834 
PROCEEDINGS OF SECTION I. 
Committee of the House of Commons in 1882; it is theoretically the 
only efficient one, and in practice it has been proved to act satis- 
factorily. At the seventh International Congress of Hygiene and 
Demography held in London, August, 1891, Martin, of Paris, proposed 
that compulsory notification of infectious diseases was desirable, and 
that it was best effected by the dual system; the proposition was 
carried by overwhelming majorities. The discussion shows that the 
system is in vogue in Germany, the United States, and Canada, in 
none of which places is there any fee payable for notification. The 
reasons why the medical man should notify are so plain : He alone is 
qualified to diagnose the disease ; he alone, bearing in mind the 
ignorance, poverty, and other disqualifications of large numbers of 
persons, is qualified by his education, his appreciation of the necessity 
of the case, his freedom from interest, prejudice, alarm, or confusion, 
to notify it, and he would by his direct action save much unnecessary 
delay. The Infectious Disease (Notification) Act requires both house- 
holder and medical man to notify. 
A moment’s reflection will show how far-reaching the benefits of 
compulsory notification are. Chiefly, the discovery of these first 
cases, which may swell into an epidemic, their isolation and removal, 
and the consequent prevention of dissemination by public vehicles, 
laundries, shops, dairies, lodgings, schools, &c\, &e. 
It acts hand and glove with the sanitary inspector’s work. 
Typhoid is notified and is traced to a dairy, and the sanitary authority 
steps in ; visitors go to a lodging-house at, say, a watering-place, and 
contract scarlet fever or typhoid ; the disease is traced back to there, 
and the place disinfected or the drains attended to. Respectable 
hotel and lodging-house keepers would rather welcome the inquisitorial 
inspection of a sanitary officer, as they could then say they could 
show an official “clean bill of health.” In case of an epidemic it 
would force the hand of the local authorities to provide hospital 
accommodation. I am certain that if the system ot notification had 
been in existence in Brisbane during the last scarlet fever epidemic, 
from the beginning of that epidemic, hospital accommodation would 
have been provided months before, and many lives might have been 
saved. 
Moreover, it is now agreed that different epidemics of the same 
disease vary much in malignity, and it is only from notification returns, 
not from mortality returns, that the prevalence and cause of mortality 
can be determined. 
Results . — Speaking generally, notification has succeeded in largely 
reducing the spread of infectious disease and in decreasing the 
mortality, though to what exact extent remains to be seen, as sufficient 
time has not yet elapsed to give accurate estimations. Instances such 
as this may be multiplied: — Portsmouth Medical Officer’s Report for 
1893 gives in ten years preceding compulsory notification the average 
on male death-rate of notifiable diseases as 1*54 per 1,000. In the 
subsequent ten years with compulsory notification the rate fell to *71, 
a decline of 54 per cent., while the diminution in non-nctifiable disease 
was only 3 per cent. (B.M. J 10th J une, 1894.) 
The B.M.J. for 16-12-93 contains a special report to the Parlia- 
mentary Bills Committee of the B.M.A. on compulsory notification in 
England and Wales in 1892. 
