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Children's Convalescent Homes 1845-1970

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Children's Convalescent Homes 1845-1970 Children's Convalescent Homes 1845-1970 Maria Patricia Marven Clare Hall University of Cambridge April 2019 This thesis is submitted for the degree of Doctor of Philosophy Declaration I hereby declare that this thesis is the result of my own work and includes nothing which is the outcome of work done in collaboration except as declared in the Preface and specified in the text. It is not substantially the same as any that I have submitted, or, is being concurrently submitted for a degree or diploma or other qualification at the University of Cambridge or any other University or similar institution except as declared in the Preface and specified in the text. I further state that no substantial part of my thesis has already been submitted, or, is being concurrently submitted for any such degree, diploma or other qualification at the University of Cambridge or any other University or similar institution except as declared in the Preface and specified in the text. It does not exceed the prescribed word limit for the relevant Degree Committee The length of this thesis is 79,893 words. Summary Maria Patricia Marven, Children's Convalescent Homes, 1845-1970 From the middle of the nineteenth century a new type of health care institution, the children's convalescent home, began to provide care to sick children. Institutional convalescence quickly became an established part of medical orthodoxy, particularly for urban working-class children. Convalescent homes combined simple medical care with the natural therapies of diet, rest, and fresh air within a home-like environment. But they were also institutions of their time. They catered for medical conditions and socials needs that no longer exist today. Moreover, they were culturally acceptable in a way that is no longer recognisable. Their position within a particular epoch makes them revealing about health care provision during that time, and has broader historical significance for how we understand periods of significant social and cultural change; pointing towards points in time when ideas of children's emotional, physical, and health care needs diverged or changed. Despite their potential richness as a source, children's convalescent homes have gone largely unstudied. Historical research on developments in children's health care has focussed on the provision of child welfare clinics, domiciliary nurse visits, and school medical inspections. Numerous scholars have argued that it was primarily through welfare clinics that professional medicine came to ‘know’ children, and conversely, through clinic visits that mothers were exposed to new methods of scientific child care, as their children were weighed, measured, and monitored. Since Roy Porter's call to study history from below, historians have turned to new methods of analysis to study the subjective experiences of the non-hegemonic classes and subaltern groups. In doing so they have produced studies that have illuminated the experiences of diverse patient populations. However, the voices of child-patients have remained persistently silent, and the bodies of literature that study children's health care and children's subjective experiences of that care have rarely been drawn together. Through the contextualised study of children's convalescent homes this thesis begins to draw these works closer together in a fusion that both supports and disrupts current historiography. Although residential health care for children was increasingly available from the mid-1850s, children's convalescent homes occupied a unique space within the provision of children's health care; bridging the divide between residential welfare provision, and familial homes. It will be argued that this distinctive space provides a unique location for historians to explore changing ideas of childhood, health care provision, and children's subjective experiences of these regimes. This thesis has been divided into two sections that have used distinct sources and methodological approaches to explore different aspects of children's convalescent homes. Section one uses archival sources to provide a narrative account of the institutional convalescent care of children in the Metropolis between 1845 and 1970. While section two, uses oral history interviews to explore individuals' remembered experiences of childhood convalescence in the closing decades of the system, between 1932 and 1962. Contents List of Graphs and illustrations Acknowledgements Chapter One Introduction to section one 1 Chapter Two Development and Growth 19 Chapter Three Diseases, therapies and spaces 66 Chapter Four Introduction to Section Two 113 Chapter Five Separation 124 Chapter Six Agency and Isolation 167 Chapter Seven Kinship Bonds: Going Home 207 Chapter Eight Conclusion 236 Bibliography 241 Appendix 292 List of Graphs and Illustrations Figure 1.1. Directories and registers sampled at five year intervals 14 between 1845 and 1970. Figure 2.1. Homes that only admitted children by sponsorship type, 1850-1970. 20 Figure 2.2. Double page advertisement in The Times, 1935, part of a feature 41 appealing for funds to build a convalescent home. Figure 2.3. Envelope and Front cover of the Coaxing Book, 1926. 42 Figure 2. 4. The Brocklesby Sunday School Girls and District Cot at the Little 43 Folks Home, 1923. Figure 2.5. Provision of convalescent care per head of population under 50 eleven years in London. Figure 2.6. Total number of convalescent homes that admitted children, 50 1840-1870. Figure 2.7. Homes that only admitted children by sponsorship type, 1850-1970. 51 Figure 2.8 Physical assessment of children on admission to convalescent 61 homes. Figure 2.9 Number of rooms occupied by families of children referred to 62 convalescent homes, 1865-1935. Figure 3.1. List of twenty-one medical and nursing text books published between 69 1885 and 1970, surveyed for references to children's convalescence. Figure 3.2. Broad classification of diseases for which children admitted to 75 convalescent homes, 1870-1970. Figure 3.3. Cow and Gate poster, 'Important additional evidence concerning: 79 AN INVESTIGATION INTO THE RELATIVE MERITS OF INFANT FOODS'. Figure 3.4. Comparison of average weekly expenditure per patient on food and 82 medical ancillaries in children's convalescent homes and hospital. Figure 3.5. Menu from The Friends Convalescent Home Annual Report 85 1877 - 1909. Figure 3.6. Menu from St Andrew's Convalescent Home 1929. 86 Figure 3.7. The plans for Bayley Convalescent Home. 98 Figure 3.8. Photograph of dormitory at St Mary's Convalescent Home, 1882. 104 Figure 3.9. Photograph of dining room at Beech Hill Convalescent home, 1951. 107 Figure 4.1. Details of interviewees. 115 Figure 4.2. Letter by six-year-old Jeremy, 1949. 151 Figure 4.3. Letter by seven-year-old George, 1959. 151 Figure 4.4. Admission card granting parents permission to visit their daughter. 153 Acknowledgements This study would not have been possible without a great number of people. My first thanks go to the seventy-two individuals who allowed me to interview them for this thesis. They gave so generously of their time and themselves; frequently opening both their homes and their hearts to me. Without them this project would not have been possible. My very special thanks go to my supervisor, Simon Szreter, whose knowledge, expertise, enthusiasm, continual support, and understanding has been invaluable at all stages of this project. Without his encouragement I would not have started or completed this study, and I owe him my heartfelt thanks. I am very grateful to Siân Pooley, whose early support and warmth nurtured this fledgling work and the author. I would like to express my love and gratitude for the lifelong love, support, and encouragement of my parents Terence and Patricia. They have been with me throughout. Above all, I owe an enormous debt to my husband, Tony, who has been steadfast in his love and support. Without him this study would not have been possible. Chapter One: Introduction History of case Father healthy; Mother delicate, Mother’s mother died of phthisis. 3 other surviving children, 2 of whom are in good health, 1 attending amongst the outpatients with diarrhoea in teething. 4 dead. 1 at 7 1/2, mother does not know of what disease, 1 at 1.8 of diarrhoea, 1 at 1.4 of diarrhoea - both in teething, 1 at 1.4 of measles. Child had measles followed by whooping cough at 4 ... Since whooping cough she has never enjoyed good health for long ... 1 week ago became worse, she took cold in the chest and complained of pain in R. Chest, esp. on deep breathing or coughing, she occasionally spat phlegm streaked with blood, she is feverish. Hospital case notes of Esther Halloway, eleven years old, 1869 1 Eleven-year-old Esther was admitted to the Hospital for Sick Children, Great Ormond Street, suffering from haemoptysis and haemorrhaging from her bowels. Her notes describe her as a 'well formed, thin girl with long black hair and hazel eyes.'2 We know that she was one of eight children, although only four survived at the time of her admission. The entire family occupied two rooms, and although there is no mention of their domestic arrangements in Esther's medical notes, it is easy to imagine the overcrowding in which the family lived, and in which four young children died - three before reaching their second birthday. Esther was a hospital patient for one month, during which time her notes describe the gradual transition of a girl who had 'never enjoyed good health', debilitated by recurrent infections, inadequate nutrition, and poor housing to that of a 'well looking girl', with a good appetite and gradual weight gain. After one month Esther was considered to be healthy enough to be transferred to Cromwell House Convalescent Home to complete her recovery. She was a patient at Cromwell House for six weeks and was discharged home 'improved'.
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