HH62/1/DUMFRI/47

Transcription

[Page] 46

The third requirement, Disinfection, to some extent depends
on the second, as a proper disinfection chamber to which articles
of clothing may be taken usually exists alongside every well-
equipped Hospital. Since the appointment of Mr Osselton and
myself we have to the best of our ability given assistance in any
case where we were asked to disinfect, and have provided dis-
infectants wherever we have seen the necessity of doing so.
Single-handed it has not been possible to do much in this way,
but in the event of sufficient assistance being provided by the
Public Health Committee or County Council, it will be part of the
duty of the assistants to carry out disinfection under our orders,
when we trust it will be more efficiently done.
The most important requirement for the prevention of the
spread of Infectious Disease is that we are now about to consider,
viz., Isolation Hospitals. There is no question of the power of
Authorities to provide such. Under Section 35 of the Public
Health Act, 1867, they may be required to do everything that may
be advisable for mitigating epidemic, endemic, or contagious
diseases. Section 39 gives power to provide hospital accommoda-
tion, which may be done by erecting buildings of a permanent or
temporary nature, or by arranging for the use of existing hospitals,
or by purchasing or renting a house or other building and adapting
it for the purpose. Such accommodation must, however, be within
the district of the Authority, or, in the event of a combination,
within the district of one of the Authorities so combining. Disin-
fection may either be done by an Authority at its own expense,
or an owner or occupier may be called upon to disinfect his
premises, under Section 40, which also declares it to be lawful for
an Authority to provide and maintain a carriage or carriages for
the conveyance to hospital of individuals suffering from infectious
disorders. Powers may be taken under Section 42 for the compul-
sory removal of individuals whose surroundings my not enable
their treatment to be carried out in their own homes or lodgings
without risk of spreading the disease. Further, under the 2nd
Section of the Public Health Amendment Act of 1871, Authorities
may borrow on the security of the assessments for the purpose of
building or otherwise providing permanent hospitals.
There is little doubt that if suitable provision is made during
what may be called a non-epidemic period it gives Sanitary
Authorities an opportunity for coping with disease that may be of
the utmost value. Where, however, Authorities have not taken

[Page] 47

advantage of such periods, but have run up hospitals under the
influence of panic caused by the rapid spread of an epidemic, these
have generally failed in their object. If evidence of this is desired
it can be had to repletion in a volume on the Use and Influence of
Hospitals for Infectious Diseases issued by the Local Government
Board in 1802. In it Dr Thorne Thorne, writing of hospitals
hastily erected while smallpox or fever was making head in the
district says - "It is often not ready for occupation until the im-
"mediate cause of its erection has passed by, it provides accommo-
"dation of a very indifferent sort, it fails almost without exception
"to meet the permanent requirements of the district, even
"when in amount it turns out to be more than the district
"needs, and thus the object of the hospital as a part of the
"sanitary defences of the district is often attained in a very
"imperfect manner and at a needlessly large cost." This opinion
was arrived at after an inspection by Dr Thorne of a large number
of hospitals in various parts of England.
If any argument from the local circumstances of our County
in favour of making such provision as early as possible is wanted,
it will be found, I think, in the dairy trade, one of the most
important industries in Dumfriesshire. Milk is sent from within
our area to many of the large towns in Scotland and the North of
England. It is the duty of our Authorities to see that the milk
leaves us pure and uncontaminated. The necessity of this is
apparent when we consider that milk is a fluid which has been
proved over and over again to have carried contagion and spread
disease. As matters are at present, should fever break out in any
of our dairy farms there is little chance of securing that isolation
which is necessary to prevent contamination of the milk, and it will
then be our duty to stop its sale, thus entailing upon the dairyman
a loss which at times cannot fail to be very heavy, and one which
in all fairness he should not be expected to bear entirely himself.
Indeed, it is a question whether he might not have a fair claim
against the Authority for compensation for damage sustained.
The existence of an isolation hospital would at anyrate relieve the
Authority of any moral responsibility, even if it be held that they
have no legal responsibility.
What is true of milk is true in a minor degree of other articles
of food. It was only the other day that Mr Ossleton and myself
were compelled to order a butcher to cease selling meat while his
children suffered from scarlet fever. The shop in this instance