In the autumn of 1868 a general election took place, with the result of replacing the Liberal party in power. With the concurrence of the Council of the Poor Law Medical Officers Association, I had issued a circular letter to the various candidates for Parliamentary honours, in which I drew attention to the imperfect character of the Poor Law Board, and the usurpation by the permanent officials of powers they were not entitled to, and asked whether the candidate would assist us in our efforts to reconstruct the Board, and to improve the system of medical relief. The replies I obtained were not only very numerous, but they held out the prospect of an alteration for the better. Looking back at the various changes that were made subsequently, I have no hesitation in asserting that many of these improvements were brought about by the action our Council took at this general election. These will be briefly referred to.
I will here relate an incident that gave me the cue as to the line to be taken in the introduction and establishment of a Public Health Act. I was desirous of visiting an aged relative who lived in a village in Hampshire. The local medical gentleman kindly volunteered to fetch me from the station, some seven miles distant, and to put me up for the night, &c. As I neared his house my sense of smell was assailed by one of the most awful odours I had ever encountered. To my inquiry from whence it originated, my host said, "That is from the farmyard over there. Young Green, the son of the corn dealer, has taken Miss Smith's farm, and has commenced to breed pigs. He has at least 300." "Well," I replied, "if I lived here I should make short work of Mr. Green and his pigs; I would at once indict him." "Ah," he said, "you can afford to be independent, you live in London. I dare not; for if I complained, or took any action in the matter, old Green would go to all the markets round about, and would denounce me for attempting to interfere with his son's business, and I should make enemies by the score." Some three or four years after Mr. Stansfeld brought in his Public Health Bill, one of the essential features of which was that every district medical officer should be the health officer in his district. I opposed the proposition with all my might. I knew the Act would be absolutely abortive if Poor Law medical officers were placed in this utterly false position which Mr. Stansfeld proposed. In taking this course I encountered much opposition, and became for a time very unpopular, though at last my views prevailed, and gentlemen wholly independent of local influences were appointed to large areas. Among the remonstrants was the medical man who was the neighbour of the pig breeder, when I silenced him by reminding him of Mr. Green and his pigs, and of the fear that he had that if he complained that his business as a country medical gentleman might be damaged. He said no more.
Having come to the conclusion that the course followed by my poor friend, Richard Griffin, of Weymouth, in continually calling attention to the grievances of Poor Law medical officers, would never eventuate in an improvement of their position, for the general public have never cared for our class in any way, I cast about to ascertain whether there could be any course adopted by which the attention of the public could be drawn to the shortcomings of the system, and decided that the only chance that existed, whereby an improvement could be effected, was by proving that an amended system of medical relief would eventuate in the diminution of the duration of sickness, and consequently of its cost to the ratepayers; and having at this time a copy of the annual report of the Irish Poor Law Commissioners placed in my hands, I studied its pages, and saw that under the Irish Medical Charities Acts the poorer classes of that country had secured to them the most complete system of Poor Law medical relief. I resolved to go over to Ireland, and study its administration on the spot. I carried out my intention, and during my stay in Ireland obtained a complete insight into the way in which the Irish dispensary system was carried out. I also brought back with me all the papers and documents that enabled me to popularize the subject here. I also spent much time in examining the annual returns of the English Poor Law Board, with the result that I was enabled to prove conclusively that efficient medical relief was followed by diminished poor relief expenditure, not only by shortening the duration of sickness, but by the actual saving of human life: this latter was shown also by a return I got Mr. W. H. Smith to move for, which was as follows—
"A return of the population at the last census in England and Wales, in Scotland and in Ireland.
"A return of the mortality from general causes in the three portions of the United Kingdom, and of preventable mortality."
That return exhibited the following: That whilst one in every 43 died yearly in England, one in 44 in Scotland, only one in every 60 died in Ireland; and whilst in England zymotic, or preventable diseases, constituted one-fourth of the total mortality, or one in 190 of the population, Scotland one-fourth, or one in 194 of the population, in Ireland it was one-fifth of the total mortality, and one in 308 of the population; the fact being this, that in England and Scotland there existed the same miserable system of medical relief, whilst in Ireland, after the potato famine and the fever which followed it, calamities which swept away a large portion of the inhabitants, the Medical Charities Act was introduced, and led, by its efficient working, to the beneficial changes which had taken place in the health of the country.
The views I advanced met with much favour, and were commented on and approved by many general, as well as by all the medical journals. Having sent a copy of the paper I read at a meeting of our Association to Mr. C. P. Villiers, that gentleman wrote to me stating that he had derived much pleasure from its perusal, and that I had thrown more light on the causes of pauperism, and devised better measures for its diminution, than any previous writer on the subject. Subsequently, through the influence of Mr. Corrance, then M.P. for East Suffolk, I was invited to address the Central Chamber of Agriculture, which I did, when a resolution, couched in very flattering terms, was adopted, and further it was moved that a copy of the Chamber's approval of my address, and the principles contained in it, should be sent to the Poor Law Board, coupled with the request that the attention of all the provincial Chambers should be called to the subject. Subsequently I was invited to address the Worcester Chamber on the same subject, as well as that of Suffolk.
At a very early period of the presidency of Mr. Goschen, several of the provincial Poor Law Inspectors were directed to make inquiry into the question of medical relief to the poor, and the desirability, or otherwise, of establishing dispensaries, modelled on the principles contained in the Irish Medical Charities Act. One of the most able and exhaustive reports was sent in, as might have been expected, by Mr. Farnall, who thus proved true to the views he held in his interview with me some ten years before; whilst the very feeblest of these was that preferred by Mr. R. B. Caine, who manifested the same lack of heartiness here as he exhibited earnestness some years before in upsetting poor Richard Griffin's statistics, of which he boasted to me during his conduct of the inquiry at the Strand Union in 1866.
One of the results that sprang from my visit to Ireland was the establishment of a good understanding between our Association and that of the Irish Dispensary Medical Officers, of which the late Dr. Toler Maunsall was the honorary secretary. Dr. Maunsall was the most indefatigable secretary I ever knew. His appetite for work, and his skill in getting up statistics was remarkable. He was most valuable to me, as he assisted in getting out dry figures for my use, which would have given me infinite trouble. Poor fellow! like many others of my fellow-workers, he was destined to die early, and I sustained a great loss by his premature death. Unfortunately, too, he died badly off. I started a subscription in England for the benefit of his widow and children, which helped to swell the sum that his friends got together in Ireland.
During my stay in Ireland it was arranged between us that we should mutually help each other, and consequent on that, when the Irish Association strove, under the leadership of the late Dr. Brady, M.P. for Leitrim, to obtain superannuation allowance for dispensary and workhouse medical officers, I called attention to the subject in the medical journals, and induced the members of our Association not only to petition, but to interview members in their respective localities, in favour of the Bill. Dr. Brady, having succeeded in carrying this measure, essayed the next year to do the same for England and Wales. The success of the appeal we had made to members in the general election of 1868, facilitated the passing of the measure most materially, as we had promises of support from upwards of eighty gentlemen who were subsequently elected. Prior to the second reading of our Bill, I interviewed several members, and got promises to attend the second reading and vote for the measure. Some of these gentlemen, having intimated their desire to speak in its support, and having asked to be supplied with information on the subject, I coached them up. To one of the ablest of our supporters, who asked me to provide him with facts, I said that I was opposed to superannuation on principle, as I held that every one should be able during the working days of his life to provide for the exigencies of his old age—but then it was necessary if he held an office that the pay should be such as would enable him to do so. Now it was notorious that the pay of the medical officer was based on such a starvation principle as to render it impossible for him to save anything. This argument, reproduced very much as I have written it, in the House assisted a great deal in the success of the Bill. At the time this occurred I was out of office, and had not the most distant idea I should ever again be a workhouse medical officer. I did not know what was again in store for me, nor that I was destined to have another fourteen years of it; that I should be again suspended, restored to office, and eventually, through broken health, compelled peaceably to resign and to be myself a pensioner.
After the Bill had become law Dr. Brady most generously bore tribute to my efforts, and stated that he never could have carried the Bill without my help. The Lancet published this statement of Dr. Brady's, and I for the time gained from my Poor Law medical brethren credit for what was, at that period, absolutely disinterested labour.
About this time I was invited by a leading physician in Edinburgh to visit that city and address a meeting at the College of Physicians on the subject of Poor Law medical relief in Scotland. Although I was aware that the condition of things in that country was worse even than it was in England, yet I had not studied the subject so completely as to justify me in asserting it. Consequently I declined what was a very great compliment. Some years afterwards I went and delivered an address. It took place at the time when the annual meeting of the British Medical Association was last held there, when a highly complimentary resolution was adopted at that meeting in reference to that visit and address of mine. After occupying the position of president for a brief period only, during which time the Department was administered most vigorously and successfully, Mr. Goschen was transferred to another office in the Government, and Mr. Stansfeld was appointed President, the effect of which became immediately apparent, for the leading permanent officials, whose influence had been checked during Mr. Goschen's presidency, came directly to the front again.
One of the first measures introduced by Mr. Stansfeld was the conversion of the Poor Law into the Local Government Board. This was carried out by the absorption of the Public Health Department of the Privy Council in the destitution element of the Poor Law Board—a most disastrous act of policy, as it subordinated the Health Department, which had done its work so well to the discredited section of the Poor Law Board as exhibited in the permanent officials of the Board, who had always been obstructive, and had neither carried out, nor permitted any one else to carry out, any reform whatever.
This was early made apparent, for at the first deputation to the President, at which I was present, after his appointment, I saw Mr. H. Fleming and Mr. Lambert sitting together with the President, whilst Mr. (only just recently made Sir), John Simon and his staff, who were the only intellectual element of the new Board, were relegated to distant seats in the corner of the room.
That a Public Health Bill started under such circumstances should be framed absurdly, seeing that those who understood the subject were ignored, and those were consulted who had never done anything well, was nothing but what might have been expected.
One of the provisions of the Bill was, as I have before stated, that every district Poor Law medical officer should be the health officer of his district, and that his reports of insanitary conditions should be sent to the Board of Guardians, many members of which Board would be found to be the principal offenders against sanitary requirements.
This scheme speedily evoked an opposition, and a deputation, representing the British Medical Association, the Social Science Association, and the Poor Law Medical Officers Association, had an interview with Mr. Stansfeld at the Local Government Board. The speakers from the two first Associations having addressed the President, Mr. Stansfeld announced that he had just received a summons to attend a meeting of the Cabinet, but he would leave Mr. Fleming to hear any further remarks that might be made, which would in due course be communicated to him and meet with attention. Being the sole remaining speaker, I said to Mr. Fleming that when I first heard of the proposed utilization of the Poor Law medical officers in the Public Health measures of the Government, I hailed it as a tardy recognition of the valuable services that class of official might render. But when I came to look into the details I saw it would not work, as medical officers would hesitate in affronting their Board of Guardians, many members of which would be found to be the principal offenders against the contemplated Act, and that in the few cases where the parish officers would faithfully carry out the requirements, and thereby offend their respective Boards, they would be sacrificed to the resentment of their members, and if appeal was made for support to the Central Department, such honest men would be called on to resign for not exhibiting sufficient courtesy, &c., and working with their Boards. It was very evident that my observations went home to this Permanent Secretary, but whether they were ever communicated to Mr. Stansfeld is open to much doubt, for his Bill was eventually brought in on the lines he had originally indicated, only to turn out on trial a disastrous and ludicrous failure.
About a twelvemonth after the Act was in operation I appealed, through the medical journals, to my brethren in the provinces as to the arrangements that had been made in their respective localities. A large number of letters from all parts of England and Wales were sent to me, and with the information thus furnished I prepared a paper which I called "Chaos," in which I turned into ridicule the arrangements that had been made, showing that the Department, faithful to its traditions, had made a complete mess of the administrative arrangements. This paper, read at the meeting of the British Medical Association at Sheffield, attracted a good deal of attention both in the medical and general Press. It materially acted in evolving order out of the chaos into which the subject had drifted, owing to the indifference and incompetence of those who had drafted the measure.
In the spring of 1872 I was informed that the alterations and enlargement of the old Workhouse of St. James's, commenced at the time when the Westminster Union was formed, were complete, and that Mr. French, who had been the medical officer of the workhouse and parish of St. James's for upwards of forty years, was about to retire on a superannuation allowance of £200 a year. I was told that the Chairman of the Board, a Mr. Bonthron, a Scotch baker living in Regent Street, had selected a fellow Scotchman, one Dr. S., as Mr. French's successor, and as Mr. Bonthron claimed to be omnipotent at the Board, this gentleman's appointment to the vacancy was considered to be certain. In the course of a few days I heard that a formidable opponent to Dr. S. had appeared in the person of Dr. M., who was also a Scotchman. In due course the election took place, when Dr. M. was elected. This resulted from a protest on the part of certain members of the Board who resented the predominance of Mr. Bonthron. When apprised of the result of the election, I remarked that Dr. M. could not take the office as he did not possess the necessary legal qualifications. On the following Saturday morning a member of the Board told me that a letter had been read at the meeting of the Guardians, held the previous evening, announcing that the election of Dr. M. was null and void, as he held no surgical qualifications. As his election had surprised all the Guardians, because it proved that the Chairman had not the influence he claimed, my informant advised me to apply for the office. At first I hesitated, but upon being urged again I assented. The same evening I called on Dr. M., told him of my intention, and asked him for the support of his friends. To my utter astonishment he told me he had made up his mind to try again. "Nonsense," I said; "how can you get a diploma from the College of Surgeons?" "Oh," he replied, "I have arranged all that; I have a splendid memory, and I remember all my anatomy and surgery." As I had every ground for the belief that he had never attended lectures on surgery, nor attended the surgical practice of an hospital, inasmuch as I had known him ever since he had come to London, I saw that, without collusion with some one in authority, it was impossible for it to be done; but, as he appeared determined, I left him. As soon as it was known that I seriously intended to compete for the appointment, testimonials in my favour were forwarded to me by several eminent physicians and surgeons, by Members of Parliament, among them one of a very flattering character from Mr. C. P. Villiers, M.P., the ex-President of the Poor Law Board, who strongly recommended me to the Board of Guardians, those lady visitors who had known me at the Strand, and others. Two days before the election took place I was surprised by a visit from Dr. M., who called to inform me that he had passed his examination at the College of Surgeons the night before, and now asked me to retire in his favour. On my declining to do as he wished, he said it was very hard I would not, as he had incurred an expense of upwards of £60 to get the diploma. Prior to the election my friends entered into a compact with his supporters to the effect that if I was in a minority on the show of hands my name was to be withdrawn, when they would support him, but if I was in the majority his friends would support me. This occurring, I was elected, to the great surprise of the Chairman, who looked on me as a dangerous person, seeing that I had taken an active part in bringing about the formation of the Union, whereby St. Anne's had been joined to St. James's, which had the effect of somewhat increasing his poor rate assessment in St. James's—for St. Anne's, a poor parish, had considerably improved its position by being put into union with St. James's, which was comparatively a rich one.
Having at this time received an invitation from the Irish Dispensary Medical Officers Association to address them at the College of Physicians in Dublin, I did so, when Sir Dominic Corrigan, Bart., M.P., was in the chair; and I afterwards spent a very pleasant week there, visiting the North and South Dublin Workhouses, the latter having 4,000 inmates, with a large staff of visiting physicians and surgeons, besides resident medical officers. It is one of the finest hospitals in Dublin, and the arrangements for the efficient treatment of the sick poor were in the highest degree creditable to the Irish Poor Law, now the Local Government Board.
I also visited the Richmond Lunatic Asylum, situated on the outskirts of Dublin, at that date under the superintendence of Dr. Lalor, who, I understand, was the first physician who introduced vocal and instrumental music as a means of relieving the insane. There I witnessed one of the most extraordinary sights it was ever my lot to see. I will give a sketch of the tableau. In the foreground sat a young lady discoursing most eloquent music on a harmonium, immediately behind her there stood some young Irish women, three or four of them, singularly beautiful, with music in their hands, accompanying her; behind them were older women, and then on to the old and weird, all joining most heartily in the performance. The fringe of this female gathering of nearly 100 performers were harmless imbeciles and idiots. I stood and listened some moments whilst this singular performance continued. I was so struck with the beauty of one of the Irish girls that I asked her history, when I was informed that her condition had been induced by a disappointment in a love affair. It was the old story of love followed by desertion, and she had been admitted some six months before in a state of maniacal excitement. She was too young and altogether too pretty to be an inmate of a lunatic asylum. Dr. Lalor also showed me a typical case, exhibiting the truth of the opinion I have long held, that of all the forms of insanity, none are so uncertain of having been really cured as those which have exhibited symptoms of homicidal or suicidal violence. The patient in question had been admitted when suffering with a homicidal tendency but had steadily improved, and his name was on the list of those to go before the Visiting Committee for discharge on probation, when a startling incident occurred. He had secreted one of the knives used in the asylum about his person, and he had, when unobserved, whittled away the thick, blunt portion used in the asylum, until he had given it a sharp cutting edge, from handle to point; when, raising his right leg up, he cut through the calf down to the bone, severing the muscle completely. This patient, Dr. Lalor told me, had been employed on various offices of trust, and that he was commonly considered to be completely cured, and altogether harmless. I obtained one of the old knives used in this asylum, had it copied, and, having got the sanction of the Board for getting several, used them all the time I was at the Westminster Union, in the male and female insane wards. The cutting edge was about two inches in length, but the rest of the knife was about the twelfth of an inch thick. It was impossible for lunatics to do any harm either to themselves or others with such knives.
On my return to London I was informed that my appointment to the Westminster Union had been confirmed by the Local Government Board.
A day or so before the 23rd of June an appointment was made by Mr. French for me to go over the House with him, and to have the establishment formally handed over to me. I went, accompanied by a young Irish physician, recently one of the resident surgeons of an Irish hospital, with whom I was in treaty to be my assistant. I had never been in this workhouse infirmary before. Shortly after my arrival Mr. French joined us, and, in company with the head nurse on the female side, we went through the female part of the establishment. The nurse was most elaborately "got up." We went on and examined each patient, a large number of whom were in the wards—in fact, although it was midsummer, the place was full. I noticed bed-cards over each patient's bed, but as I could not make out what was given to the patients, I asked what was being done for this and that case. To my astonishment Mr. French said, "Nothing; I do not believe in physic, and therefore do not give the people anything." Presently we entered a large ward where a woman, evidently in great pain, was lying in bed, writhing in apparent agony. After ascertaining the nature of the case, which was one of colicky diarrhœa, I asked, "Well, what do you here?" to which he replied, "Nurse, give her a glass of Number Two." With that, he pulled me into the centre of the ward, and giving me a friendly nudge of the ribs, laughingly said, "What do you imagine is Number Two? Why it is peppermint-water coloured; I never give any physic." Feeling by this time somewhat disgusted by these remarkable confessions, seeing that his stipend was £350 a year, out of which it was arranged by the Board that he should supply these medicines. I dropped his company, and went on examining the people independently. Mr. French speedily buttonholed my young companion, and went on looking at the patients with him. At last our visit came to an end, and on coming out of the male sick wards he shook me warmly by the hand and wished me the same happy official life as he had had. He had hardly got out of hearing when the young Irishman commenced to reproach me with having transferred Mr. French to him; saying, "I take it, sir, as a very unkind thing that you should have done so, as I was shocked at his boasting that he never did anything at all for these poor sick people."
The next day I entered on my duties. On taking my seat in the consulting-room the master brought in and laid before me a large volume, the Workhouse Medical Relief Book. I turned over the pages for the week, and noticed the names and extras ordered for the sick. I saw that ham, sausages, tripe, fish, eggs, were entered rather frequently. At last I said to the master, who was standing by, "You surely have not all these people on the sick list in the House! I did not see a third of this number when I went over the House yesterday." "Yes," he replied, "they are here;" on which I said, "Let everything remain as entered in the book until I can arrange to go over the establishment and see them all, which I will do this week." I then went through the sick and infirm wards. On going through the wards I ordered what in my judgment was necessary for the sick in the way of medicines, much to the astonishment of the head nurse, who stared at me in a half-dazed manner. There was one patient with a very foul and offensive ulcer, for whom I ordered a charcoal poultice: she came to me before I left the House to ask me "what I meant." I replied, "A charcoal poultice." She then said, "I never heard of such a thing before." I then asked her how long she had been there; she said eight years. The next day I had occasion to order a carrot poultice; I met with the same astonishment and ignorance of what was meant. At last she frankly stated that she was about to learn her duties, for nothing of the kind had ever been used by her before; and further, she said that as she never had any medicine to give the people, she had not troubled herself much about the patients; indeed, I learned on inquiry that she used to be in waiting to see the doctor each morning, and so soon as he was gone she considered her duties were over, and she returned to her own sitting-room till next day. I could never get her to give my medicines as directed. Apart from this indifference as to medicines, she was kind to the patients and respectful to me. On the male side I found a superintendent nurse who really knew her duties. She confirmed the statement voluntarily made by Mr. French, that no medicines were ever provided for the sick. She also said that the Guardians knew all about it, and that they treated it as a great joke. This was not correct as regards some of the Guardians, as I subsequently ascertained. It was known to the St. James's section of the Board, but repudiated by those of St. Anne's. Seeing that we had had a medical inspector and self-called medical adviser for five years, whose duty it was to visit this Workhouse infirmary, his failure to discover these omissions was in the highest degree remarkable; but then the system prevailed at the Local Government Board, and our Workhouse Infirmaries Association had utterly failed to alter it. The reason for all this was not far to seek.
On the day after, in company with a pauper inmate, told off to carry the Medical Relief Book, I went through the wards for the purpose of seeing the infirm men and women who were on extras. I found on the women's side that, as it was leave-day, many had gone out, and therefore drew the inference that if they were well enough to go out they could dispense with sausages, ham, tripe, eggs, &c., entered against their names, and could eat the ordinary infirm diet provided by Dr. Markham's diet table, which I saw hung up in the wards, which diet table had been drawn up from the form drafted by our Association some years before. It is curious that he claimed it to be his, without any reference to any one. Whilst going through the female wards some of the inmates returned drunk, one old woman very much so. She at once proceeded to ask me who I was, and what I was doing there. On my replying that I had come into the ward to see why she was on a diet of daily sausages, she tartly replied, pulling up her petticoats and showing both her legs, which she struck with her hands, "For these bad legs." I at once ran the pen through her name. She lived in the House years after that, but she ate no more sausages. I learned on inquiry that this fat old woman, who could go out and return drunk, had had sausages, nominally, as her dinner for two years. I write nominally because I learned afterwards that in the matter of diets an extensive system of exchange obtained throughout the House without any check or hindrance on the part of the officials. It took me the greater part of four days to see all the infirm people on extras, but the result was satisfactory, as it enabled me to put the establishment so far as the diets were concerned, on an economic basis. The clerk of the Board assured me at the time that I had caused a saving of some hundreds of pounds, a statement which I honestly believe was the truth.
It might be a matter of wonder how this could be, but having regard to the very large amount of extras purchased from day to day, none of which were supplied under contract, it can be well understood what an opportunity was given for large prices being charged for such extras, as practically no check existed on the cupidity of the tradesmen (selected by the master) who supplied these things. I do not state that such was the case here, but unless some good understanding existed between those who ordered and those who supplied, how is it possible that masters of workhouses, with their limited incomes, should succeed in leaving at their deaths so much money, as many of them do? I was informed that the old master who preceded Catch at the Strand Union had gone there after failing in business as a tradesman in Covent Garden, that he held office as master twelve years, and when he died that he left some £2,000.
I found on inspection of the specially infirm, paralytic, and wholly infirm, that the women were located in wards 16, 17, and 18, and on inquiry discovered that there were no conveniences whatever for the instantaneous removal of excreta, and yet this condition of things had not been discovered by the Government Inspectors or by the medical advisers, or if it had been no steps had been taken to alter it.
On my first visit to these wards I noticed some black patches in the corners of the compartments, which stood out very distinctly from the recently whitewashed ceiling and walls. Noticing some days after that these patches had increased in size, I asked the nurse what it was due to, when she quietly said, "Those are bugs." So soon as I could I saw the master, and told him of it, and asked him to see to it. He did not say he would or he would not, he only laughed. Finding some days after that nothing had been done, I again saw him in his office, when I told him that I must insist on those bugs being removed. The labour master was present, who remarked, "Well, doctor, as you make such a fuss about the bugs I will see to it for you" (evidently regarding the matter in the light of a personal favour); and the bugs were swept down into a dustpan by hundreds and put into the fire and burnt. This was told me by an eye-witness, who was present whilst it was being done.
I do not wish it supposed that the master was harsh or cruel; quite the reverse, he was very kind to the inmates. But he had lived long enough in the service of the Poor Law not to be fully aware that no good would accrue to him or his by too much zeal in the performance of his duty. He calmly let things slide; consequently there was more drunkenness on liberty days than could be possibly imagined, and was unchecked, and although I repeatedly begged that the names of all persons who were on my sick list who had been allowed to go out should be reported to me if they came home drunk, I never could get my wishes attended to, though occasionally it happened that I discovered the circumstance, especially when an accident occurred.
I was not wholly unprepared for this laxity of discipline, as some few days before entering on my duties I met the ex-chaplain of the Strand Workhouse, who, whilst congratulating me on my return to the Poor Law service, said, "You will have a great deal to meet with at St. James's. I have taken the duty there for the chaplain occasionally, and the scenes of drunkenness and quarrelling among the inmates on their return home on liberty days, which I have witnessed, exceeds anything you can imagine." One of the most terrible exhibitions of this kind I ever witnessed was on the first Christmas Day after my appointment. The subject having previously been brought under the attention of the Board, an order was issued that for the future this indiscriminate permission to the inmates to leave the house on Christmas Day should be stopped. It will hardly be believed that on the next Christmas Day the Chairman took upon himself, most presumptuously, to go to the House and give permission for them to again go out. The scene that occurred that night was the most disgraceful that ever happened in the history of a workhouse. Several of the drunken inmates on their return home fought like demons. I and my assistant were engaged for some time in dealing with the injuries that were caused. I must state that I never saw the master so justly indignant as he was at the impertinent interference of this Chairman, in setting his authority and that of the Board at defiance in the way he had done.
Finding that no dietary for the sick and infirm had been adopted at the House, I at once drew up a form which continued in force until ill-health caused my resignation. It was similar to that which I had introduced at the Strand several years before. There was one diet for which I claim especial credit. It was framed with the view of dealing with capricious appetites or severe sickness. It was called Number Five, or ad. lib., and consisted of either eggs, fish, a chop, beef-tea, or arrowroot, or anything else of the same value. It was enjoined that the nurse should at 8 a.m. ask what these special sick would take for dinner. When she had ascertained the wishes of the patient, a statement on a diet-sheet showing how many of each description of diet would be required was sent down to the kitchen. At the end of the week the cook handed to the master's clerk the number of each diets she had supplied, who then proceeded to distribute these among all those who were on ad. lib. diet. It might appear on the master's side of the Medical Relief Book that A or B had had a chop daily, whilst in reality the dinner might, by this arrangement, have been changed every day. This plan of dealing with capricious appetites has since been adopted in several workhouses.
Although five years had passed away since the Metropolitan Poor Law Act had become law, no attempt had been made to carry out the dispensary clauses until after my election, and one of the first things I had to do was to put the dispensary in order. I had been taught a lesson in economic prescribing whilst at the Strand, and therefore was enabled to speedily arrange for a pharmacopœia. I also drew up a formula for the supply of large bottles of simple medicines, which were placed in charge of the nurses, for administration in trivial ailments so common among the aged poor. I also introduced bed pulleys, to enable the sick to assist themselves in rising, or in getting in or out of bed. I also ordered small shawls for the aged women and woollen jackets for the men—a great comfort to those who were suffering from consumption or bronchitis, the principal affections I had to encounter.
I have stated that although it was midsummer the House was full of sick people, which arose partly on account of the sickness that prevailed in the worst part of St. Anne's and similarly in that of St. James's, and also to the fact that the Chairman had opposed the transfer of any of the sick to the Sick Asylum Hospital, at Highgate, to which the Westminster Union, in conjunction with the Strand, St. Giles's, and St. Pancras, was affiliated. He had opposed the junction of the two parishes on personal grounds, and being beaten, had, in conjunction with his party, obstructed the removal of the acutely sick.
As medical officer I did not object to this, for as the sick wards were extremely good and were all that I had desired to carry out when I initiated the Workhouse infirmary movement, I simply complied with the wishes of the majority of the Guardians not to send any one away. I had held office some weeks when, in the autumn of the year, I encountered Dr. Drydges in Regent Street. This gentleman, who had acted temporarily whilst Dr. Markham was ill, had about this time been permanently appointed to be Metropolitan Inspector, Dr. Markham having resigned. He came up to me and said, "I was coming to the Westminster Union to learn why it was you did not comply with the law, and send your acute sick away." "Oh," I replied, "that is soon explained; it is because the majority of the Board will not let me." "Indeed," he said; "you must do your duty, even if the Board object to it." To which I replied, "I did that at the Strand, and your Secretary called on me to resign because I was not sufficiently respectful to the Guardians. I shall comply with the wishes of the Guardians now, and not with that of the Local Government Board, as they would throw me over." To which he rather angrily replied, "You speak to me like that, when I am an Inspector, and you only a Workhouse medical officer?" To which I answered, "And who, pray, made you a Poor Law Inspector. Why, if it had not been for me and my initiation, neither you nor Dr. Markham would ever have been Inspectors." "Oh," he replied, "I did not know you had had anything to do with it." "I think," I said, "if you will trouble yourself to inquire you will find what I state to be correct." When I broke down in 1886, and he had to call and see me, he was then most kind and sympathetic, and I take this opportunity of stating as much.
This refusal on the part of the majority of the Board, led on by this Chairman, to allow me to send suitable cases of sickness to the Asylum Hospital, was in the highest degree absurd, seeing that the ratepayers of the Union had to pay their proportion of all expenses at the Asylum Hospital, and for the beds to which the Union were entitled; and although this Workhouse infirmary was a perfect paradise in comparison with the den at the Strand, still the House had not been arranged on the principle that all the sick should be retained in it. My nursing staff was insufficient to enable me effectually to deal with the great number of sick persons there at the time of my entrance on my duties. One illustration will suffice. There was a man in an infirm ward who had been under Mr. French some five or six years. He did not belong to Westminster, he was kept there because he alleged he was so ill that he could not bear the fatigue of journeying some sixty miles in the country. He was a healthy-looking man about forty years of age. He always lay in bed with his knees drawn up, and constantly asserted that he could not stand nor walk, nor put his legs down. He complained piteously of his sufferings. I exhausted every conceivable treatment, but all without the least apparent benefit, as he never owned to being any better for my attention to him. This went on for two years, until I began to get suspicious of him. One day an inmate of the ward, who had recovered and left the House, called on me at my private residence. On seeing me he said, "I have called to thank you for your kindness to me, and also to tell you that you have been deceived by that man Webster, who you have done so much for. He is an impostor. He can walk as well as I can, and, what is more, does walk about." "Nonsense," I replied; "he says he cannot get out of bed, and the nurses confirm it." "Well," he continued, "he takes very good care never to allow them to see him get out of bed, he takes his constitutional walk about the wards between 2 and 4 a.m., when the lights are down, and most of the inmates asleep." "But, surely," I said, "the night nurse must have seen him, and if so she would report it to me!" "Oh," he replied, "she hardly ever comes into the ward during the night, she is generally in her own room fast asleep—she gets herself called when she is wanted." I made some further inquiries, and finding that there was evidence of deception, I sent him to the Asylum Hospital with a letter to the superintendent medical officer, giving his history, and telling him of my suspicions, and asking that he might be carefully watched by reliable persons. He came back in a fortnight, having been found out. He was immediately transferred to his settlement, where doubtless he recommenced the game of deception, having found it answer so well.
It may be here said, If you had not confidence in your nurses, why did you not get rid of them? For the simple reason that I had no power to do so. They were not selected by me, but by the Guardians, and therefore were not my officers, but the Board's. I once reported the night nurse on the male side (the woman who had allowed the malingerer to deceive me) for drunkenness, but I had so much trouble to get rid of her that I was not induced to repeat the experiment, added to which I was most grossly insulted by the master for bringing this woman's conduct before the Guardians.
In my opinion the medical officer should select and discharge all the nurses—of course, reason for this latter action being shown. I should have discharged several at the Westminster Union for neglect of duty and for general incompetence if I had had the power. Simple complaint would be attended by no beneficial result, as it would be a hundred to one that the nurse would be supported in her misconduct by some member of the Board, whose protege she might be. On mentioning this to an ex-workhouse medical officer, he told me that on having occasion to represent the conduct of the resident midwife, who claimed and exercised the right to go out on every Sunday for several hours, leaving the wards wholly unattended on every such occasion except by pauper helps, the only action taken by the Board as a return for it, at the instance of the midwife's friend, was the adoption of a resolution that a return should be prepared and laid on the Board-room table, showing the occasions when the medical officer went out and the length of time he was out, &c., &c. Of course he found out that he had achieved worse than nothing by his effort to check this abuse. This circumstance occurred in one of the largest of our metropolitan workhouse infirmaries.
When first I entered on my duties at the Westminster Union the chaplain there was a very energetic little man named Duval. I do not remember his Christian name, for the reason that he was known and spoken of as Claude Duval, and for a long while I supposed him to possess no other. At last I discovered that the name had been given him in joke, and that he was in no way connected with the celebrated highwayman. He most assuredly did not convey the idea that he had any brigand blood in his veins. He was extremely attentive to his duties, and deserved and had gained the respect of all the inmates and officers.
Frequently he organized entertainments for the aged and infirm. These were held in the dining-hall, which on all such occasions was crowded to excess. After I had held office about a year he desired me to provide an entertainment, which I did on several occasions, and my efforts met with much success. In the carrying out of these entertainments, which were musical and recitative, I had the assistance of my nephew, Mr. Julian Rogers, and his wife, who brought with them vocalists of a high order, who contributed much to the pleasure of the inmates. These entertainments were highly appreciated by the inmates, and were frequently attended by members of the Board, and by some of the ratepayers living in the neighbourhood. Now and then I used to read extracts suitable for penny readings. On two occasions my efforts took a higher form, when I gave a lecture on the "Ear and Hearing," and on "Sight and the Eye." The preparation of these lectures and the diagrams to illustrate them was a work of considerable trouble and some anxiety, but the signal success achieved on both occasions amply repaid me for any trouble occasioned. To show the appreciation of my audience for a joke, I will relate an incident that occurred during the delivery of my lecture on "Sight and the Eye." I was describing the function of the iris, or coloured portion of the eye, as an involuntary movable veil, which regulated the amount of light which should be admitted to the eye, and said that in order to make the veil complete it was covered behind with a black pigment, so as to exclude all light except that which passed through the pupil. I then told them that in certain animals this pigment was wanting, and not only there but in the skin generally, and instanced the white mouse, ferret, &c., and showed that all these animals had red eyes and always blinked and winked when exposed to a strong light. I then passed on to state that this condition was sometimes found in man, where again the winking and blinking was noticeable as well as the whiteness of the skin and hair, from the absence of this dark pigment, hence the name of "albinos" applied to those thus afflicted. I then went on to state that recently we had a notable example of this in the Chancellor of the Exchequer, who suffered from this infirmity, and that his dread of light was so extreme that he had attempted actually to put a tax on matches. This joke was followed by a positive scream of delight from visitors and inmates—showing that Mr. Lowe's fiscal effort to increase the revenue was known to them all. At the conclusion of the night's proceedings, Miss Augusta Clifford, who was present, came up and said she should repeat my story of Mr. Lowe and the match tax wherever she went. At the next meeting of the Board, several of the Guardians having been present on the occasion referred to, it was moved and seconded and carried unanimously, that a vote of thanks should be given to Dr. Rogers for the entertainment provided by him, and for the highly interesting and instructive lecture which he had delivered.
I found in the sick and infirm wards several of my old acquaintances of the Strand, who were chargeable to St. Anne's, and had been transferred to this House when the Union was formed, among them a woman by the name of Maria Hall. She had gone into the Strand several years before I left; her friends at first paid for her maintenance. She was an epileptic—and something beside. When I knew her in the Strand she professed an inability to talk, except unintelligible gibberish. She was very artful; she claimed to be a deeply religious character, and contrived to take in the benevolent lady visitors to a considerable extent. She continually showed me letters she had received, and books that had been given her by ladies, and would ask me to share with her the grapes, cakes, and sweetmeats sent her by her dupes. This went on for several years, altogether about twenty. She always posed and was spoken of as "poor Maria"—in fact, she was the pet of the nurse and of the ward. At last it came to my knowledge that she presumed on her condition to be exacting and troublesome. Finding that remonstrance was unavailing, I reluctantly ordered her removal to the insane ward. It was attended with the best result, for, finding that she was at last sternly dealt with, she threw off the mask she had worn for twenty years and talked as distinctly and clearly as any healthy person. She had traded for years on her alleged infirmity. It was true she was an epileptic, and eventually died from that form of disease; but she had been the most persistent cheat I had ever met with.
On the male side I found a poor fellow who had also been transferred from the Strand, where I had known him when he was first admitted there. He was paralyzed all down on one side. He was the most patient, honest fellow I had ever seen. After I had been in office some years Sir Charles Trevelyan came to call on me respecting a public movement that we were both engaged in. Finding I was at the infirmary, he came round to the House and was shown into my room. I asked him to go over the wards with me. He did so. I introduced the poor paralytic to him as an honest, patient, and grateful poor man. Sir Charles asked him how long he had been afflicted, and he answered, "Some twenty years." Then I said, "This poor fellow cannot get downstairs; he has not seen the streets for all these years, but he is always happy and cheerful." Sir Charles kindly left with me £1 to pay his cab fare, so that he might have the chance of seeing them once again. As I had to send two people with him each time the £1 soon went. His enjoyment of this treat in his daily dull, routine life was, I was informed, most pleasing to witness.
There were several other very interesting persons I found on both sides of the ward. One was an old man who was said to be eighty-eight years old. On my morning visit he was always standing on the staircase smoking. He had lived many years in Australia, and his long white hair and beard, which reached to his waist, conjoined with a florid complexion and bright blue eyes, caused me to consider him one of the handsomest old men I had ever seen. One day I took two young ladies over the infirmary. We found the old man in his usual place. I jocularly introduced him to them as the Adonis of the House. The old man was terribly offended. As we walked away I heard him muttering aloud, "That's a pretty name to call a man—'Donis indeed!" He did not forgive me for a long while. I wonder what he thought the epithet really was intended to signify.
I also found in the male infirm ward an old French physician whom I had known by sight for a great many years when he was practising his profession in Soho. He was a tall, fine man when I first knew him. He always used to wear a very singular-looking broad-brimmed hat. He was in all externals a very gentlemanly-looking person. I had missed him for a long time, and was surprised and hurt to think that he should have drifted to a workhouse infirmary. On inquiring into the cause of his becoming an inmate of the House, for I always thought he was well-to-do, as he dressed exceedingly well, I learned that he had lived with a lady who was an employé at a French milliner's in Regent Street, that she was much younger than he was, and that he had given to her all his money, which she, in preparation for possible consequences, had put in the Funds, but in her own name only. Unfortunately for him she was taken suddenly ill, and being ignorant of English courts made no disposition of the property, simply telling him, on her deathbed, where it was. When she was dead, he found to his dismay that the money could not be obtained, as he could not establish any legal claim of ownership. Grief at the loss of his mistress and of all his money caused the complete break-down of the poor fellow, and he had come into the House utterly crushed. He was a very interesting old man, being the only son of a French noble family. His mother and father were both executed during the Reign of Terror, and when the family property was confiscated he was but a youth. When he grew up he studied medicine, and in the year 1802 entered Napoleon's army as a regimental surgeon. After serving with his regiment in Germany, Italy, and Austria, he was attached to the Army of England, as it was called, which was stationed on the heights of Boulogne. He was there some time. Suddenly an announcement came that the encampment would be broken up, and that the army would go to Russia. He traversed the whole of Europe, taking part in the various engagements on the road to Moscow, which he saw in flames. He was in the memorable retreat, and returned to France without a scratch. On the return from Elba he rejoined his old regiment, and, as its surgeon, fought against the English at Waterloo. After the peace his regiment was disbanded, and as the old soldiers of the empire were very much at a discount he elected to come to England, where he lived since 1816. He died at the age of ninety-five, retaining his faculties to the last. After his death I raised a fund to bury him, by writing a letter to The Times, in which I gave his history, heading my letter, "A Relic of the Grand Armée," and asking any friends of the first Napoleon to help me in burying him in some other place than a pauper's grave. My appeal having brought me £25, the Empress Eugenie being one of the subscribers, he was buried at the Catholic Cemetery at Kensal Green. There were two seamstresses who lived in Gilbert Street, Oxford Street, who were his countrywomen and his sole visitors, with the exception of the Catholic priest of the French chapel in Leicester Square. I asked them and the priest to accompany me to the funeral, which I attended as chief mourner. On our arrival at the mortuary chapel, the coffin was placed on a raised bier with three others. Presently two lads, wearing long black cloaks which reached to the ground, came from the altar. When they arrived at the spot where the coffin was resting, one lad suddenly produced from under his cloak a censer containing fire and proceeded to incense the quartette. How he ever carried the fiery thing without setting fire to himself was to me a wonder. He was immediately followed by the other lad, who, taking just as rapidly from under his cloak a vessel like a whitewash-pot, proceeded with a brush to throw holy water on the coffins. This being completed, the coffin was put on a truck and we hurried away as fast as we could go through the miry ground for a long distance to the grave. On reaching it, down went my two lady companions on their knees in the clay. My respect for the deceased did not carry me so far as that, especially as it was raining hard and the ground was a mere bog. Presently the acolyte produced his whitewash-pot and brush, and I was courteously asked to sprinkle the poor fellow's coffin with holy water, which I did. This having been also done by my companions, I was amused by a little girl about fourteen, who, suddenly taking the brush and pot from one of the young women, went to work sprinkling in grand style, and, what was rather alarming, let me in for more than I had expected. On our return journey the priest asked me to attend service in the Catholic Chapel, in Leicester Square, on the next Sunday. This I did. He was a very gentlemanly person. He thanked me very much for the little service I was enabled to render to the poor old French doctor, whom I missed very much, as it was my habit to sit beside the old man's bed and hear him fight his battles o'er again.
The opposition to the removal of the sick to the Asylum Hospital at Highgate continuing, and plausible ground for some action having been shown in the fact of that establishment being so far away, a move on the part of the Department became necessary. The old Workhouse in Cleveland Street being no longer wanted by the Strand Board (as they had built a new House at Edmonton), it was proposed to pull down and rebuild an additional Asylum Hospital upon the site. The vestry of St. James's, instigated by the Chairman of the Board, gave a determined opposition to the proposition. But for once the Department was firm and the hospital was built. At first the four Unions were associated in its use and management, but after a time its use for the reception of acute cases was limited to the St. Giles's, and St. George's, Bloomsbury, the Strand, and Westminster Unions. The Chairman having for a time retired from the Board, his place was filled by a fresh Chairman, and no obstacle being made to my utilization of Cleveland Street Asylum, suitable cases were transferred there, to the relief of the Westminster House, which, through the resistance of the Board, had become inconveniently full. The new Chairman was a very weak man, who was neither by his financial position or general intelligence justified in aspiring to hold such an office. It is possible that if he had devoted the time he spent at the Board and at the Sick Asylum to his private business he might have delayed, and possibly have staved off, his eventual bankruptcy and ultimate death in the Asylum Hospital in Cleveland Street, to the building of which he gave the most determined opposition. His successor as Chairman was a surgeon in Soho, who was a man of very fair attainments, and during the time he occupied the chair the business of the Board was carried on with remarkable success. I received from him the most generous support, and during his tenure of office my official life was hardly chequered by a single cloud.
I have spoken of the clerk of the Board as having expressed a favourable opinion of the economy I had effected on my first entrance on my duties. The clerk had occupied a similar position at St. Martin's prior to its amalgamation with the Strand Union. As I never went near the clerk of that Union after the discovery of his perfidy in making, in conjunction with Catch, a false charge against me, I was often at a loss to know to whom I could go when any difficulty cropped up. Having had an introduction to this clerk, I frequently called and consulted him; consequently I was not surprised when, through the loss of his office, as the result of St. Martin's being joined to the remaining parishes of the old Strand Union, he was without employment, that he should call on me and invoke my good offices in favour of his being appointed to a similar position in the Westminster Union—the gentleman who had filled the office and that of vestry clerk for St. James's having elected to continue in the latter office only, and not to combine therewith any appointment under the Poor Law. Having some influence in St. Anne's at that time, and being also known in St. James's, I gave him my support, with the result that he was elected clerk to the Board. He never exhibited gratitude for my doing this; indeed, on the contrary, he was distinctly hostile to me during the first few years after my appointment, more especially in all matters relating to lunatics, the truth being that he had a sympathy with all those who were alleged to be of unsound mind, arising, I consider, from the fact that he had a consciousness of not being quite right himself. During the two-and-twenty years I knew him I never saw him half-a-dozen times with a shirt on. I do not state that he never wore one, it was simply never visible; what did duty for it was a sheet of more or less crumpled whitey-brown paper. His clothes were as torn and ragged as those of the most poverty-stricken casual—his shoes down at heel, and the legs of his seedy-looking black trousers hanging in rags. He always complained of being so very poor through the strain put upon him in having to support some needy relatives. His condition and poverty-stricken appearance were often the subject of conversation and commiseration: "Poor fellow," it used to be said, "he has had a great deal of trouble, and is very poor." It was therefore a matter of great astonishment to find, after his death, which took place somewhat suddenly, that he was possessed of several thousand pounds. He died without making any will, and there was a legal struggle among distant relations as to who should secure his very considerable belongings. I have frequently noticed on the part of eccentric people this disbelief in and morbid sympathy with lunatics, and believe it to arise from a species of innate consciousness of mental deficiency, and a fear lest they also should be incarcerated.
One morning, some time before his death, he came to me in my room and showed me a letter he had received from the military Commandant of Devonport Barracks Hospital, which was to the effect that they had a young soldier under treatment for lunacy, who, in his attestation when enlisting, had stated that he belonged to St. James's, London, and that the authorities determined to send him up to us. The clerk said to me, "That does not show that he belongs here, as there are several St. James's in London; I shall write and refuse to take him until his settlement has been determined." But he reckoned without his host, for when did the military ever recognize the civil power? The same evening I was requested to go to the insane ward, where I found the young soldier, and the attendant informed me that he had been brought by a corporal and left in the ward, and that the corporal said that he should call the next day for the hospital clothes. The attendant also stated that when brought in the man's hands were tied together behind his back. I could make nothing of the poor fellow, as no history was brought with him, and he would not speak. As he appeared to be very exhausted I ordered him some milk, beef-tea, and wine, and desired that when the corporal called the next day he should be detained, so that I might learn something about the patient, but when asked to stay and explain, the corporal would not stop.
On visiting the man on the next morning I found that he had taken nothing, and as he would not open his mouth, speak to me, nor do anything, I sent for the stomach-pump and some of the strongest of the pauper inmates, that he might be fed by artificial means. It took four to take him out of bed, secure him in a chair, and to assist me to get his mouth open, when I made the dreadful discovery that all his teeth had recently been broken away in the forcible efforts that had been made to feed him. After a most desperate struggle I administered some beef-tea, arrowroot, and wine. This had to be repeated for two or three days, until the necessary certificates were ready, which enabled me to send him away to Hanwell. I was so disgusted with the barbarous manner in which the young man had been treated, that I wrote an indignant letter to the military authorities at Devonport, complaining of his treatment, and their neglect in sending the poor fellow to the Workhouse without affording any history of his case. The reply was a cool denial of the truth of my statement, and an assertion that he took his food readily and without artificial feeding. I sent this letter to the medical superintendent of Hanwell, and asked for his opinion, when he replied that the man had been forcibly fed for some time, and that his teeth had been destroyed in doing so. I then wrote an account of the case and sent it to Dr. Lush, M.P. for Salisbury, and asked him to see the Minister for War on the subject, and in the House to ask the question I had drafted.
A few days after Dr. Lush replied, telling me that he had seen the Minister, who read the statement, and said he thought that it was a very shocking story, but he hoped that I would not press for an official inquiry, as it would ruin the officers inculpated, and promised that he would send out to all military hospitals such an instructional letter as would prevent the occurrence of such things in future. Dr. Lush also added, "I have promised not to press the matter, especially as the Minister for War did not hesitate to tell me that he entirely believed your statement," and continuing, said, "I know, Rogers, you do not want to ruin anybody, and if the matter is made public there will be a dreadful row, and the whole blame will be thrown on the doctor." I reluctantly assented to this view, and the matter dropped.
The poor fellow was afterwards proved not to belong to St. James's, Westminster, but to some parish in the East End. He did not remain chargeable to any parish very long, as he died soon after at Hanwell. Dr. Raynor, when I appealed to him for his opinion, stated that if I had not written at the time of his admission and explained how I had become possessed of the man, he should have felt it his duty to have made a special representation to the Commissioners in Lunacy as to the condition he was in on admission, and the barbarous usage he had received.
When at the Strand I was required to give the certificate in lunacy and attend before the magistrates in its support, and was paid a fee for my trouble; when appointed to the Westminster Union it was arranged that my salary should include all extra fees, particularly because the magistrates at Great Marlborough Street, contrary to the statute, required two certificates. The Guardians being unwilling to pay the fees of two medical men, the medical man called upon to give the second certificate was paid. As this appointment was dependent on the caprice of the Board, it frequently happened that the other medical man, who was aware of the feeling of certain of the Guardians, would refuse to endorse my opinion, but I always succeeded in getting my way in the end. One medical man who held this office for some time was constantly striving to secure favour by giving the most unaccountable certificates as to the condition of the lunatic submitted to him. I had the satisfaction of getting rid of him at last, but not until he had given me and the officers of the House a great deal of unnecessary trouble and annoyance. In addition to this, the magistrates at Great Marlborough Street, forgetting altogether that when two certificates were presented their duty became simply a ministerial one, would frequently decline to certify for removal of undeniably insane persons, and direct the return to the House for further observation. No magistrate was more original in this way than Mr. Newton, of Miss Cass notoriety. Over and over again Mr. Newton has set up his expression of opinion in opposition to my certificate and that of the extern, but after giving unnecessary trouble and delaying the removal of the patient, thereby diminishing her or his chance of recovery, he would eventually be obliged to affix his signature to the certificate. To such an extent did this action prevail, and so much were the officers worried by this magistrate, that it became a custom on the part of the removal officer to send and inquire what magistrate would be on the bench, and if he found it was Mr. Newton, to take the case on the next day when he was not there.
As I am on the subject of lunacy, and as I believe that much mischief has ensued from the laity assuming that persons are improperly confined in asylums, I will relate one or two instances of ill results that have followed from treating insane persons as responsible for their conduct when a very small amount of consideration of their actions would show that they were of unsound mind. Upon one occasion, on going into the male insane ward, a tall, decent-looking man, turned round and looked at me. His aspect instantly told me that he was of unsound mind. To my inquiry where he came from the attendant replied, "I do not know, sir; all I do know is that his wife brought him here yesterday and left him". I spoke to the poor fellow, and was perfectly convinced that he was insane. I directed the attendant to go for the wife. On my return from the wards to the consulting-room I found a decent-looking little woman waiting my arrival. To my inquiry what she wanted, she said, "You sent for me." "Oh," I replied, "you are the wife of that poor fellow over the way in the insane ward—how long has he been out of his mind, and where have you brought him from?" To my astonishment she burst into tears, at the same time saying, "He came out of prison yesterday, sir." "Out of prison," I replied; "why, how could he have got into a prison? That poor man has, to my certain knowledge, been a lunatic for a long while." She immediately said, "Yes, sir, I have known it for nearly a twelvemonth, but no one but you has ever said so before." I told her to compose herself and tell me his history, when she stated as follows: "We have been married about five years, and a better husband no woman could have had, but about a twelvemonth ago he complained of his head, and could not sleep or work as he had done. I did my best to cheer him up, and told him to struggle against the feeling and all would come right. His occupation was that of a coat-maker for one of the best West End master tailors. One afternoon, some months ago, he threw down a coat he was making, saying he could not go on with it, he must go out, which he did. About an hour afterwards a policeman came to tell me my husband was in Vine Street Police Station, and that he had been taken up for stealing. I hurried there, when I heard that, walking along Little Pulteney Street, he came opposite a poulterer's shop, when, suddenly springing on the show-board, he clambered up by the hooks till he reached the top, and, taking off a hare, he put it over his shoulder, and jumping down some ten feet, he stood there. The proprietor gave him into custody. The next day he was taken before Mr. Knox, who committed him for a term of six weeks' imprisonment and hard labour, it being his first offence.
"Whilst he was in prison I had to part with many of my things to keep my children. On his discharge I met him at the prison gate, and saw he was worse. I did my best to cheer him up, and told him if he would not do anything of the kind again I would do all I could for him. On his reaching home I said that I had been compelled to part with some of our things, and that, therefore, he must go to work at once. The same day I went to one of our employers, a master tailor in Maddox Street, and asked for some work. A dress coat was given me to make up. My husband went to work at it, but he did it so badly that when he took it to the shop the master refused to pay him, and gave it him back again. During the conversation my poor husband took off a pair of black dress trousers from a hook, and put them under his arm. He had not long left the shop when it was discovered, and one of the shopmen, running after him, caught him with the property. He was again given into custody, and taken before Mr. Knox, who committed him for trial. At his trial at Clerkenwell Sessions shortly after, he was found guilty, and evidence of a previous conviction having been given, he was sentenced to six months' imprisonment and hard labour. That his time was up yesterday morning, that she had met him at the prison gate, and seeing that he was much worse she had brought him straight to the Workhouse, so that he might be kept out of further mischief." She followed it up by saying (with a burst of tears), "You are the only gentleman who has ever said that he was not right in his head, but I have known of it for months past."
I stood utterly astonished that so gross a miscarriage of justice should have been perpetrated; that a man evidently so bereft of the knowledge of right and wrong should have been punished as a criminal. After inquiring where she lived, and also for some references, I told her if my inquiries bore out what she had stated, I would publicly expose the treatment her husband had been subjected to. I made inquiry the same afternoon, and found that both the husband and wife had borne a most excellent character up to the time of his first arrest. The next morning, so soon as my official duties were over, I went to Great Marlborough Street Police Court, and asked to see Mr. Knox. I related the story to the magistrate. When I had finished it he was very much affected, and expressed his regret that such a dreadful thing should have occurred. He also went on to state that they had so many people brought before them, and it was all done in such a hurried way, that without special attention was drawn to a case, and if the facts were not disputed, and if no one appeared for a prisoner, a decision was come to at once. He further said, "I remember the poor fellow being brought before me perfectly. I do not think that it is desirable that this story should be made public; it can do no good. Send the wife to me and I will give her a present from the poor-box."