Vol. 14, No. 1. SINGAPORE MEDICAL JOURNAL 49 March, 1973. THE PAUPER HOSPITAL IN EARLY SINGAPORE (PART I) (1819-1829)

By Y. K. Lee

Tan Tock Seng Hospital, Singapore, started The cost of running the hospital for the three its history as a Pauper Hospital. The foundation months from 1st November 1821 to 31st January stone of the first Tan Tock Seng Hospital was laid 1822 was $72.19, as follows: on 25th July 1844. This hospital built at Pearl's Establishment of the Hospital (i.e. Hill was not used until 1847. The hospital was for salaries) at $16 per month - $48.00 many years known as Tan Sing's Hospital, Tock Diet money - - - - 14.00 named after its founder. It was the first hospital Articles furnished for use in the in to Singapore be built with non -Government hospital - 10.19 funds. In the official records, the name "Tock Sing" was changed to "Tock Seng" in the 1850s. $72.19 Tan Tock Seng Hospital was however not the first Pauper Hospital in Singapore. It had a number In the three months from 1st May of predecessors. It is the purpose of this article to 1822 to 31st July 1822, it was record the development of Pauper Hospitals in the $68.30 (S.S.R., L. 8., 1822). Mr. Prendergast was paid first ten years of modern Singapore's history. not any salary for this addi- tional duty of Later articles will trace and describe the events looking after the paupers. leading to the founding of Tan Tock Seng Hospital, In June 1822, the buildings used as Hospitals and its vicissitudes during the first few decades of in the Cantonment became a nuisance and were its history. moved as a result of this Station Order by the Resident and Commandant, A general introduction to the study of the Colonel William Farquhar, issued on 2nd June, 1822 medical history of early Singapore has already (S.S.R., L. 8., 1822): been briefly outlined (Lee, 1973). "The site of the temporary Very soon after the founding of Singapore on buildings in use as Hospitals for 6th February 1819, people from nearby countries the Europeans and Paupers, appearing to the Resident flocked to Singapore to seek their fortunes. Some and Commandant to be objectionable in prospered, but not everyone was lucky enough to as far as these buildings encroach too on succeed in this pioneering outpost, where each much the Parade Ground, and are also contiguous to the man was for himself and the weak went to the wall. Line of Officers' Quarters, as to become a nuisance. Those who fell ill or were injured were left to fend A Com- mittee of which for themselves. These unfortunate people had no Survey of Captain Murray is President, will means of support, and before long the streets of assemble on Monday morning at six o'clock the Singapore were filled with sick and starving beggars for purpose of examining the site of the said buildings and vagrants. They lived and died in the open as and out -houses, and reporting on the there was no where for them to go to for aid, expediency of removing the same financial or medical. further back so as to form a line with the European Barracks and Sepoy Hospital. To alleviate this distressing situation, the Mr. Assistant Surgeon Montgomerie will be Government erected a shed in the Cantonment as pleased to attend the Committee for the purpose a Pauper Hospital, and Sub -assistant Surgeon of affording his professional opinion on such Prendergast was put in charge. The money for points as the Committee may- require informa- running this hospital came from the Licence Fund, tion." which was the revenue received from granting In November, 1822, Sub -assistant Surgeon licences to sell opium and arrack, or for operating Prendergast wrote to the Resident for an allowance gambling dens (S.S.R., L. 7., 1822). for looking after the Pauper Hospital: "... Aware as you must be, Sir, of the many and heavy ex- penses incidental to a person having a family to support, from the exorbitant rate of wages and Thomson Road General Hospital, Singapore. high prices of the necessaries of life in this Settle- Y. K. LEE, Am MD F R.0 P Lond., F.R.C.P. Edin., M.R.A.C.P., LL.B., Senior Physician. ment, I need not point out the obvious inadequacies of my present salary.... " He quoted as a prece- 50 SINGAPORE MEDICAL JOURNAL dent, Sub -assistant Surgeon Palmer who received there was a great risk of having to spend a lot of an allowance for looking after the Pauper Hospital money on the sick and poor of the neighbouring in Penang (S.S.R., L. 9., 1822). countries who flocked to Singapore. He also There is no record of Prendergast having ordered that in the interests of economy the system received an allowance. He was in fact dismissed of dieting patients by the Surgeon should be from the Singapore Medical Service on 20th abolished: January 1823 and returned to India. This came "... means must be devised to raise the ex- about partly as a result of shortage of staff in the pense by some assessment on the Chinese, on General Hospital. An appeal had been made to whose account, it (the Pauper Hospital) is Sir Stamford Raffles for funds to increase the principally incurred. The expediency of such an establishment of the General Hospital (S.S.R., establishment may be doubted in a place like L. 6., 1822). This was sanctioned, but Raffles this, where there is no indigenous population. decided that in the interest of economy and to The effect must naturally be to bring upon us balance the budget, the Pauper Hospital should be all the sick and invalids of the neighbouring discontinued and Prendergast dismissed (S.S.R., islands. The patients are now fed at a fixed A. 31., 1823). rate by the Medical Officer in charge, which as the Surgeon far exceeds the The local authorities in Singapore managed to reported by Senior rates allowed on similar cases at Penang. A convince Raffles that the Pauper Hospital should regular contract should be substituted on the not be abolished, but could not prevail on him to lowest terms procurable." retain Prendergast. In May 1823, it cost only $20.30 to maintain the hospital (Establishment $16 The Authorities at Singapore tried to carry -and Diet $4.30) (S.S.R., L. 20., 1823). out the instructions but failed with regard to voluntary contributions by the Chinese com- The Pauper Hospital was moved again from munity. On 24th August 1827, a very drastic step its site in December 1825, "the ground being was taken by Mr. J. Prince, the Resident Council- required to build a part of the new Sepoy Lines lor. He issued the following instructions to the upon, owing to the late augmentation to the Troops Surgeon: serving at the Settlement, and without which this could not have been effected." This was the second "I take this opportunity to acquaint you that Pauper Hospital, and the third one was partly it is my intention not to admit any more patients built with materials salvaged from it. "The old into the Pauper Hospital until the Chinese building was in a state of considerable decay, and Community establish the means of covering its would shortly have required extensive repairs. The expense, and consequently that the present available materials have been however brought to patients are to be discharged as early as possible account in the new building" (S.S.R., M. 12., consistent with humanity" (S.S.R., N. 2., 1826). 1827). Since money matters seemed to be all-important And in October 1827, he recommended to the be made in the to the Government authorities, a brief mention of Governor that reductions should the financial aspect of the hospital administration establishment of the Pauper Hospital. The Gover- would not be out of place. The Surgeon in charge nor however was of the opinion that the "Pauper of the hospital was given a fixed allowance to Hospital should be struck off" (S.S.R., N. 3., employ subordinate non -medical staff for the 1827). This was also the view of the Senior Surgeon establish- hospital. In this instance, it was $16 a month. The after a tour of inspection of the medical Surgeon also supplied the patients with food, ments at Singapore. This was his official report to clothing and medicines at a fixed rate, and sub- the Governor (S.S.R., A. 51., 1828): mitted his bill to the Government at the end of "Pauper and Chinese Hospital each month. The rate was 20 cents per man per This is a large attap boarded shed close to the day in 1826 (S.S.R., A. 28., 1826). Singapore Infirmary. Supplied also with a few In June 1827, the Medical authorities submitted cots. They have discontinued to receive addi- through the Resident Councillor at Singapore to tional sick and four Chinese only now remain the Governor a proposal that more funds should in that Institution. be allotted to the Pauper Hospital as the ad- missions had increased. Return of the Establishment Attached J. Caswell Assistant Surgeon. The reply which is quoted below was by no means encouraging (S.S.R., V. 2., 1827). The J. Powell Assistant Apothecary (employed, Governor suggested that the Chinese should here occasionally). contribute towards supporting their poor, and that Mittre Dresser. MARCH, 1973 51

... observing that the numbers both in the the purpose of providing funds for the support of Singapore Infirmary and in the Pauper Hospital their old and infirm, and it continued for a long are extremely limited, that the objects of both period under the direction of the principal persons establishments are precisely the same, but that of that nation, but in consequence of neglect and they are maintained at the expense of two houses mismanagement, Government was obliged in the and a double establishment of servants, I there- year 1803 to assume the collective management of fore beg leave to recommend to the favourable the tax as well as the charge of the Asylum for the consideration of His Excellency the Honourable poor, and the farm has ever since composed a part the Governor in Council that the Pauper Hos- of the public revenue" (S.S.R., B. 7., 1824). The pital should be forthwith abolished, the build- Pork Farm was also to play an important part in ing placed at the public disposal and the estab- the history of the Pauper Hospital in Singapore. lishment of servants discharged." In the meantime, medical seivants were dis- The Governor and Council decided to postpone charged from the Pauper Hospital (S.S.R., A. 54., decision and ordered "that the subject do lie over 1828), and the remaining staff had to look after for consideration", for Mr. K. Murchison who both the General Hospital and the Pauper Hospital succeeded Mr. Prince as Resident Councillor at (S.S.R., A. 53., 1828). There were only three Singapore, had other views. He was of the opinion patients with ulcers ("ulcus") in the Pauper Hospi- that something had to be done for the diseased and tal in July 1828 (S.S.R., A. 56., 1828). decrepit beggars who were once again filling the The Government, reluctant to re -impose a tax streets of Singapore. He proposed that a tax which would affect the poorer class of Chinese should be levied for the the maintenance of Pauper oppressively, asked the Resident Councillor, Mr. Hospital. Murchison, for other concrete proposals. (The The imposition of a new tax was not within the Pork Farm had been introduced into Singapore in authority of the Governor, and he wrote to the 1823, and the income derived was paid into the Court of Directors of the East India Company in general revenue of the Settlement, and was not London in May 1828, setting forth the case (S.S.R., ear -marked for the Pauper Hospital. It was only in A. 53 and B. 9., 1828): force for that one year, as the then Resident "... relative to the proposed establishment of Councillor, Mr. Crawfurd was not in favour of an infirmary at this Settlement, the arrange- this "extremely injudicious tax, affecting one of ments connected with which, particularly in the principal necessaries of life of the most numer- respect to inviting contributions, were entrusted ous and industrious class of our population"). to the Resident Councillor, but we regret to Mr. Murchison replied on the 15th January, state that there appears to be much reluctance 1829 (S.S.R., AA. 1., 1829): to comply with the suggestion for voluntary "... I fear that I cannot suggest any efficient subscriptions, and that attempts to induce remedy for the great and increasing evil of voluntary subscriptions either on the part of mendicity. In such a place as Singapore, it is the Europeans or Chinese, have been entirely hardly possible to check the influx of paupers unsuccessful, and we apprehend the burden of and diseased persons from China, Rhio, etc. expense must principally fall on the Govern- and when once here, there is no apparent ment, unless indeed it may be considered remedy but the establishment of a hospital and expedient impose to a tax upon the retail of poor house, which would entail a very consi- the pork in same manner as at Penang, the derable expense on the East India Company, for receipts from which at that settlement afford generally speaking, the miserable objects who an ample fund for the support of a Poor House, now infest the streets are beyond cure and which for has a series of years afforded an would have to be maintained as long as they asylum to a vast number of distressed and lived. On a former occasion, the Honourable diseased objects, principally Chinese." the Governor in Council was pleased to take In Penang at that time, the monopoly of killing this subject into consideration but the measure pigs and selling pork was awarded by auction, and then contemplated entirely failed in . con- was known as the Pork Farm. The Renter or sequence of the Chinese inhabitants refusing Farmer had authority to demand one dollar from to make any contributions towards the expense anyone else (except European butchers) for every of a Poor House." pig killed. The revenue from the auction of the At about the same time, at the Criminal Ses- Pork Farm was used to support a Poor House and sions of the Court in Singapore on 18th February Infirmary. "The Farm in question was originally 1829, the Grand Jury made a Presentment which, initiated at the desire of the Chinese themselves for among other things, called for action to deal with 52 SINGAPORE MEDICAL JOURNAL the increasing problem of the pauper sick, and On 15th April 1830, the Farm was put up for suggested that funds be obtained by assessment on auction and sold (CHR. 1830). The Resident properties in the Town (CHR. 1829). Councillor forthwith wrote to the Governor for sanction to build a Pauper Hospital and its main- A minor digression is necessary here to explain the funds obtained from the Pork the function of the Grand Jury at Singapore in tenance from Farm. The Governor and Council approved the the early year of the 19th century. This function proposal but advised caution in its implementa- was not similar to that of Grand Juries in England during this period. In England, the function was tion: strictly legal and consisted in presenting criminal "The Board approves of the Resident Coun- cases to the Court for trial. The Singapore Grand cillor's suggestion to build a Hospital and Jury, however, in addition to its legal duty, felt Poor House, and desires he will forward Plans free to criticise the Government and made recom- and Estimates of the same without delay. As mendations for the better administration of the the ground alluded to in his letter as the site Town. for these Buildings is understood never to have been occupied or enclosed in the Botanical in 1829 The Grand Jury February presented Gardens, and is on the opposite side of the (CHR. 1829): Stream, there seems no occasion to reserve it "... Fifthly, the Grand Jury beg further to for Botanical purposes. (The `Stream' referred present to your Lordships as a great public to is the present-day Stamford Canal. It used nuisance, the great increased and daily in- to be a fresh water stream). creasing number of public beggars, particularly The Board directs that the Resident Councillor Chinese. The most shocking and loathsome be reminded of the danger of such institutions, objects are daily exhibited in all parts of the as those now to be established from the pro- Town and roads of Singapore of Chinese ceeds of the Pork Farm, increasing beyond the paupers who since their emigration to the means of support, and especially in a place Settlement have fallen victims to sickness and situated like Singapore, and that great care disease so as entirely to incapacitate them from must therefore be taken that not more than earning an honest livelihood. The Grand Jury two-thirds of the monthly accruing income be therefore beg to be permitted to recommend expended, and every means taken to confine and suggest to your Lordships, the great benefit the benefits of the institution within the circle which they conceive would arise from the of our own Population" (S.S.R., A. 70., 1830). construction of a General Pauper Hospital for Further developments will be recorded in the the reception of these miserable and disgusting next article of this series. objects. By this means the Town will be freed from the present nuisance and the ends of public charity at the same time effectually APPENDIX A answered. Such a hospital should also be pro- vided with a ward for the admission of sick A.D. 1830. REGULATION VI. PORK FARM. Europeans who are sometimes unavoidably thrown upon the public. The maintenance of Designation this hospital would be provided for from the Regulation for rescinding Regulation IX of funds of the Assessors, and after its establish- 1825 of the Code of Prince of Wales Island and for ment, they recommend that all public beggars vesting in one person the exclusive privilege of from the Settlement be taken into custody of killing hogs in the Settlement of Prince of Wales the Police, and if proper objects, sent to the Island, Singapore and Malacca. or otherwise treated as idle persons hospital Section I-Preamble and vagrants...." Whereas it has been found expedient to rescind The merchants and property owners however Regulation IX of 1825 of the Code of Prince of were not in favour of this proposal. Wales Island entitled "A Regulation for vesting in The Court of Directors of the East India Com- one person the exclusive privilege of killing Hogs pany did not authorise the building and main- and selling pork"; to make certain alterations in tenance of the Pauper Hospital from the tax on the rules hitherto in force for that purpose and to pork until September 1829. In the days of the sailing extend their operation to the Settlements of Singa- ships it took a few months before the authorities pore and Malacca. Wherefore the Honourable the in the Straits knew of this decision. The Pork Farm Governor in Council of Prince of Wales Island, Regulations of Penang were accordingly amended Singapore and Malacca has passed this regulation and extended to Singapore in 1830 (see Appendix A). sanctioned by the Honourable Court of Directors MARCH, 1973 53 and approved by the Board of Commissioners for duly licensed by Government for every catty so India Affairs to .take effect from the date of its retailed three pice, giving notice of the place and promulgation. time where the hogs are to be killed and the flesh exposed. Any person or persons breaking or violat- Section II-Regulation IX of 1825 rescinded ing these conditions shall on conviction before a Regulation IX of 1825 of the Code of Prince of Magistrate forfeit and pay for each and every Wales Island is hereby rescinded. offence Sicca Rupees 50. Section III-The privilege of killing hogs and Section VII-Persons duly licensed not to kill hogs selling pork vested in such persons as the Governor that are unhealthy or of less weight than 60 catties. in Council may license for that purpose Breach of this rule to forfeit Sicca Rupees 50 The exclusive privilege of killing hogs and The renter or person or persons duly licensed selling pork within the limits. of Prince of Wales by Government and retailers of fresh pork as Island, Singapore and Malacca and its dependencies specified in the preceding section shall not kill for shall be vested in such person or persons as the sale hogs that are unhealthy or that weigh less than Honourable the Governor in Council may license 60 catties or blow water into the meat for the for that purpose, whether renters for a certain purpose of increasing its weight. For every breach period on terms and conditions to be determined of this rule the offender or offenders shall on by Government or committing it to public officers conviction before a Magistrate forfeit and pay as agents acting under the direct orders of Govern- Sicca Rupees 50. ment, due notice being given at the commencement Section VIII-To declare when wild hogs are ex- of each financial year. posed for sale. For neglecting to do so to forfeit Section IV-Person not allowed to kill hogs without Sicca Rupees 50 the or or permission from renter person persons The Renter or person or persons duly licensed licensed by the Government. neglecting to Persons by Government shall particularly declare when Sicca Rupees obtain permission shall forfeit 50 wild hogs are exposed for sale to be such. If he or No persons, inhabitants or residents of Prince they neglect to do so and if the same shall be sold of Wales Island, Singapore and Malacca or of the as home -fed pork, he or they shall on conviction territories or places subordinate or annexed thereto, before a Magistrate forfeit and pay Sicca Rupees 50. shall be permitted for the purpose of an entertain- duly licensed have authority ment or for the use of their own families, to kill a Section IX-Persons all hogs within the limits hog without permission be first had and obtained to take an account of of and from the renter or person or persons duly licensed Prince of Wales Island, Singapore Malacca. Proprietors of hogs to permit their hog styes to be by Government and persons so licensed by Govern- ment shall have authority to demand and take one examined Spanish dollar for every hog killed for either of the The Renter or person or persons duly licensed purposes in this section contained. If any person by Government shall have authority to take from or persons neglect to obtain such permission, he the first day of May an account of all hogs within or they shall on conviction before a Magistrate the limits of Prince of Wales Island, Singapore and forfeit and pay Sicca Rupees 50. Malacca and their dependencies, and all proprie- tors of hogs shall permit him or them to examine Section V-Persons duly licensed not to demand a their hog styes at any time in the daytime during greater price than 22 pice a catty. For breach of the said term as they may think proper to ascertain this rule to forfeit Sicca Rupees 50 that the number of hogs from time to time corres- The renter or person or persons duly licensed pond with the account kept by the renter or person by Government shall not demand a greater price or persons duly licensed by Government. for fresh pork sold than 22 pice a catty. For every Section X-Account to be furnished by importers of breach of this rule, he or they shall on conviction salt pork to the person duly licensed by Government. before a Magistrate forfeit and pay Sicca Rupees 50. For a breach of this rule, importers to forfeit Sicca Section VI-Persons desirous of killing hogs and to Rupees 50 retail are at liberty to do so on paying to the renter The importers of salt pork from any of the three pice for every catty so retailed. Persons break- adjacent states shall furnish the renter or person ing or violating these conditions to forfeit Sicca or persons duly licensed with an account of the Rupees 50 whole or any part thereof previous to landing the Persons desirous of killing hogs for the purpose same. For the breach of this rule the owners of of retailing the flesh shall be at liberty to do so on such imported salt pork shall on conviction before agreeing to pay the renter or person or. persons a Magistrate forfeit and pay Sicca Rupees 50. 54 SINGAPORE MEDICAL JOURNAL

Section XI-Not to exercise any control or inter- CHR. = Singapore Chronicle (1827-1837). Microfilm. National Library Holdings, Singapore. ference with hogs killed by. European butchers or CHR. 26.2.1829. by their immediate use killed Europeans for CHR. 22.4.1830.

The renter or person or persons duly licensed Lee, Y. K.: "The General Hospital in . early Singapore by Government shall not exercise any control or (Part I) (1819-1829)." Sing. Med. 3., 14, 37-41, 1973. interfere with hogs killed by European butchers S. S. R., A. 28., 1826. for sale to Europeans or the supply of the Army S. S. R., A. 31., 1823. or Navy of His Majesty or the Honourable.Com- S. S. R., A. 51., 1828. 1828. pany or killed by Europeans themselves for their S. S. R., A. 53., S. S. R., A. 54., 1828. use, are hereby declared to be free immediate which S. S. R., A. 56., 1828. this Regulation. and exempt from the operation of S. S. R., A. 70., 1830. Section XII-Nett revenue derivable from this S. S. R., AA. 1., 1829. source appropriated to charitable purposes S. S. R., B. 7., 1824. All the revenue that may result from the renting S. S. R., B. 9., 1828. S. S. R., L. 6., 1822. of the exclusive privilege above provided for shall S. S. R., L. 7., 1822. be appropriated to the purposes of supporting a S. S. R., L. 8., 1822. Native Poor House and Infirmary for the benefit S. S. R., L. 9., 1822. of such fixed residents of these Settlements as may S. S. R., L. 20., 1823. from time to time require such assistance. S. S. R., M. 12., 1826. REFERENCES S. S. R., N. 2., 1827. S. S. R., N. 3., 1827. S. S. R. = Straits Settlements Records (1800-1872). Micro- film. National Library Holdings, Singapore. S. S. R., V. 2., 1827.