in Bulgaria

in harmony with the teachings of christ to love one’s neighbor, initially in Byzan-
tium and then in other countries, a number of charity institutions arose – inns, or-
phanages, nursing homes, and poorhouses at the monasteries – where the homeless
and ill people could find shelter and food. at a later point those facilities grew into
hospitals, where inhabitants of the area received medical care7. The beginning of this
tradition in charity activities and the building of hospitals and poorhouses is associ-
ated with the Bishop of constantinople John chrysostom.8
in Bulgaria, a few centuries later, we have only fragmentary data about the creation
of inns, hospitals and poorhouses at some monasteries in the Byzantine fashion.
Most reports do not allow for definite conclusions, but only conjecture. it is a wide-
spread opinion that the earliest such institutions occurred at the Patleina Monastery
near Preslav and at the St. Pantaleon Monastery near Ohrid.9 Such assumptions,
however, are based more often on the name of the monastery patron St. Pantaleon
6
ivan dujchev, drevnoezicheski Misliteli i Pisateli v Starata Bǎlgarska Živopis, Sofia 1978
7
Mincho georgiev, ibid, p. 145
8
prot. georgi Florovski, iztochnite Otzi ot ivv, Moskva, 1992, p. 312
9 istoria na Bǎlgarskata Srednovekovna literatura, edited by anisava Miltenova, Sofia 2008, p. 222

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– the saint-healer (wherefrom the name of the Patleina region has been derived)
than on concrete archaeological evidence. The opinion (formulated half a century
ago) about the existence of a hospital and orphanage in the area of avradaka near
Preslav in the iX–X c.10 today is considered to be untenable.11
More detailed information on hospitals can be found in the typicon of the Bachko-
vo Monastery from the Xi c., wherefrom we learn that on cold days the three mon-
astery inns provided food, shelter and warmth to all travelers and the poor. also, ill
people could stay for three or more days (if necessary) until they felt better.12
it is evident that the data concerning hospitals and organized health care in medi-
eval Bulgaria is extremely scarce. This leads us to the conclusion that such events are
rare and almost not present as a phenomenon in the life of Bulgarians from this pe-
riod, and where found, they are often of Byzantine origin. This was the case with
Bachkovo Monastery, founded by the Bakuriani brothers, georgians at Byzantine
service, at a time when the Bulgarian state did not exist and for nearly two centuries
(1018-1195) was part of the Byzantine empire.

Physicians and People’s Disappointment in Them

as for the learned physicians, as well as the medical practice in medieval Bulgaria,
the lack of written sources does not allow for extensive comments. we only have a
few names who could be classified as physicians of Bulgarian origin. These are eu-
stathius the doctor, who lived in Meglen in Xi-Xii c.13 and Basil the Physician, a
Bogomil preacher, whose profession can be deduced from his name, and about
whom a number of Byzantine authors wrote.14, as well as the Synodicon of tsar Bo-
ril of 1211.15 Hodja Bulgar, who was famous in the arabian caliphate in the Xii
c.,16 should not be included in this list because he originates from volga Bulgaria.17

10nikolaj Mavrodinov, Starobǎlgarskoto izkustvo 1959, p. 187–190; neli chaneva-dechevska, čǎrkvi i

Manastiri ot veliki Praslav, Sofia 1980, p. 128–135
11 totju totev, novi nabljudenija i danni za Oblika na grazhdanskata architectura prez Parvoto Bylgarsko

tzarstvo, http://preslav.shu.bg/webs/deinost/archive/tOM1/t.% 20totev.pdf

12
typicon Bacuriani, giBi vii, p. 58
13 ivan dujchev, "Prinosi kǎm Srednovekovnata Bǎlgarska istoria" in godišnik na Plovdivskata narodna
Biblioteka i Muzej 1937-1939, 1940
14 ioahnnes zonaras, epitome Historiarum, giBi vii, izvori za Bǎlgarskata istoria, p. 205. anna Komnene,

alexias, Berlin. new York 2001. Xv 8, 3-10, p. 540–542

15 The Synodicon of tsar Boril, edited and translated by ivan Bozhilov, anna-Maria totomanova and ivan

Bilyarski, Sofia 2010., p. 304

16
Petar Koledarov, 1974, p. 66–69
17
g. M. davletschina, volzhskaja Bulgarija: duchovnaja Kultura (domongolskij Period, X - nach. Xiii vv.),
Kazan, 1990 River. 172

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But there were also physicians of foreign origin, working in Bulgaria. John Petritzi, a
famous georgian physician and philosopher, spent some time in Bachkovo Monas-
tery.18 Theodorites, a monk and physician from constantinople, lived in the capital
city of veliko tarnovo in the Xiv c., as evidenced in the Passional of St. Theodosius
of tarnovo.19
in the iX c. John exarch stated in his aforementioned treatise on the structure of the
human body that knowledge of organs and body parts was of a special character and
therefore it should have been left to the physicians.20 This shows that even in this
early period in history the importance of the medical profession and its inherent
specific knowledge and skills were recognized. But did people practicing the medical
profession in medieval Bulgaria have the necessary professional and moral qualities?
in most cases we come across evidence of inappropriate, unprofessional and some-
times unethical practices by physicians. The common character in literature of an ill
man spending his entire wealth on doctors and not finding relief is most probably
based on real events – patients of various complaints must have been treated by in-
effective and avaricious physicians.
Both Byzantine and Bulgarian hagiographic literature after the X c. is full of exam-
ples of unfortunate patients, victimized by greedy and incompetent physicians, con-
suming their entire wealth and not achieving the desired results. Kekaumenos, a
Byzantine author from the Xi c., expressed genuine dislike of physicians, who he
considered charlatans, because of their habit to prolong the treatment long enough,
so as to take all of the patient’s money. The author, therefore, advises his readers to
avoid physicians and utilize methods of self-treatment instead.21 in Bulgaria we find
the same motif in Theophylact of Ohrid (Xi - Xii century.) He tells the story of a
woman, who "...spent most of her fortune on physicians, but having found their
treatment to be weaker than her pain, decided to resort to free treatment. She used
the relics of the saints instead..."22 euthymius of tarnovo (the end of the Xiv c.)
wrote of a woman, who "...was the victim of a terrible suffering. Her breasts were
corroded by the severe illness and even though she spent too much of her wealth on
physicians, she found no relief."23
From the sources cited one could conclude that the learned physician was a mar-
ginal figure, who had little presence in the life of the medieval Bulgarians, or pro-

18
Mincho georgiev, ibid, p. 145
19 Prostranno zhitie na teodosij tărnovski ot Patriarch Kalist, SBl vol. iv, p. 452
20 Joan exarch, p. 263
21 a. P. Kajdan and ann wharton epstein ibid., p. 178; genadij litavrin, Sovetǎj i rasskazǎj Kekavmena, Moskva 1972, p. 225

22 Theophylact of Ohrid, Mǎchenichestvoto na15-te tiveriopulski Mǎcheniči., giBi vol. iX, p. 77

23
euthymius of tarnovo. Prostranno Žitie na Philotea temniška, SBl, vol. iv, p. 208

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vided no benefit to their health due to incompetence and greed. The disappoint-
ment with the medical profession, the insufficient availability of medical services,
and their high price finally led to the search for alternative healing practices. differ-
ent means and methods were developed for filling up the deficit of healthcare ser-
vices:
• Self-treatment and self-proclaimed healers,
• Healing through sacred objects,
• Faith in saints and their relics.

Self-treatment and Folk Medicine

The fragmentary and scarce information about physicians and medical care at clin-
ics could be accepted as proof that in Medieval times people relied more on self-
proclaimed healers to get help for their ailments, than on learned physicians. The
healing practices of mediums, medicine-men and magicians, as opposed to officially
sanctioned medicine, are a common theme in Old Bulgarian literature. in the X c.
cosmas the Priest urged his congregation not to trust the self-proclaimed healers,
even if the latter were able to cast out demons and raise the dead.24 in the Passional
of Theodosius of tarnovo we find an interesting description of practices of tree wor-
shiping for the sake of healing.25
Theophanes of Rila (Xv c.) testifies to the common search for a cure from "magi-
cians" and the widespread folk healing practices of pagan origin in the late Middle
ages26 in the Xvii c. Joseph the Bearded wrote: "i have been to many lands, but i
have never seen so many mediums and witches as in this Bulgarian land of ours."27
although the aforementioned work dates from a later period, it gives us an idea of
the centuries-old Bulgarian folk healing practices.
Folk medicine (in its oral and written form) developed as an alternative to scientific
medicine during the Middle ages28. The existence of a considerable number of Me-
dieval works with utilitarian applications (used as guides) on the subject of medicine
can be viewed as proof of the presence of a Bulgarian tradition of healing.
The documents of the old Bulgarian medical literature illustrate the different layers
of medieval medical knowledge and its development over a long period of time.

24 cosmas the Priest, Beseda protiv Bogomilite, Sofia, 1998, p.87

25
Prostranno zhitie na teodosij tărnovski ot tarnovski Kalist, SBl vol. iv, p. 452
26 Petǎr dinekov, ibid., p. 433–434
27
donka Petkanova, ibid., p. 127
28
donka Petkanova, ibid., p. 123

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Their large number and distribution is evidence of a widespread use of folk healing
art. a combination of three components is mentioned therein: a strong pagan tradi-
tion, the Byzantine medical culture and the ancient understanding of calendar and
astrological influences on human life and health, reflected therein, as expressed in
Menaion and the later Lunnitsi 29 Some texts reflect the Byzantine model in a greater
degree: "Medical art for all Occasions", dietal works, etc. traditional experience
and knowledge prevails in other sources, for example the earliest copy of medical
advice, retained in "The Psalter of dimitri the Oltarnik" (old Bulgarian glagolitic
psalter from the X-Xi c.) under the name of "The Remedies of St. cosmas". it
would be interesting to point out that the text has no Byzantine counterpart and
contains advice for the treatment of different diseases: swelling, fever, mad dog or
wolf bites, limb spraining or fracture, infected wounds, coughs, colds, skin prob-
lems and more.
The written sources of common medicine are the collections of prescriptions – the so
called Lekovnitsi and apocryphal prayers30. The lekovnitsi represent a later recording
(most of them date back to the Xvii c. or later) of a centuries-old oral tradition of
medical knowledge. in them we can find prescriptions, copied from much older Byz-
antine treatises. This is proof that some of them had been originally written in Byz-
antium and were then used for many centuries by Bulgarian healers. alongside the
names of ailments, herbs and food as cure, one can find incantations, magical formu-
las, and prayers in them. Their instructions and prescriptions had been practically
tested, and their placement in collections of various content and utilitarian intended
purpose proves that they were used as manuals, both by self-proclaimed healers and
the very patients for the purposes of self-help and self-treatment.
apocryphal prayers and incantations for protection against ailments were an excep-
tionally productive medieval genres which is yet another proof of their wide applica-
tion. They first appeared from Byzantium in the X c. and remained in circulation
until the XiX c. The first preserved healing prayers were included in the Breviary of
Sinaia (Xi c.), (also known as euchologium Sinaiticum).31 Folklore incantation for-
mulas turned into recovery prayers (with fixed texts), published in prayer books and
have as their aim the attainment of magical healing.

29
istoria na Bǎlgarskata Srednovekovna literatura, p. 223 –224
30 donka Petkanova, ibid., p. 123
31
istoria na Bǎlgarskata Srednovekovna literatura, p. 224 –225

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Belief in the Healing Properties of objects

Faith in the magic power of objects is indeed ancient and represents the materializa-
tion of an idea with contagious action and euchological intended purpose. The
wearing of amulets and objects of apotropaic power has been a human trait from
the dawn of mankind’s struggle for survival and finding of our proper place in the
universe. This belief and the associated ritual routine have their roots in pagan
times, but they were later incorporated in christianity and transformed into the
honoring of a number of cult objects: the cross, the Scriptures, holy water, holy oil,
icons, etc. They were seen not only as sacred religious objects, but were attributed
miraculous healing and saving powers. The miraculous power of the cross was de-
scribed in a number of medieval works, of which we will only mention here The
Saga of the iron cross.32
literature has often been referred to as a mirror of reality, and therefore we could
deduct from it that the Medieval Bulgarian sought healing and deliverance in every-
thing that surrounded him/her, and was accessible in spacial and financial terms -
signs, dreams, inanimate objects, relics of saints, etc.

The Cult of Saints-Healers

The trust in saints’ assistance is the surest means of filling and addressing the short-
age of health care in medieval Bulgaria. Starting with the reports about the earliest
Bulgarian saints of the X c., such as St. Boris-Michael i, Prince of Bulgaria and
clement of Ohrid, and going further to the literary monuments of Xviii c., litera-
ture is replete with examples of the popular veneration and worship of saints, and
miraculous healings as a reward for faith and repentance. The cult of saints is highly
utilitarian and focuses on the meeting of health care needs. it has two aspects related
to the two phases of their manifestation and the functions of saints:
• their supernatural powers and their capabilities, while they were alive,
• as well as the wonders, performed by their relics and tombs.
Both in folk beliefs, and in literary sources, there exist the examples of saints, who
were considered capable of healing and resurrection practices, even within the peri-
od of their natural lives. in one of the passionals of John of Rila the following can be
found: "and many resorted to him, bringing their sick. and having been cured,
with the prayers of the saint, they headed back home."33

32 ancho Kalojanov, Maria Spasova and todor Mollov, "Skazanie za Železnija Krǎst" i epochata na čar Simeon,

veliko tǎrnovo, 2007, p. 191– 211

33 Prolozhno zhitie na ivan Rilski ot Stishnija Prolog, SBl, vol. iv, p. 133

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 Nadezhda Amudzhieva, Pavel Tsvetkov: The cult of saints-healers – an alternative and opposition...

information contained in the hagiogrpaphic sources is often more specific than ex-
pected, and we can therefore deduce that such beliefs have originated as a result of
the faith in the documentary truthfulness of the data and real magical abilities.
On the one hand, in the extraordinary and devout life of saints healing abilities were
so common that they became a necessary and almost invariable sign of the initiation
of saints. On the other hand, the emphasis on their sanctity and god’s sanction in
hagiography promotes common belief in their healing powers, thus almost com-
pletely displacing physicians from the healthcare focus. Religious reverence for the
saints-healers, and the fact that common people sought help and treatment from
them, ultimately resulted in the rejection of scientific medicine. in the countenance
of saints such as John of Rila, Prohor Pčinjski, Joachim of Osogovo, gabriel of les-
novo, Philothea of Thrace (of argesh), Petka of tarnovo and others, there are collec-
tive features of the saint-healer and the self-proclaimed healer. The common under-
standing was that a healer (because of his compassionate and selfless work) is a
companion of christ. Thus a parallel between self-proclaimed healers and saints was
drawn, as saints were also believed to have been able to cure the faithful through
god’s power.
The cult of the relics of saints (a link between god and earthly life) emerged with
the development of worship of the early saints. it demonstrates to the fullest the
pragmatic nature of the faith in saints-healers. Relics are the most tangible and ma-
terial basis of honoring those saints and touching them is considered to be the best
guarantee for securing the desired results. it is not surprising that honoring the
saints in medieval Bulgaria has utilitarian nature. it stems from the recent pagan
past of the population. Until the adoption of christianity in the iX c., people had
sought deliverance in the touching of healing stones and magic items, and it is only
natural to replace the object, but keep the mechanism of religious relations. as early
as the second half of X c. the worship of saints was inextricably linked to the wor-
ship of their relics. cosmas the Priest described the Bogomil heretics in the follow-
ing way: "and by refusing to glorify the saints, they (the Bogomils) also reject god’s
miracles, perpetrated by their relics through the power of the Holy Spirit."34 This
quote could also serve as evidence of how wide spread relics were at the time. evi-
dence of the popularity of the practice to seek treatment and deliverance from all
physical and mental suffering by turning to the relics of saints can be found in many
literary works. Theophylact of Ohrid offers an extensive list of the miracles, com-
pleted by the imperishable relics of the martyrs of tiveriopol.35 euthymius of tar-
novo provided evidence of the healing power of the relics of St. Philothea of Thrace

34
cosmas the Priest, ibid., p. 56
35
Theophylact of Ohrid, ibid., p. 77

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(of argesh), which for him is an extension of the miraculous power, manifested by
her in her lifetime.36
Faith in the imperishable relics of saints characterizes not only the lower, but also
the higher classes. in the Xii c. george Skylitzes tells how emperor Manuel i Kom-
nenos and himself received healing from the relics of St. John of Rila: "...which
wonder could not have been accomplished by ipocratus’s prohibition, or the recog-
nition of gallienus’s reason."37 in the text, as well as in many other hagiographic
writings, authors contrasted the healing power of the holy relics and the achieve-
ments of learned medicine.
There were also examples of how the location of a tomb or relic storage was directly
likened to a clinic and visiting them by the sick and infirm was similar to seeing the
doctor.38
Judging by source data early christian religious life in Bulgaria had two centers - the
church and the last home of the saints. This reminds us of the situation in western
europe in the era of early christianity, when churches were insufficient or even
non-existent, and the centers of worship and prayer were the martyriums of the
saints.39 This explains why the collection of relics in the capital was turned into state
policy by the Bulgarian rulers Samuil, ivan asen i, Kaloyan, ivan asen ii. The sig-
nificance of such events was so great that they become national celebrations, and
their description was so widespread in literary works that it finally led to the emer-
gence of a separate genre.
The cult of the saints in Medieval Bulgaria was not so much a religious affair, but an
element of everyday life, and the utilitarian attitude toward their relics was the one
that promoted worship for them. The medicine of Medieval Bulgaria was not very
different from that of the pagan times. Pagan Bulgarians tried to heal themselves by
amulets, magic stones and spells, while christianity later substituted those with
prayers for health, pilgrimage and sacred objects. People took care of their health at
a very primitive level – even in traditional medical practices knowledge and profes-
sionalism were substituted for mysticism. The fundamental medical practice was at-
tributed not to certified physicians, but to saints-healers and their relics.

36
euthymius of tarnovo. ibid., p. 208–209, 215
37
ivan dujchev, zavetǎt na Sveti ivan Rilski. Sofia, 2000. p. 113
38
Kratko Žitie na Kliment Ohridski ot dimitǎr Homatian "in SBl, vol. iv, p. 396
39 Peter Brown, The cult of the Saints, Sofia 2000, p. 20

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