defence, but leaves this essential point
untouched. Can it be that Mr. Hardy's friends,
"the sensational writers," have brought about
what the Poor Law Board and its officers
shamefully neglected to enforce; and can Dr.
Smith be unaware that his department can
compel guardians to appoint paid nurses? "In
moderately sized and small workhouses," we
read, "one nurse may properly attend to thirty
sick cases. In the larger workhouses, where
there is a properly built infirmary, and where
the wards are large, it is possible that more than
that number might be allotted to one nurse."
This is a reasonable estimate enough for day-
nursing, but how are the patients to be looked
after at night? We have seen during the workhouse
experiences recorded in this journal, paid
nurses who have secured their night's rest by
putting several locked doors, long passages, and
stone staircases between themselves and their
patients whenever they went to bed; and
unless some special arrangements for night-
nursing be made, the thirty sick people confided
to one nurse would be certainly overlooked.

And now as to local medical officers. One
of them said to the writer of this article not
long ago: "I can't do my duty to my patients
for the simple reason that I can't afford it. The
wards of my workhouse and its classification
will not bear scrutiny. When I first put on
harness here, I was young and enthusiastic,
and tried hard to get the guardians to
provide what I knew to be absolutely necessary.
But I only gained ill-will for myself, and did
no good for my patients, so I've just struggled
on as well as I could. The parish board could
soon make a man's life a burden if they took a
prejudice against him; and I could tell you of
instances in which a really zealous man has
been worried into resigning, and a selfish drone
appointed in his stead, who has been popular
because he let things alone—in other words,
because he neglected the paupers and did not
trouble the guardians. Why, there's many a
country workhouse where the doctor attends
pretty much as he likes, and if it could be found
out I haven't a doubt that deaths from medical
neglect are far commoner than you'd
suppose."

Dr. Smith's admissions are confirmatory of
this appalling statement; for at page fifteen of the
Report we find him saying calmly, "In practice
there is much diversity of action amongst visiting
medical officers, as to the frequency of their
visits and the time devoted to their duties. In
very many country workhouses the medical
officer is required to attend but thrice (sometimes
only twice) a week, and if he attend oftener it is
on special requisition, or from a conviction that
the cases require more frequent attention.
Having regard to the fact that in almost every
workhouse there is at least one case requiring
constant medical supervision, I think" (wonderful
boldness!) "it very important that arrangements
should be made so that every medical
officer of a workhouse shall attend daily, and
also that he shall make his visit at or about
a convenient and fixed hour. He should go into
every sick ward daily, and should not wait to
be requested to see any particular case. It
should also, I think, be a part of his official
duties to inspect every part of the workhouse
once a week, and to report in writing to the
guardians. This is not his duty at present,
but it would do much to supply the defect
which very generally exists in the unfrequent
visits of the visiting committee."

"Much diversity of action," is Dr. Smith's
discreet phrase for abominable neglect. It is
not difficult to foresee the end of a sick man
who requires medical attention every day, and
whose doctor only sees him twice a week. A
paragraph concerning the power given to medical
men to order stimulants for their patients
describes the length of time during which they are
ordered, and the quantity consumed to be
"sufciently astonishing," and names it as a subject
which "will ultimately engage the attention of
the Poor Law Board." If it be true that Dr.
Smith is an ardent teetotaller, this side-blow
at stimulants is ingenious and effective. It
has already increased the difficulties of medical
men. To the unprofessional mind it would
seem that stingy and ignorant guardians should
be precluded from dictating or even hinting to
doctors what should be prescribed for patients.
The only true way out of this and similar
difficulties would be to make the medical officers'
salaries wholly payable by the crown. Already
half the workhouse doctor's income is derived
from this source, while half is paid out of the
rates; and by making him solely responsible to
the Poor Law Board, we should at least rescue
him from guardians and ensure uniformity of
discipline.

A detailed account of the forty-eight
workhouses visited comes next. The different
inspectors having informed Dr. Smith which
workhouses in their district they would prefer his
seeing, the two officials pay their call together,
measure wards, examine furniture, patrol yards and
kitchens, and come away. Dr. Smith gives
uncertain particulars of the workhouses he has
visited, and with these is printed the last official
statement of the inspector of the district.
One of these gentlemen gives, in two places,
"There is no cattle-plague here now," as part of
his report upon the condition of a workhouse,
as if paupers and animals were legislated for
and classed together. Dr. Smith's record is dry
and lifeless. Such headings as "There are no
paid nurses," "The stimulants are administered
by paupers," convey a world of bitter
meaning to the initiated; but there is nothing
to show that our medical adviser-in-chief
considers such negligence reprehensible. One piece
of information will be welcomed. It has
often been asked what the ordinary process of
workhouse inspection is, and why the flagrant
evils brought to light by independent witnesses
should have remained undetected or ignored by
the gentlemen whose special duty it has been
to find them out. The following list of questions
by the government official and answers