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The sins of Pte Enos Seth and
deeds of Staff Surgeon Thomas G. Balfour

The 1850s was not a stellar decade for the RMA. By any standards, the students were under as fierce a code of discipline as any time in the institution's history (see 1852 Crime and punishment). As compared with the 1870s (see 1874 Crime and punishment), those of the 1850s were positively brutal. The case Pte Enos Seth is outstanding for both the length of his crime sheet and the range of punishments visited upon him. The appearance in the 'REPORTED BY' column of the medical officer, Staff Surgeon Thomas G. Balfour, is not only unusual, but cause for reflection considering his sworn obedience to the uncompromising spirit of the Hippocratic oath which, in part, states:

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men [boys], which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

[Ludwig Edelstein's translation from the Greek.]

Enos Seth, the son of Sergeant James Seth of the 97th Foot (The Queen's Own Regiment), was 7 years and 8 months of age when admitted to the RMA in October 1849. His father was deceased at the time of his admission. His mother, Margaret Seth, was still living and probably pregnant at the time of her husband's death. Seth was admitted in the rank of Private (Pte) as boys were at the time designated. Later, they were referred to as boys or students. The 'interior economy' of the Asylum being modelled on that of an infantry battalion, the authorities plainly considered in the 1850s that 'private' and the various non-commissioned ranks to which boys were promoted were suitable terms of recognition.

Pte Seth was assigned to learn the trade of shoemaker, which would give him a good trade to follow once he left the institution, in the army or in civilian life. At this time in the RMA's history, boys made their own clothes and footwear entirely. The trades taught were shirt making, tailoring and shoemaking. Quite possibly there were frame knitting machines on the premises because an order from the Southampton Branch is on record for a shipment of hosiery. It should come then as no surprise that shirts, stockings, uniforms and buckled shoes were made and fitted on the premises. The master tailor was known as Master Tailor, the master shoemaker as Master Shoemaker because they are identified by these designations in the punishment register.

Enos Seth had a younger brother, George, who was age 6 years when admitted on 1 July 1853. Seth the older was a good five years his sibling's senior. It is deduced from this that George was either a babe in arms or not born when Sergeant Seth died. It also helps explain why Mrs. Seth was in need of the Army's charity.

Enos (the third son of Adam those familiar with the bible will recall) had a clean record for the first three years of his time at the school, but more than made up for its lack of entries beginning when he was 11 years old. By the time he was 14 – and enlisted n the 15th Hussars - he had racked up 50 entries in the punishment register. As used here ironically, Pte Seth's 'crime sheet' was a lamentable record. This at a time when in civil society at large, burglary, sheep stealing, or purse snatching could mean a seven-year stretch in the Botany Bay penal colony.  
The length and breadth of Seth's crime sheet is revealing for the punishments awarded. Beginning 1852 with being caught jumping on the bedsteads (trampolining), he got 7 days drill. This meant attending the defaulters drill parade for up to half an hour of extra drill daily for 7 days under a duty boy NCO. He graduated from this e innocuous blotch on his record to absenting himself from morning prayers, being out of bounds, laughing and talking in the ranks and during grave, insubordination, beating his brother George, daubing another boy's hair with shoemaker's wax, fighting during divine service, refusing to hold up his head when told to do so, annoying the Master Shoemaker by opening and closing the shoe shop door, damaging 24 pans (equivalent of a modern soldier's mess tin) by dropping them, and answering the commandant 'in a disrespectful manner'. These were some, but by no means all, of the breaches of discipline recorded against him.  

Being found 'out of bounds' is hard to understand when most of the time boys were confined to the building. But to be in the vestibule of the main building was to be 'out of bounds' or even being in a part of the building at the wrong time – in a hall or stairway. The main building was a large and capacious structure that included all the amenities necessary for the daily living of its inhabitants: sleeping, ablutions and baths, education, kitchens, meals, trades, band practice, infirmary and staff quarters. Boys paraded outside the building and spent time in the grounds for recreational activities. Inside, they paraded and marched from one activity to another from the break of day to last thing at night. By evidence of the records, they were strictly supervised for their morning prayers, ablutions, meals, school and trades. The washrooms were so inadequate and restricted a strict schedule was followed for each company to use them one at a time.

The children spent more time at their trades and music practice than in attending school. Walter McLeod's Model School, introduced in 1846, replaced the monitorial system of instruction in use since the Asylum doors opened in 1803. Classes still shared the single assembly hall. A Normal School for training army schoolmasters (see 1846 Corps of Army Schoolmasters) had also been introduced in 1846. Dr. W. S. O. du Sautoy, a Cambridge scholar, directed the Normal School. Teachers in training practice the teaching methods taught in the Model School.

So much for Pte Seth's infractions. Penalties awarded ranged from extra drills, stripes, strokes in public (meaning before the school assembly) and loss of pay to time spent in the black hole. The 'black hole' is a military term of long standing, applying to any cell, lock-up or place of close confinement. From particular entries in the punishment book it is known that the RMA 'black hole' was not entirely black. It had a window, so it was not a "...deep, dark dock in a pestilential prison with a life-long lock." The registers include two unexplained forms of punishment. One, recorded as '2 days extra at the Roller', could mean a grass roller, but this is uncertain. The other, 'Cross step jumping' abbreviated CSJ is not understood. CSJ could have been some form of physical exercise punishment, but this is speculation. That it referred to an exercise such as 'highland dancing' as a fencing drill is unlikely when compared with the other punishments recorded. Pte Seth was awarded a number of CSJ sessions: CSJ 3 days; CSJ 4 days; (Loss of) Pay one week and CSJ 3 days. Earlier entries are written out in full, 'cross step jumping', so defining CSJ.

Not the least significant of entries in the register are the names of the staff who reported the offenders. Sergeant-majors, sergeants, the quartermaster and others directly responsible for discipline are understandable. Some are more frequent than others. To find the name of Staff Surgeon Thomas G. Balfour in the 'REPORTED BY' column is odd and surprising. His entry in the register deserves explanation.

Balfour's predecessors, surgeons Peter MacGregor and Samual (sic) G. Lawrence, served the institution from 1804 – the year following its opening - until 1848 when Balfour replaced Lawrence. Their time in the office covered 44 years, yet neither name appears in any extant documents that are not of medical significance. Similarly, Balfour's successors' names are absent from the register. This suggests that predecessors and successors all stuck to the letter and spirit of their Hippocratic oath. They were all dedicated to their calling when it came to the health of their charges. MacGregor, a most committed doctor of medicine, rarely left the premises during his 25 years at the Asylum. It was his deduction that solved the medical mystery that had plagued the Asylum in 1809-10, which was an unexplained outbreak of an eye infection that caused a number of children and nurses to go blind and, in many other instances, partially blind. The pestilence spread through the Asylum (boys and girls in 1809) like wildfire. For want of a better description of the pathology, a team of leading physicians from the City settled on the word opthalmia, meaning inflammation of the eye. Conjunctivitis, a common variant of opthalmia does not normally lead to blindness. The unexplained scourge, however, held the institution in its grip for almost two years. Surprisingly, the general population of Chelsea beyond the walls of the RMA was not affected. Nothing the consulting physicians recommended worked. Despite their best efforts they also failed to find the cause. Surgeon MacGregor, only rarely admitted to the deliberations of the experts, succeeded where they had failed.  

All other recommendations and hoped-for cures having failed, MacGregor, who had observed with care throughout the epidemic, persuaded the board of commissioners to authorize an issued of two towels for each child; one for use while the other was in the wash. A simple solution, yes, but not convincing when proposed. The expense would be high. Without knowing the reason, MacGregor noted that children fell sick in pairs. In common with practice in the army, each pair of children shared a single towel. In 1810, the RMA housed 1500 children (1,000 boys, 500 girls). They also slept in close confinement, two and three to a bed. At a cost of 8d each in the old currency, therefore, the total outlay for two towels per child was computed at 1500 x 2 x 8 divided by 240 = £100, a substantial sum in the annual operating budget. Even so, MacGregor persuaded the board and a miracle occurred without benefit of prayer. The pestilence that affected its sufferers in varying degrees of severity, some falling sick repeatedly, subsided and, within two weeks of getting new towels, the children were free of eye infections.

The importance of simple hygiene is today well understood. In 1810, the existence and effect of micro-organisms was unknown. Medicine was primitive at best. Joseph Lister and fellow pioneers in the science of microbiology was fifty years in the future. Surgeon MacGregor, was far ahead of his time if he only knew it. The real cause of the debilitating eye infection of 1809-10 was not solved until 2002 during the preparation for publication of The Charity of Mars, a history of the RMA from 1801 to 1892.

The admission registers showed that a large number of children arrived from Malta and Gibraltar in 1809, a week before the outbreak occurred, a line of inquiry suggested by Dr. Jack Leeson, general practitioner and surgeon living of Cobourg, Ontario. He suggested the most probable disease was trachoma, a malady not endemic to temperate climates. It is a sub-tropical disease common in North Africa, Egypt and Mediterranean locales such as Malta and Gibraltar. The Asylum registers showed that 25 children arrived from Gibraltar and Malta ridden with scabies (known as 'the itch' in 1809). The affected cases were sent to York Hospital for treatment before they could be admitted to the RMA. Unknown, one or more of the others admitted in all probability brought Trachoma with them. In the close and warm environment of the Asylum, the disease would easily have taken hold. Physician Leeson's diagnosis was confirmed by Dr. Timothy Foster, head of the Moyne Institute of Preventive Medicine, Trinity College, Dublin, Dr. Emma Jaikaran of Diabetes Research Laboratories, Oxford, and Dr. Catherine O'Connell of the Maxwell Finland Laboratory for Infectious Diseases at Boston Medical School.

Surgeon Lawrence was equally assiduous in his medical duties during his 20 year residence at the RMA. He is best remembered for his strong objection to a proposal to relocate the Asylum to Twickenham for the health of the children. He visited the proposed site and reported to the board that it was a swampy place of foul and noxious odours, totally unsuited to the health of the children. The board accepted his opinion and shelved the idea.  (The site Lawrence condemned later became the home of the Royal College of Music,  Kneller Hall.) 

For his part, Dr. Balfour appears frequently in the punishment register under the REPORTED BY heading. In the space of two years, his name appears in excess of 250 times out of a total number of 3,500 punishments administered. Balfour's is a record by any standard. Considering he had no responsibility other than the medical care of the children, his frequent appearance in the register is unusual. In connection with Seth, his name appears three times. Of his total reported 'misdemeanours' over the two-year period, analysis provides a revealing table:

Offences reported
Out of bounds
Band practice room
Church and chapel
Corps of drums
Telling a lie (Falsehood)
Neglect of duty
Committing a nuisance
Other acts of defiance

Offences of a medical nature would be understandable: 'Failure to appear for treatment', 'Not having a dressing changed', even 'Improper conduct to Dr. Balfour' (applied to Seth) is excusable. Putting boys on a charge for being 'out of bounds' as he did, twice in Seth's case, seems less fitting while those to do with band practice (damaging a musical instrument), church and chapel, and other acts of disobedience seem incongruous and bizarre. One wonders what Seth's improper conduct was; kicking the Dr. Balfour on the shins? dumb insolence? challenging his direction in some matter? The truth will never be known. One can only speculate. 'Committing an act of nuisance' in all four cases had to do with boys piddling to relieve themselves in places where they shouldn't.

Peter Goble, who is analyzing the registers and punishment books, offered an interpretation of Balfour's time at the school. He wrote, "The only conclusion I can offer is that he was under employed, and could well have prowled the campus as a pastime. There is mention of a Hospital Sergeant in the Soton [RMA Southampton Branch] Letter book; therefore, there was a Hosp. Sgt. at the main Chelsea institution. So minor day-to-day cuts, bruises to one of the little blighters could well have been attended to by the staff rather than the Doctor, he being called if the 'emergency treatment' was beyond the experience or training of the person on duty. We must also take into consideration that at that time the Asylum population was in the region of 450. Therefore, he could theoretically see every boy each and every day. If his day began at 0845 (Morning prayers are noted as beginning at that time) and ending after the evening meal, say 5.15, (several boys are reported for; not eating meat; hiding their greens), the time available is 8 1/2 hours or 1026 minutes or 2 1/2 minutes per boy. He had ample time, and a good knowledge of the boys' names, to be able to keep tabs on all at the school.

He was also responsible for the hygiene, his many tours round the various departments may well have been to complete a survey of the possible hazards that could or would affect the health of the boys. Piddling under windows, throwing stones at the walnut tree, drinking water out of the wc cistern, not forgetting the wet ward, boys wetting and fouling the bed, fighting, beating, greed in serving the server with large portions of pudding, bath parades with one poor lad being given extra drills for not putting his head under water. I am convinced there was only one ablution room, and the boys were marched there to bath-wash in rotation. There are several incidents of the Cpl losing a week's pay for not collecting or not being there to issue the towels. There are also several reports of boys being punished for sitting on another boy's bed, in the same bed as his brother, and several boys on the bed, in all cases, I consider that emphasis has been made, and entered into the report, "they were not undressed". He would also have been responsible for the diet and possibly the menus in a general term, "The boys need this and we shall give them ...!" Also a check of the deliveries of meat, but this most probably was done by the head cook. Exercise regimens for the boys with the new fangled Gymnastic Corps, and one so to speak in every camp.

On reflection, I would like to see his note books, for I feel that he should have made an extensive study of a static population of the RMA at its fittest, (all well fed & plenty of exercise) for the 10 years or so he was at the RMA. He will have been there as the RHMS began the measurement programme [age, height, weight, chest] (1847-1877 & 1877-1907). Perhaps the missing data is among his papers. Even a mere 2 hours a week on this project would have produced some fantastic figures, and the beauty of it all is that all he had to do was tell the Hospital Sgt "Measure 50 boys a week" or, even better, "Get the boy NCOs to do it, and they get lessons in comprehension, writing, mathematics and finally exercise in taking the results up the stairs to the hospital" or was it down?

Balfour's performance being as here in the records, his claim to fame in medical circles was in conducting one of the first recorded instances of statistical research studies during an outbreak of scarlet fever. It was, presumably, a study that led to his helping form, in 1859, the statistical branch of the Army Medical Department (later the Royal Army Medical Corps). During his time at the RMA, he tested the effects of administering belladonna (deadly nightshade) by dividing into two groups 151 boys whom he judged to be free of the fever. The groups were selected from names taken alternately from an alphabetical list. To one group he administered belladonna; to the other group none. The second group might be considered to be the 'control group'. As reported by Charles West, MD, in his Lectures on the diseases of Infancy and Childhood (1854), the results were inconclusive. Two boys from each group contracted scarlet fever. (For further information on this subject refer to the James Lind Library. )

It is to be presumed that Balfour wrote notes of his experiment and either shared them with his peers or gave them to West to publish his 1854 report. For another study, conducted during the nine years he was resident medical officer at the school, and having to do with smallpox vaccinations, Balfour was severely criticised by a later reviewer, Alfred Wallace MD, who claimed that Balfour's study was misleading as well as unscientific. He is alleged to have given smallpox vaccinations and kept a register, but no trace of the register has been found among the documents at the school.

By the time the Staff Surgeon left his post at the RMA in 1859 to take up duties in the newly-formed Statistical Branch of the Army Medical Department, Pte Enos Seth had become Trooper Seth of the 15th Hussars. One must hope that he led a productive and happy life as a trooper, but he had his trade of shoemaker to fall back on if he made a hash of military life.

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