Notes on the Institutions for the Relief of the Sick, Wounded, and Disabled, of the Royal Navy
Authors: W. R. E. Smart
Journal: BMJ (1871)

DURING our visit to Plymouth, we may take a double interest, as Englishmen and as medical miien, in the grand objects of architectural and enginieerinig skill for the construction, conservation, and protection of the naval arm of our national defences.Amid so great an assemblage of notable works, we slhall find, as me- dical men, that there are many devoted to our own calling worthy of in- spection.The parent inistitution of this kind is the Naval Ilospital at Plymouth, which reflects the hlighest credit on the Admiralty.It is but a small indication of that widely spread care for the wants of the sick and wounded of the navy, that has done very much to remove the bad sanitary conditions that prevailcd to the end of the last century.It is the object of this paper, bir.President and gentlemen, to bring to your notice the more prominent facts in the growth of the naval medical system, and to show the successive steps by which its present condition has bcen reached.Our dockyards being for the care of the materials of our navy, and our hospitals for the care of the men, it became necessary that these should be twin-institutions ; but it was not until 1744 that an Order in Council provided for the conistruiction of the hospitals at Haslar and Stonehouse, near the great dockyards, on the ground of economy in money and men.Sir Gilbert Blanc writes thus : " The sick and wounded of the navy were first received into Ilaslar Ilospital in the year 1754, and it was completed about two years afterwards.Plymouth Hospital began first to be occupied in 1760, but was not completed till I764.' Previously to these dates, the sick and wounded were landed at the seaports, boarded in lodging-lhouses, and treated by civilians.The naval medical charges were thrown as much as possible on the Chest of Chatham.The sur- geons who attended the wounded, and the people who lodged and boarded them while under treatmnent, were, before the Commonwealth, paid out of the chest.Until the year 1763, there was no other source of out-pensionis.Until I796, the surgeons afloat were paid, out of its funds, twopence per man per month, to provide medicines and instru- ments ; and until 18i2, the chaplains received from it fourpence a man per month (" by the ancient custom of the service"), as the main part of their emoluments ; the funds being derived from stoppages out of the pay of the seamen anid officers.The Chest was an early benefit societv, or brotherhood, like other trade guilds and corporations.It swas the parent of our naval medical departnment, pensicn office, spiritual aid, and system of education for navigating officers.It was, indeed, a venerable institution, founded on the principle of self-help, by those gallant and charitable spirits, who stayed to play out their game of bowls in the little amphitheatre under the Hoe, before they embarked, with light hearts, to combat the great Armada, whose sails then whitened the horizon.In the year i654-5, a period of war, the income of the Chest was Z4512: 10: I 1, and its expenditure was £4531: 18: iol, out of which were paid pensions to wounded meni, relief to widows, the charges for the wounded of the navy, aid to the inmates of Sir John Hawkins's alms-houses at Rochester, a gift to a teacher of navigation to all comers at Cliatham, and the salaries of the surgeons at Chatliam, Wool%vich, and Deptford.In the year iSo2, the income had reached £So,ooo, and the deposits in the Consols amounted to £281,500, undergoing yearly increase, wliile the demand on the Chest for pensions was decreasing.There were only 8094 pensioners, of whom it was said many wvere not neces- sitous, receivin-aid according to this scale: For the loss of both eyes ........