BMJ Reports on the Provincial Workhouses and Infirmaries, 1867 - Bristol.

In 1867, in the wake of the damning reports by the Lancet on London's Workhouse Infirmaries, the British Medical Journal inspected a number of provincial establishments in Gloucestershire and the Bristol area. Below is their report on the Bristol Union workhouse, published in November 1867.

REPORT ON THE WORKHOUSE INFIRMARY OF BRISTOL UNION.

The Bristol Union, consisting of the central parishes of the town, contains a population of 66,000. The Workhouse is built in the country, on an open space of eleven acres, and usually contains about eleven hundred inmates. On entering it, we first visited the Imbecile Department, which is a wing of the main building. The male part of this consists of a dining-room, two day-rooms, and five sleeping-wards, containing over fifty people, who are attended to by three paid nurses, assisted by the most competent of the patients. The day-rooms are light and cheerful, and are furnished, amongst other things, with a bagatelle- table, which seemed to afford much amusement to many of the patients. The wards, and everything connected with them, are kept remarkably clean; but the cubical space per bed is, as a rule, less than 600 feet. We noticed, with satisfaction, that those beds occupied by patients subject to epilepsy had well padded sides to them, and that those used by patients who were in the habit of passing their urine under them, were covered with macintosh, and each had an opening in the centre for the water to run through into a vessel placed below. There were excellent bath-rooms and lavatories attached to these wards, with a plentiful supply of hot and cold water.

The Female Imbecile Department, consisting of seven day-rooms and nine sleeping-wards, contained ninety six patients : these we found very similar m their arrangements to the male one, except that we noticed that those patents suffering from epilepsy had rooms specially set apart for their use. The whole of these women were under the charge of three paid nurses, assisted by paupers.

In the part of the building used by the aged, we noticed nothing special, the wards being kept extremely clean; but the cubical space Per bed was not more than five hundred and fifty feet. Passing on, we came to the Infirmary, which is a separate building, holding i8o beds. The wards are built in two stories, with a central corridor on each, running between them, those on the lower story are thirteen, and those on the upper fourteen feet in height. Ventilation is carried out by means of windows, opening on one side into the open air, and on the other into the central corridor, and we observed that to secure a thorough current of air, some of these were fastened open by means of chains and padlocks. There are altogether twenty wards; viz., sixteen large and four small ones; the latter being used for cases requiring special attention or quietness. No ward contained less than eight hundred cubic feet per bed; those specially intended for the reception of fever cases, being allowed from seventeen to eighteen hundred for each patient. To each ward are attached a good water-closet, scullery, and lavatory; also, with one or two exceptions, a bath-room, served with hot and cold water. The water-closets, we were informed, have a strong solution of sulphate of iron poured down them every morning; and chloride of lime is thrown into all night-stools or bed-pans, before they are used. All necessary water-pillows, macintosh-sheets, and cans for containing warm water, are supplied. The sheets and linen, we were told, are changed, as a rule, once a week, and oftener, if ordered by the medical-officer. The nursing is performed by pauper-nurses, two to each ward, the whole being superintended by a paid female nurse; from the appearance of the wards, and the state of the patients, together with the statement of the medical officer, we should consider that these duties were well-performed. The clothes, beds, etc., from the fever-wards, are, we understand, first disinfected by exposure to a temperature of 300 Fahr., then washed in a building specially allotted for the purpose. The linen from the other sick wards is also washed in a separate laundry, and does not come in contact with any of the articles used in the healthy part of the establishment. All these laundries we found to be well arranged. The cooking for the sick is done in the common kitchen of the Workhouse, the food being carried a short distance, across an open space, in covered trays.

We were informed by the medical officer, that, about two years ago, during a severe epidemic of typhus fever in Bristol, many cases were admitted into the Infirmary. All the nurses employed in attending on the sick contracted the disease, and five of them died from it. Since then, the guardians have decided on building a hospital for the reception of contagious diseases, which will be completed next year. It will consist of two pavilions, connected to each other at one end, by means of a passage; this passage communicating with a kitchen, in- tended for their special use. Each pavilion will contain three wards, viz., two on the ground-floor, 40 feet long, 30 feet broad, and 13 feet high; and one on the upper floor, 80 feet long, 30 feet broad, and 14 feet high. Thus each pavilion will be capable of containing thirty-two beds, with an allowance of eighteen hundred cubic feet for each. Sculleries, bath-rooms, lavatories, and water-closets, will be attached to each ward. Ventilation will be carried out by means of windows on each side of the wards opening to the top, and also by means of funnel-shaped openings in the ceilings, communicating with the open ad by means of a tube, and having a gas-light constantly burning under them. We would suggest that the water-closets should be served from a cistern, situated over the wards, the water in which could easily be kept saturated with some disinfectant, and would thus ensure the disinfection of all matters passing into the drain. We consider that the arrangements in this Workhouse are good, particularly the laundries.


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