If the doctor, surgeon, or nursing persons could come to the patient's
home, little advantage could have been obtained in the seventeenth
century by moving the patient. The need did arise, however, to care for
persons outside the home. For example, an individual without family or
close friends might find it more convenient to move in with those who
would care for him on a professional basis, or newly arrived immigrants
and transients might need housing.
Quite in harmony with the needs of the period were the men and women
willing to take in a sick person in order to supplement their incomes.
Illness forced one colonial Virginian to offer in 1686 to grant his
plantation and his home to the person who would provide a wholesome
diet, washing, and lodging for him and his two daughters. The
beneficiary was also to carry the sick man to a doctor and to pay all
of his debts. It is probable that the man provided these services only
on this particular occasion, but by such special arrangements the
century housed its sick. The number of ill persons provided for by
relatives under similar arrangements or even without any compensation,
must have been even greater in a period without hospitals and nursing
homes.
On occasions, in the seventeenth century, the physician took the
patient into his own home, but not always without some reluctance. Dr.
Wyndham B. Blanton, in his search of the Virginia records for this
century, found an interesting account of Dr. George Lee of Surry
County, Virginia, who in 1676 had an unfortunate experience in letting
accommodations to a pregnant woman. Living in a house she considered
open and unavoidably cold, and having only one old sow for food, the
sick and feverish woman pleaded with the doctor to take her to his home
for the lying-in period. The doctor argued that the house could be made
warmer, suggested that neighbors bring in food, and protested that he
had only one room fit for such occupancy and that he and his wife used
it. Dr. Lee said he would not give up the room for anyone in Virginia.
Offering the opinion that the room was large enough for her, Dr. Lee,
and his wife, the expectant mother had her servant take her by boat to
Lee's where she remained, taking great quantities of medicine, until
she delivered. The doctor then had to bring suit to collect his fees.
Another example of a medical man's housing the sick, is that of a
surgeon promised 2,000 pounds of tobacco and "cask" if he cured the
blindness of a person he had housed--but only modest compensation if he
failed. The same surgeon received 1,000 pounds of tobacco in 1681 by
order of the vestry of Christ Church parish for keeping "one Mary
Teston, poore impotent person."
Much earlier, Virginia had what some authorities consider to be the
first hospital built in America. While the colony was still under the
administration of the London Company (1612), a structure was erected
near the present site of Dutch Gap on the James river to house the
sick. The hospital, which had provisions for medical and surgical
patients, stood opposite Henrico, a thriving outpost of the settlement
of Jamestown.
Evidence that the building was primarily designed for the sick and was
not simply a public guest house is to be found in the statements of
contemporaries. One described it as a "retreat or guest house for sicke
people, a high seat and wholesome air," while another wrote that "here
they were building also an hospitall with fourscore lodgings (and beds
alreadie sent to furnish them) for the sicke and lame, with keepers to
attend them for their comfort and recoverie." The use of the word
"hospital," which had then a general sense, does not indicate any
similarity to a present-day hospital as does the other information.
Nothing more appears about this establishment for the sick and wounded,
and it may well have been destroyed during the Indian uprising of 1622.
Plans for similar institutions in each of the major political and
geographical subdivisions of the colony came from the London Company.
Unlike the Henrico structure, these buildings bore the name "guest
house" and were to harbor the sick and to receive strangers.
Specifications called for twenty-five beds for fifty persons (which was
in accord with custom in public institutions); board partitions between
the beds; five conveniently placed chimneys; and windows enough to
provide ample fresh air.
The Company repeatedly recommended and urged the construction of these
guest houses not only as a retreat for the sick but also as a measure
to prevent illness among the newcomers. In addition, the guest houses,
if they had been built, would have saved the old settlers from being
exposed to the diseases of the new arrivals who were taken into private
homes. The colonists always had some excuse for delaying construction,
and the Company in 1621 entreated to the effect that it could not "but
apprehend with great grief the sufferings of these multitudes at their
first landing for want of guest houses where in they might have a while
sheltered themselves from the injuries of the air in the cold season."
That the London Company should have had the Henrico hospital built
during its administration and made plans for the guest houses can be
explained by the situation existing during the earlier days of the
colony. The Company, engaged in a commercial venture and realizing by
its own statement that "in the health of the people consisteth the very
life, strength, increase and prosperity of the whole general colony,"
had sufficient reason to shelter and care for the colonists. Also,
during the early days the number of incoming colonists was high
relative to the number settled and with lodging to give or to let. The
Company, in addition, knew that new arrivals fell victim most easily to
seasoning and other maladies, and needed protection from the elements.
Finally, the Company had to fill the void created by the absence of
religious orders which, during prior European colonization and
occupation of distant lands, had provided shelter and care. These
hospitals are no longer mentioned after the dissolution of the London
Company, nor were any other comparable measures taken during the
century to institutionalize care for the sick.