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THURSDAY, October 4, 1883. 9 A.M. to 12 M.


1. WHAT are the circumstances to be guarded against when you are called upon to advise regarding "ground air"? What may its influence be upon (1) A given district, (2) A given house, and how are those influences brought into play?

2. How may statistical evidence regarding death-rates be misleading if the social habits of the people are not taken into account? Discuss the influence of age, occupation, character of lodging accommodation and locality upon the death-rate of a given town.

3. A stated manufacturing process giving off organic effluvia is in your opinion a nuisance, and injurious to health: give the reasons for your opinion, and the steps which should be taken to remedy the mischief.

4. There is an outbreak of Scarlatina in a large establishment containing 900 children, it has existed for several months, repeated attempts have been made without permanent good effect to prevent its recurrence. What steps would you advise to get rid of the disease from such an establishment?

5. Give the reasons why certain occupations are classed as unhealthy. What diseases are likely to arise from those occupations? Give three examples of the measures which should be taken to prevent their incidence.

6. What is the nature of the provisions in the Public Health Act, 1875, which apply to factories? How, and by whom, are they to be enforced?

FRIDAY, October 5, 1883. 9 A.M. to 12 M.



1. What diseases would you include as causes of preventible deaths? means has a Medical Officer of Health to diminish the mortality caused by each of them respectively?

2. What causes may be assigned for the diminution which has taken place of late years in the number of cases of typhus, and in the extent of its prevalence as an epidemic disease?

3. When a population is stationary during a term of years, what difference is likely to be found in the birth-rate, and in the death-rate of infancy and old age, as compared with corresponding rates in a rapidly increasing population? What influence has a high birth-rate on the death-rate ?

4. For what purposes has a Local Authority power to make bye-laws with respect to houses let in lodgings? What advantages may be gained by adopting this provision of the Public Health Act?

5. What is in your opinion the best method for the disposal of sewage? Describe the difficulties likely to be met with in carrying out this system in large and in small towns respectively.

6. Give a short summary of the duties of a Medical Officer of Health, and those of an Inspector of Nuisances.






AN Examination in so much of State Medicine as is comprised in the functions of Officers of Health, will be held yearly in Cambridge, beginning on the first Tuesday in October, and ending on the following Friday afternoon.

Any person whose name is on the Medical Register of the United Kingdom may present himself for this examination provided he be in his 24th year at least when he presents himself for Part I., and have attained 24 years of age before he presents himself for Part II.

The Examination will be in two parts.

Part I. will comprise :-Physics and Chemistry. The principles of Chemistry, and methods of analysis with especial reference to analyses of air and water. Application of the microscope. The laws of heat, and the principles of pneumatics, hydrostatics and hydraulics, with especial reference to ventilation, water-supply, drainage, construction of dwellings, disposal of sewage and refuse, and sanitary engineering in general. Statistical Methods.

Part II. will comprise :-Laws of the realm relating to public health. Origin, propagation, pathology, and prevention of epidemic and infectious diseases. Effects of overcrowding, vitiated air, impure water and bad or insufficient food. Unhealthy occupations and the diseases to which they give rise. Water-supply and drainage in reference to health. Nuisances injurious to health. Distribution of diseases within the United Kingdom, and effects of

soil, season and climate.

The examination in both parts will be oral and practical as well as in writing.

Candidates may present themselves for either part separately or for both together at their option; but the result of the examination in the case of any candidate will not be published until he has passed to the satisfaction of the Examiners in both parts.

Every candidate will be required to pay a fee of four guineas before admission to each part of the examination.

Every candidate who has passed both parts of the examination to the satisfaction of the Examiners will receive a certificate testifying to his competent knowledge of what is required for the duties of a Medical Officer of Health.

All applications for admission to this examination, or for information respecting it, should be addressed to Professor Liveing, Cambridge.

Candidates who desire to present themselves for examination in October next, must send in their applications, and transmit the fees, to Professor Liveing, Cambridge, on or before Sept. 28. Cheques should be crossed "Mortlock and Co." No fees can in any case be


The applications of candidates, whose names have not been on the register three years, should be accompanied by a Certificate of Birth, or other proof of age.

The following suggestions have been drawn up by the Syndicate for superintending the Examination in State Medicine as some guide to candidates preparing for that Examination.

PART I. The principles of Chemistry are sufficiently set forth in any of the ordinary manuals. Candidates will be expected to understand the application of the general laws to such cases as occur in the practice of an Officer of Health, but will not be expected to shew an acquaintance with those details of Chemistry which have no direct bearing on sanitary questions. No importance will be attached to the use of any particular chemical notation. It is not expected that Officers of Health will in general be able to act as public analysts, but that they will know the methods of analysis and be able to interpret correctly the results of professional analysis. The kinds of applications of the several sciences of which the candidates are expected to shew a competent knowledge will be best understood by a perusal of Parkes's Manual of Practical Hygiene. In the actual analysis of water and air candidates will not be expected to make complete quantitative analyses, but to know how to apply ordinary chemical methods for the detection and discrimination of mineral and organic substances in the samples. Candidates will be expected to shew a practical acquaintance with the use of the microscope.

PART II. Candidates will be expected to shew an acquaintance with the sanitary laws in force in England; but if any candidate has information respecting alternative laws in force in the Metropolis or in Scotland or in Ireland, opportunity will be given him, alternatively, of shewing his acquaintance with such laws.

The rest of Part II., besides the subjects expressly mentioned, is to be understood as including those of Vaccination, Disinfectants, the management of outbreaks of Infectious Diseases, with the construction of Hospitals temporary or permanent; Endemic Diseases; Birth-rates and Death-rates; the qualities and suitableness of various Waters used for domestic purposes; the inspection of factories, mines, workshops and common lodging-houses.

The following list of works, with the names of the publishers, will probably be found valuable to some of the candidates, but the necessity of reading all or any one of them is not urged upon them.

On Parts I. and II.

Parkes's Manual of Practical Hygiene. Churchill.

G. Wilson's Handbook of Hygiene. Churchill.

Grimshaw and others, Manual of Public Health for Ireland. Fannin, Dublin; and

Cameron's Manual of Hygiene. Hodges, Foster and Co., Dublin, and Baillière, Tindall

and Cox.

Seaton's Handbook of Vaccination. Macmillan.

*Army Medical Reports. Reports on Hygiene. Eyre and Spottiswoode.

*Reports to Privy Council and Local Government Board by their Medical Officer. Eyre and Spottiswoode.

On Chemistry. General principles.

Fownes' Manual of Chemistry. Churchill.

Bloxam's Chemistry. Churchill.

Roscoe's Lessons in Elementary Chemistry. Macmillan.

Attfield's Chemistry. Van Voorst.

On Analysis.

Bloxam's Laboratory Teaching. Churchill.

Bowman's Practical Chemistry. Churchill.

Sutton's Systematic Handbook of Volumetric Analysis, Churchill.
Frankland's Water Analysis for Sanitary purposes. Van Voorst.

Wanklyn and Chapman's Water Analysis. Trübner.

Hartley's Air and its Relations to Life. Longmans.

Wanklyn Milk Analysis. Trübner.

Wanklyn and Cooper's Bread Analysis. Trübner.

Fox, C. Sanitary Examinations of Water, Air and Food. Churchill.

On Physics.

Todhunter's Natural Philosophy for Beginners. Macmillan.

Ganot's Physics. Longmans.

Everett's Textbook of Physics. Blackie.

On Microscopy.

Carpenter's The Microscope and its Revelations. Churchill.

Macdonald's Guide to Microscopical Examination of Drinking Water. Churchill. *Hassall's Food and its Adulterations. Longmans.

On Sanitary Engineering, Water Supply, Sewage, &c.

Eassie's Sanitary Arrangement for Dwellings. Smith, Elder and Co.

Galton's Healthy Dwellings. Macmillan.

Corfield's Dwelling Houses, their Sanitary Construction and Arrangement. Lewis. *Bailey-Denton, Sanitary Engineering. Spon.

*Latham's Sanitary Engineering. Spon.

*Bayles' House drainage and water service. Williams, New York.

Tomlinson's Warming and Ventilation. Lockwood.

Corfield's Treatment and Utilization of Sewage. Macmillan.

*Report of Committee appointed by President of Local Government Board on modes.

of treating Town Sewage. Eyre and Spottiswoode.

*Reports of Royal Commission on Pollution of Rivers, especially the 6th on Domestic Water Supply. Eyre and Spottiswoode.

*Report from Select Committee on Public Health Act (1875) Amendment Bill, with the Evidence. Eyre and Spottiswoode.

*R. Angus Smith's Air and Rain. Longmans.

*Ure's Dictionary of Arts, Manufactures and Mines. Longmans.

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