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The Lancet Reports on Metropolitan Workhouse Infirmaries, 1865-66: Rotherhithe.

In 1865-66, The Lancet — as part of a campaign to improve the conditions in London's workhouse infirmaries — conducted published a series of reports detailing the results of its visits to a number of the capital's workhouse. Below are extracts from the report on the Rotherhithe workhouse.


The ancient parish of Rotherhithe (mentioned in Domesday Book as part of the royal manor of Bermondsey) occupies a remarkable natural situation. It is placed on the south side of the Thames, between Bermondsey and Deptford, and its level is so low that only the embankment on the river side prevents its being flooded; and there is an alluvial deposit of some depth, which is admirably adapted for the purposes of the market gardener, though by no means conducive to the health of human residents. This humid stratum (the old river-bed in fact) forms the soil of the whole parish, and upon it the workhouse is built.

The workhouse consists of three distinct blocks of building. The main block, which fronts the east, is 300 years old, and is now used for the "able-bodied" and for offices. The block which lies on the west was built in 1837, and is now occupied by the "old and infirm," and by the midwifery and nursery wards. Lastly, the new infirmary, erected last year, stands in the garden, at some distance from the house.

The entire site, as already stated, is necessarily very damp; indeed the master told us that he had seen some portions of the workhouse actually under water. The drainage, however, is said to be good; and the water-supply (from the Southwark Company) is very satisfactory. There is professedly accommodation for 340 in the house; at the time of our visit the number of inmates was below 200. Beyond the separation of the sick and some unimportant arrangements, there is no classification properly so called. The fever and small-pox cases are sent away to London.

The one great virtue of Rotherhithe Workhouse is the new infirmary building. This contains two wards for males and two for females, which possess almost every requisite for the treatment of disease, and which we have much pleasure in commending. But even here we are annoyed at perceiving that the guardians, having acted so rightly in one important respect, have nevertheless paralysed their undertaking by neglecting to appoint proper nurses. There is only one paid nurse (with a salary of £20), and four pauper assistants, whose ages vary from sixty to seventy-five, and who wear the common house-dress. Not one of these last was either physically or mentally qualified for the duties of nursing.

But if the arrangements for the professedly sick are still very incomplete, those for the aged and infirm and the lying-in women cannot be said to deserve the name of arrangements at all. In the first place, these poor creatures are, practically, left without any nurses; a fact which deserves strong reprobation. As for the sanitary accommodations for this part of the population, they are disgraceful, and such as cannot with decency be fully commented on. We may mention that there are no bath-rooms and no water-closets attached to the infirm or to the midwifery wards; and the aged custodian (nurse she cannot be called) of one of these wards confessed that she obliged the women in this ward, whatever their condition, to go to the dry-closets in the yard, because she could not be at the pains to empty slops for them; and, in short, the whole state of things in these wards, as discovered by the questions addressed by the medical officer and ourselves to the inmates, must be denounced as entirely opposed to the directions of the Poor-law Board, and still more so to the dictates of enlightened medical science. The whole department demands entire reconstruction.

The different descriptions of food, which we examined with considerable care, appeared good, and the cooking satisfactory; but the dietaries themselves require a liberal extension, especially as regards the allowance of animal food. We saw some dietary tables which would shock the feelings of the public, and which, compared with our prison dietaries, reflect most painfully on the moral judgment of the guardians of Rotherhithe. One of these tables, we were glad to hear from the medical officer, has become practically obsolete. The great set-off to the evils which would otherwise be inflicted by the poorness of the dietaries, is the discretionary power entrusted to the medical officer, which he seems to use unchecked, of placing invalids upon extra diet.

The position and pay of the medical officer is a deplorable subject. He visits the house daily, and has about forty sick, besides the aged and infirm, under treatment; and attends about twelve midwifery cases yearly. For the whole of this duty, and for supplying and dispensing all the drugs, Mr. Firth receives £35 per annum! Any comment on these facts would be quite superfluous.

The mortality of the year 1864 was eighty-eight, and presents nothing remarkable; and there is no evidence of the outbreak of epidemic disease as far back as the records extend. This last circumstance is one for which the guardians are certainly not to be thanked.

In conclusion, we must notice the following striking points in the Rotherhithe infirmary:—

1st. The extraordinary contrast between the condition of the sick in the infirmary proper, and that of the aged and infirm; many of the latter being entitled, from their condition, to exactly the same treatment as the former.

2nd. The absolute necessity either of enlarging the infirmary, or of so altering the present infirm wards as to bring them up to the level of modern requirements for treating the sick.

3rd. The necessity of placing all the sick, acute and chronic, under the care of properly educated and paid nurses, both for day and night.

4th. The need for a revision of all the diet-tables, and especially those for the sick and infirm.

5th. The necessity of revising the position and pay of the medical officer (which at present is disgraceful), and of placing under his care the sick, aged, and infirm.

6th. The importance of providing that all drugs should be supplied by the guardians, and dispensed by some respectable chemist and druggist.

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