 Chapter 2, Part 1 of Reminiscences of a Workhouse Medical Officer, by Joseph Rogers. This LibriVox recording is in the public domain. Chapter 2, The Westminster Infirmary, Part 1 About a twelve-month 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, acted 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 drifted 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 for upwards of forty years, was about to retire on a superannuation allowance of two hundred pounds a year. I was told that the chairman of the board, Mr. Bonthran, a Scotch baker living in Regent Street, had selected a fellow Scotsman, one Dr. S., as Mr. French's successor, and as Mr. Bonthran 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 Scotsman. 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. Bonthran. 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 in as much as I had known him ever since he had come to London, I saw that without collusion with someone 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 imminent physicians and surgeons, by members of Parliament, among them a one of a very flattering character, from Mr. CP Villiers MP, 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 expanse of upwards of 60 pounds 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. For St. Anne's, a poor parish had considerably improved its position by being put into union with St. James, 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, a baronet MP, was in the chair. And I afterwards spent a very pleasant week there, visiting the North and South Dublin Work Houses, 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 at the Richmond Lunatic Asylum, situated on the outskirts of Dublin, at that date under the superintendents of Dr. Ley Lor, 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 sites 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 onto 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. Lailor 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. Lailor 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 to 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 a 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 a 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 mid-summer, 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 physics 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 Carlyke DiRia, I asked, well, what do you hear? To which, he replied, nurse, give her a glass of number two. With that, he pulled me into the center 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-colored. I never give any physics. Feeling by this time somewhat disgusted by these remarkable confessions, seeing that his stipend was 350 pounds 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 button-holed 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 approach me with having transferred Mr. French to him, saying, I take a 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 there, 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 in firm 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 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 section of the board but repudiated by those of St. Anne's seeing that we had had a medical inspector and self-called medical advisor for five years whose duty it was to visit this workhouse infirmary. His failure to discover these omissions it was in the highest degree remarkable. But then the system prevailed that the local government board and our workhouse infirmary's association had utterly failed to alter it. The reason for all this was not far to seek. On the day after in company with Popper 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, and so forth 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 anyone. Whilst going through the female wards some of the inmates returned drunk. One old woman very much so. She had 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 and 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 death so much money as many of them do. I was informed that the old master who preceded catch at this grand 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 two thousand pounds. I found on inspection of the specially infirm paralytic and wholly infirm that the women were located in wards sixteen seventeen and eighteen 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 advisors or if it had been no steps have been taken to alter it. On my first visit to these wards I noticed some black patches in the corners of the compartments which suit 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 labor 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 favor. And the bugs were swept down into a large dustpan by hundreds and put into the fire and burnt. This was told me by an eyewitness 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 all drunk. I never could to 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 quarreling 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 and 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 out 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 a special 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 the 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 diet 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 unable to speedily arrange for a pharmacopia. 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 woolen 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 mid-summer 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 part 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 Heiget to which the Westminster Union in conjunction with the strand St. Giles and St. Pankras was affiliated. He had opposed the junction of the two perishes 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 anyone away. I had held office some weeks when in the autumn of the year I encountered Dr. Dryges 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 was 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 a 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 60 miles in the country. He was a healthy looking man about 40 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 imposter. 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 two and four a.m. when the lights are down and most of the inmates asleep. But surely, I said, the nightners 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 boards. I once reported the nightners on the male side, the woman who had allowed them a lingerer 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 protease 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 for proper 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 boardroom table showing the occasions when the medical officer went out and the length of time he was out and so forth and so forth. 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 I first entered on my duties at the Westminster Union, the chaplain there was a very energetic little man named Duvall. I do not remember his Christian name for the reason that he was known and spoken of as Claude Duvall 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 highwaymen. He most assuredly did not convey the idea that he had any brigand of 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 a vocalist of a high order who contributed to 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 rate payers living in the neighborhood. 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 occasion. 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 colored 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 an instance the white mouse ferret and so forth 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. Low'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 would repeat my story of Mr. Low 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. End of Chapter 2 Part 1 Chapter 2 Part 2 of Reminiscences of a Workhouse Medical Officer by Joseph Rogers. This LibriVox recording is in the public domain. Chapter 2 The Westminster Infirmary. Part 2. 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 a 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 Ramon Struntz 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 Dravelian came to call on me respecting a public movement that we were both engaged in. Finding I was at the infirmary he came around 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 one pound 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 one pound soon went. His enjoyment of this treat and 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, Adonis 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 heard 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 employee 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 as 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 breakdown 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 95 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 asked 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 pounds the Empress Eugénie at being one of the subscribers he was buried at the Catholic Cemetery at Kensel Green. There were two seamstresses who had lived in Gilbert Street, Oxford Street, who were his country women and his sole visitors with the exception of the Catholic priest of the French Chapel at 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 beer 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 censor containing fire and proceeded to incense the quartet. 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 white washed pot proceeded with a brush to throw holy water on the coffins. This being completed the coffins were put on a truck and we hurried away as fast as we could go through the mirey 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 white washed 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 14 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 some 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 unable 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 or again. The opposition to the removal of the sick to the asylum hospital at Heiget continued and a 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 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 stayed 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 checkered by a single cloud. I have spoken of the clerk of the board as having expressed a favorable 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 favor 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 to being also known in St. James's I gave him my support with the result that he was elected to 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 sometime before his death he came to me in my room and showed me a letter he had received from the military commandant of Devonport Barrick's 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 promise 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 was dropped. The poor fellow was afterwards proved not to belong to St. James' 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. Rainer, 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 that 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 Grand 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 a favour by giving the most unaccountable certificates as to the condition of the lunatics admitted to him. I had the satisfaction of getting rid of him at last but not until he had made 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 directly 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 that 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 mail insane award 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 awaiting my arrival. To my inquiry what she wanted is 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 prison that poor man has to my certain knowledge been a lunatic for a long time. She immediately said yes sir I've known it for nearly a twelve month but no one but you has ever said so before. I told her to compose herself and tell me its history when she stated as follows we have been married about five years and a better husband no woman could ever have had but about a twelve month 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 fine street police station and that he had been taken up for stealing. I hurried there when I heard that walking along Little Polkmystery he came opposite a polterer shop when suddenly springing on the showboard he clambered up by the hooks till he reached the top and taking off a hair 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 labor it being his first offense. 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 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 Clarkamville 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 labor. 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 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 that 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 it 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 jailer 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 money should be sent me to enable 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 eighty five pounds 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 job and stock it. I decided to set the woman up in business as a laundress at Battersea. I went there it took a suitable cottage and guaranteed the rent for six months. Then I went to a firm in Holburn 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 planned 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 sense. 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 from 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 record showed that such was the case. Wolfful 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 skillful 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 and one sense only vis 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 Clark 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 where upon 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 a pound a week for her maintenance therein. Getting tired of this for he was a most penurious person he took her out. Some time after he was taken ill and died leaving upwards of four thousand pounds. Dying interstate his property was divided between two brothers and the widow. Her share the third being upwards of fifteen hundred pounds. 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 fifteen hundred pounds 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 twenty four pounds worth of plants in pots which were taken to a furnished room she had hired in Gerard Street. So 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 three hundred pounds worth of personal clothing which was all sent to the single room in Gerard Street. She also went to a Piano Forte manufacturer in Regent Street and purchased a sixty guinea piano at the same time being absolutely ignorant of music and if anyone had taken much trouble they must have recognized by her appearance her mental deficiency. About two months after she first purchased at this draper shop the shopwoman who had sold her three hundred pounds worth of clothing called on her at Gerard Street and although this room contained the dead flowers and unopened boxes of the first purchase she induced her to buy two hundred and fifty pounds worth more thus making a total of five hundred and fifty pounds expended by a poor insane woman. The rector of St. Ansoho informed me that she regularly attended the sacrament and always put one pound 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 and 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 said he 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 extents so in truth. A day or two after that the chairman who lived nearly opposite the draper 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 liable 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 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. 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 outdoor 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 favor. 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 Ann Wellesheimam. 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 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 award 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 under clothing 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 under clothing as a present for my future bride. Indeed, I said, is it usual for the gentleman to buy his future wife's under clothing? 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 apply to 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 award. This was carried out. On seeing me next day in the house he spoke rapturously of the award 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. Rainer 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 as seen a DA. The underclothing, gloves, silk stockings, and so forth 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 were 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 unconsciously going to near them. Early in 1872 the present chairman of the Westminster Union, W. J. Fraser Esquire, solicitor, asked me to visit the Reverend H. Watson, ex-master of Stockwell Grammar School, who was then located in Horsemonger Lane, jail 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 council who defended him, the late Sergeant Perry, 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 council, Mr. Poland, immediately proceeded to severely cross-examine me. But to all his questions I had my reply ready, and after some half-hours 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. Blanford 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 and so forth, giving instances, whereupon Mr. Poland said in a professional tone of voice, Oh, you consider that as a sign of insanity to you? Well, I said at 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 a presentation to his council. He had written, What does this damned fellow mean by calling me only a schoolmaster? After his conviction and sentence, he was removed to horsemonger lane jail. 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, and going down the street in which I then lived some few days after, I saw Lord Elliot, the son of the Earl of Saint-Germain. 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 Biles, 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. Borrowed 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. 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 Maitin 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 mid-summer quarter. The medical officer, Dr. Noelle, who, strange to say, had been a school fellow 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 school's 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 mid-summer 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 quarreling 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 sin 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 school's and retention of the office for eight months. The occasion for my being sent down the second time was a serious outbreak of ophthalmolia, 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, delayed 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 work-house. 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 aneurysm of the abdominal aorta which giving away in the loins had slowly infiltrated the tissues until, a bent 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 neighborhood 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 German 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's 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 obey 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 had 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 ward's 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 hail 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 a 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 alleged 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 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 duties of 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 to 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 unable 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 18 months imprisonment with hard labor the poor little fellow was brought back to our house whilst the elder brother was sent to the school for seeing 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 defense 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 award of the Italian government some 10 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 now be some 18 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 light looking structure stretched across the abdomen one could make out without 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 obstructedness 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. Muatt 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 he 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. Muatt Dr. Muatt 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. Muatt promptly said as this is a purely medical visit master we can dispense with your company he colored 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. Muad 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 has 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 jackess 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 saying 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 four thousand pounds notwithstanding he had a large and expensive family after his disease 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 labor 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 lifeguards and a miss heatley a 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 hell and sundry other course 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 mouth course 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 frazier 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 sometime after in a letter to the department i did not hesitate to refer to it and state as much end of chapter two part three