HH62/45/207

Transcription

[Page] 24

that the separation between the infected house and this family was only a very
imperfect partition, and as the head of the removed household was the Rural
Postman, it was important that his surroundings should be kept free from infection.
At first everything seemed to be in favour of a wide spread of the disease, but
fortunately no more cases occurred.
During the early part of the year a large number of navvies were employed on
the Moor of Rannoch in making the West Highland Railway, and after the
experience at Crianlarich during the previous year, considerable anxiety was felt lest
a repetition of that Smallpox outbreak should take place. However, the fears
proved groundless, and the men enjoyed perfect freedom from infectious disease
during their stay on the Moor. The only difficulty experienced was in preventing
the hutkeepers from overcrowding the huts.
2. General Inspections have been made with a view to ascertain the sanitary
condition of the District, and much extra work has been entailed by special
enquiries necessitated in connection with the outbreak of Infectious DIsease, or cases of
suspected Infectious Disease.
3. Advice was given in connection with the prevention of the Pollution of Rivers,
with regard to the improving of water supplies, and in connection with nuisances
reported. No action has been required in connection with the sanitary condition of
Factories and Workshops.
4. Retail Bakehouses. - These have been inspected during the year and found
to be kept in good order, with the exception of the Rannoch Bakehouse. Where
young persons have been found employed in Bakehouses, the fact has been reported
to the Inspector of Factories.
5. The arrangement by which the Perth Infirmary was made the Infectious
Hospital for the Highland District, has been found to work well during the past year.
Eight patients were removed to Hospital, and wth the exception of one poor tinker
woman, who was removed in the last stages of Puerperal Fever, all made good
recoveries. The District Medical Officer has had ample opportunities of supervising
the isolation and treatment of patients removed to Hospital from the Highland
District. A Portable Hospital for the isolation of Smallpox cases has now been
provided for the District, but has only been used for the purpose of isolating the family
whose house was in dangerous proximity to one infected with Smallpox. From
remarks made by the family, who spent a considerable time in the building, there
seemed to be no want of comfort in the Hospital. The building is to be stored, and
will be ready for use should a case of Smallpox occur anywhere in the District.
6. The Infectious Disease Notification Act has been in operation during the
entire year in the Highland District, and has been of considerable service. During
1894 Scarlet Fever has again and again been imported into the Highland District,
but, by careful supervision of the patients, and thorough disinfection of the houses on
the recovery of the patients, the disease has been prevented from obtaining any great
hold. By the removal of insanitary conditions in the surroundings of dwelling-
houses, and the prevention of the pollution of drinking water, much has been done to
prevent the occurrence and spread of such diseases as Diphtheria and Enteric Fever.
On two occasions cases, which in some respects resembled Smallpox, caused consider-
able anxiety; but, as their true nature was early recognised, no panic resulted. As
already stated, one of the Portable Hospitals, similar to those secured by the other
Districts, has been procured, and is now ready for use on very short notice.
Respiratory Diseases caused 21 deaths, or 11.4 per cent. of the total, as com-
pared with 18 in 1893. In 13 of these the age at death was over 60 years.

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Circulatory Diseases caused 15 deaths, or 8.1 per cent. of the total, as com-
pared with 13 in 1893. In 13 of these the age at death was over 60 years.
Tubercular Diseases caused 20 deaths, or 10.8 per cent. of the total, as compared
with 16 in 1893. In 15 of these the cause of death was Pulmonary Phthisis.
Nervous Diseases caused 17 deaths, or 9.2 per cent. of the total; in 1893 the
number of deaths was the same. In 11 of these the age at death was over 60 years.
Digestive Diseases caused 8 deaths during 1894, or 4.3 per cent. of the total,
as compared with 11 in 1893. In 7 of these the age at death was over 60 years.
Cancer and Malignant Diseases caused 13 deaths during 1894, or 7.0 per
cent. of the total, as compared with 9 in 1893. Of these 13 deaths, 4 were in males
and 9 females.
Developmental DIseases caused 8 deaths during 1894, as compared with 9 in
1893. In 6 of these the cause of death was premature birth.
Old Age caused 37 deaths, or 20.1 per cent. of the total during 1894, as com-
pared with 48 in 1893.
Violence caused 5 deaths during 1894, as compared with 6 in 1893.
Zymotic Diseases caused 4 deaths during 1894, as compared with 6 in 1893.
The Zymotic Death-Rate was .313 in 1894, as compared with .465 in 1893. In all,
119 cases were reported during the year, against 73 in 1893.
Smallpox. - In June a case of Smallpox was reported from Inver, near Dunkeld.
The patient was alleged to have caught infection from Leith, by handling bags of
grain which had come from there. On enquiries, however, it was found that the
grain had been brought in bulk by sea to Perth, and had there been loaded in bags,
and, as no ill results happened in Perth, it is rather unlikely that this was the channel
of infection. The circumstances surrounding this case were very unfortunate, as, by
the action of the doctor in attendance and those in charge of the patient, it was
impossible to verify the diagnosis or to properly secure the safety of the public. It
was only by careful enquiry amongst outsiders that is was possible to find out who
had been exposed to infection, and a goodly number of visitors who had been in the
sick-room shortly before the case was notified, were traced up and re-vaccinated, where
this was thought necessary. One of the most disquieting elements in connection with
the case was the fact that the people kept a cow and sold part of the milk to neigh-
bours, and up to the time of the first visit of the District Officials, the wife who was
nursing her husband ill of Smallpox, was at the same time milking the cow and selling
the milk. This was at once stopped, and all who had partaken of the contaminated
milk were re-vaccinated. As it was impossible to obtain any control over the isolation
of the patient, the family who occupied the adjoining house were removed as has been
already stated. Although the work of protecting the public from danger was much
handicapped by the action of those in charge of the patient, it is satisfactory to be
able to state that there was no spread of the disease.
On two other occasions the Medical Officer was called to advise as to the nature
of cases which were suspected of being Smallpox. In one the disease proved to be
severe Chicken-pox, and in the other Cowpox.
Diphtheria caused 2 deaths in 1894, as compared with 1 in 1893; in all,
8 cases were reported. The cause of the disease was almost invariably found to be
insanitary conditions in the houses or their surroundings. These defects were
remedied.
Scarlet Fever caused 2 deaths during 1894, as compared with 3 in 1893. The
disease was very prevalent in the District at two periods, and in all 89 cases were
reported during the year. The type of the disease was slight, and diagnosis was

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