[Page] 12

found. M. Dauzon also found seven cases out of
72,623; four of the seven were of French breed. It is
questionable if animals in a state of nature ever suffer
from Tuberculosis. Only when they become domesti-
cated do they exhibit it to any extent; the greater the
confinement the greater will the increase be apparent.
An earlier and more easily recognisable symptom than
we already possess must be discovered, and systematically
sought for amongst the increasing number of stall-fed
animals, if their flesh and milk is to be kept free from
tubercular poison.

Sources of Infection.
As the great sources of infection are from the
expectoration and discharges of people suffering from
consumption, and from the milk and flesh of cattle, it
can only be a question of time before Tuberculosis will
be included under the Notification of Infectious Diseases
Act. Already in Germany, strict regulations are en-
forced in regard to patients so affected, and the medical
profession in America and in this country are moving in
the same direction, on account of its great increase
among the bovine race.

The Hospital accommodation for infectious diseases
is at present engaging the attention of the District
Committees. Beyond a share in the Burgh Hospital
possessed by the Parish of Dunbar, no isolation is
possible in the Eastern District. In the Western
District, small houses have been rented in Tranent and
Prestonpans. The erection of a suitable Hospital in
that neighbourhood is to be recommended, and com-
bination Hospitals at Haddington, Dunbar, and North
Berwick might possibly be arranged with these Burghs.
Combination is more likely to result in advantage
being taken of such institutions, as they will un-
doubtedly be more efficiently managed and made more
comfortable and attractive by being oftener used. The
prevailing sentiment against them will, as in other
places, disappear when it is seen that owing to superior
nursing the mortality is less and the risk to other
members of the family is entirely prevented.

[Page] 13

Where Hospitals are erected, I would recommend
that the nursing should be done by nurses in constant
employment, and that the services of nurses in Edin-
burgh or Glasgow should be retained at a small annual
fee, who would be obliged to come or provide efficient
substitutes whenever required.

Disinfecting Chambers.
What perhaps is still more urgently required, is the
erection of suitable disinfecting chambers at Dunbar,
Haddington, North Berwick, and Tranent or Preston-
pans. Here, again, combination is to be recommended,
provided that the site chosen is outside the Burgh
Boundaries, and close to the Hospitals, if possible.
Articles of clothing and bedding can be brought in
special iron boxes from the Burgh or surrounding
County. The official in charge would be likely to
manage this most important duty more efficiently by
having frequent practice in the working of the disin-
fecting apparatus. A suitable vehicle will also be
required at each centre.
Several outbreaks of infectious diseases have been
noted during the year, but, with the exception of
influenza, none have become epidemic.

First in importance is Influenza, which unduly raised
the mortality over previous years. It, however, never
became so general as in some other counties. In May
and June, and again in November and December, it was
somewhat prevalent, especially in the latter months.
In view of its dangerous and insidious mode of attack,
it is essentially a disease requiring, on its re-appearance,
the immediate attention of the Local Authority. Disin-
fection and isolation should be carried out, and leaflets
distributed showing the necessity for its careful treat-
ment and the danger of neglecting even mild attacks.
Dr Ronaldson informs me, as an interesting fact,
that the Asylum Officials suffered in a larger proportion
than the patients. It is amongst these latter, with broken-
down or weakened nervous systems, that it seems to
exert its most hurtful influences. Pneumonia (Lung
Inflammation) was the most frequent complication in
fatal cases.

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CorrieBuidhe- Moderator, Douglas Montgomery