Workhouse Medicine: Care, Cure and Control

I’ve been doing a lot of reading about health recently. Looking at the wonderful People’s History of the NHS website and researching for my undergraduate modules in the College of Human and Health Sciences at Swansea University. My second year module is called ‘care, cure and control’ so I thought I’d link that to this post about health, medicine and the body in workhouses.

Health care in workhouses generated a lot of discourse throughout the nineteenth century. Scandals, overcrowding, epidemics and death haunted these institutions for the poor. Although the 1834 poor law act had sought to bring uniformity to pauper relief, the medical treatment of inmates depended largely on the benevolence (or otherwise) of local poor law guardians. In 1866, reformer Joseph Rogers established the Association for the Improvement of London Workhouse Infirmaries and medical treatment improved across the country as a result.


Mrs. Gamp, Dickens’ dissolute, sloppy and generally drunk nurse became a notorious stereotype of untrained and incompetent nurses of the early Victorian era, prior to the reforms of campaigners like Florence Nightingale. Dickens’ character was popular with the British public and indeed a type of umbrella became known as a ‘gamp’.


Florence Nightingale need no introduction as the ‘lady of the lamp’ remains as famous (or infamous in some circles). She dipped her toe into the wide literature about workhouse medicine and published Workhouse Nursing.


This was followed in 1859 with Notes on Hospitals which proves useful to todays medical practice.

How did sick children fare in Swansea Workhouse? During the years 1837, 1838, 1839 and 1840 very few children died in the workhouse. There were 60 deaths overall, most of them attributable to old age, the eldest being 93. Some children did die during that time. William Branson, aged 16, died of scrofula, John Davies, aged 13, of fever and three year old Joseph Bowen’s cause of death is unrecorded. The remaining five deaths were of babies and children under two. John Phillips, 7 months; George Smith, 18 months; William Gammon, 12 months and John Davies, 2 months all died of infantile fever. Julia Bevans, 6 months, died of infantile syphilis and the cause of death of John Nourus, 14 months, was marasmus or malnutrition.

In Cardiff Workhouse, an enquiry into infant mortality in 1854 showed that out of 114 babies born in the workhouse in the three years prior to June 1854, 39 had died before their second birthday, however, the medical officer blamed these high figures on a measles epidemic.


However, contagious skin and eye diseases appeared to be prevalent among the workhouse children. Instances of the itch (scabies) especially and scald head (ringworm) were mentioned repeatedly in the sources, as were general eye complaints and the more serious ophthalmia, which was a major cause of childhood blindness in the nineteenth century.
Constant interaction with local children at school must have also stressed how the children of local labourers probably did not enjoy the same levels of medical care as the cottage homes children. The doctor called frequently, both to treat the sick and also to inspect the health of all the children; the 1908 diary recorded 46 such visits. Diseases such as ophthalmia, which had been rife in the workhouse, were not reported apart from an outbreak in 1902. There were very few deaths, an entry which recorded the death of Thomas Lewis from meningitis not only conveyed deep sadness, but also remarked that there had been no deaths in the homes for 13 years.

However, the resilience of children has often triumphed over adversity. Whilst visiting the children at school, Thomas Bircham the Local Government Board Inspector also apparently saw little to differentiate the cottage homes children and described them ‘as healthy and bright as the other children’.

Further reading:

Margaret Crowther, The Workhouse System, 1834-1929: The History of an English Social Institution (London: Batsford Academic & Educational, 1981).

Hurren, E. (2005).‘Poor Law v. Public Health’, Social History of Medicine []

Hurwitz, B., ‘Joseph Rogers and the Reform of Workhouse Medicine’, History Workshop Journal, vol. 43, no. 1 (1997), 218-25.

Kirby, S. (2002). ‘Reciprocal rewards: British Poor Law nursing and the campaign for state registration’, International History of Nursing Journal, 7:2, pp.4-13.

Lorentzon, M. (2003), ‘“Lower than a scullery maid”: Is this view of the British Poor Law nurse justified? Examination of probationer registers from Kensington Infirmary, 1890- 1916’, International history of nursing journal, 7:3, 4-15.

Negrine, Angela, ‘The Treatment of Sick Children in the Workhouse by the Leicester Poor Law Union, 1867-1914’, Family and Community History, vol. 13, no. 1 (2010), 34-44.




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