View report page

84
Parish of St. George the Martyr, Southwark.
The report should be chiefly concerned with the conditions affecting health in the
District and with the means for improving these conditions. It should consider these
subjects with reference to the past and future as well as to the particular year; and
the account of the sanitary state of the District generally should, while marking the
point that has been reached in the sanitary state and administration of the District,
indicate directions for further consideration and action. The sanitary history of the
year under review should include a record alike of the proceedings of the Medical
Officer himself and of the proceedings taken tinder his direction or advice.
The Medical Officer of Health, in reporting his proceedings and advice, may find it
convenient to follow, in the main, the order in which the subject matters of his duty
appear in the several paragraphs of Article 18. Special care should be taken to report
fully and explicitly in reporting on the influences affecting or threatening to affect
injuriously the public health within the District; and the causes, origin, and distribution
of disease within the district may usefully be the subjects of annual record. An
account should also be given both of the actual circumstances of the District tip to the
end of the past year, and of any improvement or deterioration that has occurred during
the year in conditions conducive to health or to disease. For example, a vigilant health
officer has in his annual report an opportunity for pointing out any facts as to water
supplies and house construction, conditions of storage, and of removal of refuse
customary in the district; together with any facts as to the adequacy or inadequacy of
means of isolation and of disinfection, and the like. And such a Health Officer, reporting
on the diseases and their causes within the district, will generally have some
instructive details to give, either of conditions newly productive of disease, or of matters
that have been remedied with advantage to the public health.
In reporting upon section 3, not only should the fact of having made systematic
inspections, but the outcome from those inspections should be duly put on record. The
report should contain a full account of inspections, whether systematic or occasional, of
the judgment which the Medical Officer of Health has formed thereon as to the sanitary
state of his District, and of the .advice he has in consequence given to the Sanitary
Authoity and the action taken by the Authority thereon. By "systematic" inspections
are meant inspections independent of such enquiries as, under other article of the Order,
the Medical Officer of Health has to make into particular outbreaks of disease, or into
unwholesome conditions to which his attention may have been specially called by complaints
or otherwise, and such inspections will include the house-to-house inspections
which may be necessary in particular localities.
In making systematic inspections, as in much of his other action, the Medical
Officer of Health will usually have required the assistance of the Inspector of Nuisances ;
and it will be for the Medical Officer to include in his report an account of the action
which, at his instance, the Inspector may have taken for the removal of nuisances
injurious to health.
The tabular statements of sickness and mortality in the District during the year,
to be made on the forms supplied for the purpose, should be the subject of comment in
the text of the report, in so far as deductions from them may assist the Sanitary
Authority to an appreciation of the lines of action needful in the future.
As regards these statements of sickness and mortality only one other observation
appears to be needful—the District under the superintendence of a Medical Officer of
Health will often contain several parts evidently differing in their circumstances, or
having very different rates of mortality, either from all causes, or of motality from
some particular disease or class of diseases. The observation of these differences can
scarcely fail to lead to valuable information, and it is in view of such differences that
the tabular statements are required in Section 15 to be classified according to localities.
and that provision for such a classification is made in the forms supplied for returns of
deaths, In the absence of any ascertained differences of the above sort, it will still be