Changes

At this time, the concept of medical records for patients was developed, where doctors would record patient information and results of treatments as they visited patients before and after treatment. Surgery was practiced in theaters where medical students would observe and medical books were also written about surgical practice and anatomy (Figure 1). The development of the pharmacy, first established by Middle East doctors as a separate science, evolved in the 9th century CE as a department that was also affiliated with hospitals and medical departments. What this development recognized is the importance of pharmacology as a separate science requiring specialised knowledge that worked along with doctors.<ref>For more on the development of Medieval Middle East hospitals, see: Ragab, A. (2015). <i>The Mideval Islamic Hospital: Medicine, Religion, and Charity</i>. New York, NY: Cambridge University Press.</ref>.

In Europe, hospitals were even more closely tied to religious institutions and the Catholic church. Monks and priests would often work these institutions, where they had to train in medicine and religious knowledge. In fact, the relationship of hospitals and the Catholic church has continued to this day. However, what created more secular hospitals was the Protestant Reformation. During the Reformation, hospitals that were once supported by the Catholic church lost their support. In England, the loss of support for hospitals led many citizens to often demand that the government begin to take control of these institutions. This began the process of government-supported and eventually private hospitals. Soon, hospital care began to be different between Catholic and more Protestant states. The Protestant hospitals gradually became more secular in the approach to medicine and healthcare, where the beginnings of nursing as a separate branch of healthcare in hospitals began to develop by the late 16th and 17th centuries. <ref>For more on the development of hospitals in late Medieval Europe and early Modern Europe, see: Lindemann, M. (2010). <i>Medicine and Society in Early Modern Europe</i> (2nd ed). Cambridge: Cambridge University Press.</ref>