BASCHURCH

 

SOME time in the ’nineties a lady called Agnes Hunt, a member of an old Shropshire family and a sister of Rowland Hunt, one time Member for the Ludlow Division of Shropshire, became interested in the crippled child. Miss Hunt had entered the Royal Alexandra Hospital, Rhyl, as a pupil in 1887, completed her training at Salop Infirmary in 1890, and joined the Queen’s Jubilee Nurses in 1891. Crippled herself she decided with a friend—the late Miss Goodford— to start a small and extremely unconventional home.

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Baschurch, a tiny village near Oswestry in Shropshire, was near the residence of the Hunt family. It was here in sheds beside a small private house that Agnes Hunt and Miss Goodford decided to experiment in the nursing of sick children. Agnes Hunt was staunchly supported by her mother—a lady of great character—and her relatives and friends. The general feeling was that the venture should not be discouraged for the short time it would survive !

 

Baschurch was, in its origin, an adventure with singularly little promise of a world-wide influence. “ The drainage,” Dame Agnes has since recorded, “ was primitive, the water supply a surface well fourteen feet deep, situated under the scullery floor. The garden, which for six years had run riot,

came right up and obliterated the door and cave-like passage leading from the house. In after years this passage was named by the children ‘ The Lion’s Den.’ The stables and cow-houses joined the house. The whole ‘ estate ’ occupied about three quarters of an acre.

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“ Encouraged by such affluence a committee was appointed with an honorary surgeon and an honorary physician, while the nearest doctor kindly offered to act as honorary medical officer to the Home. The first Committee met on October 1st, 1900, and the Home was afterwards declared open and ready to receive four little girls and four little boys needing country air and good food.

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“ Now a curious fact appeared. The home exerted a magnetic attraction towards cripples, for which it was in nowise suited. The staircase leading up to the two large rooms, ambitiously entitled wards, was never meant for their transport. In due course at the foot of this staircase the following conversation took place :—‘ This is too dangerous. We shall probably kill one of the children, and most certainly ourselves. The doctor always says that fresh air and sunshine are essential; for goodness sake let’s build a shed in the garden and let them live in it night and day ! ’

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“ The doctor was consulted, but shook his head and thought the cold would be dangerous. It was, however, pointed out that nothing could be more dangerous than those stairs. So somewhat anxiously he gave his consent.

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“ The only difficulty was money ! Five pounds was all the cash available, and with that we made a concrete floor. Now the landlord of the Home (Rowland Hunt) had thoughtfully joined up in the South African War, and left in his park, some two miles off, several wooden and corrugated iron stables

that did not appear to be of much use to anyone, as the horses had been sold. The agent lived a long way off. The stables were removed without attracting any attention, and the first

open air shed was built.

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“ The children did most marvelously well. Colds and coughs disappeared. More sheds became necessary. A certain amount of commandeered stuff remained, but not enough. Unfortunately for herself, my mother had come to live at the Home. She built a beautiful wall on the northern aspect of

the garden on which to grow peaches and apricots. Just before it was finished she went away for a holiday. With the aid of that wall and the remainder of the stuff from the patriot’s stables, and the gift of twenty pounds, two sheds were built to hold sixteen boys and sixteen girls, with two small bathrooms and lavatories. No peaches or apricots ever grew on that wall.

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“ In those early days children used to be sent to the Home to get up a little strength before undergoing another operation. These children, suffering chiefly from tubercular joints, improved to such an extent that, in nine cases out of ten, operations were unnecessary, after a stay of two or three months, and this in spite of what we should now call faulty splintage.”

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In other words the treatment of crippled children in the open-air, and with adequate rest and proper food, worked marvels.

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That was the first stage. 

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The second stage came with the periodical visits which Miss Hunt took, accompanied by her patients, to the Royal Southern Hospital, Liverpool. McCrae Aitken has told the preliminaries admirably. “ When I was House Surgeon in Liverpool, there arrived from time to time at Mr. Robert

Jones’ out-patient clinic at the Southern Hospital a woman, an outside porter from the railway station, and a home-made handcart like a large baker’s tray on perambulator wheels.

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The cart contained crippled children, perhaps as many as eight, in various forms of splints. It was cheaper to hire an outside porter in Liverpool than to pay the fare of somebody from Baschurch. A return train had to be caught, so the party was soon inspected, those requiring operative treatment

in hospital were admitted, cases left at a previous visit were put on the handcart; apparently it was as easy as changing books at the library. I cannot remember that even the most junior of house surgeons ever ventured to think that there might not be room to take a case in at once. That was Miss Hunt ! If a cripple requires treatment, that treatment brooks no delay, and no inadequacy of means would be permitted to stand in its way.”

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The first meeting between Robert Jones and Agnes Hunt was no less informal. “ My first experience of Miss Hunt,” he said, “ occurred in the out-patient department at the Royal Southern Hospital, when I saw a lady on crutches in charge of six children lying upon a railway truck. After a conversation with her, not knowing that she was by my side, I said to my House Surgeon, ‘ This is a very intelligent woman.

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She heard the observation, and I shall never forget her ringing laugh and the reply—‘ You bet.”

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What interested Robert Jones, in the Baschurch children, was their obvious improvement in health under just those conditions which he was convinced were essential, united with modern orthopaedic surgery. Accordingly he visited Baschurch, and it was from that association that the first open-air

hospital for crippled children was established. It was the pioneer of the principle to which Robert Jones referred when he said in 1925 :

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“ A long experience has taught me the injustice of segregating sick and deformed children in the vitiated air of city hospital wards. Over twenty years ago, with the help of Miss Hunt, we started the first really open-air hospital in the world, where the children lived in the open air by day and by night

all the year round. This was followed by the large country hospital at Heswall, and later at Ruislip and Pinner. In none of these hospitals is there any possibility of closing the wards, and through sunshine and storm, snow and sleet, one side of the shed is always absent. It is a most inspiring sight to visit the children. Gaiety reigns rampant. Infectious disease—the bane of hospital wards—has never spread, nor has there been one instance of so-called ‘ catching cold ’ or pneumonia. At Baschurch, this principle of open air was extended to soldiers, and nowhere in my military experiences have I met with more contented men or such rapid healing of wounds. The sheds are cheap and decrepit—there is an air of penury about it all—but it is the birthplace of a great reform,

which is steadily gaining ground all over the world. Already several hospitals have sprung up in the United States based upon this rough Shropshire model. I have emphasized this subject because I feel very strongly that orthopaedic surgeons should convince hospital authorities of the urgent necessity for open-air annexes for the active treatment of crippled children.”

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Baschurch was a pioneer also in the psychological treatment of the cripple. It preached the gospel of the cheerful heart, and the danger of sentimentality ; it proved that elaborate equipment is not the same as cure, or a large staff the first principle of recovery. Visiting surgeons learned more than

the new possibilities of surgery, more than the magical qualities of exposure to the air ; they realised that deformity is a physical and not a spiritual handicap.

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To quote Dame Agnes again—“ The early operations were primitive. They created a profound impression amongst the inhabitants of Baschurch, who were not a little shocked to hear that operations would be performed on Sunday, and complained that they smelt the ether during divine service in the parish church some eight hundred yards away.

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“ The Home, being very poor, sent out an S.O.S. to all their friends and neighbours for towels, fish kettles, etc. Very naturally everybody sent their oldest towels and hurriedly said they did not want them back. This was not surprising, as they proved to be more holes than towels, and Sir Robert

decided that somehow new towels must be provided for his next visit.”

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“ I was privileged to be at Baschurch,” writes the Honourable Mrs. Stirling, “ on the first operation day. After the operations were over, and Sir Robert Jones emerged from his hours of incarceration in the very hot dining-room, and when he had partaken of the wonderful meal of lunch and tea combined which awaited him, he rushed out to the sheds to look at inpatients and out-patients before starting on his sixty mile drive back to Liverpool. I remember Sir Robert examining four small patients in one bed with that concentration and care so characteristic of him ; after he had done with the four children on the bed—a medley of arms and legs and splints— his looking very carefully under the bed and saying, ‘ Are there no patients under the bed, Sister Hunt ? ’ ”

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Baschurch was a delightful contrast in efficiency and laughter.

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It must have been the jolliest pioneer hospital in the world. To say this is not merely a pleasantry. Robert Jones took very seriously the relationship between the spirit of happiness and orthopaedic treatment. He knew not only that crippling deformities produce a sense of inferiority partly traditional and partly psychological, but also that prolonged illness calls for a cheerful environment in the medical staff and the patients.

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In Agnes Hunt existed the spirit Robert Jones had sought and found. After a very brief experience he knew that at Baschurch there was the opportunity to test a completely new theory of mental and bodily treatment of deformity. Both shared the same enthusiasm, the same spirit of adventure, and what is perhaps the best link in human companionship, the same sense of the ludicrous. Had Agnes Hunt been a solemn woman, neither Robert Jones nor the cripple would have travelled in her company very far. She, like the children, realised that he was full of mischief, and ever on the alert for badinage. When Mr. Evan Roberts, the Welsh revivalist, came to Nelson Street, Robert Jones, wearying a little in the blast of such fervour, was suddenly aware, to his immense relief, that Agnes Hunt was in the room.

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“ This,” he said fixing her with a religious gaze, “ is Mr. Evan Roberts.”

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“ Rats,” was all that delighted lady retorted.

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Robert Jones used to arrive at Baschurch by car from Liverpool at 10.30 a.m. on Sunday mornings. “ After drinking a hurried cup of coffee,” continues Dame Agnes, “ Sir Robert would whisper to me to distract my mother’s attention, as he wished to raid the strawberry beds or whatever fruit was ripe at the time. Ten minutes or so after, my mother would miss him, and start in pursuit. In the strawberry beds we would find him surrounded by cripple children and with many probationers posted in appropriate places to call ‘ cave ’ when danger, in the shape of mother, approached.”

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At eleven o’clock work began and from forty to fifty out and in-patients were seen. At one o’clock operations started and generally lasted until six o’clock, when a much-needed meal was taken. About seven o’clock he started for Liverpool.

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No day passed without its little incidents, trivial enough, but very pointed in their revelation of the perpetual spirit of fun.

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“ One day at the Hospital,” recalls Dame Agnes, “ Robert Jones caught sight of my mother’s pet goat, whose name was Jane. He at once, in the hope of getting a rise out of my mother, decided that the poor thing had crooked legs, and must be operated upon at once. Mother, very justly indignant,

refused consent. A month or two after, the weather being very hot, a carbolic sheet was stretched across the doors of the theatre which led into the garden. Jane, who of course had no business to be in the garden, stepped in, and seeing something that looked like clothes hanging out to dry at once began to eat her way through. The operations being over Robert Jones was startled by seeing the goat’s head coyly peeping through the sheet. ‘ Look,’ he cried, ‘ that poor thing is asking for its operation ; run quickly and get Mrs. Hunt’s permission.’

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“ Another day a rather tiresome woman brought a child with bow legs. She was told that the child must come into Hospital for operation. The woman agreed, but said, ‘ Remember, I’ll not have my child’s bones broken.’ ‘ Tut, tut,’ said Robert Jones. ‘ What put that into your head ? But you would not mind a little fracturing would you ? ’ ‘ Certainly not,’ replied the mother with dignity.

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“ One day at operations Sir Robert had somehow forgotten to secure his trousers, and they began to come down. I saw him looking over his shoulder and asked him if he wanted anything, but he said, ‘ nothing, thank you.’ Then as the operation ended the trousers descended with a rush. Wrapping his overall round him he tripped out, talking hard to some doctors who were with him. Silence reigned in the theatre, no smile, all pretending with supernatural gravity that nothing had happened to the nether garments of our chief. Presently he reappeared and we noticed with some surprise that his trousers were inside out. Dr. Urwick, who was giving the anaesthetic, looked up as he came in and remarked ‘ If this is likely to happen often, I consider the junior probationers should be told to leave the theatre.’ ”

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To this small rough-and-ready home, surgeons arrived from all over the world. They came and pondered. Within a few years the message of Baschurch had crossed the Atlantic to the United States and Canada, to the Continent and Australia. Dr. Gillett, to take one single instance, returned to found in Minnesota the first open-air country hospital for the crippled child in the United States. Dr. Herbert, a New Zealand surgeon, wrote :

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“ Amongst the most pleasant and profitable visits of my trip was a visit to the Children’s Hospital at Baschurch. Here Mr. Jones has a small hospital which was in my experience unique. It was the first example I have seen of an open-air surgical home. The excellent results obtained there surprise

one, that we, with our better climate, do not more readily adopt this rational means of housing our surgical sick.

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“ The operating theatre of the Baschurch Hospital is a model of simplicity and efficiency. All visitors had to don overalls, caps, respirators, and canvas coverings to the boots, before entering the theatre ; Mr. Jones rightly maintaining that the average medical man would carry in more dust on his boots than he would on his clothes. Following the example of many distinguished surgeons nowadays, Mr. Jones is assisted solely by a well-trained, alert and competent nurse, who thoroughly understands his methods and anticipates his wants. In his simple country operating theatre, the visitor will witness a thoroughness of technique and brilliancy of operating genius I have never seen equalled anywhere.”

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Baschurch was great fun. But under the gaiety one receives a lasting impression of the grave issues which were at stake. Very affectionately and admirably has McCrae Aitken given his impression of it all. It is the tribute of one who has been associated with the Oswestry Orthopaedic Hospital in its

various developments for over thirty years. He recalls his first visit when, as the House Surgeon at the Royal Southern Hospital, he motored down from Nelson Street.

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“ These recollections are blurred ; open air hospitals were new things in those days. Baschurch was the first surgical open air hospital to keep patients out-of-doors day and night. The impression that remains is that it was impossible to believe that such crude huts and buildings could be a hospital, but the chief memory is of the woman who made it, who proved that it is the work done that counts, and that it can be done without waiting for elaborate and expensive equipment. It was only after a time that one discovered how much Miss Hunt and the late Miss Goodford were the complete complement of each other. Miss Hunt seemed to be fired by zeal to help the cripple child ; her own disabilities, which many would have considered ample justification for a life of ease, only seemed

to spur her on to increased efforts. Miss Goodford was always there when things had to be done. Not that she was in any way noticeable—the thing that was noticeable was, that every thing really needful, all the dressings, instruments, and details of asepsis were unobtrusively attended to. Behind that organisation was Miss Goodford, but it was not everybody who knew it.

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“ I have been told that the name of Baschurch has become almost legendary. Sometimes when I am urging on my own staff to attention to detail and quoting Baschurch, they look at me with a smile, as if ‘ Baschurch ’ was a place in elfland, in which impossible things were done in imagination

. . . Baschurch was no legend ; it was rather a little lump of leaven which has worked through the whole country.”

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Baschurch became, in fact, a landmark in the history of the crippled child. “ In those early days,” has written Robert Jones, “ open air received but a nervous welcome. If a child exposed in the open air recovered from its ailment, it was accounted a proof of its ‘ strong constitution ’; a draught of cold air called for a closed window, a shower of rain meant a prelude to disaster. Hospital committees and even surgeons of renown shrugged their shoulders, and buttoned up their coats when they passed through the wards on a frosty morning. This all had to be changed, and the results are now a commonplace.”

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In 1903 was established another experimental centre at Chailey, Sussex. If Baschurch showed that crippled children could be physically cured by the principles of Nelson Street in the open-air, Chailey proved that they could be mentally freed from the old legends of deformity. With his long experience of the courage and charm of suffering children, Robert Jones had always fought to dethrone the public delusion that they were by necessity fractious and morose. “ Picture to yourselves,” he said of Chailey, “ a group of buildings situated in the most beautiful country, dedicated to the service of the cripple child. You will meet with no heartrending or nerve-racking sight, no agonising incident, but healthy looking merry children and never a tear. I mean literally what I say, that I have never seen there a child crying. They are hard at work or hard at play, irrepressible in spirit, and yet fully disciplined. The spirit of Chailey is not spartan, but there is no maudlin sentimentality encouraged.

 

The child’s deformities and disabilities are rarely alluded to. He is filled with emulation and a desire to excel. If he has lost an arm or leg, he still has one or the other so trained as to minimise disability. It is a perfect joy to see the one-legged boy run a race, and the pride of a one-armed boy, when he shows you what the remaining one has accomplished. Every boy and every girl fully realise that they are to be of service in the world. There are no drones at Chailey ! See them at work in the carpenter’s shop or in other industrial developments, and you will realise the happiness of it. There is no ‘ canny.’ They are taught the joy and morality of work.”

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In 1904 was held the first conference on Invalid and Crippled Children in London. In 1906 came St. Vincent’s Surgical Home (now at Pinner). In 1908, Lord Mayor Treloar started his hospital at Alton, and in 1914 the Liverpool Open-Air Hospital was opened at Lesow.

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It would be impossible and deplorable to claim priority for any one institution over another, and if the name of Baschurch is taken as a landmark in the early life and work of Robert Jones, it is because upon the basis of the Shropshire hospital the whole development of his scheme for cripples in its progressive stages may be most simply followed. It was a growth from stage to stage—from open-air treatment to local clinics, from early surgical restoration to educational training, and from the problem of rehabilitation to the prevention of disease.

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The above Chapter was taken from: -

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THE LIFE OF SIR ROBERT JONES
BY
FREDERICK WATSON

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