The men did not get much attention until they made a great contribution to history in the city of Mechelen, in the Duchy of Brabant (in central Flanders, now Belgium), some time in the 14th century, during the terrible ravages of the Black Death.

Eventually, the Catholic Church saw the utility of the brothers and invited them to be formally recognized as a religious group and subsequently gave them pontifical status.

They were also styled in Middle Dutch lollebroeders "mumbling brothers", or "Lollhorden", from Old German: lollon, meaning "to sing softly," from their chants for the dead.

The Alexians did not escape calumny and persecution, as demonstrated from the papal bull "Ad Audientiam Nostram" (2 December 1377) which Pope Gregory XI sent to the German bishops, especially those of Cologne, Trier and Mainz, forbidding annoyance of the "Cellites" and enjoining punishment for their persecutors.

[1] In 1469, the motherhouse at Aachen voiced the general feeling of the Brothers in asking Louis de Bourbon, Bishop of Liège, to raise that house to a convent of the Order of Saint Augustine.

In Missouri, Tennessee and Wisconsin the Alexians run a group of facilities, care systems, homes and communities all for older adults.

The latter, first attached to St. Mary's Convent, Newton Heath, Manchester, was later transferred to West Twyford, near Ealing, which the Alexian Brothers had purchased in 1902.

[4] The contemporary British houses in London and Manchester, as well as the Irish ones in Dublin and Limerick, include facilities for the elderly sick and physically handicapped through a nursing home and Day Centre; an AIDS ministry; care and rehabilitation of homeless men; and support for people suffering from mental illness.