Volume 2
First-[second] report of the Royal Sanitary Commission.
- Great Britain. Royal Sanitary Commission
- Date:
- 1869-1874
Licence: Public Domain Mark
Credit: First-[second] report of the Royal Sanitary Commission. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
66/418 (page 58)
![UOYATi SANITARY COMMISSION rfWP]Jf{N1J^Egr^<3SBvxBVJDENeiafr i?. Baker, some special examination to show that they are fit for ■^^l- such office ?—I think they should. , j^jj jg^Q 9519. Did I rightly understand you to say or to '- - ' infer that each of them, notwithstanding this exami- nation, should have had some previous practice of his own ; some experience, I mean, in the treatment of disease?-—I think that that should be also; and I think that a gentleman having had such experience would be the only kind of person who Avould present himself for an examination. ; ,■ - 9520. You would not have it an examination which was undergone by a mere student in the first instance, but by a man who liad been engaged in practice, and who offered himself with those quali- fications in the first place ?—Yes, that is what I suggest. 9521. -Do not you think that the appointment of those health officers, besides the immediate benefit which would arise from it, would have this good result, that it would instruct medical men in the knowledge of what we call here State Medicine, that is to say, of all questions relating to the preservation of the public health ?—It would necessarily lead to a course of study, so that we should by-and-by have a class of men of quite a different character to what we have ]iow. 9522. You mentioned that in your opinion medical men throughout the country ought to be registrars of births ex officio, and receive the ordinary fee. What is that fee ?—I really do not know ; 35. 6c?., I think, but I am not sure. 9523. Do they receive any fee for the registration of deaths ?—I do not know. I think that the regis- trars do, and if they do not I think they ought, be- cause with the new forms of registration which I hope will come uased upon the experience of gentlemen of such great ability as we have now upon sanitary matters, a great many more questions and investigations will be necessary in case of death to get at the trade, the idiosyncrasy, the locality, and many other things. 9524. You have been asked a question with respect to the registration of diseases; does it occur to you that there would be any great difficulty in getting returns of diseases ?—No, I think not. 9525. Would it not be comparatively easy to get them, at any rate, from all institutions which are kept up at the public expense, such as hospitals and so on ? —Yes. I do not think that there would be any diffi- culty in it at all. 9526. There might be a difficulty, might there not, in getting them from separate practitioners ?—Thei'e is esprit de corps enough amongst the medical men in places to give a great deal of information added to that which would be collected from public institutions, which would render it very_^ valuable, I think. 9527. I think you also said that the examination by the certifying surgeons was of use in this way, not only to detect and report upon any inadequacy for work on the part of children brought before them, but that no sickly and very few younger children than the law allows were brought before them, because it was known beforehand that they would be rejected ?—That is so with sickly children, and comparatively so with young children. 9528. So that they are of more use than is obvious upon the surface, like many preventive remedies, which the more successful they are the less apparent is the need for them ?—It is a curious fact that in 1833, when the number of persons deformed in the knee, and with flat foot, and deformities of the spine were so grekt as to call for public attention^, 10 years after the Act had been passed compelling them to appear before the certifying surgeon, in 1844, you could not find an example, except it was an old person. 9529. {Mr. Whitbread.) With regard to your sug- gestion that eveiy medical officer should be ex officio registrar of births, how in your view would that chefik ■ infanticide ?-—In'the first place, where persons are employed in procuring abortion, of which there is evidence in the paper this morning, the second time the person';had; been brought bef&re the magistrate, the very fact of an inquiry as to how the abortion happened and who had been the attendant, would render it so dangerous an occupation that I think it would not be followed. With regard to the other part of the question, it would be useful in this way. In the Black Country, lately, when a surgeon was with me, I spoke to a woman and I said, You have plenty of children here, at all events, you will not want children here for the works. Yes, she said, I have eight, and if four of them were dead, it would be the greatest comfort that could be to me. I remarked upon that to the surgeon, and he said, There was a birth here a few weeks ago, which I attended, and the mother said to me, ' That child will be dead on a particular day;' and it was dead upon that particular day ; but how it died, he said, I do not know. But in all such cases, and in cases where children are put out to nurse to be kept whilst the mothers ai-e at work in the fac- tories, any death brought under the notice of the medical man would immediately attract his attention, and it would be brought under the notice of the officer of health, when otherwise it would pass unnoticed. 9530. I quite understand your proposition that the deaths should be brought under the notice of the authorities ; but I am rather at a loss to see at this moment how you can connect the registration of births by individual medical officers with the protection of infant life?—If they were known to be the registrars of deaths also, every death that happened would come under their immediate cognizance, and naturally would lead them to make inquiries which now escape atten- tion. 9531. {Lieut.-Col. Ewart.) Are not the duties now performed by the sub-inspectors under you largely of a sanitary nature ?—No, scarcely ever. 9532. Do not they look to the sanitary state of the factories which they visit ?—They look to certain matters. Since the Act of 1867 they are to look to the state of the employments as to the dust which may be generated, and to gases, if they fiud them ; but it is very rare indeed, as far as I know, that they refer to thern. 9533. Do they look to the question of ventilation ?— Yes, very often they do look to the question of venti- lation, and suggest ventilation of various kinds ; but ventilation is a very difficult question. 9534. They would take notice of defective drainage, would they not, as affecting the health of those em- ployed in any factory ?—I do not think so ; it is very rarely if ever they do. They may say that it was very offensive ; but it would stop there, I think. 9535. Are the sub-inspectors now selected from any particular professions ?—No, they are all gentle- men ; and they are selected as they present themselves, according to the chance they have of getting into office. 9536. Do you think that gentlemen of any par- ticular profession would possess more qualifications than those of another? — I have always thought myself that sub-inspectors should be medical men ; but taking the present gentlemen, who are well edu- cated, and very able and industrious men, and, as far as I have seen, very useful men indeed ; if I could get the other point, namely, that the certifying surgeon should go once a qiiarter through the woiks, I think that might be sufficient. 9537. But looking to future appointments, you would prefer medical men ?—Yes, I think I shoidd. 9538. You have spoken of the system of having health officers for large towns, and a corresponding system in rural districts upon a smaller scale ; do you contemplate that every one of those health officers should correspond directly with the central authority in London ?—No, with the officer in the nearest large district. 9539. Do you contemplate an intermediate officer between those health officers and the central autho- rity ?—No ; take for example the Pottery towns, the health officer appointed for the Pottery towns being](https://iiif.wellcomecollection.org/image/b21366081_0002_0066.jp2/full/800%2C/0/default.jpg)
