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Out-door relief is administered to six or seven times this number, a very large
class attending for advice and medicines at the Surgery of the Workhouse, and the
remainder being visited at their own homes by a medical officer attached to the house.
The patients attending at the Workhouse, though by far the most numerous class, are
not affected with any serious complaints : those persons whose diseases do not admit of
their going out of doors, are received into the Infirmary, or are visited at home.
The patients of the Workhouse Infirmary are very largely composed of people
exhausted by the burthen of their years or suffering from the Chronic Bronchitis of the
aged, of persons taken ill in common lodging houses, of persons labouring under
incurable forms of disease (especially of consumption and paralysis) and of some who
are even brought in in a dying state.
The mortality among such persons is of course considerable, indeed one patient
dies of every four or five that come under treatment, which is about twice the death-rate
of an ordinary Hospital.
The paupers at their own homes, exhibit ailments of every degree of severity;
a certain number of them are women visited after the midwife, and children suffering
from disorders incidental to their age. The mass of the zymotic diseases which occur in
the Workhouse practice, are visited at home. Some grave cases are occasionally
sent into the Infirmary, and cases of fever are for the most part so transferred. This
rule of removing fever cases is one which it is well to act on as universally as possible,
for under proper arrangements the opportunities of contagion must be much less in
the Workhouse than in the crowded and squalid houses of the poor.
It may here be mentioned specifically to avoid a misapprehension that has existed,
that it is not the practice to take all cases whatever of a certain gravity into the Infirmary,
but that as a rule patients who are treated at their own homes, continue to be so treated
until the termination of the case, and hence there is a certain proportion, (about one in
twelve or fourteen on an average) of deaths among this group of patients.
Vaccination is practised for the whole district at the workhouse, or if required
at the houses of the children. The numbers vaccinated have been 778, 749, and 660
in the three years 1855—7. More than a third of the whole number of children born
in each year, are vaccinated by the public vaccinators. I shall have a comment to
make on the subject of vaccination, in considering the other establishments at which
medical relief is dispensed to the poor of St. Giles.
The books of the Workhouse have all been open to me since a resolution of
the Board of Directors, in September 1857, and have afforded me much information,
especially as to the localization of disease. The medical records are examined with
this view every week, and I may mention that they are regularly kept and are much
better than those of other districts are reported to be. I take this opportunity of
making my acknowledgements to the Vestry Clerk, not only for information given me
cordially from his department, but for assistance rendered to me frequently in an infinity
of little ways.
Section 7.—Common Lodging Houses.—In the absence of any more official
definition, these may be stated to be houses in which persons can be lodged for hire
by the single night, and in which the same room is occupied by more than one family.