Two centuries of progress in making Norwich well again

To understand the matter of the chimney we have to go back 200 years. The city and county both prospered at that time and their people increased yearly in numbers; but (according to modern ideas) living conditions were bad and even for thrifty working people there was only a small margin between being able to 'manage' and being forced to depend on charity. The philosophy of the times, too, was hard: God had created the high and the low, work was part of the process of salvation, and only if you were diligent and God-fearing would all be well in this world and the next.

Unfortunately, accident and disease - and horse-drawn traffic and squalid living conditions produced plenty of each - could bring even the most deserving family to the verge of starvation. 'What confusion and distress,' one contemporary wrote feelingly, 'must enter a family when the father is overcome with one of the innumerable accidents and how deplorably wretchedness is increased when sickness visits any member of the family.'

The first firm proposal for a hospital for Norfolk and Norwich was made at a public meeting called by a Mr. William Fellowes, of Shotesham, in 1770. Shortly afterwards, the City Council made the St. Stephen's site available at only a nominal rent and so enabled the first step towards fulfilment to be taken.

Subsequently, 'so great was the sentiment in favour that the funds (some £13,000) had been raised, plans for the building adopted and the fabric reared, fitted and furnished in little more than two years.' In this way did the Norfolk and Norwich Hospital come to the city.

The building, in the form of a great H, had many of the characteristic features which we nowadays find so satisfying - red brick, beautiful proportions, large, well-placed windows and a most imposing front porch and doorway - and it justifiably generated a great deal of local pride; so, when it took its first seven in-patients in November, 1772, the event was marked by celebration in the city.

The original rules throw an interesting light upon charitable attitudes of the times. Since public subscribers had provided the hospital, donors naturally expected to be able to see that their money was well spent. A gift of two guineas brought governorship for a year and one of 20 guineas the same for life.

All governors in turn had to visit the hospital every day for a week and 'walk through the wards with White Wands in their hands and enquire of the patients whether the Physicians, Surgeons, Matron and Nurses had attended them agreeably, and enquiry of the Matron and Nurses whether the patients had all conducted themselves decently.'

People today question the effectiveness of medical treatment long years in the past and of course there were many deficiencies. But the 18th century was one of new ideas - on ventilation, sanitation and cleanliness - and some people held advanced views. The matron of the Norfolk and Norwich Hospital was then judged to be 'most unusually able' and as a result the hospital acquired a reputation for being 'kept very neat and clean, not crowded with beds and well ventilated.'

True, the floors were sanded in the same way and for the same reasons that public-house floors were until comparatively recently, but they were swept daily and entirely washed each week. This by the standard of the times was cleanliness amounting almost to mania.

One can doubt, too, the efficiency of medicines and surgery of those days, for drugs were very few and surgery without antiseptics was dangerous. Even so, cold baths, enforced rest, clean living conditions and dieting cannot have failed to be beneficial.

As for surgery, the risks were perhaps fewer than we imagine.

One of the main local troubles was 'the stone' for which people had to be 'cut.' The stones extracted were kept in a special chest-of-drawers and put on public display; and so successful was 'cutting' that after 20 years or so the chest was crammed so full that another had to be ordered. In fact, whatever the limitations and dangers the hospital had dealt with 12,000 people by the end of the 18th century and of these 'upwards of 7000 have been dismissed in perfect health.'

The early years presented their problems, of course. How to advance surgically was always difficult; but it became not unknown for the bodies of executed murderers to be provided for the hospital and doubtless there were other sources too. Money was always scarce.

In 1824, however, someone conceived the idea of a Grand Musical Festival to help the funds. It proved such an enormous success, as did the repeat three years later, that it was decided to make it a permanent function. And so was born the Norfolk and Norwich Triennial Festival.

Walk along St Stephen's Road, going away from the city, and there the new hospital chimney is on the right, rearing up like a rocket launcher, monstrous, a thing of no beauty. I hate its massiveness and the domination it exercises over that part of the city.

But it symbolises progress - in medical science, in humanity and in ideas - and one has to weight the balance of advantages. Clearly, in this case, they are well on the side of progress.