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144
the medical officer of health of the district a certificate"
giving certain specified particulars relating to the case. It
occasionally happens that two medical men are called in
successively, and manifestly it is the duty of each to notify.
Either would be liable to prosecution for neglect to do so,
and each is manifestly entitled to the statutory fee.
Each case must be judged on its own merits. Should
any question arise, it is the Sanitary Authority which has to
decide whether the second or the third fee should be paid—if,
indeed, they have any discretion in the matter ; for a copy of
the certificate must be sent to the Asylums Board, and as the
functions of that body are purely ministerial, they will
always repay the fees paid and claimed by the Sanitary
Authority. Little, if any, of the suggested damage could
accrue to the sanitary reputation of a district by the temporary
inclusion of duplicate notifications, even if the weekly list
were published ; seeing that the average number of duplicate
cases, in 1892, was only 30 weekly, for the entire metropolis,
the average weekly number of notifications being 910. But
there is no such publication. In fact, there is no publication
whatever of the notifications, other than the four-weekly
list in my reports, excepting in the annual report of the
Statistical Committee of the Asylums Board, from which
duplicate notifications are excluded. The cases notified in
1892 were 45,849, or 1,487 fewer than the uncorrected total.
The dual notifications, therefore, were in round figures, equal
to about 3 per cent, of total notifications. In our own parish,
the dual notifications were 59 in number, many of them being
due to reports received from the Medical Officers of hospitals
who are required by the Public Health (London) Act, 1891,
to notify the admission of infectious cases to such institutions.
The Infectious Disease (Notification) Act, 1889, exempted
the medical officers of general hospitals, infirmaries, etc.,
from the obligation to notify. This exemption being