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103
[1902
The report, however, shows, and shows very plainly, that the policy of
appointing medical experts to assist general practitioners was sound, and that
the results were very satisfactory. Under these circumstances one would not
have been surprised to learn, indeed, one would have fully expected that the
London County Council's Public Health Committee would have retained
the services of the experts so long as Small Pox cases continued in London,
but to every one's surprise they did nothing of the sort. On the contrary,
they eported that they "do not consider it necessary at present to continue
the arrangement" after November 6th. Their action indeed stood selfcondemned
by a later paragraph in their report, which adduced the most
cogent argument that could be supplied for the retention of the services of the
medical experts until such time as the London County Council considered
that Small Pox had disappeared. This paragraph was as follows: "At the
commencement of the Small Pox epidemic in June, July, and August, 1901,
the principal local outbreaks were due to the mistaking of modified Small
Pox for Chicken Pox, and that before and since there have been numerous instances
of wrong diagnosis with serious results." The italicised words, which do not
appear in this form in the report, prove incontestably that the retention
of the consultants was advisable, indeed necessary, considering the
lamentable failures of the general practitioners, which this report points to,
that occurred throughout the epidemic.
There can be no objection to the notification of Chicken Pox, when
its purpose is to prevent the spread of the disease itself, for thereby
useful purposes may be served, as, for instance, its prevention amongst
young children, and the consequent protection of the schools. When,
however, its utility comes to be examined as a protection against Small Pox,
a very serious question is involved. There has always been an honourable
understanding between the Public Health Authorities and the Medical
Profession that their notification certificates should be received as evidence
of the existence of disease, and that medical officers of health would not, by
examination of the patients, satisfy themselves that it had been correctly
diagnosed. If there had not been this understanding there never would
have been a Compulsory Notification Act. If, however, the notification
of Chicken Pox were to prove useful in detecting Small Pox, every case
after its notification should be visited by the Medical Officer of Health
or some medical man acquainted with Small Pox on his behalf, to ascertain
its nature, for otherwise the disease could not be detected. Such conduct
as this is clearly a breach of faith with the medical profession, and is
calculated to raise opposition to the notification of other infectious diseases,
which many practitioners even now like none too cordially, and to lead to
serious friction between them and the Health Authorities. No friction has