entering upon his duties, but that he will keep up and correct his knowledge of the several localities as changes are effected therein. This, it might be presumed, he would necessarily do in the discharge of his duties as medical officer of health, but proof of this is required by fixing a definite or stated time for visits which will appear in his diary and reports, and be known in each locality. This regulation will be very useful, since there is a tendency in official work to become irregular and desultory rather than fixed and defined. It will also remove any ground for excuse of want of knowledge, for it will presume that the requisite knowledge should have been obtained at least at the fixed periods of inspection.

It also provides that the knowledge shall be gained by personal inspection, and not by indirect means, which again increases the responsibility of the officer. This implies that the medical officer of health shall visit every village and hamlet in his district, and perambulate it, noticing the sanitary state of the roads, drains, houses, water supply, and all other influences which affect or threaten to affect injuriously the public health within his district. If this duty be discharged with intelligence and thoroughness, the officer will not be in the hands of his inspector of nuisances or any other person, but will have personal knowledge, and be enabled to act with more satisfaction to himself, and, probably, with more justice to others. If, however, it be done cursorily, as by simply riding or driving through the hamlet and making an enquiry here and there, or observing only such matters as are very prominent or are specially pointed out to him, the spirit and essence of the clause will not be observed. At the same time a zealous officer should

make his inspection with caution and discretion, so that he may not unduly excite hostility or lose himself in a number of small and comparatively unimportant particulars, and it will probably avert much annoyance and conduce to the successful working of the Act if he make as few oral observations as possible at the time and avoid personal discussions. His inspection should be rather for his own information, and to make a proper record for subsequent action than to attempt to remedy evils on the spur of the

moment.

This important duty necessarily involves the expenditure of time and money, and demands proportionate leisure and salary. It also involves the question of the extent of his district, for if it be very large, his personal knowledge acquired by such visits will probably be soon forgotten, and thereby the chief object of the regulation will fail. There certainly is a limit to the extent of the district within which the officer will be the most useful. It is probable that the systematic visitation should not be less frequent than quarterly in the country, and perhaps somewhat more frequent in towns, but the period has been left to the discretion of the officer and the sanitary authority.

CHAPTER II.

PERSONAL ACTION

UNDER

THE DIS

EASES' PREVENTION ACT, 1855, AND DURING AN ATTACK OF EPIDEMIC DISEASE.

6. ON RECEIVING INFORMATION OF THE OUTBREAK OF ANY CONTAGIOUS, INFECTIOUS, OR EPIDEMIC DISEASE OF A DANGEROUS CHARACTER WITHIN THE DISTRICT, HE SHALL VISIT THE SPOT WITHOUT DELAY, AND ENQUIRE INTO THE CAUSES AND CIRCUMSTANCES OF SUCH OUTBREAK, AND ADVISE THE PERSONS COMPETENT TO ACT AS TO THE MEASURES WHICH MAY APPEAR TO HIM TO BE REQUIRED TO PREVENT THE EXTENSION OF THE DISEASE, AND, SO FAR AS HE MAY BE LAWFULLY AUTHORISED, ASSIST IN THE EXECUTION OF THE SAME.

17. WHENEVER THE DISEASES' PREVENTION ACT OF 1855 IS IN FORCE WITHIN THE DISTRICT, HE SHALL OBSERVE THE DIRECTIONS AND REGULATIONS ISSUED UNDER THAT ACT BY THE LOCAL GOVERNMENT BOARD, SO FAR AS THE SAME RELATE TO OR CONCERN HIS OFFICE.

THE action under Clause 6 is consequent upon receiving inforination, but it is to be noted that it is not limited to official information from the inspector of nuisances, but from any source whatever, including his own knowledge and even public rumour, and he would not be justified in waiting for any official instructions or official information. This direction should be liberally construed and held to mean that he

should adopt measures at the earliest possible moment to prevent the extension of the disease. The efficacy of such action will often depend upon the promptness with which it is undertaken, and a delay of even a few hours may prevent the possibility of the safe removal of a case of small-pox to an hospital, or allow communication between healthy with infected persons.

The causes and circumstances to be enquired into will vary with the nature of the disease, but are included in the following:

1. Approach to or Contact with Infected Persons or

Things.

2. Impure Water.

3. Decomposing Animal and Vegetable Substances and Filthy Houses.

4. Sewage Emanations.

5. Impure Air.

6. Meteorological and Seasonal Influences.

The first refers chiefly to such diseases as small-pox and scarlet-fever; the second, third, and fourth, to typhoid fever ; the fifth, to typhus-fever; the sixth, to influenza; whilst cholera is associated with the second, and probably with the fifth and sixth.

SECTION I.

APPROACH TO OR CONTACT WITH INFECTED PERSONS OR THINGS.*

The Sanitary Act of 1866 contains many useful provisions in reference to infected persons and things.

*See also page 198.

THE SANITARY ACT, 1866.

(29 & 30 Vict. c. 90.)

As to the Disinfection of Houses, &c.

Section 22. If the nuisance authority shall be of opinion upon the certificate of any legally qualified medical practitioner that the cleansing and disinfecting of any house or part thereof, and of any article therein likely to retain infection, would tend to prevent or check infectious or contagious disease, it shall be the duty of the nuisance authority to give notice in writing requiring the owner or occupier of such house or part thereof to cleanse and disinfect the same, as the case may require ;

And if the person to whom notice is so given fail to comply therewith within the time specified in the notice, he shall be liable to a penalty of not less than one shilling, and not exceeding ten shillings, for every day during which he continues to make default ;

And the nuisance authority shall cause such house or part thereof to be cleansed and disinfected, and may recover the expenses incurred from the owner or occupier in default in a summary manner.

When the owner or occupier of any such house or part thereof as is referred to in this section is from poverty or otherwise unable in the opinion of the nuisance authority effectually to carry out the requirement of this section, such authority may, without enforcing such requirements on such owner or occupier, with his consent, at his own expense, cleanse and disinfect such house or part thereof, and any articles therein likely to retain infection.

As to Use of Public Conveyances by Infected Persons.

Section 25. If any person suffering from any dangerous infectious disorder shall enter any public conveyance without previously notifying to the owner or driver thereof that he is so suffering, he shall, on conviction thereof before any justice, be liable to a penalty not exceeding five pounds, and shall also be ordered by such justice to pay to such owner