BMJ Reports on the Nursing and Administration of Provincial Workhouses and Infirmaries, 1894-5.

SMALLBURGH, NORFOLK.

It seems that this rambling old house once belonged to a county magnate, who turned it into a house of industry, gathering into it such weavers as were not in a position to earn their living in their cottages. Some of the floors show the marks of weavers' looms, and the hooks that they used are still in the walls. The staircases have wide easy steps and spacious landings, contrasting most pleasantly with the narrow winding stairs of the workhouses of later date, neither serviceable for the living, nor convenient for transporting the dead.

The outward aspect of the house is that of barracks. It is built of red brick, with few and small windows towards the road; it has accommodation for 800 inmates, but only 45 were on the books at the time of our visit, and the master said that 70 would be the largest number, even in the winter. A large part of the house is therefore shut up.

The old men's infirmary is on the ground floor; it is one of the old rooms unaltered; windows small, and on one side only; low pitched roof with open rafters. There were about eight men in bed. A dreary day-room is close to the ward, well supplied with benches, but there were very few armchairs, either in day room or ward. The one redeeming feature was a pleasant and good-sized garden, where such of the old men as can get out may sit and smoke.

The old women are on the first floor in two rooms, a day room and an inner room as the ward. Here are more comforts: a good supply. of armchairs and a horsehair couch, cushions, a table cover, and growing plants gave a more homelike air. The old ladies need such compensations, as they are rarely able to go up and down stairs, and moreover their piece of ground was not so well cared for as that of the men. There were two curtains to each bed. The bedding throughout is flock; in many cases we noticed that it was lumpy and wanted teasing out.

There is a nurse, but she is untrained, and is getting on in years; there is no night nurse, only paupers sleeping in the wards at night. The male and female infirmaries are some distance apart. The class of cases is such as is usual in country workhouses, paralysed and bedridden patients, helpless as children, and requiring at the least as much attendance; whatever they may receive by day it is clear that they get none at night. There were about twenty patients at the time of our visit.

The nursery is a large dreary room near the female infirmary. A baby in a cradle was being tended by a deaf and dumb woman, and another infant was in the arms of an imbecile. A flight of stairs from this room led to the night nursery. Here we found an infant lying in a large bed placidly sucking a tube feeding bottle, and an older child in a wooden cradle. The latter was. we were told, an orphan being brought up (?) by the guardians. It was well that these infants were so capable of looking after themselves, for the deaf and dumb woman would, of course, have heard no sound, and the intellect of the imbecile could hardly be reckoned on in an emergency. When will guardians recognise their responsibility for these infants? We would suggest that the orphan should be put out to nurse in the village.

The lying-in ward is on the first floor near to the nurse's room, a small room containing two beds; it is not often used.

Sanitary arrangements are non-existent. In the wards are the usual commodes, and outside, at some distance from the wards, are privies, too far to be of any avail for the old and infirm. The commodes of course are not emptied at night. No water is laid on inside the house; there are consequently no baths. The wards are ventilated by the windows, supplemented by Tobin's system, but the tubes are not placed at the right height in the walls.

The well-cultivated garden, plentifully stocked with vegetables and fruit trees, suggested a varied diet for the sick, with jam to take the place of butter at times. We hope that the inmates share in the produce before it is sold by the guardians for the relief of the rates.

RECOMMENDATIONS.

When we find such an antiquated house in a sparsely-peopled district, we wonder if it is worth while to maintain such an establishment for so few. Could not the inmates be placed in another house, with no disadvantage to themselves and a manifest saving to the ratepayers? A certain amount of money would need to be spent on the present house to make it sanitary and workable. The master told us that he had the greatest difficulty in finding able-bodied paupers to do the work, and the fact that the infants are in the charge of an imbecile and of a deaf mute bears out his statement.