The work depicts a plague ward (or lazar house) in the West Indies, which Duggan visited, and the presence of chains conveys the involuntary nature of the subjects' isolation. For much of his adult life, Duggan himself struggled with tuberculosis, adding an autobiographical aspect to his composition. The inscription at the lower edge, "Take physic, pomp," is a passage from Shakespeare's King Lear, in which Lear exhorts himself to experience the hardship suffered by the less fortunate and learn from it (National Academy Museum).