inadequate remuneration. But low as they are, with very rare exceptions, they are made to include the cost of all the drugs ordered to the patients! It would seem as if the mere mention of such a system were enough to condemn it. Underpaid and overworked, it is impossible to expect that the labour and the cost of exhibiting the more expensive medicines can be ordinarily undergone. In many cases we believe it would swallow up the whole miserable salary of the surgeon, and go far beyond it, were he to give to the pauper sufferers the anodynes they so piteously require, and to the weak, halfstarved, scrofulous, and consumptive patients the tonics, cod-liver oil, &c., on which their chances of life must depend. Again, there may be the most difficult and intricate cases, requiring all possible skill. In every other hospital the most experienced physicians would attend such cases. Here a young man (necessarily at the outset of his profession, or he would not accept such a position) has to decide everything for himself. What would the Board think of being continually called on to pay consultation fees to the leading surgeons and physicians in the neighbourhood?

It is the received theory that it is in the power of the medical officer of each union to order all that his patients require; and guardians perpetually boast that they never refuse to countersign such orders. The nature of the case, however, is pretty obvious. The surgeon knows what things will, and what will not be sanctioned, and rarely attempts the useless task of collision with the Board, in which it almost invariably happens that along with many benevolent guardians are others whose sole object is to "keep down the rates" at any cost of human suffering.

Besides the anomalous arrangements of wards and medical attendance in workhouses, which are actually hospitals without proper hospital supervision, there remains a third source of misery to the inmates-the nurses.

It is easy

to understand that the difficulty of ob

is doubled here. Indeed it is rarely grappled with at all; for women hired by the Board are so invariably brought into collision with the master and matron, that even the kindest of such officials say (and probably say truly) that it is best to be content with the pauper nurses, over whom at least they can exercise some control. The result is that, in an immensely large proportion of houses, the sick are attended by male or female paupers who are placed in such office without having had the smallest preparatory instruction or experience, and who often have the reverse of kindly feelings towards their helpless patients. As payments they usually receive allowances of beer or gin, which aid their too common propensity to intoxication.

A good deal of misapprehension, we believe, exists as to the class of persons who are inmates of the sick wards of our workhouses. They are very frequently quite of another and higher order than that of the able-bodied paupers-their disease, not any vice or idleness, having brought them to their present condition. Especially among the women do we find the most piteous cases of reduced respectability-widows of tradesmen, upper servants, and even teachers and governesses, joined in one common lot of sordid poverty, and sleeping side by side with poor creatures whose lives have been passed in a hopeless drudgery of labour-in selling apples in the streets, or in lower avocations still. All the heaviest misery, in fact, of our country drains into the workhouse as to the lowest deep; and only by meeting it there can we hope to relieve the worst of our social tragedies.

A few notes from the memoranda of a dear friend will enable the reader who has never visited a workhouse infirmary to form some judgment of its inmates.

"I went first to workhouse to "visit an old woman whom I had "known for some time before she en"tered it. She had been more of a

companion than maid to an invalid "lady, and had the manners of a well

effectually accomplished, and many more where the intention to do it is sincere, though the absence of the female element of thoughtfulness for details and tenderness for infirmity in the very place which the sternest contemners of the sex declare to be woman's proper post, namely, at the bedside of the sick and dying-the absence, we say, of this element, constantly neutralises the good intentions of the Board. Further, however, than this. The fundamental system of workhouse management is incompatible with proper care of the sick. The infirmary is an accident of the house, not its main object; and proper hospital arrangements are consequently almost impracticable. The wards are hardly ever constructed for such a purpose as those of a regular hospital would be, with proper attention to warmth, light, and ventilation. In some cases their position with regard to the other buildings entails all sorts of miseries on the patients-as, for example, the terrible sounds from the wards for the insane. In the courtyard of one metropolitan workhouse carpet-beating is done as a work for the able-bodied paupers. The windows of the sick and infirm open on this yard, and during the summer cannot be opened because of the dust. In another court a blacksmith's shed has been erected close under the windows of the infirmary, and the smoke enters when they are opened, while the noise is so violent as to be quite bewildering to a visitor. Can we conceive what it must be to many an aching head in those wretched rooms?

The furniture of the workhouse infirmaries is commonly also unsuited to its destination. The same rough beds (generally made with one thin mattress laid on iron bars) which are allotted to the rude able-bodied paupers, are equally given to the poor, emaciated, bed-ridden patient, whose frame is probably sore all over, and whose aching head must remain, for want of pillows, in nearly a horizontal position for months together.1 Hardly in any work

house is there a chair on which the sufferers in asthma or dropsy, or those fading away slowly in decline, could relieve themselves by sitting for a few hours, instead of on the edges of their beds, gasping and fainting from weariness. Arrangements for washing the sick, and for cleanliness generally, are most imperfect. We cannot venture to describe the disgusting facts of this kind known to us as existing even in metropolitan workhouses, where neither washing utensils are found, nor the rags permitted to be retained which the wretched patients used for towels. Again, in other workhouses, cleanliness is attempted to an extent causing endless exasperation of disease to the rheumatic sufferers and those with pulmonary affections, to whom the perpetual washing of the floor is simply fatal. In new country workhouses the walls of these sick-rooms are commonly of stone-not plastered, but constantly whitewashed-and the floor not seldom of stone also. Conceive a winter spent in such a prison: no shutters or curtains, of course, to the windows, or shelter to the beds, where some dozen sufferers lie writhing in rheumatism, and ten or fifteen more coughing away the last chances of life and recovery.

But even the unfitness of the wards and their furniture is second to the question of medical aid and nursing. The salaries usually given to workhouse surgeons are low, the pressure for employment in the medical profession being so great as to induce gentlemen to accept wholly

charitable ladies at trifling expense to relieve this last misery. A knitted bed-rest, the shape of a half-shawl, five feet six inches long, and two feet deep in the middle, affords the most wonderful comfort. It should be made of common knitting-cotton, and tied by double tapes at the end to the ends of the bed, then passed round the patient's back, to which it forms a support like a cradle. Any lady who would send one of these to Miss Louisa Twining, 13, Bedford Place, Russell Square, would be sure to have her work well applied.

2 Ought not the floors of all sick wards to be waxed, so as to obviate the necessity of washing? The damp is agony to the rheumatic patients, and death to those with con

inadequate remuneration.

But low as they are, with very rare exceptions, they are made to include the cost of all the drugs ordered to the patients! It would seem as if the mere mention of such a system were enough to condemn it. Underpaid and overworked, it is impossible to expect that the labour and the cost of exhibiting the more expensive medicines can be ordinarily undergone. In many cases we believe it would swallow up the whole miserable salary of the surgeon, and go far beyond it, were he to give to the pauper sufferers the anodynes they so piteously require, and to the weak, halfstarved, scrofulous, and consumptive patients the tonics, cod-liver oil, &c., on which their chances of life must depend. Again, there may be the most difficult and intricate cases, requiring all possible skill. In every other hospital the most experienced physicians would attend such cases. Here a young man (necessarily at the outset of his profession, or he would not accept such a position) has to decide everything for himself. What would the Board think of being continually called on to pay consultation fees to the leading surgeons and physicians in the neighbourhood?

It is the received theory that it is in the power of the medical officer of each union to order all that his patients require; and guardians perpetually boast that they never refuse to countersign such orders. The nature of the case, however, is pretty obvious. The surgeon knows what things will, and what will not be sanctioned, and rarely attempts the useless task of collision with the Board, in which it almost invariably happens that along with many benevolent guardians are others whose sole object is to "keep down the rates" at any cost of human suffering.

Besides the anomalous arrangements of wards and medical attendance in workhouses, which are actually hospitals without proper hospital supervision, there remains a third source of misery to the inmates-the nurses.

It is easy to understand that the difficulty of ob

is doubled here. Indeed it is rarely grappled with at all; for women hired by the Board are so invariably brought into collision with the master and matron, that even the kindest of such officials say (and probably say truly) that it is best to be content with the pauper nurses, over whom at least they can exercise some control. The result is that, in an immensely large proportion of houses, the sick are attended by male or female paupers who are placed in such office without having had the smallest preparatory instruction or experience, and who often have the reverse of kindly feelings towards their helpless patients. As payments As payments they usually receive allowances of beer or gin, which aid their too common propensity to intoxication.

A good deal of misapprehension, we believe, exists as to the class of persons who are inmates of the sick wards of our workhouses. They are very frequently quite of another and higher order than that of the able-bodied paupers-their disease, not any vice or idleness, having brought them to their present condition. Especially among the women do we find the most piteous cases of reduced respectability-widows of tradesmen, upper servants, and even teachers and governesses, joined in one common lot of sordid poverty, and sleeping side by side with poor creatures whose lives have been passed in a hopeless drudgery of labour-in selling apples in the streets, or in lower avocations still. All the heaviest misery, in fact, of our country drains into the workhouse as to the lowest deep; and only by meeting it there can we hope to relieve the worst of our social tragedies.

A few notes from the memoranda of a dear friend will enable the reader who has never visited a workhouse infirmary to form some judgment of its inmates.

"I went first to workhouse to "visit an old woman whom I had "known for some time before she en"tered it. She had been more of a "companion than maid to an invalid 66 lady, and had the manners of a well

effectually accomplished, and many more where the intention to do it is sincere, though the absence of the female element of thoughtfulness for details and tenderness for infirmity in the very place which the sternest contemners of the sex declare to be woman's proper post, namely, at the bedside of the sick and dying-the absence, we say, of this element, constantly neutralises the good intentions of the Board. Further, however, than this. The fundamental system of workhouse management is incompatible with proper care of the sick. The infirmary is an accident of the house, not its main object; and proper hospital arrangements are consequently almost impracticable. The wards are hardly ever constructed for such a purpose as those of a regular hospital would be, with proper attention to warmth, light, and ventilation. In some cases their position with regard to the other buildings entails all sorts of miseries on the patients-as, for example, the terrible sounds from the wards for the insane. In the courtyard of one metropolitan workhouse carpet-beating, is done as a work for the able-bodied paupers. The windows of the sick and infirm open on this yard, and during the summer cannot be opened because of the dust. In another court a blacksmith's shed has been erected close under the windows of the infirmary, and the smoke enters when they are opened, while the noise is so violent as to be quite bewildering to a visitor. Can we conceive what it must be to many an aching head in those wretched rooms?

The furniture of the workhouse infirmaries is commonly also unsuited to its destination. The same rough beds (generally made with one thin mattress laid on iron bars) which are allotted to the rude able-bodied paupers, are equally given to the poor, emaciated, bed-ridden patient, whose frame is probably sore all over, and whose aching head must remain, for want of pillows, in nearly a horizontal position for months together.1 Hardly in any work

house is there a chair on which the sufferers in asthma or dropsy, or those fading away slowly in decline, could relieve themselves by sitting for a few hours, instead of on the edges of their beds, gasping and fainting from weariness. Arrangements for washing the sick, and for cleanliness generally, are most imperfect. We cannot venture to describe the disgusting facts of this kind known to us as existing even in metropolitan workhouses, where neither washing utensils are found, nor the rags permitted to be retained which the wretched patients used for towels. Again, in other workhouses, cleanliness is attempted to an extent causing endless exasperation of disease to the rheumatic sufferers and those with pulmonary affections, to whom the perpetual washing of the floor is simply fatal. In new country workhouses the walls of these sick-rooms are commonly of stone-not plastered, but constantly whitewashed-and the floor not seldom of stone also. Conceive a winter spent in such a prison: no shutters or curtains, of course, to the windows, or shelter to the beds, where some dozen sufferers lie writhing in rheumatism, and ten or fifteen more coughing away the last chances of life and recovery.

But even the unfitness of the wards and their furniture is second to the question of medical aid and nursing. The salaries usually given to workhouse surgeons are low, the pressure for employment in the medical profession being so great as to induce gentlemen to accept wholly

charitable ladies at trifling expense to relieve this last misery. A knitted bed-rest, the shape of a half-shawl, five feet six inches long, and two feet deep in the middle, affords the most wonderful comfort. It should be made of common knitting-cotton, and tied by double tapes at the end to the ends of the bed, then passed round the patient's back, to which it forms a support like a cradle. Any lady who would send one of these to Miss Louisa Twining, 13, Bedford Place, Russell Square, would be sure to have her work well applied.

2 Ought not the floors of all sick wards to be waxed, so as to obviate the necessity of washing? The damp is agony to the rheumatic patients, and death to those with con

inadequate remuneration.

But low as they are, with very rare exceptions, they are made to include the cost of all the drugs ordered to the patients! It would seem as if the mere mention of such a system were enough to condemn it. Underpaid and overworked, it is impossible to expect that the labour and the cost of exhibiting the more expensive medicines can be ordinarily undergone. In many cases we believe it would swallow up the whole miserable salary of the surgeon, and go far beyond it, were he to give to the pauper sufferers the anodynes they so piteously require, and to the weak, halfstarved, scrofulous, and consumptive patients the tonics, cod-liver oil, &c., on which their chances of life must depend. Again, there may be the most difficult and intricate cases, requiring all possible skill. In every other hospital the most experienced physicians would attend such cases. Here a young man (necessarily at the outset of his profession, or he would not accept such a position) has to decide everything for himself. What would the Board think of being continually called on to pay consultation fees to the leading surgeons and physicians in the neighbourhood?

It is the received theory that it is in the power of the medical officer of each union to order all that his patients require; and guardians perpetually boast that they never refuse to countersign such orders. The nature of the case, however, is pretty obvious. The surgeon knows what things will, and what will not be sanctioned, and rarely attempts the useless task of collision with the Board, in which it almost invariably happens that along with many benevolent guardians are others whose sole object is to "keep down the rates" at any cost of human suffering.

Besides the anomalous arrangements of wards and medical attendance in workhouses, which are actually hospitals without proper hospital supervision, there remains a third source of misery to the inmates-the nurses. It is easy to understand that the difficulty of ob

is doubled here. Indeed it is rarely grappled with at all; for women hired by the Board are so invariably brought into collision with the master and matron, that even the kindest of such officials say (and probably say truly) that it is best to be content with the pauper nurses, over whom at least they can exercise some control. The result is that, in an immensely large proportion of houses, the sick are attended by male or female paupers who are placed in such office without having had the smallest preparatory instruction or experience, and who often have the reverse of kindly feelings towards their helpless patients. As payments they usually receive allowances of beer or gin, which aid their too common propensity to intoxication.

A good deal of misapprehension, we believe, exists as to the class of persons who are inmates of the sick wards of our workhouses. They are very frequently quite of another and higher order than that of the able-bodied paupers-their disease, not any vice or idleness, having brought them to their present condition. Especially among the women do we find the most piteous cases of reduced respectability-widows of tradesmen, upper servants, and even teachers and governesses, joined in one common lot of sordid poverty, and sleeping side by side with poor creatures whose lives have been passed in a hopeless drudgery of labour-in selling apples in the streets, or in lower avocations still. All the heaviest misery, in fact, of our country drains into the workhouse as to the lowest deep; and only by meeting it there can we hope to relieve the worst of our social tragedies.

A few notes from the memoranda of a dear friend will enable the reader who has never visited a workhouse infirmary to form some judgment of its inmates.

"I went first to workhouse to "visit an old woman whom I had "known for some time before she en"tered it. She had been more of a "companion than maid to an invalid lady, and had the manners of a well