HH62/1/DUNBAR/61

Transcription

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Puerperal Fever. - Only two cases were intimated - one at
Milton in West Kilpatrick, and the other at Knightswood Rows.
Removals to Hospital. - The total number removed to
hospital has been sixteen. Of scarlet fever there were eight cases;
of enteric fever, seven; and of diphtheria, one. From Cumbernauld
parish four were sent; from Kirkintilloch, two; from East
Kilpatrick, six; and from West Kilpatrick, three. Three died in
hospital - one from enteric fever and two from scarlet fever.
In looking back on the notifications received, and on the use
which has been made, in the public interest, of the information so
acquired, two considerations impress themselves on me. The first
obviously is the need of convenient hospital accommodation. The
second is that in future, with an increased staff of Inspectors, it
will be possible to follow up systematically the facts incidentally
brought to light regarding defects of structure, overcrowding,
and various nuisances existing in connection with the infected
houses. To a certain extent this has been done already, but the
multifarious questions requiring attention in the organisation of the
county public health work have prevented, in some instances, the
completion of proceedings that had been begun with reference to
the removal of ascertained nuisances.
Measles. - Measles is not in the list of diseases notifiable
under the Act, though Local Authorities have power to add
it if they so determine. On October 11th my attention was
called to an outbreak at Smithston. The disease had been
prevalent for some time previously in Kilsyth burgh and the
surrounding district, and a number of children from Smithston
attended the R.C. school in Kilsyth. Indeed the school
attendance was divided betweed this school and the Drumglass
school, the latter being under the Cumbernauld School Board. A
house to house visitation in Smithston disclosed eighteen cases of
measles. The disease also prevailed in Auchinstarry Rows, where
nearly all the children attend Drumglass school. I communi-
cated with the teachers of both schools, but had no reply from
Kilsyth. The Cumbernauld Board, however, at once agreed to
close their school, and it remained shut from 20th October till
7th December. On re-opening, measles again began to spread,
and the school had to be again closed on 21st December. It was
finally re-opened on 11th January. As I pointed out at the time,

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joint action between the several school boards is the only way to
stamp out such an epidemic, and I have little doubt that if the
same closure had been carried out in Kilsyth, as at Drumglass,
the disease would not have recurred.

VITAL STATISTICS.

In a first report it seems desirable to put on record, as standards
of comparison for future years, some facts going further back than
1891. And in regard to all the figures about to be submitted, it
will be needful to bear in mind what has already been said as to
the influence of age, sex, &c., on the rates of mortality. It is also
essential to bear in mind that in the various comparisons which
follow between Dunbartonshire and Scotland, the latter, especially
in its small towns and rural districts, does not yield a standard of
mortality which ought to satisfy Dunbartonshire. The Lord
Advocate, in introducing the Local Government Bill of 1889, said
that the Public Health Acts had been practically a dead letter in
the country districts. Clearly, therefore, while the death-rates
consequent on this sanitary inactivity may form a convenient
measure by which to gauge the health of the county, the con-
ditions which produce these rates are merely the starting point
and not the goal of the new administration.
Birth-rate. - The birth-rate, as has already been indicated, has
a certain bearing on the death-rate. Children under one year have
the highest mortality of all, and children from one to five have the
next highest. Of course, if a population is not migratory, the births
come to add to the healthiest as well as to the unhealthiest ages
of life, but in rural districts, where youths of both sexes tend city-
wards, a high birth-rate has as its immediate effect the raising of
the death-rate. Too much weight, however, is apt to be attached
to this factor.
The following are the rates for the decade 1880-89:-