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TO THE
COUNTY COUNCIL OF BERWICKSHIRE
as Local Authority under the Public Health Acts.
DUNS, 10th February 1892.
THE County Council as Local Authority having, under Section 8
of the Public Health Act, adopted the Bye-Laws, No. 1., recom-
mended by the Board of Supervision for regulating the duties of
County Medical Officers, I, in accordance with these regulations,
have prepared the following report for the year ending 31st December
1891, which I have now the honour to submit to you.
Having been appointed County Medical Officer of Health so
recently as May, and the District Medical Officers having held their
appointments only for three months or thereabouts, it cannot be
expected that I should be in a position to give a report for the whole
year now ended.
During the months of May, June, July, and August, a mild form
of Scarlet Fever and Hooping Cough was prevalent in the different
Districts, but otherwise the County was fairly healthy. During
September there were no new cases, but in October both diseases
re-appeared, and mild cases were reported up to the end of the year.
In the East District there were 33 cases reported with 1 death, and
3 cases were ascertained without being notified. In the Middle District
46 cases were ascertained before the Notification Act came into
operation, 2 proving fatal, and 41 notified, with 2 fatal cases. In
the West District there were 21 cases notified. These figures, how-
ever, cannot be relied upon as giving any useful statistical informa-
tion, as the Infectious Diseases Notification Act was adopted by the
three districts at different periods. |
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In the way of precaution, and to prevent the spread of these
diseases, the public schools were closed as long as was thought
necessary. The cases as far as possible were isolated, and disinec-
tants were supplied by the Sanitary Inspector, who visited each case,
and in some instances not only gave instructions as to the use of
disinfectants, but also put out his hands and fumigated the apart-
ments. In the cases which came under my own personal care the
families kept cows and sold milk. On talking to the mothers of the
patients, and asking them to remove the cows, they willingly acceded
to my request, and at once sent the animals to a neighbouring farm,
where they remained for several weeks, till all chance of infection
was past. I find that in the country districts and landward parts
of parishes, the relatives of patients suffering from infectious diseases
are most willing to do all in their power to carry out instructions
given them with the object of preventing the spread of disease,
and that they appreciate the visits and services of the Sanitary
Inspector.
A few cases of mild Typhoid Fever and Diphtheria have occurred
in the county, but they call for no particular notice here. In two
cases which I visited, no explanation could be given as to the cause
or origin of the infection. Isolation of patient and strict attention
to disinfecting house, etc., prevented any spread of the disease. In
one case of Typhoid in the Middle District, as we had no hospital
for the reception of fever patients, all the inmates of the house
removed to a considerable distance, leaving the patient the sole
occupant of the house along with a nurse. He made a good recovery,
and after a few weeks in quarantine he left the neighbourhood, the
bedclothes and other articles being burned.
The Infectious Diseases Notification Act has now been adopted by
the whole county, and as I shall have an opportunity of seeing the
notifications at the Sanitary Inspector's office, I shall be in a position
to give a correct and reliable statement for the year we have now
commenced.
Influenza made its appearance in the end of October, and has
continued ever since. Many of the first cases were met with at farm
places and detached houses, both in the hills and lower parts of the
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county - towns and villages, however, by no means escaping. In
November it rapidly spread over the whole county, attacking the old
and young, strong and weak, rich and poor, male and female alike,
whole families being struck down within a few days. Town and
country, the hills and lower parts were equally liable to the disease.
The cases were numerous and severe, but not of a dangerous nature.
The usual symptoms, headache, burning hot skin, quick pulse and rise
of temperature, ranging from 100 to 103, more or less bronchial
irritation and cough, were generally present for the first few days
after seizure. After a little time these symptoms abated, the patient
was left weak and prostrate, with pains in back and limbs. Unfor-
tunately, some were induced to leave the house in a few days, the
general result being a relapse. In former epidemics, infants and
very young children were not affected, but the present form of the
disease is no respecter of persons, and in many instances young
children were laid low with all the symptoms typical of the disease.
It is worthy of remark that Coldingham Shore or St. Abbs, with a
population of 400, has escaped.
During the last quarter there has been a great amount of sickness,
but the greater part of this has been due to Influenza and its sequelae,
such as Bronchitis, Pneumonia, and other affections of the respira-
tory organs. The mortality, particularly amongst the old and infirm,
must have been high, but in some parishes the death rate was lower
than in the corresponding quarter of the previous year. In
Edinburgh and other towns the death rate reached an alarming
point, but in this county, although I am not in a position to give
the exact rate, I am safe in stating that it has not reached so high
a figure as one might have expected, considering the number of cases.
An hospital for the reception of infectious cases might be of use
for isolation and treatment, but in a county like this, where the
population is so widely scattered, I doubt whether one with a fully
equipped staff of nurses, etc., would be practicable without the
Burghs joining with the Districts.
The houses of the labouring classes are in most places good and
suitable. In some localities, however, these are very old, as at Little
Swinton in the Middle District; the accommodation is too limited, |
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and the houses are otherwise unhealthy. Where new cottages are
built at farm places, they are complete and commodious, with two
apartments on the ground floor and two large sized attics above,
which latter serve as sleeping rooms if the family should be numerous.
Some of these attics may, in winter, be cold, but with a little
attention in the shape of lath and plaster they would be quite
suitable. Those cottages which have been built during the last 40
years or so are convenient, and those very old ones above referred
to, will, in the course of a short time, be pulled down and others
built in their places. Little Swinton is for sale, and when a
purchaser is found new cottages must follow as a matter of course.
The village of Chirnside in the East District was not in a satisfac-
tory condition as regards drainage and privy accommodation, so I, on
3rd September, along with the District Medical Officer of Health
and Sanitary Inspector, visited the locality and reported as to what
course should be adopted in putting things right. On 10th Dec-
ember, I again visited the place and met by previous arrangement
a Committee of District Councillors and Representatives of the
village. After an inspection of the plans, and also of the fields and
roads, a notification of the plan of drainage previously fixed upon
was arranged, by which a certain limited extent of irrigation of the
effluent was adopted. Much requires to be done before the village
and its surroundings can be said to be in a satisfactory sanitary
condition. There are very few water-closets, and properly con-
structed privies are the exception. This village, from its position
(situated as it is on the top of a hill with sloping grounds), with a
good water supply, and a properly arranged system of water-closets,
ought to be extremely healthy. If water closets were constructed,
and made to discharge into the public drain, a more complete system
of irrigation would be necessary.
In December, I visited Greenlaw along with the Sanitary Inspec-
tor, and examined the new drainage which has been carried out
recently.
A Skinnery at Earlston in the West District has led to a great
deal of discussion, and I have been consulted by the District Medical
Officer and Sanitary Inspector as to this nuisance. The Medical
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Report and Sanitary Officer's Report are conclusive, and with their
conclusions and opinions I entirely agree. The case having been
given by the District Committee against the tenant, the continuance
of the work in its present form and position could not be sanctioned.
The tenant, however, appealed to the Board of Supervision, and the
matter will again come before the District Committee for consi-
deration.
The pollution of the Clockmill Burn by a part of the sewage
from the west part of the Burgh of Duns has also come before me,
and I have frequently visited and examined the locality. An open
ditch conveys the sewage to the Clockmill Burn, commencing where
the common sewage pipe terminates south-west of the Public
School. It runs south for 60 yards and then joins a run of water in
the corner of the field which flows due west till it reaches the Clock-
mill Burn, a distance of 820 yards. This burn continues its course
to the south-west for 250 yards, where it is joined by the Pouter-
lynie Burn; these joinings make a considerable sized streamlet
which flows south for nearly half a mile, through the farm of
Langton Mill, where it runs into the Langton Burn. The open
ditch, before joining the Clockmill Burn, runs parallel with the
Duns Road leading to Gavinton, but at no point is it nearer this
public road than 180 yards. This open ditch with sewerage is far
removed from human habitation, and the nearest houses are three
at Clockmill, where the distance is 240 yards. The ditch was foul
at certain places where impurities and other articles were noticed.
The source of the Clockmill Burn is a large pond at Duns Castle
Kennels which is supplied by the lake called the "Henpoo." The
run of water leading from the lake to the said pond has the sewage
from the Castle running into it as well as that of the cottages at the
Kennels. The burn runs south through Clockmill, drives the engine
at the foundry situated there, and runs to the corner of the field where
the open ditch above referred to joins it. There are twelve houses at
Clockmill with about sixty-three inhabitants. Those near to the
foundry on the south side of the Duns Road have no privy accommo-
dation, consequently all manner of sewage is put into the burn which
runs in front of the houses at a distance of two or three yards |
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When the run of the water is diverted, which it frequently is for
days at a time, the excreta and other sewage are left exposed, and
cause abominable odours in the immediate vicinity of these cottages.
Four of the cottages on the north side of the public road have privies,
but all the slops and liquid sewage run into the burn before it crosses
the Duns Road. There are two water-closets at Langton Mill farm
house which empty into a cesspool, the overflow of which, with slops,
etc., runs into the burn.
The open ditch has the outcome of 150 water-closets, and must
therefore carry much pollution. If steps are taken to remedy the
evil the question will arise whose duty it is to take the initiative
to compel the authors of the pollution to do what is needful. If
the authors of the pollution do not take the necessary steps to
purify the sewage, is it the County Council as Local Authority, or
the riparian Proprietors, who should institute legal proceedings?
The ditch is too far distant from any house to bring it under the
section as a nuisance injurious to health. If proceedings should be
taken by the County Council they should be under the Rivers Pollu-
tion Prevention Act.
It is much to be desired that reliable statistics of mortality and
sickness of the county should be obtained, and that a tabular state-
ment should be given annually as suggested by the Board of Super-
vision. There are difficulties in the way of getting the information
necessary for filling up the Forms of Returns sent by the Board of
Supervision to the District Medical Officers of Health. To enable
them to do this it is necessary that they should obtain a list of the
annual numbers of deaths and births, which can only be procured
from the local Registrars of Parishes. By the English Act, these
Registrars are bound to afford the information to the District
Medical Officers, but it is not yet so in Scotland. Application must
be made by the Local Authority to the Registrar General for per-
mission to the Local Registrars to give this information and after
this permission has been obtained an application must be made to
the Local Registrars. The Registrar General has given his consent,
but the difficulty now is to make arrangements with the different
Registrars. In this county some of them, as a personal favour,
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would be willing to give a certain amount of information, while
others decline to do anything until a general arrangement is come to
as to fees payable and forms of schedules. It is impossible for the
Medical Officer to rely on this uncertain way of getting the neces-
sary information, and until legislation is brought to bear upon this
point nothing can be done which will be of the slightest use, as
statistics, unless correct, are misleading. Most anxious to know
how I might put the District Medical Officers on a plan of getting
information from the Registrars, I put myself in communication
with many County Clerks and Medical Officers, in the hope that
they might suggest something to simplify matters. From one and
all I got answers to the effect that they had failed to get satisfactory
returns from the Registrars, and that in many instances they had
been denied all information, although small fees had been offered.
Such being the state of matters, no reliable tabular statement of
mortality, etc., for the county, can be given for the year 1891. Let
us hope that in the course of a short time, we will be put on the
same footing on this point as some of the large towns, who procure
all necessary information from the Registrar General's Returns.
The Board of Supervision may possibly obtain legal statutory powers
to force Registrars to make regular returns at a moderate fee. This
would put matters on a proper footing, but until this, or some other
plan is adopted, no correct statements can be given.
Where Special Drainage and Water Districts are formed, power
should be given by legislation to include the scavenging of villages
situated in those districts.
ROB. C. MACWATT, M.D.,
County Medical Officer of Health for Berwickshire. |
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Health of the County, including Burghs, for the last
six months.
I have been able to compile the following statement of Deaths
and Births for the last six months from the Registrar General's
Return.
During the quarter ending 30th September, (July, August, and
September) there were 117 deaths, being at the annual rate of
14.489 per 1000 of the population.
During the same months there were 196 births, being at the
annual rate of 24.272 per 1000 of the population.
For the quarter ending 31st December, (October, November, and
December) there were 175 Deaths, being at the annual rate of
21.671 per 1000 of the population.
During the same three months there were 195 Births, being at
the annual rate of 24.148 per 1000 of the population.
Considering that the Burghs are included in the above return, the
death rate compares favourably with other places.
During the first quarter, the death rate was low. For the last
quarter the rate, although high, (21.671 per 1000) was still greatly
below some other places, where it reached 30 and upwards.
During the last quarter, Influenza, Hooping Cough, and Scarlet
Fever were more or less prevalent over the County. Disease of the
respiratory organs cut off a number of the aged, and Hooping Cough
with Congestion of the Lungs accounted for a number of deaths
amongst children. One death took place at 95 years of age; twelve
above 80; seven between 70 and 80, and others bordering on 70
years.
ROB. C. MACWATT,
County Medical Officer. |
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