A History of the Isle Of Wight Hospitals by E. F. Laidlaw
Part One: From the beginning to 1948
In the census of 1851, a year or so after the opening of the Ryde Hospital (known then as the Royal Isle of Wight Infirmary), the population of the Island was 45,640; it had increased, indeed nearly doubled, since the first census in 1801 when it was 23,687; and the figure for 1771, the year of the foundation of the House of Industry which became St. Mary's, estimated from the returns of the parishes, was 18,700.
As to doctors the earliest figures I have been able to get were from the local list in the Medical Directory of 1848; at this time there were 33 doctors on the Island; if we consider only General Practitioners, the proportion of doctors to population is not so very different from the present.
Medicine and surgery were about to develop rapidly; anaesthesia had been introduced during the previous few years and the possibilities of surgery were thereby very greatly extended; up until then, surgery must have been mostly concerned with injuries, broken limbs, war wounds; hernias and other local swellings and superficial growths and infections; and cutting for stone. Medicine must have dealt mainly with infectious diseases especially Cholera, Smallpox, Typhoid Fever, and Typhus, Scarlet Fever, Pneumonia, Erysipelas, and others including Tuberculosis. Otherdiseases and disorders, - Parkinsonism, - the Shaking Palsy, Multiple Sclerosis, - the Creeping Palsy, Strokes, Apoplexy, Gout, Rheumatism and Arthritis, Epilepsy, Diabetes were known, but there was no systematic knowledge of medicine based upon human anatomy and physiology; the first treatise of Human Histology (The Microscopic Structure of Tissues and Organs) was published by Arthur Hill Hassall in 1849, and the first edition of Gray's Anatomy was in 1858. The work of Pasteur & Lister and the recognition of micro-organisms as a cause of disease, was still about two decades in the future.
There was however a medical service of some sort; the Board of Guardians which was responsible for the House of Industry, also provided a medical and nursing service for those who could not pay. From 1836 onwards the Guardians were responsible to the Poor Law Board, which sent inspectors annually to report on the Workhouse. But the Guardians operated before 1836, - the leading landowners and clerics of the Island, - 'The Oligarchy of Gentlemen' as J. & J. Jones have described them, - and it was in 1830 that Mr. Sewell suggested that the Island be divided into ten areas; to each one a doctor was to be appointed; they varied in size and population and were to be chosen by the doctors in their order of seniority in the profession; their salaries were to be proportional to the population in their area, and ranged from £25 p.a. to £95 p.a.; and as will be seen later a doctor was also appointed to the House of Industry and one to the associated wards for the mentally afflicted; we may assume that all these were part-time appointments, these arrangements were made for those who could not pay. The scheme unfortunately did not work very well, perhaps partly because of the extremely isolated condition and situation of the South Wight, most especially of the Undercliff. At the end of a year or two, five areas were vacant. Many re-arrangements were made, but the principle remained that some sort of salaried service was provided for the poor.
The Guardian's medical services also included the provision of dispensaries. The first of these, in Castlehold, Newport, was opened in 1823; a surgeon (doctor) attended between 8 a.m. and 10 a.m.; by 1832, about the same time as the ten areas were designated, the Guardians ordained three dispensaries in each of the east and west Medines; accommodation was to be provided, and one supposes maintained, by the Guardians, and medicines by the doctors; each dispensary was to be visited daily; parish overseers were authorised to send a pauper with messages, and to bring back medicines prescribed. A dispensary in Ryde was started in 1842 and was ultimately housed at the junction of West Street and Swanmore Road close to the Hospital which in 1952 finally took it over. The headquarters of the Ryde Red Cross now occupies the site of the former dispensary.
Some years before that in 1826 it was thought that the midwives on the Island were too few in number, and surgeons were asked to find four eligible women who were to go to London for training and return to the Island to practice; they would receive 5 shillings for each case they delivered successfully.
The practice of medicine at the higher levels in those days demanded an astonishingly comprehensive understanding of philosophy and logic; Dr Gray in his biographical study of Arthur Hill Hassall By Candle-light, describes the examination for the London M.D. in 1847, which includes a written paper on Elements of intellectual philosophy, logic and moral philosophy; how, one wonders would today's membership candidates deal with such questions as `There are, and can be, but two ways of investigating truth. What are these two methods and what is the difference between them as regards the process of the mind?' or 'Give Stewart's definition of consciousness. How according to him do we get the notion and conviction of our personal identity? Give any other solution of the question.' or 'What are the presumptions that we shall live after death deduced from our present physical, intellectual and moral state?' (These are three of the twelve questions posed.)
What happened to patients in need of hospital care before there was a General Hospital on the Island? The only hospital available in those early years was the County Hospital in Winchester; patients could be taken there, but the number able to make the journey and to benefit must have been very small, and the difficulties formidable; the regular service from Cowes to Southampton only began in the mid 19th century; and the journey from Southampton to Winchester must have had to be on horse-back or by a horse-drawn carriage of some sort until the railways came into existence also in the mid century. Nevertheless, a few did find their way there and Guardians were authorised to arrange this and to accompany a patient to Winchester, and to be reimbursed the expense of the journey and return.
It is perhaps a little unexpected to find that the hospitals which eventually came into being on the Island numbered so many as (about) 20, though it is true that some of them need only a very brief mention. Besides the general hospitals we have to consider the special hospitals, Whitecroft, the R.N.H., Longford, and Ashey; three small fever or isolation hospitals besides the larger one at Fairlee; Frank James and the three small Shanklin hospitals, - the Cottage Hospital, the Arthur Webster Institute and Scio House; the military and naval hospitals; and the prison hospital and some others that had only a very brief existence. During the two world wars several of the big houses were taken over as service hospitals or convalescent homes, these included Ryde House, Ryde Castle, Gatcombe, Swainston, Afton Manor, Northwood House and Winchester House in Lake and Haslewood in Ryde and there were of course, and are, numerous convalescent homes and nursing homes some of which have been more or less closely associated with the hospital work - Ryde Nursing Home, for example and Kitehill Nursing Home. The Harriet Guy and Cowes War Memorial Convalescent Home was given as an endowment for public service; whilst Osborne House has been a convalescent home since the beginning of the century available for a limited range of the public, but giving great help to the hospital service during the wars.
St. Catherine's Home in Ventnor also requires special mention; it opened as a nursing home for adults in 1879, founded by a committee with the support of the C of E Convent of St. Margaret at East Grinstead, this association continued, and until the modern era it cared mainly for adults and children with respiratory illnesses. In 1910 it became a childrens' home, increasing in size by building at taking in adjacent houses, and ultimately having as many as 150 children which 120 were boys, 30 girls. During the Second World War about a third the children moved to the Hermitage, at the back of St. Catherine's Hill.
Hospitals necessarily work in co-operation with other medical services, general practice and public health - and any account of hospitals cannot be separated entirely from these; up to 1948 most of the senior staff in the hospitals were also in general or specialist practice independent of their hospital duties and the County Medical Officer and his staff controlled St. Mary's Hospital and Longford until 1948; several clinics were housed in County Hall even after 1948 for a few years, and there was constant communication between the County Medical Officer and hospital workers and authorities; and the county provided a district nursing service and of course the nursing staff for its own hospitals, and was concerned with nurse training in the hospitals. Consequently although I do not attempt to give a history of medical and nursing services of the Island, it is impossible not to mention them from time to time.
The very first hospital on the Island, not yet mentioned, must of course have been the Leper Hospital at Gunville in the 13th century, associated with St. Augustine's Priory at Carisbrooke from which monks visited the nearby hospital regularly. Father Hockey wrote that a monk from St. Augustine's celebrated mass there three times a week; and that Isabella de Fortibus when she was the owner of the Island made it a regular allowance of one silver marlk yearly. Leper hospitals in those days probably accepted a number of other disorders associated with skin rashes; Leprosy itself was quite uncommon. Father Hockey moreover mentions that the accounts of the hospital reveal that over a period of a year in 1312 only one single patient, on an average, was resident in the hospital. I do not know when this hospital closed down; if if survived until the dissolution of the monasteries, it would have had a longer life than any other hospital on the Island has had as yet.
The history of hospitals on the Island obviously can only enter occasionally and tangentially into the wider history of the towns in which they were built and of the Island itself. I hope I have been able to say enough, here and there, I indicate some of the developing scene and the ideas, the problems and activities of the people, - our forebears of five and six generations - who although their life-styles over the years may have been very different from ours, were not themselves less intelligent, thoughtful, considerate, or at time more bewildered than their descendants. The new hospitals are built figuratively and sometimes literally on the foundations of the old and we stand on the shoulders of those who created them.