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The "Lock Wards" of Edinburgh Royal Infirmary*

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The Br J Vener Dis: first published as 10.1136/sti.37.3.187 on 1 September 1961. Downloaded from Brit. J. vener. Dis. (1961), 37, 187. THE "LOCK WARDS" OF EDINBURGH ROYAL INFIRMARY* BY ROBERT LEES Royal Infirmary, Edinburgh There is some difference of opinion regarding the part. This was contrary to the charter and motto of origin of the term "lock wards", some holding that the hospital, patet omnibus. these were in fact "lock-ups" for the forcible segrega- The varying fortunes of the Lock Wards are tion of patients, while others think that the name recorded in the hospital minutes. In 1831 it was was derived from les locques, which were the dres- decided that the Lock Wards should be closed and sings or rags with which leprous and poxy patients appropriated to the reception of general patients. covered their sores, and which they were ordered Among the reasons given were their high cost (£400 to deposit in a receptacle outside the doors before per annum) and also the fact that they did not entering a church. contribute to the instruction of students who were The beginnings of hospital treatment in Edinburgh strictly excluded from them. copyright. were small and humble. The first public hospital, In 1833 the Lock Ward was prepared for the which opened in 1729, had six beds. The hospital reception of cases of delirium tremens, but in the grew rapidly in size in subsequent years; the regula- following year the Magistrates requested the re- tions forbade the admission of venereal cases but opening of the Lock Ward and offered the Managers there was provided "a salivation room", clearly for the lease of a house in Surgeon's Square for the the mercurial treatment of syphilis. It is recorded purpose at a cost of £20 per annum. In these years, also that the physicians were to provide gratis from 1831-35, the staff of the hospital were taken severely their own shops the medicines prescribed. to task for permitting the admission of syphilitic http://sti.bmj.com/ In December, 1741, a much larger hospital was patients. opened and the regulations stated-"patients suffer- In 1831 it was decided that a fee of lOs. 6d. be ing from incurable or very tedious illnesses were not exacted from women on admission to the Lock Ward to be admitted, nor those suffering from venereal and the income from this service was included in the diseases until special wards could be built for them". accounts for many years. In 1750 one small ward was assigned for venereal It is recorded that in the year 1853-54 the average cases and in 1751 another ward was authorized, period of residence in the lock wards was 66 days. on September 29, 2021 by guest. Protected making one for each sex. In 1863 a new Lock Hospital was established in There was a bagnio or bath house attached to the the building formerly occupied by John Bell as a old hospital; it contained sweating rooms for which a lecture room, which had been bought for £500. A fee of four shillings was exacted, and the "rubber" plan of the hospital dated 1853 shows the separate was strictly forbidden to accept a gratuity. This building of the Lock Hospital in a corner of the bagnio was demolished in 1884. These establishments grounds between the "burn hospital" and the "fever were often used for the mercurial treatment of hospital". It is of interest that in 1831 the Commis- syphilis. sioner of Police had requested the Managers of the In 1811 the managers of the hospital decided that hospital to increase the accommodation for V.D. the female venereal patients should pay a fee of because about sixty persons each year went to 3 guineas, but it was left to the discretion of the "Bridewell" solely to be treated for venereal com- physicians to dispense with payment in whole or plaints. In 1884 or 1885 a male lock ward of sixteen beds * Invited article received for publication on October 14, 1960. was provided. 187 Br J Vener Dis: first published as 10.1136/sti.37.3.187 on 1 September 1961. Downloaded from 188 BRITISH JOURNAL OF VENEREAL DISEASES The regulations for the female patients in 1864 are surgical and medical staff. In 1920 a lectureship on quoted below: V.D. was created in Edinburgh University and attendance at lectures and clinical instruction in REGULATIONS FOR LOCK HOSPITAL V.D. was made compulsory before graduation in (1) Patients can be admitted only on a recommenda- medicine. tion from an Inspector of Poor or other person who shall Mr. J. Graham, F.R.C.S., is, I think, the only have satisfied the Treasurer that the patient will be survivor of the old regime of general surgeons who paid for at the same rate as is charged for pauper had charge of the venereal department. The late patients. Mr. W. J. Stuart, F.R.C.S., was in charge for a short (2) No patient while under treatment shall be period in 1918 after his return from war service and allowed to go out of the hospital and return, without he recounted to the writer his memories of the old the written permission of two of the Managers. lock wards. These he described as "an awful place". (3) Patients shall on no account go to any other Mr. J. Patterson, who has just retired as wardmaster ward than their own without permission. of the male V.D. department, has also described the (4) Patients shall keep themselves and their beds conditions he found in 1919 when he arrived as one clean and tidy and make themselves generally useful, of the first of the specially-trained male nurses. so far as the Matron shall require. Mr. Stuart emphasized the enormous number of (5) Patients able to leave their beds shall be in the to Work-room at 10 o'clock a.m., shall remain there dur- patients he used see in 1918-1919. It was not ing the pleasure of the Matron, and work as she may uncommon to have 150 out-patients at an evening direct. Those who satisfy her in the Work-room by session, and these he examined and treated single- their diligence shall be allowed a cup of tea at 4 o'clock handed, seldom getting home before 9 or 10 p.m. p.m. for a belated dinner. Even at that hour he often (6) Patients not able to be in the Work-room shall found an anxious man on his doorstep pleading for not leave their beds without permission from the a private consultation. Treatment of syphilis was Matron. by injections of neosalvarsan, which the surgeon (7) All letters to or from patients must pass through had to prepare himself, and the porter from the gate copyright. the hands of the Matron. Letters addressed by patients was often called in to prepare the patient's arm and to persons not near relatives must be submitted to her to apply a tourniquet and iodine. Large doses of inspection, and letters supposed to be from persons not "914" were then in vogue and Mr. Stuart did not near relatives must be opened in her presence, and retained recollect many complications. He found he could by her if objectionable. administer about 25 doses per hour, and even so he (8) Patients may be visited by their parents at such hours and under such restrictions, as the Managers may was kept very busy. Each patient received a course from time to time deem necessary. of about seven doses, which included two or three (9) No visitors except parents, clergymen, and doses of 0 9 g. "N.A.B." Mercury was also given, http://sti.bmj.com/ persons authorized by the Managers, shall be admitted usually by injection of grey oil. to the hospital. For gonorrhoea the treatment was by irrigations (10) Patients guilty of disobedience, or who are of the urethra and prescriptions of various "sooth- noisy and quarrelsome, shall be dismissed at once from ing" medicines. Patients most frequently came of the hospital and shall not be readmitted unless by an their own accord, but many were referred by their order from the Managers. doctor, or were transferred from other wards of the hospital. on September 29, 2021 by guest. Protected In 1870 the new building (the present Royal The female patients received treatment, mainly Infirmary) was started and in October, 1879, the from a devoted and capable sister, whose good moral plans provided accommodation for twelve female influence on the girls was considerable and probably V.D. patients in Ward 20 up beside the clock in the of more value than her medicines. central tower. Accommodation was found in 1891 For some years before 1919 the "nursing" of the or 1892 for sixteen male patients in Ward 5A, one male patients had been in the hands of an old soldier of the basements below a surgical ward, and the who had served in the Guards and had been chosen venereal patients were given into the charge of the for his ability to maintain order rather than for his most senior of the assistant surgeons. This staffing knowledge of nursing or any desire to help the arrangement continued until 1919, when Col. patients. He exploited them all with impartiality L. W. Harrison, and a few months later Mr. David and was reputed to conduct a lucrative private Lees, were appointed to take charge of all V.D. in- practice outside as well as exacting payment for patients and out-patients with the same status and services inside the hospital.
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