HH62/1/ABERD/23

Transcription

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comparative death-rate in different counties and towns.
The single circumstance that the rural parts of the counties
have a higher death-rate from these bowel complaints than the
large, over-crowded towns in the same county seems to
favour the idea that the greater impurity of the water in the
rural parts is the cause of the higher death-rates in them.
Thus, contrast the death rates from these bowel complaints
in the town of Edinburgh - 693 (per million) - with that in
the rural parts of the county - 976; or that of Glasgow -
590 - with that of the rural parts of the county of Lanark -
766. In both of these cases, notwithstanding the greatly
higher general death-rate which prevailed in the towns, the
relative death-rates from bowel complaints was much higher
in the rural parts than in the towns. These towns are both
well supplied with wholesome water; but the water which
supplies the rural parts of the counties of Lanark and Edin-
burgh is chiefly derived from small open streams, which
receive the drainage of the highly manured parks which are
under cultivation, or from wells within the influence of
deterioration from surface drainage. All these bowel com-
plaints are know to be aggravated and increased by the
use of water full of decaying animal or vegetable matter;
and till further researches are made in the subject, the above
facts seem to lead to the conclusiosn that such is one of the
leading causes for the difference in the mortality from bowel
complaints in the counties and towns of Scotland."

It is very interesting, accordingly, to note that in the
upland districts of Huntly, Alford, Turriff, and Deeside,
where the water supplies are probably the most pure, the
death-rates from diarrhœa are lowest, and that in the city
of Aberdeen itself this rate is only half of what it is in the
district around it.

SLEEPING APARTMENTS.

The accommodation of the unmarried male servants on
farm steadings is a matter that must receive careful atten-
tion. In many cases it is quite insufficient in size, and is
situated above the stables, or sometimes above a byre. The
entrance is from the stable by a rickety ladder and trap
door. This standing generally open, allows the foul air
from the stable to rise into the sleeping chamber. The only
other opening consists usually of a skylight. As this in
winter must be shut the only means of ventilation is from
the stable. This is a condition of matters that unfortunately
prevails too much throughout the whole county, and will
require to be slowly but steadily changed. In some of the
newly-built farm steadings the sleeping apartments are
greatly improved, and are provided with fireplaces - a very
essential requirement in cases of sickness.

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The work of inspecting the houses of the labouring
classes - one of the most important duties of a Health
Department - is being carried out very thoroughly in this
district. I hope to be able to enter more fully into this
subject in my next year's Report, and show what advance
has been made.

HOSPITAL PROVISION.

With regard to means of isolating infectious cases, the
District is provided with a Cottage Hospital at Ellon. It
had been erected by the Parish and was taken over by the
Local Authority and made a District Hospital. It has
proved of the greatest service, but it will be found necessary
by-and-bye to add to it two more wards. The District
Committee have at present under consideration the provid-
ing of a good ambulance. Hitherto a cab has been employed,
but it is hardly sufficient for the requirements of the district.

SANITARY ORGANISATION OF THE DISTRICT.

The sanitary organisation is excellent. The parochial
medical officers have been retained meanwhile, and many of
them have rendered excellent service. I think no error has
been committed in making the change from the old system
to the new a gradual one. It has proved, in my opinion, an
advantage to gather the experience gained in the past to
help to direct and strengthen our present action.
A Sanitary Inspector was appointed for the district, to
act as chief district inspector. I cannot express too strongly
my approval of this system. Each district of a large county
like Aberdeenshire should have a well-trained and efficient
Inspector, who should make himself thoroughly acquainted
with every part of his district, and give his whole time to
the discharge of his duties.

SPECIAL INQUIRIES.

An inquiry into an outbreak of scarlet fever which had
begun in July in the Savoch portion of the district, before
my appointment, elicited one or two points of interest.
The primary case had been, or is said to have been,
mistaken for an attack of nettle rash. No doctor was called
in attendance until a second child was attacked. Meanwhile
the infection had spread to several houses through milk
supplied from this farm.
This shows the importance of diagnosing and dealing
with first cases of infectious disease, and illustrates the
danger of milk as a carrier of infection.