The eighteenth century, a period when pain, suffering and illness was an ‘omnipresent threat’, saw medicine became more institutionally-based, increasingly state-funded, and wedded to a more scientific and analytical approach to disease. Voluntary hospitals, county infirmaries, medical supply dispensaries for the poor, the Royal Colleges of Physicians and Surgeons, and various medical guilds, schools and societies, were established or grew in importance. Collectively these institutions did much to influence how Ireland's main medical practitioners (physicians, surgeons, apothecaries) were educated, trained and organised, as well as the way the sick were cared for. While university-trained Irish physicians catered mostly for wealthy elites, the sick, rural poor usually only possessed the means or opportunity to engage the services of apothecaries or, occasionally, surgeons. Along with commercial, patent medicines, domestic remedies and self-medication, the sick had at their disposal an array of untrained, unregulated empirics, quacks, mountebanks, druggists, oculists, and faith and magical healers.