§ 199. In cases of epidemics the saving of life by the prompt intervention of an officer of health, on the occurrence of the first death, and the immediate removal of the survivors affected, would be very considerable. In cases of fever, on the removal of patients to the fever hospital, they are often received in a state of violent delirium, or in a state of coma succeeding to violent delirium. After they have been washed in a bath, and placed in a clean bed, in the spacious and well-ventilated ward of the hospital, in a few hours, often before the visit of the physician, the violent delirium has subsided, or the state of coma having passed away consciousness has returned. Although in a great majority of cases the patients are only sent to the hospital in the last stage of disease, this mere change in the locality and external circumstances of the sufferers diminishes the proportion of deaths from one in five to one in seven. Supposing the cases occurred in equal numbers daily, the functions of registration in the metropolis would carry the officers of health to upwards of 20 cases per diem of deaths from epidemic disease, for the most part in the most wretched districts. § 200. The principle of this part of the proposed arrangement is in necessitating visits of inspection, and thence necessitating the initiation of measures of relief where there has hitherto been, and whence it may safely be said there will be, no complaint or initiation of measures of relief by the sufferers themselves. It is observed by Dr. Southwood Smith, in confirmation of the observations made on the demoralizing effects of the physical evils which depress the bodily condition of large classes that, as they have not the bodily vigour, so they have not the intelligence of a healthy class. One of the most melancholy proofs of this, he observes, is, that they make no effort to get into happier circumstances; their dulness and apathy indicate an equal degree of mental as of physical paralysis. And this has struck other observers who have had opportunities of becoming acquainted with the real state of these people. “The following statement impressed my mind the more, because it recalled to my recollection vividly similar cases witnessed by myself. ‘In the year 1836,’ says one of the medical officers of the West Derby Union, ‘I attended a family of thirteen, twelve of whom had typhus fever,—without a bed in the cellar, without straw or timber shavings—frequent substitutes. They lay on the floor, and so crowded that I could scarcely pass between them. In another house I attended fourteen patients: there were only two beds in the house. All the patients lay on the boards, and during their illness never had their clothes off. I met with many cases in similar conditions; yet amidst the greatest destitution and want of domestic comfort, _I have never heard, during the course of twelve years’ practice, a complaint of inconvenient