The Express.
London, England, 1865-07-26 00:00:00

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LONDON. WEDNESDAY. JULY 26.

Ax investigation of the condition of workhouse
infirmaries has been commenced by our contem-
porary the Lancet, which promisee to shed light
upon abuses which are a scandal to a civilized com-
munity. Medical commissioners have been ap-
pointed, who have made it their business to inspect
and report upon as many of the metropolitan in-
firmaries as were willing to receive their visit.
One parish alone has refused to admit these
gentlemen to their wards. When a solitary
juryman holds out pertinaciously against his
fellows in a clear case, we are apt
to conclude either that he is very thick-
headed, or that he is influenced by some
interested motive. The authorities of the
parish of St. Margaret and St. John may very
easily be supposed to be in the former condition,
but, judging from recent workhouse revelations, it
is fairer to explain their refusal by the latter
reason. Be this as it may, no leas than thirty-
eight institutions have been inspected, and as re-
gards the recusant thirty-ninth, the Commissioners
report that they have had no difficulty in obtaining
all the required information through other sources.
We are met at once, on reading the Report, by a
striking fact. The London workhouses, no longer
confined to the custody of vagrants and others of
irrepressible pauper tendencies, have gradually
grown up into the condition of huge district hos-
pitals. Now, under any circumstances, the care
of the poor and helpless is an office which in the
nature of things is liable to gross abuses. Where,
as in such a case, there is great trouble,
often of • peculiarly dimmable charac-
ter, small thanks, and a powerless condition
of those requiring attention, there is a tendency
in human nature to shirk the necessary labour.
Hence the enormous advantage, although it is not
always appreciated by the inmates, of the absolute
publicity which characterises our hospitals. It is
as impossible for neglect to pass unobserved and
uncorrected in them as for dirt to remain un-
noticed in a room exposed to sunlight. The great
bane of parish infirmaries is the privacy which ap-
pertains to them. Dangerous as always must be
such secrecy, the evil is enormously increased by
the fact that those who are entrusted with the
office of providing for the sick have • direct interest
in reducing the outlay by every means in their
power. And even though so selfish a motive be
absent, the guardians of the poor, it must be re-
membered, inherit the traditions of their prede-
cessors. Their expenditure is watched with
jealous care by those who help to furnish the sup-
plies, and any increase is contrasted to their disad-
vantage with the sums which were previously
found adequate. The business of relief is difficult
to learn. The tendency of new-comers must ne-
cessarily be to be guided by the peat, and evils of
long continuance are thus indefinitely propagated.
The metropolitan workhouses are hospitals in the
sense that their inmates are sick. In nearly every
other requirement of hospitals they are deficient.
As regards the buildings themselves, a portion
is described as so irremediably bad that the build-
ings ought to be altogether abandoned. There are
others which, with certain alterations, might be
retained for the treatment of chronic disease and
infirmity. Some, again, are capable of being de-
veloped into really good hospitals for the treat-
ment of all kinds of disease. In all the infirmaries
there are great defects as to classification and
separation. Many of the inmates are indebted to
the name attached to their ward for the informa-
tion that they are "infirm." Their own sensa-
tions, and the aspect they present to the visitor,
would prove them indisputably " sick." The
ventilation of the wards and their gene-
ral management are in moat cues ineffi-
cient, in many grossly so, owing to
the want of good supervision. The arrange-
ments for cleanliness and decency form perhaps
the worst features in the institutions. The general
absence of paid nurses is an evil which exhibits
itself not only in the scanty attention to the help-
less sufferers, but in the gross defects of ward
management. The employment of pauper nurses
carries with it its own condemnation. These per-
sons would not be inmates of a workhouse at all
but that they are too old, decrepit, or infirm, or
that their vicious tendencies are too strongly con-
firmed for them to obtain their living out
of doors. Such attendants, it is asserted, can
only manage their patients by inspiring fear,
and their conduct is consequently often brutal.
Their antecedents are frequently such that the
patients do not respect them. It is satisfactory to
learn that, with few exceptions, the quality of the
provisions, wines, &c , is good, and that the diets
of the sick as well as the extras allowed appeared
to be liberal. But there is a great want of variety
of cookery, and many of the so-called "infirm "
are condemned to a diet which is monotonous, and
would be injurious if they could only eat
it. The condition of the medical officers
is one of the most flagrant evil' of
the system. They are nearly always overbuy-
thened with work, and so paid as to ensure
a proper discharge of their duties. The general
custom of permitting these officers to engage in
private practice, whilst it doubtless carries with it
the advantage of inducing them to regard their
reputation, is manifestly a great temptation to
neglect. They should be at once relieved of all
expenses on the score of drugs and appliances, and
of the labour of dispensing. Any improvement in
the independence of their position will necessarily
be reflected upon the management of the institu-
tion.

Such is a brief sketch of the first Report of the
Lancet Commissioners. The work of inspection
would seem to have been carefully performed,
and with an amount of fairness and moderation
which ought to commend it to the careful study of