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Contents
Foreword xi
Introduction xiii
Acknowledgments xv
The Prayer of a Nurse Servant Leader xvii
vii
viii Contents
Index 343
Foreword
This book is a treasure in so many ways. All nurses should send a
resounding note of gratitude to Sister Mary Elizabeth.
She has collected in one volume an incredible amount of research on
centuries-old nursing heroes and matched that with compelling research
on contemporary nursing heroes. Her book manages to be both scholarly
and inspiring at the same time.
I was struck by a quote from a 1914 article in the American Journal of
Nursing by Dr. Charles Emerson, describing nursing as “a profession that
does not yet know how great are the responsibilities that are to rest on its
shoulders.” In so many ways, I think that is still so true today. Nurses, in
spite of more education and experience, still only partially glimpse the
magnitude of their role, as Florence Nightingale so beautifully said, to
“often hold God’s precious gift of life in their hands.” It may be that to
realize this too clearly would overwhelm us.
As challenging as nursing can be in today’s world, it is wonderful
to have the resources in this book to inspire and encourage us as we read
about the wonderful nurses who blazed the trail before us; however, it is
even more inspiring and encouraging to couple this with actual quotes
from today’s nursing heroes. Most of us who have been in health care can
think of other nurses in the various positions and specialties highlighted
who also see their care of patients in exactly the same way.
The love of people that motivated the emergence of nursing is still
so evident today. It is no wonder that in interview after interview nursing
is the most trusted voice. Only this love keeps nurses practicing with the
challenges that are so stressful today. We count on this love to continue to
inspire nurses and to keep our healthcare system, in the face of increased
technology, focused on the human being to be cared for.
This is a wonderful book to give to a nurse. It is also an excel-
lent book for executives and board members. Reading it will help them
appreciate the wonderful and saintly things being done each day and
night in their facilities. It will help them make boardroom decisions that
protect this great treasure for their communities.
We are indebted to the author for bringing together such an inspir-
ing collection and relating it to contemporary nursing and leadership
theory. It confirms the timeliness of this magnificent profession.
xi
Introduction
In 1977, Robert Greenleaf introduced a conceptualization of leadership
that he labeled “servant leadership” with the publication of his seminal
work Servant Leadership: A Journey into the Nature of Legitimate Power and
Greatness. Greenleaf’s philosophy purported that a true leader, in any
venue, must be a servant of those he or she leads. Since that time the con-
cept has been embraced by many business and educational communities
for whom the practice of servant leadership has been found to be a highly
successful leadership style. This is reflected in the plethora of books and
articles on servant leadership published during the past three decades.
It is, however, only more recently that the practice of servant
leadership has captured the attention of healthcare institutions and,
more specifically, of nurses practicing in those facilities. Recent nursing
servant leadership articles do, however, strongly support the adoption
of servant leadership as the most appropriate leadership philosophy and
practice for nursing and health care.
Ever since becoming acquainted with the philosophy of servant
leadership, I have wanted to explore the concept as a potential leadership
style for contemporary practicing nurses. In fact, my own clinical nursing
practice, as well as my nursing education and nursing research experi-
ences over the past 35 years, have suggested that the majority of nurs-
ing leaders are already practicing servant leadership although not using
the label. To validate or contradict my perception I decided to conduct
a phenomenological study of the philosophy and behavior of currently
practicing nursing leaders entitled Called to Serve: The Lived Experience
of a Nursing Vocation.
A unique characteristic of this book is the inclusion of the Called to
Serve study data, which contain many powerful and poignant nursing
servant leadership perceptions and anecdotes elicited in tape-recorded
interviews with 75 nursing leaders. These data provided the foundation
for an empirically based model of servant leadership for nursing that
can be used to teach and guide the practice of servant leadership among
nurses. The sample population of 75 nursing leaders interviewed for the
study consisted of 4 administrators, 13 managers/supervisors, 10 head
nurses, 18 charge nurses, 10 team leaders, 9 advanced practice nurses
(clinical nurse specialists, nurse–midwives, nurse practitioners, parish
nurses, and nurse anesthetists), 9 nurse educators, and 2 nurse research-
ers (pseudonyms are used in all cases where nurse leaders are named).
xiii
xiv Introduction
xv
The Prayer of a
Nurse Servant
Leader
Gentle God,
Teach me to listen with my heart to
those who are anxious
and afraid.
xvii
xviii The Prayer of a Nurse Servant Leader
Teach me,
dear Lord,
to become a nursing servant leader
worthy of my
calling.
Amen.
1 Called to Serve:
The Nurse’s
Vocation of Caring
The greatest among you must become like the youngest and the
leader like the one who serves.
—Luke 22:26–27
Several of the nurses that I work with said that they saw servant
leadership and nursing as synonymous.
—Caitlin, Nurse manager of a palliative care department
In a nursing vocation—a calling to serve—sometimes you have to
extend yourself to do the right thing and be caring and compassion-
ate in that calling. I think especially as a nursing supervisor in the
hospital, empathy and compassion stand out. Once . . . we had a
patient who was dying in the critical care unit, and one of the eve-
ning staff was hesitant to let the family members stay because it was
past visiting hours. But, as the CCU (critical care unit) supervisor,
I said they could stay because it was important; the patient was
aware of what was happening. She knew that she was dying, and she
knew that the family was there, and it meant a lot to the family also.
I think you have to cross over and put yourself in the place of the
patient and family to do the right thing and be compassionate and
caring. . . . Sometimes we have to bend the rules a little bit so we
make sure we are allowing that caring and compassion of our nurs-
ing vocation to be evident.
—Anne, supervisor of a critical care unit
The concept of servant leadership in nursing is both old and
new, both ancient and modern. From the beginning of time individuals
have been called forth from their societies to serve the needs of the ill
and the injured. In Chapter 2 of this book, nursing’s tradition of service
is documented through exploring the lives of nursing leaders from the
1
2 Chapter 1 Called to Serve: The Nurse’s Vocation of Caring
nursing as a vocation was much more evident during the era of the
3-year diploma nursing programs, which consisted of an apprenticeship
in a hospital with some formal classes provided to support practice.
Nightingale’s Christian faith underlying her philosophy of nursing, is
also cited as central to the earlier perception of nursing as a vocation of
service (Bradshaw, 2002).
Considering Bradshaw’s understanding of Nightingale’s Christian
philosophy of nursing, Swedish theologian Mikael Lundmark has
offered an interesting analysis of the nursing vocation by comparing
the writings of Bradshaw and Katie Eriksson, who also finds in nursing
central concepts of love and charity as identified by Saint Paul. Ultimately
Lundmark concludes that both Bradshaw and Ericksson’s models
“prevent nursing practice from being reduced to a mechanistic application
of techniques” and reinforce “a high ethical standard” (2007, p. 778).
Their theories, Lundmark concludes “explicitly (Bradshaw) or implic-
itly (Eriksson) advocate a vocational understanding of nursing as being
essential to nursing theory” (p. 778).
As the founder of professional nursing, and as a Christian, Florence
Nightingale recognized nursing as a spiritual calling in her classic work
Notes On Nursing published in 1859:
Christian nurses, it is suggested, are called to serve the ill and the
infirm by the teaching and example of Jesus, as recorded in the gospels:
For I was hungry and you gave me food, I was thirsty and
you gave me something to drink, I was a stranger and you
welcomed me, I was naked and you gave me clothing, I was
sick and you took care of me, I was in prison and you visited
me…. Truly I tell you, just as you did it to one of the least of
these who are members of my family, you did it to me.”
6 Chapter 1 Called to Serve: The Nurse’s Vocation of Caring
vocation or calling to serve the sick. Writing in 1885, Clara S. Weeks, who
authored one of the first textbooks in nursing, described the confiden-
tial nature of the nurse–patient relationship with the admonition “No
one (nurse) with any sense of delicacy can regard (the relationship) as
otherwise than inviolably sacred what is thus tacitly left to her honor”
(p. 22). In an 1898 text identifying “practical points in nursing,” Emily
Stoney commented that “The Profession of nursing is one in which there
is no limit to the good that can be done; it is also one in which every
woman [sic] embracing it must walk worthy of the vocation to which
she is called” (pp. 17–18); and, in her 1921 book, The Psychology of Nurs-
ing, Aileen Cleveland Higgins, superintendent of the Stanford School for
Nurses, wrote “The trained nurse, like cloisonné, is made up of many
precious things. Virtue upon virtue, gift upon gift, power upon power,
the ideal nurse possesses” (p. v).
Writing on “The Place of Religion in the Life of the Nurse,” in a 1914
American Journal of Nursing article, physician Charles T. Emerson described
nursing as “a profession that does not yet know how great are the respon-
sibilities that are to rest on its shoulders” (p. 856). Emerson continued, “We
need cultured nurses, educated nurses, and we need spiritual nurses …
nurses who hear their call most clearly… (nurses who) have seen the highest
spiritual vision of service to their fellow man” (pp. 863–864). He concluded:
“Do this and society will call you blessed” (p. 864). In a 1922 address on
the spiritual aspects of nursing, Rev. Wilson Stearly is quoted as speak-
ing of the nurse as both professional and minister: “To the physician, the
nurse … is a colleague in science and a coworker in the ministry and art
of healing” (p. 336); and in a 1923 article in The Public Health Nurse, nurses
were reminded that “all who embrace nursing as a life profession must
have as the secret source of their ministering contacts the ability to do
what (saints) did, namely, give their help in the name of God” (White,
1923, p. 283). In 1926, the journal entitled The Trained Nurse and Hospital
Review, published a paper on the “Christ Spirit” in the hospital in which
the author asserted: “Nurses go to the bedside from a season of prayer.
They meet the waning hopes of the poor bedridden soul with the radiant
beams of a morning glimpse of God” (Lumpkin, 1926, p. 628).
The spiritual vocation of the nurse was recognized in a 1939
American Journal of Nursing paper entitled “The Religious Function of
the Nurse,” which noted that the nurse “above any other professional
worker” is called to “serve the religious needs of her patients” (Dicks,
p. 1110); and a 1940 article in The Trained Nurse and Hospital Review
pointed out the relationship between the nurse’s profession and vocation
stating: “The immense moral strength, the elevation of ideals, and the
8 Chapter 1 Called to Serve: The Nurse’s Vocation of Caring
inspiration toward self-sacrifice and service that come from the teachings
of Christ are of priceless aid to the nurse even from a professional stand-
point” (Gill, p. 189).
As well as attention to professional duties, the inspiration of the New
Testament makes nursing a “profession of kindness” asserted Mary Ranson
in a 1952 article (p. 29). “There are only a few vocations that Christ explicitly
promised to reward; yours is one of them,” promised an author speaking
to student nurses in 1954 (Hain, p. 57); and “Your role as a nurse is to take
human suffering, lift it in hands that are tender, bless it with lives that are
dedicated, enrich it with the incense of prayer, and offer it to God almighty,”
was a minister’s message to nurses published in 1955 (Murphy, p. 58).
Finally, in a 1956 nursing text dealing with moral issues, the authors asserted
“Because the nurse’s vocation is so singularly Christlike, it is imperative
that she work through Him, and in Him, and with Him. The nurse will find
the solution to most of her difficulties, will see her vocation in a new light,
through personal contact with Christ” (Hayes, Hayes, & Kelly, p. 8).
In the early days of professional nursing, books and articles both by
nurses and about nurses, such as those cited above, described nursing as
a special calling, a vocation of service, characterized by the highest ideals
of caring and commitment. This was partly to highlight the positive and
elevated nature of this newly identified profession in order to counteract the
preprofessional era of the unseemly women to whom nursing roles were
often relegated. The spirituality of the nursing vocation was also applauded
in order to remind those aspiring to the professional nursing role that much
would be asked of them in their chosen work. This was especially true in
earlier times when nurses were called upon to work long hours, in often
less than comfortable conditions, for little pay. Even as working conditions
and salaries improved, however, nurses themselves continued to envision
their caregiving activities as constituting a service to humankind, chosen
for altruistic rather than material reasons. Many Christian nurses perceived
a direct link between their profession of caring for the ill and the Lord’s
teaching in Matthew 25:35–36; for other nurses, simply the humanitarian
nature of the nurse’s service provided satisfaction and fulfillment.
For the majority of nurses this ideal of service, whether religious or
secular, has not changed even as both the art and science of the profession
have evolved into a more sophisticated catalog of knowledge and skills.
That fact is clearly and poignantly demonstrated in contemporary nurses
attitudes and behaviors reported in later chapters of this book. While it
must be admitted that a few of today’s nurses have decried the service
commitment of nursing, strong voices supporting and applauding the
concept of the nursing vocation continue to be heard.
Contemporary Nursing as a Vocation to Serve the Sick 9
“This,” Lane adds “generally enables the nurse to reach out more
sensitively, more hospitably, and more compassionately to other spir-
its in the world” (p. 337). Lane ends by describing nursing as a “noble
vocation” (p. 337) as does Downe (1990) in her article entitled “A Noble
Vocation” (1990). Downe asserted that if we are to support professional
status for our nursing, “We should be linking that professionalism to
better care for our clients … if we are recognized for our skills, caring and
dedication, in other words for our vocation,” the professional status will
be assured (p. 24). Downe concludes by suggesting:
perhaps the time has come to insist that caring for people and
caring about the care we give is not a sign of weakness, but
an essential part of humanity. Maybe our resurrection of the
Contemporary Nursing as a Vocation to Serve the Sick 11
responding to the survey believed that “nursing is a vocation” (p. 13). And
in another 2004 Nursing Standard article, author Jane Salvage observed that
although some nurses may “stay away from describing what they do as a
vocation … it is time to rehabilitate the term” (p. 16). Salvage admits that in
some quarters nursing’s “vocational ideal has been undermined by social
and cultural change: the triumph of scientific thought and the extinguish-
ing of religion, mysticism, and metaphysics” (p. 16). “A consequence,” she
points out, “is the current focus on evidence-based practice, measurement,
outcomes, and technical rationality. Coupled with growth of bureaucratic
control over care delivery, this leaves little room for faith, devotion, or the
apparently irrational” (p. 16). This, Salvage admits, “creates a paradox.”
Most nurses come into nursing “because they want to help people”; some
have a religious motivation, others a humanitarian philosophy, but while
not all call nursing a vocation, the majority of nurses “act out in their
career choice their wish to be of service” (p. 16). In asking where that
leaves nursing today, Salvage turns to our founder Florence Nightingale
who “saw nursing as an ‘act of charity,’ a branch of the ‘love of our kind’
but … (was not) sentimental about it. The nurse had to acquire art, science,
skill, and knowledge to turn her values into effective action” (p. 17). Sal-
vage, thus concludes: “Even if they do not readily use the word vocation,
nurses continue to heed their inner call to be of service. Our challenge now
is to rehabilitate the idea of vocation … and forge a new collective ideal of
service that can help transform health services and society” (p. 17).
In a recent survey of 131 student nurses, the question was asked:
“Why do you want to be a nurse?” The two most significant categories of
response were “to help or care for people” and “because they felt called
or led.” The authors reported:
and “The care taken by the servant leader [is] to make sure that other peo-
ple’s highest priority needs are being served” (Greenleaf, 1977, p. 27). Ser-
vant leaders are to place others’ needs before their own and to serve those
over whom they assume leadership. Surely these characteristics of the
servant leader bring to mind the scripture model: “The Son of Man came
not to be served but to serve and to give His life as a ransom for many”
(Mark 10:45). This conceptualization is validated in writings such as those
of servant leadership scholars Ken Blanchard and Phil Hodges (2003) who
authored the book, Lead Like Jesus: Lessons from the Greatest Leadership Role
Model of All Time. Blanchard and Hodges assert that “Jesus modeled the
heart of a true servant leader by investing most of His ministry time train-
ing and equipping the disciples for leadership” (2003, p. 46). They point
out that at the end of His ministry, Jesus told His disciples “I no longer call
you servants … I call you friends” because He wanted them to grow into
greatness in their discipleship after He went to the Father (p. 46).
Echoing a similar theme is the 2008 book “Black Belt Leader, Peace-
ful Leader: An Introduction to Catholic Servant Leadership” by counselor
and Aikido martial arts sensei Tim Warneka. In his book he presents a
global image of servant leadership for the world community. Warneka
observed poignantly, “Today’s world cries out for people who can lead
with a global perspective. We need leaders who lead from the heart as
well as the mind … leaders who can act ethically, intentionally, and with
respect…. Most of all we need leaders who understand that the primary
function of a leader is to serve, not to be served” (p. xi).
The 10 principles of servant leadership identified by Warneka are:
1. Love
2. Humanity
3. Right use of power
4. Leadership as spiritual practice
5. Leadership as a journey of faith
6. Building an embodied peaceful presence
7. Valuing community
8. Seeking personal transformation
9. Understanding the universal
10. Lifelong learning (2008, p. 32).
Language: English
A N D T H E I R D AY S
BY DR. DORAN
AUTHOR OF “LIVES OF THE QUEENS OF ENGLAND OF THE HOUSE OF HANOVER,”
“TABLE TRAITS,” “HABITS AND MEN,” ETC.
REDFIELD
3 4 B E E K M A N S T R E E T, N E W Y O R K
1856
TO
Is inscribed
BY HIS VERY SINCERE FRIEND,
THE AUTHOR.
CONTENTS.
PAGE
A FRAGMENTARY PROLOGUE
9
THE TRAINING OF PAGES 30
KNIGHTS AT HOME 36
LOVE IN CHEVALIERS, AND CHEVALIERS IN LOVE 51
DUELLING, DEATH, AND BURIAL 65
THE KNIGHTS WHO “GREW TIRED OF IT” 78
FEMALE KNIGHTS AND JEANNE DARC 104
THE CHAMPIONS OF CHRISTENDOM 113
SIR GUY OF WARWICK, AND WHAT BEFELL HIM 133
GARTERIANA 148
FOREIGN KNIGHTS OF THE GARTER 170
THE POOR KNIGHTS OF WINDSOR, AND THEIR DOINGS 184
THE KNIGHTS OF THE SAINTE AMPOULE 194
THE ORDER OF THE HOLY GHOST 200
JACQUES DE LELAING 208
THE FORTUNES OF A KNIGHTLY FAMILY 228
THE RECORD OF RAMBOUILLET 263
SIR JOHN FALSTAFF 276
STAGE KNIGHTS 295
STAGE LADIES, AND THE ROMANCE OF HISTORY 312
THE KINGS OF ENGLAND AS KNIGHTS; FROM THE NORMANS TO
THE
STUARTS 329
“THE INSTITUTION OF A GENTLEMAN” 351
THE KINGS OF ENGLAND AS KNIGHTS; THE STUARTS 358
THE SPANISH MATCH 364
THE KINGS OF ENGLAND AS KNIGHTS; FROM STUART TO
375
BRUNSWICK
RECIPIENTS OF KNIGHTHOOD 388
RICHARD CARR, PAGE, AND GUY FAUX, ESQUIRE 410
ULRICH VON HUTTEN 420
SHAM KNIGHTS 439
PIECES OF ARMOR 455
THE
Dr. Lingard, when adverting to the sons of Henry II., and their
knightly practices, remarks that although chivalry was considered the
school of honor and probity, there was not overmuch of those or of
any other virtues to be found among the members of the chivalrous
orders. He names the vices that were more common, as he thinks,
and probably with some justice. Hallam, on the other hand, looks on
the institution of chivalry as the best school of moral discipline in the
Middle Ages: and as the great and influential source of human
improvement. “It preserved,” he says, “an exquisite sense of honor,
which in its results worked as great effects as either of the powerful
spirits of liberty and religion, which have given a predominant
impulse to the moral sentiments and energies of mankind.”
The custom of receiving arms at the age of manhood is supposed,
by the same author, to have been established among the nations
that overthrew the Roman Empire; and he cites the familiar passage
from Tacitus, descriptive of this custom among the Germans. At first,
little but bodily strength seems to have been required on the part of
the candidate. The qualifications and the forms of investiture
changed or improved with the times.
In a general sense, chivalry, according to Hallam, may be referred to
the age of Charlemagne, when the Caballarii, or horsemen, became
the distinctive appellation of those feudal tenants and allodial
proprietors who were bound to serve on horseback. When these
were equipped and formally appointed to their martial duties, they
were, in point of fact, knights, with so far more incentives to
distinction than modern soldiers, that each man depended on
himself, and not on the general body. Except in certain cases, the
individual has now but few chances of distinction; and knighthood, in
its solitary aspect, may be said to have been blown up by
gunpowder.
As examples of the true knightly spirit in ancient times, Mr. Hallam
cites Achilles, who had a supreme indifference for the question of
what side he fought upon, had a strong affection for a friend, and
looked at death calmly. I think Mr. Hallam over-rates the bully Greek
considerably. His instance of the Cid Ruy Diaz, as a perfect
specimen of what the modern knight ought to have been, is less to
be gainsaid.
In old times, as in later days, there were knights who acquired the
appellation by favor rather than service; or by a compelled rather
than a voluntary service. The old landholders, the Caballarii, or
Milites, as they came to be called, were landholders who followed
their lord to the field, by feudal obligation: paying their rent, or part of
it, by such service. The voluntary knights were those “younger
brothers,” perhaps, who sought to amend their indifferent fortunes by
joining the banner of some lord. These were not legally knights, but
they might win the honor by their prowess; and thus in arms, dress,
and title, the younger brother became the equal of the wealthy
landholders. He became even their superior, in one sense, for as Mr.
Hallam adds:—“The territorial knights became by degrees ashamed
of assuming a title which the others had won by merit, till they
themselves could challenge it by real desert.”
The connection of knighthood with feudal tenure was much
loosened, if it did not altogether disappear, by the Crusades. There
the knights were chiefly volunteers who served for pay: all feudal
service there was out of the question. Its connection with religion
was, on the other hand, much increased, particularly among the
Norman knights who had not hitherto, like the Anglo-Saxons, looked
upon chivalric investiture as necessarily a religious ceremony. The
crusaders made religious professors, at least, of all knights, and
never was one of these present at the reading of the gospel, without
holding the point of his sword toward the book, in testimony of his
desire to uphold what it taught by force of arms. From this time the
passage into knighthood was a solemn ceremony; the candidate was
belted, white-robed, and absolved after due confession, when his
sword was blessed, and Heaven was supposed to be its director.
With the love of God was combined love for the ladies. What was
implied was that the knight should display courtesy, gallantry, and
readiness to defend, wherever those services were required by
defenceless women. Where such was bounden duty—but many
knights did not so understand it—there was an increase of
refinement in society; and probably there is nothing overcharged in
the old ballad which tells us of a feast at Perceforest, where eight
hundred knights sat at a feast, each of them with a lady at his side,
eating off the same plate; the then fashionable sign of a refined
friendship, mingled with a spirit of gallantry. That the husbands
occasionally looked with uneasiness upon this arrangement, is
illustrated in the unreasonably jealous husband in the romance of
“Lancelot du Lac;” but, as the lady tells him, he had little right to cavil
at all, for it was an age since any knight had eaten with her off the
same plate.
Among the Romans the word virtue implied both virtue and valor—as
if bravery in a man were the same thing as virtue in a woman. It
certainly did not signify among Roman knights that a brave man was
necessarily virtuous. In more recent times the word gallantry has
been made also to take a double meaning, implying not only courage
in man, but his courtesy toward woman. Both in ancient and modern
times, however, the words, or their meanings, have been much
abused. At a more recent period, perhaps, gallantry was never better
illustrated than when in an encounter by hostile squadrons near
Cherbourg, the adverse factions stood still, on a knight, wearing the
colors of his mistress, advancing from the ranks of one party, and
challenging to single combat the cavalier in the opposite ranks who
was the most deeply in love with his mistress. There was no lack of
adversaries, and the amorous knights fell on one another with a fury
little akin to love.
A knight thus slain for his love was duly honored by his lady and
contemporaries. Thus we read in the history of Gyron le Courtois,
that the chivalric king so named, with his royal cousin Melyadus, a
knight, by way of equerry, and a maiden, went together in search of
the body of a chevalier who had fallen pour les beaux yeux of that