Medical care was short on the ground in East Anglia, most of the trained doctors went to London to work. There were two cottage hospitals, one at Bury St Edmunds founded by Messenger Monsey and another at Shotesham in Norfolk founded by William Fellowes and Benjamin Gooch. London was many miles of rough roads away.
Bishop Thomas Hayter of Norwich initiated a scheme in 1758. He asked Benjamin Gooch to visit all the London hospitals in order to obtain as much information as possible on their design and management. Gooch wrote "At his Lordship's request I visited all the hospitals in London with the greatest attention".
The architect William Ivory (1746-1801) drew up plans based upon Gooch's researches, but in 1761 Bishop Hayter was translated to London, dieing soon afterwards. The scheme faltered, the plan lay dormant. Gooch commented (1761), "I have good reason to believe, had he lived and continued Bishop of Norwich, such a beneficient establishment would have been completed ere now - - - and nothing seems wanting even now to accomplish it but to have a subscription properly opened".
In August 1770 William Fellowes organised a meeting at the Guildhall in Norwich to discuss the project. A committee of wealthy and influential Norfolk gentry was appointed, a subscription fund opened and a site for the hospital purchased. Large sums of money were liberally subscribed by the inhabitants of Norfolk and Norwich for carrying the laudable design into effect. Gooch wrote excitedly to his friend Messenger Monsey about all this. The scheme faltered no more and on 5th March 1771 the foundation stone was laid by William Fellowes and the hospital erected at the cost of £13,323/8/11, with about £8,000 spent on subsequent additions and improvements.The rebuild in 1883 cost £54,494/0/10.
The land (three acres) on which the hospital was built was leased for £6 per annum for 500 years. The building was two storeys high and in the form of an 'H'. "A building in the form of an 'H' would be most convenient for the purpose, as admitting the freest circulation of air, provision of which had, by Gentlemen of the Faculty of Physic, been earnestly recommended" (Gooch).
Gooch had strong views on how the wards should be equipped and run. "The curtains for the beds were to be of checked linen to draw round. Feather bolsters were to be provided, but no pillows at present: the beds were to be stuffed with straw, oat-flights or flock with two blankets and coverlid". "The wards are of different sizes and all fifteen feet high. They are kept very neat and clean, not crowded with beds, and well ventilated by having the convenience of letting down the upper sashes occasionally in the wards and in the galleries communicating with them, which is done every day for a time when the weather will permit it. The wards were lighted by lamps supplied with the finest Spermacetti oil".
Gooch gave continued advice and assistance to William Fellowes and became the only medical member of a sub-committee of six, the only other member known was the Rev Samuel Cooper, father of Sir Astley Cooper. They were charged with drawing up rules and orders for the conduct and government of the hospital. "No principle surgeon shall appoint an assistant surgeon to perform any capital operation". " No person to be permitted to smoke on the wards under any circumstances whatsoever". "Matron direct such patients as are admitted into the hospital with their hair on and if there appear cause for such patients' hair not being clean, that it be cut off immediately; and in case of refusal that she refer such objection to the next weekly Board". "A table of diet be wrote out and fixed up in the wards and read with the rules and orders".
The hospital was built mainly for the relief of the sick, lame and poor. It was a general hospital admitting all types of cases. A very common case was that of bladder stone, Norfolk had the reputation of being a county where the stone flourished, the stones collected between 1772 and 1822 are still kept at the hospital.
The first outpatient attended on July 25th 1771 and the first patient admitted to the wards on 7th November and on Boxing Day the first accident case was brought to the hospital. Many cases of stone; cancer of the oesophagus and breast; an epidemic of mumps ("A species of tumour called by the common people, the mumps"); tumours of the eye and rectum; uterine haemorrhage; amputations of limbs.
By modern standards the hospital was primitive, much like some of the taverns, inns and hotels London had to offer at the time. No drains; no trained nurses; nurses really only kept the wards clean and tidy; one resident doctor; no piped water; no anaesthetics; speed was an essential skill of the surgeon; no antiseptics; pus was still thought to be 'laudable'; frock coats stiffened with blood and pus from previous operations were worn in theatre. Joseph Cole and his horse were paid a shilling an hour to raise the water from a well.
Gooch helped to select the first members of the staff. Five physicians, three surgeons and three assistant surgeons were appointed at a meeting on 10th October. The physicians were John Beevor (1726-1815), John Manning (1730-1806), Dr Peter Hooke and Dr John Murray. Dr Dack was appointed but declined to accept. The surgeons were; William Donne (1746-1804) who performed 170 lithotomy operations during his 32 years on the staff; Mr C.Maltby and Joseph Rogers. The assistant surgeons were Mr Edward Rigby who was later "promoted" to physician. He had 12 children including quadruplets the patriotism of which was rewarded by the City with a presentation of plate - his wife's contribution was not mentioned - he was Lord Mayor in 1805; James Alderson (1742-1821) was a surgeon at the hospital for fifty years and was also promoted to physician - described by John Crosse as "a cunning man, with less candour in him than I like"; William Palgrave.
Sarah West was the first matron.
Gooch himself had been appointed Consultant Surgeon the day before but never did an operation. He was ill with kidney stones and was lame following his accident. The principal surgeons thought this an odd appointment and were at pains to define the limits to his duties. He died in 1776. He was interested in medical education, suggesting the formation of a library and pathological museum.
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