so prevalent as to give rise to malingering—the wilful production of disease: while, partly no doubt in order to counteract this tendency, there is in such mixed establishments an unconscious disposition to treat the hospital patient with the same stern economy that is justly made the rule in dealing with able-bodied pauperism, but which, in the infirmary, is not only cruel, but in the long run is not truly economical. Another most serious evil is entailed upon the hospital by connexion with the workhouse. The habits and traditions prevalent among the habitual paupers—able-bodied paupers—in the workhouse (at least in the workhouse of a large town), are too often deeply infected with cunning, deception, and dishonesty of all sorts, against which strict precaution and stern repression are requisite; and it is most important that no communication should be allowed, whereby these habits of vice and stratagem might be introduced into the hospital, where indulgence is the rule, and where many things strictly denied to the inmates of the workhouse, as stimulants for instance, are necessarily permitted. The introduction of workhouse tricks into a hospital, where they cannot be met by workhouse control, must bring in an element of confusion, disorder, and waste, and therefore the intercommunication which might introduce those tricks should be as effectually prevented as possible, which it cannot be while the two institutions are, as at present, combined. The two systems—to use an English word in its French sense—demoralize each other; and even in the English sense, their union demoralizes the individuals subject to each. When this is better understood and more clearly apprehended, as it soon will be, through the experience of several Unions in which the separation has been already resolved on—it is probable that it will be enforced by law. This may be expected to take place in no very long time; and then it will be found that any expenditure incurred in providing increased accommodation on a plan which does not recognise the necessity of separation has been, in part at least, thrown away; and the work will have to be done, and the money to be spent, over again. Footnotes [1]Liverpool is a seaport, and a receptacle where the poverty and vice of Great Britain and Ireland seem to accumulate; and it is probably on this account that the able-bodied female paupers are peculiarly vicious and worthless. [2]Among the replies of the London medical officers, one which seemed especially to impress the Sub-Committee was given by the senior honorary medical officer of St. Thomas’s. Mr. Hagger asked him, “If you had to cure the sick by contract at so much a head, and had to choose between unpaid pauper nurses allotted to you gratis, or paying yourself for skilled nurses, which would you choose?” “To pay for skilled nurses, certainly,” was the unhesitating answer.