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medical practitioners or by coroners, has steadily declined of
late years. It was 4.7 in 1879. The percentage varies widely
in different parts of the Kingdom. In 1893 it was 0.9 percent
in London ; 0.13 in Kensington ; 2.7 in England and Wales
as a whole ; ranging upwards to 5.4 in North Wales, where,
probably, certification is often impracticable, because, by reason
of the inaccessibility of the place of death, or remoteness from
a doctor's residence, medical attendance cannot be obtained.
In such cases the suggested duty would be impossible of
performance by the Medical Officer of Health. It would
take up too much space to deal exhaustively with the subject,
but I may further remark, speaking now from my experience in
this Parish, that, practically, all deaths returned as " uncertified "
are referred to the Coroner, and registration takes place only
after the Coroner's decision that inquisition is unnecessary.
The preliminary inquiry by the Coroner's officer is not satisfactory
; and it is probable that in many of the cases in which
inquests would be held under existing circumstances, an inquiry
by an expert—e.g., a Medical Officer of Health—would save
the time of the Coroner, and of persons liable to serve as
jurymen, as well as some expense to the county, if his decision
that an inquest was unnecessary were accepted. In these
circumstances,the Medical Officer would become,practically,the
"Coroner's Officer," as indeed the St. James's Vestry proposed.
If suitably remunerated for the task, he might reasonably be
authorized to inquire, in the first instance, into the causes of
uncertified deaths, and to certify in proper cases ; referring
those from violence, or otherwise involving suspicion of foul
play,to the Coroner. Any such change would require legislation
to give it effect ; but it may be doubted whether the legislature
would entrust to any individual powers of such an exceptional
nature. In the cases of deaths registered as " not certified," in
which,after reference to the Coroner inquest is not held,it cannot
be doubted that an inquiry and report by a Medical Officer of
Health would be more satisfactory than that by a Coroner's