Metropolitan workhouse infirmaries, &c. : Copy of the report of Dr. Edward Smith, Poor Law inspector and medical officer to the Poor Law Board, on the Metropolitan Workhouse infirmaries and sick wards / (Viscount Enfield).

  • Smith, Edward, 1818?-1874.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Metropolitan workhouse infirmaries, &c. : Copy of the report of Dr. Edward Smith, Poor Law inspector and medical officer to the Poor Law Board, on the Metropolitan Workhouse infirmaries and sick wards / (Viscount Enfield). Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    in by wood and glass. They are, moreover, too narrow, and are like narrow and deep cupboard or wells. The corridor is not an efficient ventilator, since it is not open at the ends directly to the outside, but only at an angle to a small outer door, and since it is not open to the air above. A new lying-in room, and children’s nursery, have been made without any special ventilator, except the fanlights. On one side a folding wooden partition has been placed, which whenever in use would be closed, and further lessen the ventilation. Hence, notwithstanding the efforts which have been made to improve the ventilation, they have not been intelligently directed. The paid nurse, who appeared to be a very intelligent person, stated that the ventilation in the women’s wards was not bad; and that the smell at night was scarcely more than that of an ordinary bedroom. The medical officer was of opinion that the ventilation was very bad. A paid nurse from St. Thomas’ has recently been appointed at a salary of 25 /. per year. She has charge of all the sick wards. The medical officer has held his present position for about a year; and, in addition to the workhouse, he has a district. He keeps an assistant, but, so far as the workhouse is concerned, only for dispensing. His duty is to attend at the workhouse on alternate days; but he attends more fre- quently, and nearly daily. He usually visits every ward at each time, but sometimes he concludes his visits of the whole on the following day. Night visits are very rare ; perhaps six times a year. He sees about 36 cases at each visit; and from one to three hours (average pei'haps two hours) are devoted to the duties on each occasion. There are upon his books 67 sick, and 24, amongst the aged and infirm, for diet. His salary is 40 /. for the workhouse, and 100/. for the district; and he finds all the drugs and the dispenser. He is of opinion that, under another arrangement, the guardians should find drugs and a dispenser, both for the workhouse and the district, and the salary (in addition to this) for the workhouse should be 100/. per year, with extras for mid- wifery. In addition to the present paid nurse, there should be a paid night nurse. Many of the wards, and particularly the infectious wards, are unsatisfactory. He said that the cases do not do as well in the workhouse as out of it; and that he had known instances of persons dying poisoned from their own emanations and that of others. This latter statement is one which reflects most gravely upon the guardians, and should, if proved, receive their earnest attention ; but nothing was presented to my notice which would have led me to infer the possibility of such a result. 1. The first attention should be given to the subject of ventilation. (A.) The windows in the upper rooms should be raised the height of one pane. (B.) Two or more ventilators should be placed in each ceiling, and covered with perforated zinc. (C.) Circular ventilators, 10 inches in diameter, should be placed in the floor, and kept open. (D.) Both of the two latter should communicate with the outer air by air-bricks. (E.) Air-bricks, 9 in. by 6 in., covered with perforated zinc, should be placed in the outer wralls, over the windows; and others, 12 in. by 6 in., should be placed at the toj) of each partition wall. Air-bricks, to admit air from the corridors, are required at the bottom of the rooms. (F.) Window's should be opened into each room from the corridor, and fixed open to a small extent. (G.) Holes should be bored into the bottom of the doors of the wards and the water closets and sinks. (H.) The water-closets and sinks should have the enclosures cut down, or opened as iow as possible. Air-bricks should be inserted, and a free circulation of air in all directions must be effected, both at the top, and at the bottom of the closets. (I.) The corridors should have louvre shutters running along the top, with the skylight placed horizontally; and a direct opening to the outer air, in the direction of the corridor, should be effected at each end. Without these alterations, no sufficient improvement in the ventilation can be effected. (Iv.) Air-bricks are needed in the front wall of the lying-in ward, and openings should be made in the folding partition. (L.) The proper course, with regard to the infectious wards, is to throw dowm the partition wrall, and make the two rooms into one. If, hovrever, each be used for one or two cases only, and that temporarily, it may suffice to have the present windows raised, a new window put in at the end, and a ventilating window on the staircase, with air-brick ventilators, covered with perforated zinc, at the top and bottom of the partition wall. The Avater-closet adjoining must be properly ventilated. 372. F F 2. A paid Appendix. Hampstead. Nursing. Medical officer.