Appendix to the First report of the Commissioners : minutes of evidence 7th November 1913 to 6th April 1914 question 1 to question 12,549.

  • Great Britain. Royal Commission on Venereal Diseases.
Date:
1914
Catalogue details

Licence: Public Domain Mark

Credit: Appendix to the First report of the Commissioners : minutes of evidence 7th November 1913 to 6th April 1914 question 1 to question 12,549. Source: Wellcome Collection.

    12/474 (page 4)
    7 November 1913.] STEVENSON. [ Continued. 79. There, again, the Poor Law institutions furnish a very large number ?—In the case of locomotor ataxy. Of course, in the case of G.P.I. the vast majority of deaths occur in asylums. 80. Yes; the Poor Law institutions have not many. In both those cases of locomotor ataxy and G.P.I., you think the figures may be regarded as likely to be accurate ?—I think substantially so. We know that none of our figures are absolutely accurate, but I think those should be substantially so. 81. I have passed over page 97, on which there is an important table. That is the table in which you split up into classes of administrative areas >—Yes. 82. You deal with London as a separate item ?— Yes, as representing a degree of urbanisation entirely beyond that of any other town. 83. And the county boroughs represent all other towns in the country, I suppose?—The county boroughs figure is simply the aggregate of all the county boroughs in the country. 84. (Canon Horsley.) It will include Liverpool, for instance P—Yes. 85. (Chairman.) What is the population of the county boroughs ?—It is given in Table 2. It is nearly 11 millions. 86. And ‘other urban districts”; include all the smaller towns in every county ?—Yes, all the towns that form a part of the administrative county. 87. And fall below the borough standard ?—Yes, which belong to administrative counties, but not independent. 88. Then rural districts exclude all towns P—AIl districts which have the status of urban districts in any of their forms. 89. And what does ‘all urban districts” mean precisely >—It means every area that is not a rural district. 90. (Str David Brynmor Jones.) Excluding boroughs, I take it P—No. 91. Excluding the county boroughs ?—No, includ- ing all the country except the rural districts. 92. (Chairman.) That includes all the county boroughs ?—Yes, and London. It is merely added to give the contrast between all the towns and all the country as far as we can give it. 93. According to that, the mortality from syphilis for all infants is higher in the county boroughs ?— Yes, very little higher than in London. 94, London being 1°86 and county boroughs 1°90? —Yes. Of course that is a degree of difference that one would attach no significance to. 95. But in your return of county boroughs there are marked differences ?—I have not got the figures for syphilis taken out separately for county boroughs. That is being done at the present moment at Dr. Newsholme’s request, so that I could give you those figures on another occasion. 96. They would probably be useful to us as showing high prevalence in some county boroughs ?—Yes, I presume so. Of course the deaths certified as due to syphilis after all are so few in any one year, that to get reliable data one would have to assemble the results of several years’ certification, possibly. 97. Are there any suggestions you would like to make to the Commission as to sources of information supplementing those of your statistics P—I do not know that there are really. 98. Could we make any enquiries which would result in clearing up some of the uncertainties which you say surround your statistics in certain cases P—I do not know of any way of improving the value of these figures in themselves by any inquiries ; but, no doubt, means of inquiry outside the official statistics may suggest themselves to the Commission. 9J. Have you any suggestions for improving the classification of statistics with a view to giving us greater knowledge, and more certain knowledge, in the future than at our disposal now ?—I do not really see that the question of classification comes in very much with such clear-cut diseases as syphilis. For instance, in tracing the history of the disease back, we go many years before any change in classification comes in to upset the comparison, Thatisthe point. In changing over to the international list no alteration of classifica- tion was involved with regard to syphilis or general paralysis of the insane, or locomotor ataxy or aneurysm. So that questions of classification as such I do not think affect these statistics very markedly. 100. But you have told us there are certain cases where, when you are not sure in your own mind, you have sent down and made further inquiry ?—Certainly ; that is with regard to the quality of the information that we receive. I thought you spoke of classification. 101. I am speaking of classification. To clear up that point, in the first instance it would be rather a matter of classification, would it not? You could so put it that the information would come first-hand ?—I was using the word classification in the sense of dealing with the material received. 102. I am referring to nomenclature rather than classification. With litle differences in nomenclature, these supplementary inquiries, which you say you sometimes make, would be avoided ?—I doubt it. For instance, amongst the letters in my bag here, I have one from a practitioner in which he alludes to a sug- gestion that the word “specific” might be used as indicating syphilitic. He says in regard to that sug- gestion, it would not go down in his part of the world. People know the meaning of the term. I should think the same thing would apply after a longer or shorter time to any synonym that might be adopted. 103. (Ser Malcolm Morris.) Does that apply equally to mere symbols ; that the practitioners of the country might be supplied with symbols which would be absolutely secret so that the individual faimlies would not know ?—I should be very sorry to trust the practi- tioners of the country with the use of a code of symbols. 104. (Chairman.) Have you given any thought to the subject of compulsory notification which has been broached in a good many papers of late P—Not very much. In view of what we know of the way in which the compulsory certification works, I should think it would be very largely evaded. There would be a strong temptation to evade it. ° 105. You think so, even if it were made legally compulsory ?—The obligation to certify the cause of death is legally compulsory, but it is very difficult to prove that any practitioner knew any definite fact. i 106. You do not think under any form of com- pulsory notification as regards these diseases, your figures in future years would be very much modified ? —I should not like to speculate as to the effect of compulsory notification on our figures; I do not know. 107. (Str Malcolm Morris.) Do you know what the effect has been in New York ?—I understand the noti- fication there has been in operation for a very short time. J have the “New York Monthly Bulletin” for June in my pocket, and I rather gathered from it that the effect had been slight so far. 108. So far as the actual causes of death are con- cerned, you mean ?—I just started reading this to-day. I have not gone all the way through it, but my impres- sion is they only regard their work as beginning. 109. They have only been at it a little over one year ?-— Yes, something like that. 110. (Chairman.) Do you follow the statistics in foreign countries P—To a certain extent, yes. 111. Do you know what has been the effect of com- pulsory notification in Sweden and Denmark ?—No, I do not. ; 112. Do you know how long it has been in opera- tion in those countries P—I see in this report that they were the first to use the new system, but I do not know how long it has been in operation. I gather, not many years. 113. (Sir David Brynmor Jones.) I heard you say, I think, that you do not guarantee the absolute accuracy of the figures in this report >—None of the figures; and I would say with regard to the figures relating to syphilis that they must be accepted with a very great deal of reserve. \ 114. That remark prompts this question: how are these figures obtained? Ihave a general idea, but I want to analyse the matter a little. Take any page