We all meet up at Carluccio's in West Smithfield. We have travelled from the four corners (well 3 at least) of the home counties, Devizes and Perth, WA.
The Smithfield area of London is really interesting but today we are concentrating almost exclusively on some medical history. Last year we focused on Engineering and the Industrial Revolution, so this year was our turn.
First stop is St Bartholomew's Hospital Museum. http://www.bartshealth.nhs.uk/bartsmuseum
To find the museum, enter the hospital through the Henry VIII gate on Giltspur Street. The museum entrance is about 30 metres to your left under the North Wing archway. The nearest tube stations are Barbican and Farringdon.
St Bartholomew's Hospital and Priory were founded in 1123 by Rahere, a courtier of Henry I. He had become sick on a pilgrimage to Rome when a vision of St Bartholomew inspired him to found the hospital for the poor sick at Smithfield in London.
In the early medieval period the sick were cared for by the brethren and sisters of the Priory as sickness was responded to with religion, not medical interventions. Indeed Monasteries provided a medieval form of care in community, and havoc ensued when they closed as we will hear in a minute.
Gradually the hospital became independent from the abbey and by 1420 the two institutions had become entirely separate.
The Priory was closed as part of Henry VIII’s dissolution of the monasteries in 1539. Henry became the tyrannical monster he apparently was because of a personality change following brain injury due to a serious jousting accident which occurred on 24 January 1536. He was unconscious for two hours and was thought at first to have been fatally injured. Perhaps the vicious destruction of our monasteries was a result of that accident and the lack of effective medical interventions. Perhaps he had a chronic bleed that would have been amenable to drainage in this day and age. We shall never know.
Following the closure of the priory, although the hospital was allowed to continue, its future was very uncertain as it had no income.
The citizens of London were concerned about the disappearance of provision for the sick and poor. They petitioned the king for the grant of four hospitals in the City including St Bartholomew’s.
Henry finally relented near the end of his life. For more than 400 years the authorities have had to bail out health services on a regular basis.
In 1609 William Harvey, discoverer of the circulation of the blood and physician to Charles I, was appointed hospital physician.
In the eighteenth century the hospital was rebuilt. William Hogarth decorated the grand staircase with two magnificent paintings that depict the biblical stories of The Good Samaritan and Christ at the Pool of Bethesda and illustrate the spirit of the hospital's work. All the medieval hospital buildings were demolished during the eighteenth century, except for the tower of the Church of St Bartholomew the Less. Formerly a chapel of the priory, the church is now a parish whose boundaries coincide with the precinct of the hospital.
In 1749 Percival Pott was appointed surgeon. A type of ankle fracture is named after him.
John Abernethy was appointed surgeon to the hospital in 1815 and established the medical school.
1850 was an important year; Elizabeth Blackwell, an American woman, one of the pioneers of medicine as a career for women, was permitted to study at St Bartholomew's Hospital by James Paget (as of the bone disease). However, following Blackwell’s departure female students were opposed and excluded until 1947.
In 1877 The School of Nursing was founded and in 1881 Ethel Gordon Manson was appointed as matron and went on to become Britain’s first state registered nurse.
In 1948 St Bartholomew’s Hospital became part of the National Health Service and in 1992 the future of St Bartholomew's was called into question by the publication of Sir Bernard Tomlinson’s Report on the Inquiry into the London Health Service. The report did not see St Bartholomew's as a viable hospital. Thus, in 1994 The Royal Hospital NHS Trust was formed, amalgamating The Royal London, St Bartholomew’s and The London Chest hospitals. In 1998 the government announced that St Bartholomew's was to remain open on its Smithfield site as a specialist cancer and cardiac hospital
Our willing pupils look at the museum. I advise them not to miss Rahere’s grant of 1137, the 1546 agreement between Henry VIII and the City of London which refounded the hospital and the paintings by William Hogarth.
As we leave the museum, stepping out into glorious sunshine, I make a little speech. I say that
Medicine is a very new science. Effective interventions only appeared 150 years ago. The biggest advances have been safe surgery, anaesthesia and blood transfusion. Pharmacology, medicines, have had a more modest impact. My colleague from WA points put that public health measures such as clean water, sanitation and vaccination are of equal if not greater importance and I agree.
We still use some interventions today that have a very limited evidence base. Maybe in the future they will be seen as whacky. In the past there were treatments which really were very whacky. Although Linacre, who we will hear about later (not Gary) once told Henry VIII that abstinence was the best way to avoid syphilis (good hippocratic advice; do no harm) he also once prescribed ‘nettles in the cod piece ’ and I believe in the seventeenth century tertiary syphilis was treated as follows with: a
lash on shoulder in order to bleed a pint of blood, a rocksalt enema, juice from a goat, gall stones and juice a dead mans skull. This patient died five days later.
Hogarth's masterpieces on the staircase.
St Bartholomew the Less
As we head for St Paul's Underground, we deviate from the medical theme for a minute to wander, relax and think about the Memorial to Heroic Self Sacrifice in Postman's Park https://en.m.wikipedia.org/wiki/Postman's_Park
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