Medicine or not!

Firstly I apologise for my absence over the last few weeks but I have been rather unwell, a nasty virus snuck up on and gave me a wild temperature, sore throat, dizziness, nausea, reflux and has left with a rather woolly headache.

However I was able to get to our local surgery and was given the diagnosis that it was in fact a virus and I have to let it run it’s course…I still feel a bit off to be honest, but you just get on with it don’t you.

And you certainly had to in the Victorian era as you had no sick pay, if you were sick you didn’t eat or your family didn’t eat as money was not forthcoming. If on the other hand you were wealthy then you got the best medicine that money could buy which was still always that good.

Certainly at the beginning the Victorian period hospitals were not as a place you’d want to go they were more often viewed as ‘gateways of death’ (a nice turn of phrase). These places were over crowded and unsanitary, a perfect breeding ground for diseases of all kind and there was a high potential for the spreading of disease within the hospital environment itself.

It was believed that foul air, or miasma, caused infection and it wasn’t until about 1850 the that the idea was challenged blaming the spreading of disease on germs.

And until then these ‘Hospitals’ tended to be run either by a charity or run by local authorities and even then there were very few.

Enter Joseph Lister, a bright chap who discovered “antisepsis”, a help to prevent wounds and incisions from becoming infected.

The Medical Act of 1858 created a group called the General Medical Council responsible for establishing a register of qualified doctors. Before that anyone could set up as a Doctor as there were no standards. Out of this came more hospitals, they consisted of the Voluntary hospitals, Specialist and cottage hospitals, Poor Law infirmaries, Hospitals for Infectious Diseases and as we have looked at before, Asylums for the mentally ill.

The Voluntary Hospital began as a charitable institution initially developed to serve the poor without charge, this can generally be traced back to churches or monastic communities who serving Christ saw looking after the sick and poor as part of their service. They were funded by donations and subscriptions from wealthy benefactors and philanthropy was very popular in the Victorian era.

Admission was initially upon the receipt of a letter of recommendation by the committee of benefactors who accepted this assignment of power as influencing their social status in the community, a bit of mismanagement really, this however was seen as a barrier to the more needy cases so was soon dropped.

Doctors working in these types of hospitals worked out of a moral conscience and were not paid for there work, generally they would be sponsored or make their living from private practice.

By 1860 medical advances contributed to many more successful operations and more of the wealthier people wanted to be treated in the hospital. This type of hospital included in addition to the patient wards, an operating theatre, an anaesthesia room as well as a pharmacy, a kitchen, a laundry, a mortuary and a chapel.

Cottage Hospitals evolved meet the needs of those excluded by the Voluntary hospitals. These types of hospitals were started by relatives or doctors who had a particular interest medical condition and it was the doctor who admitted the patient. I wonder what sorts of ‘experimental’ medication was used in these…makes me shudder really!

Cottage Hospitals began to develop in the rural areas thus reducing the distance people had to travel to get to a hospital.

The patients in these hospitals are serviced by a general practioner and have between six to twenty-five beds.  Modest weekly sums are charged for the services provided by these facilities. The first of these cottage hospitals opened at Cranleigh in Surrey in 1859.  By 1875, 148 cottage hospitals were opened.

The Poor Law infirmaries were hospitals within the workhouses. The appalling 1834 Poor Law required that all who wanted public relief enter the workhouse and therefore worked for there means. The infirmaries were far worse than any other medical facility which is hardly surprising when you consider where they were. It was here where the aged or incurable sick often ended up with paid Doctors visited these facilities only once or twice a week with the daily care the responsibility of nurses

Hospitals for Infectious Diseases were set up as sensible precaution against infectious diseases (bear in mind the cholera epidemics of the 1840’s). They were set up in obviously to prevent the spread of infection and had the capability to isolate patients with contagious diseases.

Pretty glad to use the NHS lets hope that it is not dismantled by the current government.