[Sidenote:  “Average rate of mortality” tells us only that so many per cent. will die.  Observation must tell us which in the hundred they will be who will die.]

Averages again seduce us away from minute observation.  “Average mortalities” merely tell that so many per cent. die in this town and so many in that, per annum.  But whether A or B will be among these, the “average rate” of course does not tell.  We know, say, that from 22 to 24 per 1,000 will die in London next year.  But minute enquiries into conditions enable us to know that in such a district, nay, in such a street,—­or even on one side of that street, in such a particular house, or even on one floor of that particular house, will be the excess of mortality, that is, the person will die who ought not to have died before old age.

Now, would it not very materially alter the opinion of whoever were endeavouring to form one, if he knew that from that floor, of that house, of that street the man came?

Much more precise might be our observations even than this and much more correct our conclusions.

It is well known that the same names may be seen constantly recurring on workhouse books for generations.  That is, the persons were born and brought up, and will be born and brought up, generation after generation, in the conditions which make paupers.  Death and disease are like the workhouse, they take from the same family, the same house, or in other words the same conditions.  Why will we not observe what they are?

The close observer may safely predict that such a family, whether its members marry or not, will become extinct; that such another will degenerate morally and physically.  But who learns the lesson?  On the contrary, it may be well known that the children die in such a house at the rate of 8 out of 10; one would think that nothing more need be said; for how could Providence speak more distinctly? yet nobody listens, the family goes on living there till it dies out, and then some other family takes it.  Neither would they listen “if one rose from the dead.”

[Sidenote:  What observation is for.]

In dwelling upon the vital importance of sound observation, it must never be lost sight of what observation is for.  It is not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving life and increasing health and comfort.  The caution may seem useless, but it is quite surprising how many men (some women do it too), practically behave as if the scientific end were the only one in view, or as if the sick body were but a reservoir for stowing medicines into, and the surgical disease only a curious case the sufferer has made for the attendant’s special information.  This is really no exaggeration.  You think, if you suspected your patient was being poisoned, say, by a copper kettle, you would instantly, as you ought, cut off all possible connection between him and the suspected source of injury, without regard to the fact that a curious mine of observation is thereby lost.  But it is not everybody who does so, and it has actually been made a question of medical ethics, what should the medical man do if he suspected poisoning?  The answer seems a very simple one,—­insist on a confidential nurse being placed with the patient, or give up the case.