suggested that in these cases it should be granted on loan.[163] [161] Instructional Letter, 6th May 1836, in Second Annual Report, 1836, p. 50. [162] Report on the Further Amendment of the Poor Law, 1839, pp. 73-81. [163] Minute, 27th March 1840, in Sixth Annual Report, 1840, pp. 95-96. The first suggestion that we have found of this policy not being wholly satisfactory occurs in 1840, in the Central Authority's comments on the case of a boy who had died, it was asserted, from privation whilst his father was actually in receipt of outdoor relief. No blame was imputed to the local authority, which, it was said, had been "acting under a recognised mode of relief"; but it was suggested that the case showed the dangers of "partial relief"; that illness was likely to be more quickly cured "with the advantages of the superior cleanliness and the better regulated warmth and ventilation of the appropriate rooms or a sick ward" of the workhouse together with the superior nursing, dietary, and doctoring there possible; and that, especially where there was likelihood of the outdoor relief or other family income being unwisely applied, it was better to relieve by admission to the workhouse.[164] But this first suggestion of an alternative policy stands alone; and it was not embodied in any Order. [164] _Official Circular_, No. 9, 10th November 1840, pp. 113-118. What the Central Authority was concerned about, with regard to the sick poor, was not their outdoor relief, but the extent to which they took advantage of the services of the parish doctor. Already in 1836 it was laid down by an Instructional Letter (which expressed no criticism on the practice of granting relief "in food or clothing") that medical attendance could be allowed only in cases of destitution. As, however, sickness quickly involved destitution, it was suggested that provident sick clubs should be promoted, to provide for medical attendance when needed.[165] Four years later it is pointed out that members of friendly societies, entitled as such to medical attendance, must not be allowed the services of the parish doctor.[166] This was repeated in 1844.[167] "Medical extras," such as "meat, milk, wine, and porter," could not be ordered by the doctor, but could be granted, on his recommendation, by the local authority; and it is to be noted that the Central Authority adds no words in any way discouraging such grant.[168] The Central Authority became even more concerned about the organisation of the medical attendance, the area of each medical officer's district, the method of selecting him, his qualification, and above all the mode of his remuneration, so that he might not be tempted to increase the number of cases.[169] Its views on this subject were embodied in the General Medical Order of 12th March 1842, and explained in the accompanying letter of the same date.[170] We omit this, along with other