HH62/45/263

Transcription

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of Infectious Disease. No certificates have been required under the Public Health
Acts during the past year, nor has any action been necessary in connection with
Factories or Workshops.
3. Retail Bakehouses. - These have been inspected during the year, and found
to be in good order. The old premises at Rannoch have been closed and the Bake-
house transferred to a new and more suitable building, much to the satisfaction of all
concerned.
4. Advice has been given in connection with the proposed sewage purification
works at Murthly Asylum, the securing of a suitable site for a store-shed for the
Smallpox Hospital, and the selection of a site for the Burying-Ground at Moulin.
5. The arrangement by which the Highland District Committee were entitled to
send infectious cases to the Perth Royal Infirmary for treatment will soon terminate,
and it will be necessary to reconsider the agreement at an early date. During the
past the Hospital at Perth has been found to be very suitable for the District, and
the arrangement has been a very good one in so far as expense was concerned for the
Committee. The Chief Medical Officer has now ceased to have any official connection
with the Infirmary Staff, and has consequently no supervision of the treatment of
patients admitted to the Hospital from the District. All of the five patients who
received Hospital treatment during the past year made good recoveries. The Portable
Smallpox Hospital, which was procured at the time of the scare in Dunkeld in 1893,
has now been removed and stored in a shed erected for the purpose on ground kindly
granted by the Highland Railway Company; the shed has been so placed as to allow
of the sections of the Hospital being easily loaded in trucks when required for
transport. It is hoped that it will not soon be necessary to use the Hospital, but in
view of the proposed doubling of the main line through Perthshire, it is well to be
prepared for any contingency.
6. When Infectious Disease has broken out the energies of the Public Health
Officials have been directed to protecting the public by removal of patients, and where
that was refused, in endeavouring to maintain isolation at home; however, this, even
with the greatest care, is often quite insufficient, and it is to be hoped that a clause
may be inserted in the new Public Health Act which will make removal compulsory
where reasonable isolation is not obtainable. Much valuable assistance has been
given in combating Infectious Disease by the Assistant Sanitary Inspector who has
been unremitting in his endeavours to remove insanitary conditions and most
particular in carrying out the disinfection of infected premises. Thanks are due to
many of the Teachers in the Public Schools in various parts of the District for the
valuable information given in connection with absentees when epidemics threatened
the districts in which their schools were situated.
Respiratory Diseases caused 32 deaths, or 13.0 per cent. of the total, during
1895, as compared with 21 in 1894. In 13 of these the age at death was over 60
years.
Nervous Diseases caused 20 deaths, or 8.1 per cent. of the total, during 1895, as
compared with 17 in 1894. In 15 of these 20 deaths the age was over 60 years of age.
Circulatory Diseases caused 23 deaths, or 9.3 per cent. of the total, during 1895,
as compared with 15 in 1894. In 17 of these the age at death was over 60 years.
Tubercular Diseases caused 23 deaths, or 9.3 per cent. of the total, during 1895,
as compared with 20 in 1894. Of these 23 deaths, 16 were attributed to Pulmonary
Consumption.
Digestive Diseases caused 10 deaths, or 4.0 per cent. of the total, during 1895,
as compared with 8 in 1894.

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Cancer and Malignant Diseases caused 14 deaths, or 5.7 per cent. of the total,
during 1895, as compared with 13 in 1894.
Developmental Diseases caused 6 deaths, of which 4 were ascribed to Premature
Birth, as compared with 8 in 1894.
Old Age was the cause of death in 35 cases, or 14.2 per cent. of the total, during
1895. In 1894 the number of deaths due to Old Age was 37.
Violence caused 12 deaths during 1895, as against 5 in 1894.
Zymotic Diseases caused 8 deaths during 1895, as compared with 4 in 1894.
The increase in number was due to Diarrhoea. The Zymotic Death-Rate was .632
during 1895, as compared with .313 in 1894. In all there were 90 cases of Infectious
Disease reported to the Chief Medical Officer in 1895, as compared with 119 in 1894.
Scarlet Fever caused one death during 1895, as compared with two in 1894.
Fifty-six cases of the disease were reported during the year 1895, as compared with
89 in 1894. The type of disease was again exceedingly mild, and in most of the out-
breaks little difficulty was experienced in stamping it out. One outbreak at Acharn
on Loch Tay side gave much anxiety to begin with. Before the disease was reported
it had been prevalent amongst the children attending school for a considerable time,
the nature of the complaint being considered to be Influenza, and no precaution had
been taken. When the true nature of the disease was discovered, there was a
tendency on the part of the parents to consider it hard that they should be compelled
to isolate their sick when the neighbours from whom their children had caught the
disease had been allowed to escape; and it finally became impossible to receive
intimation of all of the cases, as no doctor was called, owing to the mildness of the
disease. One of what may be called return cases of Scarlet Fever occurred in the
family of a visitor to the district. A case of Scarlet Fever was notified, and on enquiring
as to its probable cause, it was discovered that shortly before the patient sickened,
another of the family who had been ill of the disease had returned to the house. The
remarkable feature in this case was that the first patient had been confined to Hospital
for seven weeeks, and thereafter had been sent to a Convalescent Home, moreover,
that all the infected clothes had been destroyed, the patient being furnished
with a new wardrobe. It was found that the only evidence of anything being amiss
with this patient was that the nails were being shed at the time of his return to the
family circle.
Enteric Fever. - No deaths occurred from this disease during 1895. Six
cases of the disease were reported during the year, as compared with four in 1894.
One of these cases came sick into the district. The others were in small groups of
two and three, and were due to insanitary conditions, which were remedied. Two of
these patients were removed to Hospital, and made good recoveries.
Diphtheria caused one death during 1895, as compared with 2 in 1894. Only
two cases of the disease were reported, as compared with 8 in the previous year. The
cause of the disease was dampness of the walls and floor of the house.
Influenza. - To this cause 5 deaths were attributed during 1895. These Deaths
occurred during the earlier months of the year.
Diarrhoea caused 6 deaths during 1895, as compared with none in 1894. The
majority of the deaths from this disease occcurred during September and the following
months.
Deaths in which the cause of death was uncertified, or insufficiently stated, were
46, as compared with 24 in 1894. This state of matters is most disappointing, as it
was anticipated that, as time went on, diseases relegated to this class would be reduced
to a minimum. Much valuable information has thus been lost through neglect
on the part of the medical men in some parts of the country to furnish the necessary
certificates.

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