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COUNTY OF CAITHNESS.
REPORT BY MEDICAL OFFICER - 1891.
TO THE HONOURABLE
THE BOARD OF SUPERVISION
and to the Members of the Council and District
Committee of the County of Caithness.
MY LORDS AND GENTLEMEN,
In accordance with the Regulations of the
Board of Supervision and the Bye-laws of the Council, I have
to submit the following report as to the Sanitary condition of
the County.
Since entering upon the duties of Medical Officer in
August last, I have examined all the villages and visited most of
the districts, and have called the attention of the Local Authority
to the necessity of putting in force several of the
Statutory Enactments
set forth in the Public Health Acts, more particularly those
relating to Common Lodging Houses, Dairies, Milk Shops, and
Sellers of Milk.
I would also impress upon the Council the great impor-
tance of adopting the "Infectious Diseases (Notification) Act"
at an early date. It will be impossible to control the spread of
Contagious diseases and to prevent epidemics unless early know-
ledge of the first cases be obtained, so that isolation and super-
vision can be at once adopted - both as to those attacked and as
to those exposed to infection. This matter has doubtless mixed
up with it the question of Hospital accommodation which will
require sooner or later to be taken into consideration. Notwith-
standing however that Hospital provision in the meantime is
insufficient, much benefit must accrue from the adoption of the
Act. It will bring the Sanitary Officials more directly in contact
with the people, and with places in an insanitary condition where
disease may actually exist, Slaughter houses should be licensed.
and bye-laws regulating them issued. Several of these in the
villages are situated too near dwelling houses; they are all
defective in structure, are badly drained, without water
supply, and their condition generally is unsatisfactory.
The Council is further empowered by the Local Govern-
ment Act to make bye-laws "for nuisances not already punishable
"in a summary manner by any Act in force." It would be well if
bye-laws under this head could be made, for instance, regarding
piggeries which are a frequent source of nuisance, being often
attached to the walls of dwelling houses or situated in byres, &c.,
and are generally found to be in a filthy condition.
Nuisances committed by exposure of the person near
houses and alongside dykes and roadsides could also be reached
by similar bye-laws. Cleanliness and decency around dwellings
could in this manner be ensured, more especially in the vicinity |
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of villages and populous localities. This implies the erection of
closets in connection with every house.
Sanitary Improvements.
The Sanitary Improvements to be aimed at throughout
the County may be included under the general designation of
better attention to cleanliness - cleanliness as to air, water, and
food supplies, and cleanliness of the clothing and of the person.
The drawbacks to obtaining pure air in the houses of the people
are very considerable. The houses in many of the districts are
defective in structure and arrangement. The floors and founda-
tions are often damp, and the roofs and walls leaky. There is
a want of sufficient light and ventilation, and generally no drain-
age, so that pools of filth are observed lying about in all directions.
The dunghills are, for the most part, too near the dwellings, and
are often found heaped up against the backwalls of the houses.
There is over-crowding in several of the smaller houses.
but this is not so marked in the sitting rooms, during the day
time, where fires are burning and doors occasionally open, as
during the night, when the inmates shut themselves up in "box
beds," or stow themselves away into dark recesses, or unventilated
closets, Side windows, if they exist, are seldom opened, and the
sleeping apartments remain close and stuffy. An idea prevails
that fresh air is either unnecessary or injurious during sleeping
hours, so that every opening and crevice by which pure air can
find entrance is carefully closed. If draughts however be
avoided, and the body kept perfectly warm, cold fresh air can be
breathed by those in health as safely during the night as during
the day, and with every advantage to health.
In many places the old style of houses, - where the cattle
live under the same roof and enter at the same door with the
inmates - is common.
The office houses on many of the crofts are also very
unsatisfactory, being badly paved, without drains, and generally
dark and filthy. They are frequently crowded on to the dwellings
and prevent the circulation of fresh air around the houses.
Under the conditions thus briefly detailed, the air must
necessarily be always more or less impure, and bad smells from
the effluvia of decomposing matter be always present. This state
of matters not only lowers the general health, but provides a
suitable medium for the development of micro-organisms and
disease germs. In many cases no improvement can be suggested
short of total demolition, in others a good deal might be done
in the way of draining, paving. lighting, and ventilating, with
attention to cleanliness generally.
The water supply in a great number of cases is subject to
pollution. The wells in the County, from the nature of the
geological formation, are generally shallow dip-wells. They are
apt to receive washings from the surface, and are often fed by
agricultural drains which convey soakage from manured fields.
In other cases they are subject to direct sewage contamination,
from being situated in too close proximity to farm steadings and
dung heaps, and often at a lower level. Wells should be deeply
sunk so as to catch the water from as low a stratum as possible.
They should be enclosed by impervious walls, which should be
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raised above the surface of the ground to the extent of nine or
ten inches. By this arrangement water cannot enter the well
except from the bottom, and its filtration through a deep layer
of subsoil would be ensured,
Articles of food are liable to be polluted and adulterated
in many ways, and in most cases it is impossible for the consumer
to be protected without public intervention. The "Food and
Drugs Adulteration Act" should be adopted, and a Public
Analyst appointed for the County.
Milk is especially liable to contamination, and has been
frequently a medium in spreading such diseases as Scarlatina,
Typhoid Fever, and Consumption. Care should be taken to use
the milk of cows which are absolutely healthy. Byres and the
cows themselves should be kept very clean, and the dishes and
the hands of the milkers scrupulously so. Milk should not be
stored in sitting rooms nor in bedrooms, nor in milk houses
having communication with dwelling houses, which is frequently
the case throughout the County. As already mentioned, dairies
and all sellers of milk in however small quantities should be
registered in order that the cows and byres may be regularly
inspected. No one suffering or recovering from an infectious
disorder should approach the byres nor handle the milk, and
any illness that may arise amongst the cows should be notified
at once to the Sanitary Authorities, and the affected animals
examined forthwith by a duly qualified veterinary Surgeon.
The flesh of diseased animals, or meat otherwise unwhole-
some, is also a source of danger. All meat therefore intended
for human food should be subjected to regular inspection. Un-
fortunately the principal slaughter houses are situated in the
Towns and are therefore beyond the control of the County Local
Authority, and where I understand there is little or no arrange-
ment for their inspection. This is one reason among many
others for having the town and rural districts put under the
management of one Sanitary Authority.
Cleanliness of clothing and of the body, cleanliness and
skill in cooking and in domestic arrangements and personal
hygiene generally are matters for individual effort and control,
and improvements under this head must largely depend upon
a higher standard of living, wider diffusion of knowledge, and a
better training.
In October last I briefly reported to the District Com-
mittee on the principal villages in the County and called
attention to their insanitary condition. Last year the village of
Castletown was very fully and ably reported upon by my
predecessor Dr Brock, when he pointed out the necessity for
certain sanitary reforms which I entirely endorse. The water
supply of the villages is obtained mostly from surface wells. It
is unsufficient in quantity especially during the dry months of
the year and is generally liable to pollution. There is no proper
drainage, no closet accommodation, and no properly constructed
ashpits. The want of water is much felt at Lybster, Latheron-
wheel, and Scrabster, which are fishing stations, and where there
is a large accession to the population for two or three months of
the year. At Scrabster I am informed, by Fishcurers, Fisher-
men and others, that the scarcity amounted almost to a water |
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famine on more than one occasion. I have also brought under
the notice of the Local Authority the insanitary state of the
small villages at Brubster and Spittal roadside. I have also
reported to the Watten School Board on the School premises
at Gersa, to the Reverend Mr Macpherson as to the condition
of the Church of Canisbay, and on complaint by the Reverend
Mr Falconer as to the Church at Dunnet. I also sent a note to
the tenant at Drumhead, Bower, as to the improvement of
premises there.
Zymotlc Diseases.
An epidemic of hooping-cough was very general over the
greater part of the County during the summer and autumn
months, but gradually declined towards the end of the year when
it almost ceased. It was very prevalent in the Olrig and Dunnet
districts, and the Durran School had to be closed owing to its
severity. Several sporadic cases of Scarlet Fever occurred in
different districts. At Castletown however in the month of
October it threatened to assume an epidemic form. The usual
measures as to isolation and disinfection were employed, and
instructions were given to the Clerk of the School Board to take
precautions for the protection of the School. The arrangements
were ably supervised by Dr Durran, and the disease did not
spread to any extent.
There were cases of Typhoid Fever in a house at West
Dunnet, and one death occurred. The infection was traced to
the hill of Stemster where Typhoid had been prevalent about
two years ago, and where one of the sons was engaged as a herd-
boy and had gone home labouring under the disease. Disinfec-
tion of the discharges, strict cleanliness, and isolation were
enjoined and the disease did not spread beyond the family.
There was also one case of Typhoid at Gersa School House, the
source of which could not be traced with certainty. I ascertained
that there were likewise one case at Castletown village, one case
at the farm of Murza, and two at Bruan.
About the middle of November influenza made its
appearance in the east district and here and there throughout
the County, it spread rapidly and during the latter half of
December the epidemic had become universal, but although the
cases were very numerous they were usually mild.
I was also informed that sporadic cases of Erysipelas had
occurred in different quarters, but the exact prevalence of
infectious diseases throughout the County cannot be accurately
ascertained nor their prevention supervised unless the Notification
Act be adopted.
I regret that I am unable in the meantime to forward the
Statistical Returns owing to the fact that several of the Registrars
have not yet sent me the necessary information.
I am,
MY LORDS AND GENTLEMEN,
Your obedient Servant,
JOHN ALEXANDER, M.D., D.P.D.,
Medical Officer of Health.
TOWN AND COUNTY HALL,
WICK, 30th Jan., 1892.
*TABLE OF BIRTHS AND MORTALITY FOR 1891.
The County contains about 448,000 acres; Population (exclusive of the Parliamentary Burgh of
Wick and the Police Burgh of Thurso) in 1881 - 27,720; Population in 1891 - 24,638.
[table inserted]
*Since writing the foregoing Report I have been favoured with Returns from all the Registrars
and have appended this table made up so far as the data would permit. |
