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What we now propose is this: to put into action by our present
future sanitary laws, a simple machinery, by which contagious
maladies, or those diseases termed pestilential, contagious
infectious, or catching and spreading— such as small pox,
scarlet fever, measles, whooping cough, typhus, typhoid, and
puerpreal fevers, erysipelas, and cholera, should at all events, if
required by the santitary authorities, be made known to the
medical officer of the district. With small pox and typhus, the
plan would soon extend to the other forms of catching diseases.
Not merely by the registration of Deaths (as we now have),
but an early notice of the origin, and locality of these diseases,
so that measures may, if necessary, be taken for the protection of
public health, by preventing a further extension, and removing
an obvious and threatening danger to the community. It would
benefit all alike, rich and poor, to have larger powers for compelling
strict isolation, whether at people's own dwellings, or
by removal to hospitals.* Other diseases will be sufficiently
known for statistical purposes by the simple registration of death.
My belief is that at present we require only a registration of
the epidemic or zymotic diseases. It should be compulsory for
prompt information relating to all such cases in hospitals,
dispensaries, refuges, workhouses, schools and tenant houses,
let out to more than one family, to be reported to an
officer of Public Health of the District. This return must
be compulsory as to the name, address, and condition of people
suffering from the said contagious diseases. In this way very few
cases would escape observation. Penalties would have of course to
be inflicted for concealment, or for refusing to give all reasonable
information to the sanitary authority. The returns should
be sent periodically to a central office by the registrar of the
district. These data would form the basis of work for administrative
action, that could not fail to be attended with excellent
results.
Separation and Isolation of persons suffering from
Contagious Maladies.
Large hospitals at a distance, and exclusively intended for
paupers, are ill adapted as a permanent arrangement for carrying
* "It surely could not be reckoned a hard measure," said Sir James Simpson,
"for the public safety that every householder should by himself, or through his medical
attendant, be obliged by the legislature to report upon the existence of any case of small
pox that might appear in his establishment. In the same spirit every medical practitioner
might be bound to report immediately any case of the disease so found in his practice."