HH62/1/ABERD/1 |
[Page] viii.
human habitation, so that it may be possible to present to
the Council, from time to time, a partial, and ultimately a
complete, record of the County. Such a survey can be
carried out by merely systematising the work of the Inspec-
tors, and it would be of great value. It does not imply that
everything is to be made perfect at once, but merey renders
us cognisant of the conditions throughout the County.
I have the honour to be,
MY LORDS AND GENTLEMEN,
Your obedient Servant,
JAMES P. WATT,
Medical Officer of Health for Aberdeenshire.
ABERDEEN, 8th April, 1892.
[Page 1]
Aberdeen County Council.
REPORT
ON THE
Aberdeen District of the County of Aberdeen.
Prepared in accordance with the Regulations of the Board
of Supervision, under the Local Government (Scot-
land) Act, 1889.
To
The District Committee,
ABERDEEN DISTRICT, COUNTY OF ABERDEEN.
GENTLEMEN,
I beg to submit the following Report on the district,
prepared in accordance with the Regulations issued by the
Board of Supervision.
The Aberdeen District is a district which, from a health
point of view, derives special importance from its vicinity
to the City of Aberdeen. The district itself is an extensive
and populous one. Like the rest of the County it is almost
entirely agricultural; but along the Don valley there are
several very large works for the manufacture of paper and
one for manufacture of cloth. Accordingly, in the parish
of Newhills we have a considerable factory population.
In the Dee valley there are many suburban villas, while the
villages of Cults and Culter are rapidly increasing in size.
At Culter there is a large paper factory.
The total population, which is larger than that of any
other district in the County, with the exception of Deer, |
HH62/1/ABERD/3 |
[Page] 2
was, in 1891, 20,274. The acreage is 94,330 acres, giving
an average of .214 persons to the acre, or one person for
every five acres.
The total number of children born in the district in 1891
was 544. The total number of persons who died was 292,
the difference of births in excess of deaths thus being 252.
The total death-rate was, in 1891, 14.402 per 1000 of the
population. The following table shows the position of the
district in this respect in comparison with the other districts
in the County, and with the Mainland Rural Districts of
Scotland, and Scotland as a whole:-
[Table inserted]
The total number of deaths from zymotic (i.e., epidemic and
contagious) diseases was, in 1891, 34, giving a total zymotic
death-rate of 1.672. This is very much higher than that of
any other district in the County (see Table I. in Appendix),
and the explanation of this is undoubtedly to be found in the
immediate vicinity to the district of a large City, where
zymotic disease is always more or less prevalent. This is a
matter that requires all the more attention when we consider
that there are in the district no fewer than 191 dairies, from
which a large part of the milk supply of the City is drawn.
The District Committee, therefore, deserve great praise for
the energetic measures which they at once took for dealing
with zymotic disease. The adoption of the Notification
Act, the arrangement made for the reception of patients
into the City Hospital and the Woodside Burgh Hospital,
and the appointment of a well-trained Inspector, were steps
of the greatest importance for the district no less than for
the City.
[Page] 3
The total tubercular death-rate was 1.330, that from
phthisis or consumption alone being .887.
Table B shows the population of the parishes in the
district in 1881 and 1891, the average parochial death-rate
in 1891, and also during the ten years from 1861 to 1870,
inclusive.
[Table inserted]
Table C shows the average death-rate in the district, as
a whole, during the last ten years.
[Table inserted] |
HH62/1/ABERD/5 |
[Page] 4
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT.
Following the order adopted in my other District Reports,
I shall deal first with the villages.
AUCHMILL. - The village with the largest population in the
district is Auchmill, the Waterton District as it is now
called, since its formation into a Special Water and Drainage
District. At two or three points in the village the main
sewer will require to be extended to secure connections with
some of the houses. The water supply has been exceedingly
deficient in the past, but works are in process for increasing
it considerably.
Few villages in the district stand in greater need of systematic
scavenging. The urgent necessity for this was shown by a
Report, prepared by a Sub-Committee, on the condition of the
village. The District Committee determined to petition
Parliament for scavenging powers, being of opinion that the
power under the Act was insufficient for the purpose. Cases
of typhoid fever and diphtheria have occurred in consequence
of the insanitary surroundings of some of the tenement
houses. The attention of the Sanitary Inspector has been
constantly directed to these places, and considerable improv-
ments have been effected, though nothing but systematic
scavenging will be effectual.
SUMMERHILL. - The drainage of this village is at present occupy-
ing the attention of the District Committee, who have under
consideration its formation into a Special Drainage District.
Attention was specially called to the need for this by cases
of disease which were clearly traceable to the want of proper
drainage. The water supply, which is from deep pump wells,
is plentiful and of good quality, except where, as in one or
two of them, it has been contaminated by sewage, due to
defects of drainage.
CULTS. - This important village, the population of which is in-
creasing rapidy every year, claims attention both as regards
drainage and water supply. There is no drainage system
whatever. Cesspools are the only means of disposal of the
sewage. As the water supply to most of the houses is from
pumps, and as the soil is sandy and porous, the danger of
such a condition of matters is at once apparent. The water
supply is also exceedingly deficient towards the end of the
summer, as many of the pumps become dry. The only
remedy for this condition of matters is the formation of a
Special Water and Drainage District.
CULTER. - The drainage of this place will require attention.
The only sewer existing in the meantime is that belonging to
[Page] 5
the Culter Paper Mills Company, who decline to allow any
connection to be made from the houses not occupied by their
own employés, on the ground that the sewer is already in-
sufficient in size to carry away the sewage from the houses
of their own work people. Several of the houses in the
village have accordingly no means of disposing of slop and
waste water, and a nuisance has been created by the discharge
of it on the roadside. A good sewerage system is necessary,
and the village should be formed into a Special District for
Water and Drainage.
PARK. - I may just state shortly that the drainage of this
hamlet is being put into a thoroughly satisfactory condition,
and improvements are being carried out in regard to ashpits
and privy middens.
HATTON OF FINTRAY. - Defects exist in regard to the drainage
and ashpits of several of the dwelling-houses in this small
village. Legal steps are being taken to have these remedied.
BLACKBURN. - Improvements in regard to drainage and water
supply are under consideration. An increased water supply
is to be introduced.
These are all the villages in the district.
FARM STEADINGS.
In connection with the farm steadings the most impor-
tant matter for consideration is the sleeping accommodation
provided for unmarried men. This is a matter not peculiar
to the Aberdeen District, and the following remarks are
applicable to many of these places in every district in the
County. The chief sanitary defects found in connection
with these are:- (1) Bad position, and (2) bad ventilation.
They are generally placed above the stable or byre, connected
therewith by a trap-door. As this stands always open, the
foul air rises from the stable into the room. In fact, this
is the only source of air supply, when, as in winter the
invariable skylight is closed to keep out cold and rain.
The foul hot vapours from the stable find their way also
into the sleeping room through crevices or holes in the
floor. (3) Insufficient size. Not only are these sleeping
apartments in a bad position and badly ventilated, but they
are often insufficient in size. I have measured many of
them and found the cubic space allowed for each man
totally inadequate. In many cases they do not have one-
half, occasionally even not one-third, of what is enforced by
law for a tramp in a common lodging-house. (4) Dampness. |
HH62/1/ABERD/7 |
[Page 6]
There is rarely a fireplace, and moisture rising from the
stable, or coming, as it often does, through the roof, renders
the place damp and unhealthy.
There is another very important view from which to
regard these sleeping apartments, and that is their general
moral effect on the men. Comfort in such places is, of
course, a thing unknown. Dr. Lawson, Medical Officer for
Midmar, well describes this view of the question. After
giving a vivid description of some such places, he continues -
"The men-servants are, as a rule, healthy, hardy young
fellows, and are quite capable of roughing it somewhat, and
I do not think it is their health so much that suffers by
living in such dens as their morals, the feelings of decency
and self-respect, which are at the foundation of good conduct
and character, cannot be kept alive in such places."
It will be necessary to insist on these places being dis-
used and replaced by others more fit for human habitation.
In the newer steadings more attention is being paid to pro-
viding suitable accommodation, and it is certain that the
comfort of such sleeping apartments is fully appreciated by
the men.
The District Committee have dealt very sharply with one
case which it was found necessary to bring before them.
COTTAR HOUSES.
The cottar houses on farms are too often in a very
unsatisfactory condition. The point most important to
secure in connection with them is - that they shall be dry
as far as they can be made so. I think it is unquestionable
that the percentage of deaths from respiratory diseases, in-
cluding consumption, would be less were these conditions
better attended to. Too often, also, the houses are draughty,
and the effect of this on the same class of disease is well
described by Dr. Paterson, Inverurie. "In bad weather," he
says, "many cases of bronchial trouble have scarcely a
chance of recovery on account of the impossibility of keep-
ing out draughtss from defective roofs, doors and windows."
Inspection of the houses of the labouring classes is one
of the most important parts of Public Health work. The
whole work of a Public Health Department is directed
towards the prevention of disease. Recent medical research
has thrown great light upon the cause of many diseases
and the conditions that favour their development. Inspec-
tion of the dwellings of the labouring classes is directed
towards the removal of such conditions, either in the
[Page] 7
building itself or around it - a wiser plan than to wait till
our attention is forced to their existence, and the necessity
for their removal by the actual outbreak of disease. The
better classes are perfectly alive to the necessity of securing
healthy homes, and are in a position to do so. The poorer
classes are too often not in the same fortunate position, and
cannot obtain unaided the advantages of healthy homes,
however much they may desire them.
WATER SUPPLY.
The water supplies to individual houses in the district
are here, as in all the other districts, open, in many cases, to
pollution, from thier proximity to drains, ashpits, and
middens. This is undoubtedly the cause of most cases of
enteric fever and diarrhœa that are prevalent in country
districts, and the practice that I have for some time adopted,
of analysing a sample of the drinking water in every case
of typhoid reported, has led to some interesting results.
THE NOTIFICATION ACT.
This Act has been in force for fourteen months, and has
proved of invaluable assistance in checking the spread of
infectious disease. The close connection with Aberdeen,
through scholars attending school there, and people living
in the district going into town to business or work, renders
it impossible to prevent the dissemination in the district of
every form of infectious disease prevalent in town. During
the latter half of 1891, while an epidemic of unusual severity
was raging in the city, many cases, clearly traceable to in-
fection brought from the town, occurred here and there, and
but for the advantage gained by immediate notification and
hospital or house isolation, a widespread epidemic would, in
all probability, have occurred. In his report on North
Newhills, Dr. Maver, Medical Officer, says:- "An epidemic
of scarlet fever has been nipped in the bud, and this entirely
owing to notification and the enforcement of isolation. Had
fever made its appearance at so many points before the
adoption of the Notification Act we would have had a wide-
spread epidemic."
HOSPITAL ACCOMMODATION.
The hospitals to which the Local Authority have been
entitled to send patients were the Aberdeen City Hospital
for Infectious Disease and the Woodside Hospital. The |
HH62/1/ABERD/9 |
[Page] 8
latter, though far from being in accordance with the re-
quirements of a modern hospital, was exceedingly convenient
for patients in the Buxburn District, more especially as the
City Hospital was overcrowded during the latter months of
the year, and could only take the most pressing cases. I
was able, by using it, to carry out hospital isolation in all
cases where it appeared necessary. I visited it repeatedly
and found, under Dr. Fowler's charge, everything as satis-
factory as could be with the means at his command. It
has been disused as a hospital since the absorption of the
burgh into the town.
I have paid very frequent visits to the City Hospital,
which is well equipped and under excellent management.
ZYMOTIC DISEASE IN THE DISTRICT DURING 1891.
From information obtained from the Sanitary Inspector,
I learn that during the earlier part of the year a number
of cases of scarlet fever connected with Craigton School
occurred in the parish of Peterculter. The breaking up of
the school for holidays had the effect of checking the disease,
for no fresh cases occurred thereafter. The school was
thoroughly disinfected. This is an accidental illustration
of the benefit of closing schools in arresting the spread
of disease.
The latter portion of the year was marked by an out-
break of scarlet fever which especially affected Newhills,
a few cases occurring in other parts of the district. Many
of these cases were traced to infection spreading from
the town, where, from August to December, a very severe
epidemic was raging. Prompt measures were taken in all
cases for the removal of patients, clothing, bedding &c., to
hospital, wherever isolation could not be carried out in
the house of the patient. In the cases where isolation was
carried out in the house every precaution was taken, and
in no case is there evidence of infection having spread from
any of the houses so isolated. Out of twelve cases where
patients were isolated at home, in only three did infection
spread to any of the other members of the family.
Every assistance was rendered by the Medical Officers
of the various districts where the outbreaks occurred.
I msut also express my appreciation of the services of
the District Sanitary Inspector, Mr. Reid, who carried out
my instructions with zeal, promptitude, and ready tact.
With regard to typhoid fever, of which eleven cases
were reported to me since the beginning of August, the
[Page] 9
usual steps were taken in regard to them. Four were
isolated at home, the others removed to hopsital.
DIPHTHERIA. - Six cases were reported. Two of these
were traced to the drinking of dirty water taken from a
ditch, two others to defective drainage, another to eman-
ations form a foul ashpit, and the sixth to defective
trapping of the house drains. In all cases efficient measures
were taken to prevent the spread of the disease.
WHOOPING COUGH. - A severe epidemic occurred in the
district during the year. Nearly all the cases reported were
visited by the Sanitary Inspector. The children were not
allowed to go to school, and the parents warned of the
danger of infection.
MEASLES. - Only two cases of measles were reported
during 1891.
GENERAL AND SPECIAL INQUIRIES.
The results of the general inquiries made are summed
up in the previous remarks.
A special inquiry was made into an outbreak of fever
on a dairy farm at Northfield, from which milk was supplied
to Aberdeen. The results of that investigation I submitted
at the time to the Public Health Committee. The infection
was traced to the milk boy, whose work took him to houses
where scarlet fever was. In consequence of this inquiry,
the Committee issued a warning to dairy farmers against
leaving milk-cans in houses during the prevalence of the
epidemic of scarlet fever, and to take other precautions,
which were specified.
Many other investigations were carried out in connection
with outbreaks of enteric fever, diphtheria, and scarlet
fever.
A special inquiry was also made, at the request of the
Public Health Committee, into the drainage of Culter.
OFFENSIVE TRADES.
The only offensive trade is the slaughtering of cattle.
There are four slaughter-houses, three of which I have
already visited. Two of these, viz., at Broomhill and
Westhills, Skene, I found defective as regards drainage,
and instructions have been given to carry out improve-
ments.
BAKEHOUSES.
I have inspected many of the bakehouses, but have
found none unfit for use as bakehouses. In one case a con- |
HH62/1/ABERD/11 |
[Page] 10
travention of Section 15 of the Act of 1883 was found in
the opening, within the bakehouse, of an open drain. This
was immediately remedied by the owner.
DAIRIES.
There are in the District, as mentioned above, 191
dairies. Bye-laws have been drawn up by the District
Committee for regulating the cubic space, the ventilation,
the keeping clean of the cowsheds, and for securing clean-
liness of the dairies and milkshops, the Sanitary Inspector
being commissioned to see that these regulations are
attended to.
Supervision of dairies is a duty imposed on a Local
Authority by an Order, which is equivalent to an Act of
Parliament, and from the view of Public Health it is a
matter of the very utmost consequence.
The systematic inspection was unfortunately delayed,
but will be taken up and carried through, as far as possible
this year.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASE.
This is a very wide subject and would require more
time to enter upon with any satisfactory or sufficient results.
The cases of enteric fever and diphtheria which I inves-
tigated I found invariably associated with insanitary con-
ditions. Polluted drinking water was found to be the
cause in a number of the enteric cases; in a few others at
Auchmill the condition of ashpits in connection with the
tenement houses was clearly the cause of the disease. The
foul condition of these ashpits was apparently also the
cause of one case of diphtheria at Auchmill. In the other
cases of diphtheria drainage was always present.
One may reasonably hope that, with improved sanitary
conditions, these cases will become fewer, if they do not
altogether disappear.
Whooping Cough and scarlet fever will, I am afraid,
always persist in the district, owing to the vicinity of the
town. The means of notification and isolation now at the
command of the Sanitary Authority will, however, enable
scarlet fever outbreaks to be immediately controlled and
minimised. Whooping cough is a disease which, from
various causes, we are hardly in a position to deal with
satisfactorily. It would be impossible to resort to hospital
isolation, both from the heavy expense such a proceeding
[Page] 11
would entail and the opposition that would be met with
from parents. The disease often lasts for a long period
or breaks out afresh, and thus renders any attempt at
home isolation extremely difficult. It is my intention, when
time allows, to examine into the statistics of places where
notification of this disease has been in operation for some
years, and to ascertain what the results have been.
Phthisis is not so prevalent in this as in other districts
in the County. Many of the cases are undoubtedly im-
ported from the town, those affected coming back to their
homes, or into the country to recruit, in too many cases to
die. In this way the tubercular death-rate of a town will
be lessened, that of the country district increased. The
death-rate from respiratory diseases is higher in the Aber-
deen District than in any of the other districts of the
County. It would be interesting to inquire to what extent
the deaths from diseases of the respiratory tract are depen-
dent upon the condition of the houses of the people.
I hope to enter more fully into this subject in subsequent
reports.
STATISTICAL TABLES.
Appended are the Tables prepared in accordance with
the Regulations of the Board of Supervision.
I have the honour to be,
GENTLEMEN,
Your obedient servant,
JAMES P. WATT.
COUNTY HEALTH DEPARTMENT,
MUNICIPAL BUILDINGS,
ABERDEEN, 1892. |
HH62/1/ABERD/13 |
Aberdeen County Council.
REPORT
ON THE
Ellon District of the County of Aberdeen.
Prepared in accordance with the Regulations of the Board
of Supervision, under the Local Government (Scot-
land) Act, 1889.
To
The District Committee,
ELLON DISTRICT, COUNTY OF ABERDEEN.
I beg to submit the following Report on the sanitary
condition of the district, as prepared for the Board of
Supervision and the County Council.
The Ellon District of the County of Aberdeen comprises
the parishes of Ellon, Logie-Buchan, Cruden, Slains, Foveran,
Udny, Tarves and Methlic. The parishes of Cruden, Slains,
and Foveran lie on the coast, giving to the district an exten-
sive seaboard. The fishing villages are Port Erroll, Bullers
of Buchan, North-haven, and Whinnyfold, in Cruden; Old
Castle and Collieston in Slains; and Newburgh in Foveran.
The other villages in the district are Ellon, Methlic, Tarves,
Hatton, Pitmedden, and Green of Udny.
The district comprises an area of 106,907 acres, with a
population, according to the census of 1891, of 16,767. The
population of the district in 1881 was 16,755, showing an |
HH62/1/ABERD/15 |
[Page] 14
increase in the ten years of 12. While the population of
the district, as a whole, has thus remained almost stationary,
it will be seen from Table D that there has been considerable
fluctuation in the several parishes. The density of population
is .157 persons to the acre, or one person for every 6.36
acres.
The total number of births in the district in 1891 was
568. The total number of deaths from all causes was 228.
The total death-rate for the district is thus 13.597 per 1000
of the population. From the following Table it will be
seen that the Ellon District has the third lowest death-rate
of the eight districts into which the County is divided
and the highest birth-rate:-
Table A.
[Table inserted]
The average death-rate in the Mainland Rural Districts
of Scotland, according to the Returns of the Registrar-
General was, in 1891, 17.3 per 1000, while the average
death-rate for the whole of Scotland was 20.7. It will thus
be seen that the Ellon District compares favourably, not
only with the Mainland Rural Districts of Scotland as a
whole, but also with the other districts in the County.
The total number of deaths in 1891 registered as due to
zymotic (i.e., epidemic and contagious) diseases was 23.
This gives a total zymotic death-rate of 1.371 per 1000 of
the population. The zymotic death-rate in the eight
principal towns of Scotland was, in the same year, 3.34 per
1000. Of the 23 deaths due to zymotic diseases, 9 were
caused by diphtheria, one by typhoid fever, three by
whooping-cough, and three by measles; while seven are
put down as due to diarrhœa, which is now included among
zymotic diseases. With regard to diphtheria, I may here
mention that attention was directed by the Registrar-
General, in 1874, to the fact that Aberdeenshire had the
highest death-rate from this disease of any county in
Scotland during the decennium 1860-1870. The following
[Page] 15
Table shows the number of deaths per million in Scotland
and several of the counties (from diphtheria) during that
period:-
Table B.
[Table inserted]
Table C shows the death-rate in 1891 from diphtheria
in the eight districts of the County (exclusive of Burghs) and
in the town of Aberdeen, and it may be interesting to com-
pare with it here the death-rates from the other infectious
diseases:-
Table C.
[Table inserted]
It will be noticed from the above Table that the death-
rate from diphtheria is greater in the Country districts than
in the City. The greater prevalence of diphtheria in
Country districts is an old and well-known fact - though,
for some cause not yet sufficiently understood, diphtheria
has of late years been increasing at an almost alarming rate
in some of the larger cities, as, e.g., in London. |
HH62/1/ABERD/17 |
[Page] 16
The dampness of so many of the houses, and want of
subsoil drainage, along with the insanitary conditions
round many of the cottages in the country, may go far
to explain the above facts. Moisture, dampness, and filth
are favourable to the development of the micro-organism
which is the cause of the disease.
Seventeen deaths in the district were registered in 1891
as due to phthisis. The total of deaths from tubercular
diseases (including phthisis) was 21 - giving a tubercular
death-rate of 1.251. This is nearly equal to the zymotic
rate of 1.371.
TABLE D shows the death-rates in the various parishes
in 1891, and the average death-rate during the decennium
1861-70, also the population of each parish in 1881 and
1891, with the increment or decrease.
TABLE D.
[Table inserted]
TABLE E shows the death-rates during the last ten
years in the Ellon District.
Table E.
[Table inserted]
[Page] 17
SANITARY STATE OF THE DISTRICT.
In describing the sanitary state of a district, I shall
follow in my Reports the same order for facility of refer-
ence. I shall consider, first, the general condition of the
villages; next, the condition of the houses of the labouring
classes and their surroundings, and the accommodation pro-
vided for farm labourers. Lastly, I shall describe the
hospital provision and the means at command of the Local
Authority for dealing with infectious disease.
VILLAGES.
In the autumn of last year I made an inspection of the
villages in the district to determine what measures were
advisable for improving their sanitary condition. The fol-
lowing notes are taken from the Report presented to the
District Committee.
There is no question that, in the case of all the villages, the
first and foremost need is scavenging. The scheme the
Sanitary Inspector suggests, of grouping the villages for
purposes of scavenging, is excellent, and, probably, with the
better prices commanded for the manure when stored in depôts
and sold only as required by the farmers, the cost of the
working expenses would be comparatively small, But the
Public Health Act of Scotland gives no power to carry out
scavenging, and, until the enactments on this head in the
English Public Health Act are extended to Scotland, we will
have to be content with prosecuting for nuisance those who
keep their ash-pits and privies foul.
As regards drainage, Newburgh, Ellon, Hatton, Port Erroll,
Whinnyfold, Old Castle, and Collieston, will, to a more or
less extent, require the attention of the Committee.
In regard to water supply, the lower or fishing village at Port
Erroll stands most in need of increased supply, which is,
fortunately, a very simple matter - for as at Pitmedden, a
larger storage tank will be sufficient to meet the require-
ments of the case. An increased supply of water at New-
burgh, a supply to the upper part of Collieston, a new
supply to Tarves, and attention to the supplies at Hatton
and North-haven are all desirable, and should be dealt with
by the Committee.
NEWBURGH. - I found some of the small houses in the village
in rather a dilapidated condition. The ashpits in many places
were very faulty in construction and badly kept. Privies in
the same condition. The effluents from the sewers are
poured out along the side of the burn, and as the sewage
is strewn along the bank by the tide, the whole strand is |
HH62/1/ABERD/19 |
[Page] 18
converted into a sort of huge cesspit. Some scheme of
sewerage for the place ought certainly to be entered upon
without delay.
There is here very clamant need for scavenging, as soon as
powers for that can be obtained.
COLLIESTON. - A water supply for the higher part of the village
is a desideratum.
A sewer laid down along the line of the road from the higher
part of the village to the lower part, and emptying into the
sea, would certainly be an advantage.
The village was wonderfully clean when I visited it, but I have
no doubt that at the height of the fishing season it would
not be in such a sanitary condition. There is a scavenger in
the village, an old man, who was engaged by the old Local
Authority at a salary of £6 a year.
OLD CASTLE. - Behind the village is a kind of natural amphi-
theatre formed by some low hills. The rainwater gathering
here pours down in a torrent, and floods the houses. Fifty
yards of drainage pipes would carry away the storm water
and entirely remedy the evil.
There is a manure stance here that forms an abominable nuisance.
It will require to be emptied regularly.
WHINNYFOLD. - This village consists of two rows of houses,
situated on ground sloping to the sea. The houses face the
sea. All the slop water from the upper row of cottages is
thrown out on the piece of waste ground behind the lower
row of cottages. As there is no drainage to carry away the
slop and rain water, the ground under the lower row of
houses is excessively damp, as I ascertained by examining
the earth under the flooring of one of the houses. In this
same house one of the sons had died of consumption, a
disease which is now acknowledged to be closely associated
in its causation with dampness of sub-soil.
The condition of matters here is one which ought to receive
the immediate attention of the Local Authority. I found
the ashpits in front of the houses and at the back of the
village in an abominable condition. These ought to be done
away with entirely. Stances should be provided at either
end of the village for the fish offal, which should be removed
every second day.
OLD WHINNYFOLD consists of a congeries of old houses, which
will fall to pieces by a process of natural decay. The place
is not worth the expense of drainage. It might, however, be
cleaned occasionally by a scavenger. The houses are very
poor - some of them hardly fit for human habitation - but
as several of the tenants pay no rent, it is rather a difficult
matter to deal with these cases.
[Page] 19
PORT ERROLL. - Several points demand immediate attention.
(1st) The ashpits were in the worst condition of any I have
as yet seen. This was due mainly to the fact that the drains
for carrying off slop water were entirely blocked with the
drifting sand, and that all the slop water was, accordingly,
thrown into the ashpits, with which the privies were also
directly connected. A condition of things more detrimental
to health, especially for children, or more calculated to origi-
nate or intensify disease, can scarcely be imagined. Dr.
Duguid, of Hatton, informed me that he had repeatedly
called the attention of the old Local Authority to the condi-
tion of matters here, but nothing had ever been done.
(2nd). The water supply for the lower village is very deficient,
especially when the fishermen are all at home. This de-
ficiency has led to water riots. On one occasion the fishermen
cut off the supply to the upper village, being determined
that their neighbours should not enjoy a supply which left
them in scarcity. The supply for the lower village is ap-
parently about 2160 galls. per day, giving to the population,
which is over 300, a supply of about 7 galls. per head.
Probably, at times, the amount is very considerably less than
this. I think the Sanitary Inspector's scheme for increasing
the supply should be considered by the Committee.
BULLERS OF BUCHAN AND NORTH-HAVEN. - These small clusters
of houses will need the occasional services of a scavenger.
The water supply is not very good, but might easily be
improved.
The sewage runs in open drains or gutters, and in summer
time must constitute a nuisance.
HATTON. - Something will require to be done towards improv-
ing the drainage of this village. It is very defective.
Some of the ashpits shown me by the Inspector were in a very
foul condition. The owners of these should, in the mean-
time, be compelled to prevent them from becoming a nuisance.
METHLIC. - Little requires to be said of this place. An in-
creased supply of water may be brought in by-and-bye.
A few nuisances existed requiring to be remedied, and these
will, I have no doubt, ere this time have been removed.
TARVES. - It is greatly to be regretted that the proposal to
procure a fresh and abundant water supply to this village
had to be abandoned through the opposition of the inhabi-
tants. The present supply is of a very unsatisfactory char-
acter. It is certainly open to suspicion of contamination.
One of the pumps is so situated close to a midden, which is
on slightly higher ground, that it could scarcely escape pollu-
tion. A rough analysis, which was all I could make with
the materials at my command, of a sample taken from this |
HH62/1/ABERD/21 |
[Page] 20
pump, strengthened my suspicions. I hope to be able, at a
later time, to present to the Committee a full report on the
water supply of this village.
A plan for the drainage of the village has been proposed, and
is, I understand, to be executed at the expense of the Earl of
Aberdeen. I cannot help remarking that, in my opinion, a
wholesome supply of water would have been a more import-
ant gift from a public health point of view, taking into
consideration the danger of a system of drainage without
sufficient water for flushing purposes.
The services of a scavenger could be usefully employed occasion-
ally in parts of the village.
ELLON. - Ellon requires improved drainage and scavenging.
Scavenging is strongly demanded here, and I fear it will be
utterly impossible otherwise to kee the place in a condition
compatible with health. The drainage of the old town should
be dealt with at once. WIth regard to the present outfall
of the sewers, I would suggest that, if permission were ob-
tained to do so, they should be carried well into the stream
so as to avoid the nuisance that their outfall on the bank
produces.
The Public Health Sub-Committee, at a Meeting held
on the 5th of December, unaminously agreed to recommend
that Newburgh, Hatton, and Port Erroll be formed into
special water and drainage districts; that Ellon should be
formed into a special drainage district; and that the pro-
prietors of the several other villages be asked to carry out
improvements as regards drainage and water supply. With
regard to scavenging of the villages, the Sub-Committee
agreed to recommend "that the District Committee should
join in any petition to Government by other districts or
County Councils, with a view of having the law providing
for the cost of scavenging by District Committees defined,
and uncertainty on the point removed."
Next year's Report will show how far these measures
have been carried to completion.
HOUSING OF THE LABOURING CLASSES.
Many of the cottages of the labouring class are not in a
condition that can be described as sanitary. Damp roofs,
damp walls, damp earthen floors, imperfect ventilation, the
old unhealthy box-bed, badly constructed ashpits and
privies, dung heaps close to windows or doors, pumps or
shallow wells in close proximity to ashpit, midden, or
[Page] 21
midden drain - these are some of the common faults met
with in connection with these cottages. Much will require
to be done in improving their condition
The dampness of the floors and walls that is met with so
often is a matter that deserves careful attention. The close
connection of phthisis with dampness of subsoil, and the
effect of damp dwellings generally on health, render it of the
greatest importance to take measures to secure for the work-
ing classes that their houses shall be thoroughly dry. The
following extract from a sheet on Diphtheria, issued by me
for the information of Sanitary Inspectors, will help to
show the necessity fot this:-
"Another condition that has been shown to be associated as a factor in
the production of Diphtheria is dampness in houses. Consumption
and Diphtheria are both caused by micro-organisms, the
development of which is favoured by dampness of subsoil.
"With regard to dampness, everyone is familiar with the in-
fluence of a damp house in causing Rheumatism. Dampness
has also to answer largely for glandular affections in children,
especially enlargement of the tonsils, a condition often causing
a serious interference with general health. It may further
be the direct cause of, or render more dangerous, such lung
diseases as Bronchitis (Acute and Chronic), Pneumonia, and
Pleurisy. It may intensify, and cause dangerous complications
of, many other diseases not directly due to it, as, e.g.,
Whooping Cough and Measles in children. We cannot, then,
lay too much stress upon the necessity of having this defect of
dampness remedied as far as possible in every house in which
it is found."
Improvements in many points will doubtless be effected
through the education of the people in sanitary matters.
They are often greatly at fault themselves by creating
insanitary conditions in or around their dwellings.
Attention will also have to be directed to securing in all
cases to the single houses equally with the villages an ample
supply of pure water. In some parts of this District, as,
e.g., in the Parish of Slains, the water supply at some of the
farms is very defective.
In connection with this, I would like to direct attention
to the sixth column in Table C - the death-rates in the
several districts from diarrhœa. The following extract,
taken from a volume issued from the Registrar-General's
office in 1874, will help to throw light on this subject:-
"It would be a subject as well worthy of investigation whether
the purity of the water from vegetable or animal matter in
a state of decomposition has anything to do with the |
HH62/1/ABERD/23 |
[Page] 22
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.
[Page] 23
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. |
HH62/1/ABERD/25 |
[Page] 24
The school of Savoch was closed by the School Board on
18th July, and during the vacation it was thoroughly
cleaned, the walls disinfected, and the woodwork painted.
A few weeks ago a boy at Quilquox, attending the
Savoch School, took scarlet fever. Blame was laid upon
the school as the source of the infection, but, on investiga-
tion of the case, I could establish no connection with the
previous outbreak. The infected houses and everything in
them had been disinfected in a most thorough manner by
the Sanitary Inspector himself, all the school books used by
the children in the infected houses being burnt - a most im-
portant precaution. I was inclined to trace the source of
the disease in the Quilquox case to the boy's father, whose
work took him constantly to Aberdeen, where scarlet fever
was very prevalent. This seemed to receive confirmation
from the fact that, though the boy was immediately isolated,
and his father went to reside in another house, the latter
was, a few weeks after, himself attacked. No other case
occurred amongst the scholars attending the Savoch school.
OFFENSIVE TRADES.
The only offensive trade in the Ellon District is the
slaughtering of cattle. Some of the slaughter-houses in the
different villages are not in accordance with strict sanitary
requirements. They are being dealt with.
BAKEHOUSES.
As bakehouses are placed under the direct supervision of
the Medical Officer of Health, I have made a personal in-
spection of a number of those in the district. In several
of them in which I found the conditions not quite satisfac-
tory, I gave instructions for having improvements carried
out.
DAIRIES.
The Sub-Committee have under their consideration a
series of bye-laws for regulating the condition of the dairies
in the district.
A strict supervision of dairies is a matter of the utmost
importance from the point of view of the public health.
Milk forms one of the best means of multiplying and
conveying disease germs. Any contamination, therefore, of
the milk by polluted water, drain effluvia, or contact with
anyone suffering from an infectious disease, may be the source
of a dangerous epidemic. The transmission, now proved, of
[Page] 25
disease from animals, and we need mention only tuberculosis,
has rendered it further necessary to regulate more carefully
the conditions under which the cows themselves are kept.
HOSPITAL SUPERVISION.
As I mentioned before, the Local Authority have an
excellent hospital, so far as its accommodation goes. It con-
sists of an administrative block and one pavilion connected
with it by a covered way, the pavilion being divided into
two wards, with a nurse's room between. Each ward is
capable of accommodating four beds. There is in the ad-
ministrative block a room with one bed which may be used
for a single case.
The original plan evidently took into consideration an
extension, for which there is ample room. A pavilion behind,
like the one in front, would give ample accommodation for
the needs of the whole district.
A steam disinfector, or a disinfecting oven, at the hospital
would be of no little service. Bedding and clothes could be
taken there and disinfected, and this even in cases where a
patient is isolated at home. A small sum might be charged
for the use of it to cover the cost of up-keep.
The hospital is fortunate in possessing an excellent
matron, whose kind treatment of the patients and excellent
manner with children have been of the utmost service in
overcoming the dislike on the part of the public to hospital
isolation. The wards are also bright and clean, and every-
thing about the hospital reflects great credit on all who
have been connected with the charge of it.
One shilling a day is charged to patients, but a wise
discretion is allowed in relaxing the rule in special cases.
MEASURES FOR THE PREVENTION OF OUTBREAK AND
SPREAD OF INFECTIOUS DISEASE.
Removal to hospital, where isolation at home was im-
possible, thorough disinfection of house, bedding, and clothes
under the personal supervision of the Sanitary Inspector in
every case - these are the measures that have been employed
with marked success in checking the spread of infectious
disease.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASES.
This is a question that the short time at my command
will hardly allow of my giving any sufficient account of,
and I shall, therefore, reserve it for a future Report. |
HH62/1/ABERD/27 |
[Page] 26
TABLES I. and II. in the Appendix are prepared from the
Returns courteously supplied by the Registrars in the
District and County. They are drawn up in accordance
with the forms adopted by the Board of Supervision.
JAMES P. WATT.
COUNTY HEALTH DEPARTMENT,
MUNICIPAL BUILDINGS,
ABERDEEN, 1892.
Aberdeen County Council.
REPORT
ON THE
Alford District of the County of Aberdeen.
Prepared in accordance with the Regulations of the Board
of Supervision, under the Local Government (Scot-
land) Act, 1889.
To
The District Committee,
ALFORD DISTRICT, COUNTY OF ABERDEEN.
GENTLEMEN,
I beg to submit the following Report on the district,
prepared in accordance with the regulations issued by the
Board of Supervision.
The District of Alford is the third largest of the eight
districts into which Aberdeenshire has been divided. Its
total acreage is 165,894 acres, that of Deer being 166,817,
and that of Deeside, 416,882. While standing thus third
in extent, its population is next to Huntly, the lowest.
The census of 1891 gves it as 10,813. In 1881 it was
11,555, thus showing a decrease in the ten years of 742.
A large part of the district lying along the upper reaches
of the Don is purely Highland, and is very sparsely |
HH62/1/ABERD/29 |
[Page] 28
populated. Over the whole district the total density of
population in only .065 persons to the acre, or 15.3 acres
for every person. The Vale of Alford, a fine tract of
country lying in an amphitheatre of hills, is the most
fertile part of the district.
Alford is in the fortunate position of having the lowest
zymotic death-rate of any district in the County. This
position is due to several causes, which will be commented
upon in a subsequent part of this Report. As in the other
districts of Aberdeenshire, diphtheria adds a considerable
quota to the death-rate. The death-rate from diphtheria
is .277 per 1000, as against .184 each from enteric fever,
scarlet fever, and diarrhœa respectively.
The death-rate from phthisis alone is also a low one, .832
per 1000, coming next to Huntly, which stands with .727.
The total tubercular death-rate is 1.294, which is thus .369
in excess of the total zymotic rate.
The following Table shows the position of the rural part
of the County as a whole, and the various districts
separately, in relation to the death and birth rates - (1) of
the whole of Scotland, and (2) of the Mainland Rural
Districts of Scotland, as given by the Registrar-General
in his returns for 1891:-
[Table inserted]
On the whole, to judge from these statistics, the District
of Alford occupies a good position, and, in some respects, is
fortunately situated, as regards the incidence of disease.
The following Table shows the parishes embraced in the
district, with their acreage, their population in 1881 and 1891,
with increase or decrease, and the death-rate in each parish
[Page] 29
in 1891. As an interesting comparison, I have added in the
last column the average death-rate in each parish during
the ten years from 1861-1870 (inclusive):-
TABLE A.
[Table inserted]
Table B shows the death-rate (i.e., the number of deaths
per 1000 of the population) in the whole district during
the years from 1881 to 1891 (inclusive):-
TABLE B
[Table inserted] |
HH62/1/ABERD/31 |
[Page] 30
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT.
This district has an advantage, from a sanitary point of
view, in having few villages. There are only two - Alford
and Lumsden.
The drainage of Alford is in an exceedingly unsatis-
factory condition, while the water supply is also defective.
I need not enter into a detailed account as this has been
very well given by Mr. Hogg, the Sanitary Inspector, in
his Report. I will content myself with corroborating from
my own personal observation all that he says with regard
to drainage and water supply. I would strongly advise the
formation of the village of Alford into a Special Water and
Drainage District. The health of the village would un-
doubtedly be much improved by the introduction of an
ample supply of pure water, and by thorough drainage.
Cases of diphtheria and typhoid fever occur from time to
time in the village, and it may be hoped that these diseases
will occur less frequently under improved sanitary con-
ditions.
The village of Lumsden shows some peculiar features
regarding its drainage, but the place is exceedingly healthy.
Were it not for the gravelly nature of the soil, the existing
conditions would be very dangerous to health, more es-
pecially were the water supply not introduced, as it is, by gravi-
tation from a distance. The sewage is removed, one may
say, by a natural process of downward intermittent filtration.
Something, certainly, may be done to carry away the slop
water, but it is questionable how far a regular system of
drainage is necessary under the circumstances, unless it were
shown to be requisite for the benefit of the inhabitants. It
would be well, however, to institute a careful inquiry
into the health of the village during a number of years, to
find out if disease has resulted from the present method of
sewage disposal. Of this, as yet, I have found no evidence.
SANITARY CONDITION OF THE FARM STEADINGS AND THE
HOUSES OF THE LABOURING CLASSES.
In connection with farm steadings, the most important
matters for consideration are the sleeping accommodation for
the unmarried men and the condition of the cottar houses.
With regard to the sleeping apartments and cottar
houses, I would beg to refer to my remarks in my Report
on the Aberdeen District. In the newer steadings more
attention is being paid to providing suitable accommoda-
tion for farm servants. One such apartment I inspected at
[Page] 31
a new farm steading in this district might well be taken as
a model for all the others. I was assured by the foreman
on the farm that the comfort of such an apartment was
fully appreciated by the men.
Before passing from farm steadings, I cannot help
emphasising strongly that the Sanitary Inspector's suggesstions
regarding the method of dealing with the liquid manure,
and pointing out that such a plan would more than repay
the primary outlay through the non-deterioration of the solid
part, and the preservation and utilisation of what is really
the most valuable part of stable or byre manure, viz., the
liquid part. It would also prevent the too frequent
pollution of small streams by farmyard sewage, which is a
very important matter. Such streams are used for cattle,
and sometimes for human beings, and polluted water may
produce disease in cattle, as it certainly does in man.
SCHOOLS.
I have looked into the health conditions of some of the
schools in the district. The school at Corgarff was specially
unsatisfactory with regard to cubic space and ventilation,
but improvements are to be effected.
THE NOTIFICATION ACT.
With regard to infectious disease, the adoption of the
Notification Act, as contemplated by the Public Health
Committee, will facilitate the more prompt dealing with
such cases. The only object aimed at by the Notification
Act is to secure the earliest intimation to the Sanitary
Authority of cases of infectious disease, so that more
immediate steps may be taken than would otherwise be
possible, and the spread of disease perhaps averted.
It gives no extra power of dealing with such diseases.
Some form of hospital provision, or means of isolating the
cases that cannot be readily isolated at home, will be of
undoubted service to the district. This latter question will
require the careful consideration of the Committee.
GENERAL AND SPECIAL ENQUIRIES.
During the latter part of the year, I made a general
inspection of a large part of the district, directing my atten-
tion to the villages, farm houses, cottar houses, and schools.
Several special inquiries were made into the cause of
outbreaks of enteric fever, as at Auchline, Castlenewe, and
Deuchary. I will no enter at length into details. Some |
HH62/1/ABERD/33 |
[Page] 32
of these investigations showed the necessity of adopting
careful precautionary measures in dealing with first cases
of typhoid fever.
OFFENSIVE TRADES.
The district is purely an agricultural one. There is only
one slaughter-house, and it is in fairly good condition.
BAKEHOUSES.
I have inspected a number of these, but found none in
such a condition as to require interference.
MEASURES ADOPTED FOR PREVENTION OF SPREAD
OF DISEASE.
In all cases of infectious disease that came to my know-
ledge, the case was visited by the Sanitary Inspector, and
in most of the cases by myself; and every precaution was
taken to secure the isolation of the patient and of the house.
Disinfection was carefully attended to in all cases by the
Inspector.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASE.
Diseases of the respiratory system bulk very largely in
the death-rate, being 2.774; including phthisis, they amount
to 3.606, out of a total of 13.780. That these may be
diminished by improvement in the houses of the working
classes is extremely probable.
In this district typhoid fever is the most prevalent of
the zymotic diseases. Typhoid or gastric or enteric fever is
due generally to the drinking of water contaminated by
sewage, or to the emanations of foul drains. Milk is an
admirable carrier of the germs of this disease, and many
epidemics have been caused in this way. These germs are
always contained in the stools of a typhoid fever patient, and
these stools are most virulently infectious. The number of
cases in the district ought undoubtedly to be diminished
by:- (1) prompt isolation; and (2) improvement of the
water supplies.
(1) Prompt isolation. It has been my experience in
this and other districts of the County that cases of typhoid
fever, unless isolated, are apt to give rise to others in the
same house. The great authority of Murchison engendered
a false security in regard to typhoid fever, and the necessary
precautions in regard to it have been too much neglected.
(2) By removal of the sources of water pollution. The
removal of the dangers of water supply pollution will tend
to prevent outbreaks of typhoid fever, as well as diarrhœa.
[Page] 33
In my Report on the Ellon District, I have called attention
to the remarks of the Registrar-General regarding the
incidence of these diseases in towns and country districts,
and have pointed out that in Alford and the other upland
districts of the County, where the water supply is naturally
purer, the death-rate from this cause is less than in the
more low-lying parts of the County. Prompt attention to
the water supply, in the first case of enteric fever or diarr-
hœa in a house may often be the means of preventing
others.
One of the cases of enteric fever that I investigated
appeared to have originated from the patient - a mechanic -
sleeping above a byre in which some calves were kept,
and from which a most nauseous and sickening smell
emanated. Typhoid fever is undoubtedly common among
farm servants; but it is probable that most of these cases
are due to the drinking of polluted water from about the
farm steading.
Diphtheria is a common form of disease in this district.
Several cases occurred at the village of Alford. Improved
drainage of the village may prevent the recurrence of such
cases.
A number of cases of scarlet fever occurred during
1891. Most of these were traced to infection from Aber-
deen. The immediate notification and prompt isolation
of such cases is, therefore, all the more important to prevent
the disease from spreading through the district.
In future Reports I hope to enter upon a more full
discussion of this question.
TABLES.
The Tables in the Appendix are prepared from Returns
kindly furnished me by the various Registrars in the
County, to whom I must express my obligation for fur-
nishing me gratuitously with the information I required,
information involving very considerable labour, in many
cases, on their part.
I have the honour to be,
GENTLEMEN,
Your obedient Servant,
JAMES P. WATT.
COUNTY HEALTH DEPARTMENT,
MUNICIPAL BUILDINGS,
ABERDEEN, 1892. |
HH62/1/ABERD/35 |
Aberdeen County Council.
DEER DISTRICT.
REPORT BY MEDICAL OFFICER OF HEALTH
For Year 1891.
The Deer District is the second district in extent, and by
far the largest in population of the districts into which the
County is divided. Its total acreage is 166,817, while the
population at last census amounted to 34,020 (i.e., 13,746
more than the Aberdeen District, which comes second in
point of population.) It is a wide district, and contains
numerous villages both inland and on the coast.
The total death-rate in the whole district for 1891 was
15.079, which is above the average of the rural death-rate
in Aberdeenshire for the same year - the average being
14.484. The number of villages and the density of the
population would lead us to expect a higher death-rate than
we would find in a district with few villages and a more
scattered population. When we look into the elements that
make up this death-rate, we find that the rates from the
general groups of diseases, tubercular, respiratory, nervous,
and circulatory, are high. (See Table in Appendix.) The
zymotic rate, on the other hand, is a very low one, being
only .970.
The following Table gives the parishes comprised in the
district, with their population in 1881 and in 1891, with the |
HH62/1/ABERD/37 |
[Page] 36
increment or decrease of population in each, the death-rate
in each parish last year, and the average death-rate in the
same parish during the ten years from 1861 to 1870
(inclusive):-
Table A.
[Table inserted]
[Page] 37
The following Table shows the average death-rate in the
district during the past ten years:-
Table B.
DEATH-RATES DURING EACH OF THE TEN YEARS PREVIOUS TO 1891.
[Table inserted]
Table C shows the position of the Deer District as
compared with the other districts in the County, and with
the Mainland Rural Districts of Scotland, and Scotland as a
whole:-
Table C.
[Table inserted]
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT. - The sanitary state of the Deer District is capable
of improvements in many points, and more especially in
regard to many of the villages. In addition to improvement
in the drainage and water supply of a number of them, there
is no part of the County in which increased powers of
scavenging are more urgently required. To this the Local
Authority are fully alive, and the members of the District
Committee have joined most heartily in the petition framed
by the Public Health Committee of the County, and adopted
by the County Council, to ask Parliament for increased
powers in regard to scavenging of villages. Such powers,
if obtained, will undoubtedly be the means of vastly im- |
HH62/1/ABERD/39 |
[Page] 38
proving the sanitary condition of all, but but more especially the
fishing, villages.
With regard to drainage, the villages of New Pitsligo,
New Leeds, Boddam, Mintlaw, Longside, St. Combs, New
Stirling, Cairnbulg, and Inverallochy, are all more or less
defective. The inhabitants of New Pitsligo have undertaken,
at their own expense, to improve what is most defective in
the drainage of that village. The other places will be
gradually dealt with.
Improved water supply is required at Stuartfield, New
Stirling, New Deer, and Cairnbulg. Old Deer has now been
formed into a Special Water District, and the works are in
process. Attention is being directed to the improvement
of the water supply at Strichen and Cairnbulg.
HOUSING OF THE WORKING CLASSES. - With regard to
this subject, the same sanitary defects exhibit themselves in
these as prevail in other parts of the County. Damp walls,
damp earthen floors, sometimes dilapidated roofs, the pump
or well often in suspicious proximity to midden drain or ash-
pit, middens too near the house, badly constructed ashpits,
privy accommodation defective or absent, these are the
common defects met with, and give ample scope for im-
provement.
SLEEPING APARTMENTS OF UNMARRIED SERVANTS. - The
sleeping apartments on farm steadings are here, as elsewhere,
in great need of improvement, though in some parts of the
district, in more recently erected steadings, this has been
effected.
INFECTIOUS DISEASES NOTIFICATION ACT. - Passing to
the consideration of infectious disease, I have first to remark
that the Notification Act has been in force for fourteen
months, and has proved of great service. In many cases it
has enabled prompt measures to be taken in regard to out-
breaks that might have led to dangerous consequences. I
need not say more in regard to an Act, the utility of
which is so self-evident.
HOSPITAL PROVISION. - During 1891 the Local Authority
possessed only one small hospital, which in fact was not open
except during the latter two months of the year. Previously
to that it was closed, and, I understand, the summer before
was let for summer lodgings. Though very small, consisting
only of two rooms avaiable, besides the matron's room,
it has been of some service since it was reopened. It
may, however, be found expedient to close it altogether
[Page] 39
if we have a new hospital built at Maud, as the most
convenient centre. A Sub-Committee of the Public Health
Committee, drawn from representatives of the various parts
of the district, has been appointed to examine into the
whole question of hospital provision.
The District Committee have now taken over, as a
district hospital, the small cottage hospital at Crimond,
which, built by Lady Carnegie, was supported by the
voluntary contributions of the inhabitants of St. Fergus,
Lonmay, and Crimond. With a few improvements it will,
I think, answer well for the requirements of that part of
the district which lies too far from Maud, where a central
hospital will probably have to be erected.
During the earlier part of 1891 the Local Authority
contributed a certain proportionate sum to the upkeep of
the Fraserburgh Hospital for the parishes which had a right
to send patients there, but that contribution ceased in
October, as it was considered out of all proportion to the
benefits accruing. It may, however, be worth considering
how far the hospital should be utilized by the Committee
for patients from the surrounding parts of the district. The
district of Deer is a very large one, and one hospital is in-
sufficient for its requirements. Some such scheme as the fol-
lowing might be found most workable:-
1. A well-equipped hospital at Maud, which being a railroad
junction, might enable the railway service to be brought
into requisition for conveyance of patients, as has been
done in Ayrshire. Maud also would be convenient for
friends visiting patients at the hospital.
2. The small hospital just taken over by the Local Authority
at Crimond.
3. The use of the Fraserburgh hospital for patients from the
north part of the district at a fixed rate per patient.
A good ambulance service will be necessary.
GENERAL INQUIRIES AS TO SANITARY MATTERS. - I have
made investigations into the conditions of the villages in
the district during the latter portion of the year, and also
as far as possible into the state of the surrounding districts.
The result of my inquiries I have summarised in the pre-
vious part of my report.
SPECIAL INQUIRIES. - An investigation was made in con-
nection with an outbreak of typhoid fever that occurred at
the farm of Buckie, in the neighbourhood of Boddam. Two
cases of typhoid were removed at the same time from this |
HH62/1/ABERD/41 |
[Page] 40
farm, and on inquiry it was found that other cases of fever
had occurred at the place in previous years. It was also
thought that typhoid fever had been conveyed from here to
Boddam, through the milk sent there. On making a com-
plete inspection of the premises, the only cause that pre-
sented itself to me as likely to cause the fever was the
drinking water. This was taken from a well situated at a
distance of about 40 yards from a midden and at a lower
level. The urine had been drawn away from the midden
by a superficially cut drain, but the nature of the soil,
which was of clay lying close to the surface, suggested the
possibility that the urine had found its way along the sur-
face of the clay bed into the well. I took away with me a
sample of the water, and on analysis found it to be greatly
polluted. Two years ago the water from other two wells at
this farm had been analysed by Professor Brazier, in connec-
tion with an outbreak of typhoid fever at the time, and
pronounced by him to resemble rather sewage mixed with
water than water mixed with sewage. Directions were
given to disuse the well, and steps to be taken to procure a
fresh supply.
I made a careful investigation, in conjunction with Dr.
McLeod, Medical Officer for New Deer, into a case of typhoid
at the Free Church Manse there. The water supply was
suspected by him, and I accordingly made two analyses of
it. The first analysis pointed to recent contamination. The
pump was then thoroughly cleaned. A second analysis was
then made. It showed that all traces of recent pollution had
disappeared, but traces of more remote pollution remained.
An inspection of the ground gave reason for suspecting that
the pollution came from an old cesspool at some distance
from the pump. This was all the more likely as the soil
was exceedingly sandy and porous. The taste of the water
at the different times corresponded exactly with the results
of the analysis. After the emptying and cleaning of the
pump, when the sample for the second analysis was taken,
the water was quite good to the taste, but it gradually
changed and became unpleasant. The question of a
new supply to the Manse by gravitation is now under the
consideration of the Deacons' Court.
Other investigations were made into outbreaks of scarlet
fever, diphtheria, and typhoid. Any insanitary conditions
in connection with typhoid fever and diphtheria were dealt
with.
OFFENSIVE TRADES. - The slaughter-houses in the
district are not all that could be desired. It has been,
[Page] 41
however, determined by the District Committee, as only one
man had received licence for the old Local Authority, to
intimate to them that they must now apply to the District
Committee for permission to slaughter cattle. The Com-
mittee will take care that all grounds of nuisance are
removed before such permission is granted. This is the
only offensive trade in the district.
BAKEHOUSES. - I have inspected a number of these, and
with one or two exceptions, found their condition satisfactory.
HOSPITAL SUPERVISION. - The hospitals available for the
use of the Local Authority in 1891 were, the Old Deer
Cottage Hospital and the Thomas Walker Hospital at
Fraserburgh. I visited the latter, and found it satisfactorily
equipped.
I made several visits to the Old Deer Hospital, and
always found, under Dr. Wilson's charge, everything in ex-
cellent order.
MEASURES TAKEN FOR PREVENTION OF SPREAD OF
DISEASE. - Cases of infectious disease were visited by the
Sanitary Inspector, or, where there seemed any circumstance
requiring personal supervision, by myself. Outbreaks of
scarlet fever were dealt with personally at Fetterangus,
Strichen, New Pitsligo, Rathen Schoolhouse, Kininmonth
Schoolhouse, Longside, New Aberdour, and Boddam. Every
assistance was rendered by the various Medical Officers of
the district.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASES. -
The principal zymotic diseases in 1891 were diphtheria,
enteric fever, and diarrhœa. The two latter undoubtedly
depend on the polluted condition of many of the water
supplies. (See report on the Ellon District, page 22.) As
the investigation of a number of them has clearly shown,
improvement in this respect will, in all probability, lead to
a diminution of these diseases.
The outbreaks fo diphtheria were, in nearly all the
cases, traced to defective drainage of the houses in which
they occurred.
One of the commonest diseases reported under the
Notification Act is erysipelas. It often appears to be
connected with, if not dependent upon, insanitary conditions,
and its prevalence in Boddam is very instructive in view of
the insanitary condition of the village.
Phthisis and other forms of tubercular disease are ex-
ceedingly common. The total tubercular death-rate is 1.445. |
HH62/1/ABERD/43 |
[Page] 42
Diseases of the respiratory system show also a high rate,
due, probably, to the proximity of the district to the sea
and its exposure to east winds, as also to the damp charac-
ter of a large part of the district. In future reports I shall
deal more fully with this subject.
The Tables in the Appendix have been prepared from
information given me by the various registrars in the
County.
ABERDEEN COUNTY COUNCIL.
GARIOCH DISTRICT.
REPORT BY MEDICAL OFFICER OF HEALTH
FOR YEAR 1891.
The Garioch District has an acreage of 104,397 acres
with a population of 15,713. The density of population is
thus .150 persons to the acre, or 6.6 acres to each person.
The number of births during the year 1891 was 457;
the number of deaths for the same period being 223. The
total death rate in the district 14.318 is almost exactly
the average of the rural part of Aberdeenshire, viz., 14.484.
The zymotic death rate is only .954. Next to Alford, this
is the lowest zymotic death rate in the various districts in
1891.
Tubercular diseases are in this district rather above the
average of the whole county, being 1.399 per 1000; to
which phthisis alone contributes 1.018.
The following Table shows the population of the parishes
in 1881 and 1891, with the death rate for each parish, and |
HH62/1/ABERD/45 |
[Page] 44
also the average death rate in the same parish during the
ten years from 1861 to 1870 (inclusive):-
[Table inserted]
GENERAL ACCOUNT OF THE SANITARY CONDITION OF THE
DISTRICT. - The Garioch District is purely agricultural. In
regard to sanitation, the same defects are found as in the other
districts of the County. Many of the houses of the working
classes present conditions that are not always in accordance
with the maintenance of good health by the inmates, and
this is especially true as regards the children. Moreover,
when sickness comes upon them it is apt to be aggravated by
these conditions. I would beg to refer to my remarks on this
subject in some of my other district reports.
Many of the sleeping apartments provided for the farm
servants are also very insanitary in regard to position, cubic
space, ventilation, and other matters. Improvements in all
these directions will require some time to accomplish, but is
[Page] 45
a matter of the utmost importance. The general education of
the working classes themselves in sanitary matters is of not
less consequence, and will effect no less an improvement as
regards health.
VILLAGES.
PORT ELPHINSTONE. - The water supply here will require im-
provement. It is got by pumps which, in the lower part of
the village, lie at a lower level than the ashpits and privies.
The water is in danger of pollution, and a systematic analysis
will have to be made, and the water dealt with according to
the results.
The drainage of the place is bad. There is no regular
sewerage system, the drains being simply of stone. In the
upper part of the village the water is supplied by dug wells
which, from the different nature of the ground, are not so
exposed to danger of contamination.
DAVIOT. - The water supply is here exceptionally unsatisfactory.
The well from which almost all the drinking water is
taken is at too great a distance from the village; while the
pumps beside the houses are open to the gravest suspicion,
from their proximity to the churchyard, to which they lie
at a lower level. I took a sample from one of these pumps,
and, on analysis, found it to be greatly polluted.
INCH. - The water supply here is good, but the drainage will
require attention, as some of the drains are laid at too high a
level to admit of being connected to the houses on one side
of the street.
KEMNAY. - The water supply is somewhat deficient in summer.
With regard to the village, Dr. Henry, Medical Officer for
Kemnay, reports:- "The houses are mostly new and have
been built at as little expense as possible, and with no atten-
tion to sanitary requirements. The village is supplied with
good water by a system of properly jointed iron pipes, but
the supply is apt to run dry in a protracted drought. There
are also a considerable number of pump wells in which the
water is easily reached at a depth of from 20 to 30 feet, and
these are frequently liable to contamination from middens and
cesspools, of which there is a considerable number, although
the peculiarly receptive nature of the sub-soil - a dry gravel
- has hitherto prevented serious trouble from this source.
There is no proper sewerage system possible with the present
water supply, which is quite insufficient for proper flushing,
though in the lower part of the village there is a drain flushed
periodically by water pumped into a cistern for that purpose.
"Beside Mr. Fyfe's quarry there are several blocks of
tenement houses supplied with pure water, but the ashpits,
&c., attached to these are often in bad condition and require |
HH62/1/ABERD/47 |
[Page] 46
more frequent cleaning out. In one block several cases of
enteric fever have occurred."
The enteric fever at this tenement may have arisen from
emanations from a most foul undrained ashpit of huge size,
which was little better than an open cesspool, and into which
everything from the tenement block was thrown. Instruc-
tions were given for improving the condition of the place, and
a promise received from the manager that it would be
attended to. I have met with cases of typhoid fever origi-
nating under similar circumstances, as at Auchmill in the
Aberdeen District.
MONYMUSK. - With regard to Monymusk, Dr. Henry reports
as follows:- "With few exceptions the houses in Monymusk
contain no water pipes, sinks, or closets. The village is
efficiently drained by a sewer running through the main
street, and there is an abundant supply of water in the street
wells, brought from springs about a mile distant. In the
bakehouse the sink pail and water tap are not what they
should be, and the office and dunghill, in the rear, are too
close to the house."
OLDMELDRUM. - Dr. Wilson, Medical Officer of Health for
Meldrum, reports as follows:- "The water supply of the
village is deficient in summer, and no extra supply can be
obtained in the vicinity of the reservoir. From the nature of
the soil, contamination of the wells has never to my
knowledge taken place, and I would suggest the erection of
pump wells, in properly situated stations, to augment the
limited supply.
"Drainage. - The drains of the village are well arranged; most
of the houses, as well as the ashpits, have connection with the
main drains. The Local Authority has for years bestowed
much attention to the drainage of the village.
"Slaughter-House. - The slaughter-house is erected on a bad
site, it being next to impossible to obtain proper drainage,
and there is not a sufficient supply of water. Recent steps
have been taken to improve matters."
(Dr. Wilson had sent several reports to the old Local
Authority, but apparently without much effect.)
"Infectious Disease. - There was one death during the year
from infectious disease, viz., a child that came from Glasgow
ill with whooping cough, and died a few days after its
arrival. The disease spread to two children in an adjoining
house, but no further.
"There has been no case of typhoid fever for very many
years. I have observed for a long time back that, in the
summer months, we have annually imported into the village,
scarlet fever, measles and whooping cough. During the past
[Page] 47
year we had a case or two of this, otherwise I should have
said that the parish was entirely free, as it now is, from this
disease.
"Dwelling-Houses. - The state of the dwelling-houses in the
village is on the whole fairly good, with the exception of a
block of buildings in Back Wynd. These are in a most filthy
condition, overcrowded, and unfit for human habitation."
(Note. - These have since been closed).
Dwelling-Houses of the Labouring Classes. - In connection with
this subject, I desire to draw attention to the remarks
of Dr. Paterson, Medical Officer for Inverurie, Landward,
which are deserving of careful consideration. "In regard
to the dwelling-houses of the labouring classes, great
improvement is required. In such weather as at present
we are having, many cases of bronchial troubles have scarcely
a chance of recovery, on account of the impossibility of
keeping out draughts from defective roofs, doors and
windows."
Improvement is also necessary in the case of sleeping
places on farm steadings. On the newer farms these are
somewhat more satisfactory. On this subject, Dr. Wilson,
Oldmeldrum, reports:- "The sanitary condition of the farm
steading might with great benefit and profit be greatly
improved, and better accommodation for farm servants is, in
many cases, much to be desired."
Hospital Provision. - Some hospital provision will be required
for the district. The following passages from the reports of
Medical Officers of the district are of interest in this
connection.
Dr. Paterson, Inverurie, says:- "In cases of infectious
disease occurring among servants at farm towns, we are very
much in want of hospital accommodation. It will be difficult
to say what accommodation would be required, but the
removal of all cases at the outbreak might be the means
of curtailing an epidemic which might assume large propor
tions."
Dr. Wilson, Oldmeldrum, writes:- "There is much need
for an hospital for infectious disease for this and adjacent
parishes, and I am of opinion that the present Parochial Board
room and the two adjacent wings of the Poorhouse could be
altered, at a nominal cost, to meet the requirements."
Dr. Davidson, Medical Officer for Rayne, Daviot, and
Chapel of Garioch, writes:- "Hosptial accommodation is
needed for fevers and critical cases, where the home is poor and
the nursing inadequate, as is too often the case. Should an
hospital not be forthcoming, one or two efficient nurses in
the district, available at a cheap rate, would be of service."
Dr. Currie, Insch, has expressed to me the great need |
HH62/1/ABERD/49 |
[Page] 48
that has been felt for years for a cottage hospital in that
district, and I have myself had experience in my work of the
benefit that would have resulted from such a hospital.
THE NOTIFICATION ACT. - The adoption of the Notifica-
tion Act will be of undoubted benefit in dealing with in-
fectious disease in the district, and will, I hope, enable us
to reduce still further the low zymotic death-rate of last
year. It is always necessary as a measure of prevention.
The question of hospital provision, and with it the adop-
tion of the Notification Act, will, I trust, receive the at-
tention of the Committee, so that the district may be ready
to meet an epidemic when it comes, and not be taken un-
prepared.
SPECIAL INQUIRIES. - A special inquiry was made into
the cause of an outbreak of typhoid fever at the farm of
Pitscurrie, near Pitcaple. It was supposed to have been
brought by infection from Auchline, in the Alford district.
The drinking water was analysed, and found to be polluted.
The pump, which from its position could not escape con-
tamination, was disused, and drinking water taken from a
spring at a little distance. A supply is to be taken from
this to the farm.
Another investigation was made into an outbreak of
typhoid fever at Colpy, near Insch. This forms an excellent
illustration of the danger of not isolating first cases of in-
fectious disease. The first case was not isolated. Infection
spread to several of the inmates, resulting in one death,
and was also carried to a woman and her daughter who
were supplied with milk from this house.
Another inquiry was made into an outbreak of diph-
theria at Duncanstone. The cottage was in a wretched con-
dition, with a midden close behind it, from which the urine
must have soaked under the foundations of the house and
polluted the subsoil.
OFFENSIVE TRADES. - The only offensive trade in the
district is the slaughtering of cattle. The District Commit-
tee has intimated to owners of slaughter-houses, none of
whom held a licence to slaughter from the old Local
Authority, to apply now for licence. The Committee will
secure that the places are put into good condition, or re-
moved from any objectionable position, before such licence
is granted.
BAKEHOUSES - Those I have examined are satisfactory.
ZYMOTIC DISEASE. - In all cases of which information was
[Page] 49
obtained (the Notification Act not being in force), the house
was immedicately visited by the Sanitary Inspector, who re-
ported to me full particulars. If any case seemed to require
special attention, I visited it personally, and gave the neces-
sary directions. In all the cases disinfection was carried
out under the instructions, and with the assistance of, the
Sanitary Inspector. Means of hospital isolation will,
however, be of great assistance in the district.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASE. - There
is very little of interest that I can say as yet on this head.
Much of what I have mentioned in other reports as to the
origin of such diseases as diphtheria, enteric fever, diarrhœa,
respiratory diseases, &c., is applicable to this district as well.
It is, however, a subject that will require more time to enter
fully upon than the short part of last year at my disposal
allowed. |
HH62/1/ABERD/51 |
Aberdeen County Council.
DEESIDE DISTRICT.
REPORT BY MEDICAL OFFICER OF HEALTH
For Year 1891.
The Deeside District has by far the largest area of any
district in the County, its total acreage being 416,882, while
the Deer District, which is second in extent, has 166,817
acres. But a great part of the district consists of mountain
and moorland, and the total population is only 13,070. It
is far the most thinly populated of the districts, the density
of population being only .031 persons to the acre, which
gives about 32 acres for every person. Alford, which comes
next in sparseness of population, gives .065 persons to the
acre, or 15.3 acres for each person.
The births in the district in 1891 amounted to 370; the
total deaths to 224. The total birth-rate, 28.3, is very
slightly under the average of the rural districts of the
County, which is 28.8, but slightly above that of the
Mainland Rural Districts of Scotland, which is 27.9. The
average birth-rate for the whole of Scotland is 31.2.
The death-rate from all causes, for 1891, is 17.138.
This is very high as compared with the average of the rural
districts in the County, which is only 14.484. The disease
groups that contribute most towards it (see Tables in
Appendix) are the tubercular (especially in the form of
phthisis) nervous, circulatory, and respiratory. The death-
rate from zymotic diseases, on the other hand, is rather
under the average. The tubercular death-rate is very
high, being .6 per 1000 more than that of any other
district. The explanation of this may, perhaps, be found
in the fact that people resort to the district for cure from
this disease. It is a point worthy of careful investigation.
It will be seen, however, from Table B that the death-
rate for last year is unusually high, and may have been |
HH62/1/ABERD/53 |
[Page] 52
due to the severity of the epidemic of influenza in this
district during that year.
The following Table shows the population of the parishes
in the district in 1881 and 1891, with the increase or decrease,
the death-rate of each parish in 1891, and for comparison
the average death-rate of the parish during the ten years
from 1861 to 1870 (inclusive) as given by the Registrar
General:-
TABLE A
[Table inserted]
The following Table shows the death-rates in the whole
district during the last ten years:-
TABLE B.
DEATH-RATES DURING THE TEN YEARS PREVIOUS TO 1891.
[Table inserted]
[Page] 53
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT. - We have in Deeside very much the same
conditions as obtain in other districts. A report on one
district will present in the main the sanitary picture of
another. In better housing for the working classes,
especially the agricultural labourer, there is a wide field for
sanitary improvement. With regard to the villages, the
drainage of these into the river Dee, and the purification
of the sewage, has been a subject of no inconsiderable
difficulty and contention between the Town Council of
Aberdeen and the District Committee.
The question of hospital provision is one which, from
the character and configuration of the district, will require
careful consideration. Aboyne would undoubtedly be the
best centre for the erection of a cottage hospital. It is the
natural centre for the most populous part of the district,
and a small hospital here would probably meet most of the
requirements.
The Notification Act is not yet adopted, but it is the
intention of the Local Authority to do so at an early date.
I subjoin a few extracts from the reports of the Local
Medical Officers on their special districts:-
BRAEMAR. - Dr. Noble reports that no cases of infectious
disease have occurred for two years. Before that time they
had outbreaks of scarlet fever and measles, spreading
apparently from Aberdeen. "It was interesting," he says,
"to notice how the greater communication between Ballater
and Braemar first affected Braemar, and from here contagion
spread to the Crathie and Balmoral districts."
The general sanitary state of the district he considers good,
and quotes in proof of this the fact that no case of typhoid
fever has originated in the district within his recollection.
(Compare remarks on purity of water supply in relation to
typhoid fever, in the Ellon District Report).- "The new
system of sewerage and water supply," he say, "has been
a great boon to Braemar. The more efficient trapping of
the sewers in the Castleton district has been attended to by
the sanitary inspector. The bakehouse is in good repair.
while the condition of the slaughter-house is being improved."
GLENMUICK, TULLICH, AND GLENGAIRN. - Dr. Mitchell reports:
- " As regards the occurrence of infectious disease, the
condition of this district is satisfactory, there having been no
case during the last year, so far as I know. When I came
here four years ago, scarlet fever was the most common
infectious disease. Since then it has decreased, and during
the last two years, I believe, there has not been a single case. |
HH62/1/ABERD/55 |
[Page] 54
In the outlying districts, many of the old uncomfortable,
draughty farm-houses have been replaced by new and more
comfortable buildings. The want of a cottage hospital," he
says, "is sometimes felt."
ABOYNE, BIRSE, AND LUMPHANAN. - Dr. Keith describes an
outbreak of diphtheria that occurred in the parish of Aboyne,
and which was due, in his opinion, to pollution of the well
from which the drinking water was obtained. He directed
the well to be disused, and the "house to be pulled down,
as it was at best a mere hovel."
An outbreak of typhoid fever in the village gave rise to
uneasiness regarding the water supply, and several analyses
were made without any result. Dr. Keith regrets the
entire absence of hospital accommodation in the district.
KINCARDINE O'NEIL. - Dr. Cran reports:- "The sanitary
condition of the houses of the working classes is fairly
good, but in many cases they sleep in rooms small, badly
ventilated, and damp, and with no fireplace. I may say this is
quite common. In case of sickness I always insist on the
patient being removed to a larger room with a fireplace.
This is not entirely confined to the working classes. In farm
houses, where one might expect better things, this state of
matters also exists. In many houses the floor of the kitchen
is composed of earth, which is often damp.
"A fortnight ago my attention was called by the Inspector
to two cases. The houses were much in the same condition
- filth, bad smells, dirty beds, and damp, rotten floors. The
utmost confusion existed, and sickness reigned. One of the
cases I removed to the poor's cottages; in the other case, a
room in the house was put in order, fires put in, and a nurse
took charge of the case. I may mention that during the
last fifteen years many of the thatched houses have fallen,
or are not used.
"As far as infectious diseases are concerned, we are
remarkably free from them. Last year at Maldron several
of the family died of enteric fever, all due, in my opinion, to
the damp, dirty condition of the old farm-house. The
drinking water was analysed without results.
"A case of scarlet fever that occurred at Craig was im-
ported from Strichen."
MIDMAR. - Dr. Lawson sends an exhaustive report on this
parish. He describes the sanitary condition of the large
farms as on the whole satisfactory, with the exception of the
sleeping apartments for the unmarried labourers, which he
strongly condemns. His description of these may be quoted:
- "A part of a loft, above a stable, to get to which you
[Page] 55
have to pass along the stable, behind the heels of half-a-dozen
horses, and then up by a rickety stair or ladder. Inside the
room are two or more beds, according to the size of the farm,
and if any space is left, it is nearly all taken up with trunks,
which also serve as seats. Soiled clothes, bits of harness,
&c., are lying about. The floor is often not very clean.
There is no fireplace of any description. The place is
lighted by a sky-light, with one or two panes broken, perhaps,
and filled up with straw or a pair of trousers, which is,
perhaps, of excellent use for ventilation. Such, with varia-
tions, are the sleeping apartments I have visited in the course
of my practice during the last three years. The sleeping
apartments at the farm of Shiels which was on the ground
floor had a large fireplace, but, evidently, never a fire, and
seemed very cold and damp. I am afraid that by far the
greater number of sleeping apartments are of this latter sort."
The cottar houses, he says, are in some cases good, while
others present insanitary conditions, which have sometimes
led to disease.
The crofts and small farms, Dr. Lawson continues, are,
from a sanitary point of view, not nearly so satisfactory
as the larger farms. The buildings are generally of older
date and not in such good repair.
"These small holdings, so important socially, and perhaps
soon politically, are at present a difficulty to the landlord.
I understand it costs much more in proportion to the rent
received to rebuild these than larger farms. The result is
when these buildings get worn down, a small place is either
added to a large one, or two old houses are merely patched
up to serve another period of years; so that to-day we find
them standing pretty much as originally built, and seldom
quite satisfactory in arrangements or condition." There is
no doubt that this fact, taken in conjunction with the
employment of unmarried farm labourers by farmers in prefer-
ence to married men, accounts largely for the diminution of
the country population, and the growing scarcity of labour
in country districts.
Some very old houses exist in Midmar, of the style
common two generations ago. When the thatch is well kept,
these, Dr. Lawson says, are comfortable enough. The
general water supply and drainage in this district are satis-
factory, and, on the whole, the parish is a very healthy one.
"The landlords are, as a rule, liberal and anxious to
maintain good feeling. On the Corsindae estate, the most
backward, a great deal has been done in recent years to
improve the houses of the tenantry.
"Zymotic Disease. - During the last three years no cases of
diphtheria, membranous croup, relapsing or puerperal fever, |
HH62/1/ABERD/57 |
[Page] 56
has occurred. There has been only one case of erysipelas,
following an attack of influenza, in an old man over eighty.
Three cases of scarlet fever occurred at Cairndye, but they
were at once isolated and the diseaase did not spread. How
they originated was a puzzle, as there were no cases within
six or seven miles. Only two cases of typhoid have occurred
to my knowledge within three years, and one of these was
imported from Echt, and the other may have been con-
tracted by the patients in Aberdeen.
"Measles. - There was an epidemic of measles in this parish
in the autumn of 1889. In June of that year two cases
occurred at Meikle Midmar, which were isolated, and the
disease did not then get a hold of the parish; but, two
months thereafter, it spread from Cluny, and attacked all
the liable persons, causing one death from concurrent
pneumonia.
"Whooping Cough. - During the spring and summer of 1891
there was an epidemic of whooping cough, causing four
deaths.
"Influenza. - Midmar has been visited each time that in-
fluenza has been epidemic. Three deaths occurred during
the last outbreak.
"Phthisis. - I have had only one death from phthisis. I
have at present only one other case. He came into the parish
about a year ago, for his health." Tubercle in other forms
is very rare.
"The pure air," Dr. Lawson considers, "the good
water, the out-door agricultural life, the absence of the
press and stress of city life, the elevation of the district,
make the inhabitants more resistant to the attacks of epi-
demic disease, and more able to cope with it when it gains a
hold of their systems."
TARLAND, MIGVIE, COULL, AND LOGIE-COLDSTONE. - Dr. Alex-
ander reports:- "We have through the district some houses
in very bad condition. I have drawn the Inspector's atten-
tion to several. On the whole the working class is not well
housed."
Dr. Alexander draws attention to the condition of the
water supply and drainage of Tarland village, and the
condition of many of the houses, as also of the ashpits and
privies. He also comments on the want of a hospital for the
isolation and treatment of cases of infectious disease, the
want of which he has felt greatly. Aboyne, he considers,
would be the best centre.
During the past four years Dr. Alexander says he has
had in his practice about twenty cases of typhoid fever, and
six outbreaks of diphtheria, with a total of sixty cases.
[Page] 57
Scarlet fever broke out in two families during 1891.
Phthisis, according to Dr. Alexander, is very prevalent in
this district.
The epidemic of influenza was very severe in this, as in
many other parts of Deeside, during last year.
The Tables in the Appendix, prepared from the returns
furnished by the Registrars, show the mortality statistics in
this and other districts of the County. |
HH62/1/ABERD/59 |
Aberdeen County Council.
TURRIFF DISTRICT.
REPORT BY MEDICAL OFFICER OF HEALTH
For Year 1891.
The District of Turriff comprises the parishes of Auch-
terless, Fyvie, King-Edward, Monquhitter, and Turriff land-
ward with the two quoad sacra parishes of Millbrex and
New Byth. The acreage of the district is 100,419 with a
population of 12,982. The density of population is thus
.129 persons to the acre, or rather over seven acres to each
person. The total births in 1891 was 355, the total deaths
176. The birth-rate (i.e. the number of births per 1000 of
population) is thus 27.3, while the death-rate is 13.5. This
is a comparatively low death-rate, and for the year is stands
second lowest of the death-rates of the various districts, as
will be seen from Table II. in the Appendix.
The zymotic death-rate was rather a high one, caused
mainly by diphtheria and whooping cough. Fifteen deaths
in all were due to infectious disease, and if we take the
rough estimate of ten cases for each death, there would
have been 150 cases of zymotic disease in the district last
year.
The total tubercular death-rate is above the average,
being 1.617, the district in this respect standing third;
Deeside having the highest death-rate with 2.356, and Deer
the next, 1.640.
The death-rates from the diseases grouped under the
names nervous, circulatory, and respiratory, are very low.
The following Table shows the parochial acreage, |
HH62/1/ABERD/61 |
[Page] 60
population, and death-rate, with the average death-rate in
each parish, during the ten years from 1861 to 1870:-
TABLE A.
[Table inserted]
*Quoad sacra parishes.
The following Table is the death-rates during the last
ten years:-
TABLE B.
DEATH RATES DURING EACH OF THE TEN YEARS PREVIOUS TO 1891.
[Table inserted]
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT. -The general sanitary condition of the Turriff
District resembles closely that of Alford and Huntly. The
same defects from a sanitary standpoint exhibit themselves
as in these districts. I would beg to refer to my remarks
in the Aberdeen and Ellon Districts Reports on the condi-
tion of the cottar houses and farm-servants' sleeping apart-
ments, which may be taken as more or less applicable to all
the districts in the county.
There are four villages in the district - Fyvie, Cumines-
town, Garmond, and New Byth. Garmond stands in need
[Page] 61
of a new water supply. Samples from four of the wells
were analysed by Mr. Jamieson, the city analyst, and found
suspicious.
Cuminestown was formed some years ago into a special
water district. An increased supply is now being got for
the village. The drainage is not good, and will require
early attention.
With regard to Fyvie, neither the drainage nor the
water supply can be said to call for attention meanwhile.
In New Byth the water supply is defective, and an in-
creased supply is under consideration.
NOTIFICATION ACT. - The Notification Act is not in
force for the district, and there is no hospital provision as
yet made by the Local Authority for the treatment of in-
fectious disease.
There is at Fyvie an excellent cottage hospital, built and
endowed by the late Mrs. Gordon of Fyvie, part of which,
when required, is used for the treatment of infectious cases
from this parish. The consent of the managers might be
secured by the Local Authority for the use of the hospital.
A small cottage hospital erected at Turriff itself would com-
plete the equipment of the district.
The necessity for hospital accommodation is very greatly
felt in connection with the unmarried male servants at farm
steadings. If one of them is seized with infectious disease,
a great deal of trouble is often experienced if there is no
hospital to which the patient may be sent. Again, if an in-
fectious disease breaks out in a two-roomed cottar house,
one room of which is sometimes uninhabitable, isolation is
impossible, and without hospital provision the disease must
be spread through the family, causing, occasionally, the death
of one of the members, and involving often much expense
and trouble. In many of these cases, too, the nursing is not
very efficient; nor are the conditions of the house itself such
as to give the patients the best chance of life.
There is further the general consideration which forms
the strongest reason for the existence of fever hospitals,
viz., the power of dealing promptly with first cases, and so
being able to check what might otherwise spread and lead
to an epidemic. For an illustration of this I would refer to
the effect of hospital isolation in the outbreak of scarlet fever
at Newhills. (See report on the Aberdeen District.) In the
Ellon District, also, the prompt removal of patients to Hospital
has undoubtedly been the means, in a number of cases, of
checking the spread of disease. People soon learn to |
HH62/1/ABERD/63 |
[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
[Page] 63
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. |
HH62/1/ABERD/65 |
Aberdeen County Council.
HUNTLY DISTRICT.
REPORT BY MEDICAL OFFICER OF HEALTH
For Year 1891.
The Huntly District is the smallest of the eight Dis-
tricts into which the County is divided. It embraces seven
parishes, viz., Cairnie, Drumblade, Gartly, Glass, Forgue,
Huntly, and Ythan Wells. The total acreage is 71,263, and
the population of the district, exclusive of the Burgh of
Huntly, is 7,538.
In 1891 this district had the lowest death-rate of the
districts in the County, the death-rate being 12.337. This
was due to low death-rates in the following disease groups:
- Tubercular, nervous, respiratory, and circulatory and
malignant. The district shows the lowest death-rate in the
first three groups of any district in the County. On the
other hand, the zymotic death-rate (i.e., deaths due to infec-
tious or contagious diseases), stands third highest of the
districts. The scarlet fever death-rate is more than the
total of the scarlet fever death-rates in all the other districts.
Diphtheria and typhoid fever are the other infectious dis-
eases which contribute to the zymotic death-rate.
The Tables in the Appendix give the general mortality
statistics for this and other districts.
In the following Table is given the acreage of each
parish, with its population in 1881 and in 1891, with the
increase or decrease, the death-rate in each parish in 1891,
and the average death-rate in each parish during the ten
years from 1861 to 1870 (inclusive):- |
HH62/1/ABERD/67 |
[Page] 66
TABLE A.
[Table inserted]
The following Table shows the average death-rate in the
district during the ten years from 1881 to 1891:-
TABLE B.
DEATH-RATES DURING EACH OF THE TEN YEARS PREVIOUS TO 1891.
[Table inserted]
GENERAL ACCOUNT OF THE SANITARY STATE OF THE
DISTRICT, AND MEASURES WHICH SHOULD BE ADOPTED FOR
ITS IMPROVEMENT. - The district is entirely an agricultural
one, and presents the usual sanitary features of such a district.
There is only one village in the district, viz., Rhynie. With
regard to it, improved drainage and a better water supply are
undoubtedly necessary. This applies especially to the upper
part of the village, where in summer the inhabitants are
very badly provided with water on account of the too low
level at which the supply is introduced. The drainage of
the whole village is capable of improvement, and the only
satisfactory plan will be its formation into a Special Water
and Drainage District.
Many of the ashpits here are badly constructed, and
badly kept, and will have to be dealt with.
[Page] 67
HOUSING OF THE WORKING CLASSES. - As regards the
rest of the district, the same observations apply as I have
made at some length in my Report on the Alford District, to
which in its general character it bears a close resemblance.
Improvements are required in regard to the houses of the
labouring classes, and the sleeping apartments of the ser-
vants on farm steadings.
INFECTIOUS DISEASES NOTIFICATION ACT. - The Notifica-
tion Act is not yet in force. Its adoption will be of un-
doubted service. Early intimation of the cases and proper
isolation may help to lower the high zymotic death-rate
shown by last year's returns.
In order to complete the means for effectively dealing
with infectious disease, the District Committee, as Sanitary
Authority, should make provision for the isolation of such
cases of infectious disease as cannot be otherwise isolated.
There are at present two cottage hospitals in the district,
the Victoria Jubilee Cottage Hospital in Huntly, and a small
cottage hospital in the Parish of Forgue. Both these hos-
pitals have fever wards, and together they would have, I
think, sufficient accommodation to meet the requirements of
the district. It would be well for the Committee to secure
the right to send cases to these hospitals. It is of the
greatest importance for a Sanitary Authority to have means
of isolating cases of infectious disease, and it is essential for
efficient sanitary administration.
ZYMOTIC DISEASE. - The cases of infectious disease in
the district that have come to my knowledge since August
have been exclusively cases of diphtheria. Intimation was
received of seven cases in all. Two cases occurred in the
house adjoining the slaughter-house at Gartly Station. The
drainage was found, on inspection, to be in a condition that
could hardly have failed to cause disease.
The slaughter-house itself was not kept as it ought to
have been - the blood being frequently allowed to remain in
casks in the yard until it became exceedingly offensive - a
source of peculiar danger.
In most of the other cases the cause was clearly traceable
to insanitary conditions in connection with the dwellings.
Care was taken to have these insanitary conditions re-
moved, so as to prevent the recurrence of the disease. This
illustrates one of the advantages of notification. In all the
cases the isolation of the patients was seen to, and the
subsequent thorough disinfection of the houses and of any
articles likely to retain infection - a matter of especial con-
sequence in diphtheria, the germs of this disease being very
apt to adhere to articles of clothing and furniture, and retain
their vitality for an indefinite time. |
HH62/1/ABERD/69 |
APPENDIX. |
HH62/1/ABERD/71 |
TABLE I.
SHOWING POPULATION, ACREAGE, BIRTHS, AND DEATHS; ALSO THE AGES AND CAUSES OF DEATH.
[Table inserted] |
HH62/1/ABERD/73 |
TABLE II.
SHOWING DEATH-RATES IN THE DIFFERENT DISTRICTS.
[Table inserted] |
|
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