HH62/45/71

Transcription

[Page] 4

It is true that in such a District as the Western the majority of fever cases
must be treated on the spot by strict isolation, but there will be occasional cases
which cannot be so dealt with, and for which Hospital accommodation must be
provided. Should the Perth Royal Infirmary be decided upon as the centre to which
infectious cases from the Western District are to be sent, as Senior Visiting
Surgeon, the Chief District Medical Officer has, under the Directors, the full
supervision of the treatment and accommodation of fever cases in that Institution.
6. The first steps necessary to prevent the outbreak and spread of infectious disease
are the removal of such accumulations near houses as are likely to lower the general
health, and the prevention of the use of impure water for domestic purposes. In
many instances these have been seen to during the past year by the Sanitary staff.
In treating infectious cases strict isolation has been insisted upon, and disin-
fectants have been freely supplied. Cases of enteric fever have occurred in houses
using water drawn unfiltered from the Forth, and consequently filters have been placed
in these by the proprietors. This is, however, only a temporary measure, as the
Forth can hardly be considered a satisfactory source for a pure water supply,
owing to its sluggish current and the amount of sewage it receives.
When measles broke out amongst the navvies working on the West Highland
Railway, the source of infection was clearly traced to the Island of Harris, where the
disease was prevalent at the time. As the patients were too ill to be removed, the
Contractors, Messers. Lucas & Aird, very kindly put the use of a hut at our disposal,
and the whole treatment, except the final disinfecting of the hut, was taken over by
Dr. Kay, the local medical man.
Scarlet fever occurred at Killin during the year. The cases were treated at
home, and the local Medical Officer and Sanitary Inspector were happily able to
prevent the disease from spreading. This was the more fortunate, as the fever,
judging from the death rate (viz., 2 deaths in 18 cases), must have been of a malignant
type.
Measles and whooping-cough have been prevalent in the District, but, as a rule,
the cases have been very mild, only one death from each disease being reported.
7. The voluntary notification of infectious diseases has been so complete throughout
the District (134 cases having been so notified during the year) that there seems to
be no necessity for adopting the Infectious Diseases (Notification) Act.
From Returns received from local Medical men, giving data of 2000 cases of
sickness, the various diseases occur in the following proportion:- Diseases of the
Digestive System, 27 per cent. of the sickness, and 3.8 per cent. of the total
deaths in the District. Habitual constipation is a chief factor in the causation of
this disease, and with improved sanitation, and an education to regular habits, a
distinct diminution of the same may be expected. Another cause of the prevalence
of digestive troubles is to be found in the large consumption of tea which, in most
cases, is not infused as it to be ought to be, but rather boiled, and so impregnated with
tannis as to pervert the action of the stomach by its constant use. Tea should never
be infused for more than five minutes. If it be necessary to keep it, the liquid should
be poured off the leaves and kept hot. If this rule be attended to, tea is found to be
not only harmless, but a healthful beverage.
Diseases of the Respiratory System caused 24 per cent. of the sickness, and
15.3 per cent. of the total deaths. This is what might have been anticipated during
such a changeable season as we experienced last year, along with the all-prevailing
epidemic of influenza, which was so frequently complicated by chest affections.

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Consumption and other Tubercular Diseases formed 3 per cent. of the total
sickness, and 11.5 per cent. of the total causes of death. This disease is most
prevalent, and has been said by one authority to affect about one-half of the human
race. It has now been proved that every case is infected by another from which the
specific poison is derived, and that, not consumption, but the tendency to take con-
sumption, is inherited. In cases where it affects the lungs, the usual mode of infection
is by the poison being conveyed into the air passages in the form of suspended dust
which contains the germs of the disease. In a healthy being the processes of nature
are able to successfully combat the intruders; but where any weakness exists, or even
where the general health of the recipient is below normal, the germs find a suitable soil,
and rapidly establishing a footing, they seldom cease their baneful mission while life
lasts. Those germs are derived from the dried expectoration of a previous
case of tubercular consumption, and it behoves guardians of patients suffering from
such complaints, in their own interest, and that of the public at large, to exercise a
constant vigilance in dealing with the discharge from the lungs. The expectoration
should be received into a porcelain spittoon, containing some disinfectant, and the
spittoons should be regularly cleansed by immersion in boiling water. If this simple
measure were regularly carried out a very fertile source of consumption would be
eliminated from the field. A patient suffering from consumption should be kept
in a well lighted and efficiently ventilated room, all over-crowding of which by
visitors should be avoided, and the patient should always occupy a single bed.
Another mode by which the germs of tubercular disease reach the human race
is to be found in milk. Infants are specially liable to suffer from this, as it is the
usual custom where bottle-feeding is resorted to, that the milk from one cow should
be obtained for this purpose. If that cow should be the subject of tubercular disease
the danger of infection is necessarily great. To prevent this, milk used for feeding
children should always be boiled.
Rheumatic Affections form 15 per cent. of the sickness Returns. This large
proportion must also be ascribed to the wet season, especially in a district whose
rainfall is nearly double that of any other in Perthshire (during the past ten years the
rainfall at a station in the Western District averaged 74.64 inches annually).
Diseases of the Circulatory System, which may be classed alongside of the above,
caused 14 per cent. of the total deaths during the year.
Of persons over 60 years of age there were 69 deaths, or 44 per cent. of the
total, and in 16 cases old age was the reported cause of death.
Infectious Diseases formed 6 per cent. of the sickness Returns, and there
were 8 deaths reported from these diseases, or 5 per cent. of the total.
Influenza has been very prevalent, and has caused, as a sequence, a large
amount of respiratory disease. The epidemic seems now to have spent itself, in so
far as Perthshire is concerned, and it is hoped, that for this generation, it will now
be quiescent. It would, however, be well to be prepared should the disease again
appear in our midst, to grapple with it at the very onset by enforcing strict isolation.
There seems to be no doubt that influenza is a disease which spreads by
contagion, and that the poison lies dormant in the system for a short period before
declaring itself by violent constitutional disturbances. During this period of incu-
bation, the disease seems like some others of the same class, to have the power of
infection, so that it is easily understood how many cases may be traced to one in a
very short time. It is this rapidity of infection which has caused so much speculation
to arise, as to whether influenza had not some peculiar method of spreading itself

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