From The Annual Journal

So, what was life like at the inception of our beloved Middlesex Hospital in 1745, amidst the slum dwellers, gin drinkers and prostitutes of Georgian London?

In the same year the College of Surgeons was founded near Newgate Prison, when they split from their barber colleagues. John and William Hunter were leading surgeons and anatomists at the time, with the procedure of dissection of cadavers becoming more common. Specialist hospitals sprung up much later in the nineteenth century, so we can assume that the first Windmill Street hospital catered for generic conditions. A lying-in hospital for married women was opened nearby at Betterton Street, WC2 in 1749, so unmarried woman would have been turned away and possibly left their illegitimate children at the Foundling Hospital opened by Thomas Coram in 1741.

Hygiene was poor, the roads had open sewers, women not yet wearing underwear until the following century. Medical knowledge was limited and many succumbed to infectious disease, particularly smallpox. Smallpox was no discriminator of class, with the wealthy as well as the poor dying young. Lady Mary Wortley Montagu (1689–1762) introduced the practice of smallpox inoculation because of travels to Turkey, where she witnessed the success of inoculation first-hand. She persuaded Queen Caroline to have her own children inoculated. Syphilis was also rampant, with the use of wigs a popular fashion accessory, hiding the tell-tale hair loss that accompanied the disease. Not until the end of the eighteenth century did wigs fall out of fashion, mainly because of the rising tax on wig powder imposed by William Pitt the Younger. There had been a bad wheat harvest and the powder was obtained from the ground wheat.

So, who were the first patients and what were their complaints? What level of medical training was there? How much would people have paid for their care at that time? Anaesthesia became part of surgical practice from 1846, so what impact did this have on the hospital’s treatment and outcomes in the next Century?