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Medicine and the Workhouse

Medicine and the Workhouse

Jonathan Reinarz
Leonard Schwarz
Volume: 27
Copyright Date: 2013
Published by: Boydell and Brewer,
Pages: 286
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  • Book Info
    Medicine and the Workhouse
    Book Description:

    While the welfare functions of the workhouse have been well researched, its medical services have been comparatively neglected. Throughout the eighteenth and nineteenth centuries, and despite much administrative reform, workhouse medicine remained central to the medical experiences of the poor. Workhouse beds in Britain, for example, far outnumbered beds provided by charitable hospitals, which have often been the subject of historical study, and, by the 1830s, most parishes possessed their own workhouses. A high percentage of entries to workhouses consisted of the sick of all ages. In those communities where the elderly comprised the majority of workhouse inmates, most required medical relief. Perhaps inevitably, the position of workhouse doctor, or medical officer, became progressively more central to the management of these institutions, though we know very little about these overworked and undervalued practitioners. Historians of welfare, the English poor laws, and medicine have been aware of the importance of workhouse-based medical relief in the past, but the topic has not bee studied in depth. This is the first book to examine the history of the medical services provided by these welfare institutions, both in Britain and its former colonies, over the period covered by the Old and New Poor Laws. Jonathan Reinarz is Director of the History of Medicine Unit at the University of Birmingham, UK. He has published extensively on the history of English medical institutions, 1750-1950. Leonard Schwarz has recently retired as a Reader in Urban History at the University of Birmingham, where he founded the Birmingham Eighteenth Century Centre.

    eISBN: 978-1-58046-802-2
    Subjects: Sociology

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Preface
    (pp. vii-viii)
  4. Introduction
    (pp. 1-16)
    Jonathan Reinarz and Leonard Schwarz

    Despite a relative dearth of work on the subject, the student of workhouses is bound, within a short space of time, to be led into the field of medicine.¹ Nevertheless, one might ask why there has not been more work on this subject, given that emotional responses to suffering within the workhouse led the institution to figure so prominently in popular literature of the nineteenth century, the most well-known case being Charles Dickens’s Oliver Twist (1838). In any case, what is becoming ever clearer is that workhouses were not established simply to warehouse the destitute, but they had their own,...

  5. Part One: The Old Poor Law

    • Chapter One Contagion, Exclusion, and the Unique Medical World of the Eighteenth-Century Workhouse: London Infirmaries in Their Widest Relief
      (pp. 19-39)
      Kevin Siena

      Georgian workhouses served many functions. Although they were nominally devoted to work, they routinely provided care and education for children and refuge for single mothers, as social historians know well. They sheltered, fed, and nursed the elderly, disabled, and mad and acted as de facto employment agents, placing young people in apprenticeships and jobs. They also provided considerable medical care. Medical historians have been slow to explore workhouses, even though simply itemizing their medical services impresses; a partial list includes obstetrical care, surgery, outpatient care, emergency medicine, doctor training, and even trials of experimental drugs and procedures. Workhouses need to...

    • Chapter Two The Elderly in the Eighteenth-Century Workhouse
      (pp. 40-57)
      Susannah Ottaway

      In the late nineteenth century, a photograph was taken at two of London’s largest workhouses. Each shows the inmates gathered to eat a meal; one is of women, the other of men. Row after row of grim-faced, uniformed elders sit despondent before identical plates of food. The images are hauntingly stark and filled with despair, and they compel the question of how British society came to adopt institutionalization of the elderly poor. But in their power to unsettle the viewer, the images also reveal the tendency of contemporaries and historians to privilege emotional responses and the historical memory of the...

    • Chapter Three “These ANTE-CHAMBERS OF THE GRAVE”? Mortality, Medicine, and the Workhouse in Georgian London, 1725–1824
      (pp. 58-85)
      Jeremy Boulton, Romola Davenport and Leonard Schwarz

      It is often forgotten, or overlooked, that it was in the eighteenth century, not the nineteenth century, that most London parishes built workhouses to house a proportion of their parish poor. Workhouses were new institutions in the eighteenth century, and in London at least they were large and prominent and until recently have, on the whole, been underexplored by historians.¹ Yet virtually all suburban parishes in the metropolis operated them in the eighteenth century.² Usually built in the 1720s or 1730s, they often occupied prime locations in the parish and might well dominate those locations, acting prima facie as purpose-built...

    • Chapter Four Workhouse Medical Care from Working-Class Autobiographies, 1750–1834
      (pp. 86-102)
      Alannah Tomkins

      Historians of the workhouse under England’s Old Poor Law who wish to move beyond the generalities of returns to Parliament and examine the daily lived experience of workhouse life must generally turn to one of two sources. The policy intentions at the time a parish workhouse was opened are occasionally accessible in vestry minutes, workhouse rules, dietaries, or daily schedules. Alternatively, there are the entries in parish overseers’ accounts, which show the practical result of accommodating the poor and sometimes generated itemized shopping lists of goods and services supplied to the house. At their best, the latter might include the...

    • Chapter Five “A Sad Spectacle of Hopeless Mental Degradation”: The Management of the Insane in West Midlands Workhouses, 1815–60
      (pp. 103-120)
      Leonard Smith

      The significance of the workhouse in the tapestry of care for mentally disordered people in England has tended to be underestimated by historians.¹ The nineteenth century has been regarded principally as the era of the rise and triumph of the universal, monolithic public lunatic asylum system.² County authorities were first empowered to establish a pauper lunatic asylum as early as 1808. Several had taken the opportunity before the key legislation of 1845 mandated counties and boroughs to provide an asylum.³ Within a decade almost every county had built an asylum, on its own or in conjunction with others, or was...

  6. Part Two: The New Poor Law

    • Chapter Six Workhouse Medicine in Ireland: A Preliminary Analysis, 1850–1914
      (pp. 123-139)
      Virginia Crossman

      Introducing his Guide for Irish Medical Practitioners (1889), Professor Richard J. Kinkead noted that care of the sick population in Ireland devolved on state-supported functionaries to a far greater extent than in England or other European countries. In England, he observed, none but the actually destitute were entitled to medical relief, and therefore the artisan class “provided for themselves in sickness by the agency of co-operative organizations such as ‘clubs’ or by resort to cheap practitioners. In Ireland, on the contrary, all such citizens look as a matter of course to the tax-payer for medical relief.” Kinkead calculated that the...

    • Chapter Seven Exploring Medical Care in the Nineteenth-Century Provincial Workhouse: A View from Birmingham
      (pp. 140-163)
      Jonathan Reinarz and Alistair Ritch

      The history of medical institutions has been central to the emergence of medical history as a field in British and other national contexts. Hospitals and medical schools, for example, have attracted considerable attention from historians, and published histories began to appear after the first anniversaries of these institutions were publicly memorialized in the nineteenth and twentieth centuries. A catalog of these celebrated institutions is literally too long to reproduce here but is confirmed by the most cursory glance at any history of medicine collection. Compared to the history of voluntary hospitals and medical faculties, however, other institutions have received minimal...

    • Chapter Eight “Immediate Death or a Life of Torture Are the Consequences of the System”: The Bridgwater Union Scandal and Policy Change
      (pp. 164-191)
      Samantha Shave

      That the Poor Law Amendment Act (1834) was a controversial piece of legislation is a historical given. Through the creation of union workhouses, it removed the long-held rights of the poor to obtain outdoor relief, and through the establishment of a centralized welfare authority the Poor Law Commission weakened the powers of local parish officers and magistrates in the administration of relief. The transition from Old to New Poor Law was not a smooth one, and even “compliant” localities faced a number a problems with the new system—especially so in relation to medical relief. In the early years of...

    • Chapter Nine Practitioners and Paupers: Medicine at the Leicester Union Workhouse, 1867–1905
      (pp. 192-211)
      Angela Negrine

      In England and Wales the Poor Law Amendment Act (1834) required all unions to appoint a medical officer to attend the sick in the workhouse. The 1842 General Medical Order required poor law medical officers to be doubly qualified in both medicine and surgery, which often meant that they were better trained than other local private practitioners, who may have had only one qualification. The requirement to be doubly qualified did not, however, bestow a high status on the post, nor was it rewarded by a significant or even standard scale of remuneration.¹ Despite working in a profession that gradually...

    • Chapter Ten Workhouse Medicine in the British Caribbean, 1834–38
      (pp. 212-227)
      Rita Pemberton

      A considerable portion of the traditional historiography of the British Caribbean colonies is devoted to the plantation complex, with emphasis on its economic, political, and social systems and the sociocultural characteristics of the African population. Only marginal attention has been paid to issues pertaining to health and medicine. This omission has been addressed in the more recent phase of Caribbean historiography, which includes studies on health and medicine.¹ However, despite its importance in the culture of enslavement, prison and its associated medicine do not feature significantly in the literature. With reference to the workhouse, this chapter discusses the role of...

    • Chapter Eleven Poverty, Medicine, and the Workhouse in the Eighteenth and Nineteenth Centuries: An Afterword
      (pp. 228-252)
      Steven King

      The literature on poverty and medicine has developed considerably since Anne Crowther, Ruth Hodgkinson, Michael Flinn, Joan Lane, and Geoffrey Oxley were building the field.¹ New work—on doctoring contracts, subscriptions by parishes to extraparochial medical institutions, infirmary building programs, the extent of sickness and ill health among the poor, the nature of medical relief under the Old Poor Law, medical negligence, and the medical marketplace—has begun to test ingrained historiographical notions that the nature of medical relief was better under the Old Poor Law than the New and to establish the centrality of sickness to the pauperization process.²...

  7. Selected Bibliography
    (pp. 253-266)
  8. List of Contributors
    (pp. 267-270)
  9. Index
    (pp. 271-282)
  10. Back Matter
    (pp. 283-283)