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Hanover Square, asked me to see a case of diphtheria with him, and
I did so. The child was choking, and the only thing that could be
of any avail was tracheotomy or intubation, and I left the house
after giving that opinion, and I believe that a surgeon was applied to
and that an operation of some kind was performed. Some few
weeks afterwards I was much surprised to receive a curt official note
from the office of the medical officer of health for the said parish,
inquiring why I had not notified the case to him as I was bound to
do. I replied that I never did notify, that I always left that duty
to the medical man in charge.
The answer I received to this was that the Act requires every one
who is called in to a case of infectious disease, scheduled under the
Act to notify, and I was referred to the wording of the Act, which
reads that "everyone attending or called in to visit shall," etc. I
was further politely informed that as I had sinned in ignorance no
action would be taken on this occasion. In other words I must not
be a bad boy again or I should receive a whipping.
Now there is no doubt that the strict letter of the Act is in accord
with the contention of the medical officer of health of St. George's,
Hanover Square, but it is obvious to me that this strict interpretation
of it was not intended by its framers, for see what it leads to. In
the case I have given three of us saw the case, and we all were in
duty bound to notify. In another instance the gentleman who first
saw the case notified it as scarlatina; I came next, and thought it
was enteric fever; a friend who saw the gentleman in my absence
did not know what it was, and after a few days it turned out to be
influenza. Take one other case: I saw in consultation a bad case
of scarlatinal nephritis in the fourth or fifth week after the fever.
The boy was peeling freely. He was infective enough certainly.
According to the medical officer of St. George's, Hanover Square, I
ought to have notified. If so there would be no end to the work of
the medical officers of health. Their energies would be eaten up in
finding out who was who and what was what. But, Sir, I would
interpret the letter of the law thus: Everyone "attending, or called
in to visit," is a legal periphrasis deliberately intended by the
draughtsman to cover his man, namely, the doctor first called in to
see the patient. And very wise is this wording in my opinion, for
there are many cases where there is no attendance ; the doctor is
merely called in to say what a disease is, and he never sees the case
again. The only instance in which I have myself notified was a case
of this sort: I was asked to see a case of scarlatina, to say what it
was; there was no one in attendance, but I was covered by the Act,
being called in to visit, so I notified.
I venture to urge, Sir, most strongly, that this is the reasonable and
right interpretation of the Act as regards the duty of those called in