The Sun.
London, England, 1866-01-03 00:00:00

VILLAGE HOSPITALS.

If a man in some remote country district happens
to meet with a severe accident which for a time dis-
ables him, he speedily finds out that the country
lacks many of those elements of civilisation which he
looks upon as a matter of course in large towns. He
must not expect a skilled surgeon on the moment to
perform some critical operation, or would look in
vain for a trained nurse, or indeed for any of those
appliances and means of alleviating his sufferings
which await the cabman or the dock labourer in
a metropolitan hospital, which, in many instances,
render these institutions preferable to his own home.
Our great centres of civilisation are amply supplied
with these medical houses of refuge, but their in-
fluence and advantages are but small when com-
pared with the area of the rural districts. One of
the first inquiries a gentleman makes when taking
up his residence in the country is with reference to
the skill of the village practitioner, on whom, if he
happens to be of infirm health, so much of his com-
fort depends. Now, the case of the gentleman who
spends a portion of his time only " outof town" is
the perpetual state of the rural population. Of old
the nature of their occupations did not entail upon
them any chance of severe accidents, but the intro-
duction of steam machinery into agricultural labours
has changed all this, and the labourer is now as
liable as any artisan to those dreadful casualties
to which machinery gives rise, and which require
prompt treatment upon the spot. " Necessity,"
says the old adage, "is the mother of invention,"
and the increase of such accidents of late years led
a village practitioner (Mr. Albert Napper, of Cran-
ley, in Surrey) in the year 1859 to establish a village
hospital—not such an institution as we are accus-
tomed to in great cities (grand establishments, with
a staff that eats up a large portion of the subscrip-
tions), but a simple cottage, fitted up with six beds,
with one surgeon, who visits every day, and oftener
when necessary, a nurse, and a general servant.
The cottage in this instance was provided, rent free,
by the Rev. Mr. Sapte, the vicar of the parish, who
has by his active co-operation greatly aided Mr.
Napper in the working out of his idea. From the
first moment the experiment was a success. The
labourer found in his hour of need what ho could
not find in his own confined cottage, nor in the
workhouse—a trained nurse, acting under the eye
of the surgeon, skilled in emergencies, and furnished
with all the appliances necessary for his case.
When any serious accident happens to a rural
labourer, in the majority of cases, he is at once
removed to the nearest county or town hospital,
often at great physical agony to the patient,
who has, perhaps, with a broken limb, to be jolted
over long distances in a country cart on a rough
road. From these preliminary agonies and dangers
for which man is responsible the village hospital at
once emancipates him, and the gain is not only to
the poor patient. As a rule, except in mining and
manufacturing districts, operating surgeons of eX-
perience are rarely to be found in rural districts ;
the surgery general practitioners have learnt during
their studies, the capital operations they have wit-
nessed in the operating theatre of St. Bartholomew's
or St. Thomas's, are remembered only as exciting
incidents in their student days. In the ordinary
routine of practice they rarely meet with such cases,
and when they do, as we have said before, they send
them to the great towns, where all the appliances of
art are at hand, and the best skill of the surgeon is to
be found. The want of such experience is, of course,
a loss to the better classes of the country side. It is
clear, therefore, that these village hospitals will act
as a school in which the skill of the surgeon is kept
up. The lessons he learns day by day in them, in
time of need, is of value in the ancestral hall. Thus
the poor peasant's misfortune may be the cause of
saving the life of the squire.
One of the most valuable features of the village
hospital system, as we find it working at Cranley,
is the payment by the patient of a weekly contribu-
tion towards its funds. The amount of this pay-
ment is estimated according to his means by his
employer and the manager of the hospital. It has
been found that this rule has never been objected
to, and there can be little doubt that it tends to
maintain the self-respect of the patient. Those
only who are acquainted with the working of the
London hospitals are aware of the shameful abuse
of these charities by a class of patients who are well
able to contribute to its funds, but who prefer to
seek their aid in the shabbiest clothes rather than
be refused. Persons whose means are ample are
mean enough to practise these arts from day to day ;
it is therefore all the more gratifying to know that
the poor agricultural labourer willingly pays for the
services rendered to him, and that to an extent
which amounts to a full third of the entire,expenses
of the hospital.

In order to prevent the absorption of the limited
number of beds by chronic cases, only those patients
who cannot be effectually treated at their own homes
are admitted, and subscribers are not allowed, as in
other hospitals, the privilege of ordering the admis-
sion of any patient—a privilege which is but too
often abused. The example of the Cranky village
hospital, after its successful career of six years, has
led to the establishment of similar hospitalsin many
other rural districts—at Bourton-on-the-Water, at
Fowey, at Wrington, at East Grinstead, and at St.
Andrew's, Fifeshire. Indeed, the idea has now
taken such hold that we may speedily anticipate
their establishment in most well-ordered villages
remote from the medical charities of the large
towns. The Ladies Bountiful of our rural districts,
who have hitherto exercised their leech-craft among
the poor, will here render still more valuable aid—
that of affording human sympathy and kindness to
the poor inmates, provided they do not mar their
usefulness by interfering too much with the doctor.
As many of our readers may like to be acquainted
with the details of these village hospitals, we cannot
do better than describe their requirements accord-
ing to the experience of their founder. Mr. Nap-
per says, " to accommodate from 6 to 8 patients a
small farm-house or double-tenemented cottage,
having on the ground-flour a kitchen, scullery, sit-
ting-room, and larder, and upstairs from four to six
rooms, well ventilated," is all that is necessary in the
way of house accommodation, while the furniture is
planned on an equally moderate scale ; a kitchen
range, dresser, bath, easy chair, clock, common
chairs and tables, and iron bedsteads with horse-
hair mattresses, bed-linen, &c., fulfil all the re-
quirements of these economical little establishments.
The total cost, indeed, of furnishing a hospital for
six beds is only £7O. The sum is so small, and
the value of these maisons de sante so great to a
remote rural community, that we feel sure that
the idea only requires to •be made known to be
widely acted upon. We may safely say that
medicine was never more economically administered,