The state had not been involved previously in the maintenance of health and health-related issues but many writings and works led to the initiation of the intervention of the government in these issues. This century could not be considered as an era of great medical development because it did not reach very close to the actual concept and meaning of medical practice. But the advances and progression in this regard were great enough as compared to the previous centuries.
The concept of disease was previously considered to be the problems encountered by a patient. It was the presentation of the symptoms and signs by the patient which laid the basis for the explanation of the disease. This practice was very common until the start of the eighteenth century. This is clearly presented by an example that was put forward by Alexander Morgan who was a surgeon in Bristol. He put forward a case which he encountered with a patient in 1744 when the patient presented him with his problems. This was the period when the doctor was not the person solely governing the pathology with which the patient was suffering and the prescribed medications. It was rather the doctor and the patient who discussed the problems together and reached a conclusion regarding the treatment to be prescribed to the patient. It is said that during this time it was actually the patient who ruled the right to reach a conclusion regarding his problem and medicine and practice basically lay in the hands of the sufferer. During this time patients explained the reasons for their diseases. They could actually stand against the treatment given to them by the doctor. The reasons explained for illnesses ranged from sudden changes in temperature to the curse of God. Not only were there vague reasons for diseases but treatments were also of a similar range.
By the middle of the eighteenth century, certain changes to these concepts were noticed. Hospitals were created by this time. And the other .influences on the running of hospitals also changed and it came to be under the responsibility of the doctors to manage them. .