2.2.2

Physicians, Surgeons & Hospitals

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Changes in Hospitals in the Renaissance

In the renaissance, hospitals started to become more modern.

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Hospitals

  • The modern hospitals that we use today were born in the 17th and 18th centuries.
  • These hospitals were funded by wealthy people or by private subscriptions from the local community.
  • Specialist wards (like maternity wards) and specialist hospitals were established to treat certain diseases. This organisation was more effective at curing disease.
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Changes in hospitals

  • Not much changed in nursing during the Renaissance.
  • Reformers like Florence Nightingale drove a lot of reforms in hospitals, but this didn't happen until the mid-1800s.
    • Following the work of Nightingale, a higher level of cleanliness and organisation was demanded from hospitals.
  • Hospitals began to create pharmacies which could provide medicine.
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Workhouses

  • Poor people were often looked after in workhouses.
    • Workhouses were large buildings where the unemployed, ill or elderly could be looked after.
  • Conditions in workhouses were often very bad, although they got better after 1850.
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Number of hospitals

  • In the 18th century there was a significant increase in hospitals.
    • For example, in London there were 5 new general hospitals built between 1720 and 1750. Hospitals like Guy's Hospital opened.
  • This was accompanied by a rise in patient numbers.
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Attitudes and beliefs

  • Hospital treatment was free but most treatment was still based on Hippocrates' four humours.
  • Attitudes to illness began to change in the 18th century.
  • The idea that illness was a punishment for sin was increasingly less popular.

Changes for Physicians and Surgeons in the Renaissance

Surgeons’ status began to improve towards the end of the Middle Ages and doctors’ training also improved. The ideas of the four humours and miasmas remained common, but there was growing awareness that dirt and disease were connected.

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College of Physicians

  • The College of Physicians was set up in 1518. Most British doctors were trained here and they were still learning Galen’s works.
  • In the 18th century, most doctors still believed in the four humours or that disease was spread through ‘bad air’ (miasmas).
  • Doctors got a license if they were trained at the college of physicians.
    • Quack doctors did not receive this license, but some unlicensed doctor were also good doctors.
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Florence Nightingale

  • Florence Nightingale (born in 1820) helped nursing to become professional.
    • Her work with 38 nurses (chosen by her) in the Crimean War in 1854 reduced death rates hugely because of her improvements in the hygiene of wards.
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Nursing

  • When Nightingale got back from war, she published a book “Notes on Nursing”.
  • The status of nursing was enhanced as they were expected to care for patients and assist doctors.
    • The Nightingale School of Nursing was set up in St Thomas’ Hospital in London.
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Surgeons

  • By this point in the Middle Ages there were 2 main types of surgeon:
    • Professional surgeons, who had trained at university and were expensive and well paid.
    • Barber surgeons, who were unqualified and not very well respected.
  • Surgeons’ status began to improve and in 1800, the London College of Surgeons was set up. It created training standards for surgeons.

The Work of John Hunter

John Hunter was a pioneer in surgery. People think that he is responsible for improving the status of surgeons. He is now viewed as the father of the scientific approach to surgery.

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Dissections and knowledge

  • John Hunter is a legend in the Royal College of Surgeons today.
  • Before Hunter, surgeons were effectively barber-surgeons, operating in the hope that what they did worked.
  • Hunter donated 14,000 exhibits to a surgeon teaching museum and observed thousands of dissections whilst at anatomy school.
    • This gave him a great knowledge of the human anatomy.
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Discoveries as an army surgeon and teacher

  • Hunter discovered sexually transmitted diseases.
  • Hunter saved millions of people's legs by learning in 1785 AD to treat an aneurysm in the leg by tying up an artery so that blood could flow to the rest of the leg. This stopped the amputation of the leg.
  • Hunter served in the army as a surgeon, working on the battlefields of France.
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Positions and writings

  • His work won him prestigious positions as the Surgeon to King George III and the Surgeon-General to the army.
  • Hunter wrote books based on his experience in the army, dissections, experiments, and observations.
    • His books included On Venereal Disease in 1786 and The Natural History of the Teeth 1771.
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Scientific approach

  • As an individual, Hunter taught hundreds of surgeons.
  • He encouraged them to use his scientific approach.
    • This involved learning as much about the body as possible, testing new ways to treat diseases and observing the outcomes to know what worked best.

Jump to other topics

1Medicine Stands Still

2The Beginnings of Change

3A Revolution in Medicine

4Modern Medicine

5Themes in Public Health

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