years, so that the time of recovery for the cost of hospital maintenance is materially shortened.

patients in

It is not wise for a local authority to extort Payment for unwilling payment; the patient is removed, as a rule, hospitals. to hospitals not for his own good, but for the good of the community, and a district should not grudge payment for the purpose of segregating infection.

provide

A local authority has power to provide ambu- Power to lances for the conveyance of the sick by Section 123, ambulances. P.H., 1875, and the working section under which persons are removed to hospital compulsorily is the 124th, which enacts as follows:

'Where any suitable hospital or place for the reception of the sick is provided within the district of a local authority, or within a convenient distance of such district, any person who is suffering from a dangerous infectious disorder, and is without proper lodging or accommodation, or lodged in a room occupied by more than one family, or is on board any ship or vessel, may, on a certificate signed by a legally-qualified medical practitioner, and with the consent of the superintending body of such hospital or place, be removed by order of any Justice to such hospital or place at the cost of the local authority; and any person so suffering who is lodged in any common lodging-house may, with the like consent, and on a like certificate, be so removed by order of the local authority.

'An order under this section may be addressed to such constable or officer of the local authority as the Justice or local authority making the same think expedient; and any person who wilfully disobeys or obstructs the execution of such order shall be liable to a penalty not exceeding £10.'

lodging or ac

It is not easy to say what meaning the original What is 'proper framers intended to be given to the words 'proper commodation? lodging or accommodation;' if the words should be interpreted strictly, and in their ordinary meaning,

they must refer solely to the patient, and if the patient has proper attention, and a sufficient quantity of air and light, and the room in which he is be suitable for habitation, such a state of things would satisfy the conditions.

If, on the other hand, the proper lodging or accommodation refers to the possibility of the malady spreading, in that case it would be right to remove, by the compulsory procedure laid down, any person whose surroundings were such that, in the opinion of the officer of health, the disease was likely to spread. In practice, the view taken is that the removal is mainly for the good of the community, but, at the same time, the welfare of the patient is considered.

Compulsory removal is not wise, save in cases in which even imperfect methods of isolation cannot be adopted.

In applying to a court of summary jurisdiction. for an order for removal, the applicant should always be prepared with evidence that the hospital authorities are willing to receive the case.

Procedure to be followed in

The exact procedure is as follows: In a case in the compulsory which the medical officer of health considers there

removal of patients to hospital.

is no proper lodging or accommodation, and a hospital is available, it is represented to the patient or friends that the case should be removed; if there is opposition, then notice should be given to the patient and friends that an application will be made for a Magistrate's order, so as to give them opportunity of opposing the order, application having

been made, and evidence given of the patient's ability to be removed without danger, and also of the willingness of the hospital to receive, the Magistrate probably will grant the order. The patient or friends may still refuse to obey. In such a case, as soon as the illness is over, a summons should be taken out against the offending party or parties, and a prosecution instituted for disobedience to a Magistrate's order.

It should scarcely be necessary to say that a Magistrate's order for removal to hospital in no way warrants or justifies force; were it not for the fact that more than once a zealous officer has attempted, armed with the order, to convey away unwilling patients by force.

In a summons for resistance of an order given under this section, it would seem, from the case of Booker v. Taylor (Times, 21st November 1882), that the validity of the order cannot be questioned, but the Magistrate must deal simply with the facts. If resistance or obstruction be proved, he is bound to convict.

regulations for

The local authority has power to make regula- Power to make tions with regard to keeping patients in a hospital, keeping patients in and also with regard to the details of removal by hospital. Section 125 (P.H., 1875). All local authorities, having the use of a place for isolation of the infectious sick, will find that it is convenient to make regulations on these matters.

The infectious dead.

(8) Disposal of the infectious dead.

By the 142nd Section of P.H., 1875, it is enacted that where the body of one who has died of any infectious disease

'is retained in a room in which persons live or sleep, or any dead body which is in such a state as to endanger the health of the inmates of the same house or room, is retained in such house or room, any Justice may, on a certificate signed by a legallyqualified medical practitioner, order the body to be removed, at the cost of the local authority, to any mortuary provided by such authority, and direct the same to be buried within a time to be limited in such order; and, unless the friends or relations of the deceased undertake to bury the body within the time so limited, and do bury the same, it shall be the duty of the relieving officer to bury such body at the expense of the poorrate, but any expense so incurred may be recovered by the relieving officer in a summary manner from any person legally liable to pay the expense of such burial.

'Any person obstructing the execution of an order made by a Justice under this section shall be liable to a penalty not exceeding five pounds.'

The section is defective. It only enables burial after a Justice's order has been obtained. It is true, however, that the Poor-Law Amendment Act, Sect. 31, gives power to the guardians to bury the body of any poor person within their parish or union, but they are not obliged to do this unless the body is actually in the workhouse, or on premises belonging to the guardians.

LECTURE VII.

STATUTORY PROVISIONS WITH REGARD TO THE

PREVENTION OF DISEASE (continued)

The Law in districts which have adopted the Notification of Infectious Diseases and the Infectious Disease Prevention Acts, one or both.

In those districts which have adopted one or both of the above Acts, the local authorities possess increased facilities for dealing with infectious diseases. Under the one Act the officers are informed, or notified promptly, of the existence of each case of infectious disease as it occurs, and under the other there are additional powers conferred with regard to disinfection, cleansing, and the law is amended in some points which were overlooked in framing the Public Health Act, 1875.

Disease Notifi

We will first make a few remarks upon the Infec- Infectious tious Diseases (Notification) Act, 1889. This Act cation Act. was applied to the Metropolis, and afterwards consolidated into the Public Health (London) Act, and therefore, so far as the Metropolis is concerned, repealed. It is adoptive in the provinces, but so obvious has been the utility of the Act that, up to the present time (November 1892), it has been adopted by 1139 provincial sanitary districts out of