Changes

With the Muslim conquest, the city and academy in Gondishapur fell into eventual disrepair; however, the knowledge and training were now increasingly transferred to Baghdad, as that city became the new center for medical education and development of hospitals. There, knowledge was not only integrated with Sassanid medicine and development of hospitals, but Indian medicine, such as Ayurveda, were incorporated. Lecture rooms, pharmacies and libraries were incorporated in instructions. Hospitals were soon founded in the 7-10th centuries throughout the Middle East, including in Cairo, and Damascus, and Baghdad. While hospitals became affiliated with Islamic teaching and instruction, Christians and Jews were active in medical work and in developing hospitals. Doctors and medical students began to make rounds and examine patients closely after treatment. 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. 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 doctorsas a separate science, evolved in the 9th century CE as a separate department that was also affiliated with hospitals and medical departments. What this development recognized is the importance of pharmacology as a separate science requiring both herbal and chemical knowledge<ref>For more on the development of Medieval Middle East hospitals, see: Ragab, A. (2015). The medieval Islamic hospital: medicine, religion, and charity. New York, NY: Cambridge University Press.</ref>.

In Europe, hospitals were even less secular and affiliated with religious institutions, particularly the Catholic church. Monks and priests would often work these institutions. In fact, the relationship of hospitals and the Catholic church, in particular, has continued to this day. However, what created more secular hospitals was the Protestant Reformation. In this case, 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, care began to be different between Catholic and more Protestant affiliated hospitals. The Protestant hospitals gradually became more secular in the approach to medicine and health care, where the beginnings of nursing as a separate branch of health care 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). Medicine and society in early modern Europe (2nd ed). Cambridge: Cambridge University Press.</ref>