Members of the confraternities of penitents practice mortification of the flesh through fasting, the use of the discipline, the wearing of a hair shirt, among other instruments of penance, etc.
By the mid 12th century lay individuals practicing penance in central and northern Italy had begun to join together in associations for mutual spiritual and material support.
In 1227 Pope Gregory IX recognized and approved canonical status for groups he called "Brothers and Sisters of Penance".
The Confraternity of Saint Lazarus in Marseille was founded in 1550 and undertook as its charitable work the maintenance of a local leper hospital.
Andrew E. Barnes describes Penitential Confraternities as initially "small exclusive associations for urban male elites, distinctive both for their robes and hoods which cloaked their members' identities and for the independence from parochial interference which their status as protégés of the mendicant orders permitted.
Some confraternities had their own chaplain, and even non-members would attend the shorter Masses, where no sermon was given, drawing a number of parishioners from the local church.
[4] The penitents "used the baroque spirituality of the Counter-Reformation, with its taste for display and collective activities, as an expression of communal religious devotion and vitality.
"[5] The number of these confraternities increased to such a degree, Rome alone counting over a hundred, that the way of classifying them was according to the colour of the garb worn for processions and devotional exercises.
This consisted of a heavy robe confined with a girdle, with a pointed hood concealing the face, the openings for the eyes permitting the wearer to see without being recognized.
St. Bonaventure, at that time Inquisitor-general of the Holy Office, prescribed the rules, and the white habit, with the name Recommendati B. V. M. This confraternity was erected in the Church of St. Mary Major by Pope Clement IV in 1265, and four others having been erected in the Church of Santa Maria in Ara Coeli, was raised to the rank of an arch confraternity, to which the rest were aggregated.
The obligations of the members are to care for the sick, bury the dead, provide medical service for those unable to afford it, and give dowries to poor girls.
Originating in Italy, such as those of St. Julian in Monte Giordano, Madonna del Giardino, Santa Maria in Caccaberi, these confraternities were later established in Spain and France, the largest being in Nice and Toulouse.
Their statutes urged members to generously assist the poor and sick in the hospitals, prisons, and elsewhere, and to give alms to orphaned apprentices or at least contribute to the almoners.
This includes, besides the Stigmati of St. Francis, the confraternities of St. Rose of Viterbo, The Holy Cross of Lucca, St. Rosalia of Palermo, St. Bartholomew, St. Alexander, etc.