Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/829

Rh, VIEW.] formed by obstetric medicine or midwifery, and with, obstetrics there is usually associated gynaecology, or the diseases peculiar to women. Diseases of children are the subject of a voluminous separate literature. Dermatology (diseases of the skin) is an important province of practice which, like the diseases of women and children, pertains as much to medicine as to surgery. The greatest of the so- called special departments of practice is ophthalmology (diseases and injuries of the eye). Laryngology is a department that owes its existence mainly to the invention of the la^ngoscope, its special province being the treatment of the inflammations (ordinary and specific), tumours, and the like, to which the larynx is liable in common with other parts. Diseases of the ear (otology) form even a more restricted department of practice, owing to the comparative inaccessibility of the chief part of the organ of hearing. The congenital condition of deaf-mutism may or may not be taken as falling within the province of the last-mentioned subdivision. Dentistry or odontology is extremely limited in the range of its subject-matter; but it affords great opportunities for refinements of technical skill, and it is given up to a distinct branch of the profession. The care of the weak-minded and the insane (psycho logical medicine) is an integral part of medical practice, inasmuch as it is concerned with diseases of the nervous system and with numerous correlated states of other organs ; but it occupies a unique place by reason of the engrossing interest of the subjective phenomena. Habitual drunkenness is also a subject of special treatment. A state of war, actual or contingent, gives occasion to special developments of medical and surgical practice (military hygiene and military surgery). Wounds caused by projectiles, sabres, Arc., are the special subject of naval and military surgery ; while under the head of military hygiene we may include the general subject of ambulances, the sanitary arrangements of camps, and the various forms of epidemic camp sickness. The administration of the civil and criminal law involves frequent relations with medicine, and the professional subjects most likely to arise in that connexion, together with a summary of causes ce l ebre;, are formed into the department of medical jurisprudence. It is the practice in Great Britain to call independent medical evidence on both sides of a cause, whether the proceedings be civil or criminal. The system of life assurance is based upon the co-opera tion of the medical profession. Heredity, constitution, and diathesis are here the chief subjects of general considera tion, while prognosis is the skilled faculty specially called into play. delations of Medicine to the Body Politic. The statutes of the United Kingdom which have direct relation to medicine are (1) those relating to the public health; (2) those relating to lunacy (and habitual drunkenness) ; (3) those relating to the status of the medical profession, to dentists, and to pharmaceutical chemists ; (4) those relating to restrictions on the &quot; practice &quot; of anatomy and physiology. There are, besides, several statutes in which medicine is concerned indirectly, such as the Poor Laws, the Prisons Acts, the Shipping Acts, the Registration of Births and Deaths Act, the Sale of Food and Drugs Act, the Sale of Poisons Act, the Factory and Workshops Act, the Artisans Dwellings (Metropolitan) Act, the Rivers Pollution Pre vention Act, the Contagious Diseases (Animals) Act (1878), and the Public Health (Water) Act. 1. Most of the statutes relating to the public health in England and Wales were consolidated by an Act of 1875, the Acts relating to the metropolis being excepted ; there are separate statutes of about the same period for Ireland and Scotland. The system of administration is by local 71)7 sanitary authorities, in correspondence with the local govern ment boards in London and Dublin and the board of supervision in Edinburgh. The board in London has a medical department, consisting of a chief medical officer, assistant medical officer, and inspectors, while the Dublin and Edinburgh boards are professionally advised on a some what different system. The sanitary authorities throughout the United Kingdom are divided into rural, urban, port, and metropolitan (sanitary and nuisance); they are formed out of pre-existing bodies, either the corporations of cities and towns, the improvement commissioners, or the local authorities. A medical officer of health is attached to most of the several sanitary authorities, or to the combined sanitary authorities of a large district ; his duties include making reports on the death-rate and the causes of mortality, the denunciation of nuisances and unwholesome dwellings, workshops, &c., inquiries into the local causes or favouring circumstances of epidemic outbreaks of disease, measures to prevent the spread of contagion (by disinfec tion, isolation, and otherwise), and other more occasional duties arising under a variety of statutes. Each sanitary authority is required by law to appoint an inspector of nuisances, who practically carries out the instructions of the medical officer when there is one. The Vaccination Acts (consolidated 1871) areau import ant part of the public health law of the kingdom ; they are administered by the local government board, for the most part through the agency of the medical profession at large, but in some populous parishes also by means of public vaccination stations. Prosecutions under the Acts are insti tuted by the parochial authorities. The practice formerly (and not unsuccessfully) resorted to of inoculating with the small-pox has been, made a criminal offence ; but there is still much uncertainty as to the theory of vaccination, and, in particular, as to the relation of vaccinia to variola. Other statutes which were not consolidated in the Public Health Act of 1875 are the Burials Act, the Contagious Diseases Act, and the Quarantine Act. The first of these is administered by a department of the home office, with a medical inspector. The second (1866 and 1869) relates, under a too general title, to the regulation o f prostitution in certain garrison towns, the surgeons under the act being appointed by the board of admiralty or the secretary of state for war, and the administration otherwise carded out by the police. The quarantine laws stand in the somewhat anomalous position of statutes which it is not thought desirable to repeal, while yet they are stripped bare of all their executive machinery. The Quarantine Act can be set in motion, as occasion arises, by an order of council ; not only, however, is there no official medical advice at the disposal of the privy council, upon which action under the act might be taken, but there is not even the framework remaining (except the ghost of a quarantine station on the Motherbank between Portsmouth and the Isle of Wight) of the once considerable quarantine establishment, by which the provisions of the Act might be enforced. On the other hand, port sanitary authorities enjoy certain limited powers under the Public Health Acts of isolating vessels arriving with contagious sickness on board. A quarantine at British ports has not been put in force for many years, opinions being divided as to the abstract efficacy and suitableness of quarantine measures to prevent the importation and diffusion of plague, cholera, or yellow fever (see QUARAXTINK). Numerous instances having occurred of the extensive diffusion of scarlet fever, typhoid fever, and diphtheria by means of milk, the privy council has issued an order, under the Contagious Diseases (Animals) Act of 1878, called the Dairies, Milkshops, and Cowsheds Order, with the object of enforcing extreme cleanliness in the premises and nppur-