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power in certifying as to what is or is not injurious to the public health, that he cannot but feel the grave responsibility which will devolve upon him, if, through ignorance or neglect on the one hand, or through mistaken zeal and want of tact on the other, he fails to carry out his duties honestly, judiciously, and to the best of his ability.

As there is no doubt that considerable difficulty will be experienced at the outset by most health officers in regard to the mode in which their duties should be carried out, the suggestions and information, gathered from various sources and summarised under the following sections, may, it is hoped, prove of some service :

SECTION I. - NATURAL CONDITIONS AFFECTING THE HEALTH OF THE POPULATION CONTAINED IN THE DISTRICT.

These comprise the geological and topographical characteristics of the district, the water-supply, and the climate.

1. Geological Conditions.-Official information as regards these may be obtained from the Ordnance maps and the special sections published by the SurveyorGeneral; while fuller details could be readily collected from local sources. In most districts there will generally be found some one who has made the geology of the locality a special study.

2. Topographical Conditions.-These relate to the situation of the various parts of the town or district, whether low-lying, elevated, or sloping.

3. Water-supply.—The quantity and quality of the obtainable water-supply in a district will depend very

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much on the two previous sets of conditions. So also will the nature of the subsoil and the facilities for drainage and sewerage. All this, however, has been fully explained in previous parts of this work. (See Chapters VI., VII., and XII.)

4. Climate. Under this heading are comprised the meteorological conditions of the district, such as, the daily temperature and rainfall, the force and direction of winds, the barometric pressure, the degree of humidity, and the amount of ozone. In most large towns these observations are already being carefully recorded, and where this is the case, the health officer should endeavour to obtain, through the sanitary authority, the record of the observations weekly. In districts where no such observations are made, he should, if possible, procure the necessary instruments from the sanitary authority, and arrange that accurate observations be made daily, after the manner and at the hours stated in the reports published from day to day in the Times newspaper. The short chapter on meteorology in Dr. Parkes' Manual of Practical Hygiene or Buchan's Handbook of Meteorology will give all the needful information.

As the science of climatology is yet in its infancy, health officers here and there throughout the country would render immense service to sanitary science if they would contribute to this important branch of public hygiene either by undertaking chemical analyses as Dr. Angus Smith has done (see Chapters III. and. V.) or, as Dr. Ballard, by comparing the sick-rate and death-rate with seasonal variations. (See Eleventh Report of the Medical Officer of the Privy Council.) But whether such voluntary services be imparted or

not, it is essential for the fair and faithful discharge of the duties of a health officer, that he should take cognisance of meteorological fluctuations, because they constitute most important factors of health or disease in every district.

SECTION II. -ARTIFICIAL CONDITIONS AFFECTING THE
HEALTH OF THE POPULATION CONTAINED IN THE
DISTRICT; such as-

1. Habitations of the People.-So far as possible the sanitary condition of every house in the district should be inquired into. Of course, the health officer himself could not undertake such a laborious inquiry, but it could be easily and efficiently carried out by the temporary appointment of one or more competent persons, who would be paid by the sanitary authority and directed by the health officer. With regard to this part of the subject, the remarks of Mr. Dyke, the accomplished health officer of Merthyr Tydfil, are well worth quoting:"Such an inquiry was made in Merthyr in the autumn of 1866; nearly 10,000 houses were examined and reported on by four intelligent persons; five weeks were occupied in the examination and report, the cost to the local board being £25. This inquiry embraced the following:-The name of the street, number of each house, names of occupier and owner, number of family and lodgers; the ventilation, how it was secured, .whether by back doors, or by windows whose upper sashes could be fully let down; the number of privies or of water-closets, and the state of these; the watersupply, whence derived, and the state of any back premises, noticing particularly whether any animals or

poultry were kept. When these returns were completed they were tabulated by the medical officer, for each street in each district, and the results summed up. The usefulness of these returns has been continuous. They now afford stand-points of reference whence to mark the improvements made, and to note the dark spots that call for amendment; by referring to this Dictionary of Habitations,' the state of each house is at once apparent, and upon the occurrence therein of any case of disease, such as, e.g., enteric fever or phthisis, the exciting cause, whether excrementitious exhalations or dampness of foundations, may be found." (Brit. Med. Journal, November 16, 1872.)

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An inquiry of this description, if sanctioned by the sanitary authority, would be of immense service to the health officer of every district, and would cost but little. As far as possible, it should embrace full details concerning lodging-houses and the crowded and dilapidated dwellings of the poorer classes, with regard to cubic space, means of ventilation, refuse-removal, etc. (See Chapter VIII. and Appendix I.)

2. Water-supply.-In districts where the watersupply is public, the health officer should make himself acquainted with the quality of the water, amount per head, and the risks of pollution. The localities of wells should also be carefully examined and noted. Chapter VI. and Appendix I.)

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3. Drainage, Sewerage, Scavenging, etc.-Full information with regard to these conditions would be. obtained from the borough engineer or town surveyor. In country districts, all open ditches and filthy stagnant pools in proximity to dwellings should receive particular attention. (See Chapters X., XI., XII., and Appendix I.)

4. Factories, Workshops, Bakehouses, Public Institutions, Slaughter-houses, etc. These should be carefully examined with reference to overcrowding, air-impurities, and the production of nuisances generally. (See Chapter III. and Appendix I.) Factories already under Government inspection would not of course be subject to the supervision of the health officer, except in so far as they prove to be a nuisance or injurious to the health of the neighbouring inhabitants.

SECTION III.—VITAL STATISTICS.

Having thus obtained a full knowledge of the natural and artificial conditions which affect the health of the population, the health officer should next make himself acquainted with the vital statistics of his district. By referring to the more recent quarterly and annual reports of the Registrar-General, and the half-yearly abstracts of the boards of guardians, he will obtain all the statistical data representing the vital history of the district for the past few years, as indicated by the number of the population, its rate of increase, the birthrate, the marriage-rate, the rate of mortality, the prevalency of epidemic or other fatal diseases, the death-rate at different ages, the amount of pauperism, etc. From the last census returns, again, he would obtain much useful information as regards the areas, houses, and population, and the ages, civil condition, occupation, and birthplaces of the people. Such a retrospect, it need hardly be said, would be especially valuable in enabling him to arrive at reliable conclusions concerning the effects of sanitary improvements and the more rigid enforcement of the various Sanitary Acts within his

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