HH62/1/DUNBAR/51

Transcription

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mated the Vale, and spread far beyond it, was prevented. But the
expense was not a trifle. The total cost to the District was about
£350. This included hospital charges, medical fees, disinfecting,
upkeep of quarantined persons, renewal of destroyed bedding and
clothing, and a variety of other payments. in addition there was
one life lost - that of a man about 50 years of age, with a wife and
family depending on him.
The lesson of the outbreak is the necessity for strict sanitary
supervision of such places as Renton. With nearly all the popu-
lation employed in the great dyeworks, with lodgers kept in very
many of the families, and with consequent overcrowding of houses
many of which are of an inferior class to begin with, it would not
be easy to find a more favourable field than Renton for the spread
of typhus.
Typhus is a disease that for the last score of years has been
almost extinct in Britain, and sanitarians have tended to the opinion
that it had died out for ever. But of recent date it has begun to
reassert itself here and there throughout the country. In the
West of Scotland it has shown itself, among other places, in
Glasgow, Greenock, Ayr and Mull. Three years ago it was at
Inverness, and lately it visited Dundee and Aberdeen. In such cir-
cumstances it behoves all communities like those situated on the
banks of the Leven to carry out the sanitary measures which
have been proved by experience to have the greatest control over
the malady. It is a disease of overcrowding and dirt, and its pre-
ventives are fresh air and cleanliness.
Almost at the close of the year, typhus reappeared in the Vale
of Leven. On Christmas morning Mr. Dunbar and I were sum-
moned to celebrate the day by tracing out the disease in the slums
of Alexandria. It had begun in a tramps' lodging-house, kept
by people named Kyle, and had killed both of the keepers,
so that no information could be got as to the part of the country
from which it had been carried. The poison had, however,
found a congenial home, and was beginning to thrive in it.
There had been four days between the deaths of the wife and
husband in the lodging-house, and a variety of people had been
exposed, either through neighbours' visits or through attending
the funerals. On the day of my visit there were three existing
cases of the fever. Each of these had been a lodger with the

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Kyles. From them the disease had branched out in the usual
way, and it ultimately attacked eleven persons in all. These were
at once removed to hospital, and steps were taken similar to those
already detailed. Though the cases were fewer than at Renton,
the outbreak caused no less than three deaths. I may be allowed
to call attention to one interesting fact connected with it. Among
the persons who had been exposed to infection was a relative of
the Kyles from Glasgow, who had stayed in the lodging-house, and
aided in the nursing, while the disease had not yet been recognised
as typhus. After the funeral she went home, probably unaware of
the character of the illness to which she had been attending. I suc-
ceeded in learning her address, and sent it on to Dr. Russell with
a note of the facts. In a few days I had a reply that the woman,
who had been put under observation, had developed typhus, and
had been removed to Belvidere. So that perhaps a Glasgow
epidemic was also strangled in the birth.
Scarlatina in "Empress" Training Ship. - In September
and October a slight outbreak of scarlatina occurred among the
boys on board the training ship "Empress" in the Gareloch.
Accompanied by Dr. Douglas Reid, the medical officer, I inspected
the ship, and learned that all necessary steps had been taken or
were in process of being taken, to check the spread of the disease.
The first case was that of a new boy who had come from Glasgow
on September 10th. Fever developed on the 16th, and he was
sent to Helensburgh hospital on the following day. Six more
cases were sent to the same hospital, but as these nearly filled it,
other measures had then to be resorted to. The brig belonging
to the ship, and used in summer for educating the boys in
seamanship, was turned into a temporary hospital, a nurse was
obtained, and it was arranged to remove cases as they occurred.
No better isolation could have been conceived, and the outbreak
was promptly brought to a conclusion. Only two cases had to be
removed to the brig. The necessary fumigation and other disin-
fection processes were energetically carried out under the super-
vision of Captain Deverill and Dr. Reid. In all, there were nine
cases, and the whole of them made a good recovery.
At Clynder in December a case of scarlatina occurred in a house
of three apartments, among whose inmates were several children
who had not had the disease. The case was the only one in the