This blog was inspired by an essay by J K Edwards back in 1967 when he looked back at the changes that had taken place at the Norfolk and Norwich Hospital during the time it was located at its old city centre site on St Stephens Street. However, I was initially thrown by his opening sentence when he wrote: “To understand the matter of the chimney we have to go back 200 years”; but from there on, things began to fall into place with a concluding, but all too brief, explanation at the end.
He considered that both Norwich and the County of Norfolk prospered during the 18th and early 19th centuries and their peoples increased yearly in numbers; however – and according to modern thinking, living conditions were bad then, even for thrifty working-class people where there was only a small margin between being able to “manage” and being forced to depend on charity. Also, the philosophy of the times was hard:
“God had created the high and the low, work was part of the process of salvation, and only if you were diligent and God-fearing would all be well in this world and the next”.
Unfortunately, accident and disease, along with horse-drawn traffic and squalid living conditions produced plenty of each, either of which could bring even the most deserving family to the verge of starvation:
“What confusion and distress must enter a family when the father is overcome with one of the innumerable accidents and how deplorably wretchedness is increased when sickness visits any member of the family”, wrote one contemporary author.
The first firm proposal for a hospital for Norfolk and Norwich was made at a public meeting called by a Mr. William Fellowes, of Shotesham, in 1770. But even before then, certainly before 1754, Fellowes and a local surgeon by the name of Benjamin Gooch joined forces to set up one of the very first cottage hospitals in the country – and in Fellowes’s his own village of Shotesham by the way! He was, after all, Lord of the Manor and owned almost all the land and houses thereabouts but, at the same time, he did care for the people in his charge.
The idea of a new hospital for Norwich was, in fact, a late-comer in the wave of provincial hospital building, which had begun in the 1730’s. Certainly, by 1744, there was pressure for the City to have one of these new voluntary hospitals, although impetus was lost after 1761 when Thomas Hayter, Bishop of Norwich and a leading advocate, moved to a bishopric in London. Enter William Fellowes who was the one to call this open meeting in 1770, the moment when subscriptions were opened – kick-started by a fund-raising concert in Norwich Cathedral.
Very soon the Norwich City Council came on board when it made the St. Stephen’s site available at only a nominal rent, thus enabling the first steps towards fulfilling a dream. Subsequently, the sentiment towards the scheme was so great that funds of some £13,000 was raised, building plans adopted and the fabric fitted and furnished in little more than two years. In this way, a much improved Norfolk and Norwich Hospital came to the city.
The building was constructed in the form of a great figure ‘H’ and it had many of the characteristic features which, at the time, was considered very satisfying – red brick, beautiful proportions, large well-placed windows and a most imposing front porch and doorway; it “justifiably generated a great deal of local pride”. It therefore followed that when the hospital took its first seven in-patients in November, 1772, the event was marked by a celebration in the city.
The original rules of the hospital, as outlined by Edwards, threw an interesting light upon charitable attitudes of the times. It would appear that since public subscribers had provided the hospital, donors naturally expected to be able to see that their money was being well spent. A gift of two guineas brought governorship for a year and one of 20 guineas brought the same for life. All governors in turn had to visit the hospital every day for a week and:
“walk through the wards with White Wands in their hands and enquire of the patients whether the Physicians, Surgeons, Matron and Nurses had attended them agreeably, and enquiry of the Matron and Nurses whether the patients had all conducted themselves decently.”
One of the main local troubles was “the stone” for which people had to be “cut.” The stones extracted were kept in a special chest-of-drawers and put on public display; and so successful was “cutting” that after 20 years or so the chest was crammed so full that another had to be ordered. In fact, whatever the limitations and dangers, the hospital dealt with 12,000 people by the end of the 18th century and of these “upwards of 7000 have been dismissed in perfect health.”
On this subject, Dr. Benjamin Gooch’s accounts of ‘bladder stones’ are particularly interesting for he, along with John Harmer of Norwich, were the leading lithotomists of the first half of the 18th century when bladder stones in Norfolk were reputedly to be more common than anywhere else in the country. The Norwich Gazette, of 14th July 1746 (2071/2) reported one instance of a stone removal operation, which was conducted by John Harmer, with Benjamin Gooch assisting:
“On Sunday last (June 8th) was cut for the stone by Mr John Harmer surgeon in this city, John Howse, a gardener from Poringland aged 48 years, from whom he extracted a stone of prodigious magnitude; measuring 12 inches one way and eight the other and weighed upwards of fourteen and a half ounces; and is said to be the largest ever extracted from any person who recovered the operation, as this man is likely to do, not yet having had a bad symptom” ….. and a week later:
“John Howse …… is in a final way of recovery and is judged to be out of danger. Mr Harmer has cut for the stone upwards of 170 persons, and that with as much success as any man living, but never extracted one so large before.” (Norwich Gazette 21/7/1746).
As an aside:- John Harmer is buried in Stoke Holy Cross churchyard, his monument bears carvings of his lithotomy instruments.
Benjamin Gooch said of the operation:
“It was found impracticable to extract the stone through a wound of common size, which the operator had made, or to break it by the force of the forceps, therefore at his desire I divided the parts occasionally, as he continued gentle extraction. The stone was of hard texture and was covered by a substance like spar of a considerable thickness on many parts of its surface.”
The wound remained in a foul and bad condition and was made worse by the continued wetting of urine which prevented applications from healing it. The poor unhappy sufferer’s secret of how he managed to survive is revealed next. He [the patient] tempted a little favourite dog to lick the parts. It became such a habit for the little dog that whenever his master laid down and uncovered them he [the dog] immediately set to work with his tongue; this gave the sufferer a pleasing sensation; “As long as he lived his dog was his surgeon”, and the wound kept tolerably clean and easy “to his great comfort and satisfaction” as he [John Harmer] often told Gooch.
People today often question the effectiveness of medical treatment during years long past and, of course, there were many deficiencies. But it was the 18th century that brought forward many new ideas, like ventilation, sanitation and cleanliness. Equally, there were some people who held advanced views on many things. The then matron of the Norfolk and Norwich Hospital was judged to be “most unusually able” and as a result the hospital acquired a reputation for being “kept very neat and clean, not crowded with beds and well ventilated.” True, the floors were sanded in exactly the same way and for the same reasons that public-house floors were until comparatively recently, but they were swept daily and entirely washed each week. This by the standard of the times was cleanliness amounting almost to mania. One can doubt, too, the efficiency of medicines and surgery of those days, for drugs were very few and surgery without antiseptics was dangerous. Even so, cold baths, enforced rest, clean living conditions and dieting cannot have failed to be beneficial. As for surgery, the risks were perhaps fewer than we imagine.
The early years did, of course, present their problems. How to advance surgically was always difficult; but it was not unknown for the bodies of executed murderers to be provided for the hospital and doubtless there were other sources too – this helped. But money was always scarce and, in 1788, someone conceived the idea of a ‘Grand Musical Festival’ to help the Hospital’s Fund; this particular event was to be much grander than previous funding raising concerts in aid of the hospital. It proved such an enormous success that it was repeated three years later; after which it was decided to make the festival a permanent function, using St Peter Mancroft Church in the morning and St Andrew’s Hall in the evening. In 1824 the Norfolk & Norwich Triennial was founded. This event, known as the ‘Triennial’ continued for almost one hundred years, presenting a programme of concerts in St Andrew’s Hall. In time, the Norfolk and Norwich Hospital and the Triennial went their separate ways but, importantly, they both continued to flourish.
If you had walked along St Stephen’s Road in 1967 – going away from the city – you would have seen the then new hospital chimney on the right, “rearing up like a rocket launcher, monstrous, a thing of no beauty”. Clearly, Edwards hated its massiveness and the domination it exercised over that part of the city of Norwich. But, in his opinion, the chimney symbolised progress – in medical science, in humanity and in ideas – but, equally, “one had to weigh-up the balance of advantages”. He concluded that all these developments were “well on the side of progress”.
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