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prevent what he regarded as fraud and sometimes refused
to see people who, he thought, could well pay for medi-
cal attendance. Women were the worst offenders and they
managed the thing more clumsily. They would wear a cloak
and a skirt which were almost in rags, and neglect to take
the rings off their fingers.
‘If you can afford to wear jewellery you can afford a doc-
tor. A hospital is a charitable institution,’ said Dr. Tyrell.
He handed back the letter and called for the next case.
‘But I’ve got my letter.’
‘I don’t care a hang about your letter; you get out. You’ve
got no business to come and steal the time which is wanted
by the really poor.’
The patient retired sulkily, with an angry scowl.
‘She’ll probably write a letter to the papers on the gross
mismanagement of the London hospitals,’ said Dr. Tyrell,
with a smile, as he took the next paper and gave the patient
one of his shrewd glances.
Most of them were under the impression that the hospi-
tal was an institution of the state, for which they paid out of
the rates, and took the attendance they received as a right
they could claim. They imagined the physician who gave
them his time was heavily paid.
Dr. Tyrell gave each of his clerks a case to examine. The
clerk took the patient into one of the inner rooms; they were
smaller, and each had a couch in it covered with black horse-
hair: he asked his patient a variety of questions, examined
his lungs, his heart, and his liver, made notes of fact on the
hospital letter, formed in his own mind some idea of the di-

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