Fifty years ago the state of things which Miss Nightingale had seen, and cured, in the military hospitals during the Crimean War was almost equalled, and was in some respects surpassed in scandal, by the condition of the peace hospitals for the sick poor at home. Those hospitals were the sick wards or infirmaries of workhouses, for the hospitals usually so-called skim only the surface of sickness in any great town. The state of the Metropolitan workhouses, as reported upon by the Poor Law Board in 1866, showed that the sick wards were for the most part insanitary and overcrowded; that the beds were insufficient and admirably contrived to induce sores; that the eating and drinking vessels were unclean; that there was a deficiency of basins, towels, brushes and combs; that the food for the patients was cooked by paupers and frequently served cold; that although the medical officers did their duty to the best of their ability, the attendance given and the salaries paid were inadequate to the needs of the sick. As for the nursing, it was done by paupers, many of whom could neither read nor write, whose love of drink often drove them to rob the sick of stimulants, and whose treatment of the poor was characterized neither by judgment nor by gentleness. This is the restrained euphemism of an official report.[74] Sometimes a patient would miss the ministration of a nurse for days because the pauper charged to give it was herself bed-ridden. The rule of one nurse was to give medicine three times a day to the very ill and once to the rather ill. It was administered in a gallipot; the nurse "poured out the medicine and judged according." Cases were reported in which a patient's bed was not made for five days and nights; in which patients had no food from 4 o'clock in the afternoon of one day to 8 o'clock in the morning of the next; in which patients died, or, to speak more correctly, were killed, by the most wanton neglect. [74] Mr. Farnall's Report, 1866, summarized in the Majority Report of the Poor Law Commission, 1909, p. 239. The statements which follow above are from _An Account of the Condition of the Infirmaries of London Workhouses, Printed for the Association for the Improvement of Infirmaries_, 1866. The dawn of a better day came with the passing of the Metropolitan Poor Act of 1867, an Act which figures in histories of the Poor Law in this country as "the starting-point of the modern development of Poor Law medical relief." Many persons contributed to this reform. In the case of London, a "Commission," instituted by the _Lancet_, under Mr. Ernest Hart, which afterwards developed into the "Association for the Improvement of the Infirmaries of London Workhouses," should especially be mentioned. But the person who inspired the proper nursing of the sick poor, and who, behind the scenes, was a prime mover in the legislation of 1867, was Florence Nightingale. II