HH62/45/149

Transcription

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2. During the year many general inspections have been made of various parts of
the District, and a number of special visits have been necessitated in consequence of
complaints as to matters alleged to be injurious to health. Enquiries into the
causes and means of isolating cases of Infectious Disease have entailed a great amount
of anxiety and supervision. In one instance it was the unpleasant duty of the Medical
Officer to express dissatisfaction with the action of those in power in Crieff, as they
deposited a tramp from the police cells, suspected of having Smallpox, in a disused
hut in Monzievaird. This hut was close beside a much-frequented thoroughfare,
and the only person left in charge of the case was a woman of the same class
as himself. Considering the situation of the hut, and the supervision of the case,
it was no wonder that the residents of the neighbourhood felt a good deal of
alarm. On examining the man, it was found he was not suffering from Smallpox;
and the Burgh Authorities were informed that, whilst willing to assist them in every
way in a difficulty of the kind, the removal of cases of infectious disease to this hut
would be opposed in future, on account of its dangerous situation. Measles and Scarlet
Fever have been unusually prevalent, and have demanded much attention from the
Medical and Sanitary Staff during the year.
3. Advice was given and examination made of various houses considered to be in
an insanitary condition; most of the defects found were remedied through the good
sense of the proprietors, but in one instance a certificate under Section 16 of the Public
Health Act was required, and the premises were only made right by order of the
Sheriff. In a case of Scarlet Fever, in Auchterarder, it was found necessary in order to
effect proper isolation to apply to the Sheriff for a warrant to remove from the room
occupied by the patient all the rest of the family except the mother, who was nursing
him. The warrant had the desired effect, and no further difficulty was encountered
in connection with this case, or any others, in securing the isolation considered essential
either by removal to Hospital or at home. No action was demanded in connection with
the sanitary condition of Factories and Workshops, as no complaints were received
during the year.
4. Retail Bakehouses. - There are seventeen of these in operation in the land-
ward portion of the Central District; these were visited and examined during the year,
and were found to be kept in good order. One in Comrie has been transferred to new
premises, which, having been specially built for the purpose, are excellent.
5. During the past year the arrangement made with the Perth Royal Infirmary to
receive cases of Infectious Disease requiring removal has been taken full advantage of;
in all, 25 patients were removed, and all, with one exception, recovered. The fatal case
was that of a young man who, whilst suffering from chronic disease of the kidneys, was
unfortunate enough to contract enteric fever. The agreement of the Railway Companies
to carry the Ambulance loaded has been taken advantage of, and found in practice to
be very satisfactory, as not only are the removals more quickly effected, but the motion
is so easy that the patients are more comfortable in the Waggon, with a Nurse in
attendance, than they were at home. The Smallpox Hospital has happily not been
required to be taken from the store shed in the engine yard at Crieff, where, through
the courtesy of the Road Board, it is kept ready for use at any moment. Should
this hospital be required, the supervision of its management would be entirely in the
hands of the Medical Officer, one of the assistant Medical Officers being specially
appointed to take charge of the patients.
6. The whole energies of the assistant Medical and Sanitary Staff have been
directed to discover cases of Infectious Disease, and in a very satisfactory manner have
they done their work in preventing anything like a serious epidemic. The work was

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rendered exceptionally difficult in one part of the District from the parents discovering
some weak points in the Public Health Act, and being thus enabled to evade removal of
patients until the Sheriff granted a Warrant, which showed that, removed or not removed,
patients must be isolated. In addition to the assistant Staff, in 1894 the Infectious
Disease (Notification) Act is to come into operation in the Central District, which will
make the means of ascertaining the existence of cases even more complete.
7. The population of the Central District was 14,441 according to the Census of
1891, consisting of 6868 males and 7573 females, and, estimated to the middle of 1893,
it was 14,092. In 1893 there were 334 Births and 251 Deaths, giving a Birth-Rate of
23.70 and a Death-Rate of 17.81, as compared with a Birth-Rate of 22.6, and a Death-
Rate of 17.47 in 1892. The natural increase of the population in 1893 was 83, against
74 in 1892. Of those who died in 1893, 128 were males and 123 females. Deaths in
persons over 60 years of age were 122, or 48.6 of the total. Deaths in children under
one year were 42, of which 14 were due to Developmental causes, giving an Infantile
Mortality of 125.7 per 1000 Births, against 71.2 in 1892. This is an excessive mortality
for such a District as the Central, and, as six of these Deaths were caused by diarrhœa,
it shows that there is yet great room for improvement.
Respiratory Diseases caused 38 Deaths, or 15.1 of the total in 1893, against 41 in
1892. In 19 of these 38 Deaths the age was above 60, and in 7 it was under 1 year.
From sickness returns supplied by the assistant Medical Officers, it was found that
26.4 per cent. of the total sickness during the year was caused by these diseases.
Circulatory Diseases caused 41 Deaths (of which 32 were in persons over 60 years
of age) in 1893, against 33 in 1892. This gives a percentage of 16.3 of the total as
due to this class of diseases, and the sickness returns show 6.4 per cent. of the total
sickness to be due to them.
Tubercular Diseases caused 39 Deaths (of which 17 were due to Phthisis) in 1893,
against 41 in 1892. This gives a per centage of 11.9 of the total Deaths, and it was
found that 3 per cent. of the total sickness of the District was due to this class of
diseases. Of the 30 Deaths, 12 are credited to Auchterarder, and 10 of these were
certified as due to Phthisis, abundantly proving that with all its boasted healthiness
that place is not what it should be.
Nervous Diseases caused 39 Deaths, in 21 of which the age at Death was over 60
years, giving a mortality of 11.9 per cent. of the total Deaths as due to this class of
diseases. The sickness returns show 8.3 per cent. of the total due to them.
Digestive Diseases caused 18 Deaths in 1893, as against 7 in 1892. This gives a
mortality of 7.1 per cent. of the total as due to this class of diseases, and the sickness
returns show 22.7 of the total sickness caused by them.
Rheumatic Diseases caused 1 Death and 5 per cent. of the total sickness during
1893.
Cancer and Malignant Diseases caused 13 Deaths in 1893, against 12 in 1892.
This gives a percentage of 5.1 of the total as due to this class of diseases, and
sickness returns show that .87 per cent. of the total was also due to them.
In the sickness returns 1.2 per cent. of the total was ascribed to Alcohol as a cause.
Developmental Diseases (of which 10 were due to Premature Birth) caused 14
Deaths, against 10 in 1892.
Old Age caused 19 Deaths in 1893, or 7.5 per cent. of the total, against 26 in 1892.
Zymotic Diseases -
Zymotic Diseases caused 16 Deaths in 1893, against 9 in 1892. The Zymotic
Death-Rate was 1.135, against .631 in 1892; but, considering the large number of cases
reported (277, exclusive of 7 of Diarrhœa), the case mortality of 3.2 was not excessive.

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