The Infirmary of the Glasgow Town's Hospital, 1733-1800: A Case for Voluntarism?

Introduction

Eighteenth-century Britain experienced a flurry of hospital foundation. Between 1719 and the opening of the infirmary of the Glasgow Town’s Hospital in 1740, eight voluntary hospitals were founded countrywide. By the end of the century there were at least forty infirmaries (thirty-three voluntary hospitals), besides a number of clinics and dispensaries, which had evolved into hospitals by the nineteenth century. ¹ In all, some 150 British medical foundations sprang into life, originating in the provision of charitable health care for the poor. The infirmary of the Glasgow Town’s Hospital has yet to be given a place within this development: in most recent accounts, the Glasgow Royal Infirmary takes precedence as the west of Scotland’s first voluntary hospital, while the infirmary of the Town’s Hospital is generally relegated to the realm of poorhouse history. ² I would like to argue that this infirmary can be perceived as part of the voluntary hospital movement. It has not been included among the other infirmaries (except notably in histories written by clinicians) ³ because little attention has been paid to its medical provision, but also because it was a hybrid contribution more difficult to classify. It combined features of the older hospital tradition, in which institutions were supported by both municipal sources and voluntary subscribers and employed salaried physicians, and of the newer voluntary hospitals, which were maintained by voluntary subscription and attended by physicians gratis. Yet it was in precisely those settings where medicine became entwined with poor relief, and where social differentiation was articulated through public charity, as Mary Fissell has demonstrated, that the relationship between healer and patient metamorphosed from one of client/patron to that of professional/working-class poor. ⁴

The following discussion considers the planning and administration of the infirmary of the Glasgow Town’s Hospital, the medical attendance provided there by the Faculty of Physicians and Surgeons of Glasgow, and clinical instruction between 1733 and 1800. These dates take the study from the founding of the Hospital to the close of the century—a point shortly after the opening of the Glasgow Royal Infirmary in 1794, but before the departure of the lunatic patients in 1814. ⁵ However, the paucity of extant clinical records for the infirmary makes it difficult either to establish a complete patient profile or to show definitively how disease was treated, though incidental details of medical care of the sick at least give hints about the theory and practice of medicine in Glasgow during this period. ⁶ On the other hand, the Town’s Hospital kept administrative records because of the need to account to its subscribers. ⁷ These sources reveal that the Town’s Hospital was a significant and up-to-date, if not necessarily innovative, focus for medical care in Glasgow, and is worthy of greater attention than it has hitherto been paid.

I. Foundation and Administration

Founded in 1730, the Glasgow Town’s Hospital officially opened to receive the poor of the town on 15 November 1733. ⁸ The initiative came from a committee appointed by the general session of the Kirk in Glasgow who, on 2 December 1729, petitioned the Town Council to erect such an institution. ⁹ Prior to the 1845 Scottish Poor Law, the administration of poor relief in the burghs was the responsibility of the Town Councils, though in practice they tended to delegate to other organizations. By February 1731, £1,200 sterling had been promised in subscriptions from individuals: “The richer persons signed twenty and twenty-five pounds; the ordinary merchants and shopkeepers ten and five pounds.” ¹⁰ On 6 April 1731, the Town Council embodied in an act its proposals for a Charity Workhouse, to which the craft guilds also agreed to pay twelve pounds per annum, voluntarily, for five years, and then to reassess their contribution (they continued to pay in this manner until the Town Council formalized the voluntary contribution). ¹¹

The Hospital’s founding charter was duly sanctioned, on 3 January 1744, by an act of Glasgow...