CHILD PATIENTS, HOSPITALS AND THE HOME IN EIGHTEENTH-CENTURY ENGLAND

Abstract

This article seeks to map out some of the principal pathways to medical care used by the parents of poor children. We focus on the most formal provider of healthcare in eighteenth-century towns, the voluntary general hospitals, but we use these institutions as a prism to consider the way that the treatment of child sickness was managed more generally in five local settings. Utilising eighteenth-century hospital admissions and discharge registers we find that not only were children consistently treated as patients; but that these institutions also operated as part of a wider medical network which included domiciliary care, poor law services, and other medical charities. The boundaries surrounding hospital treatment in eighteenth-century towns were thus considerably more porous than is usually thought, and suggests that they operated as part of a wider medical network accessed by poor families for their children.

Notes

1 This was low compared with the proportion of children in the total population, but is very notable for a set of institutions which aimed predominately to assist adults. Wrigley and Schofield estimate that between a third and a half of the English and Welsh population was under 15 in the early modern period (Wrigley and Schofield 1981: 216, 443–50).

2 55 per cent of boys and 36 per cent of girls were surgical patients at the Newcastle Infirmary, for example, and 37 and 30 per cent respectively at Manchester. The skew towards young adult women corresponds to the use of the hospitals by domestic servants.

3 The identification of pregnant women relies on their being described as such in the registers. The search terms used were ‘pregnant’, ‘lying in’, ‘to lie in’, and ‘with child’. The terms used for the venereal patients were ‘venereal’, ‘foul’, and ‘pox’, although the word ‘foul’ was sometimes used in conjunction with other conditions, as in ‘foul humours’ (these cases were not included in the count). There were three venereal patients in the Manchester cohort, all outpatients, and including a one-year old, and possibly several in Northampton as well (here the terminology was ambiguous). The rules of the infirmary at Chester excluded contagious diseases, although venereal conditions were not specifically listed (The statutes of the General Infirmary at Chester 1799: 12).

4 In Manchester, subscribers of one guinea could recommend one outpatient at a time, those giving two guineas one inpatient or two outpatients at a time, and so on. There was apparently no upper limit on the number of patients a subscriber could recommend in a year (Rules and Orders of the Public Infirmary at Manchester 1769: 11). In Northampton, subscribers could recommend five inpatients and five outpatients per year (An Account of the Rise, Progress, and the Present State of the County Infirmary at Northampton 1747: 4). The number of recommendations often varied according to the size of the annual subscription.

5 40 per cent of the Manchester Infirmary’s patients were from outside the city in 1756, although only 23 per cent of child patients. In Newcastle in 1779, 52·3 per cent were from outside, and 47 per cent of children.