MASARYK UNIVERSITY BRNO Faculty of Education DEPARTMENT OF ENGLISH LANGUAGE AND LITERATURE The Development of Medical Care in Great Britain since the 17th Century Diploma Thesis Brno 2007 Supervisor: Written by: Andrew Philip Oakland, M.A. Zuzana Teplíková 0 TEPLÍKOVÁ, Zuzana. The Development of Medical Care in Great Britain since the 17th Century: diplomová práce. Brno : Masarykova univerzita, Fakulta pedagogická, Katedra anglického jazyka a literatury, 2007. 72 s. Vedoucí diplomové práce Andrew Philip Oakland. Declaration: I hereby declare that this diploma thesis is my own work and that I used only the sources listed in the bibliography and websites. Zuzana Teplíková 1 Acknowledgements: I would like to thank my supervisor, Andrew Philip Oakland, M.A. for his kind help, comments, and valuable advice. 2 Content 1. Introduction.................................................................................................................4 2. Medical Care in Britain before 1946............................................................................5 2.1. The Seventeenth and Eighteenth Centuries............................................................5 2.1.1. William Harvey (1578 – 1657).......................................................................7 2.1.2. Thomas Sydenham (1624 – 1689)..................................................................8 2.1.3. Edward Jenner (1749 - 1823).......................................................................12 2.1.4. Hospitals......................................................................................................13 2.2. The Nineteenth Century......................................................................................14 2.2.1. Cholera and Precautions against the Disease................................................14 2.2.1.1. John Snow (1813 – 1858) ......................................................................16 2.2.2. James Parkinson (1755 - 1824).....................................................................17 2.2.3. Hospitals......................................................................................................18 2.3. The Twentieth Century.......................................................................................20 2.3.1. Alexander Fleming (1881 - 1955)................................................................21 2.3.2. Sir Ronald Ross (1857 – 1932).....................................................................22 Notes 1..............................................................................................................23 3. The National Health Service (NHS)...........................................................................25 3.1. History of the National Health Service................................................................25 3.1.1. Aneurin Bevan (1897 – 1960)......................................................................26 3.2. How the NHS Works..........................................................................................28 3.2.1. Primary Care................................................................................................29 3.2.2. Secondary Care............................................................................................31 3.3. Contemporary NHS............................................................................................33 3.3.1. The Structure of the NHS in England...........................................................37 3.3.1.1. The Department of Health .....................................................................37 3.3.1.2. Strategic Health Authorities ..................................................................39 3.3.1.3. Primary Care Trusts..............................................................................39 3.3.1.4. GPs .......................................................................................................40 3.3.1.5. Dentists.................................................................................................40 3.3.1.6. Hospitals...............................................................................................41 Notes 2..............................................................................................................43 4. The Medical Profession.............................................................................................44 4.1. Doctors and the Past...........................................................................................44 4.2. Nurses................................................................................................................45 4.2.1. Nurses in the Past.........................................................................................45 4.2.1.1. Florence Nightingale (1820 - 1910).......................................................48 4.2.1.2. Mary Jane Seacole (1805 - 1881)..........................................................49 4.2.2. Nurses and the Present.................................................................................51 Notes 3..............................................................................................................52 5. Conclusion................................................................................................................53 6. Summary...................................................................................................................54 7. Resumé.....................................................................................................................55 8. Appendices................................................................................................................56 9. Bibliography and Internet Sources.............................................................................66 3 1. Introduction I became interested in healthcare while I was studying nursing at secondary school, during the course of my studies I started to be more interested in the subject of healthcare, especially in England. I had heard about certain well-known Britons in the medical field, such as Nightingale, Harvey and Fleming, so I decided to gain more information, not only about those people but also about the whole system of medical care in Britain in the past as well as the present. My thesis is a theoretical work focused on the overall state of medical care in Great Britain from the historic point of view until the present. The intent of my work is to make an outline of the development of British medical care from the seventeenth century until the present, concerning the dubious remedies used in the seventeenth and eighteenth centuries. I also cover the creation of the National Health Service, including hospital care and medical staff. Moreover, my work contains short concise sub-chapters about several famous Britons who have contributed to medical advances in British history and therefore even today have benefited many people’s lives. It is not my intention to tell their life stories. I focus only on the areas of their lives which somehow relate to medicine or are necessary to mention because of their significant influence upon the person and his or her professional life. At the end of my work there is an Appendix with additional materials which extend the thesis and can help with understanding or explaining the matters which are mentioned only marginally in the body of the work 4 2. Medical Care in Britain before 1946 2.1. The Seventeenth and Eighteenth Centuries The seventeenth and eighteenth centuries were periods of time when the people lacked knowledge about their bodies and how to treat illnesses effectively. During this time developments in medicine were made little by little. This work is concerned with some of the major developments which occurred in Great Britain. Many diseases existed then which do not exist nowadays, because there has been much progress made, not only in medicine but also in the way of life of people living in the 21st century. For instance, proper drainage allows people nowadays to stay healthy whereas people in the 17th century could not perhaps imagine such a luxury. Nowadays there are many books about medicine, and even without being a doctor, one can know quite a lot about medicine and how to treat a fever or simple diseases such as influenza or tonsillitis, for example. In that time such minor illnesses might have caused death because of the lack of proper treatment which is available nowadays. The terrible disease in the seventeenth century was the plague which was sometimes called “Black Death.” It had already appeared in Britain in the Middle Ages and there were also many outbreaks in the 17th century; in 1603, 1625, 1640 and 1665. In the last mentioned year was the worst outbreak, also known as Great Plague of London. Plague was a viral disease transmitted to people from rats through plague-carrying fleas. People did not know its cause and therefore, precautions against plague were not effective enough. If a member of a family died of plague, the rest of the family was locked up in the house for forty days, although the corpse was removed from the house by the “Searchers of the Dead”.1 It frequently meant death for the family members too, especially due to the infected rats which lived in their dwellings. Such houses were marked with a red cross on the door and the words “Lord have mercy on us”. Plague progressed very rapidly with the following symptoms: The first the man knew of this was a cold shivering, followed by terrible vomiting,