View report page

certificates for exemption from inhabited house duty, and
which it is usually not to the interest of owners of old property
to apply for.
The Holborn Borough Council addressed a circular
letter to the Borough Councils of London inviting them to a
Conference to be held to consider the large number of
admissions to the Board's Hospitals of persons who were
supposed to be suffering from notifiable diseases but who were
afterwards considered by the authorities to be not so affected.
The matter was referred to me for a report, of which the
following is a copy : —
Gentlemen, —In my opinion the calling of a Conference between
the Metropolitan Boroughs and the Metropolitan Asylums Board would
be absolutely useless. Only those in actual practice can realise the
difficulties of an immediate diagnosis in the various infectious diseases,
especially enteric fever, and the mere fact of the detention of the patients
for an average of three weeks in the Board's Hospitals, during which time
they have been under the care of those specially experienced in such
maladies, should be sufficient to point out the difficulties in ordinary
practice which must prevent an immediate recognition of the disease.
The suggestion that the Medical Officer of Health should confirm the
diagnosis is, to my mind, inadvisable. Most of us are willing to help
practitioners, but friction between the local authority and the doctors
within its borough would be certain to arise, and in the case of doubt I,
like the medical staff of the hospitals, should possibly take an average of
three weeks per case before coming to a decision, during which time a
possibly infecting person must perforce be kept at home. Looking at the
subject from the point of view of the harm which is frequently done by
doubtful cases, in my opinion the money spent on the ten thousand
patients has not been wasted, because it has no doubt led to removal in
other instances where the nature of the disease, uncertain at first, afterwards
turned out to be notifiable. I should, therefore, advise that the
Council do not appoint representatives.
(Signed) FRANCIS STEVENS, Medical Officer of Health.
Early in 1905 a letter was received from the Borough
Council of Lewisham dealing with the ventilation of the sewers
by the house drains and the abolition of the requirements as
to interceptors. The question was referred to the Borough
Engineer and myself for a report, which was duly presented
to the Council:—
January 5th, 1905.
Gentlemen,—There can be no question but that the ventilation
of sewers is a serious difficulty at the present time. That they are bound
to be ventilated seems to be agreed, in spite of the experience of Bristol
and several other places, for the sake of the health of those who are
obliged to work in them. The only means of ventilation, now that house