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receiving information of the outbreak of any contagious, infectious, 
or epidemic disease of a dangerous character, to visit the spot 
without delay, and inquire into the causes and circumstances of 
- such outbreak, and advise the persons competent to act, as to the 
measures which may appear to me to be required to prevent the 
extension of the disease, and, so far as I may be authorized, assist 
in the execution of the same.” Unfortunately, however, at present 
there being no compulsory registration of disease, and no one to 
inform me of such outbreak, it very often happens that the first 
information I receive is from the district registrar, when there has 
been a death. Any interference then is, of course, of very little 
use. It is my opinion that some steps should be taken by 
Parliament, in order that the Medical Officer of Health shall be 
immediately informed of the occurrence of any infectious disease; 
and this is the more necessary, for it is the first cases which are of 
the most importance. Then is the time for isolating the patient, 
and using the various means within our power for disinfection. 
As Dr. Simon states in one of his annual reports that ‘the first 
isolated cases of epidemic diseases almost invariably, if not checked 
by sanitary precautions, are the forerunners of a general outbreak ; 
and in matters of sanitation, as in all others, any measure to be 
really effective, must be precautionary.” 
I now purpose to give you some particulars as to the real 
state of affairs, in a sanitary point of view, within my district. 
Commencing at Egremont, which may be considered head quarters, 
I have not a very bright picture to place before you, although its 
condition has been wonderfully improved of late. The supply of 
water up to a few months ago was almost infinitesimal in comparison 
to the population... In fact, during the dry weather last summer, 
many people were absolutely without water, within a distance of 
from half a mile toa mile. Could it expected that poor people 
—perhaps a wife with a swarm of little children to care for at 
home—would, or even could, carry, water such a distance, for 
sanitary purposes. I have no doubt, in fact I am aware of it, that 
many of the people living at the high end of the town, could 
scarcely find time to convey the water for domestic purposes from 
