History 207 “The most humane attention”: patient care and treatment at , 1753-1855 J V S Wickenden

Introduction wounds, and suffering.”2 General Sir John B. Richardson, When Haslar Hospital admitted its first patients in 1753 writing here, was the son of the Sir John Richardson who was (Figure 1), there was no book of instructions for the Naval Chief Physician and Inspector of Fleets at Haslar between Hospitals. There was, however, a collection of forms for use 1838 and 1855. in any naval medical establishment: By the Commissioners for taking care of sick and wounded seamen, and for exchanging From beginning to end of this period, Haslar’s chief aim prisoners of war. Instructions to be observed by their officers seems unaltered: yet the instructions for the staff of the naval [...] : joint instructions to the physician, surgeon and agent.1 hospitals, while indicating a slow change, also reveal the early existence of more humane sentiments, even if only in The need for care was centred on the concept of the sailor theory. as part of its fighting machine: “For the better preventing Delay to the King’s Service, and any unnecessary Expence Arriving at Haslar to His Majesty, by keeping People longer in the Hospital or A seaman transferring from his ship to Haslar would be Sick Quarters, than shall be needful for their Cure, they are embarked on a ship’s boat and rowed ashore; boats could strictly enjoyned, to use all their Skill and Care in hastening beach within 300 yds (274 m) or so of the hospital, depending the same.”1 on tide and the condition of the sea and foreshore. He would then, if necessary, be transferred to a wheeled trolley which Over eighty years later, returning men to effective service, ran on rails into the hospital, following the course, some feet rather than caring for the sick, was still the priority: “The below, of the hospital’s main sewer (Figure 2). Haslar Hospital of my father’s time was governed in a different fashion to what it is now. It was then treated more as if it was a On the patient’s arrival in hospital, his comfort and cleanliness – man of war than an institution for the amelioration of sickness, not necessarily in that order – were dealt with first. Dr James

Figure 1: The Royal Hospital Haslar, engraved in 1799 by J Hall. 208 Journal of the Royal Naval Medical Service 2019; 105(3)

Figure 2: One of the entrances to the hospital, photographed in 1967, showing the trolley rails.

Lind, shortly after his arrival as second Physician of Haslar In 1808 it was noted that “When a man is received into the in 1758, wrote to Sir Alexander Dick, President of the Royal Hospital, the bedding, clothes, and other effects, which he College of Physicians, carried with him, are to be ... washed and purified... and the bedding and clothes, having been so marked as to prevent their “We are remarkably clean. No patient is admitted into the being taken away through mistake by any other men, are to be hospital until he is stripped of all his cloths and well washed carefully deposited in the place appointed for keeping them, with warm water & soap in tubs always kept for the purpose, whence they are to be taken, opened, and exposed to the air, he is allowed the hospital dress during the time he continues in as frequently as circumstances will admit.”5 The instruction the hospital or until his cloths are returned to him quite clean, “that every Patient, on his first admission into the Hospital, & he is regularly shifted and kept quite neat clean & sweet at under your care, be allowed a clean bed to himself, with clean the Government’s expence. None of his cloths bedding &c is bedding”,5 suggests that this was not always the case. ever permitted to be brought into the hospital we have large outhouses for their reception.”3 Men were allowed their own clothes again once they had been cleaned, unless there was a danger of contagion: “The clothes Although this reads to the modern eye as laudable attention, of every description, belonging to men sent with contagious Thomas Trotter suggests otherwise: “Tubs were employed disorders, excepting such as the Governor shall order to be for this purpose, while I belonged in Haslar, in the form of burnt.... are to be boiled in water, for the space of a quarter those used in slop ships, for purifying new-raised men; but of an hour, and then properly washed.”5 If the clothes were the seamen had such a dislike to them, that it was found burnt, a sum of money equal to their value was returned to impracticable to get a rheumatic patient to bathe, because they the patient, or added to his effects if he died. Men admitted reminded them of scrubbing, by way of punishment, on board. from ships brought their clothes, bedding and effects with Instruments of this kind degrade a public charity; a sailor them, and the same policy was applied, an inventory being under disease ought to be bathed like a gentleman.”4 made on the back of the “sick ticket” which each man carried History 209 with him on admission and which was issued by the surgeon this arrived, the panes were found to be too small for the aboard ship. However: “sick men are not permitted to bring frames which had already been cut and had therefore to be with them the hammocks which are allowed them on board patched.8 Lamps and fires added warmth and drying power, of their Ships; therefore, should any men do so, you are not to while the instructions set out a strict fire and candle inspection take charge thereof, but they are to be taken back to the Ship regime, with regular testing of the hospital’s fire engine. by the Officer who conducted the Men to the Hospital.”5 Men could not therefore have been, as popularly believed, buried in Instructions to ventilate wards and to air beds, bedding and their hammocks. stored material recur frequently. In 1753 it was required “that the Wards in the Hospital, and Rooms in Town-Quarters, be not Hygiene and general conditions too much crowded with Beds or Cradles, and that a convenient 1 Haslar is famous as the largest brick building in Europe of its space of two Feet at least, be allowed between every Two”; later the distance was increased to “at least four feet ... but time: it was originally designed to take 1800 patients, with an 5 9 air space of 600 ft3 (17 m3) per head. Nonetheless James Lind, never less than two” and so remained in 1834 (Figure 3). in the letter already quoted, wrote that “Haslar Hospital ... will certainly be the largest hospital in Europe when finished Nurses were employed at the rate of one to every seven but even then will not be able properly to receive above 2200 patients “unless in case of emergency, and where the nature of patients. This is owing to the largeness of the regular wards. their diseases shall require it” all through the period. ... we never have had above 1040 patients, we this winter shall open wards for 500 patients more.”3 Plans for the unbuilt Floors were not sanded but scrubbed; there is, however, fourth wing were presumably still active at the time of writing: evidence for occasional sanding of floors in a letter of March four years later, that side of the quadrangle was part-filled by 9, 1762 from Martha Taylor, matron, to the hospital council: St Luke’s Church. J. Turner’s elevation and plan of Haslar, “I beg leave to acquaint you that Mr Parker wont alow of my circa 1750, shows three wings of three floors each, with twelve having his Wards washed on accont of his Patients being so wards in each side wing and fourteen in the main wing, plus at Bad and desire I would apply for sand as its impossible to be least two wards in separate, smaller buildings.6 kept Clean without it” (in the original spelling).10

Tait notes that the hospital’s walls are 4 ft (1.22 m) thick at A surprising number of animals seem to have frequented the ground level, narrowing to 1½ ft (0.46 m) in the attics.7 There hospital. Discussing smallpox, Thomas Trotter wrote, “We was no damp proofing, and damp will have been exacerbated shall hope to see some of the Gloucestershire cows transferred by the ill-fitting windows; during building, cheaper glass had to the navy farm, that surrounds the walls of Haslar Hospital, been ordered from Newcastle, instead of the more expensive for the purpose of inoculating the whole seamen at Spithead, crown glass from London, and when after considerable delay and thus prevent any return of that infection into our ships of

Figure 3: A modern replica of one of Haslar’s eighteenth-century beds. 210 Journal of the Royal Naval Medical Service 2019; 105(3) war, that we are now employed to defeat. “11 In addition, the The most heartfelt plea for kind treatment was printed in three well-pump was powered, until 1855, by four horses. The area places in the 1808 instructions, and re-issued almost verbatim in front of the hospital was grass, “generally grazed by the in the orders and instructions for surgeons afloat in 1825,12 and principal officers’ cows”2 which were kept for milk. Cows also for hospitals in 1834: “And as sickness generally depresses grazed on the airing grounds and (according to Tait) on the the spirits, it becomes, not only your duty, but that of every burial ground, while the surgeons were in the habit of keeping person who attends the Patients, to sooth and cheer their minds dogs. General Richardson records that “The cats made night by the most humane attention, to hear with patience all their hideous. In the day-time pretty well every cellar opening had complaints, to explain and redress, as far as possible, whatever a cat sitting on the brick edge... they were very wild. I have no they may think grievances, by every expression of consolatory idea who fed them.”2 kindness, which will naturally inspire them with confidence, exhilerate [sic] their spirits, and add to their hope of recovery, This was in the mid-nineteenth century, and the situation was to which it cannot fail to contribute.”5, 9 of long standing. The Office for Sick and Wounded Seamen had found it necessary to write, on 14th August 1760, forbidding Pharmaceutical treatment and diseases the keeping of goats, and in more determined tones on the 27th Given the pharmaceutical treatments recorded, it is perhaps September of the same year: unsurprising that patients were in need of encouragement. In 1753 medicines were “made and compounded” by the “It having also appeared that Cows, Horses, Goats, Fowls and hospital dispenser and his assistant;1 the disappearance of this Geese, in very great Numbers are kept in the Airing Ground particular instruction from later volumes may indicate that of the Hospital, and must therefore become a Nuisance, we the task had become so habitual as to need no reminder. All have resolved that not any shall be Suffered to be there for the the Instructions record a precise and comprehensive system future, and desire You will govern yourselves accordingly.”10 of prescription tickets, medicine baskets and tallies to ensure Even if any notice of the letter was taken at the time, as years that patients received the correct medicine, but there remains passed the animals were re-established, either by permission the distinct possibility that these measures were thwarted by or otherwise. illiteracy among the nurses.6 General treatment Cross-infection from patient to patient was known to be a It is clear that all patients were expected to be treated with danger, although its mechanics were not properly understood. kindness as well as efficiency. The Governor, as head of Foul dressings were immersed, as soon as removed, in boiling the hospital, bore the chief responsibility: “the wards are water, and thoroughly washed. In 1808 the instructions to the to be frequently visited at uncertain times in the course of surgeon note that “the difficulty of curing wounds or sores the day, by the Hospital Mates, not only for the purpose of in surgical wards, may, in a great degree, be ascribed to the administering medical and surgical assistance, but likewise exposure of the patients to impure air,”5 and by 1834 the for the purpose of keeping the Nurses and other Attendants instructions were also taking notice of methods of preventing on the sick, strictly to their duty, and seeing that the Patients cross-infection in cases of ulcer or syphilis. The early be, at all times, treated with that attention and kindliness, so installation of an operating room, however, was governed necessary for the comfort and consolation of men languishing not so much by hygienic principles as by a desire to improve under pain and sickness.”5 morale on the wards, where operations would previously have taken place “to the disturbance of other patients”. General The surgeon too was to “shew your Mates an example Richardson remarks that “There were no anaesthetics in the of professional industry and expertness, and impress on olden days. Operations were very rapidly performed, but men their minds the necessity of paying the strictest attention to would stand anything when promised a drink of spirits and cleanliness, and to the most gentle mode of treatment,”5 while opium.”2 In this context it is worth noting that the Dictionary at the end of the chain the Ward Matron was “to superintend, of Canadian Biography Online records Sir John Richardson most strictly, the conduct of the Nurses employed in the as “a pioneer in the use of general anaesthesia in naval surgery several wards, and see that they attend the Patients with the shortly after ether and chloroform were first used.”13 utmost assiduity and kindness.”5 The pharmacopoeia of 176014 provides indirect clues to what Later, “Instructions on the management of the lunatic asylum” diseases were treated, and, interestingly, who might be sick; were added: “As no means have been found more effectual a list of preparations “ad infantes” and “antihysterica” at the for restoring insane Patients to a state of sanity than exercise end of the manuscript suggests that children and women were or moral treatment, every encouragement and facility should among the patients. be afforded to those Patients whose malady will admit of their being employed in any kind of labour, occupation, or innocent The main section lists paregorics, decoctions, poultices hot recreation.”9 Sir John Richardson was a noted pioneer of and cold, enemas, gargles, ointments, pills and electuaries gentler methods of treatment for those with mental illness; but (chews or linctus-type medicines) made of substances as he did not arrive at the hospital until four years after these innocuous as lemon barley water (boil pearl barley in spring instructions were issued. water, and add cream of tartar, lemon syrup and sugar) History 211 or as alarming as “Aethiop. Antimonii” (take powdered Richardson’s time there were indeed fruit trees in the airing antimony, mercury and flowers of sulphur). There were ground, while the walled garden with fruit trees behind the ointments “ad gonorrh. amôta inflam[m]at” (to remove present Terrace dates from the late eighteenth century (Eric gonorrheal inflammation) and mercury pills for the further Birbeck, personal communication). treatment of venereal disease, as well as antihelminthics against worms. Other substances were intended to banish By 1808, and still in 1834, surgeons and physicians were told fever, help chest problems, soothe coughs, encourage “in particular cases of debility, or where the appetite may be excretion, induce sweating and aid the digestion, while the capricious, to substitute such quantities of fish, fowl, veal, and “cervis ad scorbuticos” (beer for scorbutic patients) sounds eggs, as, with due regard to economy, you may think necessary like an inducement to malingering; leaves of scurvy-grass, for the recovery of any Patients”5. The Dispenser, as well as watercress, brooklime, horse-radish and absinthe infused in taking care of the pharmacy, saw to the daily issue of sugar, “cervis veteris et fortis” - old and strong beer.14 sago, rice, spices “and other necessaries”, and ensured that food was “good in quality, well dressed, and properly served.”5 At the end of it all the patient may have been grateful for the “haustus anodyn.” or soothing draught; in certain cases, In 1794 the diet was reported as “very good, except the beer treatment must have left marks on the body as permanent as and vegetables (which are turnip tops),”6 and the 1808 diet those of wounds and illness, though perhaps less visible. sheet shown suggests a concentration on food as fuel. The 1834 Instructions include a not dissimilar diet, with the addition of a By 1808, the monthly medical report form appended to the separate dietary for patients in the lunatic asylum. instructions gives the following list of headings: Fever, Dysentery, Pulmonic Inflamation [sic], Ulcers, Wounds & Care was taken that food should be equitably divided: the Accidents, and Other Complaints. There is now no separate Steward’s instructions in 1808 and 1834 read: “[Y]ou or your mention of scurvy, presumably because its incidence had been Clerk, with any number of Patients, not excluding six, who much reduced by that date. may chuse to attend, for seeing justice done to the whole, are to be constantly present at the weighing, and cutting up, Food and drink of the meat, and to see it properly and fairly allotted to each There are no orders for diet in the 1753 volume of instructions: ward, agreeably to the number of Patients therein, and tallied Tait discusses the dietary of 1788, but without noting his accordingly. You are, also, to take care that the greens, herbs, source.7 The amount and type of food was governed by the and leeks, be properly picked and washed, before they be perceived health and appetite of the patient; for example, a put into the copper, and that the whole of the provisions and 5, 9 Low diet in 1788 consisted of “water gruel, panado [bread vegetables, be cooked in a clean and proper manner.” sopped in hot water, sometimes with sugar, spice, or currants added], rice gruel, milk pottage, or broth, and bread and Drink was more of a problem. There was a well in the Gunboat butter if necessary. For drink, toastwater, tisane, or “white Yard, sunk to a depth of 146 ft (44.5 m) when the hospital was decoction”. The last was an infusion of burnt hartshorn and building, but the water was most likely only for washing and gum arabic, boiled, strained and mixed with “good British cleaning. Apart from the special drinks already mentioned, spirit”; toastwater is, as its name suggests, water in which beverages were alcoholic, even if only as strong as small beer toasted bread has been steeped.6 (about 3% proof).

Half diet was: “Breakfast, milk pottage; for dinner, ½ lb The letter from the Office of Sick and Wounded Seamen in mutton, some light bread-pudding, or in lieu of it, some September 1760, already quoted, describes a situation whose greens, a pint of broth, 1 lb bread, one quart of small beer”, results can only be guessed at: “We were extremely surprised and Full diet “Milk pottage for breakfast. Dinner: 1 lb meat, & concerned to find ... that [the inspector] was obliged to give 1 pint broth, 1 lb bread, 3 pts small beer.” With such a large Orders for preventing some Abuses, which We could not by amount of bread required for victualling, it is unsurprising that any means conceive, You would have suffered to be committed there are orders elsewhere for poultices to be made using other when They came to your Knowledge, but we were still less substances than bread. apprehensive, that You would give a Sanction to Practice that must destroy the good OEconomy of the Hospital ... by this In 1788 there were “discretional orders” for more delicate We particularly mean, your having ordered the Nurses to have items: rice milk, orange whey, orange and lemon water, Drams from the Dispensary, and giving Notes for Strong Beer tamarind whey and water, vinegar whey, balm tea and sage to be brought into the Wards.”10 tea.7 Thomas Trotter, always mindful of the morale-boosting effect of good food, was of the opinion that the grounds at The problem did not go away; in 1808 and 1834 the Haslar were under-used when it came to improving the Lieutenants, the Ward Matron, the Porter, the Agent - indeed, diet of the patients: “Might not the ground round Haslar be most of the staff in the hospital - are instructed to see that advantageously laid out in gardens and orchards for the use of nobody is “in any way concerned in, or to connive at the the sick? ... To these I would add a pigeon house, and poultry introducing of spirits or other unauthorized articles into the farm.”4 There is no evidence for the latter, but in Sir John Hospital”.5, 9 212 Journal of the Royal Naval Medical Service 2019; 105(3)

Discharged cured, invalided or run “Discharged run” (deserting) was an alternative route out, much favoured by patients, and facilitated by the lack of a fourth side Being discharged cured was a relatively simple matter, to the hospital quadrangle. Even after St Luke’s Church was requiring not much more than written discharge and the built in 1762, a gap in the perimeter remained until 1796, when matching up of possessions from the store-room with those iron railings were installed, all outer doors were locked at night, noted on the back of the patient’s hospital ticket. While there and gratings were added to the lower windows of the hospital; are recurrent instructions for such notes to be made, items despite which, 180 patients were reported run in 1797.6 retrieved, and so forth, there is no mention of any action to be taken if possessions were lost or stolen: whether the sailor was By 1834 the instructions state that “desertion is now rendered reimbursed, or the matter was ignored, is impossible to tell. nearly impossible by the precautionary measures taken in the nightly visits of the Physician... together with the imperative There was a “casualty diet” not only for men received, but for duty of the Nurses to make a report to the proper Officer men discharged; on the morning of leaving hospital a seaman the moment any Patient is discovered to be absent from his would be given “a pint of tea in the morning, one pound of ward...9 “Nonetheless, the Porters were still required to use bread, six ounces of cheese, and one quart of beer”. He would their “utmost diligence” in preventing desertion, and the then be expected to make his way either back to his ship, or to Ward Matron was given instructions “in the event of a Patient any other ship in harbour that would take him. deserting and carrying away any of the Hospital clothing.”9 Men invalided could expect a less certain life. In 1753 the Agent Discharged dead was expected to provide “such Crutches and other Instruments, for Lame and Infirm Patients, as either of the Chief Surgeons Every seaman hoped to be able to leave the hospital by one shall demand in Writing”, but it is not clear whether these could route or another; inevitably, this was not always achieved. be taken away in cases where the patients were invalided, and For those expecting death, the Steward and Agent attended the instruction does not recur in later years. Some invalids were to practical matters such as “fill[ing] up the customary form discharged to harbour duty - what would now be considered of wills for such patients as may require it.”9 There was a a shore posting - while those “unserviceable” had to fend for cautionary instruction that “no will is to be made by a Patient, themselves. They were not necessarily without help. From the in favour of any person whatever on the establishment of the early years of the Navy, the Chatham Chest, supported by the Hospital, or employed therein.”5 Spiritual matters for “such as stoppage of 6d per month from seamen’s wages, had acted may be dangerously ill, and may desire your attendance” were as a pension fund for the assistance of invalided or injured the province of the Chaplain.5 sailors. Samuel Pepys in the seventeenth century reported that Admiralty officials were prone to helping themselves from It is extraordinarily difficult to reconcile the printed record, or it now and then, but it survived, merging in 1814 with the at least printed opinion, with the physical and archaeological Greenwich Hospital funds, and was substantial enough in 1829 record of what now exists in the burial ground at Haslar. One for the practice of compulsory stoppage to cease. Tait notes of the few contemporary records is by Gilbert Blane, who that “the pensions awarded from the funds varied from £12 a published the figures shown below (Table 1):15 year for the loss of both eyes, to £4 a year for the loss of one eye, or for fracture of the skull.”7 By the twentieth century, estimates were reaching heights of speculation:

HASLAR PLYMOUTH

Received. Died. Received. Died. From 1755 till 1763, 34,935 1,869 25,879 1,691 both years included 1. in 18.6 1. in 15.3 From 1764 till 1777, 31,389 1,004 11,625 454 both years included 1. in 31.2 1. in 25.6 From 1778 till 1782, 52,503 3,137 27,632 1,109 both years included 1. in 16.7 1. in 24.9 From 1783 till 1792, 25,065 1,157 25,221 1,309 both years included 1. in 21.6 1. in 19.2 From 1793 till 1797, 32,498 2,262 21,277 861 both years included 1. in 14.3 1. in 24.7

Table 1: “shewing the Number of Men admitted, and who have died at Haslar and Plymouth Hospitals, from the Year 1755 to the Year 1797” 15 History 213

“From the time when the hospital was first built, the whole The Agent - “On the death of any Patient in the Hospital, land to its south-west was used indiscriminately for the you will receive a note from the Ward Matron, informing burial of corpses. No records of burial were kept, but [...] you of the precise time of such man’s death... every Patient it has been estimated that, in the last three years of the who may die in the Hospital, is to be buried at the public eighteenth century, 3600 bodies were buried in the hospital expense, in a decent manner, in the burial ground belonging paddock. Certainly, during excavations prior to rebuilding, thereto, which burial shall, when circumstances will permit, late in the nineteenth century, it was still common for take place as early in the morning as possible; and you are to skeletons to be unearthed, a few feet beneath the surface, give the Chaplain timely notice thereof, that he may attend and the paddock was found to be thick with buried bodies accordingly: but when the friends of any Patient, who may and scattered with broken tombstones. It would seem that have died in the Hospital, shall wish to bury him, at their own coffins were rarely used, and scant respect paid to the dead expense, and the Governor shall have permitted it to be done, either before, during or after burial.”7, 8 you are to require a certificate of the burial from the Clerk of the where the corpse shall have been interred... The In theory, when a patient died, a chain of events involving all effects of Patients, who may die, are forthwith to be collected levels of hospital staff was set in motion, the details of the in the bed-house, and an account of them entered in a book... orders remaining on the whole unaltered between 1808 and They are then to be deposited in the apartment allotted for 1834, save for minor changes in the wording. the same, and carefully preserved till regularly disposed of.”5

The Ward Matron - “You are to direct the Nurses when any This instruction implies that if the patient was buried at his friends’ Patient shall die in the Hospital, during the day time, to give expense it was outside Haslar; however, by 1834 the request of a you immediate notice thereof, upon which you are, without certificate of burial is gone, and the instruction simply reads “the delay, to repair to the ward, and in presence of the Nurses and friends of any Patient may bury him at their own expense.”9 two of the Patients, to take an account of such articles as the person deceased, may have left in the ward; and if any Patients The Agent was also responsible for the burial of any corpses should die during the night, you are to require this information arriving from ships afloat: “When the corpse of any person, 5 to be given you very early in the morning.” who shall have died, while serving on board any of His Majesty’s Ships, shall be sent to the Hospital for interment, The Physician - “Whenever any patient shall die... you are you are to cause it to be buried in the burying ground of to give directions that his cradle be well washed with warm the Hospital, in the same manner as Patients who die in the water and soap, that the sacking of the bed, and every utensil Hospital.”5, 9 Tait quotes a remarkable assertion that “corpses he had in use, be also well scoured and exposed to the open air, landed from the ships for burial, are often left lying the whole before any other Patient take possession of them.”5 day at the landing place, owing to the neglect of the hospital labourers”, but does not give his source, while according to The Lieutenants - “On the death of any Patient, you are General Richardson post-mortems were carried out in the forthwith to examine his effects left in the ward, and in the basement cellars whose openings were along the whole front bed-house, to see an exact account taken of them... and you are of the hospital (Figure 4).7, 2 to give directions, when a suitable or usual time has elapsed, that the body be removed in a decent manner, and that the Matron cause the bed, bedding, linen, and clothes, wherein it The final link in the chain was The Chaplain: “You are to lay, to be taken immediately out of the ward.”5 perform, with the usual solemnity, the burial service, over the

Figure 4: Haslar Hospital, here called the Royal Naval Hospital , engraved by J. Woods in the 1830s from a drawing by G. H. Sergeant. 214 Journal of the Royal Naval Medical Service 2019; 105(3) corpses of all persons who may die in the Hospital, or that may ... were ordered to be placed inside the newly enclosed be sent thither to be buried.”5 ground, and Garrett had the satisfaction of knowing that the seamen who died in his hospital were buried in a fitting Although, as mentioned above, the detailed wording of the manner.”8 two volumes of instructions remains almost unchanged in the twenty-six years between their publication, there were greater Conclusion changes in what was done in practice. These are recorded as resulting from the concerns of Rear-Admiral Henry Garrett, This article has described the progress and treatment of a Superintendent and Resident Commissioner: patient at Haslar from his arrival to his departure, illustrating his living conditions there, and recording such things as may have left their mark on him, whether illness, pharmaceuticals, “The first stage was the prohibition of further indiscriminate drink, or diet. burials in the hospital grounds ... [Garrett] arranged for deceased patients to be buried in the parochial grounds at How this establishment, which kept him to a strict naval regime , and for each burial ceremony to be attended, and yet aimed to treat him with “attention and kindliness”, ‘which they are to do in a decent and becoming manner’, affected his morale; whether he was glad or desperate to leave, by a hospital porter, the overseer of labourers and one of or found a shipboard community there to replace the one he his staff, together with a nurse from the ward in which the had left, can only be guessed at. Such marks are less tangible, patient had died. yet equally important to patient well-being. “In 1826, the north corner of Haslar paddock was enclosed This article is dedicated, in affectionate respect, to the memory by a wall, and the ground consecrated as the official hospital of Captain Claire Taylor RRC, QARNNS. cemetery. The old tombstones scattered over the paddock

References

1. Great Britain. Admiralty. Commissioners for Taking Care of Sick and Wounded Seamen. Regulations for the government of the hospital for sick and hurt seamen at Haslar. In: Instructions to be observed by their officers at [ ]: joint instructions to the physician, surgeon and agent. [London?: Admiralty; ca. 1753]. 2. Richardson JB. A visit to Haslar, 1916. J Roy Nav Med Serv 1916;2:329-39. 3. Stockman R. James Lind and scurvy. Edinb Med J 1926 Jun;33(1):329-50. 4. Trotter T. Medicina nautica: an essay on the diseases of seamen. Vol. I. London: Cadell and Davies; 1797. 5. Great Britain. Admiralty. Instructions for the Royal Naval Hospitals at Haslar & Plymouth. [London]: Philanthropic Society; 1808. 6. Lloyd C, Coulter JLS. Medicine and the Navy 1200-1900. Vol. 3, 1714-1815. Edinburgh: Livingstone; 1961. 7. Tait W. A history of Haslar Hospital. Portsmouth: Griffin & Co; [1907]. 8. Lloyd C, Coulter JLS. Medicine and the Navy 1200-1900. Vol. 4, 1815-1900. Edinburgh: Livingstone; 1963. 9. Great Britain. Admiralty. Instructions for the Royal Naval Hospitals at Haslar and Plymouth. London: W. Clowes for HMSO; 1834. 10. Letters [MSS 1760a, 1760b, 1762] (Institute of Naval Medicine). 11. Trotter T. Medicina nautica: an essay on the diseases of seamen. Vol. II. London: Longman and Rees; 1799. 12. Regulations and instructions, for the medical officers of His Majesty’s Fleet. [s.l.: Admiralty]; 1825. 13. Johnson RE. Richardson, Sir John [Internet]. Dictionary of Canadian Biography vol. 9. Toronto: University of Toronto/Université Laval; 2003–. [cited 2019 Sep 16]. Available from: http://www.biographi.ca/en/bio/richardson_john_9E.html. 14. Pharmacopoeia in usum Regalis Nosocomii Navalis apud Haslar 1760 [MS copy, 1931] (Institute of Naval Medicine). 15. Blane G. Observations on the diseases of seamen. 3rd ed. London: Murray and Highley; 1799.

Author

Mrs Jane Wickenden Historic Collections Library Institute of Naval Medicine Alverstoke PO12 2DL e-mail: [email protected]