1868. | The Public Health. 127 
Health is every day assuming more importance. This subject has 
attracted the attention of Dr. Letheby, the able and energetic Officer 
of Health to the City of London, and in a paper contributed by him 
to the ‘ Medical Press and Circular,’ he has given his views. He 
insists on the necessity of every district in the country being under 
the supervision of such an Officer. He points out the danger of 
conferring this office on medical men engaged in private practice, 
leading, as it often does, to a confliction of interests most unfayvour- 
able to the public health. He advocates a wide extension of the 
duties of the Officer of Health. To him should be referred the 
Certificates of Death, and he should be entitled to call for the in- 
vestigation of the Coroner’s Court in cases of suspicion and doubt. 
He should be also appointed assessor in the Coroner’s Court, and to 
him might be committed the necessary inquiries into the cause of 
death. These inquiries in the Coroner’s Court are often of the most 
slovenly kind, arising from the want of requisite skill on the part 
of the medical witnesses, now almost entirely depended on by the 
Coroner in his inquiries. Dr. Letheby’s paper is well worth the 
consideration of all sanitary reformers. 
At the meeting of the British Medical Association, held at 
Dublin, Dr. Rumsey read a paper on ‘State Medicine in Great 
Britain and Ireland, which, on account of the reputation of the 
author as one of the ablest writers on State Medicine in this country, 
demands attention. This paper has now been published separately.* 
It embraces an account of our registration system, our medico-legal 
institutions, and our Sanitary laws. Under these heads, Dr. Rumsey 
points out various defects, and suggests improvements. It is espe- 
cially to the Sanitary parts of Dr. Rumsey’s paper that we would 
call attention. No one can have watched the efforts that have been 
made by the English legislature in the interests of public health 
without feeling that they have proceeded on no principle, have 
effected but little good, and that our Sanitary laws are at the present 
moment a worthless piece of patchwork. For want of anything 
like power to deal with sanitary evils, nuisances of the most inju- 
rious and gigantic kind exist in all our large towns, whilst in our 
country districts, where typhus, typhoid, and scrofula carry off their 
tens of thousands annually, not even a show of legislature is even 
made to ward off those evils. With regard to the appointment of 
Medical Officers of Health alone, Dr. Rumsey points out the utter 
destitution of anything like principle in their appointment. There 
are no fixed districts, no duties laid down, no qualifications required. 
Even in London, where the Metropolitan Act requires that Medical 
Officers of Health should be appointed: there is no law pointing 
out their numbers, their salary, or their duties. The consequence 
* Ridgway, Piccadilly, 1868. 
