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The Lancet Reports on Country Workhouse Infirmaries, Wolverhampton.

In 1867, The Lancet — as part of a campaign to improve the conditions in workhouse infirmaries — conducted published a series of reports detailing the results of its visits to a number of provincial workhouses. Below are extracts from the report on the Wolverhampton workhouse, published on 2nd November, 1867.

WOLVERHAMPTON WORKHOUSE, STAFFORDSHIRE.

IF cleanliness be as nearly related to godliness as is generally supposed, it is to be hoped that the Church Congress in Wolverhampton will not have been held in vain, for assuredly the introduction of the former virtue is greatly needed in this dirty town. The roads are black with coal, and soot begrimes the houses and the people. The Smoke Prevention Act, if it exist, is never put in force, and hundreds of chimneys vomit forth volumes of dense black clouds, which darken the atmosphere around.

The workhouse is situated on the Bilston-road, and its dirty appearance reflects the character of the surrounding district. It was erected immediately after the introduction of the amended Poor Law on one of the most approved models of the time. The clerk's office and board room are placed in front. Behind them is the master's residence and office; and the kitchen forms the centre, from which radiate a series of divergent buildings, with yards between, each being devoted to a separate class. To this fan-shaped arrangement successive additions have been made, more than £10,000 having been spent upon improvements within the last ten years. These additions have destroyed the regularity: thus the dining-room is tacked on to the kitchen; and the infirmaries are in close connexion with the engine-house, the furnace chimney rising immediately in front of one of the sick-room windows. Every part of the establishment was shown us by the master, to whose kindness and ingenuity the sick in particular are indebted for many of the comforts to be presently described. Some idea may be formed of the extent and straggling character of the buildings when we state that there are more than 120 wards besides the necessary offices, and that it took five hours to inspect the whole.

The first block of buildings on the left is devoted to the aged men, of whom there are 162 at present in the house. Many are blind; many are lame; and all are unfit for work. The good, bad, and indifferent are all mixed up together; the wicked and the unfortunate come to the same end, and are treated both alike. The first day-room, which is only eight feet high, was positively stifling. Sitting round a huge fire, large enough to roast a sheep, were some fifty individuals. Every seat was occupied. Throughout the establishment the fires ar" immense. Coals are only 6s. 9d. a ton, delivered on the premises; but surely the price does not justify the wasteful consumption of thirty tons a week. The appearance of these aged inmates is melancholy in the extreme. They sit listlessly about the yards, or pick a bit of oakum in the wards. They have no papers, pictures, or amusements to pass away the time. Many have been there for years. They have a holiday once in five weeks, when they are permitted to go out to see their friends. Their life is practically one of perpetual confinement, with the sole prospect of being released by death. But, further than the mere confinement, their generally dirty aspect struck us with peculiar pain. We never saw criminal prisoners in such dirty clothes, or with such filthy persons. There are no baths, and, with one exception, the lavatories are insufficient. The fifty inmates of the ward already noticed wash in a kind of sink, and only two towels are given out daily for their use.

The next and similarly constructed block of buildings contains the able-bodied men, not three of whom are fit to do a fair day's work. Ten men were sitting in the day-room, all of whom are crippled or infirm. The dormitories on this side of the house are greatly overcrowded. In Ward 30, for example, which contains 4892 cubic feet, 22 persons slept the night before our visit; giving only 222 cubic feet per man. As 300 cubic feet of space is ordered by the Poor-law Board, the regulations have not been complied with.

At the extremity of the able-bodied wing, but opening on the other side, is the boys' school. The schoolroom is low and overcrowded. There are more than a hundred boys. Their general appearance was healthy, and it speaks well for the workhouse dietary that one boy had gained 181bs. in weight during the first month after his admission. The boys are clothed in fustian, and are personally dirty. There is a bath, but the lavatories are small, and the supply of towels, scanty, though more are promised. Itch is rarely absent from: the school; three boys are under treatment in the infirmary at the present time, and others had traces of disease. We passed through the dining-hall to the female side. It is a T - shaped room, and is used also as a chapel, for which it is totally unfit. It must be difficult to divert the paupers' thoughts from dinner to devotion, especially as the seats and tables are so closely placed that no one can kneel down. The women's wards are similarly constructed to the men's. The sewing and knitting rooms were sadly overcrowded-a fact reported some time back by one of the Visiting Committee, but not remedied. The nursery also is in a crowded state, thirty infants and eighteen orphans being crammed into two small rooms. In these the babies and children were crying in cradles and on the floor, without a single plaything to appease them.

Of the general construction of the house, and of all the arrangements for the health and cleanliness of the inmates, we feel bound to express the strongest condemnation; and we can only be surprised that they satisfy the guardians, several of whom are clergymen who take considerable interest in the welfare of the poor.

From this painful subject we turn with great satisfaction to the arrangements for the imbeciles and sick. And here it is gratifying to state, that not only did the authorities anticipate the visit of our commissioner, but were prepared to show him everything and welcome his advice. The inquiries as to the state of the London workhouses had evidently aroused the zeal of the medical officer, the energy and ingenuity of the master, and the humanity of the guardians. During the last two years a series of important improvements have been made, amounting to a perfect revolution in the treatment of the sick and imbecile. The old sick wards have been painted and ventilated, new ones have been added, and all have been furnished with the comforts we shall presently describe. New imbecile wards were also built, and special attendants were engaged. In February last, a special visit was paid by Dr. E. Smith, and, although the Poor-law Board have not favoured the guardians with a copy of his report, a letter was received from the ordinary inspector, in consequence of which 400 ventilators were put in, detached infectious wards were built, baths have been ordered to be placed in all the wards, and the closets are to be materially improved-facts which are more than sufficient to show the value of professional inspection, and prove that the guardians are willing to carry out all reasonable recommendations when asked to do so.

The male and female imbeciles are housed in a special building, which is reached from the principal infirmary. There are thirty-two females, of whom eleven are subject to epileptic fits. The ward is commodious and comfortably furnished. The ventilation has been improved. The walls are coloured, and hung about with cheerful pictures. The windows are furnished with blinds. There is a good table, several guarded fires, and comfortable seats and couches. At the end is a padded room, which is, however, rarely used; and lavatories and closets are conveniently placed. There is a paid superintendent, with several pauper helpers, and the general appearance of the patients was extremely satisfactory. They have a large and agreeable airing ground, and those who are fit are taken to walk in the garden when the weather permits. On the male side are thirty-five inmates, of whom a few only are epileptic. One was confined to bed, but he had a fire in the room. His appearance betokened. that his welfare was well looked after. A member of the Visiting Committee has drawn attention to the state of idleness in which the imbeciles exist. When distributed throughout the workhouses this willing class is often imposed upon by other inmates, and overworked. But here there is the opposite extreme. Under proper supervision they would be happier and better if employed in open-air pursuits; but we fear this cannot be done until they are collected in Special district asylums, with land attached.

The infirmary consists of a series of buildings more or less isolated, of various ages and degrees of fitness. The oldest wards are, for the most part, 30ft. long, 16 ft. wide, and only 9ft. high. Originally there were windows on one side only, but others have been added lately on the other side. In these the waterclosets open directly upon the wards, and formerly the washing apparatus consisted in a small corner sink outside the door. Other wards are only 10 ft. high; but in the new infectious wards, which are not yet occupied, nothing is left to be desired. They are 20 ft. wide, and 12 ft. high. The bath-rooms, closets, lavatories, and nurses' apartments are convenient and well constructed. The windows are opposite, and open freely from the top; and Captain Galton's system of ventilation is adopted throughout. inch ward may be kept cornp1etely separate, and the only drawback seems to be that I all the supplies will have to be furnished from the general kitchen, involving a constant traffic to and fro. Throughout the sick wards the furniture is new and excellent. The bedsteads are good, and many of them lift up. Many of the mattresses are stuffed with hair, and the ticks are covered with movable brown holland. The rest are of wool, and well filled. The walls are cheerfully coloured, and decorated with pictures. The windows have green sun-shades. Over each bed is a tin shelf, which holds the dietary ticket, the medicine, and any other small object which may be immediately required. At each bedside is a small locker, on which is placed a copy of the Psalms and Testament, and which holds the brush and comb and other little necessaries. There is an abundance of easy chairs, stuffed padded benches, and dining-tables. It is also contemplated to give bed-tables for the bedridden; and even now they are supplied with a cloth to protect the sheets from dirt. This part of the workhouse contrasted most strongly as to cleanliness with what we had previously seen. The floors are beautifully clean, and there is cocoa-nut matting between the beds. Iron wash-basins, glazed inside, with plenty of towels and sheets, are supplied to every ward. The nursing is under the charge of L paid man and woman, who have numerous pauper assistants. There is no night nurse, as the surgeon thinks that such a person disturbs those who are inclined to sleep. In serious cases, a pauper is ordered to sit up, and in that case the daily duty is for the time dispensed with. All the pauper nurses are placed upon the sick list for extra beer and diet, and it is contemplated to clothe them in a special dress. We have already expressed our opinion upon the employment of pauper nurses, except in the lowest offices, and we can only regret that so much confidence is reposed in them by the authorities of the Wolverhampton Union.

The medicines, beer, wine, and spirits are good in quality, and are given out from the surgery, under the immediate inspection of the superintendent nurses. The medicines appeared abundant, and well dispensed. The bottles were clearly labeled, each ward had a graduated measure, and the nurses were able to read the labels. The medicines are found by the surgeon, who appears to take a deep interest in his work. His salary is £200 per annum, which includes attendance on every possible case-midwifery included.

The surgery contains every appliance for the sick: such as bed-pans, foot-warmers, &c. The lying-in ward is a cheerful room, separated from the other wards. The windows were gay with flowers. There are four patients, and a second room is occupied when more come in. The cubic space is 2560 ft.; and, perhaps, it would be safer to take out a bed. The present venereal wards are inferior to the rest; but we presume that the patients will shortly be removed to the new building. Ward 95 is a gloomy-looking place, and is the least fitted for the sick of any that we saw.

Now, it may be reasonably asked if, notwithstanding this satisfactory account, there remains anything to find fault with; and, in the belief that the guardians will be glad to have defects brought before their notice, we venture to proceed. First, then, many of the wards are still overcrowded for example, Ward 74 is 36 ft. long, 16 ft. wide, and only 9 ft. high. Its cubic space is, therefore, 5184 feet. It contains at present thirteen beds, or less than 400 cubic feet per bed. Wards 91 and 92 would also be better with four beds instead of five. The same remark applies to several other wards, though in a somewhat less degree. A moderate diminution in the number of beds throughout the infirmary would greatly add to the comfort of the patients, and would approximate the space to that which is recommended by the Cubic Space Commissioners. In the next place, we would strongly recommend that one of the wards be converted into a day-room. Not only would this arrangement be better for the convalescent patients, but it would conduce to the quietude and cleanliness of the entire establishment. Anything which saves traffic into the wards diminishes dirt and contributes to the quietness necessary for the really sick, whilst those who can take exercise freely do so without disturbing the other patients. But the most objectionable feature in the Wolverhampton Workhouse is the central kitchen. It is small, dark, and the centre of workhouse gossip, because the attendants here assemble to receive the food for all the inmates. Every meal has to be carried to the imbecile, sick, and infectious wards, across a dirty yard and; and although the master has invented a water-tray to keep the rations warm, the traffic is most objectionable, as it keeps up a constant communication between the patients and inmates of every portion of the house. Even the attendants upon the fever and infected patients will draw their food from the same source. We heard that it was in contemplation to enlarge the kitchen; but we would suggest that, instead of doing this, a separate kitchen should be built for the use of the sick and imbecile, the steaming part of which might easily be accomplished by connexion with the engine-boiler.

The reception and tramp wards are very bad, and have been reported by the inspector of the district.

In conclusion, we congratulate the guardians upon their recognition of the fact that sickness is not a crime; and we trust that ere long old. age and infirmity will be treated with more respect, and those who suffer from mere misfortune be given greater liberty.

Since writing the above, we have received a letter from the master of the workhouse, stating that there is at the present moment an unusual number of inmates, in consequence of the depression of trade in the Wolverhampton district. He also desires to state that the number of beds has been reduced in No. 30 ward, and that the condition of the day nurseries will be brought before the guardians at their next meeting.

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