Born 9 April 1872 at Hadley, Kerry district, Montgomeryshire, the second child and eldest son of William H Pugh, a civil servant, and Annie Grant, his wife. He was educated at Ardwyn School and the University College of Wales, Aberystwyth. He entered the Middlesex Hospital as a scholar in 1889, won the Governor's scholarship in 1893, was senior Broderip scholar in 1894, the year in which he took the Conjoint qualification, and in 1895 at the London MB, BS examination he took honours in medicine and obstetrics and first-class honours in surgery. He served as house physician and house surgeon at the Middlesex and as resident medical officer at the Hackney Road Children's Hospital. In 1897 Pugh entered the fever service of the Metropolitan Asylums Board, and in 1907 was superintendent of Gore Farm, later the Southern Hospital, at Dartford, Kent. In 1909 Pugh was appointed the first superintendent of the Children's Hospital at Carshalton, Surrey, which as Queen Mary's Hospital for Children he made a most important centre for the treatment of surgical non-pulmonary tuberculosis, with 1,300 beds. In 1930, when the functions, of the MAB were transferred to the London County Council, Pugh became chief medical superintendent of the LCC children's and surgical tuberculosis services. He was elected a Fellow of the College as a member of twenty years' standing in 1935, and retired in 1937. Pugh was consulting surgeon to the King Edward VII Welsh National Memorial for the treatment of tuberculosis. He served as president of the section of orthopaedics at the Royal Society of Medicine in 1926. He was also an active member of the British Orthopaedic Association. He had served on the LCC departmental committee on hospital standards. Pugh made some mark as a bacteriologist, but the life-work which won him a wide reputation as "Pugh of Carshalton" was in the progressive organization of a large-scale service for the treatment and after-care of non-pulmonary tubercular children. His career ran parallel to that of Sir Henry Gauvain. As early as 1909, the year of his appointment to Carshalton, he showed the need for open-air treatment, and later made use of open-air heliotherapy and actinotherapy. In 1912 he organized the education of the children in his charge, at the Carshalton Hospital School. He designed and perfected, through a series of modifications based on practical experience, the "Pugh" frames and carriage for patients with tuberculosis of spine and hip, which allow facility in nursing with a minimum of intervention. They also allow the patient free exercise of limbs and lungs, and make sun and ray treatment easy. He organized a series of special units at Carshalton: for children suffering from marasmus, for non-tuberculous orthopaedic conditions such as poliomyelitis, cerebral palsy, and osteomyelitis, and for congenital malformations. The unit for juvenile rheumatism, which he established in collaboration with his deputy Sir Norman Gray Hill in 1926, had 390 beds when he retired in 1937. Pugh had width of vision and knowledge. Though a strict disciplinarian he was genial and affable, and took infinite pains in teaching and helping his assistants and nurses, and followed their careers with care. His book on *Practical nursing*, written with H E Cuff and his sister Alice M Pugh, went through fourteen editions, the later issues being the product of his leisure in retirement. His recreation was travel. Pugh married in 1909 Elaine, only daughter of David Edmond Hobson of Shaftesbury, Fort Beaufort, and St Laurence, Adelaide, South Africa. Mrs Pugh survived him with a son, Surgeon-Lieutenant Patterson David Gordon Pugh, RNVR, and a daughter, the wife of a doctor. He died at Greyholme, 6 Browning Avenue, Boscombe, Bournemouth, on 22 July 1945, aged 73. Publications: Method of staining B diphtheriae. *Lancet*, 1905, 2, 1901. Spinal caries in children; a method of fixation. *Lancet*, 1921, 1, 1071. Method of treating hip disease; traction by suspension. *M A B Reports*, 1926. *Practical nursing, including hygiene and dietetics*, with H E Cuff and A M Pugh. 14th edition, Edinburgh, 1944.