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Copy of certificate must be sent both to head teacher of school and Asylum Board.

(13) Infectious Diseases.

Asylum Board.

The Infectious Disease Notification and Infectious Disease Prevention Acts are embodied in the Public Health (London) Act, and have been previously considered (pp. 104-118). There are, however, a few modifications necessitated by the fact that the whole of the Metropolis has been formed into one asylum district, under managers designated the MetroMetropolitan politan Asylum Managers or Metropolitan Asylums Board, by a special statute, 30 Vict. c. 6, as amended by 32 and 33 Vict. c. 63, sects. 1 and 39 Vict. c. 61, sect. 40. The duties of the Board are the provision of asylums for the insane and infirm, and of hospitals for certain infectious diseases— that is, smallpox, relapsing fever, typhus, typhoid, scarlet fevers, diphtheria, and cholera; hitherto erysipelas, measles, influenza, and other infectious maladies have not been admitted. Non-pauper patients may be admitted into the Asylum Board hospitals, and such admission deprives the person so admitted of no right or qualification, nor is such admission to be considered charity, or of the nature of Poor-Law relief (P.H. (London), sect. 80).

An important difference of notification procedure in London and the country is the provision (P.H. (London), section 55 (4) for sending a copy of the certificate of a case of the notifiable disease both to the Asylums Board and to the head teacher of the 'school attended by the patient (if a child), or by any child who is an inmate of the same house as the

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patient.' Besides this, the different medical officers of health receive week by week a full and complete list from the Asylums Board of all notifications in the respective districts in the Metropolis, so that they are able to watch the progress of an epidemic over the whole area, and know quickly when danger approaches their own district.

The ambulance service of the Metropolitan Asylums Board is an admirable and complete one, and, by a resolution of the managers, has been practically placed at the service of the public for the conveyance, at a moderate charge, of persons suffering from the disease received at the Asylums Hospitals to other hospitals or places.

(14) Underground Rooms.

The only essential matter remaining to speak about in reference to Metropolitan Sanitary Law is the sections (96-98) of the London Act, which considerably amend former statutes as to the conditions under which underground rooms may be occupied.

An underground room must not be occupied in Provisions as London unless

to occupation of underground


(a) It is seven feet high, and the ceiling is at least three feet above the surface of the adjoining street; but, if the area outside is as much as six feet in width, then the height may be one foot above the street.

(b) Every wall has to have a damp-proof course, and, if in contact with the soil, is to be effectually secured against dampness from that soil.

(c) The area outside the room must be open, and extend along the whole length: that is, must not be curtailed by, e.g., a cistern, a wash-house, or other structure. It must be at least four feet wide in every part, must be properly paved, and must be six inches at least below the level of the floor. The area will still be called open if there are necessary steps over and across it, but the steps must not be over or across any window.

(d) The paved area and the soil immediately below the room must be effectually drained.

(e) If the floor has a hollow floor, the space immediately below must be effectually ventilated. (Solid floors, in contradistinction to hollow, are made of such materials as wooden blocks laid on asphalte.)

(f) Any drain passing under the room must be properly constructed of gas-tight pipe.

(g) There must be no effluvia or exhalation passing into the room.

(h) The occupiers must have the use of a watercloset and an ash-pit placed in a convenient place (in the language of the Act' appurtenant').

(i) The room must be efficiently ventilated. (j) The room must have a fireplace, with a proper chimney or flue.

(4) The room must have one or more windows opening directly into the external air, clear of the sash frames, equal to at least one-tenth of the floor area of the room, and so constructed that one-half at least of each window of the room can be opened,

and the opening in each case must extend to the top of the window.


'Occupation' is defined as 'passing the night.' What is Upon the defendant lies the burden of proof that the person does not pass the night in the room. The usual presumption of occupation at night, in default of direct evidence, is the discovery of a bed in the room; hence, according to the strict interpretation of the Act, a night watchman, who never sleeps by night but takes his rest in the day, might legally occupy such a room.

A family occupying both back and front kitchens, and yet using only one for sleeping, is to be considered as occupying both.

authority may

ground rooms

statute in

The enforcement of the letter and spirit of these regulations will enormously decrease the occupation of underground rooms in London, but it is expressly enacted that the sanitary authority, either by Sanitary general regulations providing for classes of under- exempt underground rooms, or on the application of the owner of from the such room in any particular case, may dispense with certain cases. or modify any of the said requisites, which involve the structural alteration of the building, if they are of opinion that they can properly do so, having due regard to the fitness of the room for human habitation, to the house accommodation in the district, and to the sanitary condition of the inhabitants, and to other circumstances, but any requisite required before the passing of this Act shall not be so dispensed with or modified.'

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