From the moment when the first thirty babies were admitted to the Foundling Hospital on 25 March 1741, the Governors of the Hospital were determined to do as much as possible to protect foundlings from ‘the speckled monster’.
At this point inoculation for smallpox was available to the wealthy but it was not yet common practice. However, with committee members such as Dr Richard Mead, the Foundling Hospital developed a progressive health policy.
All staff at the Hospital had to have survived smallpox and all the children that had not had smallpox ‘in the natural way’ were to be inoculated at the age of three before they entered the hospital.
When babies were admitted they were immediately sent to wet nurses outside the city. These women were paid to look after the children for the first few years of their lives, after which they returned to the hospital between the ages of three and five. It was only then that the foundlings were inoculated.
The period when the infants were being looked after outside the hospital was by no means safe. Of the 1,328 children sent to nurse between 1741 and 1756, over 40% died before they could return to London. This is certainly high, but child mortality was often this high in the period, even among wealthy families – the second Duke and Duchess of Richmond had twelve children, only seven of whom lived to adulthood.
The most common causes of death recorded for foundlings when out to nurse in the country were ‘convulsions’, ‘consumption’ and ‘whooping cough’. Surprisingly, the Foundling Hospital’s inspectors only reported seven deaths from smallpox.
Inoculation upon the children’s return to the city was done in off-site infirmaries so that the children would not infect others at the Hospital while still contagious. By the end of April 1756, two hundred and forty-seven children had been inoculated and only one child had died as a result. The General Committee was so proud of this record that it ordered that details should be sent to newspapers for publication.
Between 1756 and 1773 there were thirty-six deaths from smallpox – 27% of all of the deaths in the hospital. There may have been more than this, as the cause of death was not always recorded, but Governors and medical staff knew how serious smallpox could be so would have been anxious to make sure that every death from smallpox was noted.
This number of deaths must have surprised the Governors – their system of inoculation was not working as well as it should have done. There were possibly some cases where nurses thought their charges had had smallpox when this was in fact not the case. There may also have been some cases where inoculation had not ‘taken’ for some uknown reason.
Compared to their peers, even the wealthy, the foundlings were well protected from ‘the speckled monster’. Although the death figures seem high, the Foundling Hospital’s health policy did much to prevent serious outbreaks of smallpox, long before inoculation was introduced by other similar institutions.
Minute books recording Mead’s involvement in the establishment of the Foundling Hospital, and its attempts to provide state-of-the-art medical care to the children, are on display in the exhibition The Generous Georgian: Dr Richard Mead, alongside various other items exploring Mead’s role at the Hospital and his position as an eminent physician, collector and patron of Georgian London.
My next post will explore the experiments of Sir William Watson, a Foundling Hospital physician, into different methods of inoculation carried out at the Foundling Hospital’s infirmaries.