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to the several Medical Officers of Health any cases of infectious
disease that may come to their knowledge in the
discharge of their official duties, which take them constantly
into the homes of the poorer classes. To facilitate the
transmission of this information by the " Visitors," your
Vestry authorised me to prepare a form for their use, which
has been done.
6. Clergymen and District Visitors not unfrequently report
cases of sickness.
7. The Resident Medical Officers of St. George's and St.
Mary's Hospitals have on many occasions reported the
admission of cases, or the application by inadmissible cases,
of illness from houses in this parish.
8. Occasionally anonymous communications are the source of
information, for I have not felt at liberty to disregard such
communications, which have generally proved accurate.
In these several ways many cases of illness come to our knowledge;
but, all told, they form only a small percentage of total
cases, as proved by the fact that the large majority of fatal cases
remain unknown till after registration of death—a fact from which
it is a fair inference that a still larger proportion of non-fatal cases
never come to our knowledge at all.
The only remedy for this regrettable state of affairs is legislation
for the compulsory disclosure of the occurrence of infectious diseases.
The only question among sanitarians is, Who should be
the informant? As a rule the information will have to come,
directly or indirectly, from medical men. In those cases, and
they are not few, where either no medical aid is sought, or where
unregistered practitioners are employed, the information,
if supplied at all, must come from the head of the family or
from the "occupier" of the house. Where there is a duly
qualified medical man in attendance it would suffice to
require that he should give a certificate showing the nature
of the complaint, which it should then be the duty of the head of
the family, or the occupier of the house, to forward without delay
to the sanitary authority, as is done now in respect of the medical
certificate of the cause of death. This is the plan recommended by
the Society of Medical Officers of Health and it is I believe the
course adopted in those boroughs where under Local Acts, the
disclosure of such cases has already been enforced. Having regard
to the relations of doctor and patient, it is useless to expect that
the desired information will be at all generally given by medical
men until it is made their duty as law-abiding citizens, to supply
it: and even then the exaction should be made as little onerous as
possible, whether or not the public service rendered by the giving
of such certificates is recognised by the payment of a suitable fee.