HH62/45/23

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sufficient quantity of disinfectant is used to ensure thorough extinction of the infective
germs, and then removal should take place, as speedily as possible, to some safe
quarter. The local Sanitary Inspectors have now a supply of disinfectants ready for
use when required.

7. No Returns have been received from the local Medical Officers regarding the
distribution of sickness in the District during the year. The following facts are
obtained from an analysis of the Mortality Returns for the year:-

Circulatory Diseases caused 23 deaths, or 14 per cent. of the total. As, in many
cases these, diseases owe their origin to attacks of rheumatism in early life, much may
be done towards their prevention by making the dwellings less liable to damp, which
is one of the commonest causes of rheumatic affections. Another essential in the
prevention of these ailments is to protect the body from sudden chills by wearing
woollen underclothing, which, from its non-conducting properties, protects the surface
of the body. Still, in a part of the country so exposed to moisture-laden and chilling
east winds, as is the Blairgowrie District, illness of this sort must always be prevalent.
Two deaths have been certified as having been caused by rheumatic fever.

Respiratory Diseases come next on the list as a cause of death, viz. - 16 deaths,
or 9.8 per cent. of the total. These, like the Circulatory diseases, are largely due to
climatic conditions, and as a preventive warm non-conducting underclothing should
undoubtedly be adopted, especially for those who are exposed to the inclemency of
the weather.

Diseases of the Digestive System account for 15 deaths, or 9.2 per cent. of the
total mortality. As these in many instances owe their origin to constipation, often
acquired in consequence of the want of the necessary conveniences in connection with
dwelling-houses, it is only reasonable to expect a marked diminution of disease of this
class, as sanitary measures remove the initial cause, and as the rising generation
become educated to regular habits.

Tubercular Disease has accounted for 12 deaths, or 7.4 per cent. of the total.
Nine of these deaths have been caused by tubercular disease, other than phthisis.
As it has now been proved that tubercular disease is transmitted from man to man,
or from cattle to man, as the case may be, it will not be out of place here to give
some general directions for the prevention of such transmission. In the first place, it
ought to be known that the old idea that this disease is hereditary has now been
exploded. A tendency to it is certainly strongly marked in some families, but the
tendency, without the actual reception of the special infective germ, cannot now be
held as a cause of the disease. The germ of infection is received into the human
body, either in the form of minute particles which are carried by the air into
the lungs in the ordinary process of respiration, or it enters by the alimentary
canal. In the former case, when such a particle enters a lung which is in a weak con-
dition, and not in possession of its normal resisting powers against such poison, it soon
obtains a firm hold, and its work of destruction ceases only with the death of the
sufferer. In the latter, the poison may be received from the milk of a cow affected by
tubercle; to this infants brought up on the feeding-bottle will be specially susceptible,
and therefore all milk used for such a purpose ought to be boiled. It has also been
proved that eating the flesh of animals affected by this disease can cause the same in the
bodies of other animals previously healthy. Reasoning by analogy, we conclude that
such meat is quite as likely to produce a like result in the human race. Doubtless
such meat, if subjected to a sufficiently high temperature, is quite safe for use; but

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it has been proved that it is practically impossible to raise the temperature of a large
piece of meat sufficiently by roasting without entirely carbonizing the outer
portions. Although boiling is, perhaps, the most effectual method of ensuring that the
temperature has been raised to the full 212°, still such a treatment would effectually
destroy the nutritive quality of the meat, and hence its adoption cannot be recom-
mended.

As to precautions against infection from consumption, the room occupied by a
consumptive patient should be well ventilated, and as much exposed to sunshine as
possible; all overcrowding of the apartment by visitors should be avoided, and the
patient should occupy a single bed. In fact, consumption should be treated with as
much caution as enteric fever.

Influenza has been widely prevalent throughout the District; the deaths
directly attributed to this cause were 8, or 4.9 per cent. of the total. The disease
seems now to have ceased, so far as Perthshire is concerned, and we trust it has now
left us for this generation. Spreading so rapidly as it does, influenza is a disease
which it seems almost impossible to combat in the way of prevention; but as the Local
Government Board has taken up the matter, we may soon expect to have laid before
us the best means to be adopted, should the disease again attack our shores.

8. Appended are Tubular Statements of the Sickness and Mortality in the District
during the year 1891. The first three Tables are in the forms required by the
Board of Supervision, and in the fourth is a detailed statement showing the Births
and Deaths (with causes of the latter) in the various Registration Districts, into
which the Registrar-General has sub-divided the Perth District.

The local Registrars cannot be too highly commended for the unanimous manner
in which they have come forward to supply the data for these Tables.

JOHN T. GRAHAM, M.D.,
Chief District Medical Officer.
February 29th, 1892.

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