The consistency of the character of hospitals in law, as observed in Chapter 2, suggests a customary legal inheritance that preceded classical canon law. Part II turns now to the early middle ages to discover that inheritance. This chapter begins that process by unpicking the long-held model of the early medieval hospital. It surveys the many hypotheses for the origins of hospital law in the West, which claim that hospital law adopted from the East and accommodated via Frankish councils. The chapter confronts the latter of these claims and re-examines its twin pillars: a legal formula of ‘murderers of the poor’ (necator pauperum) and a hospital reform at Aachen (816). The first hinges on the council of Orléans (549), whose efforts were aimed at one royal foundation, King Childebert and Queen Ultrogotha’s xenodochium at Lyons. The council of Aachen’s (816) rules for canons and canonesses prescribed a way of common life for these religious, with different facilities for each for the poor. The chapter argues that the efforts of both councils were singular, and carefully circumscribed. Frankish councils were not to take an interest in xenodochia until c.850. Legal initiatives regarding hospitals began elsewhere.