might be useful in the controlling and managing
of state hospitals. "Deficiency of the medical
element," was the cry when scandals became
frequent, and Dr. Smith was appointed, first, a
poor-law inspector, eventually, "medical officer"
and adviser-in-chief. But as aged, infirm, and
sick paupers continued to be sacrificed to the
false god, System, the public were unreasonable
enough to imagine that even a change in official
designation did not meet the whole difficulties
of the case. Questions were put in the House
of Commons, and the newspapers teemed with
inculpatory statements concerning paupers who
maliciously refused to live; so the department
made another laborious effort. The shameful
facts, familiar to every man and woman in
England who could read or talk, were not
known "officially" at Whitehall. It was
determined to despatch Dr. Edward Smith on a
voyage of discovery through the poor-law
districts of the kingdom, and to so learn how
matters really stood. Six workhouses were to
be visited in each district; and in order that
the investigation should be searching, and
impartial, the people whose characters were
chiefly at stake were actually asked how much
and how little of their deficiencies they wished
to disclose. Mr. Secretary Gathorne Hardy,
was the president of the Poor Law Board when
these astounding instructions were given, and
the Report under consideration may therefore be
taken as a guide to the form of composition of
which Mr. Hardy approves.

Upon the 16th of August, 1866, Mr. H.
Fleming writes Dr. Edward Smith an official
letter that the president being dissatisfied with
the treatment of the sick in country workhouses,
"he requests you, in conjunction with"—not
some impartial witness, not a skilled authority,
not even an unbiassed official, but "the inspector
of the district, to visit some five or six
workhouses in each district, and to report upon the
sufficiency of the existing arrangements." Then
comes a sentence which is either a model of
discretion, or, as a public document presented to
the House of Commons, the climax of audacity.
"The Board do not think it necessary to
particularise the workhouses in each district which
you should visit, as they think the selection of
the workhouses will be best made in consultation
between you and the inspector of the district."

On what principle in law are men before
the bar of justice allowed to dictate to judge
and jury the offences for which they will be
tried? Was it innocently thought that these
negligent inspectors would sacrifice themselves
for past wrong-doing, and call Dr. Smith's
attention to the most flagrant instances of
workhouse neglect and mismanagement? In
other words no pains were spared to make
his inspection an empty form. The ten subjects
discussed are less important than those to be
avoided.

1. Classes of sick cases.
2. Officers in charge.
3. Site of the workhouse, and arrangements
for exercise.
4. Character and construction of wards.
5. Separate sick wards and detached sick
wards.
6. Sanitary appliances, as cleaning water-
closets, baths, lavatories, and kitchens.
7. Nurses' apartments.
8. Furniture for the wards.
9. Medical appliances.
10. Dietary, cooking, and distribution of food.

Let us ask whether Dr. Smith examined the
workhouse medical officer's report-book, and, if
so, why the significant information it affords
was not incorporated in his statement? whether
the drugs furnished to the sick were inspected,
and with what result? why no return is given
of the number of personal attendances made by
the medical officers of each workhouse, and the
circumstances under which ill-informed or
uninformed attendants or pupils are sent in their
masters' stead? and, lastly, why our inspector
of inspectors passes over in comparative silence
such vital points as water-supply, drainage,
and main-sewer arrangements? These are
surely matters within the province of a medical
adviser; and their omission suggests unpleasantly
that there are drawbacks as well as
advantages in leaving the inspection of
professional men in purely professional hands. The
habit of herding together patients suffering from
different complaints, which prevails in many
parish establishments, might have fairly been
made a subject for discussion. Dr. Smith only
tells us that in the majority of instances classification
would involve "placing a sick person in a
room alone," and that "to a case of consumption
likely to live for many months this would be
intolerable, and would render the workhouse ward
little better than a prison." This does not meet
the question. Is it not the case that in some
rural workhouses asthmatical and consumptive
cases are warded side by side with noisy
imbeciles; and would our medical adviser sanction
any such possibility save in workhouse wards?
In comparing the relative advantages of a
workhouse and a poor man's house in time of illness,
our teacher admits rather unnecessarily that a
poor man's "wife, with all her defects, has often
the great advantage of affection and devotion."
So that we have it on official authority that
paupers are really men and women.

But when he touches the question of nursing,
Dr. Smith's reticence becomes amazing. In
the face of recent disclosures, and with the
alleged object of his report in view, the following
placid statement will be read with wonder:
"The feeling is now very general throughout
the country that paid nurses should be
appointed to the care of the sick, and a very large
number have been elected within a very recent
period. In very large or moderately sized
workhouses these officers exist; but in numerous
small country workhouses none have been
appointed." Why have they been elected within
a very recent period, and why are any country
workhouses left without paid nurses now? Dr.
Smith devotes three pages to a laboured statement,
which reads like a wordy brief for the