BRIEF HISTORY DURING THE SNOW ERA (1813-58)
The hospitals of London during the 18th and 19th centuries developed in a haphazard way. in general, the government contributed very little to their maintenance and exercised little or no control. Instead, the State used workhouse infirmaries to provide care, but only for unemployed persons. Several of the institutions were deemed Royal hospitals, founded by the Crown. Among these, Chelsea Hospital was to house and assist disabled soldiers, St. Thomas's and St. Bartholomew's were to take care of the ill and the incurables, Christ's Hospital was to care for orphaned children, and Bethlehem Hospital was to treat the insane. Some hospitals such as St. Bartholomew's, St. Thomas's and Guy's were endowed by benefactors. They did not need to appeal to the public for assistance and were known as the endowed hospitals. As the nineteenth century progressed, hospitals changed and became institutions for curing and education, rather than just care and comfort. New hospitals arising during the 18th and 19th centuries began to develop quality reputations of their own, notably Charing Cross, Lock Hospital, London Hospital, Middlesex, St. George's, St. Mary's, and Westminster, and Several started new medical schools. Finally, hospitals also became part of academic institutions, specifically University College Hospital and King's College Hospital.
The medical profession In early 19th century England consisted mainly of physicians, surgeons, and apothecaries. To be a physician required a degree from Oxford University, Cambridge University or similar institutions in Scotland and Ireland, necessary to join the Royal College of Physicians. The title of "doctor" was only bestowed on physicians. They prescribed but did not dispense medication, did not operate, and did not take apprentices. Surgeons were persons who had undergone a 5-6 year apprenticeship, attended formal education at a private medical or anatomy school, and spent time in hospitals walking wards with other surgeons. They were overseen by the Royal College of Surgeons who provided licensing. Apothecaries were persons who has spent 5-6 years in an apprenticeship with a medical practitioner and attended some academic courses. They were entitled to both prescribe and supply medicines and to advise on the management of non-surgical conditions. Their licensing came from the Society of Apothecaries. The Society of Apothecaries Act of 1815 established Licentiate of the Society as the primary medical qualification for British physicians.
An alternative to apprenticeship and licensing by surgeons and apothecaries emerged in 1836 when the University of London started to confer degrees and was constituted as a Board of Examiners. This examination in 1839 was extended to recognized London medical schools, thereby breaking the educational monopoly of Oxford and Cambridge. The requirements of the University of London's Board was much higher than those of the Apothecaries Licentiate. Some years earlier the Royal College of Surgeons had become an examining body. They required a three-year course of study with a curriculum similar to that required by the Apothecaries. Eventually, the major London hospitals established their own schools of medicine and used the Royal College of Physicians, Society of Apothecaries, Royal College of Surgeons, and University of London's boards as the licensing mechanism.
Following his apprenticeship and early medical education, John Snow spent time on the wards at Westminster Hospital. He then took and passed his licensing examination for the Royal College of Surgeons in May 1838 and for the Society of Apothecaries in October 1838. Snow went on to receive the MD degree from the University of London in 1844 and became a licentiate of the Royal College of Physicians in 1850. Thereafter he was referred to as Dr. John Snow.
Click below for the location and history of the major hospitals and medical schools during the lifetime of Dr. John Snow. Besides the usual terminology, the word "hospital" is also used by the British to describe a charitable institution for the needy, aged, infirm, or young. Thus not all hospitals in nineteenth century London provided medical care and surgical services.
Charing Cross Hospital and Medical School
Christ's Hospital (charitable educational institution for children)
Foundling Hospital (charitable institution for children)
Hospital for Women (Soho Square)
Hospital for Sick Children
King's College Hospital and Medical School
London Hospital and Medical College
Middlesex Hospital and Medical School
St. Bartholomew's Hospital and Medical College
St. George's Hospital and Medical School
St. Katharine's Hospital (charitable institution for children)
St. Mary's Hospital and Medical School
St. Thomas's Hospital
University College Hospital and Medical School