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FIFESHIRE COUNTY COUNCIL
AND
DISTRICT COMMITTEES.
MY LORD AND GENTLEMEN, - I have the honour to submit for
your consideration my first Annual Reports as Medical Officer of Health
to the County and to Districts into which it is divided. As my
appointment dates from May, it will be understood that the various
reports refer only to matters which I have had to consider since then.
In the compilation of these reports various difficulties have been
experienced, due in part to the short space of time I have been in
office, and to very many matters which had to be arranged at the
commencement of an entirely new department, and a new system of
sanitary administration.
The year with which this Report deals being the census year, it was
necessary to get the populations in the various parishes before the
Registrars' returns were sent in to the central office, and this caused a
considerable amount of correspondence. As there are so many burghs
in the County, there was considerable difficulty in getting the rural
separated from the urban populations.
The arrangement of this Report may not be followed in subsequent
reports, but a better did not suggest itself than to write the District
Reports, and then to write a County Report, which would be a com-
mentary on these, and also deal with certain matters which fall to be
reported to the Council rather than to the District Committees. This
arrangement is not strictly in accordance with the Board of Super-
vision's Regulations, which order that District Reports are to ready by
the 31st January, succeeding the year with which the reports deal, and
the County Report on or before 31st March. The advantages of having
all the district reports printed and bound together along with the
county report determined the present arrangement. I may point out
that too short time is allowed for the preparation of district reports, as
the statistical information which they should contain cannot be available
till the last day of the year to which it refers, and in fact is not sent in
for some days after, leaving little time for arrangement, tabulation, and
printing, before the end of the month.
The County Council and District Committees all agreed, I am
pleased to state, to have these annual reports printed, as otherwise they
might almost as well never have been written at all. It appears to me
that it is necessary in the highest degree, that every person in the County,
assessed for public health purposes, should know, as far as possible, the |
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[page] 2
objects and aims of the Public Health Department, and what benefits
have accrued from this during the past year, and what may be expected
in future years.
PRELIMINARY REMARKS
The County for administrative purposes is divided into the Districts
of Dunfermline, Kirkcaldy, Cupar, and St Andrews, and these again
are subdivided into their respective parishes; but for health purposes
the district is the unit to be dealt with, not the parish; and is is well that
this idea should, especially for sanitary administration, be kept steadily
in view. The County forms a peninsula, bounded on the east by the
North Sea, on the north by the Firth of Tay, on the South by the Firth
of Forth, on the west and north-west by the counties of Clackmannan
and Kinross. The northern boundaries of Auchtermuchty, Strath-
miglo, and Newburgh, touch Perthshire. From the most easterly point.
- Fife Ness - to the most westerly point, the distance is about 46 1/2
miles. The greatest breadth is about 23 miles, and the average is
about 18 miles. With the inclusion of the parishes of Culross and
Tulliallan the County contains, as far as I can make out, not having
the figures from the changes of the Boundaries Commission, 322,195
acres, equal to 503.4 square miles, and a total population of 190,185
by the last census.
At the census of 1881 the population was 172,131.
In order to show those figures more clearly, and the bearing they
have on this Report, they are abridged in tabular form:-
[table inserted]
In a furture Report these figures may have to be altered, owing to
changes in the boundaries of parishes, but they are correct, as far as I
know, in relation to the population, the census returns being founded
on the old areas.
From the above table, it is seen that Kirkcaldy District has the
largest population, and hence the smallest proportion of acre to person.
Next in order is Dunfermline, next St Andrews, and last Cupar.
The arrangement of greatest population and greatest number of
persons to acre is in the following order:
[table inserted]
The connection of these figures to the present Report will be
[page] 3
referred to when dealing with the sanitary administration in the various
districts, and with the death-rate of the County and Districts.
CHANGES IN THE POPULATION.
As this Report falls to be made in a census year, it behoves that
some reference be made to this subject: not only from the general
interest attached to the enumeration of the population, but especially
as, to obtain correct vital statistics, it is necessary to have the correct
numbers of the population of the various Districts and County. The
subject of vital statistics having been a matter which I have had fre-
quently to bring before the notice of the County Council, I shall in the
section devoted to that subject deal with it specially. The first census
taken in this country was in the year 1801, and then decennially, the
last being the tenth.
The populations given at the various census reports are as
follows:-
[table inserted]
(*Including Culross and Tulliallan.)
In the following tables certain details are given, showing the
growth of the population from census periods, the relative
numbers of males and females, and increase from previous census periods.
COUNTY OF FIFE CENSUS RETURNS.
TABLE SHOWING GROWTH OF MALE AND FEMALE POPULATION.
(1.)
[table inserted]
(2.)
TOTAL POPULATION.
[table inserted]
(3.)
INCREASE FROM PREVIOUS CENSUS.
[table inserted] |
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(4.)
1891.
[table inserted]
(5.)
DISTRIBUTION OF POPULATION IN SCOTLAND.
[table inserted]
Table I. needs no comment, except that, as in almost every
place, the female is in excess of the male population.
Table II. requires this note, that the population given for the
census 1891 does not include that of Culross and Tulliallan.
In Table III., it will be seen that the census 1891 shows the
greatest increase of all, and the census 1861 the smallest.
In Table IV. are given certain important figures bearing on the
sanitary condition of the population.
In Fifeshire there are fewer persons to the room with one window
than for all Scotland or Clackmannan. There are fewer persons per
family, and the population has increased 9 per cent., while for all Scot-
land it has only increased 7.96. Sixteen counties show a decrease.
Table V. is introduced for a special reason, viz., to show that there
is a tendency all over the country for the population to leave rural dis-
tricts and migrate to large towns. The connection between these
figures and this report will be seen in the vital statistics of the District
Reports for Cupar and St Andrews.
The last Tables I shall introduce into the preliminary part of this
report are to show in (No. 1) the increase or decrease of the populations
of Fife and the contiguous counties of Kinross and Clackmannan.
(No.2) In this are shown the families, houses and rooms, and persons
per room in the same counties.
RATES OF INCREASE OF POPULATION IN FIFE, KINROSS, AND
CLACKMANNAN from 1831 to 1891.
INCREASE OR DECREASE PER CENT.
[table inserted]
[page 5]
TABLE SHOWING FAMILIES, HOUSES, ROOMS IN FIFE, KINROSS,
AND CLACKMANNAN - 1891.
[table inserted)
GENERAL SANITARY STATE OF COUNTY.
In a county of the extent of Fife - with 62 parishes, and contain-
ing 322,195 acres - it is by no means an easy matter to give even a
condensed summary of the main sanitary features of each parish.
Another difficulty occurs in a County Report as regards the relation-
ship of the County Medical Officer to Police Burghs: Is the County
Medical Officer expected or entitled to report on the Sanitary Condition
of Police Burghs to the County Council? The opinion of Lord-Advo-
cate Robertson was, that the County Medical Officer is appointed to
take a general supervision af the sanitary condition of the whole county,
including both urban and rural districts. In the absence of a more
specific definition of my relationship to Burghs, I shall not make any
reference in this Report to any Burgh; and I may point out at the same
time that the demands on my time in attending to matters peculiar to
my office have left me no time for other work.
In this section of my Report I shall deal very generally with certain
specific matters, but fuller references to these, however, will be found in
the various District Reports.
WATER SUPPLY.
In every District in Fifeshire this all-important question of water
supply has been before the Local Authority, time after time; and while
not desiring to enter into full particulars of the subject, as it affects
individual Districts, still some of the circumstances in these are of
interest to the whole County. The first report made by me as to water
supply was to Dunfermline District Committee, and in this report I
referred to the water supply of all the villages in the District. In some
of the villages water is supplied by gravitation, both of excellent quality
and quantity, but in many others the supply is from shallow wells in
close proximity to houses, and hence liable to danger of serious pollution.
In the case of the village of Torryburn, my remarks were disputed - that
the wells there were dangerous sources of water supply, being quite close
to houses and close to ashpits and pig-styes; and the inhabitants, by
their members of committee, represented this to the District Committee,
who then authorised me to get the wells analysed and shut up if they
were found bad. Two samples taken were declared unfit for use, and
the wells were shut up; but the matter did not end here, and two more
samples were analysed. The analyst's report of these waters was that
one was quite unfit for domestic use and should be discontinued, and
that the other, although not so impure, was not a high class water, and |
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contained suspicious ingredients, pointing to the near proximity of
dangerous pollutions, which should be removed before the water could
be considered safe for domestic use.
I refer specially to this case to show that if we follow the Public
Health Act, and shut up wells, a Local Authority seems to have no
direct power to deal with an insanitary condition produced by an
impure water supply. Certainly Local Authority might proceed
under Section 89, Sub-Section 1; but, as the expense falls to be paid out
of the general assessment, this method is rarely adopted. Of course,
the best method for a case like this is the formation of a Special Water
District, and it appears that it would be quite competent for any ten
inhabitants, of the District of the Local Authority, to present the usual
requisition. This appears to me to be a procedure which should be
adopted in this and other cases.
There is another difficulty in connection with the water supply, which
presented itself in the case of Crossgates. Here the water is supplied
by gravitation, and is both of a very indifferent quality and of insuf-
ficient quantity. During the drought of this last summer the supply
was within 2 days of being exhausted, when the rain came and removed
the grave danger of a water famine in Crossgates. The assessment for
water alone has reached the maximum in this Special Water District, and
the difficulty arises from the fact, as no more money can be spent either
on water supply or in improving the deplorable insanitary condition of
Crossgates from want of drainage.
To meet this difficulty, by diminishing the water assessment, so as
to leave a surplus, either for improving the water supply or constructing
sewers, it was resolved to adopt the Act of 1891, an Act to amend the
Public Health (Scotland) Acts. The main provisions of this Act are
of general importance, and I therefore quote them:-
(1) It shall be lawful for the County Council, and they are hereby authorised
and required, once in every year, to impose and levy an assessment (to be called
the Domestic Water Rate) upon all lands and heritages within the district,
which shall have been supplied with water by the District Committee as Local
Authority, at such rate in the pound as shall be sufficient, when supplemented
by the Public Water Rate, if any, to defray the expenses hereinbefore men-
tioned.
(2) It shall be lawful for the County Council, and they are hereby authorised,
once in every year, to impose and levy an assessment (to be called the Public
Water Rate) if they shall think fit, upon all lands and heritages within the
district, but such rate, if imposed, shall not exceed threepence in the pound, and
may be such less amount as the County Council may from time to time determine.
The practical benefit to follow the adoption of this Act, in places
where the maximum assessment has been reached, will be to allow an
assessment of threepence per pound to be devoted to other sanitary
purposes within the District.
In Dunfernline District there are 9 Special Water Districts, and
the quality and quantity of the water are excellent, with the exception
of Crossgates. In the case Aberdour Special Water District there
has been irregularity of supply, but means are being adopted to over-
come this.
In Kirkcaldy District I have presented no special report dealing
[page] 7
with water supply, but have referred to any defective water supply in
connection with the reports on other insanitary conditions. Upon the
whole, the water supply of the district is good; but there are many
villages which are supplied with water from wells in the usual dangerous
proximity to sources of pollution. It is desirable to report in connec-
tion with water supply, that Kirkcaldy District Committee had to raise
an action in the Sheriff Court to enforce the Rosewell Gas Coal Com-
pany to supply - amongst other things - to their tenants at Rosewell,
Flockhouse, and Westfield, a sufficient provision of water. In the first
two places the necessary steps have been taken to improve the water
supply; but in the case of Westfield, the Rosewell Coal Company have
appealed against the decision of the Sheriff, that they were responsible
for the insanitary conditions there, holding that the proprietors were the
authors of the nuisance - under the common law obligation - to keep
their premises in a good condition, structurally.
A serious difficulty in the parish of Wemyss has arisen, from the fact
that the water supply for the parish of Wemyss has been considered and
treated as in a Special Water District, whereas only a small portion
actually is a Special Water Supply District. A very serious question as
to the assessment has thus been raised, and the opinion of counsel
is to be taken on the matter. From this complication, the proposal to
obtain a Provisional Order for the extension of the Wemyss Water
Scheme has been abandoned in the meantime. The districts supplied
by this scheme were beginning to feel the necessity for a more abundant
water service, and the turn events have been taken is much to be regretted
in consequence.
There are Special Water Districts at Kinglassie, Thornton, and
Coaltown of Balgonie. Where there are faulty water supplies will be re-
ferred to under the District Report.
In Cupar District a report was forwarded to the District Committee
in regard to the water supply of Kettlebridge, pointing out that the water
was derived from the shallow wells with loosely built walls, and without
any means having been adopted to keep out impurities, such as from
pigstyes and ashpits, which were in close proximity. As there is no
proper drainage system in the village, slop water and soakages from
surface pollution are most liable to find entrance into the wells. The
report also pointed out that the inhabitants of the village were in the
habit of using the water of a burn which runs through the village, and
into which, whatever drainage there is in the village, find its way into
the burn. In fact, the drainage from a slaughter-house could be traced
into this burn. This report suggested the necessity of a supply of
water by gravitation for the village.
In another report the water supply of Strathmiglo was dealt with;
and it was pointed out that the inhabitants were using water from
shallow wells in close proximity to dwelling-houses, and to the roughly
laid gutters which are the only means of drainage for the village.
The principal well in the village stands in the street, with houses
on two sides, and within a few feet of its sides: the gutter, carrying
away the slop water and street washings, run past the well. It
need not surprise anyone to hear that analyses of these wells showed |
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that most of them were grossly polluted. The analyst's reports will be
found in the District Report, and they were submitted to a meeting of
Strathmiglo Local Authority in August 1876. Attempts were thereafter
made to improve the water supply by cementing the walls of the wells
and by removing sources of pollution, but no radical measures were
attempted. The reports on the Water Supply of Kettlebridge and
Strathmiglo were referred to a committee for consideration, who advised
that as regards Strathmiglo, "Where the gutters are exceptionally bad,
or where such circumstances as 'the position of the wells' require it,
glazed fireclay gutters should be laid to prevent stagnation or soakage
of sewage into the soil."
These reports on the Water Supply of Kettlebridge and Strath-
miglo were considered by the Committee to represent the general
condition of the village Water Supply in Cupar District, and therefore
no other report has been submitted to the District Committee. To
deal with the whole question of the Water Supply of the villages in
Cupar District is a very important and extensive one, and no attempt
has as yet been made to deal with it in a manner consistent with its
immense importance, and no scheme, except the introduction of water
from a source removed from the possibility of the organic pollutions,
which accumulate near to houses, can, in my opinion, be considered
sufficient. The order in which the Water Supply of villages should be
dealt with must depend on various circumstances, but the necessities of
Strathmiglo and Kettlebridge place them amongst the first. There are
Special Water Districts at Newburgh and Pitlessie.
In St Andrews District I have reported specially on the Water
Supplies of Largo, Lundin Mill, Kilconquhar and Barnyards, Guard-
bridge, and indirectly on St Monans Special Water District, but with
special regard to the assessment having reached its maximum, and pre-
venting the possibility of dealing with insanitary conditions in St
Monans, which will be referred to afterwards.
In regard to Largo, the Report pointed out the serious want of a
proper water supply for such an important and thriving sea coast resort
- the present supply being from shallow wells - and the result has been
very satisfactory, as requisitions have been sent to the Local Authority
for the formation of Special Water Districts. It is gratifying to find
that measures recommended for the public good are received in a spirit
like this, and not with the opposition and ill feeling usually encountered.
Lundin Mill is also to be supplied with water by a branch from Leven
water main.
Barnyards being only a hamlet, and in rather a decaying position
from a diminishing population, an expensive scheme could not be
carried out; but it was advised that a fairly good water supply by a
well, with the sides made impervious by bricks and cements, might be
obtained.
The question of a water supply for Guardbridge has been under
consideration for a long time, as will be seen in the District Report;
and it is hoped that, as at Largo, the inhabitants will take the necessary
steps to form a Special Water District, as at the present time the water
which is used for domestic purposes has been condemned after analysis.
[page 9]
The water supply of Leuchars is by shallow wells, sunk in a bed of
gravel and sand. The principal well is at a lower level than the village.
It is therefore not at all a satisfactory means of water service. In the
various hamlets over the District, the water supply partakes of the same
doubtful nature, but means will gradually be taken, I hope, to improve
the quality of the water by remedies appropriate to the circumstances.
It will be seen from this general review of the water supply of Fife
- as far as it comes under the supervision of the County Council - a
very great deal has to be done before it can be considered that the pro-
visions of the Public Health Act, as regards water supply, have been
fulfilled.
As I have so frequently referred to wells close to, or in the midst
of populous places, as dangerous sources of supply, I think it desirable
to give my reasons for this opinion, and they will be found in the
Report to Dunfermline District, which deals with water supply.
GENERAL CONDITIONS OF SEWERAGE AND DRAINAGE
OF POPULOUS PLACES IN DISTRICTS.
In Dunfermline District, there are Special Drainage Districts at
Aberdour (Easter and Wester), Kelly, Limekilns, and Kincardine. In
Easter Aberdour the system is on modern principles, but at Wester
Aberdour there are many defects from want of sufficient ventilation to
the main sewer, and the outfall sewers are not carried out to low water,
and sewage matters are thus liable to be returned by the flowing tide.
Of this I have satisfied myself by experimenting with floats. The
defects above referred to will be remedied soon. In Aberdour there is
not sufficient care taken in many cases to disconnect the house drains
from the main sewers by a "Buchans" or other good form of trap.
In Kelty system of sewers, the original plan of the engineers was
departed from, and no proper means of ventilating the sewers was pro-
vided. The Kincardine sewerage system is also defective, from want of
ventilators and means for flushing the sewers. Limekilns system is
apparently sufficient, but more care should be taken by householders to
have thorough "disconnection" from the main sewers.
In the various villages in Dunfermline District, there are no proper
drainage systems, and special reference must be made to Crossgates,
which, from want of a system of sewers, is rendered most insanitary,
and many nuisances at present existing cannot be prevented from want
of proper drainage. The difficulty in dealing with Crossgates has
already been referred to when dealing with the question of water supply,
and it is to be hoped that it will be overcome by the scheme now
adopted.
In Kirkcaldy District, there are various Drainage and Special Drain-
age Districts. At East Wemyss there is a Special Drainage District,
and I have reported specially on the state of the drains and sewers there
to the District Committee, pointing out the very defective state of
matters existing from household drains discharging into the burn which
flows through the village, and from the main sewer outfall discharging
above low water mark, and many private drains discharging on to the |
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foreshore. At West Wemyss there is a Drainage system, but there is
necessity for its further extension, and improvements being made on the
side gutters, which are defective in many places. The drains from
houses in many cases do not connect with the main sewers, and when
they do connect there is no proper means adopted to interrupt the
passage of sewage gas into the houses, in contravention of Section 82
of the Public Health Act, which provides that "All sewers or drains,
whether public or private, shall be provided by the persons to whom
they severally belong with proper traps or other coverings, or means of
ventilation, so as to prevent stench or deleterious exhalation." A Special
Drainage District for Windygates and Balcurvie has been defined, but
the Local Authority have not meanwhile taken the necessary steps for
carrying out the drainage scheme. Drainage for Balcurvie and Windy-
gates is most urgently needed, as the villages are in a most insanitary
state from this want at the present time.
Coaltown of Balgonie, Thornton, Binnend, and Kinglassie, may be
mentioned as prominent examples where drainage is much needed; but
there are many other populous places in the district whose wants in this
respect will yet have to be considered. In Cupar District there is no
Special Drainage or Drainage District, and important places like Strath-
miglo, Kettle, Ceres, Springfield, and Freuchie are quite unprovided
with the means for sufficient drainage. The objections which may with
reason be taken to this state of matters are increased enormously by
the fact that all these places are supplied with water from shallow wells,
with the exception of Freuchie. A sewer pipe with cement joints is not
a desirable thing to be near a well for domestic water supply; but what
can be thought of the near proximity of a roughly laid gutter which acts
as a drain for sewage matters, or of a state of affairs where there is no
provision for drainage at all, and where all kinds of refuse and
excremental matters are thrown anywhere without regard to the near
presence of the domestic water supply. These states fairly represent
the condition of nearly all the villages in Cupar District.
In St Andrews District there is a Special Drainage District at
Colinsburgh; but in no other village in the District is there any means
for sufficient drainage. At St Monance, Upper and Lower Largo, I
have reported to the District Committee of the necessity for sewerage
systems; but Leuchars and Guardbridge also stand much in need of
sewers and drains.
[page] 11
STATEMENTS OF ENQUIRIES AND PROCEEDINGS, AND
OF THE MATTERS REGARDING WHICH ADVICE HAS
BEEN GIVEN.
To treat this section fully would be to repeat what will be found
in the District Reports, but to conform with regulations, I append
a synopsis of my enquiries, proceedings, and advice given.
[table inserted]
The matters which fall to be considered under Sections 3 and 4
are referred to under the District's Reports, and therefore need not
again be considered.
SALE OF FOOD AND DRUGS ACT.
This Act has been a dead letter in the past, and I am sorry to say
that up to this nothing has been done in any of the Districts to put the
provisions of the Act in operation to detect adulteration of food and
drugs, and to secure punishment of offenders. There can be little
doubt that there is a great need for supervision being exercised over the
articles which come under the Act; and next year, when more leisure
occurs than has been in the short period since the various Sanitary
Officers were appointed, I have no doubt a good record will be shown
of careful attention to this most important Act. I also hope that Sani-
tary Inspectors will be instructed to secure samples of milk for analysis,
as this also is a most important duty. |
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RIVERS POLLUTION PREVENTION ACT, 1876.
The objects of this Act are to prevent such pollution of streams as
must injuriously affect the health of the districts in which they are
situated, and to prevent their becoming obstructed by solid matter being
deposited into them.
By "streams" under this Act, are meant rivers, streams, canals,
lakes, and watercourses emptying directly into the sea, or into tidal
waters.
It would be out of place to describe in detail the various offences
prohibited by this Act, and the present purpose will be served by stating
that the enforcement of the Act will prohibit the discharge of solid
refuse into streams, except such solid refuse from mines as may find its
way by gravitation.
Sewage matters may not be discharged into any stream, unless the
best known practicable and available means have been used to render
harmless the sewage matters so falling or carried into the stream.
Prior to the passing of the Local Government Act, the administra-
tion of the Act fell upon the Sanitary Authority of ay parish or burgh;
but now, in addition to these, County Councils have power to administer
the Act.
In the meantime, in Fifeshire, no attempt has been made to secure
the purification of the various streams which run through the county,
such as the Orr, the Eden, and the Leven.
The subject is one of such immense difficulty, and involves such
serious considerations, that there is little wonder why it has not yet been
approached, except indirectly. This occurred after a communication to
me from the Police Commissioners of Markinch, in reference to a pro-
posal to discharge the sewage from the burgh into the Leven, when I
considered it my duty to state that, so far as I was concerned, I should
certainly advise the County Council not to sanction this method of
sewage disposal. If the sewage were first treated by irrigation, then no
fault could be found, as by this treatment "the best known practicable
and availabe means' had been adopted.
In connection with remarks on sewage purification, fuller reference
will be made to the manner in which streams in Fife are polluted by
sewage, and what remedies may be adopted for the prevention of this.
The Orr, from its commencement at Lochfitty to its junction with
the Leven at Cameron Bridge, receives the sewage of all the villages
near to or on its banks; and the Leven, in addition to the sewage of
Leslie, receives the pollutions from the various paper works and
manufactories between Leslie and Cameron Bridge. After the two
streams combine they receive the waste materials from Cameron Bridge
Distillery, and the sewage from a large piggery in connection with the
distillery, so that, when the Leven reaches the sea, it is in a very foul
state indeed, and its smell in warm weather is complained of by the
inhabitants of the town of Leven.
This subject I propose to enter more fully into during the summer
of 1892.
[page] 13
HOUSING OF WORKING CLASSES ACT, 1890.
This Act consolidates and amends a group of Acts relating to
Artizans' and Labourers' Dwellings and the Housing of Working
Classes.
I would desire to call the attention of the District Committees to
the terms of Part II. of the above Act, which deals specially with Un-
healthy Dwelling Houses:-
In section 30 is found -" it shall be the duty of the Medical Officer of Health
of every district to represent to the Local Authority of the district any dwel-
ling-house which appears to him to be in a state so dangerous or injurious to
health as to be unfit for human habitation."
Section 31 - " If in any district any four or more householders, in or near to
any street, complain in writing to the Medical Officer of Health of that district,
that any dwelling-house, in or near that street, is in a condition so dangerous or
injurious to health as to be unfit for human habitation, he shall forthwith inspect
the same, and transmit to the Local Authority the said complaint, together with
his opinion thereon."
Section 32 (1) " It shall be the duty of every Local Authority to cause to be
made, from time to time, inspection of their district, with a view to ascertain
whether any dwelling-house therein is in a state so dangerous or injurious to
health as to be unfit for human habitation; and if, on the representation of the
Medical Officer, or any officer of such Authority, or information given, any
dwelling-house appears to them to be in such a state, to forthwith take proceed
ings against the owner or occupier for CLOSING THE DWELLING-HOUSE under the
enactments set out in Third Schedule to this Act."
The enactments referred to in Schedule III. are as follows:-
SCOTLAND.
PUBLIC HEALTH (SCOTLAND) ACT, 1867 ( Sections 16, 18, 19.)
Section 16 - " The word 'nuisance' under this Act shall include (A) Any
insufficiency of size, defect of structure, defect of ventilation, want of repair or
proper drainage, or suitable water-closet or privy accommodation or cesspool, and
any other matter or circumstance rendering any inhabited house, building,
premises or part thereof, injurious to the health of the inmates or unfit for
human habitation or use." Sections 18 and 19 describe the proceedings to be
adopted by the Local Authority, and the form of decision the Sheriff, Magistrate,
or Justice may give.
I have quoted very fully from the Act of 1890, because it is one
of the utmost importance, and will year by year attract more attention.
It will be seen that the Act leaves no option for the Local Authority,
but they are required to exercise the powers they are provided with to
secure that all dwelling-houses are in a sanitary condition. The
Medical Officer is bound to report to the Local Authority any house in
the district in an insanitary condition. The main defects of houses,
which cause them to be insanitary, are given in Section 16 (A) of the
Public Health Act for Scotland, already quoted, but the expression "any
other matter or circumstance" is a very comprehensive one, and would
certainly include dampness of walls or floors, want of rhones and rain-
water conductors, general structural defects, want of drainage, and
most certainly want of a proper water supply. When houses are found
wanting any or all of these conditions, or with any defects so as to
render them insanitary, the Medical Officer must report them to the
Local Authority, who must deal with them as provided for in Section
32 of the Act already quoted, by applying for a closing order.
I can report nothing done under this Act; but after the general |
| HH62/1/FIFE/15 |
[page] 14
insanitary condition of whole villages have been dealt with, individual
houses must certainly be examined. From my general inspection of
the Districts, I am able to state that, to fulfil my duty under the Hous
ing of the Working Classes Act, there is work in store for several years.
INFECTIOUS DISEASES (NOTIFICATION) ACT 1889.
This Act has been adopted in all the Districts of Fife. It is
desirable that there should be a clear perception of the provisions and
objects of the Act, as they are not generally understood. By the adop-
tion of the Act, its is imperative that every medical practitioner attend-
ing, or called on to visit, a patient suffering from an infectious disease
to which this Act applies, will send to the Medical Officer of Health to the
District a certificate stating the name of the patient, the situation of the
building, and the infectious disease from which, in the opinion of the medi-
cal practitioner, the patient is suffering. It is also imperative that the head
of the family, and, in his default, the nearest relatives of the patient
present in the house, the person in charge of, or in attendance on, the
patient, or the occupier of the building, shall also notify, in like manner,
as the medical attendant, Every person who fails to grant a certificate
is liable to a fine of two pounds. It will be seen that a system of
notification is dual, and, as well as a medical man's certificate, one must
be sent by some one of the persons above referred to. This duty up
to the present time has been neglected, and only medical certificates
have been forwarded to me. I am sorry also to state that in some
instances medical certificates have been sent in after considerable elapse
of time since the patients have been affected, but the Act being newly
introduced, and this duty therefore new, it may have thus been forgot-
ten. I must impress upon everyone concerned with the duty of notifi-
cation, of the importance of early intimation of cases.
The Act is not compulsory meantime; but, judging from recent
remarks of the President of Local Government Board, it will soon
be so; and this is highly desirable, as, unless the Act applies equally
to every part of counties, very much of the benefit of early inti-
mation of infectious cases in the places where the Act is in force will be
lost, from importation of infection and from those places where this very
important sanitary Act does not apply.
In the County of Fife there is only one burgh, as far as I know,
which has adopted the Act; and it would only be fair for all the burghs
to follow suit, and confer on rural districts a benefit similar to the one
that rural districts confer on burghs. Sanitary administration to be
effective must be uniform, not only in every part of a county, but in all
counties, and until this is possible by a new Public Health Act, appli-
cable to rural and urban districts alike, the struggles made against
disease by our vigilant Sanitary Authority will be defeated by the indif-
ference of others to all preventive measures, and which are so often
considered to be meddlesome, and the cost which they cause extrava-
gant, forgetting that no extravagance is so wasteful as that of human
lives.
Since the Notification Act was adopted, I was asked to report on
what other diseases, other than those mentioned in the Act, should be
[page] 15
included as notifiable diseases; and to Cupar District Committee I
reported on the reasons for and against the notification of measles,
whooping-cough, and tuberculosis. As there is no isolation hospital
in this District, I could not recommend very strongly that any others
should be included until a hospital was provided, and until further
experience of the working of the Act as it is had been gained.
The following statistics of the mortality of measles, whooping-
cough and tuberculosis in Fife, and for the whole of Scotland for ten
years, show the necessity of preventive measures being attempted to
deal with these important diseases.
[table inserted]
These three infectious diseases increase the mortality of Fife to a
great extent, and whooping-cough and tuberculosis do not show much
tendency to decrease. Yet they are like other infectious diseases -
amenable to the influence of sanitary reform. The advantages of these
diseases being included in the Notification Act, would be from its being
then possible to instruct friends and relatives of patients how to
prevent others from being affected by adoption of preventive measures.
In the following table a statement of the cases of infectious
diseases, notified to the Health Department since 1st October is given:-
TABLE.
CASES OF INFECTIOUS DISEASE COMING UNDER THE NOTICE OF THE
HEALTH DEPARTMENT DURING THE YEAR 1891.
[table inserted) |
| HH62/1/FIFE/17 |
[page] 16
MORTALITY STATISTICS.
In Dunfermline District Report alone will be found the statistics
that every Medical Officer's report should contain. In the other
Districts, the returns sent by the local registrars were so incomplete
as to render it impossible to give the statistics of the entire Districts.
The difficulties experienced in this matter have been before you so
often, that it is not necessary to say more on this point. It is to be
hoped that, before long, the same facility for obtaining these returns
will be granted to Local Authorities in Scotland, as is provided for in
England by the Registration of Births and Deaths Act, 1874, Section 28.
For the Four Districts, I have calculated the "crude" death rates
for ten years; but, as both rural and urban deaths are included, from
the impossibility of separating them, these are of less value than they
otherwise would be.
In the following charts will be seen the death-rates of the counties
of Fife, Kinross, and Clackmannan for 10 years; also, the zymotic
death-rates for the same periods. In 1878, Fife death-rate was 18 per
1000, and in 1887, 17.9, showing very little decline in 10 years. The
zymotic death-rate in 1878 was 2.8, and in 1887 the same. In 1882,
it was as high as 3.5. The zymotic death-rates for Kinross-shire are
much more satisfactory than for Fife - due, no doubt, to the sparse
population.
DISTRICT REPORTS AND ABSTRACT FROM SANITARY
INSPECTORS' REPORTS.
In the remainder of this Report are the Reports which I have to
make to the District Committees, and abstracts from the Sanitary
Inspectors' Reports, which, by the Regulations of the County Council,
I have to make and include in my Report. The Sanitary Inspectors'
Reports are voluminous, and therefore cannot well be read at District
meetings, and I think it would be useful in future that they should be
printed and circulated, otherwise they can be of little use.
[page] 17
DUMFERMLINE DISTRICT.
SANITARY INSPECTOR'S REPORT.
DAIRIES AND COWSHEDS.
From Mr McLennan's Report I find that there are 115 cowsheds
in Dumfermline District, 33 of which have been registered during the
year. The whole of the 115 were inspected and measured, and a good
many of them were gone over a second time. The total number of
cows, in the Registered Dairies, is 1484, with a total space of 967,046
cubic feet. Each cow has, therefore, an average of 650 cubic feet.
Satisfactory conditions number 40, or nearly 35 per cent.
Not quite satisfactory conditions number 51, or nearly 44 per cent.
Very unsatisfactory conditions number 24, or nearly 21 per cent.
From my own personal inspections, I can state that that there are
several dairies in the District as carefully conducted, and with as much
attention to securing absolute cleanliness, as endeavours can effect. In
one, at my suggestion, arrangements are being made to supply specially
purified milk for the use of infants, on the principles of the Copenhagen
Milk Supply Company, which I was able to give from information I
derived from the Congress of Hygiene in London. In Denmark, the
care and attention paid to every detail of dairy management are far
ahead of anything attempted in this country; and the regulations in
force for securing the purity of such an important article of diet as milk
at once put the Danes far ahead of us in endeavouring to secure that
dairies arei n [are in] the perfectly sanitary condition they ought to be.
KIRKCALDY DISTRICT.
SANITARY INSPECTOR'S REPORT.
The report of Mr Low, the sanitary inspector for the District, is
a very complete one, and gives the main particulars of the sanitary con-
dition of the villages and hamlets in the District. This report by no
means indicates a satisfactory state of matters prevailing over the
District.
From the report on dairies and cowsheds, I find that there are 764
cows in the byres and cowsheds that have been inspected, with a total
cubic space of 537,139 feet, giving for each cow a little more than 700
cubic feet. This, the Inspector explains, will be curtailed when cow-
keepers take in their winter stock. Out of 114 dairies inspected, over
90 of them will require structural alterations, or nearly 79 per cent.
were found defective.
From the abstract statement of infectious cases ascertained, it will
be seen that these numbered 42, but it must be understood that a great
many of these intimated immediately after the Notification Act
came into force, and were convalescing, and the other cases not being
quite suitable for removal to hospital, hence during the past six months
no cases have been treated there.
All notices to schoolmasters, etc., are sent out by me, therefore
there are none reported by Mr Low. |
| HH62/1/FIFE/19 |
[page] 18
CUPAR DISTRICT
SANITARY INSPECTOR'S REPORT.
SANITARY CONDITION OF DAIRIES.
In Mr Stewart's District Report, it is stated that there are in Cupar
District 161 dairies. For purposes of comparison these are divided
into classes:-
CLASS 1. - Dairies with over 20 Cows, -- 6
CLASS 2. - Dairies with less than 20 Cows, but over 10 Cows, -- 12
CLASS 3. - Dairies with between 5 and 10 Cows, -- 17
CLASS 4. - Dairies with 5 or fewer Cows, -- 126
In Class 1, four needed alterations to make them conform with the
Regulations. One needed a new byre altogether.
In Class 2, three required limewashing, three repairs to drains, and
one a new byre.
In Class 3, four required limewashing, three repairs to drains, two
required more space, and in one the milkhouse was dirty,
In Class 4, thirty-four required limewashing, seven repairs on
drains, four more space, three better ventilation, two more light, one a
new byre, and in two the milkhouses were dirty,
Out of a total of 161 dairies, 103 were satisfactory, and 58 were
not satisfactory
NUMBER OF COWS AND CUBIC SPACE.
In the District there are 760 milch cows in the 161 Registered
Dairies, and the average cubic space for each cow is 593 cubic feet.
This space is by no means too large, but it meets the requirements of
the Regulation in force.
The dairies in Cupar District are scattered over a wide area, and I
hardly think it is possible for one Inspector to visit all so frequently as
the importance of this part of his duty demands.
ABSTRACT OF SANITARY INSPECTOR'S PROCEEDINGS.
In the tabular statement it will be seen that the Inspector has
made the large number of 1715 inspections since his appointment in
May, and dealt with 339 nuisances,
In connection with dairies, 243 visits were made, and 74 contra-
ventions of Order or Regulations were dealt with.
ST ANDREWS DISTRICT.
SANITARY INSPECTOR'S REPORT.
SANITARY CONDITION OF DAIRIES.
Mr McLetchie has supplied me with a very valuable report on all
the dairies in this District, and from it I find there are 58 Registered
and 15 Unregistered Dairies, with a total number of 682 cows. I
have arranged an abstract statement in the following table, showing the
different classes of dairies, according to number of cows kept, with
[page] 19
particulars as to water supply, drainage, and state of premises
generally:-
[table inserted]
It will be seen that in Class I, as was to be expected, the dairies,
as regards water supply and drainage, are in a more satisfactory state
than in the others.
Classes 3 and 4 are in very unsatisfactory state indeed, and these
embrace 53 dairies out of the total of 73.
The percentage statement of the whole dairies, water supply, drain-
age, and state of premises, is not satisfactory, and indicates that the
Inspector has a great deal of work to do in this direction.
Water Supply - Percentage Unsatisfactory, -- 31.6
Drainage - Percentage Unsatisfactory, -- 41.1
State of Premises - Percentage Unsatisfactory, -- 52.1
The most satisfactory fact brought out in this report is that the cows on
the whole have a fair allowance of cubic space, as 682 cows have
504,287 cubic feet, or an average of 739 cubic feet for each cow. |
| HH62/1/FIFE/21 |
[page] 20
SANITARY INSPECTOR'S STATEMENTS OF PROCEEDINGS
UNDER THE PUBLIC HEALTH ACTS FOR 1891.
[table inserted]
[page] 21
CUPAR DISTRICT REPORT.
This District contains the greatest number of parishes, and the
greatest acreage of all the Districts in Fifeshire. From the extreme
west to the extreme east, the distance is about 19 miles, and from
north to south the breadth is about 12 miles. The District on the
extreme west touches Kincross-shire, and on the north-west Perthshire.
The Tay forms the northern boundary. The District of St Andrews
lies to the east, and on the south parts of Kirkcaldy and St Andrews
Districts cut off Cupar District from the Firth of Forth. The District
contains the Royal burghs of Auchtermuchty, Cupar, Falkland, and
Newburgh, and the police burgh of Ladybank.
The total population of the District (including burghs) at the
census of 1881 was 29,449, and at the census of 1891 the population
was 26,986, showing a decrease of 2,463. The decrease occurs in 18
out of the 20 parishes - Balmerino and Collessie being the exceptions.
The population, exclusive of Royal burghs,was 20,952 in 1881,
and in 1891, 19,189, showing a decrease of 1763. The parishes in
which the greatest decrease occurs are (in order of greatest decrease)
Ceres, Strathmiglo, Falkland, and Auchtermuchty.
These brief statistics of the population are of interest, as they indi-
cate the tendency at the present day of depopulation of rural and agri-
cultural districts; but they are of more special reference to the present
subject as showing difficulties in sanitary reform arising from a dimin-
ishing revenue.
[table inserted]
The above Table shows the total acreage of the whole District,
total population, and average number of acres per person, and of
fraction of person per acre. Also the acres and persons in each parish,
and the number of acres per head of population. |
| HH62/1/FIFE/23 |
[page] 22
The parish of Flisk has 13.6 acres for each person. Newburgh
has the smallest mean of acre to person.
GENERAL SANITARY CONDITION OF DISTRICT.
RECOMMENDATIONS FOR IMPROVEMENT.
In accordance with the Regulations of the Board of Supervision for
the Reports of District Medical Officers, the remainder of this Report
will follow the order prescribed, and the general sanitary condition of
the District is first in order. On referring to certain statistics of popu-
lation and acreage of the District, which form the preliminary part of
this Report, it will be understood, that although the population is a
small one, it is scattered over a wide area (and this, of course, from a
sanitary point of view, is much in favour of the people.) The difficulty
of obtaining information of all factors which may affect the public
health are very great, and cannot be ascertained in so short a time as I
have had.
I therefore shall not even attempt generally to write a report of
the sanitary condition of the District, but, following the plan I have
adopted in dealing with other Districts, take up the important subjects
of water supply and drainage of villages and hamlets, and only refer in
very general terms to house accommodation. This last section will, in
future Reports, doubtless occupy a more prominent place, judging by
the information I have got on this subject while enquiring into the two
other subjects referred to.
It will be the most convenient arrangement to deal with villages
and hamlets in alphabetical order, rather than in order of importance.
Auchtermuchty. - The town is not under the District Committee,
but what may be called the suburbs are. The water supply is by wells,
and apparently good, as they are not situated as to be liable to
pollution. Drainage is generally by side gutters. Many of the houses
are in indifferent order.
Blebo Craigs is supplied with water from shallow wells. There is
no attempt at sufficient drainage, but as this is a very small place it is
of less consequence.
Ceres. - The water supply is almost entirely by shallow wells, close
to houses, and to the various pollutions which accompany them.
Drainage has not been attempted. Many of the houses are not fit for
occupation. A good gravitation water supply is much needed for this
village, and improvements on many of the houses, so as to render them
at least free from damp, will have to be effected.
Chance Inn and Craigrothie are in very much the same position
as Ceres in regard to water supply.
Cupar Muir get its water from shallow wells near to the houses.
There is little or no attempt at drainage.
Dura Den. - This village has apparently a good water supply, and
fair drainage by surface channels. There has been an improvement in
removal of accumulating refuse matters.
Dairsie Village. - This is supplied by water from shallow wells,
[page] 23
but as a rule, somewhat further removed from houses than usual. The
condition of the houses is fairly good.
Dunshalt is supplied by shallow wells, fitted with iron pumps.
The wells are near to houses, and are suspicious sources of water supply
in consequence. There is little attempt at drainage, and many of the
houses are in bad repair.
Freuchie has a gravitation water supply, apparently of good quality.
There are a few drains in the village; but no proper drainage scheme
has been attempted. Scavenging is very badly attended to, and many
of the houses require structural alterations to make them habitable.
Gateside. - The water supply here is by wells, and of a suspicious
quality. Nuisances are very common. This place has attracted special
attention, from the occurrence of several cases of diphtheria in the hamlet
and near to it. A proper supply of water for the school is much needed,
also the substitution of the huge privy and ashpit for a trough closet,
with an automatic flushing tank.
Kettle is supplied by artesian wells in part, and the water is doubt-
less of good quality; but there are various pump wells in the village in
close proximity to dwelling-houses, and thus liable to pollution, and this
danger is increased by the absence of drains. Many of the houses are
in a bad state of repair. Scavenging is not attended to,
Kettlebridge. - This village derives its water from shallow wells in
close proximity to houses, with their ashpits and pigstyes. An additional
source of supply is the burn which runs through the village, and which
receives a considerable portion of the sewage of the village which
gravitates into it. This subject was specially reported on before, and a
recommendation made that a water supply by gravitation should be got,
as the only likely means by which a pure supply of water could be got.
Kilmany. - The village is supplied by water from wells, and from
the nearness of houses to these, and the conformation of the ground
I would hesitate to describe the water as good. A recent analysis of
one of these wells, which I saw lately, was decidedly bad, the analyst
stating that the well was polluted by sewage. There is no system of
drainage, and nuisances are abundant. Many of the houses are in very
bad order indeed; and unless they are improved, it will be my duty,
under Section 30 of the Housing of the Working Classes Act, to bring
their condition before the notice of the District Committee.
Letham is supplied by water from wells, but these are well removed
from houses, and as the little village is very well kept, I have no reason
to suspect the purity of the water.
At the school certain insanitary conditions were pointed out, but
these have now been removed.
The hamlets of Logie, Lucklawhill Feus, and Luthrie, do not
require any separate notice; the water supply is from wells, and there
are no drains.
Newton of Falkland has a small gravitation supply, but the drainage
is very defective.
Pitlessie has a gravitation water supply, and the quality, I believe,
is fair. The drainage is very defective, and the outlet is a ditch which
passes through the village. |
| HH62/1/FIFE/25 |
[page] 24
Rathillet. - The hamlet is supplied with water from wells near to
houses. The school well is very close to the school closets, and is of a
very suspicious nature in consequence.
Springfield derives its water from shallow wells sunk in a porous
sandy soil, till rock is reached. These wells are close to houses, and
often at a lower level. In one case a well is at the side of a burn which
receives a considerable portion of the sewage of the village. The whole
circumstances of the water supply of Springfield are suspicious, and a
supply by gravitation is much needed. There are no drains, and nuis-
ances are very common.
Strathmiglo. - This village has already been reported on as to its
defective water supply, want of drainage, and defective scavenging. The
wells are in many cases within a few feet of dangerous pollutions, and
are not so constructed as to offer any resistance to the entry of these.
It is argued that there is abundance of good water in Strathmiglo, if
only the sources of pollution were removed sufficiently far away. I do
not think that anything short of removal of the wells, with the introduc-
tion of water by gravitation, will be sufficient. I have considered it
desirable to express my opinion on the general subject of water supply
from wells, in Dunfermline District Report, and the reasons why wells
surrounded by or near to houses are dangerous will be found there.
The waters from Strathmiglo wells were analysed some years ago,
and I append copies of the analyst's reports of James Brown's well (No.
1); G. Laing's (No. 2); Mrs Todd's (No. 3); well in Skene Street (No.
4); Bank well (No. 5); William Robertson's well (No. 6); Manse well
(No. 7.)
ANALYST'S REPORT - STRATHMIGLO WATER.
[table inserted]
The above analytical results demonstrate that the waters No. 1, 2,
3, and 7 contain a large amount of saline matter in solution, are
decidedly hard, and are grossly contaminated with the products of the
decomposition of putrescent organic matter of the nature of sewage or
animal manure. These waters should not be employed for any
domestic purposes; they are dangerous waters.
Nos. 4 and 5 are slightly contaminated, and are undesirable for
domestic supply.
No. 6 is also considerably contaminated; I would recommend that
this water be not employed for drinking or cooking purposes.
[page] 25
It will be seen that not one of these waters was considered by the
analyst as above suspicion, and at this time the inhabitants of Strath-
miglo are using water for domestic use, which chemical analysis has
shown to be unfit for any dietetic purpose.
GENERAL ENQUIRIES MADE DURING
TENURE OF OFFICE.
The information regarding the general sanitary condition of the
District has been obtained by my own personal observation, and there-
fore is the result of general enquiries made since my appointment. A
subject of special enquiry was the sanitary condition of the salmon
bothies on the Tay in Cupar District, as there was reason to believe
that there was necessity for this. All these bothies were inspected,
and the result was to show that in nearly every case overcrowding
existed to a great extent, and nearly all were most insufficiently sup-
plied with water. The effects of overcrowding were found to be
aggravated from the fact that while the rooms in which the men were
house were used for cooking and sleeping in, they were also used for
storing nets, over-alls, and the various kinds of tackle needed by salmon
fishers. The result of this enquiry has been that arrangements were
commenced for providing water supply for these bothies, where this
was defective, and outhouses for the purposes of a store. Before these
bothies were again occupied they will be measured, and a fair allowance
of cubic space allowed for each person, and if this is encroached on,
any overcrowding will be dealt with, as provided under the Public
Health Act.
The sanitary arrangements of schools have been specially enquired
into, as far as opportunity has occurred. The duty is a most im-
portant one, and demands more attention than has been given to it.
In a school overcrowding to a large extent occurs, and the provisions
for heating and ventilation are not generally so arranged that the one
can be efficiently carried on without interfering with the other, and the
usual result is that ventilation is seriously interfered with. Under those
circumstances of overcrowding and defective ventilation the children's
health becomes deteriorated, and they in consequence are rendered
more susceptible to other injurious influences, such as an impure
water supply, defective drainage, or defective closet arrangements.
On making enquiries as to the water supply and closet arrange-
ments of schools, in many cases serious defects were found, and these
were pointed out to the various school boards, who were responsible.
The advice given was not in all cases well received, but I hope that
school boards and others in authority will consider that it is the duty
of the Public Health Department to enquire into all conditions which
affect the health of the community. School boards and teachers can do
a great deal to help the cause of sanitation in inculcating the doctrine
of cleanliness, as exemplified by school premises being in as sanitary a
state as possible, whereas any defect or laxity will have a prejudicial
effect on the minds of children, which will never be effaced. |
| HH62/1/FIFE/27 |
[page] 26
ADVICE AS TO OFFENSIVE TRADES.
In Cupar district the only offensive trades that come under the
jurisdiction of the District Committee are slaughter-houses and a
knackery and artificial manure work at Ballomill.
Regulations for slaughter-houses were drafted and adopted with
some slight alterations, and are now in force in the district,
These regulations were submitted to the Board of Supervision, and
met with their approval, and it is hoped that attention to these on the
part of butchers will lead to an improvement in the general structural
arrangements of slaughter-houses, and to a better state of cleanliness,
than at present prevails, as inspection of the slaughter-houses of the
district has shown that many are in very unsuitable premises, and kept
in a most offensive manner, and the dangers of these are aggravated by
the closeness of dwelling-houses to the slaughter-houses in many
instances.
Complaints having been made as to an alleged nuisance being
committed at Ballomill from a knackery and artificial manure work,
I made an inquiry into the matter, and reported to the District Com-
mittee as to the precautions which should be adopted to prevent any
cause of complaint. The business carried on at Ballomill is the
making of artificial manure from the carcases of horses and cattle.
The animals are either brought dead or are killed on the premises, and
then are boiled in large vats, with the object of separating the flesh
from the bones.
In order to diminish the effluvium nuisance from absorption of
putrescible matter into the soil or into the walls, it was suggested that
the floors of the knackery should be made of concrete, and the walls
faced with cement to at least 4 feet from the floor, and, to prevent the
escape of effluvia from the boilers, these should be provided with
tight-fitting lids, fitted with pipes leading into condensers, and that
when the flesh was removed from the boilers, the steam from this should
also be condensed by plunging the steaming mass into cold water.
The result of this report has been that new premises were erected,
and the recommendations have been carried out, and the effluvia, if not
quite prevented, has been diminished to a great extent.
INSPECTION OF BAKEHOUSES.
The inspection of bakehouses falls to be made by the Medical
Officer, by the Bakehouse Regulations; and accordingly I have per-
sonally examined all, as far as I know. Copies of the Regulations have
been sent to all bakers, so that they could not plead ignorance of the
terms of these. In none of the bakehouses a high state of cleanliness
was found, but, at the same time, there were no very serious defects,
Subsequent inspections have shown that there is an endeavour being
made to secure a better state of cleanliness, by lime washing of the
walls and ceilings, and washing of the woodwork. A great improve-
ment in the Regulations for bakehouses would be the provision for
making Bye-laws, as in cases of slaughter-houses, dairies, &c., but no
[page] 27
such power is given as the Regulations exist. No proceedings were
necessary to enforce attention to the bakehouses Regulations.
SUPERVISION OVER HOSPITALS.
In the District there is no isolation hospital, and my action as
regards hospital accommodation has been to advise the necessity of the
District Committee to provide suitable hospital accommodation for the
population under their administration. The Report on hospital accom-
modation for the District was considered at a meeting of District
Committee on the 4th August, and it will be useful at this time to
refer to the features of that Report. It was pointed out that the Public
Health Act provided for Local Authorities erecting temporary or per-
manent hospitals, and that different Local Authorities might combine
for the purpose of acquiring an hospital. This was pointed out to meet
the cases, in the event of a combination hospital being contemplated,
for the joint uses of the Burghs and District, or of Cupar and St
Andrews Districts entering into such an arrangement.
The advantages of a combination hospital were pointed out, that it
would not only be a cheaper arrangement for those local authorities
entering into such a scheme, but that a more efficient hospital could be
obtained.
It was also pointed out that, although now and again there might
be immunity from infectious disease, epidemics were certain to occur in
future as they had in the past, and experience has shown that the
only way to deal effectively with infectious cases, not only for the treat-
ment of the cases, but for the limitation of the epidemic, was to remove
them to hospital. In this way, now that the notification of Infectious
Diseases Act is in force, if the District were provided with a suitable
isolation hospital, a threatened epidemic, say of scarlet fever, or of
smallpox, could be cut short.
The report suggested a conference between the various burgh
authorities and the Local Authorities of St Andrews and Cupar, with
the view to acquire a very suitable building for an hospital at Ceres.
This building, designed originally for a convalescent home, has, for want
of funds, been rendered useless for the the original purpose, and my idea
was, and still is, that the best possible use that it could be applied to
was to make it into a combination hospital for the districts of Cupar and
St Andrews. This proposal unfortunately fell to the ground, owing to
the trustees of the building declining to entertain it. In the meantime
no action has been taken in Cupar District to deal adequately with the
subject; and although it is optional for any Local Authority to provide
an hospital, as far as the Public Health Act demands, still no Local
Authority can be considered to be doing all in its power to repress pre-
ventable disease, which does not fulfil this duty. The advantages of
hospital treatment, as regards recovery, are evident, when we remember
that only cases which have not proper lodging or accommodation, or
lodged in a room occupied by others besides those in attendance on
such persons, can be lawfully compulsorily removed to an hospital; and
these conditions, it is very obvious, are not such as tempt the patients |
| HH62/1/FIFE/29 |
[page] 28
and increase their chance of recovery, but quite the reverse, as quietness
and abundance of fresh air - essential parts of the treatment of all cases
of infectious disease - cannot be obtained under these conditions. In
few words, patients removed to an hospital are removed generally from
the some insanitary to the most sanitary condition, and these determine
the issue, to a very great extent. To represent as a ratio the difference in
results of house treatment and hospital treatment for infectious cases,
I quote from the Medical Officer of Health's Report for Staffordshire.
SCARLET FEVER, DIPHTHERIA, AND FEVERS.
Total Cases, -- 1394 | Total Deaths, -- 100
Cases treated at home, per centage mortality, -- 8.3
Cases treated at hospital, per centage mortality, -- 2.8
The above results show the advantage to the persons affected.
The advantages to the general community cannot be thus represented,
but are unquestionably very great, as every person who suffers from
an infectious disease runs, in the first place, a great risk of dying
under it, or has a debilitated constitution if he recovers. Every life,
young or old, has a certain economic value. If the ordinary work or
business of life is interrupted by ill health from fevers, this is always a
serious matter. If the bread-winner of a large family is ill, say, from
typhoid fever, how can the suffering to the family in consequence be
recompensed? and such cases can, without doubt, be prevented from
occurring by isolating the infected from the healthy.
I trust that in Cupar District the question of the hospital accom-
modation is not disposed of, and that before the Report for 1892 falls
to be written, the wants of the District in this respect will have been
attended to.
SUMMARY OF ACTION IN REGARD TO PREVENTION
OF INFECTIOUS DISEASES.
Prior to the adoption of the Notification of Infectious Disease Act
in the District, it was matter of extreme difficulty to hear of new cases
of infectious diseases, as the population is widely scattered. It will be
useful to give a resumé of the procedure adopted since the Act was
adopted. When any case is notified to me, the Sanitary Inspector
visits the place, and ascertains the following particulars:- Age of
patient, occupation, date of rash (if any), school and Sunday school
attended, milk supply, water supply, drainage, water closet, or other
form of accommodation, number of rooms in the house, number of
children under 14 years, any sanitary defects, remarks. When I receive
these, they are copied in a book, and become permanent records of all
infectious cases in the District. Notices are sent prohibiting attendance
at school and Sunday school till risk of infection is passed. Any sanitary
defects which have been discovered are attended to. When the Sani-
tary Inspector visits, he gives instructions as to disinfection, and the
procedure to be adopted to prevent the spread of infectious disease.
Printed instructions for dealing with infectious cases, drawn up by me,
are left in the houses where infectious cases have occurred. The pro-
cedure adopted is the same in all the districts, except that in Kirkcaldy
[page] 29
District suitable cases are removed to hospital, one being in opera-
tion. In Cupar District there have not been many cases to deal with,
but unfortunately there have been several cases of diphtheria; but in-
vestigation did not reveal any serious insanitary conditions to account
for them. Two cases occurred in a house which was sanitarily as nearly
perfect as possible, and no disease of cows, cats, or fowls - sometimes
associated with diphtheria - could be ascertained. Both cases recovered.
In another house, not far from these two cases, two other cases
occurred, one of which died. The school where the affected children
attended was far from being in a sanitary state, from a very foul privy;
and the water supply from a well was also most suspicious. These defects
have been dealt with so far, but nothing short of a gravitation water
supply will altogether meet the other want. There was no connection
to be traced between the occurrence of these cases in the two different
houses, except that members of both families attended the same church.
STATEMENT OF INFECTIOUS DISEASES NOTIFIED SINCE
1ST OCTOBER 1891.
Cupar District - Smallpox, 0; Scarlet Fever, 1; Diphtheria, 3; Erysipelas, 1;
Typhus Fever, 0; Typhoid Fever, 0; Continued Fever, 0; Puerperal Fever, 0;
Measles, 0; Whooping Cough, 0 - Total Cases, 5.
MORTALITY STATISTICS OF CUPAR DISTRICT.
My difficulties in regard to obtaining the necessary returns of births
and deaths from the Registrars of the District have been so often
before the Committee, that it is not necessary to say more regarding
these; but the result is that the Report is deprived of the all important
information obtained from mortality statistics. A mere crude death-
rate is not sufficient; and this cannot even be obtained now, nor till
some time after this Report ought to be in your hands. What is
wanted is to know what diseases predominated and proved fatal; where
they occurred; and were they preventable or not. A mere crude death-
rate gives no such information, and is accordingly comparatively value-
less. With considerable labour I have gone over the mortality returns
of Cupar District for 10 years, and in the table are given the crude
death-rates of the various parishes; but what diseases produced these
could only be obtained by a search of the Registrar-General's books in
Edinburgh. This information would be very vauable, and would well
repay the small cost of it, as then the District Committee could direct
their efforts to diminish the mortality, which could fairly be considered
preventable, with much better chance of success. To reduce the death-
rate is the object and aim of every Local Authority, and all available
means should be utilised in this direction. |
| HH62/1/FIFE/31 |
[page] 30
CUPAR DISTRICT.
DEATH RATES IN PARISHES - 1881 TO 1890.
[table inserted]
The above Table must be accepted with some reservation, as individual parishes have too small population to
give a reliable basis for calculating rates on; but when over a series of ten years, and over so many parishes,
very high death rates are found, it indicates that much can be done to reduce these in the district. Taking 17 per 1000
as a fair standard death rate for the whole District, including burghs, we find that this is exceeded in 34 per cent. of
the total cases.
[page] 31
STATISTICS FOR 1891.
It is not possible to give the birth and death-rates for the District,
owing to the registrar's returns not being sent me; but from a few
parishes returns have been sent, and I shall give the results as far as
they go. Balmerino had a birth-rate of 11.6 per year per 1000 of
population; death-rate of 14.5; and a phthisis death-rate of 2.9. Falk-
land birth-rate, 23.2; death-rate, 23.2; phthisis death-rate of 3.9.
Flisk birth-rate, 41.6; death-rate, 20.8. In Moonzie only three deaths
are recorded, In Strathmiglo the death-rate was 14.8; zymotic death-
rate, 2.2; and phthisis also 2.2.
These data are too limited to draw conclusions from; but if the
phthisis death-rate is found to be actually so high, as the above rates
would indicate, there will be good reason for enquiry into the cause. |
| HH62/1/FIFE/33 |
[page] 32
DUNFERMLINE DISTRICT REPORT.
Dunfermline District is composed of ten parishes, and is the most
western of the four Districts of Fife. On the south it is bounded by
the sea, on the north by the County of Kincross, on the west by Clack-
mannanshire, and marches with Kirkcaldy District on the east. In
this District are the Royal Burghs of Dunfermline, Culross, and Inver-
keithing, and the Police Burgh of Cowdenbeath. The total population
of the District at the last census was 49,271, but the population, which
comes under the supervision of the District Committee, was 24,652,
including the Police Burgh of Cowdenbeath. These figures show an
increase from the census of 1881, as follows:-
[table inserted]
Although there has been an increase over all the District, there has
been a diminution of population in five parishes, but this has been made
up by an increase in the remaining five. The greatest increase has
been in Beath Parish, which has increased from 5442 in 1881 to 8296
in 1891.
In the following table are shown the number of acres in each
parish (prior to any changes made by Boundaries Commission), the
total population of the District, the number of acres for each person,
and person to acre, for the whole District:-
DUNFERMLINE DISTRICT.
[table inserted]
These figures both for area and population, of course, include
burghal populations not under your jurisdiction; but the influence of
population does not stop with the boundary of a district, nor of a
county, hence must be taken into account.
In the Parish of Beath the large population diminishes the acreage
per person to .7, whereas in Saline the acreage is 9.3 per person. In
the rest of this Report the order followed is that prescribed by the
[page] 33
Regulations of the Board of Supervision for Medical Officers for
Districts of Counties.
GENERAL ACCOUNT OF THE SANITARY STATE OF
DISTRICT, WITH RECOMMENDATIONS FOR ITS
IMPROVEMENT.
At the commencement of a new system of sanitary administration,
it appears to me very desirable that it should be put on record what the
actual sanitary state of the District was prior to the Local Government Act,
and, therefore, what amount of sanitary reform falls to be carried out
under the new system. From what has already been reported in regard
to many of the hamlets and villages in Dunfermline District, I think it
must be admitted that much sanitary improvement has to be effected.
In giving a general account of the sanitary condition of the District,
space will only permit me dealing with elementary principles; and to
give a full account of all the conditions which act in producing preven-
table sickness or death, will require a much longer study than my short
tenure of office has permitted.
One of the most elementary sanitary conditions, and at the same
time one of the most important, necessary for all houses, is a pure and
abundant water supply, and I shall therefore devote a section of this
Report to this subject.
WATER SUPPLY.
In a report on this subject, which was presented to the District
Committee, I pointed out the necessities for a bountiful supply of pure
water, and the dangers from a defective system; and at this time, while
I would emphasise these remarks, I cannot enter into the subject more
particularly.
In the village of Aberdour there is a special water supply district.
The water is supplied from Dunfermline Corporation Water Supply,
and is of excellent quality. There have been some irregularities in the
distribution of water, especially in the higher parts of Aberdour; but
means are being taken to remove these.
Crossgates village is in a special water supply district, and gets the
water from Cullalo Hills by a gravitation system. The supply is both
defective in quality and quantity, and during the past summer the
storage reservoir was nearly exhausted. The difficulty in dealing with
this water supply district arises in great part from the assessment having
reached its maximum, and also from there being little possibility of
extending the water supply system so as to meet the wants of the
village. It is hoped that the adoption of the Public Health Amend-
ment Act of 1891 will meet the great difficulties of the case.
Cairneyhill. - The water supply here is by means of shallow wells
close to houses, and is therefore a suspicious system.
Carnock. - The water is supplied to the inhabitants by shallow
wells near to houses, and is suspicious in consequence.
Charlestown has a good gravitation system, and is in a special
water district. |
| HH62/1/FIFE/35 |
[page] 34
Crossford. - This village is supplied by shallow wells near houses
and the quality of the water is suspicious.
Donibristle Village has a good gravitation supply of excellent
quality.
Fordell Village. - This village has a branch pipe from Crossgates
main, and this supply is open to the same remarks as for Crossgates.
It has also a small gravitation supply of its own, which might be
improved.
Halbeath. - This village has a good gravitation supply. A small
part of the village (Morningside) had not a good supply, but this has
now been procured.
Hill of Beath Colliery Village has a good gravitation supply, by
means of a branch pipe from Cowdenbeath water main.
Hillend Village. - This village gets its supply from shallow wells,
close to houses. The water has been analysed, and found to be bad.
There has been great difficulty in finding a substitute for this polluted
water supply, but now there is a prospect of a good supply being got
before long.
Gowkhall Hamlet derives its supply from the usual type of shallow
well. Several cases of enteric fever occurred here recently, due pro-
bably to the polluted water.
Oakley Colliery Village has now got a supply of water by gravitation,
but there is a necessity for better distribution by more wells over the
village.
Kincardine, Limekilns, Kelty, Saline, Queensferry, Lassodie, and
Wellwood are all well supplied with water.
Torryburn. - The water supply of this village is mainly from
shallow wells, but at the east end by a gravitation system. Owing to
the want of better storage, a large quantity of water runs to waste;
and it was suggested by the Sanitary Inspector for the District to
utilise this waste by making a storage tank and leading a pipe to that
portion of the village supplied by shallow wells. The expenditure
would have only been a few hundred pounds, but the inhabitants did
not take our advice in the spirit it was given, and offered strenuous
opposition to the proposal. The District Committee instructed us to
take the necessary steps to have the wells believed to be polluted
closed. Two samples of water were examined, from two different wells,
and the waters were declared unfit for use by the analyst. The wells
were accordingly closed. The water which supplies the school comes
in an open ditch from a field where cattle graze in summer, and is
therefore unfit for human use. The opposition to the proposed new
supply, however, still continued; and we were instructed to take the
necessary steps with other wells, if found polluted, to have them shut
up. Two other samples were analysed, and one was found to be pol-
luted to a most dangerous extent with organic matter, and the other to
a less extent. The analyst's reports of three samples of Torryburn
water are appended, so that it may be considered whether the position
that the sanitary officials took up in regard to the question of water
supply of Torryburn has been justified or not, with this additional
information now in possession of the District Committee.
[page] 35
COPY OF ANALYSES OF FOUR WELL WATERS FROM TORRYBURN
BY MR FALCONER KING. RESULTS ARE EXPRESSED AS
GRAINS PER GALLON.
[table inserted]
No. 1, "Nelly Morris's Well." | No. 3, Rockvale Well.
No. 2, Drummond's Well. | No. 4, Drummond's Well.
These analyses show that none of these waters are of a high class,
and that Nos. 1, 2, and 3 are polluted with dangerous organic matter.
Steps were taken to have these three closed.
The analyses were made at a time when the wells were least liable
to pollution - in the autumn and winter. If they had been made after
the gardens in which they are situated had been manured, the results
would doubtless have been worse.
This general report of the water supply of the various populous
places of the District shows that in many places there are excellent
systems of water supply, but that in many others there are very defective
systems; and my duty does not end by merely condemning, but requires
that I should recommend what measures, in my opinion, are necessary
to remedy the defects.
RECOMMENDATIONS.
I have endeavoured in the District Reports to so arrange that I
shall not repeat references which are equally applicable to all the
Districts in the County; and in this Report I shall refer to other
Reports where special matters are considered.
So frequent reference has been made to the dangers liable to fol-
low the use of a water supply derived from shallow wells near to houses,
and as this means of water supply is so extensively made use of in all
the districts in Fife, it appears to me to be very desirable to give the
reasons for my opinion on this subject.
In the Rivers Pollution Commissioner's Sixth Report, the following
remarks occur regarding village wells, and as they are specially appli-
cable, I quote them:- "The common practice in villages, and even in
many small towns, is to dispose of the sewage, and to provide for the
water supply of each cottage, or pair of cottages, upon the premises. In
the little yard or garden attached to each tenement, or pair of tenements,
two holes are dug in the porous soil; into one of these, usually the
shallower of the two, all the filthy liquids of the house are discharged;
from the other, which is sunk below the water line of the porous |
| HH62/1/FIFE/37 |
[page] 36
stratum, the water for drinking and other domestic purposes is pumped.
These two holes are not unfrequently within twelve feet of each other,
and sometimes even closer. The contents of the filth hole, or cesspool,
gradually soak away through the surrounding soil, and mingle with the
water below. As the contents of the water hole, or well, are pumped
out, they are immediately replenished from the surrounding disgusting
mixture. This polluted liquid is consumed from year to year, without
a suspicion of its character, until the cesspool and well receive infected
sewage, and then an outbreak of epidemic disease compels attention to
the polluted water." These remarks, with very little variation, could be
applied to the water supply of Hillend, of Crossford, and of Torryburn
(so far as its wells are concerned). Epidemics of typhoid fever in my
cognizance have led to the knowledge that Hillend and Crossford had
polluted water supplies.
It has been forcibly impressed on me that the manner in which
wells near to houses may be polluted is not sufficiently understood, and
the following advice seems necessary. A well is a hole sunk in the
ground with sufficient depth to tap the underground water. The source
of this underground water may be near or remote, but is derived from
the rainfall in any case. The sinking of a well into the underground
water-bearing strata is to make this the centre of a drainage area of
varying extent. When the surface of the water in the well is lowered
by pumping, or other means, the drainage area is extended a distance
varying, it may be, 15 to 160 times the depression in the well. That is
to say, if the well is emptied by three feet of the depth of water in it,
the drainage action may extend from the centre to a distance of from
15 to 160 yards. In this way pollutions from ashpits, gutters, cess-
pools, byres, &c., may be sucked into the wells from distances which
seem impossible. These are briefly the reasons which render wells near
inhabited places dangerous sources of water supply. It is sometimes
possible to diminish these risks by sinking the wells to solid formations,
puddling and cementing the walls, and raising them above the level of
the surface; but these means only secure a certain amount of filtration
of the water before it reaches the well. Filtration, if carried on in the
household manner slowly and carefully, may improve a water, but it
cannot be relied on when the filtering medium is impregnated with the
organic impurities which pollute the soil round all the houses; nor can
it exclude the specific cause of typhoid fever. Wherever possible, my
recommendation for water supply must be, that a water supply, which
is not quite removed from the dangers of organic pollution, should be
substituted by a supply from a source far removed from such dangers.
Experience has taught that a gravitation supply is the best of all systems.
GENERAL SANITARY CONDITION, SEWERS AND DRAINS.
Aberdour has two Special Drainage Districts. The system in
Easter Aberdour is modern, and the sewers are provided with flushing
tanks and with ventilating manholes. The outfall sewer is carried out
to sea. In Wester Aberdour there is an entire absence of ventilators
in the system, and the outfall sewers are not carried out to low water,
[page] 37
and sewage matters are thus liable to be brought back by the tide.
This I have proved by experimenting with floats. The outfalls should
be carried out to low-water level, and ventilators should be provided for
the sewers. There is not sufficient disconnection in many cases
between the house drain and the sewer. Matters such as these are of
extreme importance, especially in a summer resort, as Aberdour is.
The villages of Cairneyhill, Comrie, Crossford, Crossgates, Carnock,
Hillend, Gowkhall, are not provided with proper means of drainage.
Some of those villages are in a decaying condition, and an assessment
necessary to provide proper water supply and drainage cannot well be
borne, and this fact must be taken into account. The want of proper
drainage would not be so serious if the water supply were not, in so
many cases, from shallow wells, and thus apt to be polluted by the
soakage, which finds its way from houses into the gathering ground of
wells.
There are Special Drainage Districts in Kelty, Limekilns, and
Kincardine. The systems of sewers at Kelty and Tulliallan require
better means for flushing and ventilation. A sewerage system, when
faulty, is often worse that no system at all, as gases generate where
flushing is insufficient, and, being confined under great pressure with
defective ventilation, tend to break out into situations where they should
not be found. These conditions also demand that there should be the
best possible system of disconnection between the sewer and the house
drain, so that sewage gases may not be "laid on" to the house. The
question of the disposal of sewage falls to be considered under this
section, but, following the arrangement determined on so as to prevent
undue repetition, I shall refer to this in Kirkcaldy District Report.
GENERAL CONDITION OF HOUSES.
It will be understood that, as my term of offices dates from so
recent a period, little or nothing has been done in regard to this. In
certain cases, where insanitary conditions were indicated by the occur-
rence of zymotic diseases, and the inspection of the houses made impera-
tive in consequence, any structural defects were put to rights. Such
insanitary conditions as dampness of the walls, from want of proper rhones
and conductors, have been frequently pointed out and dealt with, but
there are very many houses in the District with structural defects, which
should be put to right without delay, and not require the notice of the
Public Health Department at all. By the terms of the Housing of the
Working Classes Act, the duty of seeing that all houses in the District
are in a satisfactory condition is imposed on the Local Authority. No
action has as yet been taken under these Acts, but a systematic
inspection of the whole District will have to be made, in order to ascer-
tain what houses, if any, are in such a state as to be considered unfit
for human habitation. As Sub-section A of Section 16 of the Public
Health Scotland Act is to be read along with these Acts, a reference to
it will show what conditions are to be considered as rendering houses
unfit for human habitation or use.
There are many houses in the District, judging by my general inspec-
tion, which fall short of an ordinary standard of fitness for human |
| HH62/1/FIFE/39 |
[page] 38
occupancy, and I trust that attempts will be made to put these in a
satisfactory state, without recourse being needed to the application of
the Housing of the Working Classes Act.
A synopsis of the general sanitary condition of the various villages
and hamlets in the District is appended to this Report, for convenience
of reference.
GENERAL AND SPECIAL ENQUIRIES MADE SINCE
APPOINTMENT.
The systematic inspection of the whole District I have considered
a most important duty, as without this it is quite impossible to ascertain
what are the conditions injurious to health; and, accordingly, I have
visited every village and hamlet within the District, and made careful
enquiry into their conditions of water supply, drainage, and house
accommodation. It would be out of place to give a full account of all
these visits, as they are recorded in my District Journal; and as the
reports given on water supply and drainage are founded on personal
visitations of the places referred to, they will sufficiently indicate the
extent of my general enquiries. As regards special enquiries, these have
been made in connection with infectious cases that have been notified,
where the circumstances indicated sanitary defects. At St David's a
case of enteric fever required special attention, from the fact that a
while ago there was a serious outbreak in this neighbourhood, attributed
to polluted drinking water. At Gowkhall, in Dunfermline parish, a
slight outbreak of enteric fever occurred, and enquiry made into the
circumstances showed that there was every indication of a polluted
water supply existing there, as well as want of drainage and accumula-
tions of offensive matters in near proximity to houses. The condition
of the water supply of Torryburn has been the subject of special
enquiries and very numerous visits, and apparently the question is as
near solution as ever.
To secure a suitable site for the proposed Isolation Hospital has
been the subject of special enquiries and frequent visits to various sites
in the vicinity of Dunfermline, and several have been found, which
appear to meet the requirements which I have indicated in my reports
on Hospital accommodation for the District. In special cases I have
visited dairies with the inspector; and with more time than I have had,
I shall devote further attention to these very important inspections.
Special attention has been given to the sanitary state of schools
and their environments, and this duty will receive more attention, when
better opportunity occurs, as the subject is of importance, not only
from the necessities of the case itself, but from the educational effect it
is hoped it may have in directing the attention of teachers and scholars
to hygiene as a subject for instruction.
GENERAL STATEMENT AS TO ADVICE, CERTIFICATES,
OFFENSIVE TRADES, SANITARY CONDITION OF
FACTORIES AND WORKSHOP.
The fact that I have not given any certificates will indicate that,
so far, sanitary administration in the District has been working
[page] 39
smoothly, and that no legal action has been necessary. Advice has
been given as to water supply in the District generally, the adoption
of the Notification of Infectious Diseases Act, on Hospital Accommo-
dation for the District, and on a proposed Hospital for H.M.S.
"Caledonia" at Queensferry, on regulations for common lodging-
houses, slaughter-houses, and for printed handbills pointing out the
meaning of "Nuisances" under the Public Health Act, and the
penalties which may be incurred by the authors of nuisances. No com-
plaints have been made to me regarding the sanitary condition of factories
or workshops, and hence no action has been taken.
INSPECTION OF BAKEHOUSES.
All bakehouses, as far as known to me, have been inspected by
me; and while no very defective conditions have been observed, the
general state of cleanliness is not of a very high order. In two cases,
there were very serious insanitary conditions, requiring interference,
arising from the too close proximity of a manure heap to the bakehouse
in one case, and in the other from very foul accumulations, also close
to the bakehouse. The first case was satisfactorily dealt with, and the
other is now being arranged, although the occupier of the bakehouse at
first declined to do anything to improve matters.
In order that occupiers of bakehouses may not plead ignorance as
to the Regulations in force, printed copies have been sent to them, show-
ing the powers Local Authorities have under the Factory and Workshop
Act, 1878, to enforce cleanliness, ventilation, and other sanitary con-
ditions of bakehouses. In my opinion, powers are required by Local
Authorities to make regulations, which would give reasonable guarantee
that the important article of diet, bread, was prepared and presented for
sale in a pure state. The premises of a baker should be registered, just
as anyone who sells milk must be registered.
SUPERVISION OF HOSPITALS.
There is no Hospital at present in Dunfermline District under the
District Committee, and my action in this respect has been confined
to reporting on the necessity of Hospital Accommodation. Two
separate reports have been submitted to the District Committee. In
the first report I dealt with the powers Local Authorities had, under
the Public Health Act, to provide hospitals, ambulances, and means
for disinfecting, and of the necessity that there was in the District for a
thoroughly equipped hospital, sufficient to treat any cases of infectious
disease that might occur in the District. The report also suggested
that, on the grounds of economy and good management, a Combination
Hospital for the District and Burghs should be constructed at some
central situation; and also dwelt generally with the various requirements
of a site for an hospital. It was also suggested that before a permanent
hospital could be erected a considerable time must elapse; and to pro-
vide for any emergency, a temporary hospital should be secured. It
was decided that a Doecker's Hospital should be procured; and the
necessary sanction of the Standing Joint Committee of the County |
| HH62/1/FIFE/41 |
[page] 40
Council was got for this. A site was also secured, so that if any
emergency had occurred, a means of isolation could have been ready
in a few days time. In my last report the question of a permanent
hospital was dealt with, and it was referred to a sub-committee for full
consideration. As far as can be judged, there is the possibility of a com-
bination scheme being yet gone into.
ACTION TAKEN IN REGARD TO INFECTIOUS DISEASES.
Since the Notification of Infectious Diseases Act has been adopted
in the District, it has been possible the deal with any infectious diseases
as they occurred. There has not been any widespread epidemic of any
infectious disease, with the exception of the prevailing epidemic of
influenza. At Gowkhall several cases of enteric fever were notified,
and at once printed instructions for disinfection were delivered at the
houses, and notices served on various people at the hamlet to have
offensive matters removed. What were probable causes of the outbreak
at this place will be further referred to. One case occurred at St
David's, and the usual rules for disinfection were forwarded, and also a
notice that school attendance was to cease from this house till risk of
infection had ceased. Two cases of erysipelas occurred in a common
lodging-house in Kincardine; and, as this house had been formerly
reported on as being in an insanitary condition, it was decided that the
keeper must either conform to the bye-laws for common lodgings, or
steps would be taken to have it closed, as being unfit for the purpose.
Several cases of scarlet fever were reported from Aberdour and
one from Beath, and the usual directions for disinfection, and precau-
tions to be observed in such cases, were sent to the heads of families.
The schoolmasters of the schools at which members of the different
families were attending were also advised not to allow attendance from
the infected houses until a medical certificate was produced stating that
danger of infection had passed. These examples given above show the
general procedure adopted in all cases notified to me. When an hospi-
tal is available, of course suitable cases will be sent there for treatment,
and fortunately no great necessity for hospital treatment has yet oc-
curred; but this is a state of matters which will not at all time prevail.
[page] 41
STATEMENT OF THE CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASES WITHIN THE DISTRICT, AND THE
EXTENT TO WHICH THE SAME HAVE DEPENDED ON, OR BEEN INFLUENCED BY, CONDITIONS CAPABLE
OF REMOVAL OR MITIGATION.
To give a brief statement, to be made under this section, and to explain the information derived from the notifica-
tion of infectious disease, will be best attained by giving the following information regarding each case which has been
notified to me since 1st October.
TABULAR STATEMENT OF INFECTIOUS DISEASES NOTIFIED.
[table inserted]
These cases do not indicate the widespread prevalence of any infectious diseases. The five cases of scarlet fever
in Aberdour were from an introduced source, and by isolation there was no further extension of cases.
Three cases of enteric fever at Gowkhall were due most probably to the pollution of the well water there. |
| HH62/1/FIFE/43 |
[page] 42
In the statement regarding the mortality of the District, further
reference will be made to the origin and causes of certain diseases, and
to any conditions which might have been removed or mitigated.
In order to judge of the sanitary condition of a District, it is
necessary to know the rate of mortality from different classes of disease.
The mere death-rate per thousand of population is not sufficient, but in
addition we must have the death-rate of infants under 1 year to 1000
births, the death-rate of children from 0 to 5 years per 1000 of those
living at that age, the death-rate from zymotics and tubercular diseases.
These may be called the minimum requirements of a Report like this,
and the information needed for the construction of these rates is got
from (1) the Census returns, which give the numbers of the population,
and (2) Mortality returns form the local Registrars. I refer to these
matters, as the Committee has had so often before them the difficulties
experienced in getting the necessary data.
Tables of these various death-rates will be found at the end of this
Report, but, in addition, I have added a Table showing the "crude"
death-rates of the parishes in the District for 10 years. It is necessary
to state that these include burgh rates; as in the returns issued by the
Registrar-General, these are not separated from the rural districts rates.
The rates being calculated on the populations of parishes, which are
frequently small, are not altogether reliable, and vary much from year to
year.
DUNFERMLINE DISTRICT.
DEATH RATE IN VARIOUS PARISHES - 1881 TO 1890.
[table inserted]
In purely rural districts, a death-rate above 17 per 1000 is con-
sidered high, and indicates that much sanitary work has to be done to
reduce it to the normal.
In this Table, 43 per cent. of the total rates are above the standard,
and in some cases enormous death-rates are indicated. The causes of
these excessive rates could only be ascertained by searching the Regis-
trars' books, as they are not to be found in the Abstract Reports of the
Registrar-General.
[page] 43
MORTALITY STATISTICS FOR 1891.
In Dunfermline District alone has it been possible to obtain the
necessary returns of births and deaths on which rates are calculated,
and in the appendix of this Report a complete statement is given.
The proportion of person to acre is calculated on the total area
and total population of the District.
The birth-rate is high, and the deaths under one year give a high
death-rate.
The total death-rate is also high, but the death-rate from zymotic
diseases is low.
The death-rate from phthisis is low, and in a District where phthisis
is supposed to be necessarily high, from the large number of miners in
the population.
In the Table of Deaths it will be seen that influenza caused fifteen. |
| HH62/1/FIFE/45 |
[page] 44
DUNFERMLINE DISTRICT.
TABLE SHOWING NUMBER OF HOUSES IN VILLAGES IN DUNFERMLINE DISTRICT, PERSONS PER HOUSE, WATER.
SUPPLY, DRAINAGE, AND GENERALLY SANITARY CONDITION IN 1891.
[table inserted]
[page] 45
DISTRICT OF KIRKCALDY.
The District is formed of thirteen parishes, and is bounded on the
south by the sea - the parishes of Burntisland, Kinghorn, Abbotshall,
Dysart, Wemyss, and Scoonie being all bounded on the south by the
Firth of Forth; on the north are the County of Kinross and part of
Cupar District; on the west is Dunfermline District; and on the east,
part of St Andrews and Cupar Districts.
The District embraces the Royal Burghs of Burntisland, Kinghorn,
Kirkcaldy, and Dysart, and the Police Burghs of Lochgelly, Leslie,
Markinch, Buckhaven, and Leven. The Royal Burghs do not come
under the supervision of the District Committee, and the relationship
of Police Burghs, as far as the administration of public health is con-
cerned, is not well defined - if any exists at all.
The total acreage for the whole District is 67,817, from the
Ordnance Survey reports, and I do not think this has been altered by
the Boundaries Commission. At the census 1881, the population was
65,235, and at the last census 77,465, showing an increase of 12,230.
There is an increase of population in ten, and a diminution in
three, parishes. Wemyss and Buckhaven show the greatest increase,
and Kirkcaldy next.
In the following table the main facts of population and acreage are
given in tabular form.
[table inserted]
The areas of Kirkcaldy and Dunfermline Districts are very nearly
alike, but the population of Dunfermline District is only 49,271, and
there is in that District an average of 1.3 acres to each person, Kirk-
caldy having only 0.8 of an acre to each person.
The parish of Auchtertool has the largest mean of acres to person,
and Kirkcaldy the smallest, and Dysart is next to Kirkcaldy in this
respect.
These figures are necessary to show the area under the supervision
of the District Committee. The connection between person to acre |
| HH62/1/FIFE/47 |
[page] 46
and acre to person, with sickness and mortality, will be referred to in
the Section dealing with these.
In the remainder of this Report, the order prescribed by the Board
of Supervision for District Reports will be followed.
GENERAL ACCOUNT OF SANITARY STATE OF DISTRICT,
WITH RECOMMENDATIONS FOR ITS IMPROVEMENT.
To deal adequately with this subject, and at the same time without
duly extending the length of this Report, is a matter of no small diffi-
culty, when the area, the population, and the number of populous places
in the District are considered. It appears to me that this Section re-
quires as full treatment as possible, in order to show what is the sanitary
condition of the District at the commencement of the supervision by
the District Committee as Local Authority, and what work remains for
them to carry out, in order that the whole District may, in the course of
time, be put in a satisfactory state.
A good deal of time was necessarily taken up at the commence-
ment of my duties, in bringing the machinery of the department into
working action; and time has only permitted attention to such general
questions as water supply, drainage, and sewerage of villages. To take
up the subject of individual houses systematically, a most important
duty, would necessitate a greater amount of time than has been at my
disposal; and such ruling principles of sanitation as water supply and
drainage of villages seemed to demand my attention first. I have re-
ported on a good many populous places in the District, as to their pro-
vision of water supply and drainage, and their condition is therefore
known to you; but to make this Section as complete as possible, I shall
refer to all populous places (whether already reported on or not) in the
parishes in which they occur.
Auchtertool. - The water supply is from shallow wells close to
houses, and is of doubtful quality in consequence. Drainage is by
means of side gutters, and is not very efficient. The village is tolerably
free from nuisances.
Little Raith colliery village is supplied by gravitation water of good
enough quality. Drainage is carried out by surface channels and
underground drains. The habits of the people are such that nuisances
abound, and vigilant sanitary inspection is needed.
AUCHTERDERRAN. -
Cardenden has a good water supply by gravitation; but there is a
want of privy or water-closet accommodation. Ashpits for depositing
house refuse are needed.
Denend. - The water supply here is not well distributed, and there
is also the want of accommodation by privies or water-closets. Ar-
rangements are now being made to have these procured.
Dundonald has a good gravitation water supply; but there is want
of accommodation by water-closet or privy. Ashpits are also needed.
Capeldrae Row gets water from a well. A want of ashpits exists.
Westfield colliery village has been frequently referred to in con-
nection with the occurrence of enteric fever there, and very serious
insanitary conditions existing.
[page] 47
The proprietor of one half of the place has provided ashpits,
privies, and drains, but the tenants of the other half, who were held to
be responsible, refused, on the ground that the proprietor was liable. In
the meantime, ashpits and privies are being provided by the Local
Authority.
The village urgently needs a water supply; but who is to provide
this has not yet been decided.
Shawsmill is a small hamlet, and there is nothing special to report
in regard to it.
BALLINGRY. -
Flockhouse village was frequently reported on, as the water supply
was defective, being from shallow wells near to sources of pollution.
There was an absence of proper water-closet or privy accommodation,
and the drainage was very defective. After an action had been raised
in the Sheriff Court, these matters were put right.
Lochore. - The water supply here was defective, owing to want of
sufficient wells over the village in connection with the gravitation sup-
ply. There was also no water-closet or privy accommodation, and the
drainage was very defective. These matters have all been attended to.
Lumphinnans. - The village has a good water supply by gravita-
tion. Drainage is mainly by surface channels. Ashpits and privies
are provided for the tenants. Nuisances are very common, from the
untidy habits of the people.
Rosewell. - This village was in a very insanitary state from defective
water supply, want of drainage, and want of water-closet or privy ac-
commodation. After an action had been raised in the Sheriff Court, the
necessary improvements were carried out.
BURNTISLAND. -
The village of Binnend is the only populous place of consequence
in this Parish, under the District Committee.
The water supply, formerly adequate, in consequence of the increase
of the population, has now become quite insufficient, and during the
past summer the want of sufficient water was a very great danger.
There is urgent need for full supply being obtained. The drainage
is by surface channels and underground drains. These were defective
in many ways, but some improvement has been made. Huge privies
and ashpits are provided for the inhabitants, but they are structurally
bad, and not sufficiently cleaned out. In many of the houses over-
crowding to considerable extent exists.
KENNOWAY. -
The village of Kennoway derives its water supply from wells. The
principal one is in the middle of a field, in a high state of cultivation,
and with houses close to it, and on a higher level. It is a very doubt-
ful source of supply, and an analysis of the water points to this. The
water main of Wemyss supply passes the village, and this is the most
likely source of a new supply. Drainage is by surface channels, and,
as the houses are built on a slope, it is fairly satisfactory.
The condition of the houses is generally satisfactory.
Star is a hamlet in the north-west of the parish. The water supply
here is from shallow wells in close proximity to houses, and the quality |
| HH62/1/FIFE/49 |
[page] 48
is therefore most doubtful. There is no means of drainage. The
houses in many cases are in very bad order.
Bonnytown gets its water from wells; but also has a branch from
Wemyss water main.
Baintown is a very small hamlet, getting its water from shallow
wells.
Kingslassie. - The village has a good water supply by gravitation.
Drainage is by loosely paved side channels on the sides of the road,
and is very defective. The houses are, in many cases, in bad order;
but owing to the increase of coal mining in the district, houses are
being improved. There is very great need of a better system of
drainage, more efficient scavenging, and attentive sanitary inspection is
needed.
Leslie Parish. - The village of Leslie is a police burgh, and the
only populous place to refer to is Prinlaws. This place has a good
water supply of gravitation. Ashpits are regularly cleared out, and the
place generally is well kept.
MARKINCH. -
This parish contains several important places. The town of
Markinch, formerly reported on by me to Kirkcaldy District Com-
mittee, has now become a police burgh, and therefore does not fall to
be considered.
Auchmuty Village. - The village derives its water from a pipe about
300 yards distant. This should be led in, as the distance is too far.
There is drainage provided, and the houses are in good order, and the
whole place is in very good order.
Balbirnie Mills. - This hamlet has a supply of water by gravitation.
The houses are old, and are occupied by old residenters on the place,
who are satisfied with their houses, although in many cases they are
damp.
Balcurvie Village. - The water supply of this village is most
defective. One well in the village is in close proximity to a foul gutter,
and is also liable to pollution by slop-water of houses. The main well
is to the north of the village, and on my first visit, a pigstye was near to
the source of the spring. Drainage is very much needed, and nuisances
from pigstyes and manure are very abundant.
Coaltown of Balgonie has a Special Water Supply District. The
water comes by a branch form Kirkcaldy Corporation water main, and
is of excellent quality. The drainage of the village is by side gutters
and underground drains, and is not at all satisfactory. There is great
need for a properly conducted sewage system. Scavenging is not well
attended to, and, in consequence, numerous nuisances exist. Careful
sanitary inspection is needed.
Milton of Balgonie. - The water supply is by wells, in the usual
proximity to houses. The hamlet, however, on the whole, is tolerably
free from serious nuisances.
Cameron Bridge. - The village is almost part of Windygates.
Water supply is by wells and by gravitation. Drainage is defective,
and sewerage matters discharge into the Leven.
Kirkforthar Feus. - The water of part of the village is of a most
[page] 49
suspicious nature, being from a well surrounded by houses and pigstyes.
The soil is damp, and drainage is needed, as the houses are rendered
damp from want of this, and from want of rhones for rain water.
Thorton Village has a Special Water District, and gets its water
supply by a branch pipe from Kirkcaldy Corporation main, and is well
supplied. There is no drainage system, except by side channels, and
the gradients being very flat this is very defective, and quite insufficient
for the purpose. A proper drainage system is much needed. Scaveng-
ing is fairly well attended to.
Windygates. - The village is supplied by shallow wells, quite close
to houses, ashpits, and other sources of pollution. In many cases the
wells are lower than the houses, and this increases the danger of pollu-
tion being carried into the wells. There is no drainage system.
Nuisances are very abundant. A Special Drainage District for Balcurvie
and Windygates has been formed, but no steps have as yet been taken to
go on with the works. A good supply of water is urgently needed, both
for this village and Balcurvie.
Woodside. - This hamlet is supplied by water from wells. There
is little or no attempt at drainage, but the place is tolerably clean.
Scoonie Parish. - Except the police burgh of Leven, there is no
populous place of consequence in the parish. My attention has been
specially drawn to houses which were considered to be insanitary, and I
have report that these houses are in very defective conditions. None
of the houses are provided with rhones, and the soil is banked up
against the back walls, rendering the houses damp. There is no
attempt at drainage for any of the houses, nor are they provided with
privy or water closet accommodation. Very extensive improvements
are needed to render them habitable.
Wemyss and Buckhaven. - By the formation of a police burgh,
Buckhaven, Methil, and Innerleven have passed out of the control of
the District Committee; but, prior to this, I reported on their sanitary
state in connection with an outbreak of enteric fever.
Coaltown of Wemyss has a branch pipe from the Wemyss water
main, and is thus well supplied with water. The houses are good, and
the place generally is clean.
Kirkland is supplied from Wemyss water main. The village was
supplied with a public latrine by the Local Authority of Wemyss Parish.
The houses are not in very good order. The public ashpits are too
large and too near houses, especially as, not being roofed over, the
contents are not kept dry. The square nearest the Leven is in a most
unsatisfactory state from defective drainage and accumulation of house
refuse.
Muiredge. - This place is provided with a public latrine. Drainage
is by side gutters.
Methilhill. - This place is supplied from Wemyss water main.
Drainage is effected by surface gutters and underground drains. The
surface gutters, especially at the south row, are very defective, and are
not sufficient. Flushing of this gutter is done by a pipe leading direct
from the water supply pipe, and discharging by a T piece an inch or so
above the level of the gutter. This is a very bad means of flushing, |
| HH62/1/FIFE/51 |
[page] 50
and likely to lead to sewage matters being sucked into the water supply
pipe, especially after any intermission of pressure in the pipes. This
matter was reported by me in a report prior to my official appointment.
Scavenging was formerly undertaken by the Local Authority, but, in the
meantime, this is done in a perfunctory manner until it is decided who
is responsible. To the north side of the village, quite close to houses,
are many pigstyes and hen-houses, as well as accumulations of house
refuse. Arrangements are being made to have these removed. Water
latines are being erected to supply the wants of the inhabitants.
There is great need for a good system of drainage, for the reasons
given above, as well as for others, which will be referred to under the
section referring to infectious diseases.
East Wemyss. - The village is supplied by a branch of Wemyss
water main, but there are two wells at present in use, and which I have
asked permission to get analysed and shut up, if polluted, as there is
every reason to believe they are. One is quite close to a graveyard,
and the other surrounded by houses, and below the level of a burn
polluted with sewage, which runs within 20 yards of it.
The drainage of the village is very defective, being effected in part
by badly-laid gutters, and in part by underground drains. The main
sewer discharges into the sea, but is not carried far enough out. Very
many private drains discharge through the sea wall on to the foreshore,
leading to very great offence, especially in summer. The burn which
passes through the village receives the sewage of many houses, and
then discharging on to the foreshore contributes to the serious pollution
of the beach.
Public latrines, with flushing tanks, are provided, but many of the
houses are not provided with any means of accommodation. An entire
block of tenements, with numerous tenants, has no accommodation or
ashpits. This village cannot be considered to be in a satisfactory state.
West Wemyss is provided with water from the Wemyss water
main. The drainage is by side gutters and underground drains.
There is a necessity for further extension of the drainage system and
improvement of the side channels. Public water latrines are provided,
but many of the houses are not provided with any manner of accommo-
dation. Scavenging was undertaken formerly by the Local Authority;
but by resolution, adopted at a meeting of the District Committee, it
was decided that the servants of the Local Authority should only attend
to the cleansing of the property of the Local Authority, such as latrines,
public ashpits, and the gutters, &c., of the sewerage system. Many
of the houses are not provided with ashpits, and the inhabitants throw
house refuse into the streets; and, in consequence, the village has
become most unclean and offensive.
This village would almost require a special sanitary inspector for
itself, as the habits of the people tend to the causation rather than the
prevention of nuisances.
For convenience of reference a table is appended showing the
number of houses and persons per house, in villages referred to at
census 1881; also, conditions of water supply, drainage, state of clean-
liness, and general state of houses as I found them on my inspections.
[page] 51
RECOMMENDATIONS.
The various defects of water supply and drainage referred to show
that there is a very great deal to do in Kirkcaldy District to put matters
right. The question of water supply is one which does not present
difficulties which may not be overcome by money and with time, but
the question of sewers and drains is in a very different position. There
are some of the villages referred to as needing sewers, but the engineer-
ing difficulties are so serious, and the expense which would be incurred
so great, as to render the execution of the works impracticable. In
addition to these difficulties there is another one, certainly not the least,
and it affects all sewerage systems in how to get rid of the sewage
after sewers have been constructed. When the village is on the sea
shore or near to it, there is not much difficulty; but when, as in many
of the villages referred to, the distance to the sea may be 10 miles, the
case is different. It may be assumed that the provisions of the Rivers
Pollution Prevention Act will be adhered to, and that streams will not
as formerly be made to perform the duties of sewers; and, further, that
those towns and villages disposing of their sewage in this manner will be
called upon to respect this Act.
TREATMENT OF SEWAGE.
The problem, as it affects the villages with which we have to deal,
resolves itself into a narrow one, inasmuch as no scheme involving a
great expense can be entertained. Those who have studied the subject
know that, of schemes for the purification and utilisation of sewage there
is no end; but here, only those that are likely to meet the necessities
of the case, and restricted to two in number, will be referred to. The
first, and the one which seems to me to be widely applicable, is broad
irrigation. In this the sewage, after straining, is distributed in channels
over well-drained land, on which vegetables and crops are grown. The
best soil is a sandly loam, and about an acre for every 150 people is
needed.
The other method to which I intend to refer might be used when
ground for irrigation is not available, and is called the "International
Process." It is based on the principle of (1) precipitation by chemicals,
and (2) further purification by filtration. The system is at use at
Larbert Asylum, Stirling, and has been found to work well.
GENERAL AND SPECIAL ENQUIRIES.
After the account of the general sanitary state of the District, it
will only be necessary to refer to special enquiries, which have been the
subjects of reports to the District Committee.
The conditions of Westfield, Rosewell, and Flockhouse Colliery
Villages, as to their general insanitary states, have been very frequently
before the District Committee, and these places have been visited
repeatedly, along with members of the District Committee. These
visits were not made entirely in connection with insanitary states
prevailing there, but with regard to the possibility of obtaining a source
of water for a gravitation supply. A special visit, along with members
of the Committee, was also made to Lumphinnans Colliery Village, in |
| HH62/1/FIFE/53 |
[page] 52
reference to certain complaints made by the Sanitary Inspector. The
conditions of East and West Wemyss, Methilhill, and Kirkland, necessi-
tated frequent visits; and one of these was made along with a Sub-Com-
mittee, appointed to deal with the whole question of scavenging of the
District. A special report on the state of these villages was also made
to the Board of Supervison, at the request of the Secretary. The
condition of the village of Binnend was a subject of considerable
anxiety, owing, specially, to the very defective water supply there during
summer, and to other sanitary defects, and necessitated frequent visits.
A special enquiry was made regarding the sanitary condition of
East Wemyss, and a report dealing with the defects in the sewerage
system was submitted to the District Committee.
In connection with the occurrence of Enteric Fever in the Burgh
of Buckhaven and Methil, and a request by the Medical Officer of the
Burgh to visit the dairies of the District, which supplied milk to the
Burgh, I visited all the dairies, and made a careful enquiry into their
condition, in order to ascertain if any connection existed between the
outbreak and the milk supply. The result of this enquiry was not
satisfactory - not that any positive causal relationship could be traced
between the enteric fever and any of the dairies visited, but that it
showed the general condition of the byres and milkhouses to be very
unsatisfactory. The duty of inspecting dairies and milkshops is one of
the most important that sanitary officials have, and I hope to be able to to
devote considerable attention to this in the future, when time permits.
A special visit was paid to works at Thorton, where sulphuric acid is
made. The process here is conducted according to modern principles,
and no nuisance is caused by the escape of sulphur or nitrogen com-
pounds. It is of considerable interest to hear that, at this work, where
sulphurous acid loads the air where the men are employed, only one
man out of about thirty was affected by influenza; and the epidemic
was very prevalent in the district.
STATEMENT OF ADVICE OR CERTIFICATES.
One of my first duties was to advise regarding the appointment of
the Chief Sanitary Inspector for the District, and out of the number
who applied, I advised that two were specially suitable for the appoint-
ment. Mr James Low, one of the two, was afterwards appointed.
The generous offer of Mr Wemyss to hand over his Cottage
Hospital to the District for use as an Isolation Hospital was submitted
to a Committee, with the Medical Officer, for consideration; and after
inspecting the Hospital, the Committee and the Medical Officer were
unanimously of opinion that the Hospital should be taken over by the
District Committee; and this was afterwards carried out.
Draft Rules and Regulations for dairies, byres, and milkshops,
under the Contagious Diseases Animals Act and the Order of 1885,
were drawn up by me, and afterwards adopted; also Regulations for
slaughter-houses. The Regulations for houses let in lodgings were also
approved of, but they have not yet been advertised, and in consequence
cannot be enforced.
[page] 53
After a report on the desirability of adopting the Notification of
Infectious Diseases Act, the District Committee unanimously adopted it.
A short report on an alleged nuisance at Capeldrae Farm, from the
flow of sewage from Flockhouse Colliery Rows, was submitted to the
Committee, and pointed out that there was no nuisance caused, under
the Public Health Acts; but if there had been any, the complainer
would have been held responsible as the "author" of the nuisance.
Certificates under the Public Health Act were granted for nuisances at
Rosewell, Flockhouse, and Westfield Colliery Rows, and the Sheriff in
each case ordered the works necessary to remove and prevent the nuis-
ances complained of.
Certificates were also granted for nuisances at Balcurvie and
Coaltown of Balgonie, and the authors of the nuisances were ordered
by the Sheriff to take the necessary steps to remove them.
INSPECTION OF BAKEHOUSES.
The Bakehouses in the District have all been inspected, and their
general condition noted. While it cannot be said that any of them
show a high order of efficiency or cleanliness, none were found in a
very defective state. It is unfortunate that bakehouses cannot be made
subject to stringent regulations as other trades, as by this means alone
would it be possible to put bakehouses in that state of cleanliness,
which the manufacture of such an important article of diet demands.
It has not been found necessary to take any proceedings, under
the Factory and Workshops Act, in relation to bakehouses.
ISOLATION HOSPITAL.
There is one Hospital for Kirkcaldy District, and it came under
the control of the District Committee in June of this year. The
Hospital has been visited by me several times, and is in a fit state for
the reception of cases. Fortunately there has not been any necessity
of this since June; but, no doubt, it will be utilised to the fullest extent
in the future.
I propose to submit draft regulations for the management of the
hospital, and for insuring disinfection of infected clothing, bedding, &c.
PREVENTION OF EPIDEMIC DISEASES.
Prior to the introduction of the Notification Act, several cases of
scarlet fever were intimated from Binnend in an indirect manner. By
a house-to-house inspection several cases were discovered, some con-
valescing, and others in the acute stages. Rules for disinfection and
isolation were in all cases issued, and notices to schoolmasters not to
allow attendance at school till danger of infection had ceased. This
procedure is adopted in all cases. None of the cases were removed to
Hospital, as they were sufficiently accommodated at home. In connec-
tion with this slight epidemic, the insanitary condition of the village
was represented to the owners of the houses, and steps were taken to
insure better scavenging and cleansing of the ashpits Isolated cases of
scarlet fever, which occurred over the District, were treated in the same
way. |
| HH62/1/FIFE/55 |
[page] 54
At Methilhill several cases of typhoid occurred, and in these cases
rules appropriate for disinfecting were issued, also disinfectants supplied.
Some of the cases intimated had been ill for a longer time than I con-
sidered it safe for the patients' removal to Hospital, and a great objec-
tion prevails in the district against removal to Hospital. This will be
overcome as the benefits of Hospital treatment are experienced.
CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASES
WITHIN THE DISTRICT.
In this District only a few registrars have sent in statements of
mortality, and I am thus deprived of this means of information as to
what diseases have occurred and proved fatal. The District, like many
other places, has suffered severely from influenza, and this has raised
the death-rate, doubtless. In some of the parishes a great many old
people have succumbed from this cause.
Since the adoption of the Notification of Infectious Diseases Act,
42 cases of infectious disease have come to my knowledge.
In Auchtertool parish one case of erysipelas occurred.
In Ballingry four cases of scarlet fever.
Twelve cases of scarlet fever were intimated from Burntisland.
In Leslie one case of typhoid, and one of erysipelas, were notified.
Three cases of diphtheria, three cases of scarlet fever, and one of
enteric, occurred in Markinch.
In Scoonie one case of scarlet fever.
In Wemyss six cases of scarlet fever, six cases of typhoid, and three
cases of erysipelas, were intimated.
The cases intimated from Burntisland occurred at Binnend, and
the number is increased by the fact that six cases occurred in one house,
and they were all out of bed and convalescent when the cases were
notified.
Three cases of diphtheria occurred in the parish of Markinch - two
of these in a house where the sanitary conditions were as nearly perfect
as possible. It is well-known that many animals suffer from diphtheria;
and in the house I refer to a cat was ill, and was killed, as the suspected
source of infection. Unfortunately, I could not get possession of this
cat for the purpose of examining it. At Balcurvie, where the other
case occurred, the insanitary conditions existing there are sufficient to
account for the case.
The cases of enteric fever in Wemyss parish occurred at Methilhill,
and can be accounted for by defective drains and sewers, and by
accumulations of manure and offensive matters from pigstyes and hen
cribs. The water supply is good; but an improved system of sewers
is much needed for this village.
The parish of Wemyss has a large population, and only .4 of an
acre to each person, and, in consequence, there is a greater risk of
infectious diseases spreading, than, for instance, in Auchertool, where
there are 3.4 acres per person.
[page] 55
MORTALITY STATISTICS.
On account of the registrars not supplying me with mortality re-
turns, it is not possible for me to give any statement of death-rates from
all causes, and from special causes; and I have exhausted every means
likely to obtain these. This Report is accordingly deprived of the most
important information it should contain.
In the succeeding table are given the crude death-rates in all the
parishes in the district, from 1881 to 1890. It must be taken into con-
sideration that these rates being calculated on small populations,
statistical fallacies are apt to occur as a result. It will be observed that
in some years the death-rates are abnormally low, and in other years
abnormally high, and this is a result to be accounted for by the small
populations of parishes being taken as the basis for calculation. When
sustained high rates or low rates occur over several years, these are of
more significance.
The parishes of Auchtertool, Kennoway, Kinghorn, and Markinch,
show a high rate of mortality over many years.
In the parish of Wemyss and Buckhaven a very satisfactory
death-rate is shown, and this parish is one of the most overcrowded in
the District. The parish of Wemyss is one of the few parishes in Fife
where all the villages are provided with a gravitation water supply, and
most are provided with drains and sewers. The low death-rates may
justly be attributed to the attention to sanitation by the former Local
Authorities.
Assuming that a death-rate of 17 per 1000 is a normal one for dis-
tricts, mainly rural, we find that in the thirteen parishes of Kirkcaldy
District 50 per cent. of the total rates exceed this figure.
DISTRICT OF KIRKCALDY.
DEATH RATE IN VARIOUS PARISHES.
[table inserted] |
| HH62/1/FIFE/57 |
[page] 56
STATISTICS FOR 1891.
For 1891 only two parishes have sent in Returns complete for six
months - Kennoway and Markinch. Kennoway shows a very high
death-rate - 40. per 1000, but the mean age at death was also high.
Phthisis caused 1.3 per 1000 of population.
Markinch death-rate is also very high - 22.8 per 1000; zymotics
1.5, and phthisis 1.2. The epidemic of influenza accounts to a certain
extent for these high death-rates.
[page] 57
TABLE SHOWING GENERAL SANITARY STATE OF VILLAGES IN KIRKCALDY DISTRICT.
[table inserted] |
| HH62/1/FIFE/59 |
[page] 58
ST ANDREWS DISTRICT.
The District is bounded on the East by the German Ocean, on the
South by the Firth of Forth, on the North by the Firth of Tay, and on
the West by Kirkcaldy and Cupar Districts.
In the District are the royal burghs of St Andrews, Crail,
Anstruther, Pittenweem, and Earlsferry; and the police burghs of Elie,
Tayport, and Newport.
The District consists of eighteen parishes, and has an area of
90,414 acres.
At the census 1881, there were in all 36,422 persons in the District,
and at 1891 census there were 36,463, showing an increase of only 41.
In 12 parishes there is an increase of population since 1881, and in 6 a
decrease.
In Anstruther Easter, Kilrenny, and Pittenweem the decrease is
greatest, and in Forgan the greatest increase occurs. Ferryport is next,
and after this comes Leuchars.
In the section of the Report dealing with statistics of births and
deaths, the population on which the rates are calculated does not include
the populations of royal burghs, as these are not under the supervision
of the District Committee.
In the following table are shown the total acreage of the District,
and for each parish, with the population of each parish and whole Dis-
trict, and mean of acres per person.
[table inserted]
The greatest ratio of acres to person is in the parish of Cameron,
and the lowest in Anstruther Easter.
The mean for the whole District gives 2.4 acres to each person.
These figures are of interest in connection with death-rates, and will be
again referred to under the section dealing with these.
[page] 59
GENERAL SANITARY CONDITION OF DISTRICT AND
RECOMMENDATIONS FOR ITS IMPROVEMENT.
In accordance with the regulations of the Board of Supervision,
this Report has to be made under certain headings, and in a prescribed
order; and in accordance with these the general sanitary condition of
the District has to be described, and the measures which, in my opinion,
should be adopted for its improvement.
To give even a very general account of the whole sanitary condi-
tion of the District would be a task of no small difficulty, after full
opportunity had been given for ascertaining these; but as the time at
my disposal has been so limited, I thought it better to deal with
certain specific matters, and to direct my attention to the important
questions of water supply and drainage of the various villages and
hamlets in the District. To be in a position to describe fully the
sanitary condition of the whole District, and all the circumstances that
are comprehended under the term sanitary, will only be attained after
several years experience, and even then only generally.
The subjects I have taken up to be specially dealt with, are really
those elementary conditions, without the possession of which no house,
village, or town can be considered to be in a sanitary condition. I
purpose, therefore, in the following pages, to take up individually the
various villages and hamlets in the District, and describe, in as short a
manner as possible, their condition as to water supply and drainage.
The most convenient order for reference will be to take the parishes in
alphabetical order rather than in their order of importance.
Cameron Parish contains 9325 acres, and at the last census 886 people.
The soil is mostly moorland, clay, and black earth, and the climate is
cold and damp. In this parish are the hamlets of Denhead, Lathones,
and Radernie. In these the water supply is from shallow wells close to
houses, and of suspicious quality in consequence. At Lathones water
is got from a ditch running alongside the public road. There is no
attempt at drainage of these hamlets. Many of the houses in this parish
derive their water supply from shallow wells, which run dry in summer,
and then great difficulty is experienced to get the needful supply.
Carbee contains the hamlets of Arncroach and Carnbee. The soil
generally is poor. The surface is irregular, heights varying from 100 to
500 and 600 feet above sea level.
Arncroach derives its water supply from a shallow well, supplied with
a pump, situated in a sort of punch-bowl depression, and at a lower level
than the houses generally, and becomes thus a centre to which drainage
from the hamlet gravitates. The water, under these circumstances, is
of a very doubtful nature. There is no proper drainage of the village;
any soil water that gravitates out of the place finds its way into a ditch,
which runs through the village. In connection with this village, and its
insanitary state, it is desirable to point out that there were several cases
of typhoid fever in it this past summer. The condition of the school
premises is not very satisfactory, due in great part to the want of a water
supply. The urinals have no water to flush them except after rain,
and the closets are rude forms of earth closets. |
| HH62/1/FIFE/61 |
[page] 60
Carnbee is a very small hamlet, and the same defective conditions
of water supply and drainage are to be found there as at Arncroach.
Dunino. - This parish has an acreage of 2737, and, at last census,
a population of 383.
The hamlet of Dunino is a very small one. Water Supply is by
shallow wells. Drainage. - There is no attempt at drainage.
Forgan. - The Police Burgh of Newport is in this Parish, but does
not come under the supervision of the District Committee. At Wormit,
a nuisance was complained of from sewage from several new villas dis-
charging from a cesspool on to side of railway embankment. This is
now proposed to be remedied by a sewer of good construction, to be
carried out to sea. The water supply of Wormit is good, and by
gravitation
Kilconquhar. - The Parish contains Colinsburgh, Barnyards and
Kilconquhar, and Largoward. The area of the parish is 7271 acres,
96 of which are water. The soil is loam, sand, and alluvium.
The village of Colinsburgh has a good gravitation water supply,
and is in a special water district and also a special drainage district.
The village is kept in a fairly cleanly manner generally. Regarding
Barnyards and Kilconquhar, a report was furnished by me to the Dis-
trict Committee on August last, that report dealing with the marshy
condition of the glebe lands, an entire absence of drainage of the
villages, and the defective condition of the water supply, which, in
Barnyards, is from shallow wells close to dangerous sources of impurities.
The report suggested the formation of Water and Drainage Districts,
but the Committee were of opinion that this was not possible, owing to
the decaying condition of the hamlets. The conditions of water supply
and drainage now are as when formerly reported on.
Largoward. - This village is well supplied by a gravitation water
system. There is no system of drainage, and, as the ground slopes
with a considerable fall to the south, this would be easily effected.
KILRENNY PARISH. -
Kilrenny. - This village is supplied by wells, and apparently the
water is good, there being no dangerous sources of impurity near.
There is no drainage system, but the village is neat and clean.
Kingsbarns Parish contains the village of that name. The houses
are mostly detached from each other, and, structurally, are in good con-
dition. The water supply is partly by wells and partly by gravitation.
There is no system of drainage, and ashpits, pigstyes, &c., are too near
houses.
Largo Parish. - This parish has an area of 7585 acres, 600 of
which are under wood. The drainage of the parish is mainly by the
Kiel and Lundin Mill Burns to the south, and Gilston Burn to the
north.
The most important villages are Upper and Lower Largo, Lundin
Mill, and Backmuir of Gilston.
Backmuir of Gilston. - The water is derived from shallow wells.
There is no system of drainage, and the hamlet is in a very insanitary
condition.
[page] 61
UPPER AND LOWER LARGO, LUNDIN MILL. -
The states of Upper and Lower Largo have been specially reported
on by me, and as the remedies suggested in that Report have not yet
been carried out, I shall briefly describe the conditions of the villages
of Lundin Mill and Upper and Lower Largo.
Lower Largo is only very partially drained, and one of the sewage
pipes discharges into the harbour, which is very close to occupied
houses. Another sewage pipe runs along the east side of the harbour
wall, and discharges above low water mark. Numerous sewage pipes
discharge on to the foreshore above high water mark.
Temple of Largo is no better than Lower Largo, as numerous soil
pipes discharge on to the foreshore.
Upper Largo has no proper system of drainage, but a built conduit
conducts sewage matters into the Temple Burn, which discharges on
the foreshore at Temple of Largo.
Lundin Mill is not properly drained, but whatever drainage there
is goes into the Kiel Burn, which discharges into the harbour at Lower
Largo, and increases the offensiveness there already caused by the
discharge of sewage matters from Lower Largo.
At all these villages water supply is from shallow wells. The
waters from these wells were all examined several years ago, with
the following results:-
Total number of waters examined at Largo, -- 7
Number of waters grossly contaminated with sewage, -- 3
Number less contaminated, -- 2
Waters of impure quality, -- 2
Waters free from contamination, -- 0
Totals, -- 7 -- 7
Total waters examined at Lundin Mill and found to be grossly
contaminated by sewage, 2.
Since the above Report was written, requisitions have been for-
warded to the District Committee for the formation of Special Water
Districts, but no attempt has been made to deal with the very insani-
tary condition of the village from want of sewers and drains.
LEUCHARS PARISH. -
The village is not at all in a very satisfactory state from want of
sewers and drains, and from a defective water supply. The only
attempt at drainage is by side gutters, loosely laid, and in many places
with so little fall that water stagnates in them. Water is got chiefly
from the wells, one at the east end of the village, and at a higher level
than the houses; the other at the west end, and at a lower level than
the houses. Both wells are apparently sunk to same water-bearing
strata, which are sand and gravel under an alluvial soil. The well at
the east end of the village may supply good water, but it is not sufficient
for the population. The water in the well at the west end of the
village being at a lower level than the houses, and being from a
sand and gravel bed, which evidently underlies the whole of the village,
I am exceedingly doubtful of.
Many of the houses are not in a satisfactory state from want of
drainage, absence of rhones, and from the soil being banked up against |
| HH62/1/FIFE/63 |
[page] 62
the back walls or ends of the houses. There is much need for proper
systems of water supply and drainage for Leuchars.
Guardbridge. - The state of Guardbridge was recently reported on
by me, and in this report I stated that at present the inhabitants of the
village were using water which had been condemned by analysis in the
year 1887, and ordered not to be used by the Board of Supervision in
the same year.
The drainage of Guardbridge is a matter which, sooner or later,
must come up also, as at present it is in a very unsatisfactory condition.
There is little or no attention paid to removal of house refuse matters
at Guardbridge, and the general state of the village is most unsatis-
factory.
ST MONANS PARISH. -
This parish contains 1203 acres, and, at last census, had 1998
inhabitants. The village of St Monans is one of the villages in Fife
where the maximum assessment for Public Health purposes has been
reached, and this is almost entirely for providing water. The water
supply is by gravitation, and the quality is excellent, and the only
matter for regret is that the cost should have been so great.
It is self-evident that when water is introduced by pipes into a
place, provision must be made for taking it out again after it has served
its purposes, or serious nuisances will be caused; but, doubtless owing
to the already heavy assessment, no drainage system has been provided
for St Monans. Surface waters are carried away by side gutters and
channels, very badly made generally; but some, of more recent construc-
tion, are well laid and of good material, but have not sufficient fall to
render them self-cleansing. One underground drain discharges into
the harbour, and this is most objectionable, seeing houses are so close
to it.
An efficient system of sewers is most urgently needed for St
Monans, but how this is to be managed, under the present assessment,
is a question of considerable difficulty. The Public Health Act pro-
vides for Local Authorities constructing sewers and charging the cost to
the General Public Health Assessment (Section 73), and this method
might, with reason, be applied in this case, as the inhabitants of St
Monans have incurred the full assessment and cannot do more, and
grave nuisances being caused by want of sewers, it becomes the duty of
the Local Authority to remove them by provision of the appropriate
remedies. This appears to me to be the spirit of the Act, although
action is rarely taken under Section 73. the same difficulty as at St
Monans is experienced at Crossgates; and to meet it the Public Health
Amendment Act of 1891 has been adopted, and if the same action
were taken by St Andrews District Committee, this would be another
way out of the difficulty. The general state of the village is most
unsatisfactory, from defective scavenging and from the indifference on
the part of the villagers to insanitary surroundings. Many of the houses
are structurally defective, although several have been improved after the
attention of the owners was directed to them.
I think it most desirable to put on record that St Monan's insani-
tary condition is a source of concern to me, in case of the outbreak of
an epidemic, and the results which would follow any such occurrence.
[page] 63
St Andrews Parish contains 12,490 acres, and has a population
of 8755. The greater part of this population, however, is in the Burgh
of St Andrews.
The only populous places, to which reference may be made, are
Ballone, Boarhills, and Strathkinness. Ballone is well supplied with
gravitation water, and otherwise does not call for further remark.
Strathkinness is supplied by the usual type of shallow wells, and has no
system of drainage; but, as there is a very good slope on the ground
where the village is built, no great inconvenience is caused by this.
Boarhills has no drainage, and its water supply is by wells. For con-
venience of reference, appended is a tabular statement of the water
supply and drainage of the chief villages referred to.
These short statements of the main features of the sanitary con-
dition of the various villages and hamlets do not indicate that there
has been in the past any attempt to administer the Public Health Act,
and the actual condition of some of the villages approaches the primi-
tive condition of countries which have no Public Health Act at all.
The decaying state of many of the villages from fading industries
renders it almost a hopeless task to put them in a thoroughly sanitary
condition as regards the elementary provisions of sufficient water supply
and efficient drainage; and in many instances where the want of these
does not produce any acute danger to the public health, their condition
might be tolerated, taking into due consideration the financial difficulties,
but there can be no excuse for the gross pollutions which meet one at
every step. These are offences which can be dealt with under the
Public Health Act, and must be, in many instances, before the inhabi-
tants of these villages realise that they will be compelled to have their
houses and environments in a sanitary condition. Such reformations
as are needed can only be carried out by vigilant and unremitting
sanitary inspection; and, as far as one man can do it, this has been
done by your Sanitary Inspector; and I take this opportunity of stating
that a more painstaking Inspector could not be got; but he cannot
perform impossibilites, and I am distinctly of opinion that to inspect a
District with over 90,000 acres, with about 30 hamlets or villages and
73 dairies, Mr McLetchie should be provided with two Assistant
Inspectors, or with one, and the Chief Inspector either to have an
allowance for hires or for a horse and trap for himself. The railway
service only touches the fringe of the District, and to visit many of the
inland villages on foot is not only a great waste of energy but of time.
This section of the Report only touches the main features of water
supply and drainage of the populous places in the District, and it will
be seen that very few possess these two requisites - of what is called a
sanitary state - in combination; very few even possess a water supply
free from the risks of organic pollution.
The condition of the houses in the District will have to be left over
until another year, as this subject will require more attention than it
has been possible to devote to it meantime. |
| HH62/1/FIFE/65 |
[page] 64
STATEMENT OF GENERAL ENQUIRIES, AND SPECIAL
ENQUIRIES MADE SINCE APPOINTMENT.
The foregoing statements regarding the sanitary state of the
hamlets and villages necessitated personal inspections, and are founded
on these. Special enquiries were made into the conditions of water
supply and drainage of Barnyards and Kilconquhar, St. Monans,
Upper and Lower Largo, Lundin Mill, and Guardbridge, and reports
dealing with these were submitted to the District Committee. These
reports were all printed along with the minutes of the District
Committee's meetings, and, therefore, do not require to be inserted
here. The reports on Largo and Lundin Mills have been followed
with good results so far as requisitions were sent to the District Com-
mittee for the formation of Special Water Districts. Unfortunately,
however, there has been no attempt made to deal with the very
defective conditions of drains and sewers in these places. The report
on Guardbridge dealt with the necessity for a good water supply, and
pointed out that this subject was before the late Local Authority for the
parish for many years, without any attempt being made to deal
adequately with it, and unless a requisition is sent in by the villagers of
Guardbridge, they will continue for some time to use for domestic pur-
poses, waters from wells which have been condemned by analyses, as
unfit for domestic use; and the antiquated Public Health Act does not
provide for a state of matters such as this, by giving a Local Authority
the power to introduce the necessary supply of water, and to assess the
district supplied for the cost.
CERTIFICATES OR ACTION UNDER FACTORY
AND WORKSHOPS ACT.
There has only been one occasion for granting a certificate, and
this will be referred to further on. There have been no complaints
made about any workshop under the above Acts.
STATE OF BAKEHOUSES.
The bakehouses generally do not indicate a high state of structural
fitness for the manufacture of such an important article of food as
bread. A copy of the Regulations for Bakehouses, under the Factory
and Workshops Act, has been sent to all bakers, so that ignorance of the
terms of these could not be pleaded.
In one case insanitary conditions close to the bakehouse were so
serious, and the owner declining to remove them, it was decided to
institute proceedings against him. The matters complained of were a
pigsty, an untrapped drain, and a privy close to the bakehouse, but
from differences of opinion as to the reading of the Act, no action has
been taken. An attempt will be made to raise the standard of cleanli-
ness in the various bakehouses in the District by periodic inspection.
[page] 65
HOSPITAL ACCOMMODATION.
There is no Hospital in the District, and my action in this respect
has been to report to the District Committee on the question of
Hospital accommodation. The matter is now under consideration, and
I trust that before another annual Report is written, this want will have
been supplied by the provision of a properly equipped Hospital.
INFECTIOUS DISEASES PREVENTION.
In this District, the Notification of Infectious Diseases has been in
operation since 15th October, and, so far as it has been tried, is work-
ing smoothly. In a subsequent section a statement will be made of the
diseases which have come to the knowledge of the Health Department
since that date. The procedure adopted when a case is notified
is the same in all the Districts of Fife, viz.:- Printed directions regard-
ing disinfection and isolation of the patient, the dangers of exposing
infected persons, &c. - are sent to the house where the case is, and a
notice to the schoolmaster of the District, advising him of the case, and
not to allow members of the family to attend school until a medical
certificate is given him, stating that risk of infection has passed.
ORIGIN AND DISTRIBUTION OF DISEASES WITHIN
THE DISTRICT.
By the notification of infectious diseases it is possible to give an
account of the origin and distribution of this type of disease, and by
mortality returns an idea can be formed what diseases have occurred;
but, owing to the local registrars having up to this time declined to
furnish me with the necessary monthly returns of deaths, it is impossible
to supply any statement derived from these. The difficulties I have
experienced in attempting to obtain this information have been again
and again reported on, so that they need not now be considered.
CASES OF INFECTIOUS DISEASES INTIMATED SINCE
ADOPTION OF INFECTIOUS DISEASES (NOTIFICATION)
ACT.
Scarlet Fever, 9; Typhoid Fever, 2; Erysipelas, 2; Diphtheria, 1.
The cases of scarlet fever occurred at Winthank Muir, Balmullo,
and Wormit.
Both cases of enteric fever occurred at St. Monans, and one case
of erysipelas also there. The other occurred at Wormit.
The case of diphtheria occurred at Leuchars. A case of scarlet
fever occurred at West Radernie, with no medical man in attendance.
I visited the farm, and saw that no milk was being sold from this place. |
| HH62/1/FIFE/67 |
[page 66]
ST ANDREWS DISTRICT.
DEATH RATE IN PARISHES - 1881 TO 1890.
[table inserted]
For rural districts a death-rate above 17 per 1000 is too high, and at this standard 35 per cent. of the
total death rates are about what they ought be. As I have not been furnished with complete mortality
returns for the parishes of the District, it is impossible to give a statement of the mortality and death rates
for the past six months.
[page 67]
ST ANDREWS DISTRICT.
STATE OF VILLAGES AND HAMLETS AS TO WATER SUPPLY,
DRAINAGE, AND SCAVENGING.
[table inserted] |
| HH62/1/FIFE/68 |
[page 68]
APPENDIX.
DUNFERMLINE DISTRICT.
TABLE I.
BIRTHS AND DEATHS OCCURRING IN THE DISTRICT DURING THE YEAR 1891.
[table inserted]
TABLE II
DENSITY OF POPULATION, BIRTH RATE, INFANTILE, AND OTHER DEATH RATES.
[table inserted] |
| HH62/1/FIFE/69 |
TABLE SHEWING DEATH RATE PER 1000 OF POPULATION IN FIFE, KINROSS, & CLACKMANNAN FROM ZYMOTICS
[Graph inserted] |
| HH62/1/FIFE/71 |
TABLE SHEWING DEATH RATE PER 1000 OF ESTIMATED POPULATION IN FIFE, KINROSS, & CLACKMANNAN
FROM 1878 TO 1887.
[Graph inserted] |
|
|
