The present seems to be a favorable moment for directing the attention of the profession to the condition of those insane paupers who are confined in workhouses. A general disposition to criticise the management of these establishments exists in the public mind, and the profession has given unequivocal evidence that it shares in this feeling and is determined to carry out the inquiry thoroughly. If may be safely affirmed that, if this is to be done, there is no part of the subject which demands earlier attention than the condition of those workhouse-inmates who are insane; for the circumstances which call so loudly for reform in the management of “indoor” paupers, especially those who are sick, exist in an extreme degree in the instance of the insane. The upshot of all careful inquiries into these matters, and notably of that inquiry now proceeding in the columns of ‘The Lancet’, is to make prominent the fact that those workhouses which are situated in populous cities are rapidly becoming great hospitals, instead of refuges for tired or lazy vagrants: while, as yet, the guardians who manage them cannot (or will not) understand that this is the case, but persist in treating the inmates as much as possible on the old system, by which the workhouse was a penal residence intended to disgust and repress the applicants for public relief. Under such a régime it has been shown that numbers of acutely sick persons suffer great hardship and have their chances of recovering health and strength materially interfered with; while as for the patients suffering from chronic disease and debility, it can hardly be said that they receive any proper care at all; and it is my purpose in the present paper to show particularly that the insane are the most deeply injured of all classes of indoor paupers by the system usually followed.