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 weari ness. 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 rheu matic 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.

lady, and had the manners of a well

"husband was unfortunate in business, and left her with a daughter, "who herself married and died, leav"ing the grandmother to support "her son. I am not writing their "history, or I might tell of patience "and faith from which we all might "learn. At last the old woman, almost "blind and crippled with rheumatism, "could no longer do anything for her"self-the boy entered the navy, and "she took shelter in the workhouse. "Her shame at receiving me there was "at first very painful both to herself "and to me; but she is thankful now, "and talks of her comforts and of God's "goodness in providing her with shelter "and food. Her heart was cheered after "two years by her grandson's return "and offer to try and support her out "of the house; but she has few days, "she hopes, to stay there now, and she "will not burden his young life. . .. "In the next bed lies an old woman of "nearly eighty, paralyzed, and, as I "thought, gone beyond the power of "understanding me. Once, however, "when I was saying 'good bye' before an absence of some months, I was "attracted by her feeble efforts to catch my attention. She took my hand and gasped out, 'God bless you; you won't "find me when you come back. Thank "you for coming.' I said most truly "that I had never been any good to her, "and how sorry I was I had never

66

seems bright. I was praying for you "last night. I don't sleep much of a "night. I thank you for coming.' "A woman between fifty and sixty dying of liver disease. She had been "early left, had struggled bravely, and 66 reared her son so well that he became "foreman at one of the first printing "establishments in the city. His master "6 gave us an excellent character of him. "The poor mother unhappily got some "illness which long confined her in "another hospital; and, when she left it "her son was dead-dead without her care and love in his last hours. The

"too weak and hopeless to work any "longer, came to her last place of refuge "in the sick ward of the workhouse. "There day by day we found her sitting on the side of the bed, reading and "trying to talk cheerfully, but always "breaking down utterly when she came "to speak of her son. Opposite to her an old woman of ninety lies, too weak "to sit up. One day, not thinking her "asleep, I went to her bedside. I shall never forget the start of joy, the eager "hand, 'Oh, Mary, Mary, you are come ! "It is you at last!' 'Ah, poor dear,' "said the women round her, she most "always dreams of Mary. 'Tis her "daughter, ladies, in London; she has "written to her often, but don't get any "answer.' The poor old woman made "many and profuse apologies for her

6

mistake, and laid her head wearily on "the pillow where she had rested and "dreamed literally for years of Mary.

"Further on is a girl of eighteen, "paralyzed, hopelessly, for life. She "had been maid-of-all work in a family "of twelve, and under her fearful drud

gery had broken down thus early. 'Oh "ma'am,' she said with bursts of agony, "I would work; I was always willing "to work if God would let me; but I "shall never get well-never!' Alas, "she may live as long as the poor

cripple who died here last summer "after lying forty-six years in the same "bed gazing on the same blank, white "wall. The most cheerful woman in "the ward is one who can never rise "from her bed; but she is a good needle

woman, and is constantly employed in "making shrouds. It would seem as if "the dismal work gave her an interest "in something outside the ward, and she "is quite eager when the demand for "her manufacture is especially great!

"Let us go to the room above, "the Surgical Ward, as it is called. "Here are some eight or ten patients, "all in painful diseases. One is a young

66

girl dying of consumption, complicated "with the most awful wounds on her 66 poor limbs. 'But they don't hurt so "bad,' she says, 'as any one would

"she remembers when she used to climb "the hedgerows to gather them in "the beautiful country.'-Opposite "this poor sufferer, in the midst of all "those aged and dying women, lies a

strange little figure asleep on his bed. "It is a boy of ten years old, so crippled "that his little limbs as he sleeps are "all contorted. Nothing could be done "for him; so he is left here to live per"haps a few years, and then, no doubt, "he must die. He is an orphan, poor "child! but many of the women take an interest in him, and he seems so quiet and gentle one can hardly wish "him to go among other children. We "bring him little toys now and then. "His laugh is very strange-so feeble,

"almost whether it be a laugh at all

a child's laugh in that chamber of "suffering and death!"

The condition of one class of the sick in the workhouse calls, however, for more than pity-for simple justice. They are excluded from the benefits of the free hospitals, not, like the others, by accident, but by rule. Their sufferings are greatest of any, and no assumption of blame of any kind lies against them. I allude to the Destitute Incurables, for whom only of late a plea for some share of public charity has begun to be urged. We have long gone on quietly admitting that, when cancer, dropsy, or consumption becomes hopeless, the sufferer must be rejected by the hospital in which, while curable, he might have found every comfort. But why have we never dreamed of asking, Where does he go, when thus excluded? Where and how are spent the last long months, or perhaps years, of inevitable agony, whose heavy weight it has pleased an inscrutable providence to lay upon him? Perhaps it has seemed there were too few of such patients to need any special provision. The Registrar-General's report, however, gives us a different idea of the case. Taking the above-named three types of incurable disease alone, we find that upwards of 80,000 persons die of them in England every year. There are other forms of malady-as, for instance, confirmed rheumatism-entailing equally intense and more prolonged suffering. But we will confine ourselves to the 80,000 who die of dropsy, consumption, and cancer, and ask the reader to estimate how many of those under such a visitation must be flung helpless on either their friends or the community for support; and how many of them can be supposed to have friends able and willing to nurse and support them through the last months of disease? The answers may vary; but we may safely maintain that at the very lowest computation 30,000 must be driven to die in the workhouses under all the aggravations of their misery which we have described.

It is manifestly hopeless to think of

to such a demand, since, at the lowest rate of 301. per annum, we should need a revenue of 900,000l. to support 30,000 patients. In several letters in the Times, Daily News, and other journals, and in a paper read at Glasgow,1 a much simpler plan has been suggested. It is only that the incurables in the workhouses should henceforth be avowedly distinguished from other paupers; that separate wards be allotted to them, and that into these wards private charity may be admitted, to introduce whatever comforts may alleviate the sufferings of the inmates. It is conceded that to charge the Poor Rates with all the extra expenses which I would assimilate the condition of a workhouse infirmary to that of a regular hospital, might involve injustice to the ratepayers. On the other hand, it is maintained that it is still more unjust to incurable patients to exclude them from our 270 splendid free hospitals, and then, when we have driven them into the workhouses, shut them up therein from receiving whatever small alleviations human charity might bring to their inevitable sufferings. Neither is the admission of this principle of voluntary aid into the workhouse system to be looked on in any way as an evil, or disturbance of desirable order. As one of the framers of the Poor Law has remarked, those Laws were designed to form a mere bony skeleton, indicating the form and affording a basis for the flesh of voluntaryism to make a living body of national charity. By a fatal result of jealousy and routine, the voluntary element has been too often excluded, and we have only a fearful spectre, haunting with death-like image all the lower vaults of our social fabric. Let free charity be not only permitted, but invited to enter these English Towers of Oblivion (dread as that which frowned over old Byzantium), and a new order of things will swiftly arise for the child and the young woman, for the fallen, the aged, and the sick.

1 Reprinted in a pamphlet, price 2d. (Nisbet and Co. Berners Street), where our readers will find fuller information on this subject of

Everywhere we want the aid of wise men's minds and loving women's hearts; and that they should begin to work among the incurably diseased and dying is not the admission of an irregularity to be deplored, but the commencement of a new order joyfully to be inaugurated. Especially we want the presence of women in nearly every department of the workhouse. The guardians, however well disposed, cannot understand either the details of the physical or moral training of the children and young girls, or the proper care of the sick. Everything lies with the matron, and (as one of the most experienced female philanthropists of our age herself assured the writer), "there never yet lived a man whom the matron of an institution could not perfectly deceive respecting every department of her work." The care of infants, the training of young girls, the subduing of harshness by gentleness, the reclaiming of fallen women, the tender care of the suffering and dying · these are the "Rights of Woman," given her by God Himself-and woe be to man when he denies them! Monstrous are the evils which inevitably ensue. If for many reasons we cannot wish to see women claim the rights (which they probably possess by common law) to be elected as guardians of the poor, at least let their aid in the workhouse be universally sanctioned and welcomed. We are happy to think that the time is approaching when this principle will be everywhere admitted. Already the Workhouse Visiting Society, founded and maintained mainly by the exertions of Miss Louisa Twining, have obtained entrance into, and are carrying on their visits in, nearly 100 out of the 660 workhouses in England.

To return to the plan for the relief of incurables. It is suggested that in each union, on the wards being set apart for such patients, lady-visitors should collect and apply contributions for the following purposes:

1st. Furniture. Good spring-beds or air-beds in extreme cases for bedridden