In 1764 the Parish trustees felt they had taken over an infirmary rather than a workhouse. By 1837 the Guardians of the Poor reappointed one apothecary for the workhouse and three others for the district as medical officers of health. In 1849 the infirmary consisted of a single range on the west side of the ground, immediately south of the women’s ward. In 1860 with the help of the inmates a smallpox ward was put up and an iron building for sick children. The workhouse admitted a few smallpox cases and also held some harmless people. In 1866, when 119 of the inmates were visited daily by the medical officers assistant. The sick were not classified and were tended by only two paid nurses and had no day rooms. Extensions and adaptations from 1869 led to a distinction between the workhouse and the later called Hackney and Homerton Central Institution entered from Sidney Road, and the infirmary called Hackney Hospital. The workhouse in 1890 had 90 beds, mostly for the aged and bedridden, and had three paid nurses. While the infirmary had 437 beds with 35 nurses.