1884.] 
355 
ANALYSES OF BOOKS. 
A Dozen Papers relating to Disease Prevention. By Cornelius 
B. Fox, M.D., F.R.C.P. Lond. London : T. and A 
The first of these papers discusses asubjedt of manifest national 
importance— the “ Impairment of the Efficiency of the Medical 
Officer of Health produced by his want of Independence as a 
Public Official.'’ That such an impairment must occur might 
well be admitted a priori , but the author adduces fadls by which 
it is superabundantly proved. If the medical officer is a general 
pradtitioner, he cannot do his^ duty without giving offence, and 
thus losing his patients. If he advises houses to be closed as 
unfit for human habitation, or if he condemns meat, &c., in the 
market as dangerous to health, powerful local interests are 
aroused against him. 
Dr. Fox denounces the Public Health Add of 1872 as radically 
unsound, “ attaching as it did public health to poor-law work.” 
Here he is perfedtly right. The average poor-law guardian in 
England, and, we fear, still more in Ireland, is a half-educated 
being, who knows nothing of sanitary matters and does not care 
to learn. But if the medical officer is not in pradtice, but re- 
ceives from a combination of districts a salary which might 
make it worth his while to give his whole time to his duties, ^he 
is scarcely in a better position. If he tells the truth, the distridt 
which he denounces threatens to withdraw from the combination 
— as the law unfortunately permits it to do. He has thus no 
tenure of his office, and unless he is prepared to sacrifice himself 
for the good of the public, his obvious policy is to shut his eyes, 
issue delusive reports, and— quietly draw his salary. 
Much of what Dr. Fox here says we can confirm from our own 
observation. We know cases where the medical officers of health 
of considerable districts receive mere nominal salaries. They 
have been appointed as a mere nominal compliance with the law, 
with the express understanding that they should do nothing ! 
The paper on “ Coke as a Fuel in relation to Hygiene ” is the 
more important, as what is said applies equally to anthracite, 
which has been unduly extolled as a means of getting rid of the 
smoke -nuisance. The public labour under the error of supposing 
that the chief evil of smoke is the visible blackness. Admitting 
the unpleasantness of soot-flakes, we must still maintain that its 
worst features are unseen, — sulphurous acid and carbon monoxide 
