Economia and the Spiritual Hospital

Fr. Simeon initially wrote this reflection at St. Vladimir’s Seminary as part of Canon Law 101 taught by Father Alexander Rentel in September 2009. At the time, he was struck by how the terms economia (οἰκονομία) and akriveia (ἀκρίβεια), which are central to Orthodoxy’s understanding of Canon Law, were originally medical terms. Further examination of the way that Hippocrates used economia, akrivea, and kairos (καιρός) gave him a deeper understanding of the oft repeated phrase “Orthodox Christianity is a hospital, not a court of law.” He has decided to revise that paper and share it here.

St Nicholas Church on a Snowy Day
Orthodox Canon Law makes the Church a spiritual hospital

The text of Canon 103

“It behooves those who have received from God the power to loose and bind, to consider the quality of the sin and the readiness of the sinner for conversion, and to apply medicine suitable for the disease, lest if he is injudicious in each of these respects he should fail in regard to the healing of the sick man. For the disease of sin is not simple, but various and multiform, and it germinates many mischievous offshoots, from which much evil is diffused, and it proceeds further until it is checked by the power of the physician. Wherefore he who professes the science of spiritual medicine ought first of all to consider the disposition of him who has sinned, and to see whether he tends to health or (on the contrary) provokes to himself disease by his own behaviour, and to look how he can care for his manner of life during the interval. And if he does not resist the physician, and if the ulcer of the soul is increased by the application of the imposed medicaments, then let him mete out mercy to him according as he is worthy of it. For the whole account is between God and him to whom the pastoral rule has been delivered, to lead back the wandering sheep and to cure that which is wounded by the serpent; and that he may neither cast them down into the precipices of despair, nor loosen the bridle towards dissolution or contempt of life; but in some way or other, either by means of sternness and astringency, or by greater softness and mild medicines, to resist this sickness and exert himself for the healing of the ulcer, now examining the fruits of his repentance and wisely managing the man who is called to higher illumination. For we ought to know two things, to wit, the things which belong to strictness and those which belong to custom, and to follow the traditional form in the case of those who are not fitted for the highest things, as holy Basil teaches us.”[1]

[1]              The Seven Ecumenical Councils of the Undivided Church, trans H. R. Percival, in Nicene and Post-Nicene Fathers, 2nd Series, ed. P. Schaff and H. Wace, (repr. Grand Rapids MI: Wm. B. Eerdmans, 1955), XIV, pp. 356-408.  <>

Oikonomia and the Spiritual Hospital

A Closer Look at Trullo’s Canon 102

In my years as an Orthodox Christian, I have frequently heard people say that the Orthodox Church is not a spiritual court where one is tried, judged, sentenced, and punished according to a strict set of rules, but a place where you are treated and healed of your spiritual diseases and ailments, or passions.  Yet our church is filled with canons regulating church behavior and specifying punishments for miscreant clergy and laity alike and most people have, at one point, heard someone bring out “the Canons” to make a point. Of course, very few of these discussions in parish halls and on the internet that cite “the canons” have any understanding of Orthodox canon law at all, and no understanding of Trullo 102 whatsoever. The council in Trullo, also known as the Quinisext or Penthekte (Πενθέκτη) Council, produced 102 canons, most of which are simple disciplinary regulations. Various scholars have classified these councils in different ways,[1] and Father Andrew Louth calls the entire Council a summation of the Greek canonical tradition that was designed to untangle what had become quite a tangled mess of canons.[2]  Ironically, the very last canon, Canon 102, negates the use of canonical tradition merely as legislation that prescribes particular punishments for specific crimes and places a great deal of authority in the hands of those who are called to apply the canons, namely the clergy.  The title of Trullo 102 is, “That one must consider the disposition of the sinner and the peculiar nature of the sin.”[3]  This is what the physician Hippocrates called the kairos (καιρός) of medicine, and it places a considerable weight of on the shoulders of the clergy who will apply the canons and any oikonomia (οἰκονομία) that is needed in any particular case.  This, however, leaves us at a bit of an impasse, as the very term oikonomia is subject to a great deal of misinterpretation by the non-specialist, yet the word is misused with an almost alarming frequency.  The following paper will explore the proper meaning of the word oikonomia, along with the words akriveia (ἀκρίβεια) and kairos as they relate to the pastoral nature that Trullo 102 gives to entire corpus of Orthodox Canon Law.

Oikonomia (οἰκονομία) is commonly misused as “leniency” or “mercy” in discussions, and we must discard that definition if we are to gain an Orthodox understanding of Canon Law. According to Strong’s Greek Dictionary, oikonomia is translated as stewardship, or administration.  Liddell-Scott’s Greek-English Lexicon defines it as household management, direction, administration (especially of a state), and arrangement (of proceedings, a market, or literary work). Akriveia (ακρίβεια) when combined with the mis-definition of oikonomia as “mercy,” is, in this author’s opinion, what causes the most problems for the non-specialist in canon law. Akriveia is defined as “exactness,” in Strong’s, but that is insufficient depth for an Orthodox understanding of Canon Law. The Liddell-Scott Greek-English Lectionary notes several other uses, starting with precision, and followed by efficiency, rigid discipline, strictness, and severity. However, we must also remember that the Ancient Greek physician Hippocrates also used the term akriveia, and this medical understanding is a critical piece of understanding the puzzle of canon law. Medical akriveia is generally translated as “precision,” but more detail is needed for a medical understanding of akriveia. Medical akriveia requires the physician to pay particular attention to the details of an illness, and Hippocrates specifically notes “the doctor’s need to observe the καιρός in each case”,[4] so the doctor must know “not only the general patterns of illness, but the specific needs of an individual patient.” So, for our purposes, we must understand akriveia as precise attention to the details of the case so we will understand the kairos of each case.

Kairos is a term that needs more discussion before we because we don’t commonly associate it with Orthodox Canon Law. Prior to Hippocrates, medical manuals were often rigid diagnostic handbooks. Euripides and Hippocrates complained that the older diagnostic handbooks left no room for the unique circumstances of a particular medical case,[5] and Trullo 102 and its commentary that “The character of a sin must be considered from all points and conversion expected. And so let mercy be meted out” clearly means that “the Canons” cannot be used as a rigid diagnostic handbook to be applied the same way, to all people, and in all circumstances.  It is a proper understanding of kairos that will help us understand this.

We have already noted that kairos can mean either “the Lord’s time” or “the proper measure.” Time as a term, however, doesn’t serve us as English speakers well. Unlike English, which only has one very precise sense of time, the Greek language has two understandings of time: chronos, or chronological time, and kairos, the Lord’s time, or the fullness of time in which God acts. The English chronological understanding of time is very precise, but the kairos is not so easily defined. When serving with a deacon, liturgy begins with the deacon turning to the priest and quietly saying, “it is time for the Lord to act.” The Greek for this is Καιρὸς τοῦ ποιῆσαι τῷ Κυρίῳ, but it was often rendered in the past as “it is time to begin the service to the Lord.” This old rendering of the phrase and the English understanding of time as a precise chronological thing posed particular problems for any canonical understanding of Canon Law. If “time” is only a precise chronological time, how do we know when to apply akriveia in the medical sense, since “the right time” isn’t always clear from case to case? This is a critical question if the medical understanding of akriveia is central to our understanding of Canon Law and the medical understanding of akriveia requires us to understand how to apply akriveia and observing the proper kairos in each case. We must come to a more precise understanding of kairos as a medical term if we are to get anywhere. To begin, we will start with the Church’s understanding of kairos as the “fullness of time;” then we must understand the other ways that the term was used in Classical Greek. Liddell-Scott’s Greek-English Lexicon again shall be the starting point. Liddell-Scott defines kairos four important ways. First, due measure, proportion, or fitness. Second, as the vital part of the body. Third, and more frequent, the exact or critical time, season, or opportunity. Fourth, to the greatest advantage or profit [of an endeavor]. But these definitions alone are insufficient. To parse kairos further, we will look again at an Ancient Greek medical text On Places in the Human Being, from the Hippocratic Collection:

It is not possible to learn medicine quickly because of this: it is impossible for any fixed technique (καθεστικὸς σόφισμα) to come about in it, such as when a person who has learned how to write in the one way by which it is taught knows everything. And all who have knowledge how to write have the same knowledge because of this: the same thing, done in the same way, now and at other times (τὸ αὐτὸ καὶ ὁμοίως ποιεύμενον, νῦν τε καὶ οὐ νῦν), would never become the opposite, but is always steadfastly the same (αἰεὶ ἐνδυκέως ὅμοιον) and does not require καιρός. But medicine now and at other times does not do the same thing; and does opposite things to the same individual; and the same things are opposites to one another. (Loc. Hom. 41, 6.330–332 L., trans. Craik, modified)[6]

So, in Hippocrates’ treatise, one of the earliest works of Greek prose,[7] kairos indicates that medicine, due to the inherent messiness of the human condition and the many variables it presents the physician, cannot be expected to produce the same result with every procedure in every patient, giving one result at one time and a completely different result at another and making kairos a very imprecise thing. What’s right in one place for one patient may be completely wrong for another patient with the same disease but different circumstances. Hence, medicine must be approached with attention to the particular details (akriveia) of the individual case and with great attention to detail so that the physician knows the right time and right proportion (kairos) of any given treatment. We must apply Hippocrates’ understanding of kairos to our understanding of canon law if we are to properly apply the Canons for salvation and define kairos as the knowledge of the proper time and correct measure of a treatment to heal and not harm the patient or, in the case of us as priests, the penitent.

When we add kairos to our discussion of Canon Law and place it firmly in the context of medical treatment, it is clear that the proper definitions for oikonomia and the expectation of kairos when treating a patient mean that the simple and common comparison of oikonomia and akriveia as “leniency” and “strictness” is not just insufficient, it is dangerously imprecise and inaccurate. Since oikonomia is better understood as management, it implies the mastery of the kairos so that the priest as the treating physician not only knows when to apply mercy, and when to be strict, but also when the prescribed strictness of the treatment is still too lenient and requires us to go farther than the prescribed censure in a canon to achieve salvation and restoration. To continue with the medical terminology, proper use of kairos means that the doctor knows when the patient can be treated aggressively, when to treat the disease less aggressively, and when to break convention completely and treat the disease more aggressively than custom requires. Only when we apply oikonomia, akriveia, and kairos correctly can we find this balance and gain the proper understanding of Orthodox Canon Law. Orthodox Canon law is medical in its nature and can be defined as the management of the Church and all the difficulty that that sin brings (economia) with strict attention to detail of the individual case within the Tradition of the Orthodox Church (akriveia) so that the clergy who are tasked with applying the Canons[8] for healing may “consider the quality of the sin and the readiness of the sinner for conversion, and to apply medicine suitable for the disease”[9] at the right time and in the right measure (kairos).

This understanding of how oikonomia, akriveia, and kairos are the foundation to a good understanding of Trullo 102 illustrates the incredible responsibility that Trullo 102 lays upon the clergy who have been placed in a position to treat spiritual disease.  The level of conscientious pastoral care required of the spiritual physician is stated in the text of the canon.  “For the illness of sin is not simple in nature, but diverse and complex, abounding in many mischievous ramifications, from which the evil spreads further and progresses, until it is stayed by the power of the one treating it.”[10]  Of course, this statement notes that without treatment, sin spreads and grows stronger, just like any chronic disease.  The text that follows, however, requires the spiritual physician to master kairos, learn the character of his flock, and understand that his power to treat lies only in his ability to lead the sinner to repentance in Christ and then get out of the way and not let his own ego interfere with the saving grace of our Lord Jesus Christ.

Yet, kairos also tells us that the spiritual physician cannot get out of the way too much, simply sitting back and waiting for Christ to do all the work.  The Canon teaches us that it is the physician’s responsibility to know his flock thoroughly and to know the overall spiritual health of each individual whom he will counsel.  Unwise use of the Canons, which is not applying them with the proper kairos, can, as Trullo 102 warns us, lead us to the grave failure to obtain “the salvation of the one afflicted.”[11]  Such a failure should hang like the Sword of Damocles over all who aspire for the priesthood and inspire each of us who has been ordained to great diligence, caution, and learning as much as possible about our flocks.  We must attempt to learn their lifestyles, their dispositions, and how they interact as a community so we can properly balance correct and prudent action to keep the parish within the bounds of tradition with the peculiar needs of any given parishioner or culture through kairos. Most importantly, this Canon illustrates that the canonical tradition is not, as many in North America seem to think, part of the Anglo-Saxon legal tradition that we inherited from our British forbearers. We cannot simply pick up the Exomologetarion[12] or read the canons and expect that we can simply know that sin x requires punishment y with no exceptions or wiggle room on the part of the priest/bishop who is required to apply the canons for someone’s eternal salvation.

As we can see in this brief reflection, Trullo 102 lends itself greatly to the imagery of a spiritual hospital, and not to the imagery of a courtroom.  But to be a physician in Christ’s hospital requires a great deal of knowledge (akriveia) and discernment (kairos) that is frequently lacking in recent seminary graduates and among most of the laity who frequently quote “the Canons” in discussion.  If, as the canon reminds us by quoting St. Basil, we must know both “strict observance and… customary usage”[13] many of us, myself included, fall into the trap of insisting on an either/or approach to tradition and view the other approach as defective.  Anyone who is thinking about citing“the canons” in parish life would all do well to consider the implications of Canon 102 of Trullo, which calls us to learn both the traditional way and to have the ability to flex from that way when the situation so demands.


[1]              Two scholars are mentioned in an article by Isaias Simonopetrites.  I will not reproduce their data here.

                Isaias Simonopetrites, “The Pastoral Sensitivity of the Canons of the Council in Trullo (691-692),” The Greek Orthodox Theological review.  40 (1995): 1-2, pp. 52 & 53.

[2]              Andrew Louth.  Greek East and Latin West: The Church, AD 681-1071. (Crestwood, NY: St. Vladimir’s Seminary Press, 2007), p 31.

[3]              The Council in Trullo Revisited. Kanonika, 6. ed. Jōrjj Ji Neṭuṅṅāṭṭa and Michael Featherstone.  (Roma: Pontificio istituto orientale, 1995), p 183.

[4]              Camden, David Hayden. “Medicine and Cosmology in Classical Greece: First Principles in Early Greek Medicine.” (doctoral thesis, Harvard University, 2016), p. 106.

[5]              Camden, p. 108.

[6]              Camden, p 101.

[7]              Cross, James R. Hippocratic Oratory: The Poetics of Early Greek Medical Prose. Routledge 2020. Endnote 17

[8]              The Bishop, or in his absence, the priest, per Canon 102 of Trullo

[9]              The Seven Ecumenical Councils of the Undivided Church, trans H. R. Percival, in Nicene and Post-Nicene Fathers, 2nd Series, ed. P. Schaff and H. Wace, (repr. Grand Rapids MI: Wm. B. Eerdmans, 1955), XIV, pp. 356-408.  <>

[10]             The Council in Trullo Revisited, p. 183-184.

[11]             The Council in Trullo Revisited, p. 183.

[12]             Nicodemus.  Exomologetarion: A Manual of Confession. Trans. George Dokos.  (Thessalonica [Greece]: Uncut Mountain Press, 2006).

[13]             The Council in Trullo Revisited, p. 185.

Economia and the Spiritual Hospital: a Closer Look at Trullo’s Canon 102
Scroll to top