Chapter I · THE STRAND.

In the latter part of the summer of 1854 I was living in Soho, where I had been engaged in general practice for some ten years, and where, by dint of laborious attention to my profession, I had secured a sufficiency on which to live, when I became aware that an outbreak of Asiatic cholera might be looked for. Some suspicious cases had appeared, when, towards the end of the month of August, there was suddenly developed an epidemic outbreak of such virulence and extent that it became necessary for immediate action to be taken, if this fell disease was to be effectually dealt with. Having taken an active part for some years previously in sundry sanitary measures, I was requested by the parochial authorities of St. Anne's, Soho, to take charge of one of the districts into which the parish was at once divided. During the busiest of those very busy days, a medical friend and neighbour called on me, and in answer to my remark that I was too busy to talk to him, replied, "You are busy now, but you will live to regret this outbreak in Soho. It will ruin the neighbourhood and your practice for many years to come, for the public will believe that it is too unhealthy to live in, and ere long you will have nothing to do."

This casual prediction was amply verified in the following year by the death of many inhabitants, and by the removal of others. As was the case with others in other callings, I had to commence the world afresh. When casting about for the best course to follow, the medical officership of the Strand Workhouse, Cleveland Street, and of the parish of St. Anne's, Soho, fell vacant. The person who held the appointment proposed to resign in favour of his son, and I was strongly urged to compete for it. I elected to try my chance, and, after a severe contest, was selected. Here I began my experiences of the sick poor, which lasted, with a very brief interval, for thirty years. My first impressions were not very exhilarating, and could I have foreseen all that was in store for me, I question whether I should have applied for the appointment at all, but, having been appointed, I resolved to try it for a time at least. The Strand Workhouse in the year 1856 was a square four-storied building fronting the street, with two wings of similar elevation projecting eastwards from each corner. Across the irregularly-paved yard in the rear was a two-storied lean-to building, with windows in the front only, used as a day and night ward for infirm women. There were sheds on each side for the reception of so-called male and female able-bodied people, whilst in the yard, on each side of the entrance gate, was a two-storied building, with an underground apartment lighted by a single window, and with a door for the reception of male and female casual paupers; the wards above being for those of both sexes admitted to the house.

The necessary laundry work of the establishment, which never in my time fell below five hundred inmates, was carried on in the cellar beneath the entrance hall and the general dining-room, whence it came to pass that the said hall, &c., was for four days in each week filled with steam and the odours from washing the paupers' linen. A chapel was contrived out of one of the male infirm wards on the ground floor on the Sunday, and utilized on that occasion for both sexes. On the left of the entrance hall was the Board-room; the corresponding apartment on the right, and the room above on the first floor, being the apartments of the master and matron. On the right side of the main building was a badly paved yard, which led down to the back entrance from Charlotte Street; on each side of this back entrance there was—first, a carpenter's shop and a dead-house, and secondly, opposite to it, a tinker's shop with a forge and unceiled roof. This latter communicated with a ward with two beds in it, used for fever and foul cases, only a lath and plaster partition about eight feet high separating it from the tinker's shop.

There were no paid nurses. Such nursing as we had, and continued to have for the first nine years I was there, was performed by more or less infirm paupers, with the occasional aid of some strong young woman who had been admitted temporarily and was on pass. Unfortunately it frequently happened that just as she was becoming useful she left, and there was nothing for it but to fall back upon the ordinary broken-down inmates, the selection of whom did not rest with me, but with the master or the matron, or both.

Just outside the male wards of the House, at the upper end of the yard, there were two upright posts and a cross-bar. On this bar were suspended the carpets taken in to beat by the so-called able-bodied inmates, from whose labour the Guardians derived a clear income of £400 a year. In despite of the continued noise and dust caused by this beating, the Guardians persisted in carrying it on for ten of the twelve years that I was there. The noise was so great that it effectually deprived the sick of all chance of sleep, whilst the dust was so thick that to open the windows was entirely out of the question until the day's work was over. I attempted repeatedly to get this nuisance done away with, but so fierce was the antagonism of the majority of the Board that I had to abandon it.

The male insane ward, used also for epileptics and imbeciles, was on the right wing above the male casual and reception ward. To reach it you had to go up some four steps; it was absurdly unsuitable for such cases, and when I had lunatic and imbecile there together I was always in dread lest some horrid catastrophe might happen. One case of an epileptic was to me the cause of much anxiety, for he was wholly unaware when his fits were coming on. When a seizure occurred he always sprang up and then dashed himself to the ground on his forehead and face. He contrived by these means to smash his nose, make dreadfully disfiguring wounds on his forehead and face, and from a good-looking, became a perfectly repulsive-looking person. Poor fellow! I tried all sorts of expedients to prevent his doing himself any further injury, but though he constantly wore a stuffed helmet, he sometimes managed to injure himself. I got him away at last, but I had two or three years of him, during which time I had a very extensive surgical experience from his case alone. I was constantly stitching up his wounds.

The female insane ward was a rather large room, and was situated over the Board-room. As we always had the place full the space was desirable or necessary. It was immediately beneath the lying-in ward. When we had a troublesome or noisy lunatic in the ward, it must have been anything but a comfort to the lying-in women above, but then neither their interests, nor the feelings of any of the other inmates, were at that time officially considered by the Guardians, by the Poor Law Inspectors, nor by any one else. To be allowed to remain in the House and get waited on somehow was all that was looked for by these truly wretched women.

The master of the House, a certain George Catch, since deceased, had been a common policeman in Clare Market, where he had made himself useful to the Chairman of the Board, who was the proprietor of an à-la-mode beef shop in that locality. Through this Chairman's influence he became the porter of the Workhouse, and the master falling sick, he had performed his duty for him. The illness ending fatally, through the same influence Catch was promoted to the vacant office, though, at the time I first knew him, he was so ignorant that he could only write his name with difficulty. He was single on his appointment, but an alliance with the late master's niece, who had acted as matron for some time, was talked about on my taking office. As this official, Mr. G. Catch, appointed with the sanction of Mr. H. Fleming, some time Permanent Secretary of the Poor Law Board, played an important part in bringing the Department into deserved contempt, I must hereafter again refer to him.

On the morning of my entering on my duties I went over the sick ward with the son of my predecessor. My curiosity was excited by sundry ill-shaped bottles, all of which contained the same description of so-called medicine. The salary did not admit of an extensive variety of medical necessaries, as it was only fifty pounds a year, out of which all drugs were to be found. It is true that this stipend was supplemented by an occasional fee from attendance on parturient women, in cases where difficulty or danger arose, or in any illness which took place prior to the ninth day after the confinement. That fee was limited to twenty shillings only. The decision as to the necessity for such attendance was vested in the midwife or matron, and until that was given the medical officer was interdicted from entering the lying-in wards. This regulation was in direct contravention of the Poor Law Regulations, but then the Department were very unwilling at that time to interfere with the so-called discretion of the Guardians, however much their regulations were disregarded.

I have stated that the Chairman of the Board was the proprietor of an à-la-mode beef shop. During my first year of office this dignitary would often come to the House on Sunday morning dressed in the dirty, greasy jacket in which he had been serving à-la-mode beef the night before, and unshaven and unshorn, he would go into the chapel with the pauper inmates, and afterwards go to the Board-room, and have breakfast with the master and matron. Of course, between the three, there was an excellent understanding, and during this Chairman's reign all alterations for the better were resisted.

I have before stated that all my nurses were pauper inmates. The responsible duties they had to perform were remunerated by an amended dietary and a pint of beer. Occasionally for laying out the dead, and for other specially repulsive duties, they had a glass of gin. This was given by the master or matron, but I was expected to sanction the supply.

I have referred to the ward used for foul cases, which was in immediate proximity to the tinker's shop. It was altogether unsuitable for the reception of any human being, however degraded he might be; but it had to be used. I remember a poor wretch being admitted with frost-bitten feet, which speedily mortified, rendering the atmosphere of the ward and shop frightfully offensive. At first I was at a loss to know whom to get to go through the offensive duty of waiting on him. At last a little fellow, called Wiseman, undertook the task, the bribe being two pints of beer and some gin daily, with steaks or chops for dinner. Presently the patient was seized with tetanus, and after the most fearful sufferings died. He was followed almost immediately afterwards by poor Wiseman, who had contracted from his patient one of the most malignant forms of blood poisoning that I ever saw.

These two successive deaths took place whilst the tinker was plying his business on the other side of the partition which separated this ward from his smithy. This place was an utter disgrace to the Board, but they never attempted to alter it whilst I was there.

I have referred also to the nursery ward. This place was situated on the third floor, opposite to the lying-in ward. It was a wretchedly damp and miserable room, nearly always overcrowded with young mothers and their infant children. That death relieved these young women of their illegitimate offspring was only what was to be expected, and that frequently the mothers followed in the same direction was only too true.

I used to dread to go into this ward, it was so depressing. Scores and scores of distinctly preventible deaths of both mothers and children took place during my continuance in office through their being located in this horrible den.

It frequently happened that some casual was admitted with her child, or children, to the room below the female receiving ward. On my visiting the House next day I would find that her child had got an attack of measles and could not go out; and in spite of my sending the mother and child to the children's infectious ward above, measles always broke out in the nursery some eleven days after, and I have had as many as twenty down with it at a time. I will not horrify my readers by stating the proportion of deaths to recoveries, but content myself with stating that the latter were very few.

What made these continuous outbreaks so vexatious was this, that I had laid down the most stringent regulations as regards isolation and disinfection; but unfortunately my orders could only be given to pauper women. I had no other persons to act with, and with that habitual carelessness which had led to their becoming paupers, they only in exceptional instances paid any attention to what I said.

Now and then a decent widow with an infant came in, and became an inmate of the nursery ward, there being no other place for her to go to. What her feelings must have been when forced into day and night companionship with some of the most abandoned of her own sex in this miserable Gehenna, I will not attempt to portray, and yet the majority of the Board looked upon this den as a perfect paradise, and looked on me as an irreconcilable fellow for troubling them with my complaints respecting it.

I had not been the medical officer for many months before I found that my pauper nurses were frequently under the influence of drink, and that, too, in the forenoon. On inquiring, I heard to my surprise that the master was in the habit of giving out the stimulants at 7 a.m., and, as many of the inmates sold their allowance, the nurses had become partly or wholly intoxicated when I reached the House in the morning.

My first request to the master was that some other time should be selected for the issue of stimulants. Such request was angrily refused, and it was not until I had appealed to the Board that I succeeded in effecting an alteration, but my success made the master, henceforward, my determined foe.

As I have stated, the medical officer's salary was intended to cover the provision of medicine. The Guardians, however, had supplied my predecessor with linseed-meal and mustard, but finding that I had a great many consumptive and bronchitic patients, I was induced to apply to the Guardians for some linseed, to enable me to give the patients some linseed tea. Now there was one nurse in the female sick ward, by name Charlotte Massingham, who had been in supreme authority there some years. She was nearly always muddled; to work with her was impossible; Charlotte invariably treated me with supreme indifference, not unmingled with undisguised contempt. I had introduced new-fangled notions, would have my medicines correctly given, and the patients well attended to. On hearing that my application for the linseed had met with success, I went up to the Workhouse. On going into the female sick ward I told Charlotte of my having gained the assent of the Board, when, suddenly springing up at least a foot, she came down slapping both sides, with her arms on to the ground, with the startling observation, "My God! linseed tea in a workhouse!" Charlotte's reign, however, was not of long continuance after this; she died, worn out by the effects of habitual intemperance. I heard, after she was dead, and the inmates were free to speak, that she systematically stole the wine and brandy from the sick.

It was obvious that one of the first points to secure was the removal of the laundry before referred to, situated in the cellar beneath the dining hall. The Guardians having assented to my suggestions, a contract was entered into with the builder to put up a laundry in the back yard. The structure was to cost some £400. On proceeding to dig out the foundation, the workmen came on a number of skeletons, the yard having been originally the poor burial ground of St. Paul's, Covent Garden, for which parish the Workhouse, &c., had been built, and had been rented by the Guardians from that parish when the Strand Union was formed. So full was this yard of human remains, that the contractor was compelled to go down twenty feet all round, before a foundation for the laundry could be obtained. In making this huge trench, they disinterred the remains of the poor Italian boy, murdered by Bishop and Williams, whose murder was discovered by the late Mr. Partridge of King's College Hospital, to whom Bishop and Williams had sold their victim for anatomical purposes. Similar murders of the same kind in Edinburgh, led to the passing of the Anatomy Act, and to the suppression of the practice of body-snatching by the abandoned wretches who formerly supplied Schools of Anatomy with subjects.

My next endeavour was an enlargement of the cellar at each wing so as to secure better accommodation for the reception of casual poor, and increased space for sick children and others. This was accomplished by nearly re-building the wings. Unfortunately these suggestions rendered me extremely unpopular with many of the Guardians, and delayed for some two years any increase of my wretched stipend, which would otherwise have been granted, if I could have remained a passive observer of that which I saw around me. But worse was in store.

My first serious quarrel with the Board happened thus. Many of the young women who came in to be confined, came under treatment afterwards, suffering from extreme exhaustion, and some were hopelessly consumptive. On making inquiry, I found that the practice in the lying-in ward was to keep the single women on a dietary of gruel for nine days, and then, at the end of a fortnight, to dismiss them to the nursery ward on House diet, with their children. Assuming, as I had a perfect right to do, that this dietary had emanated from an order of the Poor Law Board, I wrote to the Department telling what I had observed, and asking that Board's permission to introduce a more generous system. My communication was sent to the Guardians, and I was informed in a letter from the Board at Whitehall that it rested with me exclusively to order whatever form of dietary I chose, a power which I did not hesitate to use. The Board of Guardians condemned my conduct in writing to the Poor Law Board, in the strongest possible terms, and the use I had made of the power vested in me. The course taken by me was held to be in the highest degree reprehensible, as it traversed the deliberate action of the Guardians, who had established the starvation dietary for single parturient women, as a deterrent against the use of the Workhouse as a place in which to be confined. As the number of fresh admissions went on increasing, and I had not sufficient accommodation, I recommended that the side wings should be enlarged by carrying the building up a storey higher. This was done, and the pressure put on the accommodation was met for a time, but all these suggestions increased my unpopularity with certain of the Board, who condemned me for the expense I was putting them to. About this time the annoyance and obstruction I met with from the master and matron compelled me to apply to the Inspector for support. He came to the House to make inquiry, but so large a number of the Guardians attended to support the master, that after a few questions had been put, he closed the inquiry. Some years after he expressed to me his regret that at that time he could not see his way to aid me.

At the end of the first year some business took me to Scotland. The Board sanctioned my absence, and gave their approval of the gentleman who was to act as my substitute. On my return journey by the night train, on getting out at Peterborough at 6 a.m. to get some coffee, I was surprised to see the master of the Workhouse and the clerk of the Board standing on the platform. On reaching King's Cross I remained in the carriage till all the passengers had alighted and had passed me. I was in doubt whether I had been deceived, but I had not been, for presently the pair passed the carriage, each carrying a small bag. About ten days after, a letter was sent from the Board, asking for an explanation of an alleged neglect of a sick person in the House. I forthwith called on my substitute and showed him the letter. He denied in the most positive terms the allegation of neglect. On visiting the House, no information could be gained from any one, but it occurred to me on leaving to ask the porter whether he could throw any light on the matter. After reading the clerk's letter he made the remark, "Why, Catch was not in the House at the time he alleges the neglect took place, for he and the clerk went down to Peterborough from the Thursday to the Monday morning, to be entertained by the contractor who put up the laundry boiler." In my defence, I stated this to the Board, when great was the indignation expressed by some of the Guardians; first, at his false charge of neglect, and secondly, that he and the clerk should have gone away without leave, and for their being entertained by the contractor.

The exposure of course intensified this master's hostility, in which his friend the clerk cordially cooperated. The consequence to me was that I was continually sent for on most frivolous pretences. The messenger would come to my house and say, "You are wanted at Cleveland Street;" if I asked for what, he was studiously ignorant. If I went, or if I sent my assistant, Catch would keep us waiting in the hall until it suited his humour to come out to me, when in a loud voice he would say, "You are wanted in such and such a ward." Hard as this was to bear with from this ignorant and incompetent official, I put up with it for a time, but at last I again called on the Poor Law Inspector, and asked him his advice, when he informed me that the master was bound to send a written order, stating the name of the sick person, &c. On my having intimated to him that I should not again notice his calls unless this requirement was complied with, the annoyance was stopped—nearly all of these second visits having been wholly unnecessary, and arranged with the view of wearing me out.

I have stated that, unless called on, either by the midwife, matron, or master, to visit a woman recently confined, I was debarred from attendance on her, and could not claim any fee. The master and clerk arranged that no order should be given until nine days had elapsed, when it was held that I was bound to take charge of the woman as in an ordinary case of illness. This calling one in on the morning of the tenth day was so frequently done that I saw that the thing was arranged, especially as I learned on inquiry that the woman had been ill for some days, and had asked that I should be sent for. I thereupon took on myself to visit the ward daily, and to judge for myself as to the necessity for my attendance. Some half-dozen of these cases occurred within three months. On sending notice to the clerk that I had visited such and such a case, I received the reply: "I have made inquiries and find that you attended without getting the necessary authority." This I afterwards learned was done without any authority from the Board. I therefore decided that I would give up going into this ward for the future.

Some time after, and in pursuance of this man's policy of annoyance, a case occurred just as I expected, which enabled me to get rid of him. On going to the House one morning, the porter told me there was a woman ill in the lying-in ward. On going into my room the pauper attendant came and asked me to go to this ward. To the inquiry, "Who sent you?" "No one," she replied. I then said, "Go to the matron, or if you cannot find her, to the master, state that the woman is very ill, and bring me the authority to visit her." She went away. Some half-hour after, I went by the ward door, and heard this poor wretch's cries for assistance, but I did not visit her. Again the attendant came to me and implored me to go up. I asked, "Have you seen the master or matron?" "Yes," she said. "What did they say to you?" "Why, they only laughed." I again declined to visit the ward. Shortly after I left the House. I had hardly passed the gate when the master rushed into the hall and inquired whether I had left; on hearing I had done so, he said in a loud voice, "I have caught that damned doctor at last," and directed the porter to go for the nearest medical man. Some gentleman came and attended to her, and the bill, and a garbled statement of the facts, was sent by Catch to the Board. I was ordered to attend their next meeting and explain my conduct. I requested the attendance of the porter and of the pauper nurse at the Board's meeting. Catch gave his version of the story. When called on for my explanation, I narrated the course adopted by the master, the matron, and the clerk, and pointed out to the Guardians the evident intention of all three to prevent me being paid any fee; that in the case in question I had asked for an authority to visit the woman; that, although both of these officers knew of the poor woman's condition, they had maliciously allowed her to remain without proper attendance, and would not give any order, so that I should not be paid a fee. The defence was so complete, and so completely turned the tables on all three, that a severe censure was passed on the master and matron for their inhumanity, and a hint was given that they had better look out for some other appointment. This they did, and a vacancy for a master and matron having taken place at Newington Workhouse, Mr. and Mrs. Catch applied for the post, and, to the delight of all the inmates and officers of the Strand Workhouse, were selected. So intensely tyrannical and cruel had been the rule of this man, that the day he resigned the keys, and was leaving the House, the whole establishment—at least, all those who could leave their beds—rose in open rebellion, and with old kettles, shovels, penny trumpets, celebrated their departure from the premises. The incoming master subsequently told me that he had never witnessed anything like it in his life, and that the row was so general and spontaneous, that he was powerless to check it. Mr. Catch's subsequent career did not disappoint the expectations of those who were cognizant of his utter unfitness for so responsible a post. I shall refer to him again in a subsequent part of this narrative.

Before I had been long in office, I became aware that there was a benevolent agency at work, conducted by some Christian ladies, whose mission it was to visit the wards, read to the sick and infirm, and generally to help them in the effort they might make in re-establishing themselves. At the head of this movement was Miss Louisa Twining, who has devoted years of her busy life to the amelioration of the lot of the workhouse sick; Lady Alderson, the widow of the late judge, her daughter, Miss Louisa; and, though last, by no means the least, Miss Augusta Clifford, were associated in this good work. It was to Miss Twining's initiative that the abolition of the system of entrusting the care of the sick poor to the numberless Sairey Gamps and Betsy Prigs was mainly due; but she did not succeed in her laudable efforts until after several years of incessant appeal to the Guardians of the Poor and the Poor Law Board. Ultimately her demand was conceded in deference to outraged public opinion.

The efforts of Miss Clifford demand a special reference here. Very early in my official life she called on me and volunteered to help any deserving case brought to her notice. Over and over again did she put her hand in her pocket, and give money to inmates of her own sex, whose cases I called attention to. At last her good doing attracted the notice of the Board, who passed a very eulogistic resolution, in which they thanked her for her great kindness to their sick.

Here let me remark that, although the majority of the Strand Board were wholly unfitted for any administrative duties, yet it would be ungrateful not to state that there were several kindly-disposed persons among them. They were generally, however, outvoted, though occasionally their suggestions for a milder and more generous régime prevailed. Catch had hardly left the house when it was proposed to increase my stipend, at first to £75, ultimately to £100 a year; and I was also entrusted by the Board with the duty of certifying as to the lunacy of the inmates who were admittedly insane.

This office had been filled for many years by a Dr. Beaman, of Henrietta Street, Covent Garden, in deference to a view recently revived by the present Lord Chancellor, in his hitherto abortive attempts to amend the Lunacy Laws, and was to the effect that it would be hazardous to entrust such a duty to the Workhouse medical officer, as he might be tempted to eke out his salary by certifying that healthy persons were mentally affected, so as to secure a fee. The injustice implied in this gratuitous imputation, having been brought before one of the Presidents of the Poor Law Board, he was induced to get the prohibition removed, and one of the results was that my friends at the Board carried a resolution that in future I should be the examining official, as I had all the trouble of the case, whilst a stranger pocketed the fee. Dr. Beaman was much annoyed at this; and as the relieving officer, who was a friend of Beaman's, persisted in sending all cases to Dr. Beaman, a collision was inevitable. A short while after, a lad was brought by the police, found wandering at large. I diagnosed that he was a homicidal lunatic, and that it was necessary that he should be sent away. The relieving officer having called in Dr. Beaman, he visited the House, examined the lad, and took him down to Bow Street, and deposed before the magistrate that he was of sound mind. He would have been discharged, but the police having testified to the very questionable condition in which he was on coming into their hands, the presiding magistrate directed that he should go back to the House for further observation. This was done, and I again saw and examined him, and gave a fresh certificate of his insanity. Dr. Beaman was again requested to attend; he, however, sent his partner, who also decided that the lad was not insane. He was again taken before a magistrate, with the result that he was ordered to be discharged. Thereupon Dr. Beaman wrote to the Poor Law Board complaining of the action of the Guardians in appointing an inexperienced young man as the examining medical officer, and stating that neither he nor his partner could discover any evidence of insanity in the case in question. A copy of this letter was sent to the Guardians, who directed the clerk to write to me for an explanation of my conduct. I was satisfied that I was right, but I had a great deal of trouble in tracing what had become of the boy. Ultimately I found his father, who informed me that the day he was discharged he came home and sat down to his dinner; after the meal was over, the father resumed his work, that of shoe mending, when his son, without saying a word, struck him a severe blow on the head with a hammer. The aid of the neighbours and of the police was invoked, and after a desperate struggle he was overpowered, handcuffed, taken before a magistrate, who sent him to Marylebone Workhouse, from which establishment he had been sent to Hanwell, where he had been some days.

I sent a copy of my reply to the Guardians to the Poor Law Board. My judgment was never again called in question in cases of lunacy. I found this part of my duty an agreeable episode in my daily routine of all but thankless work. I also made the acquaintance of Sir Thomas Henry, Mr. Flowers, and Mr. Vaughan, and from all these magistrates received the greatest courtesy.

Before I had long held office my attention was drawn to the marvellous zeal displayed by the Catholic priests, who, although unpaid, were untiring in their attendance on the sick poor of their persuasion, a large number of whom were always in the House. A somewhat ludicrous incident occurred about this time. There was a very old woman in the infirm ward, across the yard. She was stated to be ninety-five; she had been blind from childhood, and the balls of both eyes were gone, leaving nearly empty sockets. Although life under such circumstances was not very attractive, I never met with any one who so strongly objected to dying. She was constantly sending for me to prescribe for her imaginary ailments. One very cold night, when the snow was on the ground, and it was blowing strongly from the north-east, at about 11.30 my night-bell was rung violently. I had not gone to bed, and therefore answered the door, when I found a young Irishwoman, cowering in the recess of the doorway. On asking what she wanted, she replied, "Oh, if you please, sir, the Father has sent me over to ask whether Bridget Gaines is dying, as a messenger has just come from the House saying Bridget is going, and requesting the Father to go there at once. Now the Father has a bad cold, and his feet are in hot water, and he has a poultice on his chest, and he is afraid to go out as the night is so cold." I laughingly told her to go back and tell the Father that I thought Bridget was not near her end yet. On the following morning the priest called on me. He was very anxious about Bridget, and earnestly asked whether I had heard from the House. I told him there was no need for anxiety, when, in a deprecatory tone of voice, he said, "I should have gone after all, but Bridget has been very tiresome. Do you know," he said, "Bridget has had extreme unction administered nineteen times." I saw Bridget that morning, she was much in her usual condition; she lived a long time afterwards, and probably was anointed on a great many subsequent occasions.

I was constantly encountering odd stories and odd people—many of them profligates who had seen better days. One person in particular attracted my attention, as he had evidently been a gentleman; indeed, he assured me that he had once a large estate in Yorkshire, and was Master of the Hounds. I had no reason to doubt him. He did not live very long after his admission to the sick ward. After his death I received from five different solicitors written requests for a copy of my death certificate. It was accompanied in each case by a fee of a guinea. This poor fellow had insured his life in five different offices, and had sold the policies. It will be seen that I shared in the pecuniary advantages that sprang from his death.

The immediate successor of Mr. and Mrs. Catch did not stay very long. The matron's health broke down, and she had to resign. They were followed by Mr. and Mrs. Thorne, who remained master and matron until the death of the former some years afterwards. Mr. Thorne was a kind-hearted person, who had filled a position of responsibility in the parish of Marylebone; whilst Mrs. Thorne was a well-educated, ladylike woman. They managed the House well, and treated the inmates with kindness and consideration, but do as they would they could not alter the structural deficiencies of the building, make it larger, nor prevent the fearful over-crowding with its disastrous results, nor improve upon the wretched system of pauper nursing, which was the curse of that and all similar institutions, and which the powers that were in those days at Whitehall made no genuine effort to change.

Shortly after the collapse of his friend Catch, the proprietor of the à-la-mode beef shop ceased to be a Guardian, and a wholesale fruit-dealer in Covent Garden reigned in his stead. He was a far less satisfactory Chairman than his predecessor, as all thoughts, words, and deeds were actuated by the consideration of his personal and private interests, as will be shown by the following, among other instances that could be related. One of the earliest things very properly done by the new master was to find out the previous occupation of those who had come in sick, and to utilize them, when recovered, in the trade they had followed, for the improvement of the House. One day a middle-aged man came in very ill. He had evidently seen better days; in fact, he turned out to have been a highly-skilled decorator, especially in the representation of marble and in graining. As soon as he was well enough the master set him to work to decorate the entrance hall. This he did most admirably, and his work was much admired by the Guardians, and by visitors to the House. This employment coming to an end he was allowed, as a reward for his industry, to go in and out, ostensibly to look for work. I used frequently to meet this man on my daily visits. As he continued to go out in this manner, I one day stopped him and asked whether he had been successful in finding a job. His reply, in the negative, was accompanied by a look so significant, that I was induced to push my inquiries, when he told me that he was occupied in decorating the Chairman's house, and he had been engaged at it for some three weeks. To the further inquiry, "What have you got there?" pointing to a bag he was carrying, he replied, "That is my dinner, which I always take with me, from the House." "Oh, then," I said, "the Chairman does not find you your dinner even; does he give you any beer or any money?" He replied, "I have been working there all day long for the last three weeks, and he has never given me anything." As he shortly after disappeared, I made an inquiry as to what had become of him, when I learned that he had suddenly left the work he was doing for the Chairman, and gone off and drowned himself. This Chairman did not long continue to act as such, as some months after this he died suddenly of heart disease, the only evidence he had ever afforded that he possessed one. Having occasion just at that time to go to the Poor Law Board, I was waiting in an office for the gentleman I went to see, when one of the junior officials said to me, "You have lost your Chairman." "Yes," I replied, "but I do not feel his loss very acutely;" on which he said, "It is customary for the clerk of the Board to write and apprise us of the death of the Chairman, and we always send a sympathetic letter in reply. On the clerk's letter being read the question was asked, 'Should the usual reply be sent?' The official reply was grim enough: 'Write and say that we are delighted to hear it.'"

The successor in the Chair was very friendly disposed towards me, and remained so until after the official inquiry in 1866, when, having attended to hear the evidence that was given, and having made himself conspicuous by some irrelevant interruptions, he brought down on himself the criticism of the Press, which he most absurdly attributed to me, and resented by becoming a most determined opponent ever afterwards.

About this time a Select Committee of the House of Commons was appointed to take into consideration the administration of the Poor Laws, and to decide as to the desirability or otherwise of the maintenance of the Central Department. In conjunction with my friend, the late R. Griffin, of Weymouth, who distinguished himself so much by an advocacy of an amended system of medical relief, and the late Dr. R. Fowler, of Bishopsgate Street, I volunteered to give evidence before the Committee. Some time after, being asked by the late Metropolitan Inspector, H. B. Farnall, Esq., C.B., to call upon him at the Poor Law Board, I did so. "I hear," said he, "that you have asked to give evidence before the Select Committee; pray, what are you going to state?" "Nothing," I replied, "that bears on my personal position as a Poor Law medical officer, except so far as I may support my views by reference to my personal knowledge. I shall give evidence for the purpose of urging on the Committee the desirability of abolishing the system, whereby Boards of Guardians for a stipulated sum, often wholly inadequate, bargain with medical men to find all medicines and appliances, because the inevitable outcome of the system is this—that the poor do not get the medicines they require. I feel that the sick of the Strand Union got very little in the way of medicine before I was appointed, and the provision of such medicines was to me in every sense a pecuniary loss, until the Guardians quite recently increased my stipend so as to make the strain less felt."

He at once assured me that he would do his best to put my views before the Chairman, C. P. Villiers, M.P. for Wolverhampton. I did not at that time know Mr. Villiers personally, except by repute, but I came to know him some years later. Mr. Farnall then proposed to put some questions to me and take down the answers. This he did, and as each question was put I replied briefly, giving my reasons for my suggestion. I had to be guarded in my answers, as I was not desirous of bringing the charge against my medical brethren that they systematically failed to supply medicines for the sick, though very many have with more or less questionable candour said to me, "Why do you bother about the supply of medicines? Go in and get for us an increase of our pay."

After Mr. Farnall had put me to the question, he shook me very warmly by the hand, promising that as far as I was concerned the views I held should be brought prominently forward.

Some time after I received a notice to attend, when I found Mr. Richard Griffin and Dr. Fowler in the room. Griffin had come there with evidence that would have taken a month to take down. Fowler was not so diffuse, a couple of days would have got through what he had to say. Appalled by the vast body of evidence offered by these two, the Committee ordered the room to be cleared; on our re-admission we learned that the Committee had decided that Mr. Griffin and Dr. Fowler should put in their evidence, which should be taken as if delivered. I was then called on. I had neither note nor paper, as I relied on Mr. Farnall's promise. The questions were mainly put by Mr. Villiers. I amplified briefly the views I had expressed to Mr. Farnall. This led to my being asked for some additional explanations, which I supplied. Ultimately I was dismissed, but not before I had convinced myself that my day's work had not been thrown away. Poor Richard Griffin had worked for many years with wonderful industry to call attention to the grievances of Poor Law medical officers, and thought he should succeed. But he was destined to fail, for although the Committee had allowed him to put in his evidence, yet the facts he had collected with so much pains were successfully traversed by Mr. R. B. Caine, Poor Law Inspector, who by certain statistics made out to the Committee's satisfaction that medical men had no great cause for complaint. Poor Fowler's evidence was similarly snuffed out; as regards mine, the Committee reported in its favour, but not as to the whole of it. They probably dreaded the cost to the various Union Boards of the provision of all medicines, but they suggested a compromise, to wit, that Boards of Guardians should be required to supply expensive medicines, such as cod liver oil, quinine, opium, &c. Small as the concession was, Mr. H. Fleming delayed the issue of the Committee's recommendation for fifteen months after it had been made, and then sent out a letter couched in such official language that a great many Boards contented themselves with ordering the letter to lie on the table. Some years after, I asked Dr. Lush, M.P. for Salisbury, to move for a copy of the Board's letter and a return of what had been done. I found from that return that about half of those bodies had not noticed the letter at all. Subsequently, twenty years after the issue of the letter, my brother, Thorold Rogers, moved for a similar return, only to show that there were still several Boards where nothing whatever was supplied.

When the letter was read at the Strand Board, a suggestion was made that I should be offered an increase of my stipend and be required to purchase the medicines myself. This I declined. Ultimately it was arranged that I should be allowed to order drugs of a wholesale chemist, but only to the extent of £27 a year: anything beyond that I was expected to pay for myself.

About this time (1862) the matron informed me that on the previous day a very aged woman had been admitted, and that she had sent her to the infirm ward across the yard. On looking at the order I found it was stated that she was 104. I went to see her. She was undeniably of great age, but she still retained her faculties and conversed with me for some time. She told me that she had lived in Chancery Lane between fifty and sixty years, and was forty-five years old when she went there to live. She also told me that she went down the Lane to see Nelson's funeral procession go by, that her children and her grandchildren were dead, and that she had been looked after lately by her great grandchildren, who had grown tired of waiting on her, and that was why she had come into the House. Her eyes were blue and complexion fair. She did not live long after her admission, the change from her own airy room to the close and at times fetid atmosphere of this overcrowded ward was too much for her aged frame. She passed away quietly, and I remember filling up a death certificate for 105 years.

One day, I was informed that a very distressing case had been passed from Canterbury. It was a young woman about twenty-four. She had one child, and was about to be confined again. It would appear that she had married a coach-builder, who was born in St. Paul's, Covent Garden. She told me that he was a very good, quiet man, when sober, and had been very kind and good to her, but that when he took anything to drink he became as one insane, and in one of his drunken fits he had knocked a man down and killed him; that he had been tried and found guilty of murder, and was then lying under sentence of death. I also learned that the Guardians of Canterbury had passed her on to us, away from all her friends. The poor creature was simply broken-hearted. She had a very bad confinement, and remained long sick and ill. When she got better she made an application to the Strand Board for outdoor relief. She was told to come before the Board at the next meeting in Bow Street. It was unfortunately a very wet night, and being thinly clad, she got wet through, and sat in her wet clothes two hours. She also got wet on her return journey. That night she was seized with inflammation of the lungs, and remained for many weeks in the greatest jeopardy. Ultimately, she got better, when I sent her to a Convalescent Home in Hertfordshire. She was so patient and grateful that I wrote an account of her sad story, which was published in The Morning Star. It evoked donations amounting to £25. After buying her some additional clothing, I paid her journey for self and child to Canterbury (the baby had died), handing her as she went away some £20. The Board, at my request, allowed her outdoor relief for a twelvemonth. Some years after, I happened to be in Canterbury, when I found her out. She had been in the same situation some seven years. She had supported herself and child, and had no occasion to spend the money I had collected for her; altogether she fully bore out the opinion I had formed of her. The reason why the Guardian Board had acted so harshly to this young woman was this: If they had allowed her to remain in their workhouse until after the execution of her husband, as a widow they could not have removed her for a twelvemonth; they therefore sent her away at once to avoid this dilemma.

About two years after Mr. Catch's departure, I was surprised by a visit from the medical officer of the Newington Workhouse. He told me that he had called to ask me whether I could advise him what he was to do; that Catch obstructed him in his duty, swore at him, and refused to obey his orders. I told him to go down to the Poor Law Board, but that they might or might not assist him. Unfortunately, at that time, Mr. Farnall was away in Manchester, superintending the special relief arrangements in Lancashire with regard to the Cotton Famine, and there was no one at the Board who could or would advise him. He called on me on several occasions subsequently to tell me of the misery he daily underwent. On one occasion I told him to write down in a journal all instances of obstruction, and if possible get every case verified by a witness. Sooner or later you will catch him, I said. He followed my advice. One day he came to me and told me he thought he had got together sufficient evidence, and should now ask for an official inquiry. Mr. Farnall, one of the most honourable Poor Law Inspectors the Board ever had, had just then come back to town. I got some influence to bear on the Board, and an inquiry was granted. It lasted some time, and Mr. Simmonds proved the obstruction, &c., so completely, that on the last day, and when it was evident how the case would go, Catch followed the doctor and paid nurse out of the Board-room. They stopped in one of the day wards to discuss the case and its probable results, when Catch went to his office and wrote in his journal that he had surprised the pair holding improper relations. This charge coming to the knowledge of the nurse, who was a respectable young woman, she went at once to the physician accoucheur of Guy's Hospital and requested that he would examine her. This he did, when he gave her a certificate that Catch's allegation was untrue. A special meeting of the Board having been called to investigate this charge, it was made absolutely clear that Catch had hatched this foul accusation. The Board immediately suspended him. The circumstances were reported to the Poor Law Board, who called on him to resign. It will hardly be believed that after this, Catch, mainly through the influence of his friends at the Strand Board and the aid of the clerk, got appointed to the Lambeth Workhouse, where for some time he tyrannized over the subordinate officers and inmates, until at last, his cup being full, he lost that appointment also. Hereafter I will give the particulars of this episode, and of the notable trial in the Court of Queen's Bench, where he attempted to clear his character and to get reinstated.

For five or six years after the departure of Mr. Catch my life was a fairly pleasant one. There was no obstruction from the master or the matron, and as there was nothing to ask of the Board things went on quietly, and therefore the daily duty ceased to be onerous added to which I had several pupils whose instruction in the wards was to me a very agreeable pastime. Here let me remark how melancholy it is that the vast field for clinical observation and study which the sick, nursery, and lying-in wards of large urban workhouses afford, should be utterly thrown away. There are certain diseases which can hardly be seen anywhere else, such as of those of young children and of aged persons, and yet they are completely ignored.

I have said that for a time everything went on peacefully, but a rude awakening was in store, for about the years 1862-1865, in consequence of widespread distress in the metropolis, persons were admitted beyond the capacity of the House to hold them. This necessitated a representation to the Board, and, as a consequence, a revival of the antagonism from the so-called economical members of the Board, who charged me with being too squeamish, and with having brought the influx on myself by being too indulgent to the sick. The hostility went so far with one Guardian who considered me so very troublesome that he put a notice on the agenda to reduce my salary. This was renewed by him from time to time, indeed, whenever I made a representation to the Board on this subject.

That there was abundant cause for such representations will be understood when it is stated that, in consequence of the overcrowding and the heated and vitiated atmosphere caused thereby, cases of fever induced therefrom were constantly cropping up, and it was one of my perplexities how to deal with them. In those days there were no such facilities as now exist for sending fever cases away to separate asylums, and we had to do the best we could.

Having, in 1863, had a succession of boys affected with fever sent in from St. Anne's, Soho, I inquired of the relieving officer from where they came, whereupon he informed me that a Mr. Williams, a clergyman in Porter Street, Soho, had opened a home for friendless boys. On interviewing this clergyman, I told him that I had called to protest against his sending these fever cases to the Workhouse, there being no room for them. He replied by asking me what he was to do with them, as at that time he had some four or five boys down with fever; and then he took me into an old, disused slaughter-house, where, on some straw, I saw these lads lying ill. Before leaving him I arranged that he should go over the House and see for himself that there were no vacant beds. On the morning appointed he came, bringing with him a person whom he represented to be his secretary, and who he asked to be allowed to take with him. No objection being made, he accompanied us. I was somewhat surprised at the bearing of this so-called secretary, and still more so at his conduct in the House, when we went through the wards. I thought he was a very intelligent gentleman, and wondered at him occupying the position of secretary to Mr. Williams, at say, £1 a week. I satisfied Mr. Williams that I could not continue to take in his numerous waifs and strays, and on leaving, his companion parted from me with many expressions of thanks for my courtesy in allowing him to accompany me. I had not the least idea who he was, or his name, but I felt pretty sure that he must be a gentleman. It transpired subsequently that he was no other than Mr. J. Alexander Shaw Stewart, and my chance acquaintance became in after years one of my kindest and truest friends. As a result of this interview with Mr. Williams a school was opened, called afterwards the Newport Market Refuge Industrial School, and for several years it was under my medical charge. During the years I was connected with that establishment I never had a case of fever of any kind, although the school was located in a densely crowded and repulsively degraded neighbourhood. It was a striking instance of what could be done in keeping schools free from epidemic disease, if only the persons having control of them adopt, and strictly carry out, judicious sanitary arrangements. During my period of office I made the acquaintance of the Duke of Westminster, Mr. and Mrs. Gladstone, the latter of whom was a frequent visitor there, as well as many ladies of rank, &c.

About this time there came an urgent request to go to the House. On my arrival I found a young German woman near her confinement who was in a state of great mental distress. On asking for an explanation, I was informed that the day before a gentlemanly-looking person had called at the house and asked to see the matron. To her he stated that he was a medical man, and had been commissioned by the friends of one of his patients to look out for some healthy young woman near her confinement who might be engaged as a wet nurse by a lady under his care. The master brought down to him this girl, when he instructed her to send her next day to his consulting-room, where the lady's friends might see her. She accordingly went. Shortly after her arrival there she rushed out of the house, stating that she had been insulted by the doctor. Police aid coming to her assistance, the doctor's residence was visited, with the result that he was taken into custody, and brought before the magistrate, who remanded him without bail for inquiries to be made. The publicity of the case led to the bringing of other charges of a similar character, and he was ultimately committed for trial. Having been called upon to attend the German girl, I was naturally called as a witness, and was subsequently subpœnaed to attend at the Old Bailey. I found four other young women there in a similar predicament, all in charge of a police constable, and for three days I spent my whole time in their company, for whenever I got up to walk anywhere the women and the constable got up also and followed me. The situation was suggestive, but by no means pleasant. On the Thursday morning I was informed by the prosecution that I might go away, as the prisoner, who turned out to be a man of good family and an officer in the army, had pleaded guilty to a common assault, &c., &c. As the girl's history was somewhat interesting I sent an account of it to The Times newspaper. It was as follows: She had been living at Chicago with her two brothers, when they received a letter stating that their mother in Germany was very ill, and begged that her daughter would come home. She started immediately, but on arriving at her native town found that her mother was dead. She thereupon sold all the effects, and with upwards of £100 started back again for Chicago. She passed through London to Liverpool to take passage for New York, but the machinery of the steamer breaking down when two days out, the captain returned for repairs. She had made the acquaintance of a young Frenchman on board, who finding she had money, made love to her, and induced her to go back to London and become his wife. After living with her until all the money was gone, he deserted her, and being without friends, she had to come into the House. My letter appearing in The Times, some £45 was sent me, which sufficed to enable me to send her and her child to her brother in Chicago. I provided her with an outfit, and arranged with the captain of the steamer to take charge of her, and send one of his trustworthy officers to see her to the station in New York for Chicago, and parting with her to put into her hands the balance remaining. Some months afterwards I had a letter from the captain, stating that he had carried out my request, and had finally given her the £25 or thereabouts. There was every reason to believe that one of the subscribers was Her Majesty the Queen, though it was not so distinctly stated in a letter I received from a gentleman connected with the Court.

In the early part of 1865 the Guardians appointed a superintendent nurse. She was a young, and very respectable-looking woman. The Guardians had been moved to do this by the evidence of Miss Twining before the Select Committee, and by the general feeling excited by the revelations made in Gibson's case in St. Giles's, and that of Timothy Daley in the Holborn, Union. In the winter of 1863 and 1864, and again in 1864 and 1865, as also in 1865 and 1866 the admissions had been so many, and the crowding so great, as to tax the resources of the establishment to the utmost, notwithstanding that I had moved the sick ward to the top of the building, and gained additional cubic space by removing the ceiling and re-ceiling the rafters; but I could not by any contrivance increase the area. The beds therefore were placed so close together that the patients had to get out at the end of their beds, there being no possibility of getting out at the side. It was a task beyond this young woman's strength to effectually supervise the numerous patients, but she could check some of the graver abuses connected with pauper nursing. This she did to the best of her ability. In the same spring that she was appointed—that of 1865—the late Dr. Francis Anstie called on me. He said he was deputed by the late Dr. Wakley to call and state that he had decided to appoint a commission for the purpose of investigating the state of London workhouses, and he thought I could suggest the best course to follow to obtain admission to them. I told him I would introduce him to the Chairman of the Board, who alone had the power to grant permission to a stranger to enter the Workhouse, unless special application had been made to Board, and leave given. He called on the Chairman, who gave him a letter to the master, authorizing his admission. Before he left, I told Dr. Anstie that when he went over the House I would accompany him. Some short time after, he wrote, making an appointment. I showed him through the whole House, pointing out the defects and shortcomings, and told him of my continued efforts to get the place improved, and of the determined hostility of the majority of the Board to any efforts I had made. I also showed him a list of the fever cases I had attended, and how constantly fever was developed when the numbers increased and the overcrowding was greatest. Dr. Anstie took careful notes of what I showed him, as the sequel proved. Some month or so after, I had a note from him, asking me to look in that week's Lancet for the report of his visit. I did so; when I found that he had exposed the rotten condition of things with marvellous clearness and fidelity, but as he had referred to me and my efforts to clear out this Augean stable, I was perfectly convinced that the least intelligent element of the Board would be incited by their clerk to charge me with having written the article in question. As I anticipated, this came to pass, for I heard that so it had been said at the Board meeting, and in consequence, a most insulting resolution was adopted, in which I was directly charged with trying to bring the Guardians—'who were my masters'—into contempt. So angry was their language and so bitter their hostility, that Dr. Anstie wrote to the Board, stating that he had been permitted by their Chairman to go over the House, and that the observations he had made were his own, and that I had not seen a line of his manuscript, or knew of his report, until it appeared in print; he further challenged the Board to show where, in his description, he had departed from the truth. The storm he had raised was, after a while, allayed. Dr. Anstie continued to visit other workhouses, the condition of which he similarly described. These reports, which appeared in The Lancet, were copied into, and commented upon, in sundry daily and weekly journals, and gradually produced a feeling of intense public indignation. Dr. Anstie had acted so generously towards me in screening me from the hostility of the worst elements of the Board, that I arranged a dinner-party, to meet and discuss workhouse abuses. Among the guests was Mr. John Storr, of King Street, Covent Garden, who was one of the wealthiest, as he was one of the most respectable, members of the Strand Board, and who, since his election two years before this, had proved to be my most able advocate and friend. When Dr. Anstie arrived, he brought with him Mr. Ernest Hart, whom he introduced as one of the staff of The Lancet, and as one interested in the question of workhouse administration. After dinner a discussion took place as regards the general condition of these establishments.

Ultimately it was arranged that a conference should be held at Mr. Storr's offices, King Street, Covent Garden, at a time hereafter to be named. Our dinner-party was held in December, 1865. In the early part of January, Dr. Anstie, Mr. Hart, and I, met by appointment at Mr. Storr's, when our discussion was resumed. At first it was proposed that we should call a public meeting and denounce the system, when I pointed out that if we only did that the agitation would soon come to an end, and therefore it would be better to form an Association for the purpose of more thoroughly enlightening the public. My suggestion was adopted. Mr. John Storr generously offered to put down £100 to float the Association. He also offered to become its treasurer, and to give us the free use of one of his offices, in which the meetings of the Association could be held. This meeting took place on a Thursday evening, and as The Lancet came out next day, Mr. Hart left us and went down to The Lancet office, to announce in the paper the formation of the society. At our meeting it was also arranged that we should respectively write to those we knew and ask them to join our Association. I wrote, among others, to Mr. Shaw Stewart, who at once joined us, and to Miss Twining, and to many other ladies and gentlemen who had been engaged in works of benevolence. The Association prospered beyond our wildest anticipations, and we were speedily joined by Earl Carnarvon, Earl Grosvenor, the Archbishop of York, &c.; whilst money came in freely. Shortly after the formation of the Association, of which, in conjunction with Dr. Anstie and Mr. Hart, I was one of the honorary secretaries; Mr. Farnall, the Metropolitan Poor Law Inspector, wrote to me, stating that he had been deputed by Mr. Charles P. Villiers, the President of the Poor Law Board, to offer his services in giving information to the youthful Association, and that he had written to me, as I was the only honorary secretary he knew. Mr. Farnall subsequently attended the meetings of the committee, and afforded us much valuable information. No use was ever made of Mr. John Storr's office, as all subsequent meetings of the Association were held in Mr. Hart's house, in Wimpole Street.

In the month of May, 1866, Miss Beaton, the superintendent nurse, informed me that she intended to resign her situation, and apply for another as a nurse at a general hospital; at the same time asking me whether I would give her a reference. Whilst expressing my regret that she was going, I readily promised to do all I could for her, and with that object gave her a letter of introduction to Dr. Anstie, assistant physician to the Westminster Hospital, and to Mr. Hart, who was then connected with St. Mary's Hospital. Dr. Anstie took her name and address, and promised to do what he could for her; Mr. Hart asked her to sit down, and proceeded to question her on the various matters connected with the Strand Workhouse I had mentioned at the committee meetings, &c. Ultimately he dismissed her, but not until he had a promise from her that she would write down all her experience of the wrong-doing she had witnessed at the Strand. She did this. On getting her manuscript statement he sent it to Earl Carnarvon, one of the committee, and asked him to apply to Mr. Villiers for an official inquiry. I had not the remotest knowledge that anything of the kind had been done, nor had my other colleague, Dr. Anstie. In the early part of June Mr. Hart told me that there was to be an official inquiry into the management and the condition of the Strand Workhouse, and that I should be called as a witness, but he did not tell me how it had been brought about. A few days after I received an official intimation that such inquiry would be held, and that my attendance would be required. I had hoped that the inquiry would be conducted by the Metropolitan Inspector, Mr. Farnall; but it was not so. Mr. Fleming sent another member of the staff. The inquiry was held, the first witness called being Miss Beaton. She astonished me by the extent and character of her revelations, of some part of which I was an eye-witness, and therefore knew to be true. Her examination lasted all day. Next morning, the evidence she had given appeared in all the papers, which commented thereon. On the second day I was called. On taking my seat Mr. Caine said, "Oh! we have met before;" I did not know where. I had not long been under examination before Dr. Anstie, who was in the room, came behind my chair, and said, "Take care how you answer questions; this inspector does not mean fairly by you; he is trying to put you in a false position." Forewarned by this, I simply answered his questions, and parried those which were irrelevant and misleading. The next day my evidence, in full appeared in every paper, and all the leading journals denounced the Board of Guardians for their management of the House. It was unfortunate that my Board should have been selected, inasmuch as nearly all the workhouses in the metropolis were in very much the same condition. After the close of the inquiry Mr. R. B. Caine returned to Whitehall, and made the remarkable statement in his official report that the condition of the House was due to my not having made proper representations to the Guardians. I subsequently heard that on his report being submitted to the President of the Board, it was altogether set aside by him, and that he wrote the report himself. It had, however, come to my knowledge that Mr. Caine had delivered himself of this view; when I wrote to the Poor Law Board complaining of his injustice, and pointed out that for some three years he had, as Metropolitan Inspector during the time Mr. Farnall was away in Manchester, visited the Strand, and that he had always entered in the visitors' book that he was completely satisfied with the state of the House. I am happy to say that Mr. R. B. Caine got very little credit out of the whole transaction, for his report was severely criticized by the press for its transparent bias. Just at this time a circular letter was sent by the Poor Law Board to all the workhouse medical officers—some forty in number—in the metropolis. It was issued evidently with the view of entrapping these gentlemen into contradictory answers to the questions which were submitted to them. It was clearly necessary to take immediate action. I therefore sent a letter to each of them, asking them to meet me at the Freemasons' Tavern, Great Queen's Street, Lincoln's Inn Fields. The majority of them came. Having been voted into the chair, I pointed out to them what was the object of the letter, and earnestly urged that we should agree as to the form of reply. This view was adopted, and the answers as agreed upon were sent by all present to the Poor Law Board. On the same occasion it was arranged that an Association should be established of metropolitan workhouse medical officers, so that we might be prepared to deal promptly with any similar departmental trickery. This was done, and I was elected as the first president, an office which through various changes I have occupied to this day. The Association was, during the two following years, enabled to play an important part in the settlement of many vexed questions in the administration of workhouse medical relief, which, without the practical knowledge of medical men, would have been wholly left in the hands of the officials at the Poor Law Board, who at this time exhibited a singular unwillingness to face the facts. My official life after this was a particularly unpleasant one, inasmuch as I was credited with having asked for the inquiry, and having resolved to state that which would bring "my masters" into contempt. I should have survived all this misrepresentation, but unfortunately just at this juncture the Liberal Government was overthrown, and the Derby-Disraeli premiership was established. Earl Derby speedily pointed out that he intended to deal effectually with the scandal that had been brought to light in connection with workhouse infirmary administration, and with that view he had selected Mr. Gathorne Hardy—now Lord Cranborne—as the President of the Poor Law Board, he being in Lord Derby's judgment one of the fittest men in Her Majesty's dominions to put things straight. Mr. Hardy up to that date had been principally known as a Chairman at Quarter Sessions, and an ex-officio Guardian of a Kentish Board of Guardians. One of the first official acts of this gentleman was to punish Mr. Henry Farnall for his conduct in aiding the Workhouse Infirmary Association. He was banished from London and sent to the northern counties. As Mr. Farnall's residence was at Blackheath, where his wife and children were living, this act of Mr. Hardy's was a serious inconvenience to him. The next thing done was to appoint Dr. Markham as a Poor Law Inspector and so-called medical adviser. Dr. Markham up to this date had been the editor of what was at that time an obscure journal. He was not known to have ever been associated with any sanitary work, nor to have seen the inside of a workhouse in his life, and yet out of all the able physicians at the time in the metropolis he was selected. The popular explanation given for this appointment was that he spent the larger portion of the day in looking out of the windows of the Carlton, Pall Mall, and that Mr. Hardy, making his acquaintance, gave him something to do. He fully justified the selection thus made, as will be shown hereafter, as he became in every sense one of the most difficult officials of the Board.

At this time the permanent officials, notably Dr. Edward Smith, promulgated the heresy that the area and cubic space suggested by our Association for the housing of the sick was excessive; indeed, that the area did not so much matter if the roof of the sick ward was carried up high enough. These and other statements having been promulgated by the staff, a meeting of the Workhouse Medical Officers Association was called, to take the subject into consideration. We had the aid of the late Dr. Parkes, the eminent Professor of Hygiene, at Netley Hospital, as well as of my two colleagues in the secretaryship of our Association. Conjointly, we drew up a paper stating what was in our view the minimum area and the minimum cubic space that should be sanctioned. This action forced the hand of Mr. Hardy, and caused him to issue a cubic space commission to determine this question.

Shortly after the formation of the Conservative Government a numerous and influential deputation, consisting of Earl Shaftesbury, the Archbishop of York, Earl Grosvenor, and many others, waited on Mr. Hardy, when representations were made to him urging extensive alterations on the then system. I was so hurt at the intrigues going on at the Poor Law Board and the attempt of Mr. R. B. Caine to make me solely responsible for the condition of the Strand Workhouse, that I availed myself of the opportunity to tell the President that in any scheme he might lay down for an alteration, I hoped that he would be guided by his own judgment, and not by that of the permanent officials, who would most assuredly lead him astray. This plain speaking was not particularly relished by those against whom it was mainly directed; it doubtless intensified ill feeling against me. I also handed to him a series of Resolutions drawn up by the Council of our Poor Law Medical Officers' Association protesting against the misstatements that had been propagated by Dr. E. Smith, Poor Law Inspector, against the Metropolitan Workhouse medical officers.

Immediately subsequent to this our Workhouse Association engaged itself in drawing up a scheme for a general dietary for all London workhouses, which differed in every establishment; in some being, as at the Strand, when I first went there, niggardly in the extreme, while in others it was absurdly liberal. This question had engaged my attention many years before, and when I introduced an amended dietary at the Strand I was often twitted by the economical element of the Board to the effect that my liberality in the way of dietary was the reason why the House had filled so much, paupers being attracted to the Union by the prospect of being better fed by the liberality I had evinced. This allegation was absurdly unjust. Years before, in 1863, I had, at the time I amended the dietary at the Strand, addressed a letter to the Department urging that they should issue a general order to the London Boards of Guardians enclosing a copy of a uniform dietary to be used in all Metropolitan workhouses (acute cases of sickness alone excepted). Although this suggestion had the approval of Mr. Farnall, who invited me down to the Board to talk the matter over with him, it was set aside. Mr. Fleming, the secretary, objected to everything of a controversial character. About this time, understanding that Mr. Hardy was engaged in drafting his Metropolitan Poor Bill, I wrote to him on several occasions; one of the subjects I urged on him was the advisability of turning the vast field for clinical observations which our Workhouse infirmaries afforded to some practical purpose by throwing the wards open to medical students, pointing out what had been done at the Marylebone Workhouse Infirmary some thirty years before; I also urged that the hospitals he was about to establish should be officered by a resident medical man or resident medical men, but that in no instance should they be left alone in their control, but that their work should be superintended by an extern physician. I understood that my view was overruled through the opposition of certain physicians who thought that the educational opportunities thereby proposed would interfere with the voluntary hospitals they were connected with and the students attached to them.

I also pointed out how desirable it was that pauper schools should be consolidated, and that permanent young pauper children should be separated from those who were constantly going in and out of workhouses. Mr. Hardy always replied personally and with marked courtesy to the letters I sent him. In the session of 1867 Mr. Hardy brought in his Metropolitan Poor Bill. In his speech introducing it he referred to my evidence before the Select Committee, and said that he had resolved to adopt the views I had advocated, namely, the provision of all medicines and appliances at the cost of the rates; but although the Bill passed with great facility and amidst general approval it was a very long time, in some cases four, five, and six years, before the dispensary clauses were carried out. The Bill had hardly become law before Mr. Hardy was transferred to the War Office and Earl Devon became President. This nobleman when Lord Courtenay, Poor Law Inspector, or Lord Courtenay, Parliamentary Secretary, had entirely supported the worst parts of the old system of administration and control. He always yielded to Boards of Guardians, and, when President, entirely deferred to the permanent staff. During the short time that he held office—for the election of 1868 shortly afterwards occurred and with it a strong reaction—he instituted a new order of officials at Gwydyr House—to wit, Assistant Inspectors.

Of course it was not to be expected that the evidence given by me at the official inquiry would fail to intensify the bitter hostility of a section of the Board towards me, especially as the clerk to the Guardians never lost an opportunity of putting my conduct before them in the worst light. Consequently, shortly after my evidence had been given an attempt was made to displace me. The Guardian who moved my resignation was a lodging-house keeper in St. Clement's Danes. Having been told that this Guardian contemplated this procedure, I forwarded a letter to the Board in which I gave an outline of all I had done and had attempted to do during the ten years I had been the medical officer, the amount of antagonism I had provoked, and the various resolutions which had been adopted as the result of my endeavours. It was not very pleasant reading for some of them to hear, as there were several still there who had taken an active part in thwarting me at all times, and this letter thoroughly answered them. In spite of all that was alleged, when the resolution was submitted to the vote it was found that I had just as many friends as enemies, and therefore the motion was not carried. I do not know whether at that time the intrigue between the clerk and certain permanent officials of the Poor Law Board had commenced, but it took place not a very long time afterwards, as I found out some twenty months after.

One result of the evidence I had given as regards the over-crowding was this: I was empowered to send some of the acutely sick to the voluntary hospitals, and I did so to a limited degree, but my action here was again met by the hostility of a section of this Board. It was suggested that I had sent them away to get rid of the trouble of attending to them, and it was gravely proposed that I should have the cost of the cabs in which they were removed deducted from my salary.

As an illustration of the mode adopted by some Boards to annoy their medical officers I subjoin the following: In June, 1867, a person was sent into the Strand Workhouse by the district medical officer, insane. In conjunction with a Justice of the Peace, I examined him, and we certified as to his mental condition, whereupon he was sent to Hanwell. Three weeks after, he was discharged from the asylum, not because he had recovered, but through an informality in the certificate given by the justice. As this latter gentleman was out of town, I took the lunatic before Mr. Vaughan, at Bow Street, who, after examining him for a minute or so, threw up the certificate, and said he would not sign it, the man was not mad. I again implored him to fill up the certificate, as the man had been only sent back to the House through an informality in the certificate. As he again refused, I said, "Then I have to request that Sir Thomas Henry be apprised of the case." This was done, and Sir Thomas advised that he should go back to the House for another week. That afternoon the lunatic was interviewed by three of the Board, who pronounced the opinion that he was of sound mind. Hearing of this irregularity, I wrote to the Commissioners in Lunacy, and asked them to see the man. They attended at the House and examined him, and directed his removal to Hanwell without delay. That night he escaped by scaling a high wall, and was not captured for three days, when the police caught him. In the following September he was discharged cured, when I received a letter from the clerk, informing me thereof, and stating that the Board was of opinion that I had been too hasty in sending the man away, and that too by an unusual course. I immediately wrote to the Commissioners in Lunacy, enclosing the clerk's letter, and asked their opinion, when the secretary, Mr. C. P. Phillips, wrote to me stating that at the time the Commissioners saw him he was clearly insane, and that the Commissioners approved of my action under the exceptional circumstances of the case. I sent their reply to the Board. The evening the clerk read my letter to the Board, the man's wife made an application for his re-admission to the House, as he had a relapse of his insanity. This man went into and out of the asylum on several occasions subsequently. Whenever he was at liberty he made me aware of it by coming to my house between 1 and 2 a.m., and ringing my night-bell violently. Of course I had to put up with the infliction, as the man was not in his right mind. This annoyance went on for years, and only ceased when I left Soho.

The Guardians also authorized my sending some of the infirm women to Edmonton, where the school for the pauper children was situated. This school was a favourite place of resort for the worst members of the Board, and very comfortable parties were kept up there at the expense of the ratepayers. A certain portion of the Guardians went down fortnightly in carriages to inspect the schools, and every scheme was adopted by those not on the School Committee to be asked to go out of their turn by those who were entitled to go. It meant an outing in the country, and a splendid dinner with wine, &c., and tea, free of cost, to all who went there.

Of course the resident officers were always in high favour with the majority of the Board, and to arraign them or their conduct was a hopeless affair, as the least competent element immediately stood forward to shield them.

In the September of 1867 a young girl was admitted, suffering with rheumatic fever; she remained ill some time, but towards the end of the month she recovered sufficiently to be sent to a Convalescent Home, but as the autumn was a cold one I decided that she should be sent to Edmonton, and to secure her considerate treatment I wrote a special certificate, which was addressed to the matron, in which I stated what had been the matter with her, and begged that she should be kept warm and not employed in scrubbing or any damp occupation.

About a month afterwards I found this girl again in the women's sick ward in Cleveland Street with a severe relapse of her rheumatic attack. On inquiry I was told by the girl that shortly after she had gone to Edmonton the matron came into her ward and told her to go to the laundry. On her reminding her that she was still weak, and that the London doctor had directed that she was to be kept warm, the matron abused her and again ordered her there. She went. In a very short time she broke down; the matron, however, persisted in keeping her at work, but at last she became so ill that she was compelled to put her to bed. On the school doctor seeing her it was decided to send her back, to town, some eight miles distant. She was sent in a tilted cart and very imperfectly clad—that, too, on a very cold day. It was altogether so improper a proceeding that I complained to the Board, who made inquiries of the matron, &c., who of course denied the facts in toto. This false answer was sent to me. I was so enraged that I drew up another complaint and sent it to the Poor Law Board and asked for an inquiry. Dr. Markham was deputed to go through the form of an investigation, which he interpreted by going, unknown to me, to the sick ward, asking one or two questions of the girl, and sending for the matron at Edmonton to come to his private house in Harley Street. I did not know this at the time. He then reported that I had made a "frivolous and vexatious complaint." I will leave my readers to determine whether this procedure was not a mockery of a Departmental inquiry. This report, thus obtained, was sent to the Guardians, whereupon a man, who had misconducted himself at the official inquiry by coarsely asking "whether mesenteric disease was not something to eat," moved that I be suspended from my office. This was adopted by the Board, only four of the members supporting me, the fact being that the Board had changed very considerably at the preceding election, some of the Board ejected from office two years before having unfortunately returned again. Of course it was necessary for the Board to report this suspension to the Poor Law Board. The clerk asked permission to absent himself from duty for a time. He took with him the minutes of the Board for the preceding twelve years, and busied himself with extracting all the hostile resolutions which the Board had adopted against me, frequently at his suggestion, in return for my continuous efforts to cleanse their augean stable. I do not know who had distinctly intimated to the clerk that it was desirable to get rid of me, but the mover of my suspension stated that he knew the Poor Law Board wanted to get me discharged. That was admitted some time after by Sir Michael Hicks Beach in a conversation he had with a medical gentleman living near him in Gloucestershire.

Some month after my suspension a copy of the clerk's extracts was sent me by the Poor Law Board, and I was asked what I had to say to it. I acknowledged its receipt, and asked for an official inquiry. This request was ignored, although it was suggested by a minority of the Board, by the Vestry of St. Anne's, Soho, who unanimously supported me, and by many influential inhabitants of the parish in which I had lived and worked. That my suspension would have been followed by the Poor Law Board calling on me to resign my office, without delay, would have been certain, but the President, Earl Devon, was away, although the most terrible distress prevailed that winter in East London. He had gone off to the South of France, and there he remained some three months. On his return, he at once put me out of doubt by removing me from my office. It is very curious, but true, that when I turned on this Department and stated my own case, he made the remark to a friend, who repeated it to me, that he was surprised at my hostility to the Board, as in calling for my resignation no reflection had been made by the Department on my character. At this time a general order was issued by the Department, imposing, without payment, additional and onerous obligations upon Workhouse medical officers. It was to the effect that they should make, from time to time, a return of all that was amiss in their respective workhouses to the Board of Guardians, the doing of which, on my own account, had led to my differences with the Strand Board. It had always been understood that this was one of the duties of the Inspectors, but it was attempted to throw the obligation on the doctors. After Earl Devon resigned, our Council had an interview with Mr. Goschen at the House of Commons, who promised an important modification of this unjust order.

When my compulsory resignation was called for, it was decided by the Rev. Harry Jones, the late Dr. Anstie and others, to call a meeting of the all but moribund Infirmaries Association at Mr. Hart's house, to discuss the matter, and arrange for action. The meeting was addressed by both of these gentlemen, and by several others, and the action of the Department was severely censured by all who were present, except one person. Sir John Simeon, M.P., undertook to put a question in the House, and to move for papers. In due course the question was asked, when Sir Michael Hicks Beach made reply that the Board did not desire to make any reflection on my character, but that I had been called on to resign as I could not get on with the Board of Guardians.