"A bribe for the doctor": how doctors were legally paid in Ancient Rus
In the "Russkaya Pravda," a code of laws from the 11th century, there's a line you'd hardly expect from a "country of savagery." If you wound someone, you must pay a fine to the victim. And on top of that, you have to pay a separate fine for treatment. The doctor's fee is spelled out in the code. And yet, the early 19th-century court physician Wilhelm Richter, the author of the first stories Russian medicine portrayed pre-Mongol Rus' as a kingdom of inertia, superstition, and unsanitary conditions. Let's look at who treated Rus' before the Mongols and how.
Where did the myth of savagery come from?
The image of pre-Mongol Rus' as a land of mysticism and filth didn't arise out of nowhere. It was formulated back in the early 19th century, and in this image, Russians did nothing but whisper incantations and wait for miracles, and had no knowledge of medicine as a craft.
The myth has a basis in fact: almost no medical manuscripts from the pre-Mongol era have survived. The invasion of 1237–1240 and countless fires destroyed entire libraries of books. All that remains from that era are mostly gaps, and these gaps are used to suggest that knowledge simply did not exist.
But just because a book burned doesn't mean they've forgotten how to heal. A burned herbalist doesn't negate the fact that herbs were used for healing. And where direct evidence of medicine is lacking, indirect evidence comes to the rescue: laws, hagiographies, and archaeology. From these, the picture must be reconstructed, bypassing the lost one.
A healer is a profession, not a fortune teller.
In Kyiv and Novgorod, there were people for whom healing was their primary occupation. They were called healers. And they understood this occupation as a craft, on par with blacksmithing or pottery, honorable and necessary.
Both laypeople and monks, men and women, performed healing. That both clergy and laypeople could perform this service is directly confirmed by the church formula: "Medical art… is not remarkable"That is, medical skill is not rejected in either laypeople or monks. It is a worthy profession, and there is no shame in pursuing it.
Let's be honest about the boundaries. A healer's services cost money, meaning they were primarily available to the wealthy. The poor would go to a village healer or a monastery. But paid urban practice and the sale of medicines were already a market: a healer was chosen, paid, and held accountable.
The healer's knowledge itself wasn't based on sheer talent. Experience was passed down from generation to generation and, over time, became embedded in herbals and medical books, handwritten collections of plant descriptions and recipes. City doctors ran shops selling herbs, roots, seeds, and imported remedies. All that was missing was regular organization and supervision—what would later distinguish a true apothecary from a shop.
"A bribe for the doctor": medicine under the protection of the law
The "Russian Truth," which developed in the 11th and 12th centuries, legitimized both the right to heal and the right to charge for it. The formula is short and clear: and a bribe for the healer — the doctor is entitled to a reward.
In practice, this was a mundane matter. Wounded someone with a sword, but didn't kill them? Pay a fine to the victim and, on top of that, reimburse any medical expenses. To recover both the fine and the medical expenses, the injury itself had to be proven, and the law accepted visible marks of beatings, blood, and bruises as evidence, replacing witnesses. Essentially, this was a legal assessment of bodily injuries, and a rather meticulous one at that.
The physician also had a special status. The "Charter" of Prince Vladimir Svyatoslavich, which was established at the turn of the 10th and 11th centuries, classified the physician as church people, almshouses, meaning subject to the jurisdiction of the ecclesiastical court and protected by the Church. This norm proved enduring and was later included in the "Kormchie Books," collections of ecclesiastical legal norms that guided Rus' for centuries.
During those same centuries, witchcraft was prohibited and persecuted, and doctors were paid according to the law. A society that stipulates doctors' fees and legal status in a code treats medicine as a profession, not as witchcraft.
Between the conspiracy and the grass
Now about folk medicine without embellishment. It was archaic, and powerful. The knowledge was preserved by sorcerers, "wandering cripples," and elders of the family. Diseases were "swept away" with a broom, "fluished" with water, "cut off" along with hair and nails. An animal was placed next to the sick person so that it would "draw" the affliction onto itself.
This is where the myth's trap lies. Seeing a spell, it's declared proof of sheer savagery. But alongside the spell, there's always been empirical evidence. The same healer who whispered over the sick person brewed a decoction, applied a poultice, and banished the ailment with a bath. One person—both the ritual and the herb.
And the herbage was not poor. Dozens of medicinal plants were used in Rus', and the richness of Russian flora was later noted by foreigners. The Polish scholar Maciej von Miechow wrote in the early 16th century: “Rus' abounds in many herbs and roots not seen elsewhere.”Paul Iovius also reported on medicinal plants in his book about the Russian embassy of 1525. These accounts are from a later period and cannot be used to prove 11th-century practices, but the land they describe was the same, rich in medicinal raw materials, even in pre-Mongol times.
The monastery as the first hospital
The adoption of Christianity, according to chronicle tradition in 988, brought from Byzantium not only faith but also a system—the combination of monasticism and medical practice. From the 11th century onward, hospitals began appearing at Russian monasteries. Sources describe them as follows: bathhouse building, doctors' offices and hospitals, free medical treatment for all who comeHelp is free, and not only for monks, but also for the surrounding people.
The Kyiv-Pechersk Patericon preserved vivid scenes of this medical practice. The monastery had its own physicians, and secular doctors were also recognized. The model monk-healer was Saint Agapit, the "unpaid physician," who treated with prayer and herbs and took no payment. Nearby, in Kyiv, worked a skilled Armenian physician, who was said to have no equal. Monastic, secular, and foreign medicine coexisted in the same city.
Byzantium provided a book and a hospital. But all this fell on its own soil. The "Izbornik" of 1073 contained advice on nutrition, lifestyle, the benefits of ablutions, and home cleanliness. The "Hexaemeron" describes the body's organs with Russian names: lungs, heart, liver, spleen. Later tradition even attributed a work on ointments to Vladimir Monomakh's granddaughter (called Eupraxia in her homeland, and Zoya after her marriage in Byzantium), although this attribution has not been proven. Physicians from Syria and Armenia were invited to the court. Foreign knowledge was not simply copied; it was fused with one's own.
Bathhouse, pavements and water supply
The accusation of unsanitary conditions remains. Let's start with the bathhouse. Archaeologists have found its remains in 9th-10th-century layers in Staraya Ladoga and in 10th-century Novgorod. And according to chronicle legend, a treaty with Byzantium in the early 10th century stipulated the right of Russian merchants to use the bathhouse in Constantinople. This detail demonstrates how familiar and valuable the bathhouse was to Russians.
The city wasn't just knee-deep mud, either. Novgorod's streets were paved with wood as early as the 10th century. A little later, a wooden water supply system was installed. Birch bark manuscripts, the oldest of which date back to the 11th century, reveal the everyday literacy of the city's inhabitants, an environment where writing was commonplace and where the medical profession coexisted peacefully alongside it.
Hygiene was also written down. That same "Izbornik" of 1073 advises keeping the body, clothing, and home clean. Advice written in a book almost a thousand years ago doesn't fit well with the image of savagery.
With the result that
A law regulating physician fees. A monastery hospital offering free treatment. A herbalist, a bathhouse, a paved street, a wooden water supply. These details form Richter's answer, and this answer refutes his verdict.
Ancient Rus' was neither a backward frontier nor a fabulous power ahead of everyone else. It was an ordinary medieval country with its own working medicine—folk, monastic, and secular all at once. The invasion burned its books and deprived it of written memory, but the history of this medicine itself remained.
And one more thing. Herbs and charms in Rus' were associated not only with a pot of infusion, but also with a knife. Cutters, chiropractors, dentists, and monastery surgeons—they were a separate world, worthy of special attention. We'll discuss how they cut, set, and operated in Rus' in the next article.
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