William Smith, M. D., who, from a charitable desire to afford medical assistance to the sick, inspected and reported in 1776 upon the sanitary conditions of all the London prisons, had not a better opinion of the new Newgate than had Howard. The gaol had now a regular medical attendant, but "it was filled with nasty ragged inhabitants, swarming with vermin, though Mr. Akerman the keeper is extremely humane in keeping the place as wholesome as possible. The new prison is built upon the old principle of a great number being crowded together into one ward, with a yard for them to assemble in in the day, and a tap where they may get drink when they please and have the money to pay." Dr. Smith states that he had no fault to find with the wards, which were large, airy, high, and as clean as could well be expected where such a motley crew are lodged. But he condemns the prison, on which so much had been already spent, and which still required an immense sum to finish it. Its site was, he thought, altogether faulty. "The situation of a gaol should be high and dry in an open field, and at a distance from the town, the building spacious, to obviate the bad effects of a putrid accumulation of infectious air, and extended in breadth rather than height. The wards should have many divisions to keep the prisoners from associating." Dr. Smith found that the numbers who sickened and died of breathing the impure and corrupted air were much greater than was imagined. Hence, he says, the absolute necessity for a sufficiency of fresh air, "the earth was made for us all, why should so small a portion of it be denied to those unhappy creatures, while so many large parts lay waste and uncultivated?" Another person, well entitled to speak from his own knowledge and practical experience, declared that the new gaol contrasted very favourably with the old. This was Mr. Akerman the keeper, who was the friend of Johnson and Boswell, and whom Dr. Smith and others call extremely humane. But Mr. Akerman, in giving evidence before a committee of the House of Commons in 1779, while urging that few were unhealthy in the new prison, admitted that he had often observed a dejection of spirits among the prisoners in Newgate which had the effect of disease, and that many had died broken-hearted. Mr. Akerman clearly did his best to alleviate the sufferings of those in his charge. For the poor convicted prisoner, unable to add by private means or the gifts of friends to the meagre allowance of the penny loaf per diem, which was often fraudulently under weight, the kind keeper provided soup out of his own pocket, made of the coarse meat commonly called clods and stickings.