London's Pulse: Medical Officer of Health reports 1848-1972

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Shoreditch 1858

[Report of the Medical Officer of Health for Shoreditch]

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17
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Fever and Diarrhoea depend upon causes now well
ascertained; causes which may exist in the country
village on the hill-side, as well as near tidal rivers. I
venture to say that no Medical Officer of Health or Poor
Law Surgeon is ignorant of these causes.
Where Fever prevails, there, overcrowding, dirt,
cesspools, destitution, hovels without back-windows, bad
water are found. Given, these conditions, the presence
of Fever is certain. Given, the Fever, you find these
conditions. It is both illogical and dangerous to be defending
yourself against an imaginary enemy at a distance,
when the real one has taken possession of your
home.
3. The evidence of direct medical observation. In all
sanitary inquiries the evidence of direct medical observation
is essential for the purpose of checking the
results of the mere statistician. The figures with which
the statistician deals, are assumed to represent groups of
similar and comparable facts. Unless exceeding circumspection
be used, the application of statistics to the
complex questions of biology is likely to lead to the
grossest fallacies. In so far as the results flow from
mathematical operations they may be entitled to confidence.
Bnt, since a figure can only represent one fact,
all the details of a medical case, such as the history of
the disease, the time, place, and other circumstances of
origin, its progress, and complications must be thrown