London hospital that has survived nine centuries will not see another

April 23, 1995|By Bill Glauber | Bill Glauber,London Bureau of The Sun

LONDON -- At the hospital founded more than 300 years before Columbus landed in America, nine centuries of medicine are crammed into a dim basement vault.

Here a bleeding bowl, there a pair of flint-lock pistols once brandished by the hospital rent collector. Atop a cabinet is a 19th-century amputation kit, the saw sharpened, the tools shimmering in a red felt case.

And over there, propped on its side, is the framed hospital charter signed by Henry VIII in 1546. By the standards of the Royal Hospital at St. Bartholomew, the parchment is only middle-aged.

"It's one of the last documents the king signed before he $H became incapacitated by syphilis and died," says Andrew Griffin, the hospital archivist.

Now, all that history may be coming to a close. St. Bartholomew's has stood on the same site since 1123, but it is targeted for extinction by changing demographics and financial belt-tightening in Britain's National Health Service.

The hospital, set to be closed and merged with another by the turn of the century, is already taking on a ghost-town appearance. The 18th-, 19th- and 20th-century buildings house fewer and fewer patients.

The emergency room shut down in January. The staff is demoralized.

At St. Bartholomew's, known locally as Bart's, physicians have treated medieval plagues and AIDS. It survived the bombing raids of two world wars and the introduction of socialized medicine in 1948.

"This hospital is older than Parliament," says Mr. Griffin. "When this hospital was founded, there would have been people who remembered the Battle of Hastings in 1066."

It was the man known as Rahere, a figure in the court of King Henry I, who established the hospital after falling ill in Rome, praying to God and striking a bargain: If he was cured and returned safely to England, he would build a hospital for London's poor.

Rahere was restored to health and on his journey home had a vision involving St. Bartholomew, who told him that he should dedicate a priory church and hospital to the saint and build it in Smithfield, then a marsh just beyond London's walls.

So began modern medicine for London's poor at an Augustinian monastery. The sick came to St. Bartholomew's for rest, food and prayer, served up by a master, eight brothers and four nuns.

"You have to think of Bart's in the 12th century as a hospice, a sanctuary," Mr. Griffin says. "They were dealing with all sorts of hideous skin diseases and infections. And malnutrition. At different times, the hospital wouldn't take in the incurables."

A surviving 12th-century manuscript details the patients and cures. St. Bartholomew's was sustained by daily begging for food and daily prayers. Over and over, there are tales of the blind, the mute and the disabled being cured through prayer.

But there is also a tale of one patient, Adwyne the carpenter, whose paralysis was cured through rudimentary physiotherapy.

The brutality of primitive surgery wouldn't begin until the 16th century, about the time the hospital was reorganized as a secular institution by Henry VIII.

"The operations would have been barbaric," Mr. Griffin says. "Someone would come in with a stone in the bladder, and the surgeon would cut him open. An amputation would have been handled by hacking off the limb and cauterizing the wound. Back then, surgical skill would be measured in how quickly someone could perform the operation."

Over the centuries, the hospital attracted a rich mix of medical characters.

There was Roderigo Lopez, the hospital's first physician, hanged in 1594 after being accused of trying to poison Elizabeth I.

While working at St. Bartholomew's in the 17th century, William Harvey discovered the circulation of the blood. John Woodall made a case against the then-routine procedure of blood-letting. He also found that lemon juice could remedy scurvy, a fact that would be rediscovered about 100 years later.

In the 18th century, John Abernethy led the move away from amputation. Early in its history, the hospital's surgeons had been paid by the amputation: The more limbs they severed, the higher the surgeons' incomes.

But in what may be the earliest case of managed care, the hospital changed rules so that amputations could be performed only after approval from the hospital's treasurer, governors and other surgeons, plus notification of the patient's friends.

Bart's began collecting pathology specimens, hired a lecturer in midwifery, created a nursing school and built a residential college for medical students -- all well before the Johns Hopkins School of Medicine opened in 1893.

But today, while a big-city hospital like Johns Hopkins thrives, St. Bartholomew's is preparing for its own death.

A few weeks ago, the ward named after a famous cricketer -- William Gilbert Grace -- was closed, and Mr. Griffin found himself with one of Mr. Grace's old cricket bats.

"It's like having one of Babe Ruth's baseball bats," Mr. Griffin says.

The archivist searched for a place to put the cricket bat, finally finding an empty corner in the basement vault.

Another artifact now gathers dust in a medieval medicine cabinet.

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