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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
Authority, 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 complaints 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 mortality 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 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 desirable to classify the deaths of the
district according to the part of the district in which they occur ; and for
this purpose any areas of known population may be taken as representing
" localities " for the purposes of the Order. Classification on this basis
will be likely to lead to the discovery of real differences when the returns
of several years can be compared together. The same considerations
apply to the records of sickness (Table B). These records should be
tabulated for every sanitary district, and it will be well before proceeding