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diff --git a/58454-0.txt b/58454-0.txt new file mode 100644 index 0000000..79206b6 --- /dev/null +++ b/58454-0.txt @@ -0,0 +1,5580 @@ +*** START OF THE PROJECT GUTENBERG EBOOK 58454 *** + + + + + + + + + +_REMINISCENCES OF A WORKHOUSE MEDICAL OFFICER._ + +[Illustration: Logo] + + + + +JOSEPH ROGERS, M.D. + +_REMINISCENCES OF A WORKHOUSE +MEDICAL OFFICER_ + +EDITED, WITH A PREFACE + +BY + +PROF. THOROLD ROGERS + +London +T. FISHER UNWIN +26 PATERNOSTER SQUARE +MDCCCLXXXIX + + + + +PREFACE. + + +The author of the brief narrative which I have edited, and have seen +through the Press, passed away before the printing of his work was +completed. What he wrote was composed under the presence of a mortal +disease, the issue of which he clearly foresaw. But he was unwilling to +quit life without leaving behind him some record of the evils with which +he grappled, of the obstacles which he had to encounter, and of the +changes which he strove to effect. He might indeed, and with the +acquiescence of the profession which he honoured, have claimed the +credit of those great reforms in the treatment of the sick poor, and in +the status of his professional brethren, to which the labours of his +life were directed; but he has preferred to give a narrative of his +experiences, and to leave his reputation to the members of the great and +beneficent calling which he followed, and to those among the public who +were cognizant of his zeal and perseverance. + +My late brother was the descendant of three generations of medical +practitioners, who, from the first quarter of the eighteenth century, +plied the art of tending and healing the sick down to the last quarter +of the nineteenth, for his elder brother relinquished his practice only +about ten or a dozen years ago. And this was in the same locality. But +soon after my brother Joseph was qualified he went to London; and very +speedily after he came to London he began the labour of his life--the +reform, namely, of the medical relief accorded to the indigent poor. To +this he surrendered the prospects of professional success and +fortune--prospects which his professional abilities might have made +certainties; for this he sacrificed popularity, health, and all that a +vigorous constitution might have assured to him. He literally wore +himself out by his labours. + +It is infinitely more difficult for a medical practitioner to urge +necessary but unpopular reforms than it is for any other professional +person to do so. The physician believes that he can succeed only by +raising no prejudice against himself. He is always tempted to be +neutral, when partizanship may seem likely to imperil his interests. +There are no safe prizes to be won in the one profession which every +one allows to be beneficent, whatever may be thought of other +professions. By a code of honour which is rigidly adhered to, the +process of a physician's treatment cannot be kept to himself. By an +equally rigid rule, the confidences reposed in him are as sacred as the +secrets of the confessional. It is no easy matter to win position and +fortune in a calling which is regulated by the strictest rules of +professional honour. It seems easy to imperil the most carefully +acquired reputation by running counter to obstinacy and prejudice. A +medical man has every motive to avoid hostile criticism. If he +determines on doing that which is unpopular, the risks which he runs are +far greater than those of any other person. Now all this was encountered +by my brother's action, and he never was allowed to forget that he had +to encounter it. He had to reckon with sordid London vestrymen, perhaps +the worst class of men with whom honest people have to deal, and with +the officials of the Poor Law Board, who were determined, as far as +possible, with rare exceptions, to shirk all responsibility. In the +pages of this volume he shows plainly what were the obstacles to his +endeavours. As might be expected from an honest man, who never counted +the odds against him when he was convinced that he was in the right, +his original manuscript commented, with no little indignation, on the +persons who thwarted his efforts, and would have baffled his ends. But +it is entirely superfluous to stigmatize such people; and I have excised +these just but unnecessary judgments. It is sufficient that the +reappearance of such persons has been made improbable, if not +impossible. + +The new Poor Law of 1834 was probably a necessary measure; but it was +suddenly and frightfully harsh. The Whigs carried it, in deference to a +particular school of economists, now happily, I trust, extinct. It was +exceedingly and reasonably unpopular. The working classes had been +impoverished in the country by the enclosure of the common lands, and in +both town and country by restraints on the right of combination with the +object of raising wages. But they had always been assured that the +maintenance of the poor was a first charge on the land, and that it must +be satisfied, and should be, before the profit of the enclosure should +accrue to the landlord. When the plunder was completed the other side of +the bargain was repudiated, and the easy-going system of the old method +of parochial relief was abandoned for the new and severe provisions of +the new departure. I am old enough to remember the indignation which +the change aroused. I am sure that indignation and resentment against +the new Poor Law had a good deal to do with the political reverses of +1841, and the entire destruction of the popularity which the Whigs had +achieved by the Reform Act of 1832. + +It is true that the Act established a central authority which should +control the action of the new Boards of Guardians. But these persons +were by no means willing to check the machinery which they had erected. +If the legislation of 1834 was distasteful to the country, they were +resolved to limit their responsibility to the change which they had +themselves made in the law, and to avoid further odium. The case of the +permanent officials, who are really the departments of state, was much +simpler. They wished to earn their salaries with as little trouble as +possible, just as they wish now, and always will wish. To importunately +call attention to the cruelties practised under the new system was to +diminish their ease, to give them trouble, and such action must be +resented and discouraged. In my personal experience of the permanent +staff of the Poor Law Board I have met with officials who were +persistently resolved not to give themselves, if they could help it, the +trouble to rectify evils which were brought before their notice by the +Board of Guardians to which I belonged, if they could in any way find a +dilatory plea. + +Of course a reformer is always odious to a large number of persons. +There are people who profit by the abuse or malpractice which he tries +to remove, and such persons are naturally indignant at his +meddlesomeness. There are others who acquiesce in the existing state of +things from sheer indolence, and are impatient only at being disturbed. +There are others who hold that all reforms cost money, and are alarmed +at the expense which they may incur; while the fact is that all reforms +which are wise and true save money in the end and diminish cost. To +build a proper hospital for the sick poor, to supply it with properly +qualified nurses, and sufficiently paid medical officers, one must incur +initial expense, which is in the end constantly overpaid by eventual +economies. My late brother constantly predicted that the changes which +he counselled would relieve the rates in the end, and his prediction was +constantly verified. The reader will find these facts illustrated in the +pages which follow. A genuine reform is a sensible saving. But even if +this result did not follow, the system which he found and attacked was a +scandal to humanity and a dishonour to civilization. The London +vestrymen did not see this; but Londoners have found out at last that +the average vestryman is unteachable and incurable. + +The courage which will attack abuses such as were found in those +workhouses near forty years ago is rare indeed. The person who +undertakes the unpopular task has to come to close quarters with such +Guardians of the Poor as are described below, and such government +officials as are resolved to wink at abuses. Not but that, even in the +worst days, the Poor Law Board and the Local Government Board were of +great public service. They could be squeezed in Parliament. A judicious +and temperate question has often discomfited the most corrupt official, +and stirred the most lethargic. I am pretty sure that nearly all the +reforms which have been achieved in the administration of the law for +the relief of the poor, have been derived from persistent questioning in +the House of Commons. Much indeed remains to be done, but much has been +done; and my brother was exceedingly fortunate during his lifelong +efforts in the advocates which he obtained among Members of the House. + +It must not be forgotten that a medical reformer is apt at first to be +unpopular with his brethren, or at least to be discouraged by them. The +more fortunate members of the profession are apt to feel a serene +indifference to the purposes which he avows. I do not think that the +reform of those evils with which my brother concerned himself has had +much assistance from the more wealthy and influential among the +physicians. As Arnold said, contemptuously and justly, of Isaac Walton, +that "he fished through the civil wars," so these good people held, as a +rule, severely aloof from the struggle. To the poorer members of the +profession, who had to make every effort for a livelihood, and were +constrained to give their services for nominal sums in order to get a +status in their calling, it seemed more practical to get them better pay +and not to give offence. In the end this was part of the result of my +brother's labours. He was able to assert, towards the close of his +active career, that he had added £18,000 a year to the incomes of the +Poor Law medical officers in the Metropolis, and to allege that the +change, with others, had saved ten times that amount in the Metropolitan +rates. I am convinced--having once been a Guardian of the Poor in the +city where I live--that the adoption of the policy which he recommended +has effected a still greater saving. + +The first reform which my brother undertook, persevered in, and speedily +saw achieved, was the prohibition of intramural interment. He had good +reason to make efforts in this direction, for he had abundant evidence +of what came from the old practice in the experience of his profession. +Most of the Metropolitan clergy were very hostile to this reform, and +for obvious reasons. But it came gradually, finally, and thoroughly. The +present generation in London has a very inadequate conception of the +abominations, in the midst of which their fathers and mothers lived, and +not a few of them were born. The abandonment of intramural interment, +and the drainage of London, imperfect as the latter is, have turned one +of the unhealthiest cities in the civilized world into one of the +healthiest. One of the first churchyards closed was that of St. Anne's, +Soho, the parish in which my brother lived for many years. + +His next efforts were directed towards obtaining a mortuary in the +parish. Every one admits how serious are the evils of overcrowding, and +how difficult a problem it is to supply the London poor with decent +homes at moderate rents. A century ago, as I know very well, house-rent, +even in London, took a small part of the workman's scanty earnings; now +his earnings are sometimes very little better than they were a century +ago, and his rent absorbs from a fourth to a half of what he earns in +poorly paid labour. At best his home is crowded and unhealthy enough, +but when death occurs in the family the condition of things is +intolerable. It cost my brother three or four years of incessant effort +and pleading to obtain this concession from the Vestry of St. Anne, and +for a long time this was the only London parish which made this +necessary provision. + +The next mischief which he attacked was the window tax. His experience +as a physician proved to him that lack of light and air intensified +disease and rendered recovery difficult. There was a plea for the window +tax. It seemed to bring a fair charge on large houses, which an assessed +tax notoriously does not. In assailing the tax his principal helper was +Lord Duncan, at that time one of the Metropolitan Members. The tax went +at last in 1851. The repeal of this tax took nearly twenty years' +agitation, the first physician who attacked it on sanitary grounds +having been Dr. Southwood Smith. + +My brother commenced his practice in London in 1844. In 1855 there was a +serious visitation of cholera in St. Anne's, Soho, and he became a +supernumerary medical officer in the district. Cholera had a very +serious effect on his private practice, as he states himself, and nearly +twelve years after he had taken up his abode in London, he concluded to +become a candidate for the function of medical officer to the Strand +Workhouse. He was to receive a stipend of £50 a year, and find all +medicines for the sick. It may be doubted whether he knew what he was +undertaking: certainly they who appointed him and the officials who +confirmed his appointment at the Poor Law Board had no conception of +what they were doing. The character of his duties, and a description of +the place in which he had to perform these duties is to be found at the +commencement of his narrative. For its condition it is hard to decide +whether the Guardians of the time, or the central authority were most to +blame. + +The Strand appointment was the beginning of those systematic labours on +behalf of the sick poor and the medical profession which thenceforward +became the principal business of his life, to which he sacrificed such +leisure as he had, health, and money which he could ill spare. He gave +also what was more important--undaunted courage, and accurate +information. Thus in 1861 he gave evidence before a Select Committee of +the House of Commons, on the subject of the supply of drugs in Workhouse +infirmaries, such a supply being as essentially part of the Guardians' +duty as the purchase of food and clothing are. His views were adopted by +the Committee and pressed on the Department. What he advocated was the +germ of the Workhouse infirmary. + +During the last few months of his life he lived at Hampstead, in the +hope that the air might help him. At the back of his new home there was +built one of those great hospitals for the sick poor which it was the +principal aim of his labours to render general, and to see constructed +in such a way as would give the fairest prospect of recovery for the +patients who were treated in them. + +The practice of the Poor Law Board at this time was to assert on paper +the supremacy of the medical officer in his own department, to give him +no personal support when he did his duty, to visit on his head all the +consequences of their own negligence or dilatoriness, and, right or +wrong, to support the Guardians when they took offence at +conscientiousness and zeal. Now, in 1865, a scandalous case of neglect +led to an inquest, to an exposure of the facts, and to very severe +comments by the Press. Shortly afterwards the proprietors of _The +Lancet_ newspaper--a medical journal which has, during a very long +career, been distinguished alike for its zeal in maintaining the honour +of the medical profession and for its advocacy of humanity in dealing +with the sick and destitute poor--resolved on investigating the +condition of the London workhouses and their hospitals. Among other +places, Dr. Anstie visited the Strand Workhouse, in Cleveland Street, +and made his own report on what he saw in the columns of the paper which +he represented. The report was candid, graphic, and by no means +flattering to the Guardians, to their management, and to their +officials. But it was entirely accurate, for the Strand Union and its +Guardians at that time were probably the worst examples of a thoroughly +bad and vicious system. Of course the Guardians were as angry as they +could have been if they had been known for the best of characters and +motives and had been grossly defamed. + +The time was plainly come for concerted action, and one of the Strand +Guardians, a Mr. Storr, a gentleman of very different character from +most of his colleagues, convened a meeting at his own offices, in order +to discuss the situation. It was at first suggested to call a public +meeting; but my brother pointed out that even if the meeting were a +success its effect would be ephemeral. It was determined, therefore, to +create an association under the title of the Workhouse Infirmaries' +Association, Mr. Storr offering to find £100 towards its preliminary +expenses. But his generous offer was not needed. As soon as it was +known that the Association was in process of formation, names and money +poured in upon the scheme. New evidence about the Strand Union came out, +and was forwarded to Mr. Charles Villiers, then President of the Board. +An inquiry was held, and, as usual, the permanent officials strove to +throw the blame on the medical officers, and to exonerate the Guardians. +Now, to counteract this, my brother called a meeting of all the +Workhouse medical officers in London. The object of this meeting was the +formation of an Association for the protection of the character and +interests of these officials, and for supplying information to the +public as to the manner in which their best efforts were hampered and +thwarted. This was the nucleus of the Poor Law Medical Officers' +Association, an organization which has extended itself to the three +kingdoms. Of this my brother was, as long as his health allowed, the +president and principal administrator. + +In 1867 Mr. Gathorne Hardy, now Lord Cranbrook, was President of the +Poor Law Board, and in this capacity introduced the Metropolitan Poor +Bill, some of the provisions of which were the establishment of +Workhouse hospitals and dispensaries, and the supply of all medicines +and medical appliances at the charge of the Guardians. The President +frankly acknowledged that he owed much of the information which he had +acquired from my brother. It was unfortunate that the provisions of the +Act were not made general, throughout England at least. But London at +last got an instalment of Poor Law Reform, and on rational lines. The +administration of the Poor Law is far from perfect; but the best part of +it is that of the sick poor. Even here officials for a long time +obstructed the will of the legislature and the objects of the law, but, +on paper at least, the ancient abominations described in the earlier +part of my brother's reminiscences were swept away. + +In the eyes of the Strand Guardians, or rather of a majority among them, +his offences on behalf of justice and humanity were unpardonable. He had +to be got rid of. In this the officials of the Poor Law Board, then +under Lord Devon, agreed with the Guardians. The Guardians picked a +quarrel with him, the Poor Law Board instituted an inquiry, and +apparently instructed their Inspector as to what he should report, and +the President gave solemnity to the farce by removing him from his +office. The ground on which he was dismissed was that "he could not get +on with the Board of Guardians." Of course he could not. No man of +sense, honour, humanity, decency, and conscientiousness, could get on +with them, or, in those evil days, with the Poor Law Board either; for +the President and his officials, perhaps unconsciously, leagued with the +Guardians in the maltreatment and oppression of the poor. + +It is a common trait in mean and malignant natures to think, if they can +injure in fortune or character an advocate of justice and right dealing, +that they can arrest his efforts and discourage those of others. Many +experiences will occur to those who have any knowledge of public affairs +which will illustrate this policy and its failure. It always fails with +such men as have any character at all. They disregard the loss or the +insult, and redouble their efforts after the object which they have put +before them. I do not remember that my brother ever dwelt with any +peculiar acerbity on the circumstances of his dismissal; but he gave +himself more than ever to the self-imposed task which became the +business, and eventually the success, of his life. He spoke, indeed, +with bitterness, and wrote with bitterness of the crew who had sought to +injure him, but for the reason that they were prolonging the miseries of +the poor, and for that reason only. + +Of course my brother had the sympathy of his profession and the support +of the medical papers. But he resolved to perfect and extend the +organization which he had founded. The result was the formation of the +Poor Law Medical Officers' Association. In order to give strength and +stability to this agency he visited most of the principal towns in +England. He made several journeys to Ireland, the infirmary system of +which he highly commended, and went once at least to Scotland, where +indeed reform was greatly needed. And in these places he inculcated the +important truth, that where medical relief was abundantly and generously +accorded by the Guardians, pauperism decreased and rates were lessened. +In my frequent communications with him, I urged him to insist on this as +a matter of principle and a matter of fact. Generous relief to the poor, +if it be discriminating and founded on a few intelligible rules, is the +truest economy in the end. Owing to his efforts, many towns voluntarily +adopted the principle of the Metropolitan Act, and with the best +results. In the earlier years of his campaign he obtained great +assistance in Parliament from the late Dr. Brady, Member for Leitrim, +and from Dr. Lush, Member for Salisbury. + +Four years after his expulsion from office in the Strand Union, he was +elected to a similar office in the Westminster Union. His career here +was not one of incessant and unavailing remonstrance. The Poor Law +Board, subsequently the Local Government Board, began to awake to a +sense of its duties, and to see, though reluctantly and haltingly, that +Boards of Guardians sometimes need supervision. But soon his troubles +recommenced. The inferior officials were harsh, violent, and dishonest, +and they were abetted by a majority of the Guardians. The inevitable +consequences followed. My brother undertook the cause of the poor, and +the Guardians and their tools or accomplices turned on him. They tried +their old trick of suspending him, in hopes that the Poor Law or Local +Government Board would endorse their ruling. My brother employed his +enforced leisure in extending the organization which he had founded. In +due course he was reinstated by the Department, and his enemies were +baffled. + +The mismanagement of the Workhouse by these Guardians, and the +outrageous misconduct of the master, at length roused the wrath of the +ratepayers. An influential committee was formed, which recommended a new +list of Guardians to the electors, and the whole of the old gang were +ejected from office by overwhelming majorities. I have reason to know +that the atrocities perpetrated by the master roused the anger, and +secured the unobtrusive but effective co-operation of a very exalted +personage. The resentment which affected this total change was not the +act of one section of society or of one party only, and it is just to +say that my brother had the assistance of eminent persons in both +political parties. I mention this the rather, because my brother made no +secret of his political opinions, and never omitted any opportunity of +inculcating them. He belonged, as all his brothers did, to the advanced +Liberal party. + +During the remainder of his active life he was in perfect accord with +the Board of Guardians. He had the good fortune to see that what he had +laboured for, and had been persecuted for, was now acknowledged to be +humane, politic, and economical. He even had the opportunity of checking +reckless and unwise expenditure. He had done great services to the poor, +though his clients were unable to express more than their personal +gratitude to him. He had recognized and secured the co-operation of some +among those excellent women who have worked so energetically and +unobtrusively on behalf of the poor destitute. He had done great +services to his own profession, and had secured them a little of their +due; for, I repeat, there is no class of persons who do so much, from +whom so much is expected, and who are more scantily remunerated than +medical practitioners among the poor. Some of these practitioners in +1884 determined to offer him some recognition of his lifelong services. +There was nothing in his whole career which he dwelt on with more +satisfaction than on the rout of the Westminster Guardians, in 1883, and +on the testimonial of 1884. + +Two years afterwards he was attacked by heart disease, and became +conscious of the organic mischief against which his naturally strong +constitution struggled for nearly three years. His incessant labours had +literally worn him out. His disease rapidly increased on him, and with +great pain and effort he wrote out, in the intervals of his trying +disorder, the reminiscences which follow. Had he been in better physical +health, they would have no doubt been fuller, for his memory was exact +and tenacious. That which is printed will show what manner of man he +was. But it will be seen that he dwells but little on his own unwearied +labours. During his sickness he was attended by many physicians who knew +him and valued him: chief and most untiring among them was Dr. Bristow. + +I can say, without consciousness of partiality, that my brother's life +was one of incessant devotion to a noble object. They for whom he +laboured were the poor and helpless; who could make him no recompense, +could, perhaps, hardly understand his purposes. He was met by obstacles +which would have daunted a less resolute man; but he was sustained by +the rectitude of his aims, and by a firm belief in their wisdom. Such +men change the face of the world, as far as their own sphere goes. Their +reward is generally the approval of their own consciences, and sometimes +evidence accorded in their lifetime as to what has been the fruit of +their labours. Thousands of our fellow-countrymen have been saved from +suffering and misery by the lifework of Joseph Rogers. + +JAMES E. THOROLD ROGERS. + +OXFORD, +_April 10_. + + + + +CONTENTS. + + +CHAPTER I. PAGE + +THE STRAND 1 + + +CHAPTER II. + +THE WESTMINSTER INFIRMARY 104 + +RECOGNITION 224 + +TESTIMONIAL TO DR. JOSEPH ROGERS 231 + +CONCLUSION 241 + + + + +REMINISCENCES OF A WORKHOUSE MEDICAL OFFICER. + + + + +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 subpoenaed 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. + +The insufficiency of this answer will be understood when I state that it +had been already decided to break up the Strand Board by taking away St. +Anne's and joining it to St. James's, in order to make the Westminster +Union, and by adding St. Martin to the remnant of the Strand--thereby +making it a perfectly new Union. + +I have stated that it was arranged at the meeting of the Workhouse +Infirmaries Association, called to consider the action of the Department +in requesting me to send in my resignation, that the papers connected +with the subject should be moved for in the House. This was done, and in +due course they were presented. On their appearance, _The Lancet_ +commented as follows thereon-- + +"At last, after months of delay, the Parliamentary Papers concerning +the enforced resignation by Dr. Rogers of his post as medical officer of +the Strand Union have been published. They amply justify everything we +have said as to the unwarrantable character of the action of the Poor +Law Board and of the Strand Board of Guardians in the whole affair. + +"It is impossible for us to afford space for a detailed analysis of +these papers, but we beg to draw attention to the following damning +facts. 1. The evidence upon the whole case consists (_a_) of a series of +quotations by the Guardians, or rather by a party among the Guardians, +hostile to Dr. Rogers, from minutes and other documents extending over +many years, these extracts being selected without any reference to +contemporary facts which would throw light upon them, and (_b_) of +utterly gratuitous and unfounded insinuations that the various leading +articles in the general press which were written apropos of the +notorious scandals at the Strand were written by Dr. Rogers and his +friends. 2. That although Dr. Rogers (backed by a most respectable +minority of the Guardians and by the Vestry of St. Anne's, Soho) +protested that it was impossible to deal with these charges without an +open inquiry, such inquiry was refused by the Poor Law Board. 3. As +regards the Edmonton scandal which was the cause of the dispute which +led immediately to the suspension of Dr. Rogers, the printed evidence +distinctly bears out the justice of Dr. Rogers' allegations. 4. +Nevertheless Dr. Markham reported to the Poor Law Board that his +inquiries had proved these charges to be false. He does not, however, +venture to specify the nature of the inquiry by which he disproved +charges which, with unblushing effrontery, Mr. Fleming says were made on +the unsupported testimony of a pauper, but which are now seen to be +absolutely corroborated by two respectable witnesses (one of them a +medical man), besides the direct observation of Dr. Rogers; and either +Dr. Markham did not take, or the Poor Law Board has suppressed, the +evidence of at least one other impartial witness, the master of the +Strand Workhouse, which we have reason to believe would have absolutely +settled the matter in Dr. Rogers' favour. + +"It is well-nigh incredible, but we have heard it on authority which we +cannot discredit, that although the so-called inquiry on which the +Medical Inspector of the Poor Law Board based the unfavourable report, +which gave the Strand Guardians courage to make their onslaught upon Dr. +Rogers, included an examination at Dr. Markham's private house of the +Edmonton officials chiefly inculpated by Dr. Rogers' charges. Dr. +Markham never asked Dr. Rogers one single question. Volumes of comment +could not add anything to the ugly emphasis of this fact." + +Sir Michael Hicks Beach has been recently afflicted. I would ask him if +he does not consider that his sufferings would have been intensified if +his sleep had been disturbed by the noise of carpet-beating--if he had +been waited on by infirm and drunken women, and broken-down potmen--if +the air he breathed had been poisoned by the dust from the beating of +carpets, and utterly vitiated by over-crowding? And yet, because I had +protested against this hideous wrong-doing, and had done my best to get +it altered, he had to get up in the House of Commons and do his best to +justify the action of the Board. + +The Department thought I was disposed of; it was not long before I +showed them the contrary, as some of them did not subsequently hesitate +to admit. + +I have stated that it had been decided, owing to the all but unanimous +application of the ratepayers of St. Anne's, Soho, to the Poor Law +Board, to take that parish out of the Strand Union and join it to St. +James's, so as to constitute the Westminster Union, and within a very +brief space of time after my compulsory resignation this was done. As +there was no returning officer for the Union, the Poor Law Board +directed that the Vestry clerks of each parish should act as such for +this time, consequently all books and papers relating to St. Anne's had +to be handed over by the clerk, of Peterborough notoriety, who was the +friend of Catch, when a notable discovery was made, to wit, that the +proxy book, as it was called, was altogether illegal, and had been so +for years, as by the efflux of time the power to vote by proxy in most +instances had expired, and yet this clerk had gone on year after year +issuing voting papers to persons, though he must have known that they +had no right to vote. We had often wondered how it happened that we +could not oust the Guardians who sat for St. Anne's: they had been +returned by illegal proxy votes for years. Although the Guardians who +had recently represented St. Anne's in the old Strand Union had lost the +kindly aid of the clerk, it was so necessary to some of them that they +should still be Guardians, that they again got themselves nominated, +only to meet with a unanimous rejection on the part of the ratepayers, +as the following letter from an ex-Guardian for St. Anne's, Soho, who +was a supporter of Dr. Rogers, but precluded from again standing through +serious illness, of which he subsequently died, will show-- + + + "TO THE EDITOR OF _The Daily News_. + + "THE STRAND UNION AND THEIR LATE MEDICAL OFFICER. + + "SIR,--It will be gratifying to the friends of Dr. Rogers, who was + suspended by the Board for his continued advocacy of the rights of + the sick poor, to know that at the election of Guardians of St. + Anne's, Soho, which took place on Saturday last, the whole of those + who voted for his suspension, &c., were rejected by an overwhelming + majority of ratepayers. + + "I am, Sir, + + "Yours obediently, + + "JOSEPH GEORGE. + + "81, DEAN STREET, + + "_April 11, 1868_." + + +The story of two of these men I will here relate. The first had been +appointed Assessed Tax Collector for St. Anne's, Soho, but two or three +years after my resignation of the Strand he was discovered to be a +defaulter to some hundreds of pounds, which his sureties had to make up. +He was one of the most active of my opponents. The second had commenced +life as a milkman. Very shortly afterwards he began to take tenement +houses in the worst part of St. Anne's, Soho, which he let out from +garret to cellar to the very poor. His lodgers lived under the most +insanitary conditions, and my local knowledge induced me always to +protest against this man as a Guardian of the poor. He was always the +most energetic of my opponents at the Strand Board. At last retribution +came upon him. It was in this wise: he was a freemason, and, though very +illiterate, he had managed to obtain a high position in the masonic +brotherhood, so much so that he was deputed to preside as the returning +officer in an important election. There were two candidates, one a +Guardian of the Strand Union, who was his personal friend--in fact, that +very person who had recommended the broken-down pot-man as one of my +nurses--the other was to him a comparative stranger. + +After the ballot had been taken, this returning officer gave the +election to his friend by such a majority of voting papers that the +unsuccessful candidate, who had been promised support to a large extent, +suspected foul play, and made an application to the Prince of Wales, as +Grand Master, to order a scrutiny. His Royal Highness assented, and +directed the Earl of Carnarvon to hold it, when it came out clearly that +this ex-Guardian of St. Anne's, Soho, had knowingly made a false return, +and he was sentenced to a deprivation of all his offices in the +brotherhood, and exclusion from his Lodge for three years. He was at +this time holding various offices in St. Giles, also in St. Pancras, but +the different parochial Boards' requested him to send in his +resignation forthwith, as they refused any longer to associate with him +or allow him to remain a member of their respective Boards. + +Here let me remark that there is no occupation that can be followed at +which so much money can be made as by the system adopted by some +speculators of taking houses in poor localities and letting them out in +single rooms to the humbler classes. To get therefrom all the benefit +possible you must be absolutely heartless and unprincipled. If the +wretched tenants do not pay their rent weekly, they must go out--and do +go! Having, after their weekly collections, much spare time on their +hands, these men often get on to Boards of Guardians and frequently on +to the District Boards as well: at the first they are always present +when outdoor relief is given, which they strongly advocate as a means +whereby the rent may be more readily secured; secondly, on the District +Boards, where they are always at hand when the Inspector of Nuisances +and of insanitary tenement houses makes his report. They generally try +to be on the best of terms with this latter official, their scheme being +to minimize the character of their reports, and to minimize what is +required to be done, as it saves their pockets. One of these persons, +who had some three hundred of these houses, was fined by the magistrate +for neglecting to keep his houses in a sanitary condition. I had the +honour of his permanent hostility. He was, at the time of being fined, +not only a member of the Board, but of the Health Committee also. When I +was a member of the Strand Board of Works I carried a resolution that +the name of the owner of these tenements should be always included in +the Inspector's Report. In my deliberate judgment, all persons of this +class should be disqualified from sitting on a Board of Guardians, or on +any District Board. The same class of middlemen are to be found in all +large towns; they are the most dangerous members of the body politic, +and should be rigorously treated as such. The person I have before +referred to, was not only a member of the Strand Board of Guardians but +a member of the District Board also. He was also on that of St. Giles, +and St. Pancras. In all these places, and districts, he had tenement +houses. + +It having been my habit to go to the Workhouse infirmary for twelve +years early each morning, I found my time at first hang somewhat heavily +on my hands, but after a short while I made up my mind what to do. I +resolved to watch the action of the Department, and to do my best to +make the permanent officials do their duty, so far as my observation +could aid me. With that object in view, I arranged for an aggregate +meeting of the profession, at the Freemason's Tavern, to discuss the +composition of the so-called Board at Whitehall, and the grievances of +the Poor Law medical officers. Among other things, I told them that the +nominal Board never met, and that documents requiring the various +members' official signature, were taken round to the residences of the +Ministers, and, it was alleged, frequently signed without reading the +contents. + +This statement had been made in the House by an ex-President. + +This meeting was an immense success, for not only was there a very large +attendance of medical men, but they came from all parts of the country, +and the Department had an opportunity of learning how their permanent +officials were watched and criticized throughout the country as +permanent officials always should be. Mr. Griffin having retired from +further vindicating the claims of his professional brethren owing to an +attack of paralysis, to which, unhappily, he ultimately succumbed, the +balance of the money in his possession was handed over to me in trust +for carrying on the objects of the Association. It was also decided +that the Provincial Poor Law Medical Officers Association, of which he +was the Chairman, should be merged in the Metropolitan Association, +which had been started by me two years before, and I was elected the +President, a position I held for some years, and which I resigned only +when I recognized that the objects of our Association would be more +readily advanced by selecting some medical member of the House of +Commons to act in that capacity. So I contented myself with the humbler +position of Chairman of Council. + +At this representative meeting of the profession, I alluded, _inter +alia_, to my evidence before the Select Committee, and to my advocacy of +the supply of all medicines. I also mentioned the action of one of the +Inspectors, a Mr. Gulson, when Mr. Fleming's letter containing the +recommendation of that committee was read out by the clerk of the +Weymouth Board of Guardians at their weekly meeting. The Chairman having +appealed to this official, who was present, as to what should be done, +he stated that the resolution was only carried in committee by one vote, +and that the Chairman of the Committee, had voted against it. Thereupon +the Guardians of the Weymouth Union directed that the official letter +should lie on the table, and no expensive medicines were found. I took +care that a report of this meeting should be sent to every Poor Law +medical officer, and to the Department, as well as to every influential +Member of Parliament I could reach. One of the reports having fallen +into the hands of Mr. C. P. Villiers, the ex-President and Chairman of +the Select Committee on Poor Relief, that gentleman wrote to me +protesting against the statement which had been made, and assuring me +that it was in direct opposition to what had really taken place, as he +had warmly supported my suggestion, and that he should at once call on +Mr. Gulson for an explanation of his statement. He also stated that he +had been much annoyed at the long delay that had occurred ere the Chief +Secretary, Mr. H. Fleming, had drawn up and forwarded to the various +Boards of Guardians the letter containing the recommendation of the +Select Committee. From other sources, I subsequently learned that for a +very long period of time prior to the resignation of Mr. Villiers as +President of the Board, he held hardly any communication with his +Permanent Secretary. It will be well understood, that if it took some +fifteen months for the Permanent Secretary to draw up and issue the +letter containing the Committee's suggestion as regards expensive +medicines, that no hurry would occur in the establishment of Poor Law +dispensaries in the Metropolis, which was only an amplification of my +original suggestion. And that actually happened; and it was only by our +constantly pegging away, that at last the Board commenced to establish +them. But whilst no _bonâ fide_ effort was made to carry out this +portion of the Metropolitan Poor Act, an absolute epidemic took place as +regards the building of asylum hospitals, district hospitals for fever +and infectious diseases, asylums for epileptics, idiots and imbeciles, +district schools, &c. This arose partly from indifference on the part of +the permanent officials, but to a greater degree from their complete +ignorance of the necessary details required for economic building. It +was never my desire, in striving to amend the system--that is, to +substitute for the absence of all system of medical relief to the poorer +classes the reverse policy--that architects, surveyors, and builders, +should be at liberty to extract all the money they could get from the +pockets of the metropolitan ratepayers. As it was, finding that the +absence of all efficient control was leading to an enormous outlay, and +that the public was naturally getting not only alarmed, but indignant, +at the profligate expenditure of their money, I put myself in +communication with Mr. Torrens, then M.P. for Finsbury, and asked him to +question the President of the Poor Law Board on the subject, and to move +for a return of what had been already spent and what was proposed to be +spent in such buildings. I also requested him to inquire to what cause +the delay in establishing Poor Law dispensaries under Mr. Hardy's Act +was due. This action considerably alarmed the permanent officials. More +important still, it led to a very considerable curtailment in the amount +of contemplated expenditure on buildings, and, with this, an +approximation to some control. Soon afterwards the establishment of Poor +Law dispensaries was commenced, which was an important feature of the +Act. + +I cannot but relate the close of Mr. George Catch's career. + +I have already stated that after the enforced resignation of his +appointment at Newington, this model master was selected by the +Guardians of Lambeth, as the master of their Workhouse, notwithstanding +that he had as opponents some respectable persons who had creditably +filled similar appointments elsewhere. His election was due to the +assistance he received from the clerk of the Strand Union, and his old +friends at that Board. His appointment was challenged at the time, but +in spite of the serious evidence afforded by the Newington inquiry, it +was confirmed by the Department, but with this proviso--that a special +report as to his conduct should be sent by the Guardians to the Poor Law +Board at the end of six months. + +It was not very long before the opponents of this man's appointment were +fully justified in the course they took, as he speedily renewed his old +course of cruelty to the inmates, and of quarrelling with the other +officers. One of these acts was inquired into, and reported on by Dr. +Markham. Although it was clear that the master was in the wrong, yet Dr. +Markham, in his official report, managed to throw a doubt on the +evidence of the medical officer, evidently to screen the master; but he +was not saved for long, for shortly afterwards a young woman, who had +been subjected to much harshness by Catch, ran away and hid herself, as +it was supposed, in the chimney of one of the women's infirm wards, when +the master, with the view of forcing her to come down, induced the +junior resident medical officer, to bring from the surgery some +substance, on which he poured some hydrochloric acid, whereby some +extremely pungent gases were evolved, thinking thereby to compel her to +come down; but as the young woman was not there (fortunately for Catch, +for if she had been she would have been suffocated), the only effect was +that all the old women in the ward, were set sneezing and coughing. This +atrocious proceeding, having been reported to the Poor Law Board, Catch +was called upon to resign. It will hardly be believed that certain of +the Guardians memorialized the Poor Law Board to let him retain his +office, when Mr. Shaen, the eminent solicitor, on the urgent +representation of his wife, who was a lady visitor at the Workhouse, and +knew a great deal of Catch's doings, took the matter up. Mr. Shaen saw +me, and asked me whether I could tell him anything about Catch. I +narrated the incident of the false charge which he, in connection with +the clerk, had made against me when I was away in Scotland, and also +told him the story of his behaviour in reference to the sick woman in +the lying-in ward of the Strand Union which had led to his leaving that +Workhouse. Mr. Shaen took down my statement, and subsequently he sent me +a pamphlet of some two hundred pages, in which I found not only my own +statement, but sundry others of a highly damaging character, but +unfortunately these were so recklessly drawn, that it gave Catch the +opportunity of bringing an action for libel. Its publication had +induced Mr. Goschen to peremptorily call upon him to resign his office. +Catch sent out an appeal to all the masters of workhouses to support him +in his action, and a sufficient sum having been collected, the +Attorney-General of the day, now Lord Chief Justice Coleridge, acted as +his counsel. Having been asked by Mr. Shaen to support my statement in +the Court of Queen's Bench, I attended. When called on, I went into the +witness-box, and after giving my evidence-in-chief, was cross-examined +by the Attorney-General in such a manner that three times during the +cross-examination Lord Chief Justice Cockburn interfered to stop it, +giving as his opinion that the Attorney-General was pressing me +unfairly. As I was leaving the witness-box I turned round and thanked +the Lord Chief Justice for his kindness in screening me. I was followed +by the late porter of the Strand Workhouse, who was there to +substantiate my evidence. A similar attempt to browbeat this witness +afforded fine fun. The witness was an Irishman, and at every effort made +by the counsel to confuse him, Pat was too much for the Attorney, and +feeling that he could make nothing of him, he told him peremptorily to +stand down, which he did in such a comical way as convulsed the court +with laughter. Unfortunately Mr. Shaen failed to justify several of the +libels, and the jury, after twelve days' trial, gave a verdict in favour +of Catch for £600--an amount which the judge said was excessive, and for +which he refused to certify, thereby affording Mr. Shaen the opportunity +for asking for a fresh trial. Subsequently a compromise was effected at +the instance of the Lord Chief Justice. In summing up the case to the +jury, the judge said that my evidence, if it stood alone, was sufficient +to stamp Catch as an improper person to hold the office of a Workhouse +master. Mr. Goschen would not allow Catch to resume his office, and, +having no resources whatever, he drifted downwards until ultimately, +being without means and having tired out all his friends, he in a fit of +despair threw himself in front of a Great Western train and was cut to +pieces. + +I was so much annoyed by the action of the Attorney-General in +cross-examining me that on my return home I wrote to the Lord Chief +Justice again thanking him, and enclosing for his perusal a pamphlet I +had just written on the administration of the Poor Laws. To my great +surprise he sent me by hand the next morning a letter, in which he +acknowledged its receipt, and informed me that he should read my +pamphlet with the greatest pleasure. There is no doubt that my labours +up to that time were very well known to his Lordship, as, when at the +Bar, he was the standing counsel of _The Lancet_ newspaper, in which my +name had frequently appeared. When he became a judge he kept up his +interest in that journal. This was told me by the late Dr. Wakley, to +whom I related Catch's story and the account of my cross-examination and +of the courtesy and support afforded to me by Lord Chief Justice +Cockburn whilst under cross-examination. The Lord Chief Justice was a +man of scrupulous integrity and honour. I remember a solicitor of good +position in Soho, whose brother was then the Treasurer of the County of +Middlesex, and whose son now holds the position, saying to me, "Although +I am opposed to him politically, yet I have the highest opinion of his +conscientiousness, and of his extraordinary ability--we are all proud of +him." I esteem it a high honour to have received a letter from such a +man written under such circumstances. I have this letter still. + +An illustration of profligate expenditure, and the absence of all +efficient control at the Poor Law Board, was at this time supplied by my +old friends, the Strand Union Board. Shortly after I resigned the Board +decided to build a new Workhouse at Edmonton, and plans of the +contemplated building were issued to builders, &c. Tenders from sundry +large firms for its erection were sent to the Guardians, the lowest +tender being from an eminent firm that had acquired a great reputation +for the buildings it had put up in various parts of town, as well as in +the country. Their tender was rejected, and the contract given to a +small builder, resident in St. Paul's, Covent Garden, whose estimate was +some £2,000 higher. It was stated at the time that after the contract +had been signed the members of the Board were invited to a dinner given +by the lucky contractor. The large firm that competed for it, feeling +that they had been improperly treated, got the question raised, and the +new President, Mr. Goschen, investigated the transaction, but it was too +late, as the builder had already set to work, and had a considerable +amount of his plant on the ground. Although Mr. Goschen felt that he +could not interfere to stop this disreputable transaction, he did not +fail to give this party of jobbers a most severe lecture, probably the +most severe that ever emanated from the Poor Law Board, in connection +with the doings of a Board of Guardians. The issue of it to this Board +must have brought about a change of policy among the permanent officials +who had not remonstrated against it. I know not whether it was this +transaction, or Mr. Goschen's general knowledge of the laxity of the +staff, certain it is that during his Presidentship he kept the Secretary +in his place, and did not permit him or Sir John Lambert (then plain Mr. +Lambert) to obtrude themselves upon him when he received deputations +from public bodies and from societies. But I am anticipating. + +In the autumn of 1868 a general election took place, with the result of +replacing the Liberal party in power. With the concurrence of the +Council of the Poor Law Medical Officers Association, I had issued a +circular letter to the various candidates for Parliamentary honours, in +which I drew attention to the imperfect character of the Poor Law Board, +and the usurpation by the permanent officials of powers they were not +entitled to, and asked whether the candidate would assist us in our +efforts to reconstruct the Board, and to improve the system of medical +relief. The replies I obtained were not only very numerous, but they +held out the prospect of an alteration for the better. Looking back at +the various changes that were made subsequently, I have no hesitation in +asserting that many of these improvements were brought about by the +action our Council took at this general election. These will be briefly +referred to. + +I will here relate an incident that gave me the cue as to the line to +be taken in the introduction and establishment of a Public Health Act. I +was desirous of visiting an aged relative who lived in a village in +Hampshire. The local medical gentleman kindly volunteered to fetch me +from the station, some seven miles distant, and to put me up for the +night, &c. As I neared his house my sense of smell was assailed by one +of the most awful odours I had ever encountered. To my inquiry from +whence it originated, my host said, "That is from the farmyard over +there. Young Green, the son of the corn dealer, has taken Miss Smith's +farm, and has commenced to breed pigs. He has at least 300." "Well," I +replied, "if I lived here I should make short work of Mr. Green and his +pigs; I would at once indict him." "Ah," he said, "you can afford to be +independent, you live in London. I dare not; for if I complained, or +took any action in the matter, old Green would go to all the markets +round about, and would denounce me for attempting to interfere with his +son's business, and I should make enemies by the score." Some three or +four years after Mr. Stansfeld brought in his Public Health Bill, one of +the essential features of which was that every district medical officer +should be the health officer in his district. I opposed the proposition +with all my might. I knew the Act would be absolutely abortive if Poor +Law medical officers were placed in this utterly false position which +Mr. Stansfeld proposed. In taking this course I encountered much +opposition, and became for a time very unpopular, though at last my +views prevailed, and gentlemen wholly independent of local influences +were appointed to large areas. Among the remonstrants was the medical +man who was the neighbour of the pig breeder, when I silenced him by +reminding him of Mr. Green and his pigs, and of the fear that he had +that if he complained that his business as a country medical gentleman +might be damaged. He said no more. + +Having come to the conclusion that the course followed by my poor +friend, Richard Griffin, of Weymouth, in continually calling attention +to the grievances of Poor Law medical officers, would never eventuate in +an improvement of their position, for the general public have never +cared for our class in any way, I cast about to ascertain whether there +could be any course adopted by which the attention of the public could +be drawn to the shortcomings of the system, and decided that the only +chance that existed, whereby an improvement could be effected, was by +proving that an amended system of medical relief would eventuate in the +diminution of the duration of sickness, and consequently of its cost to +the ratepayers; and having at this time a copy of the annual report of +the Irish Poor Law Commissioners placed in my hands, I studied its +pages, and saw that under the Irish Medical Charities Acts the poorer +classes of that country had secured to them the most complete system of +Poor Law medical relief. I resolved to go over to Ireland, and study its +administration on the spot. I carried out my intention, and during my +stay in Ireland obtained a complete insight into the way in which the +Irish dispensary system was carried out. I also brought back with me all +the papers and documents that enabled me to popularize the subject here. +I also spent much time in examining the annual returns of the English +Poor Law Board, with the result that I was enabled to prove conclusively +that efficient medical relief was followed by diminished poor relief +expenditure, not only by shortening the duration of sickness, but by the +actual saving of human life: this latter was shown also by a return I +got Mr. W. H. Smith to move for, which was as follows-- + +"A return of the population at the last census in England and Wales, in +Scotland and in Ireland. + +"A return of the mortality from general causes in the three portions of +the United Kingdom, and of preventable mortality." + +That return exhibited the following: That whilst one in every 43 died +yearly in England, one in 44 in Scotland, only one in every 60 died in +Ireland; and whilst in England zymotic, or preventable diseases, +constituted one-fourth of the total mortality, or one in 190 of the +population, Scotland one-fourth, or one in 194 of the population, in +Ireland it was one-fifth of the total mortality, and one in 308 of the +population; the fact being this, that in England and Scotland there +existed the same miserable system of medical relief, whilst in Ireland, +after the potato famine and the fever which followed it, calamities +which swept away a large portion of the inhabitants, the Medical +Charities Act was introduced, and led, by its efficient working, to the +beneficial changes which had taken place in the health of the country. + +The views I advanced met with much favour, and were commented on and +approved by many general, as well as by all the medical journals. Having +sent a copy of the paper I read at a meeting of our Association to Mr. +C. P. Villiers, that gentleman wrote to me stating that he had derived +much pleasure from its perusal, and that I had thrown more light on the +causes of pauperism, and devised better measures for its diminution, +than any previous writer on the subject. Subsequently, through the +influence of Mr. Corrance, then M.P. for East Suffolk, I was invited to +address the Central Chamber of Agriculture, which I did, when a +resolution, couched in very flattering terms, was adopted, and further +it was moved that a copy of the Chamber's approval of my address, and +the principles contained in it, should be sent to the Poor Law Board, +coupled with the request that the attention of all the provincial +Chambers should be called to the subject. Subsequently I was invited to +address the Worcester Chamber on the same subject, as well as that of +Suffolk. + +At a very early period of the presidency of Mr. Goschen, several of the +provincial Poor Law Inspectors were directed to make inquiry into the +question of medical relief to the poor, and the desirability, or +otherwise, of establishing dispensaries, modelled on the principles +contained in the Irish Medical Charities Act. One of the most able and +exhaustive reports was sent in, as might have been expected, by Mr. +Farnall, who thus proved true to the views he held in his interview with +me some ten years before; whilst the very feeblest of these was that +preferred by Mr. R. B. Caine, who manifested the same lack of heartiness +here as he exhibited earnestness some years before in upsetting poor +Richard Griffin's statistics, of which he boasted to me during his +conduct of the inquiry at the Strand Union in 1866. + +One of the results that sprang from my visit to Ireland was the +establishment of a good understanding between our Association and that +of the Irish Dispensary Medical Officers, of which the late Dr. Toler +Maunsall was the honorary secretary. Dr. Maunsall was the most +indefatigable secretary I ever knew. His appetite for work, and his +skill in getting up statistics was remarkable. He was most valuable to +me, as he assisted in getting out dry figures for my use, which would +have given me infinite trouble. Poor fellow! like many others of my +fellow-workers, he was destined to die early, and I sustained a great +loss by his premature death. Unfortunately, too, he died badly off. I +started a subscription in England for the benefit of his widow and +children, which helped to swell the sum that his friends got together in +Ireland. + +During my stay in Ireland it was arranged between us that we should +mutually help each other, and consequent on that, when the Irish +Association strove, under the leadership of the late Dr. Brady, M.P. for +Leitrim, to obtain superannuation allowance for dispensary and workhouse +medical officers, I called attention to the subject in the medical +journals, and induced the members of our Association not only to +petition, but to interview members in their respective localities, in +favour of the Bill. Dr. Brady, having succeeded in carrying this +measure, essayed the next year to do the same for England and Wales. The +success of the appeal we had made to members in the general election of +1868, facilitated the passing of the measure most materially, as we had +promises of support from upwards of eighty gentlemen who were +subsequently elected. Prior to the second reading of our Bill, I +interviewed several members, and got promises to attend the second +reading and vote for the measure. Some of these gentlemen, having +intimated their desire to speak in its support, and having asked to be +supplied with information on the subject, I coached them up. To one of +the ablest of our supporters, who asked me to provide him with facts, I +said that I was opposed to superannuation on principle, as I held that +every one should be able during the working days of his life to provide +for the exigencies of his old age--but then it was necessary if he held +an office that the pay should be such as would enable him to do so. Now +it was notorious that the pay of the medical officer was based on such a +starvation principle as to render it impossible for him to save +anything. This argument, reproduced very much as I have written it, in +the House assisted a great deal in the success of the Bill. At the time +this occurred I was out of office, and had not the most distant idea I +should ever again be a workhouse medical officer. I did not know what +was again in store for me, nor that I was destined to have another +fourteen years of it; that I should be again suspended, restored to +office, and eventually, through broken health, compelled peaceably to +resign and to be myself a pensioner. + +After the Bill had become law Dr. Brady most generously bore tribute to +my efforts, and stated that he never could have carried the Bill without +my help. _The Lancet_ published this statement of Dr. Brady's, and I for +the time gained from my Poor Law medical brethren credit for what was, +at that period, absolutely disinterested labour. + +About this time I was invited by a leading physician in Edinburgh to +visit that city and address a meeting at the College of Physicians on +the subject of Poor Law medical relief in Scotland. Although I was +aware that the condition of things in that country was worse even than +it was in England, yet I had not studied the subject so completely as to +justify me in asserting it. Consequently I declined what was a very +great compliment. Some years afterwards I went and delivered an address. +It took place at the time when the annual meeting of the British Medical +Association was last held there, when a highly complimentary resolution +was adopted at that meeting in reference to that visit and address of +mine. After occupying the position of president for a brief period only, +during which time the Department was administered most vigorously and +successfully, Mr. Goschen was transferred to another office in the +Government, and Mr. Stansfeld was appointed President, the effect of +which became immediately apparent, for the leading permanent officials, +whose influence had been checked during Mr. Goschen's presidency, came +directly to the front again. + +One of the first measures introduced by Mr. Stansfeld was the conversion +of the Poor Law into the Local Government Board. This was carried out by +the absorption of the Public Health Department of the Privy Council in +the destitution element of the Poor Law Board--a most disastrous act of +policy, as it subordinated the Health Department, which had done its +work so well to the discredited section of the Poor Law Board as +exhibited in the permanent officials of the Board, who had always been +obstructive, and had neither carried out, nor permitted any one else to +carry out, any reform whatever. + +This was early made apparent, for at the first deputation to the +President, at which I was present, after his appointment, I saw Mr. H. +Fleming and Mr. Lambert sitting together with the President, whilst Mr. +(only just recently made Sir), John Simon and his staff, who were the +only intellectual element of the new Board, were relegated to distant +seats in the corner of the room. + +That a Public Health Bill started under such circumstances should be +framed absurdly, seeing that those who understood the subject were +ignored, and those were consulted who had never done anything well, was +nothing but what might have been expected. + +One of the provisions of the Bill was, as I have before stated, that +every district Poor Law medical officer should be the health officer of +his district, and that his reports of insanitary conditions should be +sent to the Board of Guardians, many members of which Board would be +found to be the principal offenders against sanitary requirements. + +This scheme speedily evoked an opposition, and a deputation, +representing the British Medical Association, the Social Science +Association, and the Poor Law Medical Officers Association, had an +interview with Mr. Stansfeld at the Local Government Board. The speakers +from the two first Associations having addressed the President, Mr. +Stansfeld announced that he had just received a summons to attend a +meeting of the Cabinet, but he would leave Mr. Fleming to hear any +further remarks that might be made, which would in due course be +communicated to him and meet with attention. Being the sole remaining +speaker, I said to Mr. Fleming that when I first heard of the proposed +utilization of the Poor Law medical officers in the Public Health +measures of the Government, I hailed it as a tardy recognition of the +valuable services that class of official might render. But when I came +to look into the details I saw it would not work, as medical officers +would hesitate in affronting their Board of Guardians, many members of +which would be found to be the principal offenders against the +contemplated Act, and that in the few cases where the parish officers +would faithfully carry out the requirements, and thereby offend their +respective Boards, they would be sacrificed to the resentment of their +members, and if appeal was made for support to the Central Department, +such honest men would be called on to resign for not exhibiting +sufficient courtesy, &c., and working with their Boards. It was very +evident that my observations went home to this Permanent Secretary, but +whether they were ever communicated to Mr. Stansfeld is open to much +doubt, for his Bill was eventually brought in on the lines he had +originally indicated, only to turn out on trial a disastrous and +ludicrous failure. + + + + +CHAPTER II. + +THE WESTMINSTER INFIRMARY. + + +About a twelvemonth after the Act was in operation I appealed, through +the medical journals, to my brethren in the provinces as to the +arrangements that had been made in their respective localities. A large +number of letters from all parts of England and Wales were sent to me, +and with the information thus furnished I prepared a paper which I +called "Chaos," in which I turned into ridicule the arrangements that +had been made, showing that the Department, faithful to its traditions, +had made a complete mess of the administrative arrangements. This paper, +read at the meeting of the British Medical Association at Sheffield, +attracted a good deal of attention both in the medical and general +Press. It materially acted in evolving order out of the chaos into which +the subject had drifted, owing to the indifference and incompetence of +those who had drafted the measure. + +In the spring of 1872 I was informed that the alterations and +enlargement of the old Workhouse of St. James's, commenced at the time +when the Westminster Union was formed, were complete, and that Mr. +French, who had been the medical officer of the workhouse and parish of +St. James's for upwards of forty years, was about to retire on a +superannuation allowance of £200 a year. I was told that the Chairman of +the Board, a Mr. Bonthron, a Scotch baker living in Regent Street, had +selected a fellow Scotchman, one Dr. S., as Mr. French's successor, and +as Mr. Bonthron claimed to be omnipotent at the Board, this gentleman's +appointment to the vacancy was considered to be certain. In the course +of a few days I heard that a formidable opponent to Dr. S. had appeared +in the person of Dr. M., who was also a Scotchman. In due course the +election took place, when Dr. M. was elected. This resulted from a +protest on the part of certain members of the Board who resented the +predominance of Mr. Bonthron. When apprised of the result of the +election, I remarked that Dr. M. could not take the office as he did not +possess the necessary legal qualifications. On the following Saturday +morning a member of the Board told me that a letter had been read at +the meeting of the Guardians, held the previous evening, announcing that +the election of Dr. M. was null and void, as he held no surgical +qualifications. As his election had surprised all the Guardians, because +it proved that the Chairman had not the influence he claimed, my +informant advised me to apply for the office. At first I hesitated, but +upon being urged again I assented. The same evening I called on Dr. M., +told him of my intention, and asked him for the support of his friends. +To my utter astonishment he told me he had made up his mind to try +again. "Nonsense," I said; "how can you get a diploma from the College +of Surgeons?" "Oh," he replied, "I have arranged all that; I have a +splendid memory, and I remember all my anatomy and surgery." As I had +every ground for the belief that he had never attended lectures on +surgery, nor attended the surgical practice of an hospital, inasmuch as +I had known him ever since he had come to London, I saw that, without +collusion with some one in authority, it was impossible for it to be +done; but, as he appeared determined, I left him. As soon as it was +known that I seriously intended to compete for the appointment, +testimonials in my favour were forwarded to me by several eminent +physicians and surgeons, by Members of Parliament, among them one of a +very flattering character from Mr. C. P. Villiers, M.P., the +ex-President of the Poor Law Board, who strongly recommended me to the +Board of Guardians, those lady visitors who had known me at the Strand, +and others. Two days before the election took place I was surprised by a +visit from Dr. M., who called to inform me that he had passed his +examination at the College of Surgeons the night before, and now asked +me to retire in his favour. On my declining to do as he wished, he said +it was very hard I would not, as he had incurred an expense of upwards +of £60 to get the diploma. Prior to the election my friends entered into +a compact with his supporters to the effect that if I was in a minority +on the show of hands my name was to be withdrawn, when they would +support him, but if I was in the majority his friends would support me. +This occurring, I was elected, to the great surprise of the Chairman, +who looked on me as a dangerous person, seeing that I had taken an +active part in bringing about the formation of the Union, whereby St. +Anne's had been joined to St. James's, which had the effect of somewhat +increasing his poor rate assessment in St. James's--for St. Anne's, a +poor parish, had considerably improved its position by being put into +union with St. James's, which was comparatively a rich one. + +Having at this time received an invitation from the Irish Dispensary +Medical Officers Association to address them at the College of +Physicians in Dublin, I did so, when Sir Dominic Corrigan, Bart., M.P., +was in the chair; and I afterwards spent a very pleasant week there, +visiting the North and South Dublin Workhouses, the latter having 4,000 +inmates, with a large staff of visiting physicians and surgeons, besides +resident medical officers. It is one of the finest hospitals in Dublin, +and the arrangements for the efficient treatment of the sick poor were +in the highest degree creditable to the Irish Poor Law, now the Local +Government Board. + +I also visited the Richmond Lunatic Asylum, situated on the outskirts of +Dublin, at that date under the superintendence of Dr. Lalor, who, I +understand, was the first physician who introduced vocal and +instrumental music as a means of relieving the insane. There I witnessed +one of the most extraordinary sights it was ever my lot to see. I will +give a sketch of the tableau. In the foreground sat a young lady +discoursing most eloquent music on a harmonium, immediately behind her +there stood some young Irish women, three or four of them, singularly +beautiful, with music in their hands, accompanying her; behind them were +older women, and then on to the old and weird, all joining most heartily +in the performance. The fringe of this female gathering of nearly 100 +performers were harmless imbeciles and idiots. I stood and listened some +moments whilst this singular performance continued. I was so struck with +the beauty of one of the Irish girls that I asked her history, when I +was informed that her condition had been induced by a disappointment in +a love affair. It was the old story of love followed by desertion, and +she had been admitted some six months before in a state of maniacal +excitement. She was too young and altogether too pretty to be an inmate +of a lunatic asylum. Dr. Lalor also showed me a typical case, exhibiting +the truth of the opinion I have long held, that of all the forms of +insanity, none are so uncertain of having been really cured as those +which have exhibited symptoms of homicidal or suicidal violence. The +patient in question had been admitted when suffering with a homicidal +tendency but had steadily improved, and his name was on the list of +those to go before the Visiting Committee for discharge on probation, +when a startling incident occurred. He had secreted one of the knives +used in the asylum about his person, and he had, when unobserved, +whittled away the thick, blunt portion used in the asylum, until he had +given it a sharp cutting edge, from handle to point; when, raising his +right leg up, he cut through the calf down to the bone, severing the +muscle completely. This patient, Dr. Lalor told me, had been employed on +various offices of trust, and that he was commonly considered to be +completely cured, and altogether harmless. I obtained one of the old +knives used in this asylum, had it copied, and, having got the sanction +of the Board for getting several, used them all the time I was at the +Westminster Union, in the male and female insane wards. The cutting edge +was about two inches in length, but the rest of the knife was about the +twelfth of an inch thick. It was impossible for lunatics to do any harm +either to themselves or others with such knives. + +On my return to London I was informed that my appointment to the +Westminster Union had been confirmed by the Local Government Board. + +A day or so before the 23rd of June an appointment was made by Mr. +French for me to go over the House with him, and to have the +establishment formally handed over to me. I went, accompanied by a young +Irish physician, recently one of the resident surgeons of an Irish +hospital, with whom I was in treaty to be my assistant. I had never +been in this workhouse infirmary before. Shortly after my arrival Mr. +French joined us, and, in company with the head nurse on the female +side, we went through the female part of the establishment. The nurse +was most elaborately "got up." We went on and examined each patient, a +large number of whom were in the wards--in fact, although it was +midsummer, the place was full. I noticed bed-cards over each patient's +bed, but as I could not make out what was given to the patients, I asked +what was being done for this and that case. To my astonishment Mr. +French said, "Nothing; I do not believe in physic, and therefore do not +give the people anything." Presently we entered a large ward where a +woman, evidently in great pain, was lying in bed, writhing in apparent +agony. After ascertaining the nature of the case, which was one of +colicky diarrhoea, I asked, "Well, what do you here?" to which he +replied, "Nurse, give her a glass of Number Two." With that, he pulled +me into the centre of the ward, and giving me a friendly nudge of the +ribs, laughingly said, "What do you imagine is Number Two? Why it is +peppermint-water coloured; I never give any physic." Feeling by this +time somewhat disgusted by these remarkable confessions, seeing that his +stipend was £350 a year, out of which it was arranged by the Board that +he should supply these medicines. I dropped his company, and went on +examining the people independently. Mr. French speedily buttonholed my +young companion, and went on looking at the patients with him. At last +our visit came to an end, and on coming out of the male sick wards he +shook me warmly by the hand and wished me the same happy official life +as he had had. He had hardly got out of hearing when the young Irishman +commenced to reproach me with having transferred Mr. French to him; +saying, "I take it, sir, as a very unkind thing that you should have +done so, as I was shocked at his boasting that he never did anything at +all for these poor sick people." + +The next day I entered on my duties. On taking my seat in the +consulting-room the master brought in and laid before me a large volume, +the Workhouse Medical Relief Book. I turned over the pages for the week, +and noticed the names and extras ordered for the sick. I saw that ham, +sausages, tripe, fish, eggs, were entered rather frequently. At last I +said to the master, who was standing by, "You surely have not all these +people on the sick list in the House! I did not see a third of this +number when I went over the House yesterday." "Yes," he replied, "they +are here;" on which I said, "Let everything remain as entered in the +book until I can arrange to go over the establishment and see them all, +which I will do this week." I then went through the sick and infirm +wards. On going through the wards I ordered what in my judgment was +necessary for the sick in the way of medicines, much to the astonishment +of the head nurse, who stared at me in a half-dazed manner. There was +one patient with a very foul and offensive ulcer, for whom I ordered a +charcoal poultice: she came to me before I left the House to ask me +"what I meant." I replied, "A charcoal poultice." She then said, "I +never heard of such a thing before." I then asked her how long she had +been there; she said eight years. The next day I had occasion to order a +carrot poultice; I met with the same astonishment and ignorance of what +was meant. At last she frankly stated that she was about to learn her +duties, for nothing of the kind had ever been used by her before; and +further, she said that as she never had any medicine to give the people, +she had not troubled herself much about the patients; indeed, I learned +on inquiry that she used to be in waiting to see the doctor each +morning, and so soon as he was gone she considered her duties were over, +and she returned to her own sitting-room till next day. I could never +get her to give my medicines as directed. Apart from this indifference +as to medicines, she was kind to the patients and respectful to me. On +the male side I found a superintendent nurse who really knew her duties. +She confirmed the statement voluntarily made by Mr. French, that no +medicines were ever provided for the sick. She also said that the +Guardians knew all about it, and that they treated it as a great joke. +This was not correct as regards some of the Guardians, as I subsequently +ascertained. It was known to the St. James's section of the Board, but +repudiated by those of St. Anne's. Seeing that we had had a medical +inspector and self-called medical adviser for five years, whose duty it +was to visit this Workhouse infirmary, his failure to discover these +omissions was in the highest degree remarkable; but then the system +prevailed at the Local Government Board, and our Workhouse Infirmaries +Association had utterly failed to alter it. The reason for all this was +not far to seek. + +On the day after, in company with a pauper inmate, told off to carry the +Medical Relief Book, I went through the wards for the purpose of seeing +the infirm men and women who were on extras. I found on the women's side +that, as it was leave-day, many had gone out, and therefore drew the +inference that if they were well enough to go out they could dispense +with sausages, ham, tripe, eggs, &c., entered against their names, and +could eat the ordinary infirm diet provided by Dr. Markham's diet table, +which I saw hung up in the wards, which diet table had been drawn up +from the form drafted by our Association some years before. It is +curious that he claimed it to be his, without any reference to any one. +Whilst going through the female wards some of the inmates returned +drunk, one old woman very much so. She at once proceeded to ask me who I +was, and what I was doing there. On my replying that I had come into the +ward to see why she was on a diet of daily sausages, she tartly replied, +pulling up her petticoats and showing both her legs, which she struck +with her hands, "For these bad legs." I at once ran the pen through her +name. She lived in the House years after that, but she ate no more +sausages. I learned on inquiry that this fat old woman, who could go out +and return drunk, had had sausages, nominally, as her dinner for two +years. I write nominally because I learned afterwards that in the matter +of diets an extensive system of exchange obtained throughout the House +without any check or hindrance on the part of the officials. It took me +the greater part of four days to see all the infirm people on extras, +but the result was satisfactory, as it enabled me to put the +establishment so far as the diets were concerned, on an economic basis. +The clerk of the Board assured me at the time that I had caused a saving +of some hundreds of pounds, a statement which I honestly believe was the +truth. + +It might be a matter of wonder how this could be, but having regard to +the very large amount of extras purchased from day to day, none of which +were supplied under contract, it can be well understood what an +opportunity was given for large prices being charged for such extras, as +practically no check existed on the cupidity of the tradesmen (selected +by the master) who supplied these things. I do not state that such was +the case here, but unless some good understanding existed between those +who ordered and those who supplied, how is it possible that masters of +workhouses, with their limited incomes, should succeed in leaving at +their deaths so much money, as many of them do? I was informed that the +old master who preceded Catch at the Strand Union had gone there after +failing in business as a tradesman in Covent Garden, that he held office +as master twelve years, and when he died that he left some £2,000. + +I found on inspection of the specially infirm, paralytic, and wholly +infirm, that the women were located in wards 16, 17, and 18, and on +inquiry discovered that there were no conveniences whatever for the +instantaneous removal of excreta, and yet this condition of things had +not been discovered by the Government Inspectors or by the medical +advisers, or if it had been no steps had been taken to alter it. + +On my first visit to these wards I noticed some black patches in the +corners of the compartments, which stood out very distinctly from the +recently whitewashed ceiling and walls. Noticing some days after that +these patches had increased in size, I asked the nurse what it was due +to, when she quietly said, "Those are bugs." So soon as I could I saw +the master, and told him of it, and asked him to see to it. He did not +say he would or he would not, he only laughed. Finding some days after +that nothing had been done, I again saw him in his office, when I told +him that I must insist on those bugs being removed. The labour master +was present, who remarked, "Well, doctor, as you make such a fuss about +the bugs I will see to it for you" (evidently regarding the matter in +the light of a personal favour); and the bugs were swept down into a +dustpan by hundreds and put into the fire and burnt. This was told me +by an eye-witness, who was present whilst it was being done. + +I do not wish it supposed that the master was harsh or cruel; quite the +reverse, he was very kind to the inmates. But he had lived long enough +in the service of the Poor Law not to be fully aware that no good would +accrue to him or his by too much zeal in the performance of his duty. He +calmly let things slide; consequently there was more drunkenness on +liberty days than could be possibly imagined, and was unchecked, and +although I repeatedly begged that the names of all persons who were on +my sick list who had been allowed to go out should be reported to me if +they came home drunk, I never could get my wishes attended to, though +occasionally it happened that I discovered the circumstance, especially +when an accident occurred. + +I was not wholly unprepared for this laxity of discipline, as some few +days before entering on my duties I met the ex-chaplain of the Strand +Workhouse, who, whilst congratulating me on my return to the Poor Law +service, said, "You will have a great deal to meet with at St. James's. +I have taken the duty there for the chaplain occasionally, and the +scenes of drunkenness and quarrelling among the inmates on their return +home on liberty days, which I have witnessed, exceeds anything you can +imagine." One of the most terrible exhibitions of this kind I ever +witnessed was on the first Christmas Day after my appointment. The +subject having previously been brought under the attention of the Board, +an order was issued that for the future this indiscriminate permission +to the inmates to leave the house on Christmas Day should be stopped. It +will hardly be believed that on the next Christmas Day the Chairman took +upon himself, most presumptuously, to go to the House and give +permission for them to again go out. The scene that occurred that night +was the most disgraceful that ever happened in the history of a +workhouse. Several of the drunken inmates on their return home fought +like demons. I and my assistant were engaged for some time in dealing +with the injuries that were caused. I must state that I never saw the +master so justly indignant as he was at the impertinent interference of +this Chairman, in setting his authority and that of the Board at +defiance in the way he had done. + +Finding that no dietary for the sick and infirm had been adopted at the +House, I at once drew up a form which continued in force until +ill-health caused my resignation. It was similar to that which I had +introduced at the Strand several years before. There was one diet for +which I claim especial credit. It was framed with the view of dealing +with capricious appetites or severe sickness. It was called Number Five, +or _ad. lib._, and consisted of either eggs, fish, a chop, beef-tea, or +arrowroot, or anything else of the same value. It was enjoined that the +nurse should at 8 a.m. ask what these special sick would take for +dinner. When she had ascertained the wishes of the patient, a statement +on a diet-sheet showing how many of each description of diet would be +required was sent down to the kitchen. At the end of the week the cook +handed to the master's clerk the number of each diets she had supplied, +who then proceeded to distribute these among all those who were on _ad. +lib._ diet. It might appear on the master's side of the Medical Relief +Book that A or B had had a chop daily, whilst in reality the dinner +might, by this arrangement, have been changed every day. This plan of +dealing with capricious appetites has since been adopted in several +workhouses. + +Although five years had passed away since the Metropolitan Poor Law Act +had become law, no attempt had been made to carry out the dispensary +clauses until after my election, and one of the first things I had to do +was to put the dispensary in order. I had been taught a lesson in +economic prescribing whilst at the Strand, and therefore was enabled to +speedily arrange for a pharmacopoeia. I also drew up a formula for the +supply of large bottles of simple medicines, which were placed in charge +of the nurses, for administration in trivial ailments so common among +the aged poor. I also introduced bed pulleys, to enable the sick to +assist themselves in rising, or in getting in or out of bed. I also +ordered small shawls for the aged women and woollen jackets for the +men--a great comfort to those who were suffering from consumption or +bronchitis, the principal affections I had to encounter. + +I have stated that although it was midsummer the House was full of sick +people, which arose partly on account of the sickness that prevailed in +the worst part of St. Anne's and similarly in that of St. James's, and +also to the fact that the Chairman had opposed the transfer of any of +the sick to the Sick Asylum Hospital, at Highgate, to which the +Westminster Union, in conjunction with the Strand, St. Giles's, and St. +Pancras, was affiliated. He had opposed the junction of the two parishes +on personal grounds, and being beaten, had, in conjunction with his +party, obstructed the removal of the acutely sick. + +As medical officer I did not object to this, for as the sick wards were +extremely good and were all that I had desired to carry out when I +initiated the Workhouse infirmary movement, I simply complied with the +wishes of the majority of the Guardians not to send any one away. I had +held office some weeks when, in the autumn of the year, I encountered +Dr. Drydges in Regent Street. This gentleman, who had acted temporarily +whilst Dr. Markham was ill, had about this time been permanently +appointed to be Metropolitan Inspector, Dr. Markham having resigned. He +came up to me and said, "I was coming to the Westminster Union to learn +why it was you did not comply with the law, and send your acute sick +away." "Oh," I replied, "that is soon explained; it is because the +majority of the Board will not let me." "Indeed," he said; "you must do +your duty, even if the Board object to it." To which I replied, "I did +that at the Strand, and your Secretary called on me to resign because I +was not sufficiently respectful to the Guardians. I shall comply with +the wishes of the Guardians now, and not with that of the Local +Government Board, as they would throw me over." To which he rather +angrily replied, "You speak to me like that, when I am an Inspector, and +you only a Workhouse medical officer?" To which I answered, "And who, +pray, made you a Poor Law Inspector. Why, if it had not been for me and +my initiation, neither you nor Dr. Markham would ever have been +Inspectors." "Oh," he replied, "I did not know you had had anything to +do with it." "I think," I said, "if you will trouble yourself to inquire +you will find what I state to be correct." When I broke down in 1886, +and he had to call and see me, he was then most kind and sympathetic, +and I take this opportunity of stating as much. + +This refusal on the part of the majority of the Board, led on by this +Chairman, to allow me to send suitable cases of sickness to the Asylum +Hospital, was in the highest degree absurd, seeing that the ratepayers +of the Union had to pay their proportion of all expenses at the Asylum +Hospital, and for the beds to which the Union were entitled; and +although this Workhouse infirmary was a perfect paradise in comparison +with the den at the Strand, still the House had not been arranged on the +principle that all the sick should be retained in it. My nursing staff +was insufficient to enable me effectually to deal with the great number +of sick persons there at the time of my entrance on my duties. One +illustration will suffice. There was a man in an infirm ward who had +been under Mr. French some five or six years. He did not belong to +Westminster, he was kept there because he alleged he was so ill that he +could not bear the fatigue of journeying some sixty miles in the +country. He was a healthy-looking man about forty years of age. He +always lay in bed with his knees drawn up, and constantly asserted that +he could not stand nor walk, nor put his legs down. He complained +piteously of his sufferings. I exhausted every conceivable treatment, +but all without the least apparent benefit, as he never owned to being +any better for my attention to him. This went on for two years, until I +began to get suspicious of him. One day an inmate of the ward, who had +recovered and left the House, called on me at my private residence. On +seeing me he said, "I have called to thank you for your kindness to me, +and also to tell you that you have been deceived by that man Webster, +who you have done so much for. He is an impostor. He can walk as well as +I can, and, what is more, does walk about." "Nonsense," I replied; "he +says he cannot get out of bed, and the nurses confirm it." "Well," he +continued, "he takes very good care never to allow them to see him get +out of bed, he takes his constitutional walk about the wards between 2 +and 4 a.m., when the lights are down, and most of the inmates asleep." +"But, surely," I said, "the night nurse must have seen him, and if so +she would report it to me!" "Oh," he replied, "she hardly ever comes +into the ward during the night, she is generally in her own room fast +asleep--she gets herself called when she is wanted." I made some further +inquiries, and finding that there was evidence of deception, I sent him +to the Asylum Hospital with a letter to the superintendent medical +officer, giving his history, and telling him of my suspicions, and +asking that he might be carefully watched by reliable persons. He came +back in a fortnight, having been found out. He was immediately +transferred to his settlement, where doubtless he recommenced the game +of deception, having found it answer so well. + +It may be here said, If you had not confidence in your nurses, why did +you not get rid of them? For the simple reason that I had no power to do +so. They were not selected by me, but by the Guardians, and therefore +were not my officers, but the Board's. I once reported the night nurse +on the male side (the woman who had allowed the malingerer to deceive +me) for drunkenness, but I had so much trouble to get rid of her that I +was not induced to repeat the experiment, added to which I was most +grossly insulted by the master for bringing this woman's conduct before +the Guardians. + +In my opinion the medical officer should select and discharge all the +nurses--of course, reason for this latter action being shown. I should +have discharged several at the Westminster Union for neglect of duty and +for general incompetence if I had had the power. Simple complaint would +be attended by no beneficial result, as it would be a hundred to one +that the nurse would be supported in her misconduct by some member of +the Board, whose protege she might be. On mentioning this to an +ex-workhouse medical officer, he told me that on having occasion to +represent the conduct of the resident midwife, who claimed and exercised +the right to go out on every Sunday for several hours, leaving the wards +wholly unattended on every such occasion except by pauper helps, the +only action taken by the Board as a return for it, at the instance of +the midwife's friend, was the adoption of a resolution that a return +should be prepared and laid on the Board-room table, showing the +occasions when the medical officer went out and the length of time he +was out, &c., &c. Of course he found out that he had achieved worse than +nothing by his effort to check this abuse. This circumstance occurred in +one of the largest of our metropolitan workhouse infirmaries. + +When first I entered on my duties at the Westminster Union the chaplain +there was a very energetic little man named Duval. I do not remember his +Christian name, for the reason that he was known and spoken of as Claude +Duval, and for a long while I supposed him to possess no other. At last +I discovered that the name had been given him in joke, and that he was +in no way connected with the celebrated highwayman. He most assuredly +did not convey the idea that he had any brigand blood in his veins. He +was extremely attentive to his duties, and deserved and had gained the +respect of all the inmates and officers. + +Frequently he organized entertainments for the aged and infirm. These +were held in the dining-hall, which on all such occasions was crowded to +excess. After I had held office about a year he desired me to provide an +entertainment, which I did on several occasions, and my efforts met with +much success. In the carrying out of these entertainments, which were +musical and recitative, I had the assistance of my nephew, Mr. Julian +Rogers, and his wife, who brought with them vocalists of a high order, +who contributed much to the pleasure of the inmates. These +entertainments were highly appreciated by the inmates, and were +frequently attended by members of the Board, and by some of the +ratepayers living in the neighbourhood. Now and then I used to read +extracts suitable for penny readings. On two occasions my efforts took a +higher form, when I gave a lecture on the "Ear and Hearing," and on +"Sight and the Eye." The preparation of these lectures and the diagrams +to illustrate them was a work of considerable trouble and some anxiety, +but the signal success achieved on both occasions amply repaid me for +any trouble occasioned. To show the appreciation of my audience for a +joke, I will relate an incident that occurred during the delivery of my +lecture on "Sight and the Eye." I was describing the function of the +iris, or coloured portion of the eye, as an involuntary movable veil, +which regulated the amount of light which should be admitted to the eye, +and said that in order to make the veil complete it was covered behind +with a black pigment, so as to exclude all light except that which +passed through the pupil. I then told them that in certain animals this +pigment was wanting, and not only there but in the skin generally, and +instanced the white mouse, ferret, &c., and showed that all these +animals had red eyes and always blinked and winked when exposed to a +strong light. I then passed on to state that this condition was +sometimes found in man, where again the winking and blinking was +noticeable as well as the whiteness of the skin and hair, from the +absence of this dark pigment, hence the name of "albinos" applied to +those thus afflicted. I then went on to state that recently we had a +notable example of this in the Chancellor of the Exchequer, who suffered +from this infirmity, and that his dread of light was so extreme that he +had attempted actually to put a tax on matches. This joke was followed +by a positive scream of delight from visitors and inmates--showing that +Mr. Lowe's fiscal effort to increase the revenue was known to them all. +At the conclusion of the night's proceedings, Miss Augusta Clifford, who +was present, came up and said she should repeat my story of Mr. Lowe and +the match tax wherever she went. At the next meeting of the Board, +several of the Guardians having been present on the occasion referred +to, it was moved and seconded and carried unanimously, that a vote of +thanks should be given to Dr. Rogers for the entertainment provided by +him, and for the highly interesting and instructive lecture which he had +delivered. + +I found in the sick and infirm wards several of my old acquaintances of +the Strand, who were chargeable to St. Anne's, and had been transferred +to this House when the Union was formed, among them a woman by the name +of Maria Hall. She had gone into the Strand several years before I left; +her friends at first paid for her maintenance. She was an epileptic--and +something beside. When I knew her in the Strand she professed an +inability to talk, except unintelligible gibberish. She was very artful; +she claimed to be a deeply religious character, and contrived to take in +the benevolent lady visitors to a considerable extent. She continually +showed me letters she had received, and books that had been given her by +ladies, and would ask me to share with her the grapes, cakes, and +sweetmeats sent her by her dupes. This went on for several years, +altogether about twenty. She always posed and was spoken of as "poor +Maria"--in fact, she was the pet of the nurse and of the ward. At last +it came to my knowledge that she presumed on her condition to be +exacting and troublesome. Finding that remonstrance was unavailing, I +reluctantly ordered her removal to the insane ward. It was attended with +the best result, for, finding that she was at last sternly dealt with, +she threw off the mask she had worn for twenty years and talked as +distinctly and clearly as any healthy person. She had traded for years +on her alleged infirmity. It was true she was an epileptic, and +eventually died from that form of disease; but she had been the most +persistent cheat I had ever met with. + +On the male side I found a poor fellow who had also been transferred +from the Strand, where I had known him when he was first admitted there. +He was paralyzed all down on one side. He was the most patient, honest +fellow I had ever seen. After I had been in office some years Sir +Charles Trevelyan came to call on me respecting a public movement that +we were both engaged in. Finding I was at the infirmary, he came round +to the House and was shown into my room. I asked him to go over the +wards with me. He did so. I introduced the poor paralytic to him as an +honest, patient, and grateful poor man. Sir Charles asked him how long +he had been afflicted, and he answered, "Some twenty years." Then I +said, "This poor fellow cannot get downstairs; he has not seen the +streets for all these years, but he is always happy and cheerful." Sir +Charles kindly left with me £1 to pay his cab fare, so that he might +have the chance of seeing them once again. As I had to send two people +with him each time the £1 soon went. His enjoyment of this treat in his +daily dull, routine life was, I was informed, most pleasing to witness. + +There were several other very interesting persons I found on both sides +of the ward. One was an old man who was said to be eighty-eight years +old. On my morning visit he was always standing on the staircase +smoking. He had lived many years in Australia, and his long white hair +and beard, which reached to his waist, conjoined with a florid +complexion and bright blue eyes, caused me to consider him one of the +handsomest old men I had ever seen. One day I took two young ladies over +the infirmary. We found the old man in his usual place. I jocularly +introduced him to them as the Adonis of the House. The old man was +terribly offended. As we walked away I heard him muttering aloud, +"That's a pretty name to call a man--'Donis indeed!" He did not forgive +me for a long while. I wonder what he thought the epithet really was +intended to signify. + +I also found in the male infirm ward an old French physician whom I had +known by sight for a great many years when he was practising his +profession in Soho. He was a tall, fine man when I first knew him. He +always used to wear a very singular-looking broad-brimmed hat. He was in +all externals a very gentlemanly-looking person. I had missed him for a +long time, and was surprised and hurt to think that he should have +drifted to a workhouse infirmary. On inquiring into the cause of his +becoming an inmate of the House, for I always thought he was well-to-do, +as he dressed exceedingly well, I learned that he had lived with a lady +who was an _employé_ at a French milliner's in Regent Street, that she +was much younger than he was, and that he had given to her all his +money, which she, in preparation for possible consequences, had put in +the Funds, but in her own name only. Unfortunately for him she was taken +suddenly ill, and being ignorant of English courts made no disposition +of the property, simply telling him, on her deathbed, where it was. When +she was dead, he found to his dismay that the money could not be +obtained, as he could not establish any legal claim of ownership. Grief +at the loss of his mistress and of all his money caused the complete +break-down of the poor fellow, and he had come into the House utterly +crushed. He was a very interesting old man, being the only son of a +French noble family. His mother and father were both executed during the +Reign of Terror, and when the family property was confiscated he was but +a youth. When he grew up he studied medicine, and in the year 1802 +entered Napoleon's army as a regimental surgeon. After serving with his +regiment in Germany, Italy, and Austria, he was attached to the Army of +England, as it was called, which was stationed on the heights of +Boulogne. He was there some time. Suddenly an announcement came that the +encampment would be broken up, and that the army would go to Russia. He +traversed the whole of Europe, taking part in the various engagements on +the road to Moscow, which he saw in flames. He was in the memorable +retreat, and returned to France without a scratch. On the return from +Elba he rejoined his old regiment, and, as its surgeon, fought against +the English at Waterloo. After the peace his regiment was disbanded, and +as the old soldiers of the empire were very much at a discount he +elected to come to England, where he lived since 1816. He died at the +age of ninety-five, retaining his faculties to the last. After his death +I raised a fund to bury him, by writing a letter to _The Times_, in +which I gave his history, heading my letter, "A Relic of the Grand +Armée," and asking any friends of the first Napoleon to help me in +burying him in some other place than a pauper's grave. My appeal having +brought me £25, the Empress Eugenie being one of the subscribers, he was +buried at the Catholic Cemetery at Kensal Green. There were two +seamstresses who lived in Gilbert Street, Oxford Street, who were his +countrywomen and his sole visitors, with the exception of the Catholic +priest of the French chapel in Leicester Square. I asked them and the +priest to accompany me to the funeral, which I attended as chief +mourner. On our arrival at the mortuary chapel, the coffin was placed on +a raised bier with three others. Presently two lads, wearing long black +cloaks which reached to the ground, came from the altar. When they +arrived at the spot where the coffin was resting, one lad suddenly +produced from under his cloak a censer containing fire and proceeded to +incense the quartette. How he ever carried the fiery thing without +setting fire to himself was to me a wonder. He was immediately followed +by the other lad, who, taking just as rapidly from under his cloak a +vessel like a whitewash-pot, proceeded with a brush to throw holy water +on the coffins. This being completed, the coffin was put on a truck and +we hurried away as fast as we could go through the miry ground for a +long distance to the grave. On reaching it, down went my two lady +companions on their knees in the clay. My respect for the deceased did +not carry me so far as that, especially as it was raining hard and the +ground was a mere bog. Presently the acolyte produced his whitewash-pot +and brush, and I was courteously asked to sprinkle the poor fellow's +coffin with holy water, which I did. This having been also done by my +companions, I was amused by a little girl about fourteen, who, suddenly +taking the brush and pot from one of the young women, went to work +sprinkling in grand style, and, what was rather alarming, let me in for +more than I had expected. On our return journey the priest asked me to +attend service in the Catholic Chapel, in Leicester Square, on the next +Sunday. This I did. He was a very gentlemanly person. He thanked me very +much for the little service I was enabled to render to the poor old +French doctor, whom I missed very much, as it was my habit to sit beside +the old man's bed and hear him fight his battles o'er again. + +The opposition to the removal of the sick to the Asylum Hospital at +Highgate continuing, and plausible ground for some action having been +shown in the fact of that establishment being so far away, a move on the +part of the Department became necessary. The old Workhouse in Cleveland +Street being no longer wanted by the Strand Board (as they had built a +new House at Edmonton), it was proposed to pull down and rebuild an +additional Asylum Hospital upon the site. The vestry of St. James's, +instigated by the Chairman of the Board, gave a determined opposition +to the proposition. But for once the Department was firm and the +hospital was built. At first the four Unions were associated in its use +and management, but after a time its use for the reception of acute +cases was limited to the St. Giles's, and St. George's, Bloomsbury, the +Strand, and Westminster Unions. The Chairman having for a time retired +from the Board, his place was filled by a fresh Chairman, and no +obstacle being made to my utilization of Cleveland Street Asylum, +suitable cases were transferred there, to the relief of the Westminster +House, which, through the resistance of the Board, had become +inconveniently full. The new Chairman was a very weak man, who was +neither by his financial position or general intelligence justified in +aspiring to hold such an office. It is possible that if he had devoted +the time he spent at the Board and at the Sick Asylum to his private +business he might have delayed, and possibly have staved off, his +eventual bankruptcy and ultimate death in the Asylum Hospital in +Cleveland Street, to the building of which he gave the most determined +opposition. His successor as Chairman was a surgeon in Soho, who was a +man of very fair attainments, and during the time he occupied the chair +the business of the Board was carried on with remarkable success. I +received from him the most generous support, and during his tenure of +office my official life was hardly chequered by a single cloud. + +I have spoken of the clerk of the Board as having expressed a favourable +opinion of the economy I had effected on my first entrance on my duties. +The clerk had occupied a similar position at St. Martin's prior to its +amalgamation with the Strand Union. As I never went near the clerk of +that Union after the discovery of his perfidy in making, in conjunction +with Catch, a false charge against me, I was often at a loss to know to +whom I could go when any difficulty cropped up. Having had an +introduction to this clerk, I frequently called and consulted him; +consequently I was not surprised when, through the loss of his office, +as the result of St. Martin's being joined to the remaining parishes of +the old Strand Union, he was without employment, that he should call on +me and invoke my good offices in favour of his being appointed to a +similar position in the Westminster Union--the gentleman who had filled +the office and that of vestry clerk for St. James's having elected to +continue in the latter office only, and not to combine therewith any +appointment under the Poor Law. Having some influence in St. Anne's at +that time, and being also known in St. James's, I gave him my support, +with the result that he was elected clerk to the Board. He never +exhibited gratitude for my doing this; indeed, on the contrary, he was +distinctly hostile to me during the first few years after my +appointment, more especially in all matters relating to lunatics, the +truth being that he had a sympathy with all those who were alleged to be +of unsound mind, arising, I consider, from the fact that he had a +consciousness of not being quite right himself. During the +two-and-twenty years I knew him I never saw him half-a-dozen times with +a shirt on. I do not state that he never wore one, it was simply never +visible; what did duty for it was a sheet of more or less crumpled +whitey-brown paper. His clothes were as torn and ragged as those of the +most poverty-stricken casual--his shoes down at heel, and the legs of +his seedy-looking black trousers hanging in rags. He always complained +of being so very poor through the strain put upon him in having to +support some needy relatives. His condition and poverty-stricken +appearance were often the subject of conversation and commiseration: +"Poor fellow," it used to be said, "he has had a great deal of trouble, +and is very poor." It was therefore a matter of great astonishment to +find, after his death, which took place somewhat suddenly, that he was +possessed of several thousand pounds. He died without making any will, +and there was a legal struggle among distant relations as to who should +secure his very considerable belongings. I have frequently noticed on +the part of eccentric people this disbelief in and morbid sympathy with +lunatics, and believe it to arise from a species of innate consciousness +of mental deficiency, and a fear lest they also should be incarcerated. + +One morning, some time before his death, he came to me in my room and +showed me a letter he had received from the military Commandant of +Devonport Barracks Hospital, which was to the effect that they had a +young soldier under treatment for lunacy, who, in his attestation when +enlisting, had stated that he belonged to St. James's, London, and that +the authorities determined to send him up to us. The clerk said to me, +"That does not show that he belongs here, as there are several St. +James's in London; I shall write and refuse to take him until his +settlement has been determined." But he reckoned without his host, for +when did the military ever recognize the civil power? The same evening I +was requested to go to the insane ward, where I found the young soldier, +and the attendant informed me that he had been brought by a corporal and +left in the ward, and that the corporal said that he should call the +next day for the hospital clothes. The attendant also stated that when +brought in the man's hands were tied together behind his back. I could +make nothing of the poor fellow, as no history was brought with him, and +he would not speak. As he appeared to be very exhausted I ordered him +some milk, beef-tea, and wine, and desired that when the corporal called +the next day he should be detained, so that I might learn something +about the patient, but when asked to stay and explain, the corporal +would not stop. + +On visiting the man on the next morning I found that he had taken +nothing, and as he would not open his mouth, speak to me, nor do +anything, I sent for the stomach-pump and some of the strongest of the +pauper inmates, that he might be fed by artificial means. It took four +to take him out of bed, secure him in a chair, and to assist me to get +his mouth open, when I made the dreadful discovery that all his teeth +had recently been broken away in the forcible efforts that had been made +to feed him. After a most desperate struggle I administered some +beef-tea, arrowroot, and wine. This had to be repeated for two or three +days, until the necessary certificates were ready, which enabled me to +send him away to Hanwell. I was so disgusted with the barbarous manner +in which the young man had been treated, that I wrote an indignant +letter to the military authorities at Devonport, complaining of his +treatment, and their neglect in sending the poor fellow to the Workhouse +without affording any history of his case. The reply was a cool denial +of the truth of my statement, and an assertion that he took his food +readily and without artificial feeding. I sent this letter to the +medical superintendent of Hanwell, and asked for his opinion, when he +replied that the man had been forcibly fed for some time, and that his +teeth had been destroyed in doing so. I then wrote an account of the +case and sent it to Dr. Lush, M.P. for Salisbury, and asked him to see +the Minister for War on the subject, and in the House to ask the +question I had drafted. + +A few days after Dr. Lush replied, telling me that he had seen the +Minister, who read the statement, and said he thought that it was a very +shocking story, but he hoped that I would not press for an official +inquiry, as it would ruin the officers inculpated, and promised that he +would send out to all military hospitals such an instructional letter as +would prevent the occurrence of such things in future. Dr. Lush also +added, "I have promised not to press the matter, especially as the +Minister for War did not hesitate to tell me that he entirely believed +your statement," and continuing, said, "I know, Rogers, you do not want +to ruin anybody, and if the matter is made public there will be a +dreadful row, and the whole blame will be thrown on the doctor." I +reluctantly assented to this view, and the matter dropped. + +The poor fellow was afterwards proved not to belong to St. James's, +Westminster, but to some parish in the East End. He did not remain +chargeable to any parish very long, as he died soon after at Hanwell. +Dr. Raynor, when I appealed to him for his opinion, stated that if I had +not written at the time of his admission and explained how I had become +possessed of the man, he should have felt it his duty to have made a +special representation to the Commissioners in Lunacy as to the +condition he was in on admission, and the barbarous usage he had +received. + +When at the Strand I was required to give the certificate in lunacy and +attend before the magistrates in its support, and was paid a fee for my +trouble; when appointed to the Westminster Union it was arranged that my +salary should include all extra fees, particularly because the +magistrates at Great Marlborough Street, contrary to the statute, +required two certificates. The Guardians being unwilling to pay the +fees of two medical men, the medical man called upon to give the second +certificate was paid. As this appointment was dependent on the caprice +of the Board, it frequently happened that the other medical man, who was +aware of the feeling of certain of the Guardians, would refuse to +endorse my opinion, but I always succeeded in getting my way in the end. +One medical man who held this office for some time was constantly +striving to secure favour by giving the most unaccountable certificates +as to the condition of the lunatic submitted to him. I had the +satisfaction of getting rid of him at last, but not until he had given +me and the officers of the House a great deal of unnecessary trouble and +annoyance. In addition to this, the magistrates at Great Marlborough +Street, forgetting altogether that when two certificates were presented +their duty became simply a ministerial one, would frequently decline to +certify for removal of undeniably insane persons, and direct the return +to the House for further observation. No magistrate was more original in +this way than Mr. Newton, of Miss Cass notoriety. Over and over again +Mr. Newton has set up his expression of opinion in opposition to my +certificate and that of the extern, but after giving unnecessary trouble +and delaying the removal of the patient, thereby diminishing her or his +chance of recovery, he would eventually be obliged to affix his +signature to the certificate. To such an extent did this action prevail, +and so much were the officers worried by this magistrate, that it became +a custom on the part of the removal officer to send and inquire what +magistrate would be on the bench, and if he found it was Mr. Newton, to +take the case on the next day when he was not there. + +As I am on the subject of lunacy, and as I believe that much mischief +has ensued from the laity assuming that persons are improperly confined +in asylums, I will relate one or two instances of ill results that have +followed from treating insane persons as responsible for their conduct +when a very small amount of consideration of their actions would show +that they were of unsound mind. Upon one occasion, on going into the +male insane ward, a tall, decent-looking man, turned round and looked at +me. His aspect instantly told me that he was of unsound mind. To my +inquiry where he came from the attendant replied, "I do not know, sir; +all I do know is that his wife brought him here yesterday and left him". +I spoke to the poor fellow, and was perfectly convinced that he was +insane. I directed the attendant to go for the wife. On my return from +the wards to the consulting-room I found a decent-looking little woman +waiting my arrival. To my inquiry what she wanted, she said, "You sent +for me." "Oh," I replied, "you are the wife of that poor fellow over the +way in the insane ward--how long has he been out of his mind, and where +have you brought him from?" To my astonishment she burst into tears, at +the same time saying, "He came out of prison yesterday, sir." "Out of +prison," I replied; "why, how could he have got into a prison? That poor +man has, to my certain knowledge, been a lunatic for a long while." She +immediately said, "Yes, sir, I have known it for nearly a twelvemonth, +but no one but you has ever said so before." I told her to compose +herself and tell me his history, when she stated as follows: "We have +been married about five years, and a better husband no woman could have +had, but about a twelvemonth ago he complained of his head, and could +not sleep or work as he had done. I did my best to cheer him up, and +told him to struggle against the feeling and all would come right. His +occupation was that of a coat-maker for one of the best West End master +tailors. One afternoon, some months ago, he threw down a coat he was +making, saying he could not go on with it, he must go out, which he did. +About an hour afterwards a policeman came to tell me my husband was in +Vine Street Police Station, and that he had been taken up for stealing. +I hurried there, when I heard that, walking along Little Pulteney +Street, he came opposite a poulterer's shop, when, suddenly springing on +the show-board, he clambered up by the hooks till he reached the top, +and, taking off a hare, he put it over his shoulder, and jumping down +some ten feet, he stood there. The proprietor gave him into custody. The +next day he was taken before Mr. Knox, who committed him for a term of +six weeks' imprisonment and hard labour, it being his first offence. + +"Whilst he was in prison I had to part with many of my things to keep my +children. On his discharge I met him at the prison gate, and saw he was +worse. I did my best to cheer him up, and told him if he would not do +anything of the kind again I would do all I could for him. On his +reaching home I said that I had been compelled to part with some of our +things, and that, therefore, he must go to work at once. The same day I +went to one of our employers, a master tailor in Maddox Street, and +asked for some work. A dress coat was given me to make up. My husband +went to work at it, but he did it so badly that when he took it to the +shop the master refused to pay him, and gave it him back again. During +the conversation my poor husband took off a pair of black dress +trousers from a hook, and put them under his arm. He had not long left +the shop when it was discovered, and one of the shopmen, running after +him, caught him with the property. He was again given into custody, and +taken before Mr. Knox, who committed him for trial. At his trial at +Clerkenwell Sessions shortly after, he was found guilty, and evidence of +a previous conviction having been given, he was sentenced to six months' +imprisonment and hard labour. That his time was up yesterday morning, +that she had met him at the prison gate, and seeing that he was much +worse she had brought him straight to the Workhouse, so that he might be +kept out of further mischief." She followed it up by saying (with a +burst of tears), "You are the only gentleman who has ever said that he +was not right in his head, but I have known of it for months past." + +I stood utterly astonished that so gross a miscarriage of justice should +have been perpetrated; that a man evidently so bereft of the knowledge +of right and wrong should have been punished as a criminal. After +inquiring where she lived, and also for some references, I told her if +my inquiries bore out what she had stated, I would publicly expose the +treatment her husband had been subjected to. I made inquiry the same +afternoon, and found that both the husband and wife had borne a most +excellent character up to the time of his first arrest. The next +morning, so soon as my official duties were over, I went to Great +Marlborough Street Police Court, and asked to see Mr. Knox. I related +the story to the magistrate. When I had finished it he was very much +affected, and expressed his regret that such a dreadful thing should +have occurred. He also went on to state that they had so many people +brought before them, and it was all done in such a hurried way, that +without special attention was drawn to a case, and if the facts were not +disputed, and if no one appeared for a prisoner, a decision was come to +at once. He further said, "I remember the poor fellow being brought +before me perfectly. I do not think that it is desirable that this story +should be made public; it can do no good. Send the wife to me and I will +give her a present from the poor-box." + +When leaving the court the jailor followed me, and said, "I am pleased +you have been here. I saw that poor fellow was out of his mind on each +occasion when he was brought before the magistrate." On reaching the +street I met Mr. W. J. Fraser, Guardian, and now the Chairman of the +Board, to whom I told the circumstances. Mr. Fraser was very much +shocked at the treatment this poor lunatic had received, and that Mr. +Knox had desired that no publicity should be given to the case, and +replied, "Give it every publicity you can." That same evening I wrote to +the editor of _The Times_ the particulars of the case, and, as the poor +husband's condition was irremediable, I pleaded that monies should be +sent me to enable me to put the wife into some way of earning her +livelihood. The letter duly appeared, and caused a great deal of +sensation, many subsequent letters from gentlemen interested in the +question of lunacy being published. As a result the sum of £85 was +subscribed for the wife, and was sent to me. + +It was a puzzle to me to know what to do with the money, which was not +enough to buy a chandler's shop and stock it. I decided to set the woman +up in business as a laundress at Battersea. I went there, took a +suitable cottage, and guaranteed the rent for six months. Then I went to +a firm in Holborn and purchased the laundry plant, which, under the +special circumstances of the case, was sold to me at a reduced rate. I +got a forewoman whom I borrowed from one of my patients in a large way +of business as a laundress, and started her by inducing people to +patronize her. I could do all this, but I could not make the poor woman +a laundress, and after a few months' trial she came and asked me to let +her dispose of the business and plant that she might go to her friends +in the country. I assented, for I had discovered that she was a business +failure. She sold off everything, went away, and I have never heard of +her since. Her poor husband did not long survive, and without doubt his +death was hastened by prison life and the treatment he had received +there. He died at Hanwell of general paralysis of the insane. + +It would prove instructive if it could be ascertained how many poor +creatures have been similarly taken into custody, convicted, imprisoned, +and after spending more or less time in prison discharged with their +mental condition hopelessly shattered from the treatment received. Some +years since I went over the Naval Hospital at Yarmouth, for those who +had become insane whilst in the service. There were several men of +magnificent physique, who were stricken with the same kind of mental +infirmity as that which had caused the death of my unfortunate patient. +I inquired of the courteous medical superintendent whether he had any +history of these men. He said yes. I asked whether the first evidence of +their mental ailment was not the exhibition of some departure from +discipline or of theft, or some other action which was totally at +variance with their previous conduct. He informed me that their records +showed that such was the case. + +Woful results have followed the action of judges and police magistrates +in dealing with numbers of their fellow-creatures as criminals when they +rather required a nurse and skilful attention than the rough services of +a prison warder. But then this deplorable condition of things will +continue so long as such scant consideration is shown to the actions of +the poor, who, being without means, cannot command the services either +of barristers or solicitors. + +It was during the reign of the Chairman of the Board who subsequently +died in Cleveland Street Asylum, that one of the most extraordinary +cases of lunacy I ever witnessed came under notice--extraordinary in one +sense only, viz., in the manifest determination of certain officials to +prevent me from sending to the asylum one of the most artful and yet +hopeless lunatics I ever encountered. + +Originally she had been admitted as a woman of unsound mind. I examined +her at the time, and at once filled in a certificate that she was a case +for removal to an asylum. She was not, however, sent away, as the clerk +intervened, and at the next meeting of the Board he showed that the +woman was the wife of the parish broker, who was a man of means and +quite able to keep his wife in a private asylum, whereupon it was +ordered that the husband should take her out. After her return home her +husband asked me to see her; he could not live with her, her conduct was +in every way so objectionable. I saw her again, certified that she was +of unsound mind, and she was sent to St. Luke's, and her husband paid £1 +a week for her maintenance therein. Getting tired of this, for he was a +most penurious person, he took her out. Sometime after he was taken ill +and died, leaving upwards of £4,000. Dying intestate, his property was +divided between two brothers and the widow, her share, the third, being +upwards of £1,500. The solicitor who wound up the estate, recognizing +her mental condition, tried to induce her to let him invest the money in +some security, but she refused. She would have her money paid over to +her absolutely. This was in November. By the middle of the following +August the money was all gone. She had squandered it all away; and +having by her habits, which were to the last degree objectionable, +caused her ejection from one lodging after another, the relieving +officer was again called in, and removed this wretched woman to the +Workhouse insane ward. She brought with her a large amount of property +which was not convertible into cash. Now, it may be asked, How was the +large sum of £1,500 got rid of in but little over eight months? The +explanation is a sad one. The first thing this poor woman did was to buy +some £24 worth of plants in pots, which were taken to a furnished room +she had hired in Gerrard Street, Soho. She never attempted to attend to +them in any way, and, therefore, in a very short time they were all +dead. She then sent to a well-known drapery business in Regent Street to +buy some clothes. Before she left the shop the person in the department +she went to had induced her to buy some £300 worth of personal clothing, +which was all sent to this single room in Gerrard Street. She also went +to a pianoforte manufacturer in Regent Street, and purchased a sixty +guinea piano, at the same time being absolutely ignorant of music; and +if any one had taken much trouble they must have recognized by her +appearance her mental deficiency. About two months after she first +purchased at this draper's shop, the shopwoman who had sold her £300 +worth of clothing, called on her in Gerrard Street, and, although this +room contained the dead flowers and unopened boxes of the first +purchase, she induced her to buy £250 worth more, thus making a total +of £550 expended by a poor insane woman. The Rector of St. Anne's, Soho, +informed me that she regularly attended the sacrament, and always put £1 +in the plate in new gold. What made the conduct of the shopkeeper of the +firm in Regent Street the more inexcusable was that at the time she +called on her the woman was in such a state, in consequence of her dirty +habits, as to be plainly insane, and this compelled the landlady shortly +afterwards to insist on her leaving the house, as all the other lodgers +complained. When she was first admitted to the Workhouse her habits were +so repulsive that she was an intolerable nuisance to the other inmates +and nurses, for she was alive with parasites. + +I considered the treatment this poor creature had received at the hands +of the proprietors of the drapery establishment so abominable that it +merited exposure, and with that view I called on a gentleman connected +with the Press, and asked him to take the matter up. He declined, as it +was not within the province of his journal. At the same time he gave me +an introduction to the editor of _Truth_, who he said would do so. On +going home I drew up a history of the case, and sent it in a letter +marked private to the editor, enclosing the letter of introduction, and +asking that he would grant me an interview, when we might arrange for +publishing my statements without my name appearing. I received no answer +from the editor, but a day or two afterwards I was told that my +statement had been published _in extenso_ in _Truth_. A day or two after +that the Chairman, who lived nearly opposite the draper's shop, called +on me and stated that he was deputed by the firm to inform me that if I +did not at once write to the editor of _Truth_ and disavow the letter +and story an action for libel would be commenced against me without +delay. My answer was as follows: "Go back to this firm and say that I +did not give any authority for the story to appear as it has done, but +as it is all absolutely true I shall decline to withdraw or modify a +single syllable." I certainly did write to the editor and complained of +the way in which he had published the story, and told him of the threat +which had been made of prosecuting me. The only result was that an +annotation appeared in the next week's issue which, under the guise of +an explanation, made the scandalous story a great deal worse. The firm +did not prosecute me or the editor of _Truth_. + +It would be imagined by my readers that there would have been no +difficulty in getting this poor woman sent to an asylum, but I never had +greater trouble in my life, owing to the action of Mr. Newton, the +police magistrate at Great Marlborough Street. Five times during the +five months that she was detained in the insane ward, where her habits +were most disgusting and highly objectionable to the other inmates and +to the nurses, I certified for her removal. On each occasion she was +sent back by this magistrate. Hearing that he was gone for a holiday, I, +for the sixth time, filled in a certificate and went with her and my +out-door colleague to the police office. To my surprise I found the +Chairman of the Board and two of his friends, members of the Board, in +attendance to give evidence in this woman's favour. The clerk had found +out what I was doing, and had sent word to them. At the hearing before +the magistrate they attempted to interrupt me in my evidence, but they +were very properly put down by the magistrate. He at once countersigned +the certificate and she was removed. But my troubles were not at an end. +The trio sent to the Commissioners in Lunacy an intimation that I had +unjustifiably sent a sane woman to Hanwell Asylum. Upon this coming to +my knowledge I went there to see her, when the medical superintendent +of the female side informed me that a special letter had been sent from +the Lunacy Commissioners requiring him, at the end of three weeks, to +send a detailed account of the case to them. He said, "I never met with +such a case. I was sure from your certificate she must be insane, but +she pulled herself together so wonderfully and was so well conducted +that I had come to the conclusion that you must be mistaken, when +suddenly she broke down, and her insanity became apparent, and I have +reported in that sense to the Commissioners in Lunacy." This story +illustrates the utter absurdity of the provision in the Lord +Chancellor's Bill committing the examination of these cases to a county +court judge, police magistrate, or Justice of the Peace, who cannot +possibly understand anything about the varied phases which insanity +presents. The district medical officer who jointly filled in the +certificate with me was deprived of his office, and a more manageable +person was elected by the Board in his stead--that person I have before +referred to in the earlier part of this narrative as giving me so much +needless trouble. + +Some three years ago I had occasion to go to Hanwell. Whilst there I +asked whether the woman was still in the asylum. On learning that she +was I expressed a desire to see her, when the superintendent medical +officer gave directions that she should be brought down. Immediately on +seeing me she sprung upon me, and, before I was able to defend myself, +pinioned me in her arms, at the same time imploring that I would take +her away with me. It took three able-bodied women to release me from her +grasp. Should I ever go to Hanwell again I will keep clear of her. I +have had quite enough of her. She is a hopelessly incurable lunatic. As +she gets older she will become more and more demented, and will be +eventually removed to some imbecile establishment. + +The female insane ward at the Westminster Union was always full, and +when a noisy or dangerous lunatic was sent in, and whilst the necessary +steps were being taken to get them away, the harmless patients had +anything but a pleasant time of it. But then the comfort of these people +was never at any time considered by those members of the Board who +considered themselves authorities in lunacy. Fortunately they could not +state that my action arose from the desire to get a fee, as I was never +paid one, but they did say that I sent them away as I did not want to +attend to them. + +We had on several occasions very amusing cases of lunacy. One of the +most so was a Welshman, who, until he lost his reason, had been a very +respectable journeyman tailor. I was asked to see him by a member of the +Vestry in whose house he lodged, and who gave him a most excellent +character for honesty and industry. He had saved money, and was +exceptionally respectable in his appearance and conduct. On being shown +into his room he rose and received me with much politeness. I noticed a +quantity of ladies' underclothing on the table, and evidently intended +for some small woman, as the various things were all on the same +diminutive scale. On asking what it all meant he said, "Oh, that is for +the lady I am about to marry. I have just purchased a complete set of +ladies' underclothing as a present for my future bride." "Indeed," I +said, "is it usual for the gentleman to buy his future wife's +underclothing?" "Well," he replied, "perhaps not, but I am a very +particular person, and my wife must dress as a lady." "Just so," I said, +"but how have you managed to get all these things so exactly arranged as +to size?" To which he replied, "You see, I am accustomed to measure +people, and I have taken my dear little girl's size exactly." I then +took up a pair of some two dozen of kid gloves, with the remark, "You +have bought her some good gloves, at any rate." "Do you think so?" he +said. "Do oblige me by taking a pair away with you; they may suit one of +your daughters." As his insanity was undoubted, I suggested his removal +to the insane ward. This was carried out. On seeing me next day in the +House he spoke rapturously of the ward he was in, and of his companions, +all of whom he had invited to his wedding. They would have been +sorry-looking persons to have made part of a company at a +marriage-feast! + +I was so amused at this poor fellow's delusions that next day I took one +of my young lady relatives to see him. On my asking the attendant to +bring him out into the yard, he came. At first he looked dazed, but, +seeing a young lady, he ran towards her, and, peeping under her bonnet, +he looked up and said, "She is devilishly like Mary Jane," this being +the only name he had for his imaginary future wife. My young companion +was so tickled that she burst into a hearty laugh in which the poor +fellow joined. Subsequently he was sent to Hanwell. On visiting the +asylum some months afterwards I asked to see him, when he was sent for. +On entering the room he recognized me instantly, and expressed his +gratification at my calling to see him. His delusions were as marked as +ever. As I had gone there on other business I resumed my conversation +with Dr. Raynor, and forgot our Welsh friend altogether. Presently we +both went out into the yard, when, to our astonishment, we found that he +had gone out, and would have escaped altogether if he had not luckily +been observed and taken back to his ward. Poor fellow! Some time after +he was removed to Wales, where he was settled, and he ultimately died of +general paralysis, and so the contemplated wedding was adjourned _sine +die_. The underclothing, gloves, silk stockings, &c., were all sold to +help pay for his maintenance. I never saw such a genial and absolutely +happy lunatic. He lived in the company of his imaginary Mary Jane. It +must not, however, be imagined that all are so light-hearted as this +Welshman. I have encountered homicidal lunatics, and have personally +experienced what some are capable of, having sometimes sustained severe +assaults from incautiously going too near them. + +Early in 1872 the present Chairman of the Westminster Union, W. J. +Fraser, Esq., solicitor, asked me to visit the Rev. H. Watson, ex-master +of Stockwell Grammar School, who was then located in Horsemonger Lane +Gaol on the charge of killing his wife. I did so, and after an interview +which lasted an hour, came away and wrote a report that in my judgment +he was of unsound mind. I formed that opinion from the levity of his +manner, his self-exaltation, his total indifference to his fate, the +absence of all regret for what he had done, and the absolute want of any +feeling on the subject. He was lost in the belief that his services in +the education of youth precluded the possibility of any punishment for +his deed. At the Old Bailey, as I was about being called upon to give +evidence, the counsel who defended him, the late Sergeant Parry, called +me over to tell me that they had decided not to call me as a witness, +but only just to support the views of the others. He said, "We think you +may be a dangerous witness." After asking me a few questions he said, +"You can stand down." But I was not to stand down, for the prosecuting +counsel, Mr. Poland, immediately proceeded to severely cross-examine me. +But to all his questions I had my reply ready, and after some half +hour's trial of questions and answers I managed to get out all the +points on which I relied to prove Watson's mental unsoundness. When I +got down Dr. Blandford said, "You have done well; you have convinced the +judge;" which was shown in his summing up and in his after action at the +Home Office. + +Whilst under cross-examination I spoke of his enormous self-exaltation, +&c., giving instances, whereupon Mr. Poland said, in a professional tone +of voice, "Oh, you consider that is a sign of insanity, do you?" "Well," +I said, "seeing he was only a schoolmaster, I do." Whereupon Watson, who +was listening attentively to my evidence, wrote on a piece of paper and +gave it to Mr. Fraser for presentation to his counsel. He had written, +"What does this d----d fellow mean by calling me 'only a schoolmaster'?" +After his conviction and sentence he was removed to Horsemonger Lane +Gaol. When Mr. Fraser went to see him next day the only thing he +complained of was my having spoken of him as only a schoolmaster. He had +nothing to say about his conviction and fate; as regards that he was +absolutely indifferent. There was a terrible row in the Press about this +man, and the doctors were all condemned for their efforts to prove that +his mind was unhinged. It was therefore some comfort to me when, in +going down the street in which I then lived some few days after, I saw +Lord Elliot, the son of the Earl of St. Germains. On meeting me he +crossed over the road, came up to me, and holding out his hand and +taking mine he said, "I see you have been figuring at the Old Bailey." +"Yes, my lord," I replied; "I hope, however, you do not think I have +done wrong in giving the evidence I did?" "Oh no," he said; "I have just +come from the Home Office, and have met there the Lord Chief Justice +(Cockburn) and Mr. Justice Byles, who have both advised the Home +Secretary that they consider that the plea of insanity was, in their +judgment, fully sustained: at any rate, he will not be hanged." His +sentence was commuted to penal servitude for life. Poor old Watson was +sent to Parkhurst Prison. Some years after the governor and surgeon +informed me that he preserved the same callous and indifferent manner +which I had described at his trial. His only complaint was that he could +not get the particular copy of the Greek Testament he wanted, and he +never to the last referred to or expressed any regret for the act he had +committed.[1] + +After I had been at the Workhouse some two years I was requested by the +Board to go down and take temporary charge of the Union school at +Wandsworth Common. It would appear that there had been a quarrel +between the superintendent matron and the medical officer, and an +official inquiry having been held by a Poor Law Inspector he had +reported that he could not decide which was in the wrong; he would +advise the Board to call on all three to resign at the end of the +following Midsummer quarter. + +The medical officer, Dr. Noel, who, strange to say, had been a +schoolfellow of mine nearly fifty years before, at once sent in his +resignation. I took over the duty at the end of April, and had charge of +the schools nine weeks. It was a very pleasant excuse for an outing, and +as the Common at that time was not much built upon and the gorse was in +full bloom, it made for me a very agreeable change. At the Midsummer +quarter a new medical officer was appointed, and my temporary +appointment came to an end. There was extremely little sickness during +the time I had charge of the establishment, and I therefore came to the +conclusion that the only possible explanation of the quarrelling was +because they had so very little to do. My successor was appointed on the +distinct understanding that in the event of any serious illness +occurring he was to send for me. His neglect to do this led, some five +years afterwards, to his being called on to resign, and to my being put +again in control of the schools and retention of the office for eight +months. The occasion for my being sent down the second time was a +serious outbreak of ophthalmia which had taken place, one-half of the +school, about sixty children, being more or less affected with it. I +could not afford the time or undergo the fatigue to go there every day, +so on my return home I made a report to the Board that on condition that +the Board gave me full powers to act as I thought best I would root out +the epidemic. This was assented to, whereupon I brought back forty-eight +of the worst cases to the Workhouse, and isolated them in the large +wards at the top of the main building. I also brought with me the nurse +and assistant school-mistress. I told the Board that some of the cases +were so very bad that I must be allowed to call in an ophthalmic surgeon +to aid me in my treatment. This was also assented to. I also arranged +that the children should go for a run in the park every day, weather +permitting. I considered the dietary of the children, and, finding it to +be wholly insufficient, I amended it. I adopted a similar course at the +school. Fortunately for the children the Chairman of the Board, a +medical man, supported me in all I advised and did. I had the children's +hospital at the school whitewashed and painted green and varnished, the +walls stopped and covered with neatly-framed engravings kindly sent me +by the proprietors of _The Graphic_. At the end of eight months I gave +up the appointment, leaving the children perfectly well, except in a few +cases where irretrievable mischief had taken place ere I was called in. +Much of my success was due to the Chairman of the Board, the late Mr. +Henry Cooper, of Soho, who throughout gave me the most generous and +unfaltering support. Many of these poor children would have hopelessly +gone blind if it had not happened that at the period of the epidemic the +Board fortunately possessed an intelligent and public spirited Chairman. +Not a very long time afterwards he was taken ill, and after lingering +some time died, to be succeeded by another person who, most unluckily +for the welfare of the House, had again been returned as a member of the +Board and elected the Chairman. + +About some two years after my appointment a woman, extremely ill, was +brought from Vine Street Police Station. She was an unfortunate, as it +is called, who had been taken ill in the cell. Repeated requests from +her for attendance met with no attention. At last, her condition +appearing desperate even to the constables, the divisional surgeon was +sent for, who directed that she should at once be removed to the +Workhouse. She was brought in on a stretcher, and I was summoned to +attend her without delay. I found that she was dying, and not a long +while afterwards she succumbed. A coroner's inquiry taking place I made +a post mortem, when I found that she had died from the rupture on an +aneurism of the abdominal aorta, which, giving way in the loins, had +slowly infiltrated the tissues until, a vent being found, the whole +thing gave way. There is no doubt that this rupture had been +precipitated by the violence attending her arrest. The verdict, under +the direction of the coroner, led to a censure of the police for their +inhumanity and indifference. The ultimate result was to immensely add to +my troubles, as will hereafter be shown. + +Just at this time the old and sagacious surgeon of the division died, +and his place was sought after by several medical men living in the +neighbourhood of the two police stations in St. James's, some of whom +were men of acknowledged position. The gift of the appointment was +vested in the Chief Surgeon of Police, Mr. Timothy Holmes, of St. +George's Hospital. He gave the office to one of his old pupils who at +the time was non-resident, but who at once took a house in Jermyn +Street. It was not very long before I experienced the result of the +change. Case after case was sent into the House from the two stations +with certificates that the persons were ill when they were undeniably +and plainly drunk. At first I complained of this to the inspectors, but +it led to no result. I then wrote to the Commissioners of Police, +complaining of the annoyance. I got only an official reply. At last the +nuisance became so great, for we were always called to these police +cases sent in from the station in the small hours of the morning, that I +again wrote to the Commissioners and requested an interview. This was +granted. I took with me my assistant who had been principally called out +of bed to attend to these cases, sometimes only to dress a wound which +the police surgeon was too indolent to do himself although he was paid a +fee for each visit. On arrival we stated our complaint, but, although +the Commissioners listened to us attentively, not much benefit accrued. +It is true they stated that an inquiry should be made and instructions +given and that more care should be exhibited. Some time after this I +happened to be at the gate when a constable brought a perfectly drunken +woman, who, he said, had fallen down in a fit. I said, "Why, she is only +drunk and incapable; take her away to the station;" and turning to the +master I said, "Do not admit her." An entertainment was being held that +evening which I had assisted to get up, and I went on into the +dining-hall. About an hour afterwards the master came to me and said, +"They have brought that woman back with a certificate from the doctor +that she is dangerously ill." I went to see her. She was only a shade +more under the influence of liquor than she was before, but, not caring +to contest the subject any further, I directed that she should be sent +to the receiving ward and put to bed. The next morning on seeing her she +had got over the drunkenness, and she owned to me that she had been only +drunk the night before. On going to my room I directed that a special +messenger should take a letter from me to the station, telling the +inspector on duty that the woman that had been sent in the night before +alleged to be ill, had confessed to having been only drunk, and +requesting him to send a constable and take her away. The constable +came. In the after-part of the day, a constable of that division called +at my house and said that Mr. Newton requested that I should attend the +police court the next morning. I went, when I found the woman there and +the divisional surgeon. The magistrate, before hearing a word from me, +proceeded to inveigh against me for my action in the matter, and +peremptorily ordered me to admit the woman at once. The divisional +surgeon also jumped up and protested against my refusal to admit the +woman, and stated, to my astonishment, that she had heart disease, and +that she was a confirmed epileptic. I mildly replied that she was +suffering under nothing of the kind, but Mr. Newton told me to leave the +court. The woman did not come into the Workhouse until the evening, and +she was then under the influence of drink. + +On my return to the Workhouse I told the master what had occurred, and +also asked him if he knew where she came from. "Oh," he said, "the +receiving wards woman informs me that she belongs to Whitechapel Union, +whose clothes she is wearing." I then asked him to write to the master +of the Whitechapel Union and ask him what he knew of her. In less than +twenty-four hours the reply came. It was to the effect that she was one +of the most abandoned characters ever in their House; that she did not +suffer from fits, though she often assumed to have one; that she never +went out except to return drunk; that she had no heart disease, but was +a hale, hearty woman; that on the day she went out, wearing the House +clothes, it was after three months' detention, she having returned on +the last occasion drunk and disorderly. + +Having received this report, I sent it to Mr. Newton. At the same time I +protested against his having sent for me to attend his court, and for +the remarks he had made to me on the faith of the opinion expressed by a +person of very little experience, and further informed him that I should +continue to protest against the use of the wards of the Workhouse as a +receptacle for merely drunken men and women, and should advise the +master accordingly. + +The annoyance still continuing, I made a point of sending for the police +each morning after every drunken admission. Then a new antagonistic +element was imported in the shape of a letter to the Local Government +Board from Mr. Timothy Holmes, containing a complaint against me for the +trouble I was giving the police authorities in objecting to the +reception of sick people from the station to the Workhouse. The letter +having been sent to me to answer, I forwarded to the Local Government +Board the names of some sixty persons brought in by the police under +the certificate of the divisional surgeon, and showed that two-thirds of +the entire number were proved to be only drunk and incapable, and that +the rest were, in the majority of instances, very trivial cases of +illness. The nuisance after this was very much diminished. + +It may be asked, What are the police to do with persons who allege that +they are ill? Are these complaints to be disregarded? Certainly not. But +I contend that reasonable care should be taken by police surgeons, +before they send cases of alleged illness to a workhouse infirmary; for +it must be remembered that they are paid a fee for each visit and +examination. To go, therefore, to the station, make a cursory +examination, and then write a certificate that the person is seriously +ill and must be removed without delay, or in the case of a simply cut +head send it at once away to the infirmary for the workhouse surgeon to +get out of bed and dress it, is, in my judgment, an entirely +unsatisfactory procedure, especially as the latter is paid no special +fee, be his trouble ever so great. There was nothing in all my duty as a +workhouse medical officer, which irritated me more than these police +cases. I remember on one occasion a superintendent of police said to me, +"I hold that if after our surgeon makes these mistakes he were to +forfeit his fee, which should be paid to you, you would not have many +then." + +Sometimes the police brought cases of interest. On one occasion two +Italian children were admitted. One was a boy of nine, clean and well +nourished, the other was a little fellow of about five, wonderfully +emaciated, and bearing about his little lean body evidence of recent +ill-usage. The parents, who were Italian Jews, had been taken into +custody for maltreating this child, and had been remanded. He was +dreadfully dirty. I had him weighed and found that he was much lighter +than he should have been, regard being had to his age. He was ravenous; +but he had to be fed with care so as to prevent mischief. His parents +had been remanded for a week, and a good-natured constable of the C +Division who had intervened and got the parents arrested came and asked +me to attend at the re-examination. Before taking the child to the court +I again weighed him, and found he had gained three pounds. After some +four remands at each of which I was enabled to show he had gained in +weight, the parents were committed for trial. I attended as a witness at +the Old Bailey when the trial came on, and the parents were convicted +and sentenced to eighteen months' imprisonment with hard labour. The +poor little fellow was brought back to our House, whilst the elder +brother was sent to the school. + +Foreseeing what was probably in store for this unhappy child, if he ever +passed into the hands of his unnatural parents, I wrote to _The Times_ +paper, and pointed out what would be the inevitable fate of this boy +when his parents came out of prison and claimed possession of him, and +pointed out that, as the Italian Consul had found counsel for the +defence of the parents at the trial, I trusted that they would find some +means whereby the child might be secured against further ill-treatment. +On the same day that the letter appeared, I received a letter from the +Consul asking me to call on him, which I did, when he told me that he +would bring the case under the attention of the King of Italy. Some +three weeks after I received a communication stating that the King had +resolved to take the child, and bring him up at the cost of the State, +as a ward of the Italian Government. Some ten days afterwards a tailor +came and measured him for clothing, and a messenger from the Italian +Consul having given an undertaking to the Board, he was taken away and I +saw him no more. If alive he must be now some eighteen years old. I +write "if alive," for the poor little fellow had a singular deformity. +He had no abdominal muscles; what did duty for them was a dull, +parchment-like-looking structure, stretched across the abdomen. One +could make out without much difficulty the various abdominal organs. I +had never seen anything like it before. Strange to relate, just at this +time a young lady from Natal was sent over to me with a request from her +parents that I would ask some expert to see her. On her arrival I found +that she had exactly the same infirmity. The late Dr. Alfred Meadows, +who saw her with me, would not believe my statement at all until he had +himself seen and examined her. Her mother was very anxious to know +whether she might be permitted to marry the gentleman to whom she was +engaged. We gave a guarded opinion on the subject, and she returned to +Natal, and was married, and has two or three children. I therefore trust +that the little Jew Italian boy has also survived. I have never heard +anything of him since he left the Poland Street Workhouse. + +One morning in 1877, shortly after I had left the House, the attendant +came round to my residence, and informed me of the almost sudden death +of the master, who was at my official visit half an hour before +apparently in good health. He had never been partial to me, as my system +of management clashed considerably with the stereotyped arrangements +that had prevailed in the House prior to my appointment, and I very much +question whether he ever approved of my having caused almost everything +consumed in the House to be supplied under contract. He did not openly +quarrel with me, but contented himself with passive resistance; and if I +complained of any order not being carried out, he always excused himself +by saying, Did you give an order for this, that, and the other? all the +time knowing full well, that I had given the order. A striking instance +of this obstructiveness occurred in the first autumn and winter after I +took office. I had asked the Board's permission that some jackets should +be supplied for the sick men and some shawls for the women, which they +might wear when sitting up in bed to keep their chests and shoulders +warm. This application was made to the Board of Guardians early in +October, and was at once acceded to. Week after week went by, and in +spite of repeated requests made by me, either to the master or matron, +no notice was taken beyond the same answer which was always given when +the one or the other thought fit to reply at all, "Oh, I have given the +order for the material and for the shawls, but the contractor is so +negligent, he has not sent us in the goods." + +In the early part of January I received a letter from Dr. Mouatt, Poor +Law Inspector, stating that he had been instructed by the Local +Government Board to go over the House and see how many persons could be +described as fit to be sent away to the Sick Asylum, and, as he wished +me to accompany him, he desired to know what day would suit me best. In +reply I fixed the next Sunday, and as I did not wish the master to +accompany us, for I knew he would report all that took place to the +Board, I wrote in that sense to Dr. Mouatt. Dr. Mouatt came on the +following Sunday morning. I had told the master he was coming, and, just +as I expected, he stayed away from chapel, in order to go with us. Dr. +Mouatt promptly said, "As this is a purely medical visit, master, we can +dispense with your company." He coloured up and looked very much put +out, but he had to comply. As I went through the wards I told the +Inspector that I had asked the Board three months before to let me have +some shawls for the women and jackets for the men, that the Board had +given an order for them, but neither the master nor matron had supplied +them, and that I felt satisfied they did not intend to do so, to which +he quietly said, "I will soon alter that." At the same time I urged on +him the necessity of so referring to the subject, as not to make them +think I had said anything about it, but that the necessity for them had +occurred to him, "For," I said, "if you do, they will make it the +subject of an open quarrel." It was humbling to do this, but I knew what +these people would do. + +At the conclusion of our examination, which lasted nearly three hours, +we returned to my room, where the master promptly joined us. On seeing +him Dr. Mouatt asked that the matron should be sent for. On her arrival +he addressed them both as follows: "I have been over the sick wards and +have seen all the sick that should be sent away and taken the number; +this I shall report to the Local Government Board. I see that your House +is kept clean and in good order, but there is one thing I notice which +must at once be altered, and that is, the large number of patients +sitting up in bed without anything over their shoulders. I have called +Dr. Rogers' attention to it, and he tells me that the Board gave an +order three months ago for jackets and shawls to be provided, but that +they have never been supplied." Both immediately began to throw the +blame on the contractor, but he cut them short by stating, "That excuse, +master and matron, will not do for me; you know as well as I do you +could have got them if you had chosen. I shall report the omission to +supply them to the Board of Guardians and also to the Local Government +Board." On hearing this they were dreadfully put out, and expressed an +earnest hope that, as it was not their fault, he would not be so severe. +"Well," he said, "I shall request the medical officer to report to me +when they are supplied, and if every person needing them is not +furnished with them before the end of the week, I shall carry out what I +have said." By the following Wednesday all my patients were provided +with them. At his death the master left some £4,000, notwithstanding he +had a large and expensive family. After his decease I learned that he +had signed a quantity of blank orders for my attendance, and had given +them to the porter with the instructions that if any person was admitted +who either looked ill or complained of being so, he was at once to send +for me. His death led to the diminution of second calls by at least +two-thirds. He was nearly always out in the after-part of the day. For +several weeks after his death the duties of master were performed by the +labour master. At last the Board advertised for a master and matron, the +appointment of matron having come to an end when the late master died. +As the Guardians were fully alive to the bad discipline which had +prevailed for so many years, they resolved to appoint two officers who +should more strictly exercise their authority. The choice of the Board +fell upon Mr. John Bliss, a corporal-major of the Life Guards, and a +Miss Heatley, lately assistant matron of the Manchester Workhouse. Both +of these officers were strict disciplinarians, and something besides, as +the sequel will show. For the first two or three years, indeed, during +the whole Chairmanship of Mr. Cooper, the surgeon, they were kept in +their places and behaved fairly well, but unfortunately for them, for +the inmates, and the Board, Mr. Cooper was taken ill and died, and +another Chairman being elected, serious results soon followed, for this +Chairman was always in the House, and when so was constantly closeted +with the master and matron in their rooms. Speedily after that the +master began to dispute my orders, and the matron did the same, and as +the Chairman again began to obstruct my sending the acutely sick inmates +away to the Sick Asylum, the House became full of sick people, who were +detained in it through the restrictions put in my way. At last the +obstruction to the performance of my duty, by both master and matron, +became almost unbearable, especially as Mr. Bliss thought fit to +accompany his refusals by telling me to go to h--l, and sundry other +coarse and blasphemous expressions; and to such an extent was it +carried, that I felt I could not put up with it. To complain to the +Board would have been perfectly futile, the majority would most +assuredly have gone against me. At last the loud-mouthed, coarse, and +outrageous blasphemy of the master quite appalled me; and this, coupled +with his refusal to obey my orders and his general interference with me +in my treatment of the sick, by deriding my judgment and by openly +stating that I did not know my profession, caused me to speak to Mr. +Fraser, a Guardian, in reference to the annoyance I was being daily +subjected to. He advised that I should go to the Local Government Board +and confer with the Poor Law Inspector. I did so, but got very little +encouragement by my action. Some time after, in a letter to the +Department, I did not hesitate to refer to it, and state as much. One +result, however, accrued from this visit, which I foresaw was in the +near future imminent, and I accordingly took steps forthwith to get some +influence in the House of Commons so as to secure a proper inquiry. On +my return I again saw Mr. Fraser, and told him of the way I had been +treated. Just about this time this Guardian came into collision with Mr. +Bliss. It happened in this way: there was a lady living on Wandsworth +Common, the wife of the chaplain of a public institution, and, being +very benevolent, she had constantly visited the Union school, and had +interested herself in the future welfare of the girls. A girl she was +much interested in had gone to a situation some months before, and, not +being kindly treated, had left and returned to the Workhouse, when she +wrote to this lady, who at once came up to the House to see her and some +other girl. The master refused to allow her to do so, whereupon she went +round to Soho Square and saw Mr. Fraser, whom she had known as a +Guardian, and told how she had been treated, whereupon he wrote to the +master, stating who the lady was, and asking him to allow her to see the +girls. The master read the letter and replied, with a coarse oath, "I +have already told you you shall not see the girls, and you shall not." +On reporting this conduct to Mr. Fraser, he was much incensed, and at +the next meeting of the Board brought the master's behaviour before the +Guardians. To his astonishment, the majority of the Guardians absolutely +howled him down. Mr. Fraser then formulated a series of charges against +Mr. Bliss, among them his constant refusal to obey my orders, his +swearing and generally violent treatment of the inmates, and moved that +these charges should be sent to the Local Government Board, and an +inquiry into the master's conduct asked for. This proposition was +rejected, but, at the suggestion of the Chairman, it was resolved that +the Board would conduct an inquiry themselves. This was done evidently +with the intention that the whole matter as against the master should be +quashed. The inquiry was held, and I was ordered by the Board to attend. +At the inquiry by the Guardians the Chairman presided, and proceeded to +ask questions; but finding he was no match for the solicitor, Baron H. +de Worms, an _ex-officio_ guardian, put in an appearance and conducted +the inquiry for them, and as I declined to recognize his or the Board's +right to put questions to me, the Baron threatened to report my +behaviour to the Local Government Board. I said to him, however, that if +it were a regular legal inquiry, conducted by a properly constituted +authority, I would answer on oath, and prove all the charges I had ever +made against the master and matron. One of my charges was that I had +discovered that my Medical Relief Book had been tampered with, and that +entries for wines and spirits, neither ordered by me or given to the +sick, had been placed against certain names. When this was gone into by +the Baron the master's clerk was sent for and insolently denied the +allegation. + +The Guardians completely exonerated the master and matron, his clerk, +and all concerned with them; but the matter did not end there. During +the progress of this so-called inquiry the matron brought before the +Guardians eight of the very worst characters in the House, in order to +depose to her and the master's continuous kindness and consideration to +all the inmates, and that Mr. Bliss never swore at all. After they had +given their evidence they were entertained by the matron in the +store-room, a hot supper and brandy-and-water being provided. As she +knew I was keeping a sharp look-out on my books to prevent any +additional frauds, the next morning she was at her wits' end to make up +the deficiency in the brandy, but at last she managed it by adding some +water; but in her hurry she forgot to add clean water. She put what she +wanted to increase the quantity into a jug which had contained milk, and +so gave a cloudy appearance to the whole of it. On my arrival at the +House I was informed of the entertainment that had been given to these +witnesses to character, and on going into the women's sick ward, the +head nurse showed me the brandy which had been tampered with, and I was +further told by her that the brandy given out on the male side had the +same appearance--indeed, that the nurse on that side had just called her +attention to it. I directed that she should carry it down into my room. +On going through to the male side, I requested the nurse to show me her +brandy. At first she objected to do so, but on my insisting she +reluctantly did so, when I took it away. On reaching my room I sent for +a large bottle and mixed it all together and sealed down the cork. I +then wrote to the contractors, Messrs. Hedges and Butler, of Regent +Street, and asked them to examine it and write me word whether the +brandy sent was the same as that supplied by them under the contract. It +was taken by one of the officers. In the course of an hour he came back +with the brandy and a statement from the firm proving that it had been +lowered by the addition of so much water, and that the water that had +been used was not clean. I then wrote to the Board giving the history +now related, and enclosed Messrs. Hedges and Butler's certificate. I +wrapped all up together in a piece of brown paper and addressed it to +the Board of Guardians. I called the clerk into my room and having in +his presence sealed up the parcel, I requested him to take charge of it +and not to let it go out of his hands until the Board met. I then +ordered a fresh supply for my sick. I had hardly left the House when the +Chairman came, and, going to the clerk, demanded to see the parcel. The +clerk gave it to him, when he immediately broke it open and read my +letter and the spirit-merchant's certificate. Of course his supporters +passed over this abominable transaction when the subject was brought +before the Board, and the matron was not even censured; at least, so I +was told. + +There was, however, a Nemesis. Just as they were rejoicing at the +success of their proceedings a letter was on its way to the clerk from +the Local Government Board, stating that, in consequence of certain +information having been sent to the Department, an official inquiry into +the master's management of the House had been determined on, and that +Mr. Robert Hedley had been directed to hold it. I immediately went down +to the House of Commons, saw some Members, and begged that they would +see Sir Charles Dilke, who was then the President, and ask him to send +some other Inspector instead. A day or so afterwards I heard that as his +name had been mentioned it could not be changed, but that another +Inspector, Mr. Taylor, a barrister-at-law, would be appointed with him +in the inquiry. + +In due course the inquiry took place, Mr. Robert Hedley presiding, Mr. +Taylor sitting on his right, Mr. Fraser, the solicitor, one of the +Guardians, on the left. Mr. Fraser conducted the proceedings against the +master, who was defended by Mr. Ricketts. The proceedings lasted several +days. During the progress of the inquiry Mr. Hedley rendered no +assistance whatever, and if it had not been for the conscientious +conduct of Mr. Taylor, not one-half of the evidence which was given +would have been brought out. Nearly all the evidence which was tendered +was voluntary--that is, inmates and officers came forward to testify to +Mr. Bliss's continual refusal to comply with my orders, to his swearing +at me and the inmates, and his general harshness and positive cruelty to +many of them. When the master's clerk was examined, he swore that he had +never made false entries in my Medical Relief Book; but when my +attendant, who had assisted in making up the book, gave evidence and +stated that he had seen him make them, his tone altered, and eventually +he confessed to sixty-three fraudulent entries of wines and spirits, +amounting in the whole to a very considerable quantity of stimulants, +presumably supplied to my sick but in reality consumed by other people. +When called as a witness, I deposed to the continued refusal of Mr. +Bliss to comply with my orders, as to his swearing at me and at others, +and to the fact that he derided my judgment, and had intimated to the +sick inmates under my charge his disbelief in my knowledge of my +profession, &c. + +When Bliss was called on for his defence he contented himself with +giving a general denial to everything that had been given in evidence +against him. At last Mr. Hedley said that he should close the inquiry. I +do not know whether at that time he had communicated to Mr. Bliss that +he intended to report in his favour, but I had a suspicion of it, as no +one could possibly be in better spirits than Mr. Bliss was that day, and +it was clear from Mr. Hedley's manner and Mr. Bliss's familiarity with +the Inspector what his decision would be. + +I was therefore not surprised on going down to the House some three +weeks after to make some inquiries that certain Members, whose names I +am precluded even now from mentioning, informed me confidentially that +it had oozed out that Mr. Hedley and the other Inspector had recommended +to the President that Mr. Bliss should be allowed to remain as master. +On my expressing my astonishment at such a monstrous decision, I was +informed that, to a great extent, the President was powerless in such +matters--that, having appointed an Inspector to conduct an inquiry, he +was by the rules of the Department bound by his decision, and that if he +made a report in favour of the individual into whose management he was +deputed to inquire, and reported favourably or the reverse of that, the +President was compelled to accept it, however much he felt that the +evidence did not support the view taken by the Inspectors. + +I lay stress upon this assumption that Inspectors cannot by any +possibility err in their judgment, or be guilty of favouritism in their +conduct of such inquiries, because ere long, if we are to have County +Government Boards, the obligations of these Inspectors will be largely +increased, and if the official inquiries of the future are to be +conducted by men such as I have had experience of, Heaven help the +unfortunate officials whose actions are being inquired into, unless +there are some special reasons why they should be officially befriended, +such as evidently held good in Mr. John Bliss's case. + +Having regard to the fate that always attends crooked courses, I am very +much disposed to think that a different line would have been followed +could it have been foreseen that Mr. Bliss would have acted as he did +three weeks after the inquiry was ended, when a woman was brought in a +cab so very ill that I decided to send her away forthwith to the Asylum +Hospital; but, as she was blue in the face from difficulty of breathing +and from general exhaustion, I told the receiving wards woman to come +into my room, and then gave her a written order for some brandy and +beef-tea to be given to the woman before she went away. I addressed the +order to the matron. Shortly afterwards the nurse came back and told me +that this woman had refused to supply what I had ordered. I then said, +"Take the order to the master." After a minute or so she returned, +telling me that the master would see me d----d before the woman should +have it. I then left the House, and on the next day heard that, +exhausted as she was, the woman was taken to Cleveland Street without +anything being given to her. That morning I wrote to the medical +superintendent of the Sick Asylum, and asked him to let me have a copy +of any remarks he had made on her admission (of course, stating the +refusal of both master and matron to give her anything at all before she +left the Westminster Workhouse). His reply bore out the view I had +formed of her condition, and he further said that if I had not written +to him he should have made a special report to the managers showing her +exhausted condition when admitted. A copy of this letter and a formal +complaint against the matron and Bliss for their refusal to give the +poor woman anything, was sent to the Board of Guardians, who simply +ignored it. I also sent a similar statement to the Local Government +Board, but no acknowledgment of its ever having been received was sent +to me. Knowing what I do, from many years' experience, what this +Department is, I very much regret that I did not send this complaint +under cover (privately) to Sir Charles Dilke. It is a curious fact that, +although the suppression of my statement at the Local Government Board, +and the refusal of the Chairman and his party to make any inquiry into +my complaint caused Mr. Bliss to keep his appointment a twelvemonth +longer, yet this refusal, having been subsequently conclusively proved, +ultimately led to his being called on to resign his appointment, as will +be shown hereafter, after the Chairman had in the interval been ejected +from office by an overwhelming vote of the indignant ratepayers. + +No report of the inquiry having been forwarded to the Board, the +Chairman, after the lapse of about three months, caused a letter to be +written to the Local Government Board asking that the result of the +inquiry should be forwarded. The President sent a copy of the evidence +given on oath to the Guardians, thinking that after the Board had read +it through they would surely concur with him in thinking that Mr. Bliss +was not a fit person to remain as master. But he reckoned wrongly. Sir +Charles Dilke did not know the Chairman. This man simply induced his +dozen followers to utterly ignore all the evidence, and to assert that +it proved nothing. + +Meeting one of these Guardians in the House two or three mornings after, +he came up to me, and, in a loud tone of voice, he said, "I have been +reading your disgraceful evidence against our master." To which I +quietly replied, "It was given on oath, and every word of it is true;" +when, in a towering passion, he said, "You have disgraced yourself, I +tell you; you have disgraced yourself:" and then, before I could reply +to this outburst of vulgar vituperation, he went on to say, "I see the +Local Government Board have directed us to pay you five guineas for your +attending to give evidence: I am the Chairman of the Board, and not one +penny shall you ever be paid for your disgraceful evidence." Had this +outburst been indulged in some few years before I cannot answer for the +form which my resentment would have taken; but I kept my temper, as I +knew no credit could accrue from any squabble with this man. The cheque +was subsequently paid. The Chairman was far too wise to enter into a +struggle with the Local Government Board over such a matter. + +At the next meeting of the Board of Guardians he, or one of his +followers, moved that a letter be written to the Local Government Board, +stating that they had considered the evidence and were of opinion that +it in no way affected the character of their master, and requesting that +the Board should forthwith send its opinion of the evidence and what +charges they considered proved, whereupon there was forwarded to them a +list of thirteen charges which the Local Government Board held had been +proved against Bliss. It is probable that if the Chairman and the +majority had remained quiet, these serious charges against the master +would never have seen the light. As it happened, the publication of them +gave the opponents of Mr. Bliss the opportunity of conclusively showing +up the action of the Board. The letter of the Local Government Board, +containing particulars of the charges proved, was as follows-- + + + "LOCAL GOVERNMENT BOARD, + "WHITEHALL, + + "_August 28, 1883_. + + "SIR,--I am directed by the Local Government Board to acknowledge + the receipt of your letter of the 10th inst. respecting the + decision communicated to the Guardians of the Westminster Union in + the letter which we addressed to them by the Board on the 18th ult. + upon the charges preferred against Mr. Bliss, the master of the + Workhouse, and recently investigated by their Inspectors, Mr. + Hedley and Mr. Taylor. + + "The Board direct me to state, in reply, that the charges to which + they referred in that letter were the following-- + + "That Mr. Bliss twice threw water from a bucket over an inmate + named Ellen Coleman. + + "That he kicked a woman named Ann Lane on the back of the thigh + [she was sixty-eight years old], the bruise caused thereby was + about four inches across. + + "That he kicked a boy named James Daley twice on the back [he was + about thirteen years old, and was a very good boy]. + + "That he was in the habit of swearing, and of using expressions of + an objectionable character when irritated. + + "That he had exercised no supervision as regards the entries in his + portion of the Workhouse Medical Relief Book. + + "That he had not entered in the Provision Accounts as absent + inmates who were in fact absent on leave from the Workhouse. + + "That he had contravened the Board's regulations by placing + Caroline Barber, aged sixty-four years, upon bread and water. + + "That there had been undue delay in the registration of four births + in the Workhouse. + + "That in the cases of two females, named Caroline Clegg and + Elizabeth Jacob, who died in the Workhouse, he did not take + sufficient care to give notice of their decease to their respective + relatives. + + "That through want of due care, a mistake was made as to a body + sent for burial. + + "That he allowed Elizabeth Farquharson to leave the Workhouse for + four days to go to work, and that he charged in his accounts + rations for her during that period. + + "That his behaviour towards Mrs. Casher, on her visiting the + Workhouse to see two girls in whom she was interested, was + discourteous; and that he used very improper language to Emily + Brown on her visiting the Workhouse to see her husband, an inmate + [who was on his deathbed]. + + "I am, Sir, + "Your obedient servant, + "(_Signed_) C. N. DALTON, + + "_Assistant Secretary_." + + +I have been informed that the reading of the above letter was received +by the Chairman and his followers with much exasperation, which +exhibited itself in threats of vengeance against all those, whether +inmates or officers, who had given evidence against the master. One of +the first to feel the wrath of the Chairman was Thomas Bailey, a man +seventy years of age, who was discharged from his employment in aiding +me and the master in keeping the Medical Officer's Relief Book, which he +had done for nearly twenty years, because of his wickedness in bringing +under my notice the fraudulent entries made in my portion of the Medical +Book by the master's clerk at the instance of the matron, an +irregularity which it is reasonable to suppose could only have been +condoned by the majority of the Board on the supposition that some of +them had helped to get rid of what had been falsely entered against the +names of my sick patients. + +Although this fraud had been clearly proved, no attention had been drawn +to it in the report, but a mere misty reference was made to the subject +in the fifth charge proved. + +Here let me observe that I believe this inquiry would have been +absolutely nugatory of any beneficial results if it had been conducted +without an assessor being present, and, considering the bearing and +physique of the two Inspectors, it seems to me that the assessor +modified his own judgment, which would have been entirely adverse to Mr. +Bliss, in deference to the manifest wish of the Inspector to screen an +old soldier from the proved charges of blasphemy and unmanly violence to +an aged woman and a small boy, for which two latter offences Mr. Bliss +would have been taken before a magistrate and severely punished if the +miserable victims had had the necessary means. + +The Chairman thought, in flouting the Local Government Board by his +protection of his friend the master, that he would triumph; but at that +time he was wholly unaware of what was in store for him and the party he +had so long led. + +The Inspector was not, indeed, an acceptable person to all Boards of +Guardians, as the following letter from the Holborn Board indicates-- + + + "_February 28, 1884._ + + "_Re_ STANTON. Official Inquiry. + + "MY LORDS AND GENTLEMEN,--I am directed by the Guardians of the + Poor of the Holborn Union to acknowledge the receipt of your letter + of the 26th inst., stating that you have instructed your + Inspector, Mr. Hedley, to hold an inquiry into the charges + preferred against Mr. Stanton, and that Mr. Hedley will give the + Guardians due notice of the time and place in which he intends + holding the inquiry, and to inform you that the following + Resolution was passed upon your communication being submitted to + the Guardians, viz.-- + + "'That the clerk write to the Local Government Board and inform + them that the Guardians are of opinion that an official should be + appointed to conduct the inquiry who has not already expressed an + opinion on the subject, which Mr. Hedley has publicly done, and + that if the Local Government Board adhere to the appointment of Mr. + Hedley to hold the inquiry, the Guardians must decline to take part + therein.' + + "I am further directed to inform you that this Resolution was + carried with only one dissentient at the Board last evening. + + "I have the honour to be, + "My Lords and Gentlemen, + "Your obedient servant, + + "JAMES W. HILL, _Clerk_. + + "THE LOCAL GOVERNMENT BOARD." + + +I do not know whether it was at the meeting of the Board when the +decision of the Department was first read, or on the occasion when the +Guardians heard their clerk read out the list of charges which the +Department considered were proved against Mr. Bliss, but it is certain +that the Chairman rose in his seat and moved that I be called on to +resign my appointment forthwith. Of course it was carried, and the clerk +was directed to forward me a copy of the resolution. I briefly +acknowledged its receipt. I understood that at this time this person was +much put out at my not at once complying with his request, and +threatened all sorts of vengeance on me. He was so ignorant that, in his +rage, he forgot that he could not so summarily get rid of me, and +therefore I waited patiently for his next move; indeed, I applied for +and took my usual autumn holiday. At this time there appeared in _The +Standard_ daily newspaper an article commenting on the evidence given at +the official inquiry, on the charges found to be proved, and the conduct +of the Chairman and his docile followers. + +It was republished and sent to every ratepayer in both parishes. And +here I may be allowed to call attention to the fact, that in the reforms +which I have tried to secure, I have had the assistance of papers of all +parties. The article was as follows-- + + + "WESTMINSTER UNION. THE LOCAL GOVERNMENT BOARD, THE GUARDIANS OF + THE POOR, AND J. D. BLISS, MASTER OF THE WORKHOUSE, POLAND STREET. + + "Defend the poor and fatherless; see that such as are in need and + necessity have right."--PSALM lxxxii. 3. + + +"The Local Government Board, in an official communication to the +Guardians of the Westminster Union, say they have 'entertained very +great doubt whether, consistently with their public duty,' they could +'properly allow' the present master of the Poland Street Workhouse to +retain his post. It is likely that the public will go all the way with +the Local Government Board, and even a little further. The Board, having +instituted a long and searching inquiry into sundry charges brought +against the master, have arrived at the conclusion that several of the +accusations have been established. They told the Guardians so much as +this some little time back; but these authorities wished to know more +precisely what were the charges considered to be proved. It is fortunate +that these gentlemen were so far disposed to challenge the conclusions +arrived at by the central power, for the answer they received puts the +public in possession of some notable facts which otherwise might have +remained in obscurity. We now learn that the demonstrated delinquencies +of this Workhouse master include such peccadilloes as twice emptying a +bucket of water over an inmate named Ellen Coleman, and kicking a woman +named Ann Lane, as well as a boy named James Daley, the latter twice. He +also contravened the Board's regulations by placing an old woman upon +bread and water. There might be some economy in this, but it was more +than counterbalanced by an awkward habit in which the master indulged, +of charging rations for paupers absent on leave. Another irregularity +consisted in a 'mistake as to a body sent for burial,' coupled with +which we hear of 'undue delay in the registration of four births.' Then +there was confusion in the Medical Relief Books, and a neglect to give +notice when people were dead. To all this must be added a 'habit of +swearing and using expressions of an objectionable character when +irritated.' This model master of a Workhouse is further proved to have +been discourteous to the wife of a clergyman, and to have 'used very +improper language to Emily Brown,' a poor woman who came to see her +husband. For all this he is master of the Workhouse still, and, as he +retains 'the confidence of the Guardians,' the Local Government Board +'refrain from adopting the extreme course of requiring his +resignation.' But, at the same time, this redoubtable official is warned +that if any further complaints are substantiated against him he will be +most certainly asked, with all due politeness, to relinquish his +responsible office. There is, for the moment, nothing more to be done, +except, perhaps, for the Guardians to present him with a +testimonial."--_Extracted from "The Standard,"_ September 14, 1883. + + +(It should be clearly understood that this inquiry was instituted by a +minority of the Board, who have steadily voted for Mr. Bliss's +resignation.) + + +On my return to town I found that the Board generally had also gone +away, but the Chairman had given notice that when the Guardians met in +September he should move that I be suspended from my office; which in +due course he did, and, having a passive majority, carried it. This did +not alarm me at all. It was not then as it was some years ago. There was +a new Secretary at the Local Government Board, who was the worthy +successor of a most estimable father, the late Hugh Owen. Added to this +I had several friends in the House of Commons, and most assuredly Sir +Charles Dilke was not prejudiced against me. Besides this, the Chairman +could not get up a case against me. So, being aware that it would take +some weeks before any decision could be come to, as the head officials +at the Central Department would be certainly out of town, and that it +was a task beyond the intelligence of the Chairman to draft an +indictment, I again went into the country. + +So soon as it became known that this Chairman had moved my suspension +simply for having resented the conduct of Bliss in cursing and swearing +at me, and disobeying my orders for the sick, numerous friends wrote to +me, and the medical journals vied with each other in denouncing the +conduct of this Board, and called on my professional brethren to rally +round me as I had been called on to resign, and was now suspended for +interfering with Bliss in his treatment of my sick poor. The action of +the Chairman and his supporters turned to my advantage, and eventually +led to his and their complete and signal expulsion from office. + +Among other annotations and leading articles which appeared at this +date, I will here insert one from _The Lancet_, bearing date October 27, +1883-- + + + "THE SUSPENSION OF DR. ROGERS. + + "The suspension of Dr. Rogers from his duties by the Guardians of + the Westminster Union because of his honest testimony in an + inquiry into the conduct of the master, is an event of very great + consequence. It is impossible that the Local Government Board can + sanction the action of the Board, or disregard the memorial signed + by fifty-four of the most respectable inhabitants of St. Anne's, + including the rector, the Catholic priest, &c.; and another, signed + by ninety-four of the ratepayers of St. James's. Dr. Rogers is a + representative man. He represents not only the Poor Law medical + service, but the independence of the members of that service, and + no greater misfortune can befall the poor or the ratepayers than + that he should be persecuted by the Guardians of Westminster for + doing his duty. We cannot believe that Sir Charles Dilke will allow + such a misfortune to happen. The Local Government Board have acted + with a strange inconsistency in retaining the master of the + Workhouse. It is inconceivable that they will play into his hands, + and those of the Guardians who assist him, by sanctioning the + dismissal of Dr. Rogers. But the profession and the members of the + Poor Law service, should lose no time in organizing a proper + movement for vindicating Dr. Rogers' claims and position." + + +After my suspension I went to Bournemouth, and whilst there heard of +the above movement in my support, and also saw that my friends in the +profession were organizing a testimonial in my favour, subscriptions to +which came from all parts of the kingdom. So that, instead of injuring +me, the action of the Guardians secured me three months' holiday, a +testimonial worth £200, and gave me that leisure which enabled me to +work up a party that some six months after drove the Chairman and his +followers from office. + +On my return from Bournemouth I set to work to get up a list of +candidates for Guardians for the ensuing year. It was necessary to get +thirteen, as I had only five supporters. It is true that they were the +most respectable men on the Board. I was not very long in getting three +respectable ratepayers to stand for St. Anne's; but the great difficulty +was in St. James's, where ten were required; and if it had not have +happened that the Rev. Henry Sheringham, Vicar of St. Peter's, Great +Windmill Street, exerted himself most earnestly, we could not have +succeeded at all. He not only came forward himself, but he induced a +colleague, the Vicar of St. John's, Great Marlborough Street, and four +very wealthy and well-known gentlemen in St. James's to do likewise. The +obtaining of four others ceased to be a matter of difficulty. The Rev. +H. Sheringham took the greatest interest in the election, and it was +through his help that the Bishop of London, the Marquis of Waterford, +and a large number of the nobility and gentry, bankers, and others who +were ratepayers in St. James's, and up to that date had never voted in +any election of Guardians, were, on this occasion, secured. + +Mr. Sheringham was the incumbent of the poorest district in St. James's, +and consequently he was constantly brought into contact with those who +had either been inmates, or had friends in the House, and for a long +time he had been cognisant of Mr. Bliss's management, and of the +Chairman's support of the master. When I was suspended, Mr. Sheringham +showed his feeling by going round to some of the leading people in St. +James's and getting them to sign the testimonial in my favour, and at +the election in the following April he worked hard all day long to get +rid of the Chairman and his party. + +It may be thought by those who have followed this narrative of Poor Law +management in 1883, that I had not sufficiently referred to the action +of Mr. W. J. Fraser, solicitor, of Soho Square, and of 191, Clapham +Road, but it does not arise from want of gratitude to this gentleman, +who has known me for many years, who asked me to see poor Watson in +1872, who induced me to become a candidate for the office the same year, +and whose worthy father used to take an honest pride in bringing him to +my house nearly thirty years before, to show me how he had got on during +his half-year's schooling. If it had not been for the high sense of +conscientiousness, and his invariable hatred of such wrong-doing as was +implied in the support of such a person as J. Bliss, as a young +solicitor he could not have made so great a sacrifice of time, of +labour, and of money. + +The fact of Mr. Bliss being no longer master of the Westminster +Workhouse, and his chief supporter no longer in power as the Chairman of +the Westminster Union, with all its possible advantages, is owing almost +entirely to Mr. W. J. Fraser, who, recognizing the wrong-doing of both, +exerted himself untiringly to get rid of both, which he achieved with +singularly complete success. + +It was not until just before Christmas that one of the Guardians who was +friendly to me, told me that a letter had just been received from the +Local Government Board, directing me to resume my duties, thereby +removing my suspension; at the same time saying there was an oblique +reference to me at the end of the letter. "Oh," I replied, "I +understand all about that; but I can afford to let that pass so long as +the President supports me." + +I returned to my duties, but had it not been for the fact that my nurses +(one woman excepted, who was Bliss's confidant, and whom I would have +got rid of months before for incompetence and worse qualities) welcomed +me back, as did the sick inmates, whose friend I had tried to be, I +really should have hesitated to continue in my office, for every form of +petty obstructiveness was exhibited by the master, matron, the master's +clerk, the Chairman, and his followers. The only retaliation in my power +was to draft questions and get them put in the House. This process made +the names and doings of the majority of the Westminster Board of +Guardians come out rather awkwardly before the public and the ratepayers +of the Union; the extraordinary circumstance being that both parties, or +rather I may state all parties, in the House assisted me in getting +these questions put to Ministers. + +At last the election took place. I feel pretty well convinced that when +the Chairman saw our list of candidates and who were the nominators, +consisting as they did of most of the nobility, gentry, bankers, clergy, +and leading ratepayers in both parishes, he felt that his reign was +over, but he did not think, even then, that his defeat could have been +so complete and overwhelming, for not only was he left in an absurd +minority, but his twelve followers were left also. + +Subjoined is a copy of the address sent to the ratepayers of both +parishes. + + + "ELECTION OF GUARDIANS. + + "_To the Ratepayers of the Parish of St. James, Piccadilly, and St. + Anne, Soho._ + + "MY LORDS, LADIES, AND GENTLEMEN,--Having been nominated to be + Guardians to represent St. James's Parish as well as that of St. + Anne's, Soho, at the Westminster Union, by many of the nobility, + clergy, gentry, and leading tradesmen and large ratepayers of both + parishes, we confidently solicit your votes and support at the + approaching election. + + "We wish it to be understood that, in offering ourselves as + candidates, we are actuated by no personal motives or + considerations whatever, but solely by a desire to secure the + faithful, humane, and economical administration of the laws + relating to the relief of the poor in the Westminster Union. + + "Public attention has, during the past year, been frequently drawn + to serious complaints respecting the treatment of inmates, + subordinate officials and others in, and visitors to, the Poland + Street Workhouse, and it is very widely felt that a searching and + careful investigation should be instituted without delay into + matters vitally affecting the comfort, happiness, and welfare of a + large body of poor and helpless people, such as inhabit our + workhouses. + + "We beg to draw your attention to the accompanying copies of two + letters addressed by the Local Government Board to the late + Guardians; and also to the enclosed copy of an article which + appeared in _The Standard_ newspaper. + + "Many of the ratepayers will learn with surprise that, + notwithstanding the serious and grave charges substantiated against + the master of the Workhouse, at the Local Government Board inquiry, + held by two of their Inspectors, a large majority of the late + Guardians felt themselves able formally to record their confidence + in the master. + + "It should be clearly understood that this inquiry was demanded by + a small minority of the Guardians, who found themselves powerless + to bring to light or redress in any other way the flagrant abuses + of which they had been informed. And at the same time it should be + known that those Guardians upon whom devolved the duty of + conducting the inquiry, were denied, both by the majority of the + Board, who were opposed to any action being taken, and also by the + master, both before and at the time of the inquiry, all access to + inmates and resident officers, whose evidence was essential to + establish the charges alleged. It was, therefore, only with the + greatest difficulty that the necessary evidence could be collected. + + "We have further to state that, after the decision of the Local + Government Board was communicated to the Guardians, and when all + the facts of the case were fully before them, the Chairman and the + majority of the Board presented to Mr. Bliss, in the Board-room of + the Poland Street Workhouse, a testimonial, in the form of a sum of + money, ostensibly for the purpose of defraying the expenses of his + professional adviser in conducting his defence during the inquiry + into his conduct. + + "It may be added that the Chairman, when compelled to admonish Mr. + Bliss, in accordance with the directions of the Local Government + Board, did so with reluctance, entertaining, it would seem, the + belief that the master was not guilty of all or any of the charges + proved against him; and, when so admonished, the master himself + expressed no regret that the charges set forth in the Local + Government Board's letter should have been held to be established + against him, and gave no assurance whatever that he would comport + himself differently in future. + + "Thus the official inquiry was rendered practically abortive, + owing, as we believe, to the action of the majority of the + Guardians in virtually upholding the master, in the face of such + overwhelming evidence of misconduct. + + "Various complaints have since been made both by inmates and + officers respecting their treatment, and, notwithstanding the + recent inquiry, the internal condition of the Workhouse remains up + to the present time unaltered and unimproved. + + "It is for these reasons that we feel it our duty to offer + ourselves as candidates at the present election, believing that the + ratepayers of St. James's and of St. Anne's, Soho, will no longer + be able to place confidence in the Board as lately constituted, and + that they will demand a searching inquiry into the whole system of + the management of the Poland Street Workhouse. + + "If, therefore, it be your pleasure to elect us as your + representatives on the Board, we shall address ourselves, without + fear or favour, promptly and impartially to the consideration of + every matter requiring attention; and with the co-operation of the + Local Government Board, which we doubt not will readily be given, + we shall make it our chief aim and endeavour to remove all + legitimate grievances, and to secure humane and kindly treatment + for the many aged sick and helpless inmates of our Workhouse. + + "We have the honour to remain, + + "Your most obedient servants, + + "----." + + +As the election had mainly turned on the conduct of Mr. Bliss, one of +the first things done by the new Board when it met was to suspend Mr. +Bliss from his office, which being done, shortly afterwards a committee +of the Board met and drew up an indictment against him; but as the +Department had condoned the whole of the thirteen charges which were +considered proved, they could not raise any of these again; but as Mr. +Fraser was aware that the complaints I had made subsequent to the +inquiry had been ignored by the late Chairman and his friends, and that +the duplicate copy had never been acknowledged by the Department, I, and +the nurse of the receiving wards, and the head nurse on the female side, +were called to prove the order given by me, the refusal of the matron +and the master to comply with it, the woman's condition when admitted, +her state on her arrival at Cleveland Street Asylum, the remarks as to +her exhausted condition when carried by the porter in his arms, she +being too ill to walk; all these facts were shown to be absolutely true, +and were completely borne out by evidence. Other matters against Mr. +Bliss were also gone into and forwarded to the Local Government Board, +and with it an intimation that it was the desire of the new Board that +he should not be permitted to return to his duties. Whilst away in +Belfast, where I went in the month of August to deliver my customary +annual address on Poor Law Medical Relief, I received a telegram that +Sir Charles Dilke had called on Mr. J. Bliss to resign. + +When the master was suspended I can hardly describe the relief I +experienced, it was so great. No longer did I dread loud-mouthed +expressions of dissent from me in my treatment of the sick, no longer +did I fear that he would stalk, unannounced, through the female sick +wards when I was examining the poor women; but instead of it there was +respectful quiet and orderly behaviour. The matron, who ought to have +been sent away also, kept out of my way and was obsequiously obliging +when I gave a necessary order. One person only did I at once bring to +book--it was the head nurse on the male side. After the formation of +the new Board, I immediately drew up and sent in a list of charges +against her, comprising refusal to obey my orders, complicity in and +support of certain malingerers who she falsely informed me were ill. One +of these I had discovered some months before to be an impostor, and +ordered his discharge, but the nurse got her friend Bliss to direct his +return, thus flouting my authority. She did not stop to meet my charges, +but sent in her resignation, and, it being accepted, these complaints +were not investigated. I speedily got rid of the malingerer also, and +during the remainder of the time I held office the man remained out of +the sick ward. What was the tie between the nurse and this malingerer I +was never able to divine. + +During the latter part of April, the whole of May, and the first part of +June, 1884, there had been an outbreak of fever at the Union schools on +Wandsworth Common, and it appeared that the medical officer of the +schools, the Visiting Committee, and the Poor Law Medical Inspector, +could throw no light on the causes of it, when it was suggested at the +Board that I should be sent down to examine into the matter and report +to the Board thereon. I wrote to the medical officer informing him of +the Board's wish, and asked him to arrange a time to meet me and we +would go into the subject together. He was not sufficiently courteous +even to acknowledge my letter. I then asked a member of the Board (a +builder) to accompany me, which he did. + +On my arrival at the schools I requested the attendance of the +superintendent and matron, as I wished to state the object of my visit +and to obtain from them certain information as regards the commencement +of the outbreak, the symptoms presented by the sick, &c. I also elicited +from them that the medical officer had said that he would not meet +me--an act of discourtesy to the Board, whose joint officers we were. + +I speedily ascertained that the outbreak commenced amongst the girls, +and had been almost entirely limited to the female side of the House, +and of these girls those mainly who were employed in the laundry. But as +I wanted to make a complete examination of all the water supply, I asked +the Guardian to pioneer the way in our general survey. With this object +I got out upon the roof of the main building and peered into all the +cisterns. I did not discover anything vastly amiss in these, and nothing +wrong at all on the male side. I then proceeded with my examination of +the cistern supply in the laundry and kitchen, and that on the roof +which furnished the kitchen and part of the laundry supply, when I came +upon the source of the mischief; for, on lifting the lid of a large +cistern there containing many gallons of water, my sense of smell was +assailed by one of the most horrible odours I had ever encountered, and +I saw a large mass of thick scum floating there which was evolving +offensive gases and in constant motion from the activity of innumerable +forms of the lowest type of animal life. I asked my friend to hand me up +a stick, and with it I took out a large piece of it and spread it out +upon the roof of the building. I also requested the Guardian to come up +and judge for himself. I did this because I knew that any statement I +might make would most assuredly be denied by the parties who are +responsible for looking into and examining the condition of the cisterns +and keeping them cleansed, a circumstance which, as I expected, did +subsequently occur, but which could not be controverted by them as I had +the gentleman in question as my witness. + +Before leaving I left a written instruction that every cistern +throughout the building should be emptied and disinfected, additional +care to be taken with the offending one. + +On my return home I drew up and forwarded to the Board my opinion as to +the cause of the outbreak, and the orders I had given to the +superintendent. As no other cases of fever occurred after my visit, it +was clear I had discovered the cause and the remedy. The Board wrote me, +through their clerk, a handsome acknowledgment of my success, and voted +me five guineas for my visit, and informed me that they had directed the +clerk to send a copy of my report and the results that had followed it +to the Local Government Board. This was somewhat of a rebuke to those +permanent officials who had placed that addendum to the letter directing +me to resign my duties some six months before, as I had discovered and +stopped the outbreak, the cause of which they had utterly failed to +ascertain; but then these aforesaid permanent officials never throw any +heart or intelligence into the work they are so handsomely paid to do. + +In the early part of June the honorary secretary of the fund, Mr. J. W. +Barnes, F.R.C.S., wrote to me, stating that it was decided to present a +testimonial to me at a meeting of the subscribers, at the rooms of the +Medical Society of London, in Chandos Street, Cavendish Square, in June, +1884, and that Mr. J. A. Shaw Stewart had arranged to take the chair. +On the day mentioned the presentation took place, and subjoined is a +condensed report of the proceedings extracted from _The British Medical +Journal_, June 28, 1884. The assemblage was a very large one, and +certainly was a striking manifestation of good feeling towards me from +many of my old friends and fellow-workers in the cause of Sanitary and +Poor Law Medical Reform. + +FOOTNOTE: + +[1] The attacks upon me were so scurrilous for the evidence I had given +that I wrote as follows to the editor of _The Lancet_, the staff there +being divided in opinion whether I should be supported or condemned-- + + + "REGINA _v._ WATSON. + + "TO THE EDITOR OF _The Lancet_. + + "SIR,--As I have been made to occupy, through the exceptionally + severe and not over-courteous cross-examination at the Old Bailey, + a more conspicuous position than I had desired before the public, + perhaps you will permit me to give the reasons why I held, and do + hold, that the prisoner in the above case was, and is, of unsound + mind; and, subsequently, to briefly comment on each head. + + "1st. There were the evidences of pre-existent melancholia. + + "2nd. The ferocity with which the deed was committed. + + "3rd. The total absence of criminal motive. + + "4th. The calmness and indifference of the prisoner's manner after + the deed was done. + + "5th. His justification of suicide, and the expression of his + belief that God would forgive the homicide under the circumstances. + + "First, as regards the proofs of mental disease prior to the + act--they were deposed to by the Rev. Folliott Baugh and his wife + as existing a month before the murder; by Mr. H. Rogers on the + preceding day; whilst further evidence on this head, not available + for the defence owing to the sickness of the deponent, has since + been forwarded to the Home Secretary, the statement being that some + months before he was in communication with the prisoner for the + purpose of employing him in his school, but on an interview he + found his mental condition to be such that he at once broke off the + engagement: the evidences of aging and altered aspect deposed to by + the secretary of the school a short while after his dismissal. And + mark, that to him was no ordinary event: at sixty-seven he found + himself suddenly without employment, without any realized money, + absolute penury in the not distant prospective, whilst, during the + nine months he had been thus thrown in upon himself, every attempt + to add to his means or to obtain an engagement, whether literary or + scholastic, had entirely failed. + + "Second. Passing to my next point, the ferocity of the act, it was + argued by the prosecution that it was done in a fit of rage; but, + for the credit of our common human nature, I would ask, Is it + conceivable that mere anger would so transform a mild, quiet old + gentleman, as he was shown to be, into such a brutal criminal, so + that, not content with slaying his victim, he should go on + battering her head and body long after passion alone would have + been exhausted? It is, I contend, explicable only as the act of a + homicidal melancholic, not otherwise. + + "Third. The senseless character of the deed. If done consciously + and by premeditation, as the verdict would suppose, I would ask, + Where could be the gain? Here, again, I argue that the act itself, + done without reasonable motive, could only be the product of reason + overthrown. + + "Fourth. The indifference, &c. Here I would submit--can a parallel + be produced from criminal records in any place (Broadmoor excepted) + for the remarkable calmness (self-possession Mr. Gibson, of + Newgate, phrases it) Mr. Watson maintains whenever the act is + referred to, such as to lead his old friend, the Rev. J. Wallis, to + state that he seemed perfectly void of shame and remorse; nay, + asserting that he was an injured person by being put in prison'? + + "Fifth. His justification of suicide, &c. I may here be met by the + remark that he is probably an unbeliever in the Christianity he + professed. To this I make reply that there is not a tittle of + evidence to show that such is the case. Until the act was done, a + regular attendant at church, a constant communicant, his whole + moral nature must have become utterly changed and corrupt ere such + a consummation could be arrived at, standing out, as it does, in + direct antagonism to his previous life, as portrayed by one who + knew him well and gives his opinion of his old friend in this day's + _Times_. + + "I pass over the subsequent blundering attempts to hide the act, as + similar things have been done by others whose insanity has not been + questioned. And as I have occupied much of your space, I subscribe + myself, + + "Yours obediently, + + "JOS. ROGERS. + + "DEAN STREET, SOHO, + + "_January 15, 1872_." + + + + +RECOGNITION. + +DR. JOSEPH ROGERS. + + +"TO THE EDITOR OF _The Lancet_. + +"SIR,--Since writing my letter to you last week I am rejoiced to see +that a movement has commenced for giving shape to the esteem in which +Dr. Joseph Rogers is held by his professional brethren and others who +know his work. I hope a large sum will be raised, which cannot fail to +be the case if all whom his labours have benefited give a little. And +surely the time could not be more opportune than when in a battle with +his persecutors: he wants to the full the encouragement of his friends. +Only one suggestion I cannot agree with--viz., that the subscription +list should be limited to Poor Law medical officers. Why? Truly, he has +been a great benefactor to them; but not to them only. His public work +has been much wider in aim and usefulness than simply to touch the +pockets of a few Poor Law surgeons. Many years ago he was a leader in +the movement that ended in stopping burials within towns. I believe I am +right in saying that to his influence is largely due the establishment +of mortuaries. It was he who succeeded in getting expensive +medicines--which it was hopeless to expect the Poor Law officers to +supply out of their slender salaries--supplied by Boards of Guardians: +an improvement directly benefiting the poor, and indirectly the +ratepayers. The Metropolitan Poor Act of 1867 was largely brought about +by his untiring zeal. From that what good has not flowed? The supply of +not expensive medicines only, but all medicines, by the Guardians. The +dispensary system, leading to a very large increase, probably not less +than £15,000 a year to the Metropolitan medical officers. Then that +great boon, the Superannuation Act, is another monument of Dr. Rogers' +energy. I do not wish to undervalue the labours of Dr. Brady, and our +other friends in and out of the House of Commons; but Dr. Brady himself +would be the foremost to admit that he never would have been able to +carry the point had it not been for Dr. Rogers' assistance. 'Instant in +season, out of season,' delivering addresses from town to town; giving +advice and assistance to persecuted public servants all over the +country; strengthening the hands of the weaker brethren in public and +private, he has been for fourteen years a tower of strength to an +important section of the community whose power for good has been +enhanced by his agency, which has again reacted on the whole nation. In +short, Dr. Rogers has been, and is, a great social reformer, and of his +work all classes reap the fruit. But as a great American philosopher +says, when the flat stone of a fine old abuse is overturned, there is a +great squirming of the flat-patterned animals that have thriven in the +darkness. Dr. Rogers has been turning over these stones for many years, +and has been attacked by the squirming animals, as is usually the case. +It is for those who have been cast in a different mould and can +appreciate his valuable, arduous, and often thankless labours, to show +their appreciation now. + +"I am, Sir, yours respectfully, + +"JAMES MILWARD, M.D. + +"CARDIFF, + +"_October 22, 1883_." + + +"TO THE EDITOR OF _The Lancet_. + +"SIR,--For a long series of years one man in the medical profession has +boldly stood forward in maintaining the rights and in endeavouring by +every legitimate means to redress the wrongs of the Poor Law medical +officers of this country. As one unconnected entirely with Poor Law +medical practice, I have, no doubt in common with a multitude of others, +admired the courage and honesty with which this man, almost +single-handed, has fought the battles of its medical officers. Had any +one of them a real grievance or hardship to complain of, Dr. Rogers at +once came to the front and became his champion. Now that he is, in his +own person, the subject of an injustice, and a very serious one (for he +is threatened with dismissal from his post as medical officer of the +Westminster Union for doing that which in all honesty he felt compelled +to do), it behoves the whole profession to give him all the moral +support in its power. It cannot be possible that the Local Government +Board will ever sanction such manifest injustice. But this is not purely +a question between the Westminster Guardians and Dr. Rogers; but one +which aims a blow at professional honour and rectitude, and if settled +in the way in which the Guardians would have it, it may be the means of +preventing some members of our body, however right-minded they may be, +from giving evidence of wrong-doing, or performing other necessary +duties not falling strictly within the scope of their ordinary work; +because forsooth they may, if they do, find themselves stranded and +deprived of their appointments. + +"Let the profession, then, as a body, and not merely the Poor Law +medical officers, rally round Dr. Rogers, and, whilst recognizing the +benefits derived from his unselfish public labours in their behalf, +labours which may have brought upon him much obliquy, and perhaps have +had something to do with his present trial, present him with such a +testimonial as shall effectually demonstrate to the Local Government +Board its approval of his conduct and its disapprobation of the +ungenerous treatment to which he has been subjected by the Westminster +Guardians. + + + "'He's true to God who's true to man wherever wrong is done, + To the humblest or the weakest 'neath the all-beholding sun. + That wrong is also done to us, and they are slaves most base, + Whose love of right is for themselves and not for all the race.' + + +"I am, Sir, your obedient servant, + +"WILLIAM WEBB, M.D., F.R.C.S. + +"WIRKSWORTH, + +"_October 24, 1883_." + + +"TO THE EDITOR OF _The Lancet_. + +"SIR,--Will you permit me to draw the attention of your readers to a +movement which has been set on foot with the view of presenting to Dr. +Joseph Rogers, the President of the Poor Law Medical Officers' +Association, a testimonial, as a mark of the esteem in which he is held +by Poor Law medical officers, and as a recognition of his unwearied +advocacy of their claims, his fearless exposure of injustice done to +them, and the able assistance and advice which he has freely given to +such of them as have been unfortunate enough to be at variance with +their Boards. + +"The unjust treatment Dr. Rogers has received at the hands of the +Westminster Guardians, will, I hope, shortly be brought before the Local +Government Board. But I venture to suggest that no better time than the +present could be chosen for his fellow-officers to express their +sympathy with him, and that such an expression from a large number would +show that they have appreciated his labours on their behalf; that in a +good cause they are capable of acting in concert, and that they respect +themselves and their office in manifesting respect for one who has +fearlessly done his duty, although for doing it he has received the +usual punishment accorded by Guardians to parochial medical officers. + +"The following gentlemen have kindly promised to receive subscriptions, +viz.:--Ernest Hart, Esq., Editor of _The British Medical Journal_; C. +Frost, Esq. (Treasurer of the Poor Law Medical Officers' Association), +47, Ladbroke Square, Notting Hill, London; J. Wickham Barnes, Esq. +(Secretary of the Poor Law Medical Officers' Association), 3, Bolt +Court, Fleet Street, London. + +"I am, Sir, yours faithfully, + +"FRANCIS WHITWELL. + +"SHREWSBURY, + +"_October 23, 1883_." + + + + +TESTIMONIAL TO DR. JOSEPH ROGERS. + + +The presentation of a handsome testimonial to Dr. Joseph Rogers, +Chairman of the Poor Law Medical Officers' Association, took place on +Tuesday last at the rooms of the Medical Society, Chandos Street, in the +presence of a numerous gathering of ladies and gentlemen. Mr. John A. +Shaw Stewart, presided. + +Mr. J. Wickham Barnes (honorary secretary of the fund) spoke of the +cordial reception with which the proposition to do honour to Dr. Rogers +had been received, and the support which had been given to it by the +medical journals, the editors of which had been among the most liberal +contributors to the fund. + +The Chairman, in his opening remarks, spoke of Dr. Rogers' work and +worth, which were so well known that little further need be said on +those points; but, on an occasion like the present, they should not +forget that Dr. Rogers was a sanitary reformer and advocate of +sanitation of about forty years' standing, and that matters which were +now accepted as facts were then subjects of the fiercest controversy. +Dr. Rogers, in conjunction with Mr. George Alfred Walker and others, was +the first who successfully advocated the closing of the burial-grounds +in cities, and had succeeded in establishing the first public mortuary +in London. Those facts alone testified to his energy and ability. Those +who were older than the speaker could remember the time when the light +of heaven was taxed; and Dr. Rogers, with the late Lord Duncan, was one +who worked hard to abolish the window-tax, a more unjust tax than which +it was impossible to conceive. He was appointed medical officer of the +Strand Union in 1856, at a time when there were no paid nurses and when +the Poor Law officer had to pay out of his small salary for all +medicines. Dr. Rogers, with Dr. Anstie, and Mr. Ernest Hart, was among +the stoutest advocates for the improvement of the workhouse infirmaries; +and, aided by the full force of the Medical Press, the great work was +commenced. The first time he (the Chairman) had had the pleasure of +working with ladies was in Mr. Ernest Hart's house; he was thankful that +now, in all useful social work, ladies came to the front. Dr. Rogers' +work led up to Mr. Gathorne Hardy's Act, and his force and determination +prevailed so far that the more expensive medicines were henceforth to be +paid for by the Guardians, but for a long time the bulk of the drugs +supplied was still left as a charge upon the ill-paid medical officer. +Dr. Rogers' great and difficult work had been in connection with Poor +Law administration. He believed one of the greatest political economists +of the day, whom he saw present, would bear him out that political +economy and philanthropy went hand in hand when they were employed in +energetic and persistent endeavours to arrest disease in its earliest +stages. No one could go much about our general hospitals without seeing +how much of the misery and distress of this world were caused by +disease. We were subject to a variety of diseases--and diseases meant +loss of health, and ultimate loss of life, to the bread-winner, and his +widow and children to be cast on the world. Dr. Rogers was subsequently +very instrumental in the carrying of the Bill for the superannuation of +Poor Law medical officers. Since then he had visited almost every large +town in England, Scotland, and Ireland, with the view of prevailing upon +the authorities to carry out improvements lately talked of in the +metropolis. Dr. Rogers was a real, true specimen of the best sort of +Englishmen, a man of tenacity, a hard hitter, a staunch friend, and a +pertinacious foe. + +Mr. G. W. Fraser, Chairman of the Westminster Board of Guardians, said +he had long known Dr. Rogers, and it afforded him very great pleasure to +find that he was so much respected by those who had had an opportunity +of appreciating his valuable work, and the many reforms he had been +instrumental in effecting in the Poor Law of this country. He was very +much respected by the Board of Guardians of the Westminster Union as at +present constituted, and before, until he had to draw the attention of +the Guardians to matters affecting the internal welfare of the +Workhouse, which action resulted in his being suspended from his duties. +All he could say was, there was no logical ground for the course that +had been taken. It was a great satisfaction to find that that apparent +evil had resulted in some good, for Mr. Wickham Barnes had told them +that the treatment which Dr. Rogers then received was instrumental in +bringing about the crowning result to be achieved in the presentation of +the testimonial that day. Dr. Rogers had, on several occasions, rendered +very valuable services to him (Mr. Fraser) and his colleagues, and he +trusted that he might long he spared to fulfil the duties he had +hitherto so long and so satisfactorily discharged. + +Professor L. E. Thorold Rogers, M.P., said it was a matter of great +gratification to him to be present on an occasion when the merits of his +brother's labours were being recognized with so much unanimity, and in +so practical a form, by the profession to which he belonged, and which, +he ventured to say, he had always adorned. + +Mr. Samuel Bonsor, as an old Westminster Guardian, spoke of the pleasure +it was to him that he had lived long enough to see Dr. Rogers' efforts +recognized as they had been. + +Dr. Farquharson, M.P., said he knew that Dr. Rogers had been a great +sanitary reformer, but he was astonished to find that he had been a +reformer of so many years' standing. Guardians were apt to go for a hard +and fast rule, while medical men, on the other hand, held more towards +the sympathetic side; and it was by carrying out their duties in a +sympathetic and liberal spirit that medical men often got into great +disputes, and great difficulty and trouble. Until recently, these +gentlemen, who were often treated cruelly, had no organization or means +by which they could make their grievances known, or obtain any redress +whatever. The action of Dr. Rogers, and the Association which he had +been instrumental in forming, had been the means of often bringing to +light cases of oppression and of obtaining redress for those who had +been oppressed. He was sure they might all congratulate Dr. Rogers on +being present, not only from the fact that he was going to receive a +substantial token of the affection and respect in which he was held by +all who knew him, but on the expressions of admiration and esteem which +poured in from all directions on that occasion. He hoped Dr. Rogers +would long be spared to give them the benefit of the shrewdness, his +tenacity, and his tact. + +Canon Wade (Rector of St. Anne's, Soho), said he had known Dr. Rogers +for some years as a man of war. The first thing which drew forth his +kindly feeling towards Dr. Rogers was observing the tender and faithful +manner in which he supported the case of the sick poor in their +workhouses. + +The Rev. W. Benham said he thought he had known Dr. Rogers and his +family longer than any one else in the room, excepting his brother, and +if he was a man of war, as had been stated, it was because no man in the +world had a more kindly heart. + +The Chairman, in making the presentation to Dr. Rogers of three +handsome pieces of silver plate in a case, together with a cheque for +£150, said he really ought to have the assistance of a lady now, for she +would so much more gracefully, in their name, present that testimonial +to Dr. Rogers. The inscription ran: "Presented to Dr. Joseph Rogers, in +recognition of his continuous effort in the cause of sanitary and Poor +Law medical reform, for nearly forty years. June 24, 1884." The date +reminded them that Dr. Rogers' voice had not been that of one crying in +the wilderness; his voice had been most usefully and beneficially +exercised in the metropolis. With the pieces of plate there was a +substantial lining. They hoped that Dr. and Mrs. Rogers would long be +spared to enjoy very many blessings. They had met together there with +one heart and one mind, to show their appreciation of his excellent +qualities both as a public and as a private man. The estimate of his +good deeds, he (the Chairman) fully believed, would never be known till +that last day, when the record of his life would be unrolled. They had +met to do honour to a good man; let each in his own capacity strive to +follow so noble an example, that when that great day came they might +have more to record of work done for others and less for themselves. + +Dr. Rogers, who spoke with some emotion, said he felt much difficulty +in giving expression to the feelings that actuated him on that occasion; +all he would state was that, in his progress through life, if he had +recognized an evil, he had done his best to relieve it; and if in the +doing of it, he had occasionally--and doubtless he had--confronted the +prejudices of some and aroused the antagonism of others, it was the +inevitable fate of all who attempted to deal determinedly with +wrong-doing, wherever it might exist. He happened to be, as it were, a +child of the new Poor Law, because he remembered well when the Bill +became law, and his father expressed to him his sense of deep +disappointment and dissatisfaction, as a Christian man, with the way in +which the Bill was framed, in regard to its harsh and bitter spirit. +They must recognize the fact that the poor would be with us always; and +that it was best to deal with them in a spirit of conciliation, +moderation, and kindness, and especially in that particular branch of +the management of the poor with which it had been his lot for many years +to be associated, namely, as medical officer of a large metropolitan +workhouse. He was perfectly satisfied of one thing, and that was that a +judicious administration of Poor Law relief meant economy. He had +studied this question most minutely. He pointed out, twenty-three years +ago, to Mr. Charles Villiers, who presided over a committee on poor +relief in 1861, that a more liberal administration of poor relief meant +true economy to the ratepayers, because if they cut short the sickness +of the poor, and if they diminished the amount of deaths that took place +among the bread-winners, they would, as the ultimate result, economize +expenditure and out-relief. As regarded other subjects that had been +referred to, it was to him a matter of immense gratification that he had +been associated in those labours that took place about forty-four years +ago, initiated by Mr. George Alfred Walker, of Drury Lane, and which +eventually germinated in the abolition of the most horrible system that +ever took place in a Christian kingdom. He could tell them many things, +terribly showing the horrible evils that arose from keeping the bodies +of the dead in the single rooms of the living. He had many times seen +the widowed mother and the children dining off the coffin of the dead +father, and other scenes which were indescribable in a gathering like +that before him. This it was which had prompted his action in the +formation of a mortuary at St. Anne's. Dr. Rogers concluded by offering +his sincere thanks for the great honour they had conferred on him, and +to Mr. Shaw Stewart in coming and speaking so kindly of him as he had +done. + +Mr. Wickham Barnes proposed a vote of thanks to the Chairman, which was +seconded by Mr. James Hogg, and to which the Chairman briefly replied. + + + + +CONCLUSION. + + +Though there were several persons of both sexes who were very advanced +in years, when one takes into account the difference in the numbers that +were to be found in the Strand and Westminster Workhouses, yet in this +latter House I did not see so many interesting old people as were to be +found in the former. About ten years ago, however, there was an +admission from St. Anne's, Soho, of an extremely aged woman. She claimed +then to be one hundred years old. She must have been extremely +good-looking in her youth, as she still retained evidences of personal +beauty. Like my old friend in the Strand, she had a bright blue eye and +a fair complexion; she was in possession of all her faculties, and +talked and laughed by the half-hour together when I was in the humour to +sit and chat with her. She knew the younger Pitt intimately, Charles +James Fox, the Prince Regent, Edmund Burke, and several of the +politicians of the latter part of the last century. She also told me she +knew Wellington and Nelson. At last I discovered what she had been. Her +constant references to Sheridan in her conversations with me induced me +one day to ask her if she knew him. Drawing herself up in a sprightly +sort of fashion, "I rather think I did," said she. Eventually it came +out that she had been under the protection of the box-keeper of Drury +Lane Theatre. On putting the question which brought out the somewhat +equivocal relation in which she had lived during the latter part of the +last century, she blushed up to her eyes--the only thing of the kind I +ever witnessed in a lady of such advanced years, so much so that I felt +sorry I had elicited the confession from her. She was a very interesting +old woman, and her remarks about the appearance of the celebrities of +the latter end of the last century and beginning of this, unmistakably +showed that she had associated on familiar terms with many of the +celebrated persons who lived and moved and produced a sensation nearly a +hundred years ago. She used to sing some very good songs; they were +chiefly Scotch, and when singing them she would work herself up into a +great state of excitement. She was very fond of talking to me, and I +suppose this arose from the circumstance of my taking interest in her +conversation. She was a very well-behaved old woman, and therefore a +great favourite with the inmates and nurses, who were highly amused +whenever they could get her to sing one of her Scotch songs. At the +latter end of the last century and the beginning of the present, she had +accompanied her male friend through Portugal and Spain prior to the war; +at the same time she knew Lord Nelson and Wellington before their names +had become famous. When she had reached 104, she rather suddenly lost +her vivacity, became childish, and insensibly passed from time into +eternity. + +We had, during the portion of the time I was at the Westminster Union, +quite a little community of aged and, so far as I could ascertain, +religious women, at any rate they struck me as being such, and I kept +them together until the harmony of their daily life was rudely +interfered with by the master and matron, Mr. John Bliss and Miss +Heatley, neither of whom had any sympathy with, or kindly feeling for, +decently conducted pauper women. Indeed they rendered the lives of these +people so wretched by harsh interference, as to compel me to distribute +them among other wards; some of them I even sent away to the sick asylum +hospitals, so as to get them out of their way. It was a wonder to me +that Miss Heatley, after all that was proved against her on the official +inquiry, should ever have been allowed to continue matron of the +Workhouse; but though spared by man's power, she was destined to perish +by one of the most fearful diseases that can afflict any woman, being +destined to die of cancer of a certain internal organ, and I have been +told her sufferings were of the acutest possible character. It is very +remarkable that, having had very large opportunities of witnessing the +deaths of my fellow-creatures, I have constantly observed that some +untimely fate has overtaken those who, exercising power in a workhouse, +have exhibited a cruel use of that power; and of one thing I am +absolutely certain from personal observation, repeated over and over +again, that, "Blessed is he who considereth the poor and needy, the Lord +shall deliver him in the time of trouble." It has often been asserted +that the inmates of a workhouse are generally worthless people, but I +demur to that conclusion entirely. Of this I am certain, that many a +person who has died in the infirmary of the sick ward of a workhouse has +gone as straight to Abraham's bosom as has ever passed from a bishop's +palace, or the death-chamber of a king or queen, or however highly +placed. During the thirty years that I was engaged in waiting on the +sick poor, I never lost sight of the fact that they were my +fellow-creatures who were accidentally placed in a humbler social +position than myself. Though, in accordance with the custom adopted in +the institution, they were stigmatized as paupers, I never allowed +myself to make them feel I thought them such. After the departure of Mr. +John Bliss and the disappearance (through illness) of Miss Heatley, the +Guardians appointed as master and matron, Mr. and Mrs. Minter. I found +them to be exceedingly respectable people, kind to the old and +afflicted, and fair and kind to the general population of an urban +workhouse. The sick poor were quietly attended to, whilst loud-mouthed +swearing and blasphemy were banished from the place. Unfortunately, +however, I began to break in health. Mounting up staircases day after +day, which had gone on for nearly forty years, told upon me, aggravated +as it was by repeated attacks of bronchitis. Then a heart affection, +followed by its usual concomitants, proved too much for me, and I was +compelled to resign the work I had done for so many years. What made the +blow the greater to me was this, that in all other respects my +professional life was a happy one. I had nothing to ask for from the +Board of Guardians, as all my legitimate requirements were at once +courteously met and complied with; a different atmosphere pervaded the +establishment, and therefore it was a pleasure to me to meet my +fellow-officers and to work with them. Looking back upon the change +which had taken place from the day I first entered upon my duties in +January, 1856, in the Old Strand Workhouse, till I finally left the +Westminster Union in 1886, a period of thirty years, the change that +occurred was enormous. Then there was hardly a paid nurse in any +workhouse in London, the duties being performed by more or less infirm, +drunken, and generally profligate inmates of the House. It was a miracle +to find an honest one among them; they were a chance medley of Sairey +Gamps and Betsy Prigs, who were selected at the will of master and +matron, and who obeyed the orders of the medical officer just as much +as, and no more than, their fancy led them. The scenes of untold misery +which might have been witnessed by the Guardians of the Poor will never +be fully exposed until the grave record of all things is opened to +universal gaze. Fortunately, a change has come over the spirit of these +things: in the present day the sick poor are housed in buildings which +were never dreamed of twenty years ago; pauper nursing is now entirely a +thing of the past; Lazarus now meets with careful, Christian +consideration, and if it be possible to restore him to health, an +opportunity is afforded him of resuming a position in society, useful, +though it maybe humble. My readers will therefore fully understand with +what great regret I took my pen and wrote the resignation of my office, +especially when I recall to mind my having been twice suspended from my +duties for the efforts I had made in bringing about the changes which I +have above referred to, and that at last, when I was no longer able to +do my work, I was constrained to sever my connection with the Board who +had come to look upon me as one solely actuated by a sense of duty. + +The day after the receipt of my resignation, I received the following-- + + + "WESTMINSTER UNION, + + "POLAND STREET, + + "_September 27, 1886_. + + "DEAR SIR,--I am directed to forward you the annexed copy of a + Resolution adopted by the Guardians at their meeting held on Friday + last, when your resignation of the offices of Workhouse Medical + Officer and Public Vaccinator of the Union was accepted. + + "I am, dear Sir, yours faithfully, + + "FRED J. LAMPARD, + + "_Assistant Clerk of the Guardians_. + + "J. ROGERS, ESQ., M.D., + + "Montagu Place, Russell Square." + + + (Copy Resolution.) + + "That this Board has received with much regret the letter just read + from Dr. Joseph Rogers, resigning the office of Workhouse Medical + Officer and Public Vaccinator for the Union, on account of his + continued ill-health, and while now accepting such resignation, the + Guardians desire to convey to him their deep sympathy that he + should thus be compelled to sever his connection with the Board + after many years of faithful service, and to record their high + sense of the zealous and efficient manner in which he has + discharged the duties of his office, and for the warm interest he + has at all times taken in questions affecting the proper treatment + of the sick and infirm poor." + + +After the resolution had been submitted to the vote and adopted +unanimously, Mr. Samuel Bonsor rose in his seat and gave notice that +that day month superannuation allowance should be accorded to Dr. Joseph +Rogers. Coming from this gentleman it was indeed an honourable +recognition of lengthened public services. Mr. Bonsor had been in +various offices of the parish of St. Anne's, Soho, since the +introduction of the new Poor Law Bill in 1834. He had filled all the +usual parochial offices, even the highest, up to the time when I first +made his acquaintance, which was in the autumn of 1846, on the occasion +when I brought before the Vestry of St. Anne's, Soho, the terrible +condition of the burial-ground of that parish. After hearing my +indictment he at once concurred in the appointment of a committee from +the Vestry, of the inhabitants, to take the condition of the ground into +consideration, and to devise such remedies as might appear desirable. +Mr. Bonsor attended several of our meetings, and entirely agreed as to +the dreadful state into which the graveyard had fallen, owing to the +frequent funerals and the enormous overcrowding. It was that Vestry +meeting that first made me a sanitary reformer, and caused me to +advocate extra-mural interment as well as many other social reforms, in +all of which I had the hearty support of Mr. Bonsor. I question whether +a finer representative of a middle-class tradesman could be found in +this kingdom; for more than half a century he has devoted more than +ordinary ability to the interests of his fellow-parishioners. I never +upon one single occasion heard, or was it ever hinted by any enemy (if +he ever made one, which I doubt), that his actions were ever influenced +by a single act of self-seeking; indeed, he has passed through an +unusually prolonged life amidst the respect and regard of all who have +come in contact with him. A very short time ago he brought me a circular +letter, issued by the Poor Law Commissioners, proposing the Board of +Guardians in London should issue a similar letter to their respective +bodies, so as to more effectually deal with casuals. Laying it down +before me, he said, "This is a return to what they did between forty and +fifty years ago, for I was a member of the special Board which was +appointed under this letter; but," said he, "I suppose they have +forgotten all about it." And so they had, no doubt. + +Before bringing my remarks to a close, I should like to briefly describe +the various changes that have taken place since the Poor Law Commission +was appointed in 1832. One of the original Commissioners was the Right +Hon. C. P. Villiers, M.P. for Wolverhampton, who has told me in the +course of various conversations I have had with him, that although a +variety of subjects was referred to them in connection with the +administration of the Poor Laws, yet that the question of sickness, as a +factor in the production of pauperism was not referred to them, and if +it had not been for the pertinacity of Dr. G. Wallis and some others, +that this important subject would have been passed over altogether. It +need not, therefore, be a matter of surprise that there has been a +continual protest going on, on the part of those who have accepted Poor +Law medical appointments against the way in which they have been treated +by the Board of Guardians, and a reference to the Poor Law Commissioners +resulting in the various changes that have taken place in the +composition of the central authority up to the Local Government Board of +the present day. Until 1864 the central authority was an extremely weak +body, as continuous efforts were made throughout the country by Boards +of Guardians and others to wipe the Poor Law Board out of existence +altogether, and had it not have happened that the investigations and +deliberations of the Select Committee on Poor Relief, presided over by +the Right Hon. C. P. Villiers, had reported in favour of the maintenance +of the Poor Law Board--not Local Government Board--such a disastrous +thing would have happened. Let it here be fully understood that although +I have taken a most determined antagonism to many of the acts of the +Board, whether as Commissioners or as the Poor Law Board, yet that +antagonism has been due to the fact that the administration has often +been seriously faulty in detail. The office of a Poor Law Inspector is +one which needs much judgment and tact. I trust this will be borne in +mind by those who will draft the contemplated County Government Board. +There is one point on which, feeling most strongly the existing mockery +of so-called Poor Law inquiries, I do trust a change will be insisted +upon, and that is, that those deputed to make the inquiry shall possess +at least a modicum of legal intelligence. Finally, I have to express the +hope that no Inspector, whether metropolitan or otherwise, will be +vested with the sole power of deciding what shall be the evidence that +shall be taken when the inquiry shall close, nor that he shall be the +sole judge of the value of such evidence. + + +UNWIN BROTHERS, THE GRESHAM PRESS, CHILWORTH AND LONDON. + + + + + +End of the Project Gutenberg EBook of Reminiscences of a Workhouse Medical +Officer, by Joseph Rogers + +*** END OF THE PROJECT GUTENBERG EBOOK 58454 *** |