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42
their attention to the omission on the part of the visitors to
report cases, the "divisional members," to whom my communication
had been referred, simply agreed that the visitors should
report cases when they had reason to suppose that no duly
qualified medical man was in attendance. "When a duly
qualified medical man has chai'ge of a case, they are not prepared
to do more than take steps for seeing that proper
precautions are taken at the Schools." This decision, if final and
acted upon, would be regretable, as I am sure the Visitors
could render us essential assistance by giving effect to the
original instructions of the Board.
6. Clergymen and District Visitors not unfrequently report cases of
sickness.
7. The Kesident Medical Officers of St. George's and St. Mary's
Hospitals have on many occasions reported the admission of
cases, or the application of inadmissible cases of illness from
houses in this parish.
8. Occasionally anonymous communications are the source of
formation, for I have not felt at liberty to disregard such
communications, which have generally proved accurate.
In one or other of these several ways cases come to our knowledge;
but, all told, they form only a small percentage of total cases, as
proved by the fact that the great 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 regretable state of affairs is legislation to
ensure the compulsory disclosure of the occurrence of infectious diseases.
The main question with 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, however, 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. When there
is a duly qualified medical man in attendance it would suffice to require
that he should give a certificate stating the nature of the complaint
which it should then be the duty of the head of the family, or the