HH62/45/99

Transcription

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transport. In the Western District, which has not united with the other Districts in
obtaining the use of the Perth Royal Infirmary for infectious cases, it is intended to
accomplish the whole isolation of these in such hospitals. As so much opposition
has been offered to the erection of permanent hospital buildings in the vicinity of
Burghs, matters will be much simplified by such a course.
Cholera. - In July, 1892, on account of the prevalence of Cholera on the
Continent of Europe, special instructions were issued that preparations should be
made for dealing with the disease in such a manner as to prevent its spreading
further should a case occur. In a Rural District the impossibility of removal of
Cholera patients to hospital will necessitate the treatment of the majority of patients
in their own homes, and one of the most important factors in such treatment will be
the nursing. In the case of Cholera this will frequently fall to the lot of a relative,
who must be prepared to lay aside all selfish fear and nervous panic, and to attend
simply to the orders of the doctor. A nurse who does this will not run any great risk
of infection from the patient. Cholera is not a disease carried by air: its infection
is transmitted by contaminated food or water. Consequently, there should be the
free use of disinfectants in the disposal of excreta, and the washing of soiled clothing,
and strict attenton to cleanliness and order in personal habits. In Diarrhoea also,
the disinfecting of discharges should take place, as, again and again, a mild case of
Enteric Fever has been passed over as an attack of Diarrhoea, and only discovered to
be the former when a more severe attack of fever occurred, infected by it.
If, during 1893, the country is again threatened with Cholera, I hope to be able
to give a short course of lectures and practical instruction on the special nursing
required for Cholera cases to those who are willing to undertake the duties.
Notification of Infectious Diseases by medical practitioners has, during 1892,
been performed very satisfactorily. In the Central and Western Districts, where the
recommendation of the County Council to appoint local Medical Officers has been
carried out, these are, in terms of their Bye-Laws, bound to notify to the Chief
Medical Officer all cases of Infectious Disease which come to their knowledge. In
the other Districts the Medical Men have almost uniformly notified infectious cases.
This was, however, only taken advantage of till it was seen whether or not Medical
Officers would be appointed in these Districts. As no such appointments have been
made, the District Committees have been recommended to adopt the Infectious
Diseases (Notification) Act without delay.
In conclusion, I would thank the Sanitary Inspector and his assistants for the
valuable work done during the year.
On the following pages will be found District Reports and Tabular Statements
of Sickness and Mortality.

JOHN T. GRAHAM, M.D.
March, 1893.

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Perth District.

1. The Sanitary Condition of the Perth District is fairly good. Much has
been done towards removing nuisances, remedying faults in the construction of
dwelling-houses, and examining the surroundings and sources of water used for
domestic purposes, with a view to securing it against pollution, or providing a safe
supply. Although no scavengers have as yet been appointed to see to the removal
of refuse in the more populous villages, a great improvement has been effected in the
surroundings of many of these. But, as the removal of refuse could only be insisted
on when it had accumulated to such an extent as to become a nuisance, the benefits
of this system cannot be compared to those which would result were a man specially
engaged to do this work regularly. The question of providing scavengers for each
of the larger villages has been before the Committee more than once during the year,
but the only result, so far, has been that, pending a final decision, the Errol scavenger
has been retained. It is to be hoped that the District Committee will soon arrive at
a decision which will be of the greatest value to the practical sanitation of the
District. So long as the removal of domestic and other refuse is not regularly
attended to, those unfailing indices of bad sanitation, enteric fever and diphtheria,
will form a blot on the records of the District.
Water-supplies have, in anticipation of an invasion of cholera, received
an extra share of attention. The Water-supply of the lower part of the Carse
of Gowrie has proved to be the largest scheme. As it was found on
analyzing samples taken from wells in this District that, almost without
exception, the water is unfit for human use, the matter is before the District Com-
mittee, and it is to be hoped that definite measures will be taken to ensure the
substitution of good, wholesome water for the liquid at present in use. The simplest
and cheapest way of meeting the difficulty would be to form a large part of the
parish of Errol into a Water District, and to have a supply for the same brought from
the Sidlaw Hills. This is, of course, rather a matter for the inhabitants than for the
Local Authority, who should, however, insist upon the houses now destitute of
pure water being immediately supplied with it. The Water-supply of Almondbank
is derived from two sources, one by gravitation, and the other from surface wells.
The former in its present condition is unfit for use; the wells yield a
fair supply of water, but, from their situations, they are liable to pollution,
and it would be advisable to have this village, along with Bridgeton, formed
into a special Water District, to which a new supply of water, readily available
by gravitation, could be brought. In many cases wells liable to surface pollution
have been ordered to be cleaned and protected from the same.
Public Schools have received a considerable amount of attention during the past
year, and it is gratifying to be able to report that, as a whole, they were found in a
very good condition; and, whilst many of them have the latest appliances in the shape
of ventilating shafts, all were found to have, what is apt to be forgotten in these
advanced days, viz., provision for ventilation by means of open windows. In some
few cases the latrines required re-modelling, and this was willingly carried out.

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