HH62/1/ABERD/63

Transcription

[Page] 62

appreciate the advantages afforded by Isolation Hospitals.
This was shown in a very striking manner by the experience
at the Kilmarnock Fever Hospital. From 1880, when it
was erected, to 1885, only 80 patients were treated in it.
During the next five years the numbers rose to 500.
A simple illustration, from a recent experience of my
own, will make clear the conditions too frequently met with
in country districts. Ten days ago I was called to visit a
cottar house in Tarves, where a child had just been attacked
with scarlet fever. I found the father, mother, and five
young children occupying the same room with the patient,
two beds being all that I could see available. There was
another room in the house, but that was uninhabitable
through damp. They could get no one to act as nurse to
the child. As isolation was impossible, I removed the boy
at once to hospital, and had the house disinfected. No
other case occurred in the house. Had the child not been
removed the fever would in all probability have attacked
the other children, and might have spread far beyond.

SPECIAL INQUIRIES. - In the end of the year I investigated
a very interesting history of typhoid fever. Cases had
occurred at a farm called North Wells, at Gordonstown,
annually since 1887. This is one of several farms in the
County on which typhoid fever seems to be endemic. In
some of these cases it is extremely difficult to discover a
sufficient cause for the continued presence of the fever. The
drinking water, generally the source of the disease, may be
found, as it was in this case, to be, chemically at least, free
from all traces of pollution. This, however, has been shown
to be consistent with the presence of typhoid bacilli in the
water, and this part of the examination cannot be completed
without a biological examination.
Again, the drainage of these farms may be perfectly
satisfactory.
Sometimes the germs seem to adhere to clothes or
bedding, and retain their vitality for an indefinite period of
time. A very striking instance of this occurred at one of
these farms in the County, the farm of South Camaloun in
Fyvie. During a period of thirty years enteric fever was
never long absent from this place. The tenants who had
occupied it during this time carried the disease with them
to their new home. Strange to say, no case occurred at the
farm after their departure, and this though the succeeding
tenant had a young family, and children are specially

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susceptible to the disease. It was suspected, with much
probability, that the germs of the disease had been retained
in bedding.
As showing how clothes may keep the virus of typhoid
fever, I cannot omit the following very interesting case told
me by one of the medical men in this county, in whose
practice it occurred. A patient of his, a seamstress, had
received for alteration a sealskin jacket, which had hung beside
a bed in which a patient had died of enteric fever four years
before. The bed and all its surroundings had been left undis-
turbed during all that time. A fortnight after receiving the
jacket, on which meanwhile she had been engaged, the
seamstress was attacked by enteric fever, which proved of
a particularly malignant type. Three others in the house
were subsequently attacked, and in every case the type of
disease presented the same characteristics. No other cause
whatever could be discovered on the closest investigation.
I need not enter into the details of the investigation at
North Wells. Only one curious fact may be mentioned,
that every primary case seemed to be associated with the
emptying of a midden near the house, from which a peculi-
arly offensive odour - compared by one of the patients to a
"rotten egg broken" - seemed always to emanate on these
occasions. The typhoid stools had always been buried in
what was really part of this midden.
The outbreaks occurred in all seasons of the year, and
did not in any way correspond to the period of typhoid
prevalence.

OFFENSIVE TRADES. - There are no offensive trades in
the district except slaughtering of cattle. I have not yet
had time to inspect the slaughter-houses in this district, and
the same remark applies to the bakehouses. I shall deal
with them in a future report.

ZYMOTIC DISEASE. - Scarlet and enteric fevers have
occurred in this district. In all cases that came to my
knowledge measures were taken to isolate the patient and
the house, and disinfection was carried out under the direc-
tions of the Sanitary Inspector.

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