Sam Ellis, a University of East Anglia biomedical science Ph.D. student has been working with us for the last three months. Here he describes some of his research into the medicine in the workhouse:
“I am coming to the end of a 3 month placement with the collections team. My day job is as a biomedical science PhD student (lab coat and everything), but for my time here I have been dipping my toes into the murky waters of historical research. Specifically, I have been both auditing the substantial range of medical items in the collection here, as well as looking into the medical care provided at the workhouse during its long history. As an example of this, I am going to give an overview of a major figure in Gressenhall’s past, Dr James Vincent.
The services of a local surgeon or apothecary are recorded here from the early days of the site as a House of Industry, but the provision of medical care became far more formalised when Gressenhall became a Union Workhouse. Alongside staff positions such as Master, Matron, and Porter, the workhouse was now required to appoint a Medical Officer to attend to the pauper inmates. Dr James Vincent was one of the first, and longest serving, to hold this post here.
Dr Vincent was a surgeon residing in Dereham, and was appointed Medical Officer in 1846 as a young man aged 25. He was likely already familiar with the workhouse, having worked with the previous Medical Officer William Warcup, both men having practised their trade from the High Street of Dereham.
The work of a medical man was very different in the 19th century, in an era before antibiotics and effective pharmaceuticals. In fact, the common term for the job was still ‘surgeon’, indicating how much of the role was via physical intervention only. What simple drugs were available at the time were unlikely to be provided for pauper patients, as the cost was expected to come out of the medical officer’s own salary (not a great motivation for liberal prescriptions). However, the sick were often given medicinal doses of alcohol, including wine, beer, porter and spirits, which were believed to give strength to the patient. In 1851 the Board of Guardians set up a special committee out of concern for the increasing expenditure on this, suggesting Dr Vincent prescribed such treatments extensively (which I’m sure the inmates appreciated).
As well as caring for the sick, a regular task for the Medical Officer was attending female inmates both during and after childbirth. As many expectant mothers entered the workhouse in this period, it was a job which would have kept Dr Vincent busy, and was the primary reason for a large pay rise he received in 1848.
The records from the Guardian’s minute books indicate that Dr Vincent was an able surgeon. We know of many occasions in which he was called to perform operations of various severity. For example, Dr Vincent was required to undertake many amputations of arms or legs; often a sad necessity due to the fatal risk from infected wounds at the time. One such case was that of a 7 year old boy named Alfred Love, whose leg was amputated in 1854 due to the danger to his life of a ‘hectic fever’ brought on by infection. Happily, Alfred survived the ordeal, was provided with a wooden leg from Norwich, and was educated at the workhouse to become a successful tailor in Dereham and Fakenham.
Other operations in the records include the treatment of a dangerous strangulated hernia on a patient named Thomas Key in 1876. For this and other major operations, Dr Vincent was often assisted by Dr George Taylor, who was a practising surgeon in Mattishall for 46 years.
In 1879, an illegitimate child named Benjamin Newell was born in the workhouse with a cleft lip (then commonly called a hare lip). The local government board were informed, and eventually decided to decline to interfere with the condition of the boy. Fortunately for Benjamin, by this point Dr Vincent had already gone ahead and successfully performed the operation. Benjamin Newell remained at the workhouse until the age of 14, when he was sent as an apprentice to a bootmaker in Northampton.
This is just one example of how medical officers often faced a difficult and often frustrating balance between what was best for their patients, and what was ordered by the Guardians or government authorities. This is amusingly expressed in the memoirs of Dr Joseph Rodgers, a medical officer for the Strand workhouse in London and a prominent 19th century health reformer, reflecting on one chairman of the Guardian Board:
‘This Chairman did not long continue to act as such, as some months after this he died suddenly of heart disease, the only evidence he had ever afforded that he possessed one’
Dr Vincent himself had a number of run-ins with bureaucracy whilst at the workhouse, especially in the early 1870’s. Firstly, the Guardian’s minutes record that he was repeatedly chastised by auditors for his methods of keeping the medical accounts, and had to be advised on the correct way of filling up the forms (some workplace annoyances have clearly not changed between the centuries!). Dr Vincent was also pushing for sick inmates and young children to be allowed free outdoor exercise on the workhouse green beyond the walls, but was denied by the Guardians who felt it was too impractical. In addition, during a discussion of salary increases for medical officers across the Union, the Guardians decided against it in respect of Dr Vincent.
While it is impossible to know for certain, it is likely that such frustrations led to Dr Vincent’s decision to resign from the post in 1874. He was replaced by another local surgeon, Dr Stephen Moulton Hopson. However, this Medical Officer did not last long before himself resigning in 1876 in the wake of a minor scandal in the local papers regarding a (probably unfounded) accusation of medical neglect of the elderly in the workhouse. When no other candidates came forward, Dr Vincent was re-elected to the position (and at a higher salary!).
As well as treating ill patients, the medical officer was also responsible for ensuring the general health of the inmates. Dr Vincent appeared to play an active role, as the Guardian’s minutes record many of his frequent recommendations. He ensured that the old men were provided with warmer flannel jackets, and that duffle capes were made available for boys running errands off the site. He also made recommendations on varied issues including provision of wooden legs, isolation of infectious patients, purchases of stoves to heat the infirmary wards, and numerous alterations to the dietary schedule of the inmates.
The Medical Officer was also consulted when paupers claimed to be too unwell to work, and Dr Vincent appeared to be rather firm in weeding out those faking illness. For example, in 1879 an inmate named Henry Wright complained he was unable to leave his bed and perform his job picking oakum. Dr Vincent was unimpressed, and on examination discovered no reason why he could not work. Henry was punished for his misbehaviour with temporary solitary confinement and a bread and water diet.
While the records suggest that Dr Vincent was a very competent medical officer in his time here, he was not immune to some of the peculiarities of the medical profession of that era. For instance, the Victorian period saw a large rise in interest in human anatomy, dissection and autopsy. Most readers will be aware of the practise of performing surgeries in front of many rows of students and interested members of the public (hence the name of operating theatres). Dr Vincent was often directed to perform post-mortem examinations of paupers who passed away in the workhouse, usually just to confirm that it was due to natural causes. However, entries in the minute books record how sometimes the doctor himself requested the chance to perform autopsies. One such case from 1870 reads:
‘On the application of Dr. Vincent the Medical Officer of the Workhouse permission is given him to make a post mortem examination on the body of William Cullen an Idiot lying dead in the workhouse, there being no objection on the part of any relatives of the deceased and the doctor having shown a peculiar reason for making such examination.’
While the clerk does not say what this ‘peculiar reason’ might be, it appears Dr Vincent had a strong personal and professional interest in exploring the human anatomy.
It also seems that Dr Vincent was a proponent of the medical benefits of electricity, a common opinion in the medical community during the early days of electrical technology. In 1873, the Board of Guardians approved his request to purchase a new ‘Electric Machine’ for the infirmary. Such devises were designed to apply a (thankfully weak) current through targeted regions of the patient, and were thought to help treat a wide range of physical and even mental conditions. The minutes do not reveal if Dr Vincent regularly used his electric machine, or what outcomes it produced.
On the left is the machine Dr Vincent wished to order, taken from the 1873 catalogue of Arnold & Sons of London which he referenced in his request to the guardians. On the right is an illustration of a similar devise in use, taken from ‘A Practical Treatise of the Medical and Surgical Uses of Electricity’ published in 1871. In this case the current is passing between a wet sponge on the patient’s forehead and a metal plate beneath the feet.
By 1883, Dr Vincent was aged 62 and stated that he was beginning to find his duties becoming ‘rather onerous’. As such, he resigned the position of workhouse Medical Officer (for good this time), successfully requesting that his son Henry Bird Vincent was considered to replace him. Henry was also a qualified surgeon, having gone straight from Holt Grammar School to the University of London to study medicine by the age of only 16! He had worked as a General Practitioner on Church Street in Dereham, as well as holding the role of Medical Officer of health for the union (responsible for monitoring and reporting on nuisances or public health risks in the area).
Henry Bird Vincent officially took over as Medical Officer for the workhouse in February 1884, although James Vincent continued to act as a deputy for his son. In recognition of his work here over the course of four decades, the normally rather stoic Board of Guardians recorded an official vote of thanks to Dr Vincent at their next meeting. Furthermore, just before the transition they gave permission for all the officers of the workhouse to hold an officer’s party in the building (albeit at their own cost). While the purpose is not recorded, I like to think they were giving Dr Vincent a lively and clearly well-deserved send-off!