HH62/1/DUMFRI/41

Transcription

[Page] 40

Zymotic Mortality. - The total zymotic mortality for the
year comes out somewhat better than in the ten preceding years,
with the exception of 1890, when it was 1·288. Moffat, Annan,
and Thornhill each show rates below, while Dumfries, Lockerbie,
and Langholm are above the total. In Langholm the rate is more
than double of what it is in any one of the other Districts. This
is explained by a high mortality from whooping-cough in the
parish of Canonbie.
There was no death registered nor case reported during the
year of either Small-pox or Typhus. The former has not, so far
as my information goes, appeared in any of the Districts since 1881,
when the death of a child in Brydekirk was registered as due to
it. Seventeen deaths from the same cause occurred in that year
in Scotland. Two deaths from Typhus have occurred during the
past ten years - one in 1887 and one in 1889. The Diarrhœa
mortality rate is below the average, but with the exception of
whooping-cough it is the highest of the zymotics. The disease is
most prevalent during the summer months, depends, as I have said,
largely on unhealthy surroundings, and affects more particularly
infants and young children. Of the other zymotics I have already
reported at some length.

The diseases included under the term Septic are those placed
in this classification by the Registrar-General. They are erysipelas,
puerperal fever, and pyaemia. Of these the two former are notifi-
able under the Infectious Diseases Notification Act. They depend
for their cause on the introduction into the system of micro-
organisms which thrive best in dirt and filth, and are therefore to
be considered as preventable diseases. They caused six deaths,
and the rate was 0·129, which is less than the average of the pre-
ceding ten years.

The discovery of the tubercle bacillus by Koch in 1883
confirmed the view that tubercular diseases are due to
preventable causes. Before this date, however, there was
ample evidence that both phthisis and the other tubercular diseases
might be prevented in several different ways. Thus, in the Report
of the Army Sanitary Commission, published in 1858, it was very
fully demonstrated that the excessive mortality from consumption
in the army was largely due to overcrowding and insufficient
ventilation. The recommendation of the Commissioners that in

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barracks where the disease had been found to be prevalent the
amount of cubic space given to each soldier should be increased
having been adopted, the phthisical mortality in the army began to
diminish. In addition to impure and vitiated air, dampness of soil
has a very important influence in the production of these diseases.
In towns where subsoil drainage has been carried out the phthisis
mortality has been reduced, and the very exhaustive investigations
made by Sir George Buchanan in 1865-6 conclusively prove
that wetness of soil is a cause of phthisis to those who live upon
it. Another cause, and one that probably affects young children
more than adults, is the ingestion of milk from tuberculous cows, as
well perhaps as the use of tuberculous flesh for food. It may be
that the latter danger has been exaggerated, but that tuberculous
milk may reproduce tubercle has been experimentally proved, and
the prevalence of tubercular diseases in young children along with
the use of milk as a large part of their diet is a point to be borne
in mind. These causes indicate the need for improved house
and byre accommodation and subsoil drainage in localities where
tuberculosis is prevalent, if any improvement is to be expected in
the mortality rates. Isolation of patients suffering from the disease
has been demanded by some, and within certain limits this might
be carried out. The difficulties in the way of complete isolation
are, however, too many and great, and more benefit would be
gained by attention to such hygienic precautions as I have
indicated. The number of deaths due to phthisis during the past
year was 61, and to other forms of tubercular disease 26. The
phthisical death-rate was 1·310, and therefore considerably below
the average. It was highest in Thornhill District and lowest in
Moffat.

In regard to other diseases, it may be noted that Cancerous
affections show a mortality slightly below the average for the past
ten years, but above that of Scotland for the same period, which is
0·58. It has shown a tendency to increase towards the end of the
decade. The highest rates are obtained in the Thornhill and
Lockerbie Districts, but the highest mean of the past ten years is
that for Dumfries, 0·874, and the lowest that for Lockerbie, 0·710.
The highest rate among the parishes occurred in Glencairn, and
was 3·035.

Deaths from Respiratory affections are above the average in
certain of the Districts, the increase being probably explained by