In his anecdote, Orwell used a lot of literary and historical references that are useful in explaining the current period that he was in. “How the Poor Die” is set in Paris, back in February 1929. At that point, Orwell wrote that hospitals already have a negative image even before he wrote his anecdote. In paragraph 5, Orwell referred to a variety of literatures from the 19th Century. Tennyson’s poem, The Children’s Hospital and the conversation between Bob Sawyer and Benjamin Allen remains unfamiliar for modern readers. Orwell also mentioned a few other characters from the 19th Century that also has the same impression of hospitals. This includes George III who shrieks when surgeons approach him, and “the names given to doctors in nineteenth-century English fiction, Slasher, Carver, Sawyer, Fillgrave and so on” (paragraph 5 line 13). A brief description of literatures from the 19th century like those mentioned before allows modern readers to understand the relation of the negativity of hospitals and these characters. Therefore, since Orwell gathered his historical references in one paragraph, modern readers still have the ability to determine that in this paragraph, Orwell is informing readers that a lot of people have always had a negative image of hospitals, even before his stay at Hôpital X.
To give readers a view about the horrific Hôpital X, Orwell used a variation of imagery to describe mostly negative perspectives about his experience. Orwell first described the setting. One of them was the ward