Tucked away amidst the hustle and bustle of one of the worlds’ busiest financial districts in West Smithfield, a part of London better known for its meat market lies St Bartholomew’s Hospital, one of the oldest and most distinguished hospitals in the world with a history of over eight and a half centuries of continuous patient care. ‘Barts’, as it is more affectionately known, is a part of Barts and the London NHS Trust; which cares for approximately 500,000 people from the City of London, east London and beyond.

A man with a vision

The hospital was founded by the monk Rahere, originally a member of the court of King Henry I who obviously had somewhat of a reputation for loving the high life, as he was described ‘A sinful and worldly wit, who led the creeping life of a courtier, indulging in carnal delights and pouring pleasantries into princes' ears’. Non-stop partying takes its’ toll on us all, and by 1118, Rahere was a changed man who had vowed to live a more worthy life and undertake religious works. Sadly, the reason for such an about-face in attitude was never recorded.

Struck down with ‘Roman fever’ (now thought to have been malaria) during a pilgrimage to Rome, Rahere vowed that if his prayers for recovery from his illness were answered he would build a hospital for the sick poor in London. His prayer was indeed answered, as he made a full recovery and began his journey home. On the way Saint Bartholomew appeared to Rahere in a vision and told him: ‘I am Bartholomew, Apostle of Jesus Christ, and am come to help thee in thy difficulty. I have chosen a place in Smithfield where, in my name, thou shalt found a church…this spiritual house the almighty lord shall inhabit, sanctify and preserve unspotted for ever and ever’.

It was lucky Rahere was a man of his word as he now had the responsibility of setting up both a hospital and a church. The two institutions – St Bartholomew’s Hospital and the Priory of St Bartholomew – were duly founded in 1123 with the blessing of both the King and the Bishop of London and sited at Smithfield (derived from 'smooth field') which was then a flat area of land on the very edge of the city wall with countryside to the north and west. Later on in the fourteenth and fifteenth centuries Smithfield was also to become a place of public entertainment of one sort or another. Knights would joust for the King's amusement, and a coppice of trees to the west was the site of a gallows where the criminals of the time were executed.

Rahere’s church quickly gained a reputation as a place where miraculous things were said to happen. A marvellous light was seen to shine on the roof of the church as the sun arose; the blind who visited it received their sight and cripples went away healed. Having taken religious orders, Rahere himself became the first prior of the Church of St Bartholomew the Great. When he died in 1144, he was buried in the church where his tomb, complete with an effigy added in 1405, can still be seen. Today, his memory is also kept alive in the hospital itself where he has a ward named after him.

On towards independence

Originally the sick of the hospital were cared for by the brethren and sisters of the priory, but gradually the Hospital became independent. It was using a distinctive seal from about 1200 onwards, and by 1300 had its’ own Master. By 1420 the two institutions were totally separate.

By 1546 the future of the hospital was uncertain, as the priory had been closed in 1539 by King Henry VIII as part of his dissolution of the monasteries and the hospital had no income with which to continue with its work. Concerned by the lack of a provision for the sick poor and alarmed by the possible outbreak of plague, the citizens of London petitioned Henry VIII for the grant of four hospitals in the City including St Bartholomew’s to aid them with the 'myserable people lyeing in the streets, offendyng every clene person passing by the way with theyre fylthie and nastye savors'. Near the end of his life, Henry finally relented and issued two documents. One was a signed agreement dated December 1546 granting the hospital to the City of London, and the other Letters Patent of January 1547 endowing it with properties and income. Along with Bethlem, Bridewell and St Thomas’, St Bartholomew’s became one of four Royal Hospitals administered by the City.

The Great Fire of London in 1666 did not leave St Bartholomew’s untouched in its devastating path through the city. Although escaping direct damage from the blaze, many of the properties endowed to it were destroyed. This left the hospital with a much reduced income which necessitated the closure of several wards.

Sons and Students of St Bartholomew’s

Although some wandering medical men may have visited the hospital, it is perhaps astonishing to learn that for the first four hundred years of its existence, Barts employed no medical staff whatsoever. This all changed when King Henry VIII’s charter stipulated the hospital employed ‘one person sufficiently learned in the science of physic, and one other person having sufficient knowledge in surgery’. In the event, several were appointed, and from 1547 onwards, the hospital generally had a staff of three or more surgeons. The most distinguished of these first surgeons was Thomas Vicary, the first Master of the Barber-Surgeons Company.

Despite King Henry VIII’s stipulation, a full time physician was not appointed until the 1560s, when the post was held by Rodrigo Lopez (or Lopus). It was not an auspicious start, for Lopez was subsequently implicated in a plot to poison Queen Elizabeth I, and his career was cut short by a visit to the gallows. Until 1609, the post seemed doomed, with many of its holders dismissed for various reasons, including dereliction of duty. The arrival of William Harvey, who went on to become one of the greatest names in medical history for his discovery of the circulation of the blood, must have come as something of a relief. Harvey held office as physician to the hospital from 1609 to 1643.

These great men have not been forgotten. Vicary and Harvey, like Rahere before them, are remembered through the wards named after them that still care for thousands of people every year.

Barts was also a place of learning. Medical students were first recorded working within the hospital precinct in 1662, when the Governors of the hospital gave orders that ‘young gentlemen or doctors or practitioners’ should seek permission if they wished to be in attendance when the Hospital’s Physicians were prescribing’.

The Surgeons also took pupils. In a move that proves Medical Students enjoyed the same reputation then as they do today, the Governors complained that ‘the admittance of patients in the cloisters was being obstructed by the young men that are apprentices to the three Chirurgions, by their pressing importunities [and] bold and saucy carriage’.

Don’t drink the water…

And you thought hospital food today was bad. Have a thought for the patients of circa 1687, whose weekly menu is described below. Although many you would meet today mourn the loss of the daily beer allowance…

A NEW DIET TABLE APPROVED BY THE GOVERNING BODY OF ST. BARTHOLOMEW'S HOSPITAL IN APRIL, 1687¹

Sunday

• 10 ounces of Wheaten Bread
• 6 ounces of Beefe boyled without bones
• 1 pint and a halfe of Beef Broth
• 1 pint of Ale Cawdell
• 3 pints of 6 shilling beere

Monday

• 10 ounces of Wheaten Bread
• 1 Pint of Milk Pottage
• 6 ounces of Beefe
• 1 1/2 pints of Beefe Broth
• 3 pints of Beere

Tuesday

• 10 ounces of Bread
• halfe a pound of Boyled Mutton
• 3 pints of Mutton Broth
• 3 pints of Beere

Wednesday

• 10 ounces of Bread
• 4 ounces of Cheese
• 2 ounces of Butter
• 1 pint of Milk Pottage
• 3 pints of Beere

Thursday

• The same allowance as Sunday
• 1 pint of Rice Milke

Friday

• 10 ounces of Bread
• 1 pint of Sugar Soppes
• 2 ounces of Cheese
• 1 ounce of Butter
• 1 pint of Water Gruell
• 3 pints of Beere

Saturday

• The same allowance as Wednesday.