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would be the elucidation of the truth, should be employed ; and, considering the injustice now perpetrated, expense would be saved. These officers might be specially appointed by the judges in common; or indeed the medical supervisors just now to be proposed might perform these functions. While the assessor would, through the judge, put pertinent questions to the witnesses, he would have to submit himself to examination by the counsel for both sides when he had recorded his opinion in writing. The appointment of assessors has been recommended by the Law Amendment Society, the Social Science Association, the British Medical Association, and some of the most eminent jurisconsults. It is
very needful also in actions for malapraxis that independent medical assessors should try the justice of the action. To have uninformed persons decide such cases is against the principle of English liberty that one should be tried by his peers.
Medical witnesses at present will go unpaid if they do not bargain beforehand, and if they refuse evidence they are liable to action if the suit be lost by their default.
Reference to precedents and authorities should be permitted to the assessor, which is often denied at present to the medical skilled witness, on the senseless plea that the author quoted from is not sworn ! Medical witnesses may be forced to divulge secrets entrusted to them by patients. In New York there is a statute preventing this: “No person duly authorised to practise physic and surgery shall be allowed to disclose any information he may have acquired in attending any patient in a professional character, and which information was necessary to enable him to prescribe for such patient as a physician, or to do any act for him as a surgeon.
The 378th clause of the French code likewise declares " that all medical men or midwives who reveal
secrets that have been entrusted to them in their professional capacity, shall be punished,” &c.
MEDICAL SUPERVISORS. If it appears from the foregoing that the registration, sanitary, and medico-legal functions of the State are imperfectly performed, the following proposal for the concentration of these functions in one officer should be dispassionately considered hy the Government and all those concerned. The following changes would be in the first instance needed : 1. Superintendence of registry should be transferred to the new officers, the clerks of unions being fitly compensated. 2. The office of coroner should be subdivided, its legal function transferred to the stipendiary magistracy or constabulary officers, either without juries, as in Scotland, or with them; and those coroners who are medical men would be eligible for the new office of Medical Supervisor. In districts where the coroners were not medical men, their office might be continued during their lifetime, if the Treasury would be unwilling to grant compensation on the average emoluments for seven previous years.
There are at present 93 coroners in Ireland, of whom 18, or less than one-fifth, are medical. In England, out of 331 coroners, 63 are medical men, 57 have no profession, and the remainder are attorneys. The new office may be discussed under the following heads :
1. TERM.—“ City or County Medical Supervisor' would be comprehensive and distinctive, but perhaps the term City or County Physician, a title under which duties somewhat analagous to those about to be proposed are fulfilled in America, would be more intelligible. The “circuit physician" and "proto-medicus," under the Austrian government, are analogous.
2. DISTRICT.-As in Ireland 93 coroners are found sufficient, a lesser number of medical supervisors would be required. One only might be appointed for the large
cities of Dublin (pop. 254,808), Belfast (pop. 123,479), and Cork (pop. 93,389), and for the smaller counties, such as Louth (90,713), and Longford (71,694), and two or three for the largest counties.
3. DUTIES-(a). To act as superintendent registrars—that is, to receive and classify the returns from the Registrars of Deaths, Births, and Marriages, and to examine into every death the cause of which was not certified within 48 hours after its occurrence.
(b). In case the cause of death was not natural, he should give evidence before the magistrate or eonstabulary officer who was appointed to discharge the duties heretofore assigned to the coroner. In this way secret murders and deaths of infants and old people by neglect would not escape detection. Under his supervision published returns might be made out more in detail; thus, instead of 7 dispensary death-rates in Dublin, 14 might be made known, or the returns from tenements and dwellings below £10 yearly value, and those from fashionable mansions might be distinguished. Death-returns, combining the mortality in the neighbourhoods of Fitzwilliam-square and in Townsend-street, can give no reliable data for sanitary reform.
(c). To act as medical officer of health, the functions of which have been before described, especially making himself familiar with the natural, social, and sanitary characteristics of his district. The visiting of ships near ports, for the purpose of ascertaining the presence of infectious diseases, is usually paid for by a halfguinea fee by local authorities, and a fee of one guinea is charged for signing bills of health for ships leaving the port. In important ports, such as Southampton, he could act with advantage as officer under the quarantine laws, or the Shipping Act, 1867.
(d). To act as witnesses at all death-courts, and as assessors to the chairmen at quarter sessions and the judges at assize.
(e). To act as burial inspectors. The injurious effects of intramural burial became so notorious by the reports of the Board of Health in England, that Mr. Grainger, the eminent physiologist, and Dr. Holland, a well-known sanitary inquirer, were appointed as inspectors under the Home Office, to imine into the tate of existing graveyards and into the suitability of proposed sites for new ones. As a result of their labours, over 4,000 churchyards which, from their proximity to dwellings and water sources, were most pernicious, have been closed or regulated, and no new ones which were not advantageously placed with regard to access, soil, and prevailing winds have been sanctioned. A million and a half has been spent during the past fifteen years in establishing new cemeteries. A Scotch Act gives power to any two members of a parochial board, or ten ratepayers, to demand sanitary investigation of any burial ground. In Ireland many graveyards are within towns, not decently arranged or protected and over-crowded ; and some of them have been shown to pollute neighbouring wells; yet no systematic inquiry has taken place, and the only legal remedy is by application to the Privy Council, where medical witnesses may contest-none of those who are to decide having medical or hygienic knowledge.
). To act as factory certifying surgeons. The Factory Commissioners of 1833 proved that much mortality, and many diseases and deformities specific to this kind of labour, were owing to want of regulation of these establishments. Inspectors (of whom Mr. Baker, M.R.C.S., was the most zealous and able) were appointed, and now, although the number of workers has doubled, peculiar unhealthiness has disappeared. Under Vic. cap. 15, inspectors may appoint certifying surgeons who, for a certain fee, shall certify as to the age and health of persons about to be employed as operatives, and shall inquire into the cause of accidents in the factories.
The Children's Employment Commission, of which Dr. Grainger was an active member, collected much information to show that many trades, carried on both in workshops and the workers' homes, especially in Ireland, required regulation analogous to that provided by the Factory Acts.
(g). RESTRICTIONS.—He should be debarred from private practice, so as never to be the rival of the local practitioner, but his friendly adviser, who would relieve him of many unpleasant duties and responsibilities, without ever taking advantage of the introductions which his public duties would confer. Besides, the constant claims of private practice would call him away from the punctual discharge of his public duties, and if dependent on the favour of patients, it requires much selfdenial to take the place of complainant against them in sanitary cases. On the contrary, connexion with the hospital or scientific departments of a medical school of a large city would be useful in keeping him au courant with the progress of his science.
(1). Other EMPLOYMENTS.—He would be probably employed as referee to government and companies' assurances, as being the most highly informed and reliable officer in the district, who would neither injure the company or the insurer by a careless examination. Such frauds as the following would be prevented. “A woman insured in an office two lives, which rapidly fell in. On this happening with a third life, the directors, haying some suspicion, demurred. The woman called at the office, and said angrily, 'Do you think I poisoned my own relation ' The manager, looking fixedly at her, said, “We know you did. In great agitation she left the office, and never appeared there again.” His statistical habits would induce him to note cases, which in life assurance is most important, as will be acknowledged by all who have been called into court in these cases.