HH62/1/DUMFRI/27

Transcription

[Page] 26

November, but found that the epidemic did not reach its height
till about four or six weeks after. He noted one interesting point,
that in the epidemic of 1889-90 the malady seemed to commence
in the town of Annan and radiate outward into the country in all
directions, whereas in this epidemic it seemed to be rife in the
country districts around before it was prevalent in the town itself.
Dr Carruthers saw cases in Rigg of Gretna in the third week of
November, but did not find the disease epidemic till about the
second week in December. In the Dumfries District cases were
seen in the vicinity of the Burgh towards the end of October, but
the malady does not appear to have become prevalent in Torthor-
wald, Mouswald, and Caerlaverock till the 15th November. In
Thornhill District the more northerly parishes appear to have
suffered most severely so far as my information goes. Dr Wilson
was called to the first cases in Leadhills about a month before.
Dr Macgregor, Sanquhar, believes that the first cases there
occurred at Crawick, and that they were the result of infection.
He made an observation of some importance in enabling one to fix
an incubation period. A man belonging to Crawick took ill in
Glasgow on Nov. 12th. He was brought home on the 15th, pre-
vious to which there had been no cases in the neighbourhood. On
the 20th two members of his family took influenza, and on the
following day two others. From the Langholm District Dr
Sturrock, Eskdalemuir, has favoured me with notes of a case in
which the incubation period would appear to have been prolonged
as much as eight days. In this instance workmen had gone from
Tundergarth to Aberlosk, Eskdalemuir, on Nov. 2. There were
no cases in the neighbourhood at that date nor until the 11th of
the month when it broke out at Aberlosk, and afterwards spread
rapidly over the parish. The majority of the practitioners who
have favoured me with this information agree in regarding the incuba-
tion period as shorter than these observations of Drs Macgregor
and Sturrock would seem to make it, 24 to 48 hours being the time
given by most of them; but Dr Carruthers not only gives five days
as the usual period, but states that he has seen in a considerable
number of cases in the same house a period of two weeks elapse
before the second case occurred. All, with one exception, agree in
regarding the malady as infectious. The evidence accumulated
elsewhere, particularly by Dr Parsons (Local Government Board
Report), has not only swept away a number of false conceptions

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regarding it, but show that this view of its infectiousness is the
only one that can now be held. The high death-rates that have
been recorded during its prevalence justify the resolution recently
passed by the English Medical Officers of Health Society, that "it
is a dangerous infectious disease." With all this it must be admitted
that our knowledge is as yet too limited to entitle Medical Officers
to advise their Authorities to take those repressive measures which
have been urged in some quarters. These measures are no doubt
successful when thoroughly carried out against diseases with
whose natural history and mode of propagation we are better
acquainted, but, as Dr Buchanan has pointed out in his introduction
to Dr Parsons' Report, they "cannot well be applied to persons
suspected of Influenza among the bread-winners of a community,
and the singular ability possessed by Influenza to disperse itself
over a population, owing to its brief incubation period, must add to
the difficulties of dealing with an infection that finds the bulk of
the population susceptible to its attack. Having, as would seem,
something like a third part of the incubation time proper to small-
pox, measles, or typhus, Influenza has correspondingly rapid ability
to reproduce itself, can, that is, give rise to some thousand attacks
in the time that small-pox and typhus had taken to produce ten,
each of the thousand cases being ready to infect other susceptible
people, and the difficulty of applying principles of isolation and
disinfection being in like manner enormously enhanced." The
discovery in the blood and purulent bronchial secretion of a micro-
organism which, it seems probable, is the exciting cause, raises our
hopes that our knowledge may be further extended; that we shall
know, for example, whether one attack affords protection against a
second, or, like malaria, renders the individual more susceptible,
whether the disease known as equine influenza, which has been
observed to occur in a somewhat epidemic form about the same
time as the human malady, is or is not the same, and whether any
or what measures are likely to be successful in preventing it
assuming the epidemic or pandemic form with which we have
become so familiar. Before leaving this matter it may be well to
note the severity of the recent epidemic as contrasted with that of
two years ago. In 1889 there were no deaths in the six Districts
registered as due to influenza, in 1890 there were 11, and in 1891
there were 41, seven of which occurred before the last quarter of
the year.