In Chapter 3 we saw how many different healing systems there were in sixteenth-and seventeenth-century England. Within the ancient and sometimes magical or metaphysical ideas the beginnings of great changes could be discerned, although it was to be nearly a century before biomedicine began to develop towards its present form and another century and a half before it came to have powerful tools at its command (Macfarlane, 1970; McKeown, 1971). This chapter will try to describe and analyse some of the changes which took place in the eighteenth century, which laid the bases from which biomedicine developed, led to its domination over all alternative healing systems and established a division of health labour which its practitioners also dominated.