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Seamen's dispensary, Liverpool 1924 to 1991




The city of Liverpool is famous for many things. One of them which achieved renown on every continent was Dr Ross's Clinic, a name bestowed by seamen of every nationality upon the building erected by Liverpool Corporation in 1923, and described on the bronze plaque beside its front door as


"THE SEAMEN'S DISPENSARY. OPEN TO SEAMEN OF ALL NATIONS FOR FREE TREATMENT AND ADVICE".




The Seamen's Dispensary was at the forefront in the treatement of sailors, actively participating in these events spanning almost seven decades, comprising evolution and significant changes in the practice of the specialty now called Genitourinary Medicine (GUM). After 67 years of the most valuable service, the Seamen's Dispensary closed in December 1991. A brief history of its origin and the placing on record of its contribution to sexually transmitted disease control in Liverpool and beyond is, I hope a fitting epitaph.


Background

Before 20th century Liverpool was a small fishing village until 1207 when King John's Charter conferred upon it a borough status. It steadily grew in size and importance, owing largely to the West Indian trade and slave trade with W.Africa and the Americas. By the beginning of the 17th century, the Liverpool port was busy importing and exporting goods. By the end of the 18th century the city was very rich, mostly as a result of shipping. The city continued to flourish well into the 20th century, its port serving as the terminus for ships to and from every region of the world bringing in cargos and seafarers of all nationalities. Liverpool had become the gateway of the British Empire. Liverpool's sailortown had sprawled over a large area around Paradise Street and Canning Place. It was around here that the famous Liverpool "forebitter", Maggie May, and others plied their trade. The sailors had to run the gauntlet to pass the parading prostitutes.



"When I steered into her, I hadn't got a care,
She was cruisin' up an' down ol' Canning Place,
She waz dressed in a gown so fine, like a frigate of the line,
An I bein' a sailorman gave chase".'



Canning Place

The special needs of the seafarers had been recognized; for example The General Infirmary in Liverpool, which opened in 1749, had two wings for the maintenance of "decayed seamen, their wives and children" However, patients with venereal disease (VD) in general, were treated as outcasts. To secure the "decency and good order of the house, venereal patients were to be so entirely detached as not to have the least intercourse with the other parts of the hospital" Nevertheless, some arrangements had existed at the Royal Infirmary, the Northern Hospital, the Stanley Hospital and the Royal Southern Hospital (opened respectively in 1824, 1834, 1867 and 1872) for the gratuitous treatment of venereal disease.



Origin of seamen's dispensary

The Liverpool Royal Infirmary Clinic was having the largest number of patients on its books. A significant proportion (40% in 1920) of those whose occupation was known were seafarers. This problem posed by large numbers of seafarers needed to be addressed and  was not helped by the Merchant Shipping Act of 1906 which while-providing for the medical treatment of the sick sailor, retained "the proviso that a seaman suffering from venereal disease shall be excluded from such benefits".


Earlier, Liverpool Corporation had recognized the special need of health care facilities, including those for venereal disease, for seamen of all nationalities. The premises were to be designated as the Seamen's Dispensary. The latter was not to be labelled as an institution specially for venereal diseases because that would prejudice not only the prospects of obtaining a site, "but also the usefulness of the premises even in regard to venereal diseases".  A suitable site for a Seamen's Dispensary was eventually found. After obtaining the approval of the Ministry of Health, the tender of Messrs R. Wearing & Sons was accepted and the building was completed in 1923 at a cost of £4,649. The Dispensary was opened by the Lord Mayor of Liverpool on 28th January 1924.




The Sailors Home

The site chosen was in the neighbourhood of the Sailor's Home and other centres where sailors and others connected with seafaring life usually congregated. It was intended primarily to deal with venereal disease. However, other ailments including tropical diseases were also to be taken care of and if necessary, such patients were to be referred to other suitable institutions. The medical officer in charge also acted in an advisory capacity to medical officers of ships, ships' captains and foreign consulates.

Seamen's Dispensary activities and progress (1924-1938)

In the earlier years the Seamen's Dispensary was open from 9.30 am to 8.00 pm, and the staff consisted of one whole-time Assistant Medical Officer and two orderlies. While one orderly attended on the Medical Officer during the examination and treatment of patients, the other supervised the routine irrigation treatment of cases of gonorrhoea. The latter orderly resided on the premises in the flat on the second floor beneath a quaint mansard roof.


Canning Place  © Bernard Rose



Dr A O F Ross (1893-1954)

In 1924 Dr Andrew O F Ross became Physician in Charge of the Seamen's Dispensary. He was a powerful character of whom anecdotes abound and whose reputation grew with the telling. The dispensary was adjacent to a public house and public urinal, a juxtaposition that came to be known irreverently as Ross's Triad. So exasperated did he become with patients attending who had emptied their bladder immediately before arrival, that he used his influence with the Public Health  committee to get the offending convenience demolished. He was also full of humour, sensitivity and  had an academic approach. The venereal disease problem among the seafarers was one of his main preoccupations. In view of their special circumstances, he developed, in 1924, an intensive treatment scheme, comprising arsenicals and bismuth injections, for early syphilis, which was soon adapted by many other centres dealing with seafarers. Dr Ross, along with his colleagues, also conducted the early field trials of penicillin in the treatment of syphilis. The doubling of attendances within four years of the Seamen's Dispensary opening was largely attributed to the interest, attention and personality of Dr Ross.



Medical Officers' consulting room, with facilities for bacteriological 
and microscopical investigations.
Operating room, with modern conveniences for examination and treatment

Curtained cubicles that patients entered from flanking corridors 
the central corridor was for the medical officer and attendants.

In 1964, resignations from nursing staff had caused difficulties. Poor layout was thought to be an undoubted factor in the staff dissatisfaction. Consequently, the building underwent certain structural alterations and was completely redecorated. These improvements were much appreciated by staff and patients alike. One of the annual reports refers to the provision of an excellent  laboratory. This was a room with a cupboard, a wall point and running water.

There were other quaint customs too. Every Wednesday morning, all the glass slides used during the preceding week were boiled in a solution of lysol. The odour can be more easily imagined than described. The slides were then re-used. And the needles used for venepuncture and intramuscular injection were sterilised by boiling in water, and occasionally, sharpened on a grindstone. The above practice of reusing needles and slides was discontinued in 1965. However, glass syringes, sterilised by steam pressure in an autoclave, wrapped in small hand-made linen bags remained in use until about 1970.



Undergraduate and postgraduate teaching and research

Liverpool, being a great port, had an abundance of clinical material. The Seamen's Dispensary served a useful function in the training of medical students, postgraduate students and male nurses. Liverpool was one of the few centres providing postgraduate training in venereology in the 1930s. The University of Liverpool continued to grant the Venereal Disease Officer's Certificate up to 1967. Much of the clinical instruction for this was given at the Seamen's Dispensary. In 1967 the University of Liverpool became the first university in Europe to offer a full time course and to award a Diploma in Venereology.  The Seamen's Dispensary has continued to be one of the two main centres for the instruction in the specialty but nevertheless closed  in December 1991. The Royal Liverpool University Hospital which did not traditionally attract seamen, had been seeing twice the number of patients per session during the previous four years. The unattractive premises  the dispensary was housed in perhaps may also have been a factor in its closure. From the more scientific point of view, however, the Seamen's Dispensary had outlived its usefulness. It did not stand up to the modern concepts of a GUM clinic for the 1990s, recently defined in an authoritative report. The serious shortcomings included lack of privacy, lack of adequate space to examine patients and to teach students. In addition, it suffered the inconveniences associated with any health facility remote from a District Hospital. Consequently, the Seamen's Dispensary had to close. The only problem was that the existing GUM clinic premises at the Royal Liverpool University Hospital (RLUH) opened in 1979, although purpose built, had in the recent years been felt to be seriously inadequate. An opportunity arose, as a result of the reorganisation of the RLUH (after acquiring Trust status) in 1991, of the availability of new purpose built and much larger premises within the hospital, enough to absorb also the workload of the Seamen's Dispensary. That certainly was the ideal answer. It was also true that shipping passing through the port had declined substantially.

Table 2 Number of ships and their tonnage passing
through the port of Liverpool

Year                       Number of Ships                              Tonnage
1930                       13,454                                                   16,184,515
1940                       10,333                                                   14,305,715
1950                       9,189                                                     15,372,207
1960                       10,164                                                   19,838,134
1970                       7,803                                                     20,970,000
1980                       4,540                                                     26,372,000

1985                       3,013                                                     19,612,000



Now the Liverpool Centre for Sexual Health (formerly known as the Department of Genitourinary Medicine and Sexual Health) the unit at the Royal Liverpool Hospital is a large and friendly department, committed to providing a high quality service to people worried about issues affecting their sexual health.





Robert F Edwards Pin It