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[Page] 12

pared with 612 in 1894. The number of these cases removed to Hospital during
1895 was 85, or 15 per cent., as compared with 80 in 1895.
Smallpox. - Only one slight case of the disease occurred within the bounds of
the Landward Local Authorities of Perthshire during 1895. The case was that of
a young man resident in Killin. As soon as his disease was recognised, he was
removed to the Glenoglehead Hospital, where he made a good recovery. There was
no spread of the disease.
Scarlet Fever caused 8 Deaths in 1895, as compared with 12 in 1894.
The number of cases reported was 277, as compared with 393 in 1894.
The disease was a source of continual anxiety to the Department, but all
the outbreaks were successfully stamped out, except at Acharn in the High-
land District, and Dunning in the Central District. In both of these places
negligence on the part of some of the householders to make themselves aware of the
nature of the disease, hindered efficient action. In many of the outbreaks the primary
source of infection was clearly traced to travelling in an infected public conveyance.
The manner in which infection reaches these public conveyances was very clearly
shown in three instances during last year. The child of a medical man took
ill in the country, it was immediately removed by rail to its home in one of the large
towns, and on its arrival was notified to the Local Authority there as suffering from
Scarlet Fever; the excuse pleaded here was that the disease was not recognised earlier.
A servant girl with a family in lodgings in the country was ill for two or three days; she
was then sent home, and on her arrival certified as having Scarlet Fever; here again
"ignorance was bliss." Again, a medical man sees a patient suffering from a puffy
face, he suspects that it is the result of a recent attack of Scarlet Fever, and wisely
recommends that the patient be removed from the midst of a large family to hospital
for isolation, but, unwisely, neither communicates with the Local Authority nor gives
proper instructions as to the mode of removal, and the patient is removed, - in a
crowded omnibus! Until the Law is amended to such an extent as to make such
actions as those above-mentioned subject to heavy penalty, and the too-commonly-
used back-door of ignorance, as an excuse, is closed for good, we need scarcely hope
to be able to stamp out Scarlet Fever.
Diphtheria caused 21 deaths during 1895, as compared with 25 in 1894. The
total number of cases reported during 1895 was 130, as compared with 71 in 1894.
The case mortality was only 15.1 per cent., which is a large improvement on 1894,
when it was 35.2. Doubtless, to a large extent, the improved Death-rate is due to
the notification of a number of doubtful cases, which, without the Notification Act,
would never have been reported; still, when in some of the outbreaks as many as 27
consecutive cases occur with only one death, one cannot help thinking that in this
dreaded disease, like Scarlet Fever, we may look for a milder type in the future.
The chief outbreaks of the disease occurred at Longforgan and Stanley in the Perth
District, and at Killin and Balquhidder in the Western District. There can be no
doubt that school attendance was the main factor in the spreading of some of these
outbreaks.
Enteric Fever caused 10 deaths during 1895, as compared with 5 in 1894.
There were 56 cases of the disease reported during 1895, as compared with 65 in 1894.
Although the number of deaths is double that of the previous year, the total number
of cases shows a substantial reduction, and when to this it is added that most of the
cases were either sporadic or clearly traceable to infection contracted without the
bounds of the Landward Local Authority, there can be no doubt that the en-
forcement of the provisions of the Public Health Acts, and especially the regular

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