As Newcastle's Royal Victoria Infirmary turns 100 on July 11, Hannah Davies celebrates the milestone in the first of a four-part feature series.
Imagine a time before hospitals existed. What would happen if you fell ill? Or if you broke a bone?
Before the creation of the great Victorian infirmaries, it was the city corporations that provided often inadequate medical care.
In Newcastle in 1592, irregular payments were made to apothecaries for responding to the mayor's requests to attend the sick. In 1599 one doctor was employed by the corporation, a system which carried on until 1700 when a surgeon was appointed.
But there was a clear need for a hospital. And, as a slow-growing awareness for the needs of the poor grew, the idea for creating a hospital in Newcastle which would cater for those unable to afford to pay for a doctor, took off.
The first suggestion that the city should have an infirmary came via a letter to the Newcastle Courant - a direct ancestor of The Journal.
In January 1751 a reader known only as BK came up with the idea of an infirmary, a proposal that captured the public's imagination.
Subscription lists were opened in coffee houses and elsewhere, and there was an immediate and generous response.
Newcastle City Corporation gave a site on Forth Banks (just south of where the Centre For Life is today) for the purpose.
However, enthusiasm was so great a building in Gallowgate was established prior to its opening. This had just 23 beds.
At that time the hospital employed its own brewer, who received an annual salary of £7 - almost twice that of nurses, who were paid just £4 a year.
In a bid to treat more people, rooms were hired in neighbouring houses until a new building could be opened.
Luckily work at Forth Banks was nearing completion and on October 8, 1753, the Newcastle Infirmary was opened.
Although better than no hospital at all, conditions at the Newcastle Infirmary would be regarded as appalling by today's standards.
Staffing was basic and nurses were non-resident and mainly illiterate. Most nursing was actually done by the patients themselves. Frequently a disturbed or seriously ill patient was put in a room with a reasonably healthy person, who was instructed to care for them.
Disorderly, dirty and drunk patients (and sometimes staff) would find their names posted shamefully in the wards.
With little more than 100 patients able to stay in the hospital, it was pitifully unable to care for the people of Newcastle.
On January 18, 1855 The Dobson Wing was opened to combat overcrowding, giving an extra 144 beds.
The Royal Victoria Infirmary
In 1896 it was suggested by Mr Riley Lord - later to become Sir Riley - that a new infirmary should be built in honour of Queen Victoria's Diamond Jubilee.
Conditions at the old Newcastle Infirmary were becoming intolerable, so a design competition for a new hospital at the Forth Banks site was held.
This was abandoned as the Newcastle-Carlisle Railway had taken off to such an extent the previously rural Forth Banks was now in the middle of a mess of railway lines and city centre traffic.
A new site needed to be found. When a 10-acre area of land near Leazes Park became available a new design competition was held. In 1899 it was won by architects WL Newcombe and Percy Adams of Newcastle.
On June 20, 1900, the foundation stone was laid at Leazes by the then Prince of Wales. Before her death in 1901, the Queen commanded that the new hospital be called the Royal Victoria Infirmary.
Building took six years. Where the Newcastle Infirmary was frequently rife with infectious disease, the RVI's wards were built to a plan laid down by Florence Nightingale, who had revolutionised the nursing profession.
The RVI - with 17 wards, 89 nursing staff and 293 beds - was finally opened by Edward VII on July 11, 1906.
Nightingale wards were light, airy and spaced apart. They included fireplaces and dining tables down the middle. Great emphasis was put on fresh air and cleanliness - records show 1,118 gallons of floor polish was applied in 1909 - as an integral part of treatment, as well as a means of preventing the spread of infection.
Heating in winter was by means of the central fire in each ward. This was often taken care of by a convalescent patient with stoking experience.
Flues from the fires ran beneath the floors to tall chimneys, traces of which can still be seen despite them being removed in the 1960s.
The corridor connecting the ward entrance to the bedded area had small rooms leading off on either side. In the early part of the last century these comprised the ward kitchen, the ward sister's room, a linen room, a clinical investigation room and a patients' day room.
There were just four honorary physicians responsible for the care of patients in the six medical wards, and one honorary physician to the Skin Department when the RVI opened.
Today there are around 60 consultant physicians.
The hospital could not have been run without the honorary doctors, who worked for free and supported themselves solely from the fees they charged private patients.
Honorary service lasted until the introduction of the NHS in 1948, when free medical treatment became available to all.
The honoraries' duties were light compared to what today's doctors have to perform.
Typically they would attend just two mornings a week for ward rounds. As the average patient's stay then was four weeks, this was considered more than enough attention.
The children's wards
When the RVI opened there were two children's wards - the Ochiltree for girls and the Victoria for boys.
At this time, no distinction was made between doctors treating adults and youngsters. The numbers of children admitted to the hospital were not recorded separately from adult patients until 1931.
However, it was noted in an RVI report of 1910 that there had been a big increase in child outpatients.
The note says there was "abuse of the hospital facilities by poor people who really needed nourishing food rather than medical treatment".
Due to slum housing conditions in the early part of the 20th Century, disease and infection was rife, with parents often barred from visiting their children in hospital in a bid to curb its spread.
In 1919 a note in the RVI archives shows the question of infection was beginning to be addressed, though. It reads: "It is said on sound authority that 50% of the blind are blind because of opthalmia, curable in almost every instance if treated skillfully at an early date."
Newcastle hospitals timeline
September 5, 1751: Newcastle Infirmary foundation stone laid by The Bishop of Durham, Right Reverend Joseph Butler.
October 8, 1753: Newcastle Infirmary is opened.
June 16, 1887: The new Newcastle hospital designated The Royal Victoria Infirmary by Queen Victoria.
June 20, 1900: The foundation stone for the new Royal Victoria Infirmary is laid by Albert Edward, Prince of Wales.
July 11, 1906: Official opening of the RVI by King Edward VII accompanied by Queen Alexandra.