THE PUBLIC HEALTH.

LONDON. After the reading of Mr. Rumsey's able address on "State Medicine," at the meeting of the British Medical Association in Dublin, a joint committee of that Association and the Social Science Association was formed, for the purpose of taking into consideration the best means of securing further sanitary legislation and, more especially, the revision and consolidation of existing sanitary laws. The committee has had several meetings, and an active correspondence has been carried on amongst its members. The result has been the publication of two separate documents, a "memorandum" and a "memorial," which have been submitted to Her Majesty's Government. On Friday, the 2nd May, a numerous deputation of members of parliament, members of the joint committee of the two Associations, and medical officers of health from various parts of the country formed a deputation to wait on the Duke of Marlborough, as President of Her Majesty's Privy Council, the Right Hon. the Earl of Devon, President of the Poor Law Board, and the Right Hon. Gathorne Hardy, the Home Secretary, for the purpose of urging the object of the memorial, which was to promote a better administration of the laws relating to registration, medico-legal inquiries, and the improvement of the public health.

If past experience had not demonstrated the almost utter hopelessness of pressing upon Government officials the necessity of amending the condition of our sanitary laws, it might have been hoped that the imposing demonstration that waited on the Government in May would have produced some impression.

Almost all sections of the medical profession and of the societies interested in sanitary matters were represented. The president elect of the British Medical Association, the president of the Medical Council of Great Britain, the late president (Sir Thomas Watson) of the College of Physicians were there. Dr. Rumsey, of Cheltenham, Dr. Farr, of the Registrar-General's Office, Dr. Guy, and Mr. Chadwick were there. The deputation was, in fact, a parliament, a body of men who thoroughly understood the great questions they were about to urge upon the Government, and who if representative institutions were in this country what they ought to be would not be suing to be heard, but would be placed in a position where they might legislate on the great subject they so thoroughly understand. The memorial of the deputation in the first place sets forth that the time has come when the imperial parliament ought to take seriously into its consideration the question of whether any of

the crude mass of legislation of which they have been guilty for the last twenty-five years has been of any good at all; whether it has not "tended to defeat, in whole or in part," the object it has had in view. The memorial then speaks in detail of the deficiencies of certain departments of state action in relation to health matters, and begins with registration. It deprecates the present imperfect system of registering births and deaths, and speaks of the absence of any registration of still-births and disease. The next subject alluded to is the present imperfect method of working medico-legal inquiries, requiring the coroner to employ inefficient medical witnesses, and refusing him the aid of efficient and experienced experts in his inquiries, and thereby encouraging secret murders, especially poisoning. The memorial also speaks of the present system of dealing with medical evidence in courts of law as such that it "altogether prevents the discovery of truth, discredits scientific medicine, and is a fruitful source of perplexity and misconception to bench, bar, and jury.

The memorial then refers to the fact that in many of the large towns of the kingdom the death-rate is steadily increasing, and that, in spite of all our sanitary legislation, few towns have taken advantage of it; that in scarcely any of them have medical officers of health been appointed at all. It also draws attention to the fact that the amount actually disbursed under the present disjointed and very inefficient system would, if otherwise distributed-the districts and many of the duties being consolidated-go far to maintain a sufficient staff of specially trained and highly qualified district scientific officers with inspectorial functions. The memorial concludes:

"For all these reasons, and for others set forth in the accompanying 'memorandum' (drawn up by Dr. Rumsey, and approved by the joint committee), we ask for a thorough, impartial, and comprehensive inquiry, by a royal commission, having power to visit, or to send sub-commissioners to visit, the large towns, and other districts of the country, to obtain information and evidence, and to report

on:

"1. The manner in which the cases and causes of sickness and of death are and should be inquired into and recorded in the United Kingdom.

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2. The manner in which coroners' inquests and other medicolegal inquiries are and ought to be conducted, having reference particularly to the methods of taking scientific evidence.

"3. The operation and administration of sanitary laws, with special reference to the manner in which scientific and medical advice and aid in the prevention of disease are and should be afforded; and also with special reference to the extent of the areas or districts most convenient for sanitary and medico-legal purposes.

"4. The sanitary organization, existing and required, including a complete account of the several authorities and officers. The education, selection, qualification, duties, powers, tenure, and remuneration of the said officers to be specially reported on.

"5. The revision and consolidation of the sanitary laws, having special reference to the increase of the efficiency of their administration both central and local.'

The speakers on the occasion were Dr. Acland, Mr. Chadwick, Mr. Michael (formerly a medical man, now a barrister), Dr. Sibson, Mr. Acland, M.P., Dr. Symonds, Dr. Stewart, and Dr. Rumsey. Most of the speakers urged upon the Duke of Marlborough the necessity of a Royal Commission. Dr. Symonds, of Bristol, late a president of the British Medical Association, urged the creation by the Government of a new order of medical men, who would give their undivided attention to sanitary matters and to questions of medical jurisprudence. He said, speaking of medical men as at present authorized, "they were chiefly educated for the care of the sick; and, in the practice of professional duties over some years, a great deal of the knowledge which they primarily possessed would be found to have slipped away from their memories when they were suddenly examined upon some particular point requiring minute investigation. Now the medical man, when called upon to give evidence in a court of law, had to do so on three different heads. He had to give evidence such as an ordinary witness would on points which would be within general observation; then he had to give evidence of matters which had come within his knowledge as a professional man; then he was called upon to speak as to circumstances of which he was supposed to possess a knowledge by an acquaintance with chemistry and natural science. But it must be stated that a man might have possessed a great amount of knowledge of chemistry and natural science at an earlier time of his life, without being able to prove his knowledge in a law-court; and he might be a most able practitioner, yet, when called upon to discharge the duties of a medical jurist, might show great shortcomings. Then medical men were differently qualified in different parts of the country, and while some were educated well, others were educated ill. Surely, under these circumstances, it was not right that men should have the administration of the sanitary laws with only a general professional knowledge. This was a most important point, for the people had the right to have the best and most efficient officers to be obtained. What was required in Lincolnshire was demanded in Lancashire, and it was not right that there should be any difference in the qualification of the men who were to administer these important laws either in the one place or the other. It seemed to those who attended there, that a new order of medical men should be called into existence, upon whom should devolve the consideration of all those questions,

who should be able to advise and instruct in all matters of sanitary science, and who would be able to answer off-hand all points which might easily have passed from the mind of general practitioners. Such a new order of medical men, by their influence on the public, by the education of the public in the laws of health, would do a vast amount of good among all classes of Her Majesty's subjects."

The Duke of Marlborough listened attentively to all the speakers said, and having replied, concluded by saying, "Whether the information wanted could be obtained by a Commission or through the offices, was a matter of secondary consideration." The Duke was quite right; nothing but delays, vexations, and annoyance will attend either process. Why do not the sanitary reformers go to the public? For ourselves, we confess that we are heartily and indignantly tired of waiting on Government officials; it has never ended in anything but vague promises and disappointment. If sanitary legislation is to be ever more than a mere name, it must be done through the people. Their voice must be heard in the House of Commons, and six men in earnest about Sanitary Reform in the Lower House, would carry every object asked for by the memorial in six months.

In connection with the above deputation, we may mention that the 5th clause in Mr. Torrens' 'Artizans' and Labourers' Dwellings Bill,' appointing officers of health without medical qualifications, has led to the following resolution from the Joint Committee on State Medicine :

"That the chairman and secretary of this Committee be instructed without delay to call the attention of Her Majesty's Ministers to the 5th clause of the 'Artizans' and Labourers' Dwellings Bill;' and to urge them to withhold their assent to that clause on the following grounds :

"1. That it would increase the confusion already existing, by creating, under the title of officers of health,' an inferior, unqualified, and inefficient class of agents, whom it would be difficult to supersede.

"2. That it would leave the appointment, remuneration, and dismissal of the proposed officers of health unconditionally in the hands of the local authorities.

"3. That an inquiry is about to be asked for into the appointment and action of medical men in the public service, and that, until the results of such inquiry, if granted by Government, shall be known, it is highly inexpedient to legislate on the question of health officers.

"4. That a better agency than that proposed in the said clause already exists; namely, the district medical officers under the Poor Law, who, pending the appointment of medical officers of health duly qualified and properly protected in the exercise of their functions, might be employed in that capacity, and should receive additional remuneration for such services."

It has appeared good to Messrs. Dixon, Kennard, and Goldney, Members of the House of Commons, to propose a Bill to amend "The Act for preventing the Adulteration of Articles of Food and Drink, 1860. Whether the new powers to be given of fining and imprisoning persons who sell adulterated food, and which are also extended to drugs, will galvanize the old Act into life may be questionable. The effort, however, is a good one, and deserves to be encouraged. We miss from this Bill the authoritative declaration, "Thou shalt not commit adulteration." Like all other permissive Acts, it gives the impression that, provided the authorities do not appoint analysts, and do not analyze the food, it is a man's privilege to adulterate.

Another sanitary Bill has also been brought into Parliament by Messrs. Clive, Golding, Newton, and Wyld, entitled 'A Bill to make better Provision for facilitating and regulating the Supply of Pure Water in Cities, Towns, and Districts throughout the United Kingdom of Great Britain and Ireland.' The clauses of the Bill will give power to persons to require that every company supplying water to a district shall supply every house in that district, and also to persons to require that landlords require the said companies to supply all dwelling-houses and tenements occupied by human beings with water.

These Bills are undoubtedly efforts in the right direction, but they are a part of the everlasting tinkering that is going on about all our sanitary legislation. It is rotten and leaking in every direction, and nothing but a sound foundation will ever give it security or value.

SCOTLAND. The Scotsman' newspaper has recently had a series of articles on the question, "Is the Rate of Mortality Increasing?" They were very ably written, and by a person who evidently has access to the freshest and most reliable information, and whose acquaintance with the sanitary literature of the last thirty years is both extensive and varied. Having read the articles in question, we can scarcely feel inclined to answer the author's question in the affirmative. It would be one of the greatest slurs that could possibly be cast upon the medical and sanitary science of the present day, if we were even to believe that the rate of mortality is increasing. It is certain that, so far as Scotland is concerned, there is much difficulty on the part of the authorities to abate those nuisances and insanitary arrangements which result in the production of epidemic disease, and necessarily in the production of a high death-rate. In Glasgow, for instance, there is perhaps one of the most completely organized staffs of Sanitary Officers that can be found in the United Kingdom, and yet epidemic disease and a high rate of mortality still continue to manifest their existence in the community. The staff in question consists of the principal Medical