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Orthodox Christianity is, according to Orthodox Christians, the original form of Christianity. The Church was founded on the Day of Pentecost, AD 33, and those that joined on that day "continued in the apostles' teaching and fellowship, the breaking of bread, and the prayers" (Acts 2:42).

Continuing in these things is known to Orthodox Christians as "Holy Tradition". The Church spread to different places, and the leaders of the Church in each place came to be known as "episkopi" (overseers), which in English is usually pronounced "bishop". The bishop of the most important city of a region (Metropolic) was sometimes called a "Metropolitan", and smaller local churches looked to those in large cities for leadership. From about the fourth century the most important churches were Rome, Constantinople, Alexandria, Antioch, and Jerusalem. The bishops of Rome and Alexandria had the title "Pope", while those of the other three cities were called "Patriarchs". Orthodox Christians believe that they have preserved apostolic succession. While Rome traces its papacy back to the Apostle Peter, Alexandria traces its papacy back to Mark the Evangelist, who founded the church in Alexandria in AD 40.

There were several doctrinal disputes from the 4th century onwards. Some of them led to the calling of Ecumenical councils to try to resolve them. The Church in Egypt (Patriarchate of Alexandria) split into two groups folloing the Council of Chalcedon (451), owing to a dispute about the relation between the divine and human natures of Christ. Eventually this led to each group having its own Pope. Those that remained in comunion with the other patriarchs were called "Melkites" (the king's men, because Constantinople was the city of the emperors), and are today known as the Greek Orthodox Patriarchate of Alexandria, led by Pope Petros VIII, while those disagreed with the findings of the Council of Chalcedon are today known as the Coptic Orthodox Patriarchate of Alexandria, led by Pope Shenouda III. There was a similar split in Syria. Those who disagreed with the Council of Chalcedon are sometimes called "Oriental Orthodox" to distinguish them from the Eastern Orthodox, who accepted the Council of Chalcedon. The Oriental Orthodox are also sometimes referred to as "monophysites" or "non-Chalcedonians."

In the seventh century the areas covered by the churches of Alexandria, Antioch and Jerusalem were conquered by Muslim Arabs, and the native Christians were treated as second-class citizens. Westerners tend to think of Christianity as dominant in society for a long period of history, but this has definitely not been the case for Christians in three of the five ancient churches, who have been in Muslim-dominated societies for 13 centuries.

In the 11th century there was a split between Rome and Constantinople, which led to the Church of the West, the Roman Catholic Church, becoming distinct from the Churches of the East. There were doctrinal issues involved in the split, but they were exacerbated by cultural and linguistic differences. The split was between the Greek East and the Latin West. Shortly before the Great Schism, the Orthodox Church had spread into the northern Balkans and Russia, to the Slavic lands, and today the Russian Orthodox Church, in spite of 70 years of persecution under the atheistic government of the USSR, is the largest of the Orthodox Churches.

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