HH62/45/319

Transcription

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with local medical men regarding suspected cases of Infectious Disease. No certifi-
cates were necessary under the Public Health Acts during the past year, nor was any
action taken under the Factory and Workshops Act.
4. Retail Bakehouses were inspected during the year, and the requirements of
the Factory and Workshops Acts were enforced regarding their condition. The
premises were, however, found in very fair condition.
5. The arrangement by which the Highland District infectious cases were
admitted into the Perth Infirmary was fully taken advantage of during the past
year, 23 patients having been removed during its course, but in May, 1897, the former
agreement terminates, so that a fresh agreement had to be completed. The District
patients are to be admitted as formerly on the payment of an annual sum. Year by
year proves that a Central Hospital is quite sufficient for the requirements
of the Highland District. During the year many patients were removed long
distances without in any way suffering thereby, - one case of Diphtheria having been
removed 47 miles to Hospital. The Portable Hospital belonging to the District
Committee, reserved for the treatment of Smallpox cases, has not been in use during
the year, but is ready for erection when and where required.
6. When Infectious Disease has been reported to exist, or suspected to exist,
immediate steps have been taken to ascertain the exact nature of the outbreak, and
prompt measures have been adopted to secure isolation. Much difficulty was
experienced through one outbreak of Scarlet Fever having been looked upon as some
other disease, until the whole locality had become infected, but careful tracing up of
suspects, and rigid isolation of these when suspicious evidence was detected, sufficed to
check the epidemic, although the infection had made considerable progress before the
Department was made aware of its existence. In one instance where a whole family
had become infected, it was thought best to provide a Nurse in order to secure
isolation. In the trying work of tracing up supposed clues regarding infectious cases,
much valuable assistance was received from the Assistant Sanitary Inspector, who
most willingly took many long journeys in order to ascertain the truth or falsity of
rumours. Wherever insanitary conditions were found to be causing or aggravating
disease, prompt measures were taken to effect a remedy. Two School Boards within
the District showed much anxiety to put their property into good sanitary condition,
the Kenmore Board having done a great deal to the premises at Acharn, where there
was an out outbreak of Scarlet Fever in 1895, and also at Ardeonaig, where there
were a number of Diphtheria cases in the Teacher's house during 1896, and where
insanitary conditions abounded. The Logierait School Board, owing to an outbreak
of Scarlet Fever amongst the children attending Grandtully Public School, and com-
plaints as to the condition of the premises, decided to erect a new School at a more
central point.
Respiratory Diseases caused 16 deaths, or 9.3 per cent. of the total,
during 1896, as compared with 32 in 1895. In 6 of these deaths, the age at death
was over 60 years, and 3 occurred in children under 1 year.
Diseases of the Circulatory System caused 19, or 11.0 per cent. of the total,
during 1896, as compared with 23 in 1895. Of these 19 deaths, 11 occurred in
persons over 60 years of age.
Tubercular Diseases caused 16 deaths, or 9.3 per cent. of the total, as com-
pared with 23 in 1895. Of these 16 deaths, 11 were attributed to Pulmonary
Consumption. Deaths due to this class of disease show, during the year, a
satisfactory diminution.
Disease of the Nervous System caused 16 deaths, or 9.3 per cent. of the total,

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during 1896, as compared with 20 in 1895. Of these 16 deaths, 10 occurred in
persons over 60 years of age.
Diseases of the Digestive System caused 10 deaths, or 5.8 per cent. of the
total, during 1896, as compared with the same number in 1895.
Cancer and Malignant Diseases caused 11 deaths, or 6.3 per cent. of the total,
during 1896, as compared with 14 in 1895.
Old Age was certified as the cause of death in 40 cases, or 23.2 per cent. of the
total, during 1896, as compared with 35 in 1895.
Developmental Diseases caused 10 deaths, of which 7 were attributed to
premature birth, during 1896, as compared with 6 in 1895.
Violence caused only 1 death during 1896, as compared with 12 in 1895.
Zymotic Diseases caused 7 deaths during 1896, as compared with 8 in 1895.
The total number of cases of these deseases reported to the Department during the
year was 116, as compared with 90 in 1895, the increase being due to an excessive
number of Scarlet Fever notifications. The Zymotic Death-rate during 1896 was
.558, as compared with .632 in 1895.
Scarlet Fever caused 2 deaths during 1896, as compared with 1 in 1895. There
were 85 notifications of the disease received by the Department, as compared with 56
in 1895. The chief outbreaks of the disease occurred at Moor of Rannoch, Dunkeld,
Grandtully, Ballinluig, and a few cases in Pitlochry. In the outbreak at the latter
place, what can be done by prompt measures was well seen; the cases were early
seen by medical men, the nature of the disease recognised, removal was carried out,
and the village was clear of infection in less than a week. The disease was of a very
mild type, and the only two deaths which occurred happened in the same family.
The epidemic in Dunkeld threatened at one time to assume alarming proportions,
but fortunately, the precautions adopted soon checked its spread. Several Schools
had to be recommended to be closed for a time, as it was found that convalescents
had been attending whilst in an infectious condition, and a scare amongst the parents
was the result of this being discovered. There were 19 cases removed to Hospital;
all made good recoveries.
Enteric Fever. - As in 1895, no death was cause by Enteric Fever during 1896,
and only 4 cases of the disease were reported to the Department during the year. One
of the cases undoubtedly received infection before coming to the District, another
was a tinker, and it was thus difficult to ascertain whence the infection in this case
had been derived. In another case the disease was probably derived from the turning
up of some old drains during alterations. One patient was removed to Hospital, and
made a good recovery.
Diphtheria caused 1 death during 1896; in 1895 the number of deaths was the
same. During the year, 12 cases of the disease were reported to the Department, as
compared with 2 in 1895. The majority of the cases of the disease occured at
Ardeonaig and in one house, the infection having spread over the family previous to
the nature of the disease becoming known; here, doubtless, insanitary conditions were
a large factor in the causation and spread of Diphtheria. Of these 12 cases of
Diphtheria, 3 were removed to Hospital, and made good recoveries.
Diarrhoea caused 4 deaths during 1896, as compared with 6 in 1895.
Deaths in which the cause of death was uncertified, or insufficiently stated, were
14, as compared with 45 in 1895. This is satisfactory, and as it should be.

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