CHAPTER I THE STRAND PART II When the letter was read at the Strand Board, a suggestion was made that I should be offered an increase of my stipend and be required to purchase the medicines myself. This I declined. Ultimately, it was a range that I should be allowed to order drugs of a wholesale chemist but only to the extent of twenty-seven pounds a year. Anything beyond that I was expected to pay for myself. About this time, 1862, the matron informed me that on the previous day a very aged woman had been admitted and that she had sent her to the infirm ward across the yard. On looking at the order I found it was stated that she was a hundred and four. I went to see her. She was undeniably of great age but she still retained her faculties and conversed with me for some time. She told me that she had lived in Chancery Lane between fifty and sixty years and was forty-five years old when she went there to live. She also told me that she went down the lane to see Nelson's funeral procession go by, that her children and her grandchildren were dead, and that she had been looked after lately by her great-grandchildren who had grown tired of waiting on her and that was why she had come into the house. Her eyes were blue and complexion fair. She did not live long after her admission, the change from her own airy room to the close and, at times, fetid atmosphere of this overcrowded ward was too much for her aged frame. She passed away quietly and I remember filling up a death certificate for a hundred and five years. One day I was informed that a very distressing case had been passed from Canterbury. It was a young woman, about twenty-four. She had one child and was about to be confined again. It would appear that she had married a coach-builder who was born in St. Paul's Government Garden. She told me that he was a very good, quiet man, went sober, and had been very kind and good to her, but that when he took anything to drink he became as one insane, and in one of his drunken fits he had knocked a man down and killed him. That he had been tried and found guilty of murder and was then lying under sentence of death. I also learned that the guardians of Canterbury had passed her on to us away from all her friends. The poor creature was simply broken-hearted. She had a very bad confinement and remained long, sick, and ill. When she got better she made an application to the Strand Board for outdoor relief. She was told to come before the Board at the next meeting in Bow Street. It was, unfortunately, a very wet night, and being thinly clad, she got wet through and sat in her wet clothes two hours. She also got wet on her return journey. That night she was seized with inflammation of the lungs and remained for many weeks in the Greatest Jeopardy. Ultimately she got better when I sent her to a convalescent home in Archercher. She was so patient and grateful that I wrote an account of her sad story, which was published in the Morning Star. It evoked donations amounting to twenty-five pounds. After buying her some additional clothing I paid her journey for self and child to Canterbury. The baby had died, handing her as she went some twenty pounds. The Board at my request allowed her outdoor relief for a twelve month. Some years after I happened to be in Canterbury when I found her out. She had been in the same situation some seven years. She had supported herself and child, and had no occasion to spend the money I had collected for her. Altogether she fully bore out the opinion I had formed of her. The reason why the Guardian Board had acted so harshly to this young woman was this. If they had allowed her to remain in their workhouse until after the execution of her husband, as a widow they could not have removed her for a twelve month. They therefore sent her away at once to avoid this dilemma. About two years after Mr. Catch's departure I was surprised by a visit from the medical officer of the Newington Workhouse. He told me that he had called to ask me whether I could advise him what he was to do. But Catch obstructed him in his duty, swore at him, and refused to obey his orders. I told him to go down to the poor law board, but that they might or might not assist him. Unfortunately at that time Mr. Farnel was away in Manchester superintending the special relief arrangements in Lancashire with regard to the cotton famine, and there was no one at the board who could or would advise him. He called on me on several occasions subsequently to tell me of the misery he daily underwent. On one occasion I told him to write down in a journal all instances of obstruction and, if possible, get every case verified by a witness. Sooner or later you will catch him, I said. He followed my advice. One day he came to me and told me he thought he had got together sufficient evidence and should now ask for an official inquiry. Mr. Farnel, one of the most honorable poor law inspectors the board ever had, had just then come back to town. I got some influence to bear on the board and an inquiry was granted. It lasted some time, and Mr. Simmons approved the obstruction and so forth so completely that on the last day and when it was evident how the case would go, Catch followed the doctor and paid the nurse out of the boardroom. They stopped in one of the day wards to discuss the case and its probable results. When Catch went to his office and wrote in his journal that he had surprised the pair holding improper relations. This charge, coming to the knowledge of the nurse, who was a respectable young woman, she went at once to the physician Akashir of Guy's Hospital and requested that he would examine her. This he did when he gave her a certificate that Catch's allegation was untrue. A special meeting of the board having been called to investigate this charge, it was made absolutely clear that Catch had hatched this foul accusation. The board immediately suspended him. The circumstances were reported to the poor law board who called on him to resign. It will hardly be believed that after this, Catch, mainly through the influence of his friends at the Strand Board and the aid of the clerk, got appointed to the Lambeth Workhouse where for some time he tyrannized over the subordinate officers and inmates, until at last, his cup being full, he lost that appointment also. Hereafter I will give the particulars of this episode and of the notable trial in the Court of Queen's Bench where he attempted to clear his character and get reinstated. For five or six years after the departure of Mr. Catch, my life was a fairly pleasant one. There was no obstruction from the master or the matron, and as there was nothing to ask of the board, things went on quietly, and therefore the daily duty ceased to be onerous added to which I had several pupils whose instruction in the wards was to me a very agreeable pastime. Here let me remark how melancholy it is that the vast field for clinical observation and study, which the sick, nursery and lying in wards of large urban workhouses of Ford, should be utterly thrown away. There are certain diseases which can hardly be seen anywhere else, such as those of young children and of aged persons, and yet they are completely ignored. I have said that for a time everything went on peacefully, but a rude awakening was in store. For about the years 1862, 65, in consequence of widespread distress in the metropolis, persons were admitted beyond the capacity of the house to hold them. This necessitated a representation to the board, and as a consequence a revival of the antagonism from the so-called economical members of the board who charged me with being too squeamish and with having brought the influx on myself by being too indulgent to the sick. The hostility went so far with one guardian who considered me so very troublesome that he put a notice on the agenda to reduce my salary. This was renewed by him from time to time indeed whenever I made a representation to the board on this subject, that there was abundant cause for such representations will be understood when it is stated that in consequence of the overcrowding and the heated and vitiated atmosphere caused thereby cases of fever induced therefrom were constantly cropping up, and it was one of my perplexities how to deal with them. In those days there were no such facilities as now exist for sending fever cases away to separate asylums and we had to do the best we could. Having in 1863 had a succession of boys affected with fever sent in from St. Anne's Soho I inquired of the relieving officer from where they came, whereupon he informed me that a Mr. Williams, a clergyman in Porter Street Soho, had opened a home for friendless boys. On interviewing this clergyman I told him that I had called to protest against his sending these fever cases to the workhouse there being no room for them. He replied by asking me what he was to do with them as at that time he had some four or five boys down with fever and then he took me into an old disused slaughterhouse where on some straw I saw these lads lying ill. Before leaving him I arranged that he should go over the house and see for himself that there were no vacant beds. On the morning appointed he came bringing with him a person whom he represented to be his secretary and who he asked to be allowed to take with him. No objection being made he accompanied us. I was somewhat surprised at the bearing of this so-called secretary and still more so at his conduct at the house when he went through the wards. I thought he was a very intelligent gentleman and wondered at him occupying the position of secretary to Mr. Williams at say a pound a week. I satisfied Mr. Williams that I could not continue to take in his numerous waifs and strays and on leaving his companion parted from me with many expressions of thanks for my courtesy in allowing him to accompany me. I had not the least idea who he was or his name but I felt pretty sure that he must be a gentleman. It transpired subsequently that he was no other than Mr. J. Alexander Shaw Stewart and my chance acquaintance became in after years one of my kindest and truest friends. As a result of this interview with Mr. Williams a school was opened called afterwards the Newport Market Refuge Industrial School and for several years it was under my medical charge. During the years I was connected with that establishment I never had a case of fever of any kind although the school was located in a densely crowded and repulsively degraded neighborhood. It was a striking instance of what could be done in keeping schools free from epidemic disease if only the persons having control of them adopt and strictly carry out judicious sanitary arrangements. During my period of office I made the acquaintance of the Duke of Westminster, Mr. Mrs. Gladstone the latter of whom was a frequent visitor there as well as many ladies of rank and so forth. About this time there came an urgent request to go to the house. On my arrival I found a young German woman at near her confinement who was in a state of great mental distress. On asking for an explanation I was informed that the day before a gentlemanly looking person had called at the house and asked to see the matron. To her he stated that he was a medical man and had been commissioned by the friends of one of his patients to look out for some healthy young woman near her confinement who might be engaged as a wet nurse by a lady under his care. The master brought down to him this girl when he instructed her to send her next day to his consulting room where the lady's friends might see her. She accordingly went. Shortly after her arrival there she rushed out of the house stating that she had been insulted by the doctor. Police aid coming to her assistance the doctor's residence was visited with the result that he was taken into custody and brought before the magistrate who remanded him without bail for inquiries to be made. The plebiscity of the case led to the bringing of other charges of a similar character and he was ultimately committed for trial. Having been called upon to attend the German girl I was naturally called as a witness and was subsequently subpoenaed to attend at the Old Bailey. I found four other young women there in a similar predicament all in charge of a police constable and for three days I spent my whole time in their company for whenever I got up to walk anywhere the women in the constable got up also and followed me. The situation was suggestive but by no means pleasant. On the Thursday morning I was informed by the prosecution that I might go away as the prisoner who turned out to be a man of good family and an officer in the army had pleaded guilty to a common assault and so forth and so forth. As the girl's history was somewhat interesting I sent an account of it to the Times newspaper. It was as follows. She had been living at Chicago with her two brothers when they received a letter stating that their mother in Germany was very ill and begged that her daughter would come home. She started immediately but on arriving at her native town found that her mother was dead. She thereupon sold all the effects and with upwards of a hundred pounds started back again for Chicago. She passed through London to Liverpool to take passage for New York but the machinery of the steamer breaking down went two days out. The captain returned for repairs. She had made the acquaintance of a young Frenchman on board who finding she had money made love to her and induced her to go back to London and become his wife. After living with her until all the money was gone he deserted her and being without friends she had to come into the house. My letter appearing in the Times some 45 pounds was sent me which suffice to enable me to send her and her child to her brother in Chicago. I provided her with an outfit and arranged with the captain of the steamer to take charge of her and send one of his trustworthy officers to see her to the station in New York for Chicago and parting with her to put into her hands the balance remaining. Some months afterwards I had a letter from the captain stating that he had carried out my request and had finally given her the 25 pounds or thereabouts. There was every reason to believe that one of these subscribers was Her Majesty the Queen though it was not so distinctly stated in a letter I received from a gentleman connected with the court. In the early part of 1865 the guardians appointed a superintendent nurse. She was a young and very respectable looking woman. The guardians had been moved to do this by the evidence of mistwining before the select committee and by the general feeling excited by the revelations made in Gibson's case in St. Giles and that of Timothy Daly in the Holburn Union. In the winter of 1863 and 1864 and again in 1864 and 1865 as also in 1865 and 1866 the admissions had been so many and the crowding so great as to tax the resources of the establishment to the utmost notwithstanding that I had moved the sick ward to the top of the building and gained additional cubic space by removing the ceiling and resealing the raptors but I could not by any contrivance increase the area. The beds therefore were placed so close together that the patients had to get out at the end of their beds there being no possibility of getting out at the side. It was a task beyond this young woman's strength to effectually supervise the numerous patients but she could check some of the graver abuses connected with pauper nursing. This she did to the best of her ability. In the same spring that she was appointed that of 1865 the late Dr. Francis Anstey called on me. He said he was deputed by the late Dr. Wakeley to call and state that he had decided to appoint a commission for the purpose of investigating the state of London workhouses and he thought I could suggest the best course to follow to obtain admission to them. I told him I would introduce him to the chairman of the board who alone had the power to grant permission to a stranger to enter the workhouse unless special application had been made to the board and leave given. He called on the chairman who gave him a letter to the master authorizing his admission. Before he left I told Dr. Anstey that when he went over the house I would accompany him. Some short time after he wrote making an appointment I showed him through the whole house pointing out the defects and shortcomings and told him of my continued efforts to get the place improved and of the determined hostility of the majority of the board to any efforts I had made. I also showed him a list of the fever cases I had attended and how constantly fever was developed when the numbers increased and the overcrowding was greatest. Dr. Anstey took careful notes of what I showed him as the sequel proved. Some months or so after I had a note from him asking me to look in at that week's Lancet for the report of his visit. I did so when I found that he had exposed the rotten condition of things with marvelous clearness and fidelity but as he had referred to me and my efforts to clear out this algae and stable I was perfectly convinced that the least intelligent element of the board would be incited by their clerk to charge me with having written the article in question. As I anticipated this came to pass for I heard that so it had been said at the board meeting and in consequence a most insulting resolution was adopted in which I was directly charged with trying to bring the guardians who were my masters into contempt. So angry was their language and so bitter their hostility that Dr. Anstey wrote to the board stating that he had been permitted by their chairman to go over the house and that the observations he had made were his own and that I had not seen a line of his manuscript or knew of his report until it appeared in print. He further challenged the board to show where in his description he had departed from the truth. The storm he had raised was after a while, allayed. Dr. Anstey continued to visit other work houses the condition of which he similarly described. These reports which appeared in the Lancet were copied into and commented upon in sundry daily and weekly journals and gradually produced a feeling of intense public indignation. Dr. Anstey had acted so generously towards me in screening me from the hostility of the worst elements of the board that I arranged a dinner party to meet and discuss workhouse abuses. Among the guests was Mr. John Store of King Street, Gov. Garden, who was one of the wealthiest, as he was one of the most respectable, members of the Strand board, and who, since his election two years before this, have proved to be my most able advocate and friend. When Dr. Anstey arrived, he brought with him Mr. Ernest Hart, whom he introduced as one of the staff of the Lancet and as one interested in the question of workhouse administration. After dinner, a discussion took place as regards to the general condition of these establishments. Ultimately it was arranged that a conference should be held at Mr. Store's offices, King Street, Gov. Garden, at a time hereafter to be named. Our dinner party was held in December, 1865. In the early part of January, Dr. Anstey, Mr. Hart and I met by appointment at Mr. Store's when our discussion was resumed. At first it was proposed that we should call a public meeting and announce the system when I pointed out that if we only did that, the agitation would soon come to an end and therefore it would be better to form an association for the purpose of more thoroughly enlightening the public. My suggestion was adopted. Mr. John Store generously offered to put down a hundred pounds to float the association. He also offered to become his treasurer and to give us the free use of one of his offices in which the meetings of the association could be held. This meeting took place on a Thursday evening and as the Lancet came out next day, Mr. Hart left us and went down to the Lancet office to announce in the paper the formation of the society. At our meeting it was also arranged that we should respectively write to those we knew and ask them to join our association. I wrote, among others, to Mr. Shaw Stewart who had once joined us and to Ms. Twining and to many other ladies and gentlemen who had been engaged in works of benevolence. The association prospered beyond our wildest anticipations and we were speedily joined by Earl Knaven, Earl Grofner, the Archbishop of York and so forth, whilst money came in freely. Shortly after the formation of the association of which in conjunction with Dr. Anstey and Mr. Hart, I was one of the honorary secretaries, Mr. Farnal, the Metropolitan Poor Law Inspector, wrote to me stating that he had been deputed by Mr. Charles P. Vidyers, the President of the Poor Law Board, to offer his services and giving information to the Youthful Association and that he had written to me as I was the only honorary secretary he knew. Mr. Farnal subsequently attended the meetings of the committee and afforded us much valuable information. No use was ever made of Mr. John Store's office as all subsequent meetings of the association were held in Mr. Hart's house in Wimple Street. In the month of May, 1866, Ms. Beton, the superintendent nurse, informed me that she intended to resign her situation and apply for another as a nurse at a general hospital at the same time asking me whether I would give her a reference. Whilst expressing my regret that she was going, I readily promised to do all I could for her and with that object gave her a letter of introduction to Dr. Anstey, assistant physician to the Westminster Hospital and to Mr. Hart, who was then connected with St. Mary's Hospital. Dr. Anstey took her name and address and promised to do what he could for her. Mr. Hart asked her to sit down and proceeded to question her on the various matters connected with this grand workhouse I had mentioned at the committee meetings and so forth. Ultimately, he dismissed her, but not until he had a promise from her that she would write down all her experience of the wrongdoing she had witnessed at the Strand. She did this. On getting her manuscript statement, he sent it to Earl Carnarvon, one of the committee, and asked him to apply to Mr. Vidyer's for an official inquiry. I had not the remotest knowledge that anything of the kind had been done nor had my other colleague, Dr. Anstey. In the early part of June, Mr. Hart told me that there was to be an official inquiry into the management and the condition of the Strand workhouse and that I should be called as a witness, but he did not tell me how it had been brought about. A few days after, I received an official intimation that such an inquiry would be held and that my attendance would be required. I had hoped that the inquiry would be conducted by the Metropolitan Inspector, Mr. Farnal, but it was not so. Mr. Fleming sent another member of the staff. The inquiry was held, the first witness called being Miss Beaton. She astonished me by the extent and character of her revelations, of some part of which I was an eyewitness and therefore knew to be true. Her examination lasted all day. Next morning, the evidence she had given appeared in all the papers, which commented thereon. On the second day I was called. On taking my seat, Mr. Cain said, oh, we have met before. I did not know where. I had not long been under examination before Dr. Anstey, who was in the room, came behind my chair and said, take care how you answer questions. This inspector does not mean fairly by you. He is trying to put you in a false position. For warned by this, I simply answered his questions and parried those which were irrelevant and misleading. The next day my evidence, in full, appeared in every paper and all the leading journals denounced the Board of Guardians for their management of the house. It was unfortunate that my board should have been selected in as much as nearly all the workhouses in the Metropolis were in very much the same condition. After the close of the inquiry, Mr. R. B. Cain returned to Whitehall and made the remarkable statement in his official report that the condition of the house was due to my not having made proper representations to the guardians. I subsequently heard that on his report being submitted to the president of the board, it was altogether set aside by him and that he wrote the report himself. It had, however, come to my knowledge that Mr. Cain had delivered himself of this view. When I wrote to the poor law board the complaining of his injustice and pointed out that for some three years he had as metropolitan inspector during the time Mr. Farnel was away in Manchester, visited the Strand, and that he had always entered in the visitor's book that he was completely satisfied with the state of the house. I am happy to say that Mr. R. B. Cain got very little credit out of the whole transaction for his report was severely criticized by the press for its transparent bias. Just at this time a circular letter was sent by the poor law board to all the work house medical officers, some 40 in number, in the metropolis. It was issued evidently with the view of entrapping those gentlemen into contradictory answers to the questions which were submitted to them. It was clearly necessary to take immediate action. I therefore sent a letter to each of them asking them to meet me at the Freemason Stavron, Great Queen Street, Lincoln's Inn Fields. The majority of them came. Having been voted into the chair, I pointed out to them what was the object of the letter and earnestly urged that we should agree as to the form of reply. This view was adopted and the answers as agreed upon were sent by all present to the poor law board. On the same occasion it was arranged that an association should be established of metropolitan work house medical officers so that we might be prepared to deal promptly with any similar departmental trickery. This was done and I was elected as the first president and office which through various changes I have occupied to this day. The association was during the two following years enabled to play an important part in the settlement of many vexed questions in the administration of work house medical relief which without the practical knowledge of medical men would have been wholly left in the hands of the officials at the poor law board who at this time exhibited a singular unwillingness to face the facts. My official life after this was a particularly unpleasant one in as much as I was credited with having asked for the inquiry and having resolved to state that which would bring my masters into contempt. I should have survived all this misrepresentation but unfortunately just at this juncture the liberal government was overthrown and the Darby-Disraeli premiership was established. Earl Darby speedily pointed out that he intended to deal effectually with the scandal that had been brought to light in connection with work house infirmary administration. And with that view he had selected Mr. Gathorn Hardy now Lord Cranbourne as the president of the poor law board. He being in Lord Darby's judgment one of the fittest men in Her Majesty's dominions to put things straight. Mr. Hardy up to that date had been principally known as a chairman at quarter sessions and an ex-official guardian of a Kentish board of guardians. One of the first official acts of this gentleman was to punish Mr. Henry Farnall for his conduct in aiding the work house infirmary association. He was banished from London and sent to the Northern counties. As Mr. Farnall's residence was at Blackheath where his wife and children were living this act of Mr. Hardy's was a serious inconvenience to him. The next thing done was to appoint Dr. Markham as a poor law inspector and so-called medical advisor. Dr. Markham up to this date had been the editor of what was at that time an obscure journal. He was not known to have ever been associated with any sanitary work nor to have seen the inside of a work house in his life. And yet out of all the able physicians at the time in the metropolis he was selected. The popular explanation given for this appointment was that he spent the larger portion of the day in looking out of the windows of the Carlton Palmel and that Mr. Hardy making his acquaintance gave him something to do. He fully justified the selection thus made as it will be shown hereafter as he became in every sense one of the most difficult officials of the board. At this time the permanent officials notably Dr. Edward Smith promulgated the heresy that the area and cubic space suggested by our association for the housing of the sick was excessive. Indeed that the area did not so much matter if the roof of the sick ward was carried up high enough. These and other statements having been promulgated by the staff a meeting of the Workhouse Medical Officers Association was called to take the subject into consideration. We had the aid of the late Dr. Parks the eminent professor of hygiene at Nellie Hospital as well as of two of my colleagues in the secretarieship of our association. Conjointly we drew up a paper stating what was in our view the minimum area and the minimum cubic space that should be sanctioned. This action forced the hand of Mr. Hardy and caused him to issue a cubic space commission to determine this question. Shortly after the formation of the conservative government a numerous and influential deputation consisting of Earl Shasbury the Archbishop of York, Earl Grover and many others waited on Mr. Hardy when representations were made to him urging extensive alterations on the then system. I was so hurt at the intrigues going on at the poor law board and the attempt of Mr. R. B. Cain to make me solely responsible for the condition of the Strand Workhouse that I availed myself of the opportunity to tell the president that in any scheme he might lay down for an alteration. I hoped that he would be guided by his own judgment and not by that of the permanent officials who would most assuredly lead him astray. This plain speaking was not particularly relished by those against whom it was mainly directed. It doubtless intensified ill feeling against me. I also handed to him a series of resolutions drawn up by the council of our poor law medical officers association protesting against the misstatements that had been propagated by Dr. E. Smith poor law inspector against the metropolitan workhouse medical officers. Immediately subsequent to this our workhouse association engaged itself in drawing up a scheme for a general dietary for all London workhouses which differed in every establishment in some being as at the Strand when I first went there niggeredly in the extreme while in others it was absurdly liberal. This question had engaged my attention many years before and when I introduced an amended dietary at the Strand I was often twitted by the economical element of the board to the effect that my liberality in the way of dietary was the reason why the house had filled so much pauper's being attracted to the union by the prospect of being better fed by the liberality I had events. This allegation was absurdly unjust. Years before in 1863 I had at the time I amended the dietary at the Strand addressed a letter to the department urging that they should issue a general order to the London boards of guardians in closing a copy of the uniformed dietary to be used in all metropolitan workhouses acute cases of sickness alone accepted. Although this suggestion had the approval of Mr. Fernal who invited me down to the board to talk the matter over with him it was set aside. Mr. Fleming the secretary objected to everything of a controversial character about this time understanding that Mr. Hardy was engaged in drafting his metropolitan poor bill I wrote to him on several occasions one of the subjects I urged on him was the advisability of turning the vast field for clinical observations which our workhouse infirmaries afforded to some practical purpose by throwing the wards open to medical students pointing out what had been done at the Marleybone Workhouse Infirmary some 30 years before. I also urged that the hospitals he was about to establish should be officered by a resident medical man or resident medical men but that in no instant should they be left alone in their control but that their work should be super intended by an extern physician. I understood that my view was overruled through the opposition of certain physicians who thought that the educational opportunities thereby proposed would interfere with the voluntary hospitals they were connected with and the students attached to them. I also pointed out how desirable it was that popper schools should be consolidated and that permanent young popper children that should be separated from those who were constantly going in and out of workhouses. Mr. Hardy always replied personally and with marked courtesy to the letters I sent him. In the session of 1867 Mr. Hardy brought in his metropolitan poor bill. In his speech introducing it he referred to my evidence before the select committee and said that he had resolved to adopt the views I had advocated namely the provision of all medicines and appliances at the cost of the rates but although the bill passed with great facility and amidst general approval it was a very long time in some cases four, five and six years before the dispensary clauses were carried out. The bill had hardly become law before Mr. Hardy was transferred to the war office and Earl Devon became president. This nobleman when Lord Cortenay a poor law inspector or Lord Cortenay parliamentary secretary had entirely supported the worst parts of the old system of administration and control. He always yielded to the boards of guardians and when president entirely deferred to the permanent staff. During the short time that he held office for the election of 1868 shortly afterwards occurred and with it a strong reaction he instituted a new order of officials at Guiderhouse to wit assistant inspectors. Of course it was not to be expected that the evidence given by me at the official inquiry would fail to intensify the bitter hostility of a section of the board towards me especially as the clerk to the guardians never lost an opportunity of putting my conduct before them in the worst light. Consequently, shortly after my evidence had been given an attempt was made to displace me. The guardian who moved my resignation was a lodging housekeeper in St. Clement's Daines. Having been told that this guardian contemplated this procedure I forwarded a letter to the board in which I gave an outline of all I had done and had attempted to do during the 10 years I had been the medical officer. The amount of antagonism I had provoked and the various resolutions which have been adopted as the result of my endeavors. It was not very pleasant reading for some of them to hear as there were several still there who had taken an active part in thwarting me at all times and this letter thoroughly answered them. In spite of all that was alleged when the resolution was submitted to the vote it was found that I had just as many friends as enemies and therefore the motion was not carried. I do not know whether at that time the intrigue between the clerk and certain permanent officials of the poor law board had commenced but it took place not a very long time afterwards as I found out some 20 months after. One result of the evidence I had given as regards the overcrowding was this. I was empowered to send some of the acutely sick to the voluntary hospitals and I did so to a limited degree but my action here was again met by the hostility of a section of this board. It was suggested that I had sent them away to get rid of the trouble of attending to them and it was gravely proposed that I should have the cost of the cabs in which they were removed deducted from my salary. As an illustration of the mode adopted by some boards to annoy their medical officers I subjoined the following. In June 1867 a person was sent into this grand workhouse by the district medical officer insane. In conjunction with a justice of the peace I examined him and we certified as to his mental condition whereupon he was sent to Hanwell. Three weeks after he was discharged from the asylum not because he had recovered but through an informality in the certificate given by the justice. As this latter gentleman was out of town I took the lunatic before Mr. Vaughn at Bow Street who after examining him for a minute or so threw up the certificate and said he would not sign it the man was not mad. I again implored him to fill up the certificate as the man had been only sent back to the house to an informality in the certificate. As he again refused I said then I have to request that Sir Thomas Henry be apprised of the case. This was done and Sir Thomas advised that he should go back to the house for another week. That afternoon the lunatic was interviewed by three of the board who pronounced the opinion that he was of sound mind. Hearing of this irregularity I wrote to the commissioners in lunacy and asked them to see the man. They attended at the house and examined him and directed his removal to Hanwell without delay. That night he escaped by scaling a high wall and was not captured for three days when the police caught him. In the following September he was discharged, cured when I received a letter from the clerk informing me thereof and stating that the board was of opinion that I had been too hasty in sending the man away and that too by an unusual course. I immediately wrote to the commissioners in lunacy enclosing the clerk's letter and asking their opinion when the secretary, Mr. C.P. Phillips, wrote to me stating that at the time the commissioners saw him he was clearly insane and that the commissioners approved of my action under the exceptional circumstances of the case. I sent their reply to the board. The evening the clerk read my letter to the board the man's wife made an application for his readmission to the house as he had a relapse of his insanity. This man went into and out of the asylum on several occasions subsequently. Whenever he was at liberty he made me aware of it by coming to my house between one and two a.m. and ringing my night bell violently. Of course I had to put up with the inflection as the man was not in his right mind. This annoyance went on for years and only ceased when I left Soho. The guardians also authorized my sending some of the infirm women to Edmonton where the school for the popper children was situated. This school was a favorite place of resort for the worst members of the board and very comfortable parties were kept up there at the expense of the ratepayers. A certain portion of the guardians went down fortnightly in carriages to inspect the schools and every scheme was adopted by those not on the school committee to be asked to go out of their turn by those who were entitled to go. It meant an outing in the country and a splendid dinner with wine and so forth and tea free of cost to all who went there. Of course the resident officers were always in high favor with the majority of the board and to arine them or their conduct was a hopeless affair as the least competent element immediately stood forward to shield them. In the September of 1867, a young girl was admitted suffering with rheumatic fever. She remained ill some time but towards the end of the month she recovered sufficiently to be sent to a convalescent home. But as the autumn was a cold one I decided that she should be sent to Edmonton and to secure her considerate treatment. I wrote a special certificate which was addressed to the matron in which I stated what had been the matter with her and begged that she should be kept warm and not employed in scrubbing or any damp occupation. About a month afterwards I found this girl again in the women's sick ward in Cleveland street with a severe relapse of her rheumatic attack. On inquiry I was told by the girl that shortly after she had gone to Edmonton the matron came into her ward and told her to go to the laundry. On her reminding her that she was still weak and that the London doctor had directed that she was to be kept warm the matron abused her and again ordered her there. She went. In a very short time she broke down. The matron however persisted in keeping her at work but at last she became so ill that she was compelled to put her to bed. On the school doctor seeing her it was decided to send her back to town some eight miles distant. She was sent in a tilted cart and very imperfectly clad that too on a very cold day. It was altogether so improperly proceeding that I complained to the board who made inquiries of the matron and so forth who of course denied the facts in total. This false answer was sent to me. I was so enraged that I drew up another complaint and sent it to the poor law board and asked for an inquiry. Dr. Markham was deputed to go through the form of an investigation which he interpreted to by going unknown to me to the sick ward asking one or two questions of the girl and sending for the matron at Edmondon to come to his private house in Arleigh Street. I did not know this at the time. He then reported that I had made a frivolous and vexatious complaint. I will leave my readers to determine whether this procedure was not a mockery of a departmental inquiry. This report thus obtained was sent to the guardians whereupon a man who had misconducted himself at the official inquiry by coarsely asking whether mesenteric disease was not something to eat moved that I be suspended from my office. This was adopted by the board only four of the members supporting me the fact being that the board had changed very considerably at the preceding election. Some of the board ejected from office two years before having unfortunately returned again. Of course it was necessary for the board to report this suspension to the poor law board. The clerk asked permission to absent himself from duty for a time. He took with him the minutes of the board for the preceding 12 years and busied himself with extracting all the hostile resolutions which the board had adopted against me frequently at his suggestion in return for my continuous efforts to cleanse their algae and stable. I do not know who had distinctly intimated to the clerk that it was desirable to get rid of me but the mover of my suspension stated that he knew the poor law board wanted to get me discharged. That was admitted sometime after by Sir Michael Hicks Beach in a conversation he had with a medical gentleman living near him in Gloucestershire. Some months after my suspension a copy of the clerk's extract was sent to me by the poor law board and I was asked what I had to say to it. I acknowledged its receipt and asked for an official inquiry. This request was ignored although it was suggested by a minority of the board by the bestry of St. Anne's Soho who unanimously supported me and my many influential inhabitants of the parish in which I had lived and worked. That my suspension would have been followed by the poor law board calling on me to resign my office without delay would have been certain but the president Earl Devon was away although the most terrible distress prevailed that winter in East London. He had gone off to the south of France and there he remained some three months. On his return he had once put me out of doubt by removing me from my office. It is very curious but true that when I turned on this department and stated my own case he made the remark to a friend who repeated it to me that he was surprised at my hostility to the board as in calling for my resignation no reflection had been made by the department on my character. At this time a general order was issued by the department imposing without payment additional and onerous obligations upon workhouse medical officers. It was to the effect that they should make from time to time a return of all that was amiss in their respective workhouses to the board of guardians the doing of which on my own account had led to my differences with this grant to board. It had always been understood that this was one of the duties of the inspectors but it was attempted to throw the obligation on to the doctors. After Earl Devon resigned our council had an interview with Mr. Gauction at the House of Commons who promised an important modification of this unjust order. And of chapter one part two. Chapter one part three of reminiscences of a workhouse medical officer by Joseph Rogers. This LibriVox recording is in the public domain. Chapter one, The Strand, part three. When my compulsory resignation was called for it was decided by the Reverend Harry Jones the late Dr. Anstey and others to call a meeting of the all but more abundant Infirmary's Association at Mr. Hart's house to discuss the matter and arrange for action. The meeting was addressed by both of these gentlemen and by several others and the action of the department was severely censured by all who were present except one person. Sir John Simeon MP undertook to put a question in the house and to move for papers. In due course the question was asked when Sir Michael Hicks Beach made reply that the board did not desire to make any reflection on my character but that I had been called on to resign as I could not get on with the Board of Guardians. The insufficiency of this answer will be understood when I state that it had been already decided to break up the Strand Board by taking away St. Anne's and joining it to St. James's in order to make the Westminster Union and by adding St. Martin to the remnant of the Strand thereby making it a perfectly new Union. I have stated that it was arranged at the meeting of the Workhouse Infirmaries Association called to consider the action of the department in requesting me to send in my resignation that the papers connected with the subject should be moved for in the house. This was done and in due course they were presented. On their appearance the Lancet commented as follows thereon. At last after months of delay the parliamentary papers concerning the enforced resignation by Dr. Rogers of his post as Medical Officer of the Strand Union have been published. They amply justify everything we have said as to the unwarrantable character of the action of the poor law board and of the Strand Board of Guardians in the whole affair. It is impossible for us to afford space for a detailed analysis of these papers but we beg to draw attention to the following damning facts. One, the evidence upon the whole case consists, A, of a series of quotations by the Guardians or rather by a party among the Guardians hostile to Dr. Rogers from minutes and other documents extending over many years. These extracts being selected without any reference to contemporary facts which would throw light upon them and B, of utterly gratuitous and unfounded insinuations that the various leading articles in the general press which were written at propo of the notorious scandals at the Strand were written by Dr. Rogers and his friends. Two, that although Dr. Rogers backed by a most respectable minority of the Guardians and by the vestry of St. Anne's Soho protested that it was impossible to deal with these charges without an open inquiry such inquiry was refused by the poor law board. Three, as regards the Edmonton scandal which was the cause of the dispute which led immediately to the suspension of Dr. Rogers the printed evidence distinctly bears out the justice of Dr. Rogers allegations. Four, nevertheless Dr. Markham reported to the poor law board that his inquiries had approved these charges to be false. He does not however venture to specify the nature of the inquiry by which he disproved charges which with unblushing effrontery Mr. Fleming says were made on the unsupported testimony of a pauper but which are now seen to be absolutely corroborated by two respectable witnesses one of them a medical man besides the direct observation of Dr. Rogers and either Dr. Markham did not take or the poor law board has suppressed the evidence of at least one other impartial witness the master of the strand workhouse which we have reason to believe would have absolutely settled the matter in Dr. Rogers favor. It is well not incredible but we have heard it on authority which we cannot discredit that although the so-called inquiry on which the medical inspector of the poor law board based the unfavorable report which gave the strand guardians courage to make their onslaught upon Dr. Rogers included an examination at Dr. Markham's private house of the Edmonton officials chiefly inculpated by Dr. Rogers' charges. Dr. Markham never asked Dr. Rogers one single question. Volumes of comment could not add anything to the ugly emphasis of this fact. Sir Michael Hicks Beach has been recently afflicted. I would ask him if he does not consider that his sufferings would have been intensified if his sleep had been disturbed by the noise of carpet beating, if he had been weighted on by infirm and drunken women and broken down potmen, if the air he breathed had been poisoned by the dust from the beating of carpets and utterly vitiated by overcrowding. And yet, because I had protested against this hideous wrongdoing and had done my best to get it altered he had to get up in the House of Commons and do his best to justify the action of the Board. The department thought I was disposed of. It was not long before I showed them the contrary as some of them did not subsequently hesitate to admit. I have stated that it had been decided owing to the all but unanimous application of the rape payers of St. Ansoho to the poor law Board to take that parish out of the Strand Union and join it to St. James's so as to constitute the Westminster Union and within a very brief space of time after my compulsory resignation, this was done. As there was no returning officer for the Union, the poor law Board directed that the vestry clerks of each parish should act as such for this time. Consequently, all books and papers relating to St. Anne's had to be handed over by the clerk of Peterborough, notoriety, who was the friend of catch when a notable discovery was made to wit that the proxy book, as it was called, was altogether illegal and had been so for years as by the efflux of time the power to vote by proxy in most instances had expired. And yet this clerk had gone on year after year issuing voting papers to persons though he must have known that they had no right to vote. We had often wondered how it happened that we could not oust the guardians who sat for St. Anne's. They had been returned by illegal proxy votes for years. Although the guardians who had recently represented St. Anne's in the old Strand Union had lost the kindly aid of the clerk, it was so necessary to some of them that they should still be guardians that they again got themselves nominated only to meet with a unanimous rejection on the part of the rate-payers as the following letter from an ex-guardian for St. Anne's Soho who was a supporter of Dr. Rogers but precluded from again standing through serious illness of which he subsequently died will show. To the editors of the Daily News, the Strand Union and their late medical officer, sir, it will be gratifying to the friends of Dr. Rogers who was suspended by the board for his continued advocacy of the rights of the sick poor to know that at the election of guardians of St. Anne's Soho, which took place on Saturday last, the whole of those who voted for his suspension and so forth were rejected by an overwhelming majority of rate-payers. I am, sir, yours obediently, Joseph George, 81 Dean Street, April 11, 1868. The story of two of these men I will here relate. The first had been appointed as assessed tax collector for St. Anne's Soho but two or three years after my resignation of the Strand, he was discovered to be a defaulter to some hundreds of pounds which his sureties had to make up. He was one of the most active of my opponents. The second had commenced life as a milkman. Very shortly afterwards he began to take tenement houses in the worst part of St. Anne's Soho which he led out from Garrett to Seller to the very poor. His lodgers lived under the most insanitary conditions and my local knowledge induced me always to protest against this man as a guardian of the poor. He was always the most energetic of my opponents at the Strand board. At last retribution came upon him. It was in this wise he was a freemason and, though very illiterate, he had managed to obtain a high position in the Masonic Brotherhood, so much so that he was deputed to preside as the returning officer in an important election. There were two candidates, one a guardian of the Strand Union who was his personal friend. In fact, that very person who had recommended the broken down potman as one of my nurses, the other was to him a comparative stranger. After the ballot had been taken, this returning officer gave the election to his friend by such a majority of voting papers that the unsuccessful candidate who had been promised support to a large extent suspected foul play and made an application to the Prince of Wales as grand master to order a scrutiny. His Royal Highness assented and directed the Earl of Cunhaven to hold it when it came out clearly that this ex-guardian of St Anne's Soho had knowingly made a false return and he was sentenced to a deprivation of all his offices in the Brotherhood and exclusion from his lodge for three years. He was at this time holding various offices in St Giles, also in St Pancras, but the different parochial boards requested him to send in his resignation forthwith as they refused any longer to associate with him or allow him to remain a member of their respective boards. Here let me remark that there is no occupation that can be followed at which so much money can be made as by the system adopted by some speculators of taking houses in poor localities and letting them out in single rooms to the humbler classes. To get there from all the benefit possible you must be absolutely heartless and unprincipled. If the wretched tenants do not pay their rent weekly they must go out and do go. Having after their weekly collections much spare time on their hands these men often get onto boards of guardians and frequently onto the district boards as well. At the first they are always present when outdoor relief is given which they strongly advocate as a means whereby the rent may be more readily secured. Secondly on the district boards where they are always at hand when the inspector of nuisances and of insanitary tenement houses makes his report. They generally try to be on the best of terms with this latter official. Their scheme being to minimize the character of their reports and to minimize what is required to be done as it saves their pockets. One of these persons who had some 300 of these houses was fined by the magistrate for neglecting to keep his houses in a sanitary condition. I had the honor of his permanent hostility. He was at the time of being fined not only a member of the board but of the health committee also. When I was a member of the Strand Board of Works I carried a resolution that the name of the owner of these tenements should be always included in the inspector's report. In my deliberate judgment all persons of this class should be disqualified from sitting on a board of guardians or on any district board. The same class of middlemen are to be found in all large towns. They are the most dangerous members of the body politic and should be rigorously treated as such. The person I have before referred to was not only a member of the Strand Board of Guardians but a member of the District Board also. He was also on that of St. Giles and St. Pancras. In all these places and districts he had tenement houses. It having been my habit to go to the workhouse infirmary for 12 years early each morning I found my time at first hanging as somewhat heavily on my hands but after a short while I made up my mind what to do. I resolved to watch the action of the department and to do my best to make the permanent officials do their duty so far as my observation could aid me. With that object in view I arranged for an aggregate meeting of the profession at the Freemason's Tavern to discuss the composition of the so-called board at Whitehall and the grievances of the poor law medical officers. Among other things I told them that the nominal board never met and that documents requiring the various members' official signature were taken round to the residences of the ministers and it was alleged frequently signed without reading the contents. This statement had been made in the house by an ex-president. This meeting was an immense success for not only was there a very large attendance of medical men but they came from all parts of the country and the department had an opportunity of learning how their permanent officials were watched and criticized throughout the country as permanent officials always should be. Mr. Griffin having retired from further vindicating the claims of his professional brethren owing to an attack of paralysis to which unhappily he ultimately succumbed the balance of the money in his possession was handed over to me in trust for carrying on the objects of the association. It was also decided that the Provincial Poor Law Medical Officers Association of which he was the chairman should be merged in the Metropolitan Association which had been started by me two years before and I was elected the president, a position I held for some years in which I resigned only when I recognized that the objects of our association would be more readily advanced by selecting some medical member of the House of Commons to act in that capacity. So I contented myself with the humbler position of chairman of council. At this representative meeting of the profession I alluded, interaulia, to my evidence before the select committee and to my advocacy of the supply of all medicines. I also mentioned the action of one of the inspectors of Mr. Gulson when Mr. Fleming's letter containing the recommendation of that committee was read out by the clerk of the Weymouth Board of Guardians at their weekly meeting. The chairman, having appealed to this official who was present as to what should be done, he stated that the resolution was only carried in committee by one vote and that the chairman of the committee had voted against it. Thereupon the guardians of the Weymouth Union directed that the official letter should lie on the table and no expensive medicines were found. I took care that a report of this meeting should be sent to every poor law medical officer and to the department as well as to every influential member of parliament I could reach. One of the reports having fallen into the hands of Mr. C.P. Villiers, the ex-president and the chairman of the select committee on poor relief, that gentleman wrote to me protesting against the statement which had been made and assuring me that it was in direct opposition to what had really taken place as he had warmly supported my suggestion and that he should at once call on Mr. Gulson for an explanation of his statement. He also stated that he had been much annoyed at the long delay that had occurred ere the chief secretary, Mr. H. Fleming, had drawn up and forwarded to the various boards of guardians the letter containing the recommendation of the select committee. From other sources I subsequently learned that for a very long period of time prior to the resignation of Mr. Villiers as president of the board, he held hardly any communication with his permanent secretary. It will be well understood that if it took some 15 months for the permanent secretary to draw up and issue the letter containing the committee's suggestion as regards expensive medicines that no hurry would occur in the establishment of poor law dispensaries in the metropolis which was only an amplification of my original suggestion. And that actually happened and it was only by our constantly pegging away that at last the board commenced to establish them. But whilst no Bonafide effort was made to carry out this portion of the Metropolitan Poor Act an absolute epidemic took place as regards the building of asylum hospitals, district hospitals for fever and infectious diseases, asylums for epileptics, idiots and imbeciles, district schools and so forth. This arose partly from indifference on the part of the permanent officials but to a greater degree from their complete ignorance of the necessary details required for economic building. It was never my desire in striving to amend the system that is to substitute for the absence of all system of medical relief to the poorer classes, the reverse policy that architects, surveyors and builders should be at liberty to extract all the money they could get from the pockets of the Metropolitan ratepayers. As it was, finding that the absence of all efficient control was leading to an enormous outlay and that the public was naturally getting not only alarmed but indignant at the profligate expenditure of their money, I put myself in communication with Mr. Torrens, then MP for Finsbury and asked him to question the president of the poor law board on the subject and to move for a return of what had been already spent and what was proposed to be spent in such buildings. I also requested him to inquire to what caused the delay in establishing poor law dispensaries under Mr. Hardy's act was due. This action considerably alarmed at the permanent officials. More important still, it led to a very considerable curtailment in the amount of contemplated expenditure on buildings and with this an approximation to some control. Soon afterwards the establishment of poor law dispensaries was commenced, which was an important feature of the act. I cannot but relate to the clothes of Mr. George Katch's career. I have already stated that after the enforced resignation of his appointment at Newington, this model master was selected by the guardians of Lambeth as the master of their workhouse, notwithstanding that he had as opponents some respectable persons who had creditively filled similar appointments elsewhere. His election was due to the assistance he received from the clerk of the Strand Union and his old friends at that board. His appointment was challenged at the time, but in spite of the serious evidence afforded by the Newington inquiry, it was confirmed by the department, but with this proviso that a special report as to his conduct should be sent by the guardians to the poor law board at the end of six months. It was not very long before the opponents of this man's appointment were fully justified in the course they took, as he speedily renewed his old course of cruelty to the inmates and of quarreling with the other officers. One of these acts was inquired into and reported on by Dr. Markham. Although it was clear that the master was in the wrong, yet Dr. Markham in his official report managed to throw a doubt on the evidence of the medical officer evidently to screen the master. But he was not saved for long for shortly afterwards a young woman who had been subjected to much harshness by catch ran away and hid herself as it was supposed in the chimney of one of the women's infirm wards when the master with the view of forcing her to come down induced the junior resident medical officer to bring from the surgery some substance on which he poured some hydrochloric acid whereby some extremely pungent gases were evolved thinking thereby to compel her to come down. But as the young woman was not there, fortunately for catch for if she had been she would have been suffocated. The only effect was that all the old women in the ward were set sneezing and coughing. This atrocious proceeding, having been reported to the poor law board, catch was called upon to resign. It will hardly be believed that certain of the guardians memorialized the poor law board to let him retain his office when Mr. Cheyenne, the eminence solicitor on the urgent representation of his wife who was a lady visitor at the workhouse and knew a great deal of catch's doings took the matter up. Mr. Cheyenne saw me and asked me whether I could tell him anything about catch. I narrated the incident of the false charge which he, in connection with the clerk, had made against me when I was away in Scotland and also told him the story of his behavior in reference to the sick woman in the lying-in ward of this grand union which had led to his leaving that workhouse. Mr. Cheyenne took down my statement and subsequently he sent me a pamphlet of some two hundred pages in which I found not only my own statement but sundry others of a highly damaging character but, unfortunately, these were so recklessly drawn that it gave catch the opportunity of bringing an action for libel. Its publication had induced Mr. Gotchen to peremptorily call upon him to resign his office. Catch sent out an appeal to all the masters of workhouses to support him in his action and a sufficient sum, having been collected, the Attorney General of the day, now Lord Chief Justice Coleridge, acted as his counsel. Having been asked by Mr. Cheyenne to support my statement in the court of Queen's bench, I attended. When called on, I went into the witness box and after giving my evidence in chief was cross-examined by the Attorney General in such a manner that three times during the cross-examination, Lord Chief Justice Cockburn interfered to stop it, giving as his opinion that the Attorney General was pressing me unfairly. As I was leaving the witness box, I turned round and thanked the Lord Chief Justice for his kindness in screening me. I was followed by the late porter of the Strand Workhouse who was there to substantiate my evidence. A similar attempt to browbeat this witness afforded fine fun. The witness was an Irishman and at every effort made by the counsel to confuse him, Pat was too much for the Attorney and feeling that he could make nothing of him, he told him peremptorily to stand down, which he did in such a comical way as convulsed the court with laughter. Unfortunately, Mr. Cheyenne failed to justify several of the libels and the jury, after 12 days trial, gave a verdict in favor of catch for 600 pounds, an amount which the judge said was excessive and for which he refused to certify, thereby affording Mr. Cheyenne the opportunity for asking for a fresh trial. Subsequently, a compromise was effected at the instance of the Lord Chief Justice. In summing up the case to the jury, the judge said that my evidence, if it stood alone, was sufficient to stamp catch as an improper person to hold the office of a workhouse master. Mr. Goshen would not allow catch to resume his office and having no resource whatever, he drifted downwards until ultimately being without means and having tired out all his friends, he in a fit of despair, threw himself in front of a great Western train and was cut to pieces. I was so much annoyed by the action of the Attorney General in cross-examining me that on my return home I wrote to the Lord Chief Justice again, thanking him and enclosing for his perusal a pamphlet I had just written on the administration of the poor laws. To my great surprise, he sent me by hand the next morning a letter in which he acknowledged his receipt and informed me that he should read my pamphlet with the greatest pleasure. There is no doubt that my labors up to that time were very well known to his lordship as when at the bar he was the standing counsel of the Lancet newspaper in which my name had frequently appeared. When he became a judge, he kept up his interest in that journal. This was told me by the late Dr. Wakeley to whom I related catch's story and the account of my cross-examination and of the courtesy and support afforded me by Lord Chief Justice Cockburn whilst under cross-examination. The Lord Chief Justice was a man of scrupulous integrity and honor. I remember a solicitor of good position in Soho whose brother was then the treasurer of the county of Middlesex and whose son now holds the position, saying to me, although I am opposed to him politically, yet I have the highest opinion of his conscientiousness and of his extraordinary ability. We are all proud of him. I esteemed a high honor to have received a letter from such a man written under such circumstances. I have this letter still. An illustration of profligate expenditure and the absence of all efficient control at the poor law board was at this time supplied by my old friends, the Strand Union Board. Shortly after I resigned, the board decided to build a new workhouse at Edmonton and plans of the contemplated building were issued to builders and so forth. Tenders from sundry large firms for its erection were sent to the guardians. The lowest tender being from an eminent firm that had acquired a great reputation for the buildings it had put up in various parts of town, as well as in the country. Their tender was rejected and the contract given to a small builder resident in, say, Paul, Gama Gardens, whose estimate was some 2,000 pounds higher. It was stated at the time that after the contract had been signed, the members of the board were invited to a dinner given by the lucky contractor. The large firm that competed for it, feeling that they had been improperly treated, got the question raised and the new president, Mr. Goshen, investigated the transaction, but it was too late as the builder had already set to work and had a considerable amount of his plant on the ground. Although Mr. Goshen felt that he could not interfere to stop this disreputable transaction, he did not fail to give this party of jobbers a most severe lecture, probably the most severe that ever emanated from the poor law board in connection with the doings of a board of guardians. The issue of it to this board must have brought about a change of policy among the permanent officials who had not remonstrated against it. I know not whether it was this transaction or Mr. Goshen's general knowledge of the laxity of the staff. Certain it is that during his presidency, he kept the secretary in his place and did not permit him or Sir John Lambert, then plain Mr. Lambert, to obtrude themselves upon him when he received deputations from public bodies and from societies, but I am anticipating. In the autumn of 1868, a general election took place with the result of replacing the Liberal Party in power. With the concurrence of the Council of the Poor Law Medical Officers Association, I had issued a circular letter to the various candidates for parliamentary honors 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 and so forth. As I neared his house, my sense of smell was assailed by one of the most awful odors I had ever encountered. To my inquiry from when said originated, my host replied, that is from the farm yard 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 three hundred. 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 will go to all the markets roundabout 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 remonstrance was the medical man who was the neighbor 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 and 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 affected 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 rate payers. 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 Act 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 unable 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. A. 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, as 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 MP 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. Goshen, 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 modeled 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. Farnel who thus proved true to the views he held in his interview with me some 10 years before. Whilst the very feeblest of these was that preferred by Mr. R. B. Cain who manifested the same lack of heartiness here as he exhibited earnestness some years before in upsetting poor Richard Griffin 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. Toller Moncell was the honorary secretary. Dr. Moncell 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.  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 MP or Lightroom 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 and their respective localities in favor of the bill. Dr. Brady having succeeded in carrying this measure assayed 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 80 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 his 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 everyone 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 that 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 14 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 land said to publish 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 labor. 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. Goshen 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. Goshen'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 anyone else to carry out any reform whatever. This was early made apparent for at the first deputation to the president at which I was president. 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 in sanitary 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 departments such honest men would be called on to resign for not exhibiting sufficient courtesy and so forth 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 and only to turn out on trial a disastrous and ludicrous failure End of chapter 1 part 3