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so vastly. Dublin people, in the third week of Jnly, 1867, were much alarmed by the registry of thirteen cases of cholera which had died in an hospital during the previous October. Justice O'Hagan, some two years ago, on the authority of the registration department, stated that over one-third of the deaths were not recorded ; and the Irish Registrar-General, in his last report, returns eight districts as being under 10 per cent. per annum, or about half the inevitable death rate. Even in England through neglect of the non-medical registrars, 17 per cent. of the deaths are not certified as to cause of death, and causes are often assigned of which the practitioner who signs the certificate has no knowledge. Thus, in a populous town in England the chief practitioner, who bears the dignity of J.P., employs as an assistant a person whom about two years ago he hired as his groom, and who has never been since out of this town, to attend medical lectures. This assistant attends all the poorer patients, and the practitioner signs the certificates of causes of death of persons whom neither he nor any qualified practitioner has seen. Another case was lately exposed, in which a practitioner left, during a three weeks' absence, signed tickets to be filled in by an unqualified person. The certificate of death has for such reasons no weight, and neither the Chancellor nor the Bank of England will receive it. The certificate of the cause of death should be sent direct to the Registrar, as it may be destroyed if it reveals any unpleasant fact, and the medical attendant may be dismissed for his candour.
The Registrars in Ireland are all medical men; in England they are not, and such ludicrous causes of death
stricture of the windpipe,” " worn-out stomach," and “ hives,” have been returned by them. They also often omit important medical remarks made by the physicians in certifying a death. The superintendent registrars in both countries are non-medical. Their places should be taken by the medical supervisors just
now to be proposed, who in this particular would be similar to those valuable officers, the “Medicins des Morts” in Paris. Even in China such a system has been established. In Scotland the registration machinery is very similar to that of England, but the RegistrarGeneral adopts a different nomenclature. There is now every hope that the registration nosology will be assimilated and improved, as a conference has been held at the College of Physicians.
The present medical certificate, which, though not a compulsory document, practitioners desire to fill for statistical ends, has to be signed without fee, and testifies to a fact which the medical man has rarely positive knowledge of_namely, the time of death of the patient. Instances have occurred in Dublin in which certificates of death were obtained from medical attendants in apparently hopeless cases, for the purpose of obtaining burial money and policies, when the individuals were afterwards proved to be living. Certificates should only be given “ super visum corporis," and for false returns the medical man might be held accountable. There is no space for the previous residence of those who die in public institutions, nor for the employment, and thus important sanitary and statistical data are omitted, and in the Irish certificate there is no note taken of the preceding disease, or of the number of attacks of paraÎysis or rheumatic fever for instance, where such data may be valuable. The registration of the birth of stillborn children seems desirable in view of the increasing crimes of infanticide and concealment of birth. The English Registrar-General sends some most valuable instructions for the registration of deaths and noting of cases to medical practitioners gratuitously, but warns unqualified men not to use them.
Dr. Farr has proposed for England a district registration officer, to whom he would assign a variety of offices, and to avoid confusion, I would suggest the
name of County Medical Supervisor. He should be appointed by some central department, or by two or three of the local authorities of districts-that is, Town Councils or Boards of Guardians conjointly. Registra- ! tion of diseases, at least those that are preventible, is allowed to be most desirable, but is at present not attempted. . The proposed officers might without difficulty undertake it. They might likewise act as census officers, and these returns might be made triennially, as with ten year intervals, in this land of emigration, the present returns are useless. They would also be rendered accurate. According to the census of 1851 there was no case of chorea, and only four of scalds among Ireland's six and a-half millions.
CORONERS. In England and Ireland county coroners are elected by the parliamentary voters, a mode which was adopted when the office was as dignified as that of sheriff. The expenses of contested elections often exceed the value of many year's receipts. The choice of officers of justice should never be made in such a way, as the degraded state of the office of judge in the United States proves. In boroughs the town council appoint the coroners, and in Scotland the analogous officer, or procuratorfiscal, is usually a skilled solicitor. The medical and legal journals often join issue as to the respective eligibility of their clients for this position, but if the sanitary office which I advocate were established, many or all of the present medical 'coroners would be suitable for these appointments, and coronerships might be abolished, the judicial duties being discharged by the stipendiary magistrates, constabulary officers, or perhaps sessional crown solicitors.
The imperfect investigations conducted in coroners' courts have been exposed by Professor Taylor, and the following instance occurred in the county Roscommon a
few years ago. The neighbours were summoned by the wife and sister-in-law of a farmer to view his dead body, the throat being cut and a bloody razor placed alongside. At the inquest no medical evidence was required, and “ suicide” was the verdict. A month after, the servant girl swore that while the man was asleep, the wife and her sister had smothered him with a bed, and had inflicted the wound on the dead body. On exhumation the wound was found to be very slight—no large vessel having been divided. The women were convicted and executed, having on the scaffold confessed to the murder. If the servant maid had remained silent, the heinous crime would never have been suspected. The expense of evidence, and of post mortem examinations, often cause them to be dispensed with. It is optional with coroners to hold inquests or not, the profitable number being often a weighty consideration with them, and there is no authority in the State to which they are responsible, and hence many of the glaring defects of the system. Very incompetent persons are often chosen to give medical evidence on account of friendship or corrupt motives; and it is said by Dr. Rumsey, that in England such difficult and capitally important investigations as the detection of poison are sometimes entrusted to persons quite unskilled in chemistry. It was for such reasons that Dr. Lankester advocated the appointment of special medical assessors, whose duties would be analogous to those performed for fourteen years by the distinguished Vice-President of the Royal College of Surgeons, by consent of the Dublin coroners. The arrangement was most reliable, as the skilled and trained witness readily ascertained the cause of death, and crime could never escape detection. Practitioners who see a few coroner's cases cannot be expected to keep up the necessary scientific and forensic knowledge. The city coroners have lately appointed their respective sons to this office, the “ Coroner's Act” (as Ser
geant Barry has advised) empowering them to do so, as these gentlemen may be held to reside " at or near” any place where inquests are held in Dublin. They each receive the commuted sum of £75 yearly from the Corporation. In all large Scotch towns there is a police surgeon, and he is required to see every body which has met with sudden death-another practitioner being called in if a post mortem is necessary. This seems a good arrangement, and works well in the detection of crime. In England the coroners are paid a guinea and a half for every case, so that in some districts the office is worth many hundreds yearly; but in Ireland borough coroners are paid this fee for only 86 cases, and county coroners for 67. Sixpence per mile travelled to the place is likewise allowed. If the office is to be continued, payment by defined salary would be far preferable.
Medical evidence upon hygienic, pathological, or pschycological questions in law courts is every day losing weight, mainly because witnesses range on both sides to debate technicalities or advance opinions which even the judge cannot estimate. If the medical witness were a mere relater of facts no error conld arise ; but, as without hearing the whole evidence, he is often pressed for an opinion, no certainty of just conclusion is provided. Again, medical men are retained to prompt. counsel in cross-examination, and assuming the position of an advocate, strive to break down their medical brethren. This proceeding is often rendered ludicrous by the misconceptions and mispronunciations of the counsel thus coached up. It must be acknowledged, also, that in cases of railway accident, practitioners will be found to give certificates and make assertions in the witness-box which can scarcely be said to be founded on honest conviction. In the Admiralty Court the judge is aided by nautical assessors, and in the same way able chemists and medical jurists, whose only desire