[Page] 10

"school. The girl M. was employed as a telegraph
"messenger at the village Post Office, but I warned the
"mother not to allow her to carry any more telegrams
"until the house was clear of infection. I saw the doctor
"who was attending, and he said he would cause pre-
"cautions to be taken against the spread of the disease,
"and have the house thoroughly disinfected."

No other cases have occurred, either in the family or
in the village, and the family are removing from such
an insanitary house.

The boy first attacked was in a position to infect
others for four days before the visit of the Sanitary
Inspector, and the sister who delivered the telegraphic
messages in the village and neighbourhood still slept
in the same bed with him, along with two other sisters.

Enteric Fever.
On communicating with many doctors who have
practised in the Eastern District during the past
twenty years and under, I find that Enteric - one of the
drain fevers - has been almost unknown; and that the
Burghs of Dunbar and North Berwick seem never to
have any epidemic disease of any kind. Imported cases
have had no tendency to spread, even when little was
done in the way of prevention. In the Western Dis-
trict, occasional cases of Enteric (Typhoid) Fever occur
from time to time, and the question of hospital
accommodation is more urgent there.

Tuberculosis must now be included under the head-
ing of Infectious Diseases. Towards its mitigation and
expulsion from the County, all the energies of the
Sanitary Department must be directed at no distant
date. A disease that is on the increase, attacking men
and cattle alike, and one that causes nearly one-third of
the infant mortality, and the death of every fifth person in
the Country, cannot be allowed to remain unchecked. It
is a preventable disease, and will prove as amenable to
the influence of Sanitation and Hygiene as the highly
infectious and formerly dreaded Typhus, which has
become almost unknown in Edinburgh during the last
25 years.
For the present, an increase of cubic space to each

[Page] 11

person in living and sleeping rooms where that is in-
sufficient, lowering the height of the sub-soil water by
proper sewerage, dry foundations, free ventilation, care-
ful meat inspection, and a pure water and milk supply,
embraces all that can be done for its prevention. It was
found that co-incident with the increase of cubic space in
army barracks, consumption (Tuberculosis of the lung)
became markedly less. The town of Leicester, previous
to the carrying out of sewerage works for the lowering of
the sub-soil water, had a mortality from consumption
amounting to 43 1/3 per 10,000 living; during the six
subsequent years the rate fell to 25 1/6.

Nothing is more certain than that Tuberculosis is
curable, but that is only possible under good hygienic
conditions. It has been found that from 23 to 38 per
cent. of people dying in advanced life have been found
by post-mortem examination to have suffered from
Tuberculosis, usually of the lungs (consumption).
"They had recovered so completely that they had lived
"in many cases to advanced life, and had died of some
"other disease. The vigour of their tissues had been
"sufficient to prevent the infection getting a hold of their
"system, and the microbe had died out (Coats)." That
vigour of the tissues may be diminished by unhealthy
surroundings and still more by the tendency to Tuber-
culosis inherited from parents. Inherent tendency alone
appears incapable of originating the disease, but external
deteriorating agencies can. The combination of these
factors is very deleterious, but any debilitated state of
body, no matter how induced, is as equally influential
- probably more so - as inherited tendency. As
probably every second person becomes infected by some
form of the disease, the necessity for vigorously carrying
out sanitary reform must be recognised by everyone.

If stringent measures are carried out for some time,
there is no reason why Tuberculosis should not be as
rare as in Algeria, where M. Bouzom, who inspected
the Abattoirs of Algeria-Mustapha for the purpose,
found that, out of a total of over 165,000 cattle of all
ages, only a few cases of pulmonary Tuberculosis were

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