HH62/45/21

Transcription

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the necessity for using the same. A frequent argument against opening windows is
to point to the fact, that where a room is completely shut up, curtains, &c., may be
seen affected by draughts. This is taken as indication that abundance of fresh air
is entering the room, forgetting that a local draught of foul air may cause movement,
but it requires the oxygen of the outer air to give health.
Many of the houses has been erected on bad sites (with earth banks against the
back wall), and these have a great tendency to become damp. In many cases this is
increased by the absence of eaves-gutters to carry away the rain water, which other-
wise must soak into the earth at the back of the houses. Where proper drainage
does not exist this is likely to cause injury to health, hence, wherever such a state of
matters has been discovered, the proper remedies in the shape of eaves-gutters and
drainage have been recommended. In many cases, also, where the floors of dwelling-
houses are made of stone, no precaution has been taken, by excavation and filling up
of the substructure, to prevent damp from rising. This is certainly not a proper state
of matters, but as the object aimed at in the administration of the Public Health Act
in Perthshire is to make the inhabitants their own sanitary reformers, improvements
will proceed, we trust, gradually but surely. Acting on the above principle, a large
amount of permanent work has been accomplished throughout the District, and it is
very much to the credit of the Sanitary Inspector that this has been done without
resorting to legal proceedings.
During the year 1892 the Dairy Regulation will come into force, and will be
the means of greatly improving the condition of cowsheds and milk-houses, as well as
ensuring a plentiful supply of pure water to farms, which are at present badly off
for such an essential element of health.
With regard to the villages, the District Committee should call for a Report on
the condition of the larger ones, especially in regard to the disposal of house refuse,
in order that, when judging of sanitary measures, they may be in possession of the
facts, and also the remedies suggested by their Officials. As the Public Health Sub-
Committee should have all the information possible when dealing with matters relating
to Public Health, it would be well that the District Officials were invited to attend
its meetings.
It is to be regretted that the District Committee have dispensed with the
services of the Local Medical Officers, for, by so doing, much valuable knowledge has
been lost irretrievably to the Public Health administration. It is quite impossible
for an outsider to acquire that intimate and personal acquaintances with the homes of
the District which a local Medical man has as a natural result of his every-day work.
The removal from office of these skilled observers will, in the future, prove a serious
impediment to the progress of Preventive Medicine in the District, and it would be
well for the Committee to reconsider their decision.
2. During the past year a systematic inspection of the more populous parts of the
Blairgowrie District has been made, including, in the first place, the topographical
and geographical features, the water supplies and drainage; and, in the second place,
the condition of houses as regards dampness and ventilation. Attention has been
directed to what was amiss, and instructions for improvement were given.
Special enquiries were made regarding an outbreak of enteric fever in the District,
and, along with the Sanitary Inspector, into some nuisances of which complaints were
lodged.
3. No Certificate under the Public Health Act has been required, as the removal
of insanitary conditions was at once undertaken willingly, so soon as the necessity
was understood.

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No action has been demanded regarding the sanitary condition of Factories and
Workshops; nor has any offensive trade been brought under notice, excepting two
slaughter-houses, which will in due course be dealt with by the Sanitary Inspector.
4. There has been, during the latter half of the year, a systematic inspection of the
Six Retail Bakehouses in the District. One of them is in very bad repair, but is
not in use as a bakehouse at present; the others have been put in good order,
both internally and externally, and are now in a thoroughly sanitary condition. One
young person was found employed, and reported to H.M. Inspector of Factories.
5. No proper arrangement has been made regarding the provision of accommo-
dation for persons suffering from infectious diseases in the District, and requiring, for
purposes of isolation, removal to Hospital. By the courtesy of the Directors of the
Perth Royal Infirmary, the Wards of that Institution set apart for the treatment of
infectious cases, have been, during the past year, placed at the disposal of the District
Committee. This accommodation has not as yet been required, but, with the view of
making a definite arrangement for the future, a Joint Meeting of Representatives from
the Directors, and from the District Committee, was held. At this Meeting the
Directors made a proposal to take the entire charge of any cases of infectious disease
(smallpox excepted) which might be sent to the Infirmary, during a period of five
years, the sole conditions being, that the Local Authorities, who are to have the use
of the Fever Wards, should pay one-half of the expenses which will be incurred in
the necessary alterations connected with the Laundry and Disinfecting Apparatus.
The Directors contemplate erecting a Steam Laundry and Disinfector of the
most modern design. These negotiations are in progress, and it is to be hoped that
all will soon be satisfactorily arranged.
The distance from the extreme parts of the District may be deemed by some an
objection to this scheme, but with a good Ambulance Waggon, such as it is proposed
to secure, there will be no difficulty in removing cases, even from the most outflying
places. At the termination of the five years' arrangement, the Committee can more
easily judge whether, or not, it is necessary to erect a special Epidemic Hospital for
the District. Should the Perth Royal Infirmary be decided upon as the centre to
which infectious cases are to be sent, as Senior Visiting Surgeon to that Institution,
under the Directors, the Chief District Medical Officer has every opportunity of
supervising the accommodation and treatment of patients admitted to it.
6. Little has required to be done in the way of taking action to prevent the spread
of infectious disease in the District, during the past year. One case of diphtheria,
which was imported from outside the District, and six cases of enteric fever are all
which have come under the notice of the District Officials. In the diphtheria case
the disease did not spread. How the first three enteric fever cases were infected has
not been definitely settled, but the other cases were undoubtedly infected from one of
these. Special precautions were taken regarding the disposal of the excreta of the
latter cases, and no fresh outbreak has occurred. Enteric, or, as it is commonly called,
typhoid or gastric fever, is one of the most infectious diseases known; but, fortunately,
its infective powers are chiefly contained in the excreta, and if these be carefully
dealt with, there is very little danger of the disease spreading. The nurse of an
enteric case should attend to the following rules:- 1st. The excreta should always be
received into some powerful disinfectant, and all clothing soiled by discharge should
at once be soaked in strong disinfecting solution, and thereafter washed. 2nd. The
nurse's hands ought to be carefully washed after assisting, or touching the patient in
any way. 3rd. In the disposal of excreta great care should be exercised that a

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