So what health services were available in the city 150 years ago? There were 3 main types of organisation where people could get medical care. Firstly there were voluntary hospitals, which were set up by wealthy citizens, some of which were quite small such as one on Canal Street. The largest hospital was the Manchester Royal Infirmary (m53025) which in 1871 was situated in Piccadilly. This hospital catered for a wide range of medical conditions from the treatment of infectious diseases to surgical procedures and also included a lunatic asylum.
One of the first things that the POH reported to the Health Committee was an ‘excessive mortality from infectious febrile diseases and the inadequate amount of hospital accommodation for isolation of cases.’ Robert Barnes, who had been the mayor of Manchester between 1851 and 1853 (m72256) ,gave a piece of land in Monsall to the council for a hospital to be built. It opened in October 1871 and was originally operated as a branch of the infirmary but eventually became Monsall Hospital which closed in 1993.
The second type of health provision in the city were the Dispensaries. These again were established and funded by wealthy citizens and industrialists. They provided outpatient care both on their premises and at home. They also dispensed medicines. There were dispensaries in Ancoats and Ardwick , (m10342) Hulme (m68113) Chorlton on Medlock and Withington. The dispensaries charged a small fee while the hospitals charged more. Most of the working classes could not afford these fees nor could they afford to pay into the medical insurance schemes available through insurance companies, churches and trade unions. For this group of people there were 2 alternatives. Firstly people within their communities, who had some basic medical knowledge, could provide such services as homemade medicines, bone setting and midwifery. These people had no formal training and there was no form of regulation. If hospital treatment was needed there were the hospital facilities within the workhouse.
There were 3 workhouses within the city. Firstly the Manchester Union Workhouse on New Bridge Street (m53391) Secondly Crumpsall Workhouse hospital which was opened in 1855 and in the 20th century became the North Manchester General Hospital and thirdly the Withington Union Workhouse (m53434) which was originally on Stretford New Road but moved to Nell Lane in 1855 and subsequently became Withington Hospital. As well as general medical services these hospitals had isolation facilities since it was recognised that isolating patients prevented the spread of the disease within the institution.
In 1871 therefore there was knowledge about the spread of disease and in the case of smallpox a preventative measure by which to combat it and there were also medical facilities to deal with severe cases. The smallpox pandemic of that year originated in north east France and was one of the sporadic outbreaks that occurred in Europe. This however was during the Franco Prussian War when there was a great deal of population movement both of soldiers and civilians displaced by the war. Most of the Prussian soldiers had been vaccinated but most of the French soldiers had not. The disease therefore was spread by them and the refugees as they travelled westwards across France and then by sea across the globe. It came to England across the channel and initially affected people in the ports of London and Liverpool. Manchester did a great deal of trading with Liverpool both to import raw materials such as cotton and to import its finished goods. Once reports of the outbreak of the disease reached Manchester the city knew it was coming.
Since he became the POH in 1868, John Leigh had been collecting data about infectious diseases in the city. He used the administrative districts of the 10 yearly census enumerators to track disease and plan the building of more privies. These statistics identified each disease, the age of those with the disease, their addresses and the number of deaths. He also started to collate statistics from the hospitals and workhouses to enable him to have an overall picture of what was happening in the city and where resources needed to be concentrated. This provided a data system by which the spread of smallpox could be tracked. The data was presented each month to the Health Committee who helped with the strategic and financial decisions that needed to be taken. The information was presented in tabular form and was obviously collated without the benefit of any technology but was crucial to the processes introduced during this period.
Part 3 to follow – A comparison of the strategies in dealing with the pandemics.
This blog post was written for Archives+ by one of our volunteers.