Port Elizabeth of Yore: State of Medical Services: Prior to the Provincial Hospital

Port Elizabeth got off to a slow start with towns such as Grahamstown stealing a march on their coastal sibling. This chapter deals with the state of medical services during the first thirty years after 1820, which I used as this town’s conception, maybe illegitimate, but nonetheless, a vital, vibrant child never to be considered as the runt of the litter.

Above: Temporary Provincial Hospital in Rodney Street, 1856

State of medical knowledge

Prior to the 19th century, the state of medical knowledge can be rated as rudimentary. Even the importance of cleanliness had not yet been appreciated. It would only be by the middle of the 19th century that the germ theory of disease transmission supplanted the “bad air” [miasma] theory.

This was responsible for breakthroughs in the suppression of the spread of diseases such as cholera in which John Snow played such a prominent role. His discovery that a germ was responsible for cholera was predicated on the fact that monks in a monastery in London only drank beer and not the water from a local well. As they never contracted cholera, whereas the residents in the neighbourhood fell like flies due to cholera, led him to make this remarkable discovery which was disavowed by even the educated classes.

The development of the principal of vaccinations, commencing with smallpox, would gradually eliminate pandemics of infectious diseases. Even basic pieces of medical equipment such as the stethoscope were only invented during this century. All of these developments would ultimately trickle down to the four corners of the world but for the first 35 years of Port Elizabeth’s history, the provision of medical services could be classified as non-existent to rudimentary at best.

Above: Laennec’s stethoscope, c 1820

In an era prior to the discovery of anaesthetics such as nitric oxide and chloroform, one can imagine what conditions were like in Port Elizabeth when a one-legged seaman, Joe, had to restrain screaming patients while the Dr O’Brien’s knife was busy hacking off necrotic body parts. One wonders what lack of discipline and decorum led to this quaint resolution being passed at one of the hospital’s Board Meetings which read as follows: “that in the event of any disorderly conduct in the Hospital, the matron to have the parties taken to the Tronk at once”.

Medical Services before the Hospital

Technically the first hospital in Port Elizabeth was not the temporary hospital established in a rented house in Rodney Street during 1856, but rather a medical facility constructed prior to the creation of Port Elizabeth itself. This was the old military hospital below the Fort. Nothing is known about it; when it was erected, how long it operated for, what facilities it possessed and when it was demolished. Nonetheless, it must be acknowledged to represent the first medical facility in the town albeit limited to military personnel.

Above: Dr Richard Nathaniel Rubidge

Even though the population had risen to about 3,500 by 1855, of whom 2,000 were white, and disease and sickness were increasing, Port Elizabeth still did not possess a hospital. What it did not lack was a leper hospital. In 1839 the Government rented Hougham Hudson’s “Mill Property” [future Mill Park], with the old mill and a small house, a wood and iron building, as the Baakens River Leper Institution. Dr. R.L. Davies was the visiting surgeon and Richard Tee was Superintendent. By 1846 the Government had decided to move all lepers and paupers in the Colony to Robben Island. In 1846, the cutter “Isaac” transported 16 lepers and 13 destitute people from Port Elizabeth to Robben Island.

During this era many surgeons had only served an apprenticeship and did not possess a degree or similar qualification. For the most part this implies that whatever medical knowledge they gleaned was by practical experience. As such, they possessed little understanding of diseases and its cause. So it was with Dr. James Chalmers who arrived in Port Elizabeth in March 1835 who had no formal qualification. Chalmers was Port Elizabeth’s first civilian doctor, Port Medical Officer and acting District Surgeon. He only occupied these positions until the end of 1839 when he relocated to Grahamstown.

Medical equipment in the 1800s

The smallpox epidemic of 1839-1840 did not make a detour around Port Elizabeth. In June 1840 it was reported that there were nine cases, two deaths and one patient who had “escaped from the nurse and cannot be found” Probably the old leper building was used again as a temporary smallpox hospital. Citizens of the town protested vigorously at the lack of hygiene during the epidemic, when bedclothes and clothing of smallpox victims were left about on the ground.

Thereafter for many years, Drs. Davies, Dunsterville and Rubidge assisted by Dr. Houseley, were responsible for the health of the entire community, with B. G. Lennon, Leslie and Lacey as the apothecaries or chemists. Without proper medicines as are known today, they relied upon elixirs and potions and placed implicit faith in “Holloway’s Pills and Ointment” which were reckoned to cure everything and were advertised in almost every issue of the newspaper from 1845 onwards.

Temporary hospital

Act No. 5 of 1856 might have given the authorities the green light to proceed with the construction of a hospital, but the acquisition of land and funds would delay its construction. In the interim, another solution was required. A wood and iron building in Rodney Street was acquired on 10th September 1856 at a rent of £4 per month. The house was largely built of wood from ships wrecked in Algoa Bay. It stood opposite a sand dune in that street. This house was later demolished and replaced with an auctioneer’s house. Later it was replaced by a modern office block.

First qualified doctors

The first qualified doctors to practice in Port Elizabeth were Dr. George E. Dunsterville and Dr. R.N. Rubidge.

Richard Nathaniel Rubidge was the son of Captain Robert Henry Rubidge of the Royal Navy, and his wife Hannah P. Jones. His parents emigrated to the Cape Colony in 1821 and Richard grew up on a farm in the Grahamstown district. He and William G. Atherstone were apprenticed to the latter’s father, Dr John Atherstone, in Grahamstown. Rubidge later completed his medical education at the University of London in 1843, qualifying as a Bachelor of Medicine (MB) and member of the Royal College of Surgeons (MRCS). Upon his return to the Cape, he was licensed to practice in April 1844 and did so in Graaff-Reinet and from 1850 in Port Elizabeth. He served as surgeon to the new Provincial Hospital in Port Elizabeth, which was initiated in 1856, and remained associated with it for the rest of his life. During 1858-1859 he and Dr George Dunsterville had to treat over 200 cases of smallpox in a temporary building, until the hospital was completed in August 1859. Rubidge was interested in natural history and, as a result of his friendship with W.G. Atherstone and Andrew Geddes Bain, more particularly in geology and palaeontology.

Rubidge never married. He died suddenly at the age of 46 from a self-administered dose of strychnine that he had taken in the belief that it would be beneficial for what he believed to be a weak heart. After his death W.G. Atherstone wrote to his son “[His] death is a tragic blow to our little scientific circle, too few of us at present and too scattered to do much good.”

The early story of Port Elizabeth’s medical growth ends with the appearance of Dr. George Dunsterville who became, along with Mr. John Paterson, his great friend, one of the town’s most respected citizens. He had qualified at the Apothecary’s Hall in London and had acquired the M.R.C.S. at the end of 1841. He arrived with his wife and child in Algoa Bay in January 1842. Dr. Dunsterville’s brother, Henry was Port Captain of Port Elizabeth at the time, and his sister Harriett had married the widower, Lieut. Daneiell of Sidbury Park, Albany. The Dunstervilles settled down in Donkin Street and Mrs. Dunsterville took in boarders with John Paterson living with them for a while. Dr. Dunsterville also opened a chemist’s shop in Main Street. In 1845, Henry Dunsterville died suddenly and about the same time Dr. Fairbridge died in Uitenhage. Dr. Dunsterville applied for and received the appointment of district surgeon in Uitenhage, an appointment which had been held by Dr. Fairbridge. Mr. Rutherford, nephew of the Cape Town merchant, was left in charge of the chemist shop, and the Dunstervilles moved to Uitenhage.   The doctor served the wounded troops during the War of the Axe and the government published the following in the Gazette, “With reference to Dr. Dunsterville, acting surgeon to the forces at Commando Kraal and elsewhere, the government will not allow his prompt services to go unrequited. When the Dunstervilles returned to Port Elizabeth and Mr. Rutherford took over the chemist shop started by Dunsterville in Uitenhage. The doctor now became a popular member of the community. He was church warden at St. Mary’s and later a town councillor. As a singer he was greatly in demand at concerts, and he belonged to both the Good Will and Good Hope Lodges of the Free Masons. His trap, drawn by two cream-coloured ponies, was a familiar sight and the children all adored the doctor with bon bons in his pockets. Dr. Dunsterville, with Dr. Rubidge, who came in 1850, supported Paterson’s efforts to build a Provincial Hospital along with Dr. Davis. The first two served as medical officers at the temporary hospital in Rodney Street where the matron had the power to send “at once to the tronk (goal) any disorderly patient.”  In 1847 Dunsterville assisted a young dentist to start in the town. “Decayed teeth,” declared Dr. Smith “stopped to render them again serviceable for mastication. For artificial teeth extraction of stumps is unnecessary. Enquire at Dr. Dunsterville’s home”. In 1853 Dunsterville offered to train an articled pupil for the examination of the Royal College of Surgeons and Apothecary’s Hall. With enterprise at the age of 53, Dr. Dunsterville returned to England in 1863 to study for his Fellowship of the Royal College of Surgeons. Three years later he was back in Port Elizabeth with F.R.C.S. after his name. He died after a long illness in 1877 and on the day of his funeral all shops were shut, and flags flew at half-mast. Dunsterville will forever he remembered for his sartorial elegance as he was invariably attired in a frockcoat and top hat and he wore a bright red tie.

However, this was in the future when, in 1847, Port Elizabeth still had only two civilian doctors and only two wards set aside in Fort Frederick to serve as a hospital. The town was still far behind the medical achievements of Grahamstown.

Sources

Port Elizabeth: A Social Chronicle to the end of 1945 by Margaret Harradine (2004, Historical Society of Port Elizabeth, Port Elizabeth)

Port Elizabeth in Bygone Days by J.J. Redgrave (1947, Rustica Press)

Nelson Square by Khitab (December 1973, Looking Back, Vol X111, No 4)

Healer and Crack Shot by Pamela Folliott (June 1965, Weekend Post)

‘https://genealogy.links.org/links-cgi/readged?/home/ben/camilla-genealogy/current+c-dunsterville92300+2-2-0-1-0

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