Copies of the forms and exemplifications of the mode of entering the particulars of the information sought in the returns circulated in England, and the reports on the sanitary condition of the labouring classes in the metropolis, are herewith transmitted for your use. The Commissioners have not asked for returns in any prescribed form from the medical practitioners in the towns of Scotland, because they are uninformed as to the nature of the existing records of facts relating to medical statistics in the towns, and they wish to consult the practitioners’ convenience, and be guided by them as to the best use to be made of the local circumstances for obtaining information.

I have the honour to be, Sir, Your very obedient Servant, EDWIN CHADWICK, _Secretary_.

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6.—_Form of General Queries addressed to Medical Practitioners and others for Information as to the Condition of the Labouring Classes in Scotland._

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1. Have diseases of the various forms of continued fever, and other contagious febrile diseases, been prevalent in any, and what, parts of your parish or district, and do such diseases recur at regular intervals, or are they rare and occasioned only?

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2. What are the seasons at which such diseases appear amidst any part of the population, and what their characteristics?

3. Did the cholera at the time of its general prevalence prevail to any, and what, extent within the district?

4. What is the _external_ condition, in the following respects, of the residences of the population amidst which such diseases occur?

(_a._) As to the contiguity of vegetable or animal substances in a state of decomposition, stagnant pools or undrained marshes, accumulations of refuse, either thrown from houses or otherwise?

(_b._) As to the means adopted or the means available for the _removal_ of such substances, or the prevention of the generation of malaria; whether there are sufficient drains or sewers, adequately well supplied with water to dilute, and sufficiently sloping to carry off all such refuse; whether such drains are sufficiently _closed_ to confine noxious exhalations from them; whether there is any regularly appointed service of scavengers or otherwise for the removal of such substances; whether there is such ventilation around the residences of, as to dissipate the noxious vapours apparently irremovable?