compulsory notification of infectious diseases. 
S35 
On 3 Lst March, 1892, the Infectious Disease (Notification) Act of 
1889 had been adopted in 1,051 sanitary districts, of which 022 were 
urban. 408 rural, and 21 port districts, with an aggregate population 
of 15,902,343 persons. The Act is in force in London with a popula- 
tion of 4,211,743, and fifty towns have a system of notification under 
local Acts, affecting 3,378,625 persons, the aggregate population 
thus placed under compulsory notification being 23,992,711 out of a 
total population in England and Wales of 29,002,525 persons — i.e., 83 
per cent. 
If we except London, we find on the date in question 19,7S0,968 
persons out of 24,790,782, or 80 per cent., were under a system of 
compulsory notification voluntarily adopted. Moreover, nine towns 
had substituted the provisions of the General Act for those contained 
in their local Acts. 
In 1892, in England and Wales, we find altogether 181,461 cases 
notified, including smallpox, cholera, diphtheria, membranous croup, 
erysipelas, scarlet fever, typhoid, typhus, relapsing and continued 
fevers, puerperal fever, with a general mortality of 8*4 per cent., at a 
total cost of £21,000. You will observe that measles is omitted, both 
on account of the enormous expense (£01,250) which its notification 
would entail and on account of the impossibility of restraining the 
spread of that epidemic to any great extent, the infective character of 
the disease being pronounced at so early a stage, and the insuperable 
apathy of parents to the real danger of so common a disease. 
He turns such as the above should be made compulsory annually, 
and in ten years’ time would furnish an invaluable aid to the correct 
understanding not only of the rates of attack in each part of the com- 
munity from each of the several diseases, but also of the equally 
important and little understood point of rates of mortality ; and I 
venture to predict that the expense incurred by any community would 
be shown to bear a very infinitesimal ratio to the number of valuable 
lives thus saved. 
In Queensland, leprosy, smallpox, and cholera are permanently 
provided for bv Acts enforcing notification and isolation ; and measles 
and scarlet fever have been from time to time placed under com- 
pulsory notification provisions, but the Central Board of Health have 
drawn up regulations within the last few months which have for their 
aim the compulsory notification of diphtheria, membranous croup, 
typhoid, measles, and scarlet fever, in addition to the three diseases 
mentioned above ; and it is hoped that before long we shall have a 
compulsory notification Act on the lines of the English Act. The 
primary necessity of appointing medical officers of health for the due 
carrying out of these regulations is now occupying the attention of the 
board. ° We shall be glad to bear from some of our southern visitors 
what has been done towards compulsory notification of infectious 
disease in their several colonies. 
To summarise in conclusion, I am distinctly of opinion that a 
compulsory notification Act which would- ensure early and complete 
intimation of the existence of infectious disease would save to the 
community a large number of valuable lives, would greatly reduce the 
expense which inevitably accrues when an epidemic obtains a footing 
in a community, and would in due time do away with the expensive 
and harassing system of quarantine which now obtains. 
