The first part of this article appeared in the last issue of the 'International History of Nursing Journal' (pages 12-22). The second deals with the advisability of incorporating training for male nurses at the 'Dreadnought' Hospital. The important issues of pay and a pension scheme for nurses in the latter years of the 19th century are also addressed. There is more information on the day-to-day routine of the nurse during these years.

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The first part of this article appeared in the last issue of the 'International History of Nursing Journal' (pages 12-22). The second deals with the advisability of incorporating training for male nurses at the 'Dreadnought' Hospital. The important issues of pay and a pension scheme for nurses in the latter years of the 19th century are also addressed.

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By the early 20th century, nurse-training at the Seamen's Hospital Society 'flagship' hospital at Greenwich was at least as well established as that in the London teaching hospitals. It had its origins in the late 19th century--in the light of Florence Nightingale's nursing reforms (she had initiated the training school at St Thomas's in 1860). Although Nightingale's major interests lay in the welfare of the soldier, she was clearly concerned with the health of the seafarer also.

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The use of open-air treatment for tuberculosis ('pulmonary phthisis') at the Dreadnought Hospital, Greenwich from 1900 to 1905 is reviewed. A marked reduction in mean mortality rate compared to 'orthodox' management was observed.

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A retrospective study was carried out on 1,250 patients who were referred to the orthopaedic clinic of the Dreadnought Unit during 1989 and 1990. These included 299 actively serving or retired seafarers (24%) with knee pathology, who form the basis of this study. Fifty-one per cent of these patients had a diagnosis of knee osteoarthritis, with a predominance of medial compartment degenerative change (34%).

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In the latter years of the nineteenth century, the 'Dreadnought' Seamen's Hospital (previously the Infirmary of the Greenwich Hospital) became London's centre of excellence for the healthcare of 'seamen of all nations' (many had 'tropical' and/or sexually-transmitted diseases); this followed a 50-year period (1821-1870) during which three successive hospital ships (anchored on Greenwich Reach) had been used for this purpose' (1). Numerous mariners 'afloat and ashore' therefore owed their lives (and good health) to the skill of the physicians and surgeons based there, but equally (and perhaps more) important was the care and devotion of the nursing staff (2).

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