I also visited the Richmond Lunatic Asylum, situated on the outskirts of Dublin, at that date under the superintendence of Dr. Lalor, who, I understand, was the first physician who introduced vocal and instrumental music as a means of relieving the insane. There I witnessed one of the most extraordinary sights it was ever my lot to see. I will give a sketch of the tableau. In the foreground sat a young lady discoursing most eloquent music on a harmonium, immediately behind her there stood some young Irish women, three or four of them, singularly beautiful, with music in their hands, accompanying her; behind them were older women, and then on to the old and weird, all joining most heartily in the performance. The fringe of this female gathering of nearly 100 performers were harmless imbeciles and idiots. I stood and listened some moments whilst this singular performance continued. I was so struck with the beauty of one of the Irish girls that I asked her history, when I was informed that her condition had been induced by a disappointment in a love affair. It was the old story of love followed by desertion, and she had been admitted some six months before in a state of maniacal excitement. She was too young and altogether too pretty to be an inmate of a lunatic asylum. Dr. Lalor also showed me a typical case, exhibiting the truth of the opinion I have long held, that of all the forms of insanity, none are so uncertain of having been really cured as those which have exhibited symptoms of homicidal or suicidal violence. The patient in question had been admitted when suffering with a homicidal tendency but had steadily improved, and his name was on the list of those to go before the Visiting Committee for discharge on probation, when a startling incident occurred. He had secreted one of the knives used in the asylum about his person, and he had, when unobserved, whittled away the thick, blunt portion used in the asylum, until he had given it a sharp cutting edge, from handle to point; when, raising his right leg up, he cut through the calf down to the bone, severing the muscle completely. This patient, Dr. Lalor told me, had been employed on various offices of trust, and that he was commonly considered to be completely cured, and altogether harmless. I obtained one of the old knives used in this asylum, had it copied, and, having got the sanction of the Board for getting several, used them all the time I was at the Westminster Union, in the male and female insane wards. The cutting edge was about two inches in length, but the rest of the knife was about the twelfth of an inch thick. It was impossible for lunatics to do any harm either to themselves or others with such knives.
On my return to London I was informed that my appointment to the Westminster Union had been confirmed by the Local Government Board.
A day or so before the 23rd of June an appointment was made by Mr. French for me to go over the House with him, and to have the establishment formally handed over to me. I went, accompanied by a young Irish physician, recently one of the resident surgeons of an Irish hospital, with whom I was in treaty to be my assistant. I had never been in this workhouse infirmary before. Shortly after my arrival Mr. French joined us, and, in company with the head nurse on the female side, we went through the female part of the establishment. The nurse was most elaborately "got up." We went on and examined each patient, a large number of whom were in the wards—in fact, although it was midsummer, the place was full. I noticed bed-cards over each patient's bed, but as I could not make out what was given to the patients, I asked what was being done for this and that case. To my astonishment Mr. French said, "Nothing; I do not believe in physic, and therefore do not give the people anything." Presently we entered a large ward where a woman, evidently in great pain, was lying in bed, writhing in apparent agony. After ascertaining the nature of the case, which was one of colicky diarrhœa, I asked, "Well, what do you here?" to which he replied, "Nurse, give her a glass of Number Two." With that, he pulled me into the centre of the ward, and giving me a friendly nudge of the ribs, laughingly said, "What do you imagine is Number Two? Why it is peppermint-water coloured; I never give any physic." Feeling by this time somewhat disgusted by these remarkable confessions, seeing that his stipend was £350 a year, out of which it was arranged by the Board that he should supply these medicines. I dropped his company, and went on examining the people independently. Mr. French speedily buttonholed my young companion, and went on looking at the patients with him. At last our visit came to an end, and on coming out of the male sick wards he shook me warmly by the hand and wished me the same happy official life as he had had. He had hardly got out of hearing when the young Irishman commenced to reproach me with having transferred Mr. French to him; saying, "I take it, sir, as a very unkind thing that you should have done so, as I was shocked at his boasting that he never did anything at all for these poor sick people."
The next day I entered on my duties. On taking my seat in the consulting-room the master brought in and laid before me a large volume, the Workhouse Medical Relief Book. I turned over the pages for the week, and noticed the names and extras ordered for the sick. I saw that ham, sausages, tripe, fish, eggs, were entered rather frequently. At last I said to the master, who was standing by, "You surely have not all these people on the sick list in the House! I did not see a third of this number when I went over the House yesterday." "Yes," he replied, "they are here;" on which I said, "Let everything remain as entered in the book until I can arrange to go over the establishment and see them all, which I will do this week." I then went through the sick and infirm wards. On going through the wards I ordered what in my judgment was necessary for the sick in the way of medicines, much to the astonishment of the head nurse, who stared at me in a half-dazed manner. There was one patient with a very foul and offensive ulcer, for whom I ordered a charcoal poultice: she came to me before I left the House to ask me "what I meant." I replied, "A charcoal poultice." She then said, "I never heard of such a thing before." I then asked her how long she had been there; she said eight years. The next day I had occasion to order a carrot poultice; I met with the same astonishment and ignorance of what was meant. At last she frankly stated that she was about to learn her duties, for nothing of the kind had ever been used by her before; and further, she said that as she never had any medicine to give the people, she had not troubled herself much about the patients; indeed, I learned on inquiry that she used to be in waiting to see the doctor each morning, and so soon as he was gone she considered her duties were over, and she returned to her own sitting-room till next day. I could never get her to give my medicines as directed. Apart from this indifference as to medicines, she was kind to the patients and respectful to me. On the male side I found a superintendent nurse who really knew her duties. She confirmed the statement voluntarily made by Mr. French, that no medicines were ever provided for the sick. She also said that the Guardians knew all about it, and that they treated it as a great joke. This was not correct as regards some of the Guardians, as I subsequently ascertained. It was known to the St. James's section of the Board, but repudiated by those of St. Anne's. Seeing that we had had a medical inspector and self-called medical adviser for five years, whose duty it was to visit this Workhouse infirmary, his failure to discover these omissions was in the highest degree remarkable; but then the system prevailed at the Local Government Board, and our Workhouse Infirmaries Association had utterly failed to alter it. The reason for all this was not far to seek.
On the day after, in company with a pauper inmate, told off to carry the Medical Relief Book, I went through the wards for the purpose of seeing the infirm men and women who were on extras. I found on the women's side that, as it was leave-day, many had gone out, and therefore drew the inference that if they were well enough to go out they could dispense with sausages, ham, tripe, eggs, &c., entered against their names, and could eat the ordinary infirm diet provided by Dr. Markham's diet table, which I saw hung up in the wards, which diet table had been drawn up from the form drafted by our Association some years before. It is curious that he claimed it to be his, without any reference to any one. Whilst going through the female wards some of the inmates returned drunk, one old woman very much so. She at once proceeded to ask me who I was, and what I was doing there. On my replying that I had come into the ward to see why she was on a diet of daily sausages, she tartly replied, pulling up her petticoats and showing both her legs, which she struck with her hands, "For these bad legs." I at once ran the pen through her name. She lived in the House years after that, but she ate no more sausages. I learned on inquiry that this fat old woman, who could go out and return drunk, had had sausages, nominally, as her dinner for two years. I write nominally because I learned afterwards that in the matter of diets an extensive system of exchange obtained throughout the House without any check or hindrance on the part of the officials. It took me the greater part of four days to see all the infirm people on extras, but the result was satisfactory, as it enabled me to put the establishment so far as the diets were concerned, on an economic basis. The clerk of the Board assured me at the time that I had caused a saving of some hundreds of pounds, a statement which I honestly believe was the truth.
It might be a matter of wonder how this could be, but having regard to the very large amount of extras purchased from day to day, none of which were supplied under contract, it can be well understood what an opportunity was given for large prices being charged for such extras, as practically no check existed on the cupidity of the tradesmen (selected by the master) who supplied these things. I do not state that such was the case here, but unless some good understanding existed between those who ordered and those who supplied, how is it possible that masters of workhouses, with their limited incomes, should succeed in leaving at their deaths so much money, as many of them do? I was informed that the old master who preceded Catch at the Strand Union had gone there after failing in business as a tradesman in Covent Garden, that he held office as master twelve years, and when he died that he left some £2,000.
I found on inspection of the specially infirm, paralytic, and wholly infirm, that the women were located in wards 16, 17, and 18, and on inquiry discovered that there were no conveniences whatever for the instantaneous removal of excreta, and yet this condition of things had not been discovered by the Government Inspectors or by the medical advisers, or if it had been no steps had been taken to alter it.
On my first visit to these wards I noticed some black patches in the corners of the compartments, which stood out very distinctly from the recently whitewashed ceiling and walls. Noticing some days after that these patches had increased in size, I asked the nurse what it was due to, when she quietly said, "Those are bugs." So soon as I could I saw the master, and told him of it, and asked him to see to it. He did not say he would or he would not, he only laughed. Finding some days after that nothing had been done, I again saw him in his office, when I told him that I must insist on those bugs being removed. The labour master was present, who remarked, "Well, doctor, as you make such a fuss about the bugs I will see to it for you" (evidently regarding the matter in the light of a personal favour); and the bugs were swept down into a dustpan by hundreds and put into the fire and burnt. This was told me by an eye-witness, who was present whilst it was being done.
I do not wish it supposed that the master was harsh or cruel; quite the reverse, he was very kind to the inmates. But he had lived long enough in the service of the Poor Law not to be fully aware that no good would accrue to him or his by too much zeal in the performance of his duty. He calmly let things slide; consequently there was more drunkenness on liberty days than could be possibly imagined, and was unchecked, and although I repeatedly begged that the names of all persons who were on my sick list who had been allowed to go out should be reported to me if they came home drunk, I never could get my wishes attended to, though occasionally it happened that I discovered the circumstance, especially when an accident occurred.