[Page] 6

tions 3 and 7, to 18. I would also draw special at-
tention to the frequency (as l shall endeavour to show
further on) with which infectious disease is introduced into
the County through carelessness or neglect. Notices should
be printed according to suggestion 17 to warn the public in
such matters.

III. In regard to the causes, origin, and distribution of
disease, I beg to append a map shewing the distribution of
influenza, and the principal infectious diseases, so far as as-
certained by me during the past year. The number of cases
of other preventible diseases that came to my knowledge in
each District is detailed in Tables, pages 18-22.

It may be seen from Chart, page [---] that influenza was
most prevalent in the County from February to June, and
again during the months of November and December. From
July to October this disease seems to have almost disappeared.
This chart also shews the manner in which bronchitis and
pneumonia followed more or less the same course as influenza.
A larger number of persons appears to have suffered from
these diseases during the excessive prevalence of influenza.
If the curves of these diseases be compared with the curve of
the mean temperature of the County, Chart page [---] it will be
noticed that whenever the temperature rose, influenza, bron-
chitis, and pneumonia got less prevalent, only to return again
as the temperature fell. In some parts of the County local
outbreaks of influenza occurred during the heat of summer.
At the same time pneumonia and bronchitis shewed a tend-
ency to get more prevalent. I am therefore inclined to believe
that persons affected by influenza are for some time after the
attack peculiarly liable to suffer from bronchitis and
pneumonia, and in all probability other lung diseases. Persons
should therefore be cautioned against exposing themselves to
sudden changes of temperature after an attack of influenza.
I have no doubt, however, that various elements or climate
have independently of the co-existence of influenza a large
share in the causation of bronchitis and pneumonia.

On Chart page [---] I also give curves representing the
course followed by diarrhoea, sore throat, and rheumatism
It will be noticed that diarrhoea followed closely the same
curve as the temperature rising and falling with it. Sore
throat also tended to follow the course of the temperature,
whereas rheumatism does not appear to have been affected by
this agent. Diarrhoea and sore throat prevailed in several
districts more or less in an epidemic form during the heat of
summer. This was probably due to the fermentation of food

[Note in margin] --- RMN

or of organic matter in soil or water; the summer heat bring-
ing into life deleterious organisms which at other times

[Page] 7

remain dormant. The proximity of middens to dwelling
houses, and the saturation of the soil with liquid sewage bring
about a state of matters favourable to the growth and pro-
pagation of such organisms.

Dyspepsia is excessively prevalent in many parts of the
County. This disease may be attributed to errors of diet, such
as bad cooking, want of proper proportion of animal and
vegetable foods, and excessive consumption of tea too long
infused. There is a great tendancy, especially among the
poorer classes, to substitute strong tea with bread and butter,
for the more wholesome diet of porridge and milk. Eggs
and butter are often sold to buy tea and sugar, a valuable
article of nourishment being exchanged for that which only
acts as a refreshing drink, and when prepared as it generally
is, it tends to retard digestion without giving any nourish-
ment whatsoever.

In the majority of cases, outbreaks of infectious disease
were traced to persons from the South either ill or convales-
cing from the disease, or after coming from an infected house.
Wherever there is a large population crowded in villages,
townships, or burghs, outbreaks of infectious diseases are
more common. This is owing in the first place to the fre-
quent communication between such places and centres of dis-
ease, and in second, to the danger of the diseases getting some
headway before action can be taken to prevent it from spread-
ing. Such localities, again, infect persons from the more
thinly populated surrounding districts. Whooping cough and
measles probably spread in this way during the past year from
the Burgh of Campbeltown to the landward part of the parish
and to Southend. Measles spread from Oban to the neigh-
bouring parts of the District of Lorn. Measles was probably
introduced into Ballachulish from the South, and spread be-
fore the disease was discovered. This also was probably the
case in the Quarry villages of Kilbrandon and Kilchattan.

Scarlet fever appears to have been carried by visitors
from the South to the Parishes of Campbeltown, Kilberry,
Kilfinan, Lismore and Appin; measles to the Parishes of North
and South Knapdale, and Muckairn; whooping cough to
Ardnamurchan, Kilmeny and Tyree.

In some places such as Kilfinan and Ballachulish, scarlet
fever was introduced more than once, but was prevented from
spreading. This reflects much credit on the local Sanitary

The infection of Typhoid fever in Jura was traced to a
young man who came home after suffering from this disease in
Glasgow. This man lived in a small ill-ventilated dwelling,

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