HH62/1/INVERN/13

Transcription

[page] 12

INFECTIOUS DISEASE IN LOCHABER DISTRICT.
Owing to the non-adoption of the Infectious Disease Notifica-
tion Act in this district, it is impossible to speak with accuracy
in respect of Lochaber. From information received from parish
medical men, I find that scarlet fever was present in Parish of
Kilmallie, that there was a fatal outbreak of typhoid fever at
Arisaig, that measles was present in Parish of Kilmonivaig, and
that there was an outbreak of gastric fever at Spean Bridge.

INFLUENZA EPIDEMIC.
The influenza epidemic was severely felt in nearly every part
of the County, and materially increased the death-rate for the
year. The number of deaths certified as having occurred from
this disease by no means gives a correct indication of the extent
of the epidemic. Chest and other complications carried off many
aged and weakly people. In the early part of the year this
disease was present in Harris and Uist, where it was followed by
epidemics of measles and whooping cough. In the month
of November it appeared in a very virulent form almost
simultaneously in all parts of the mainland of the County.
At that time it was raging in the East Coast, in the neighbourhood
of Inverness, and in the West Coast, in Glenelg, where very few
persons escaped it. In Kingussie District it appeared about the
5th December. Dr de Watteville states it caused a considerable
increase in the death-rate (7 deaths in 7 days for a population of
2000), chiefly among the aged, being, in the fatal cases, accom-
panied or followed by pneumonia. Dr Winchester, Fort-Augustus,
writes - "I would say that, roughly speaking, at least one-third
of the population suffered from the disease more or less severely."
The symptoms varied much; the attack usually began with
shivering, general constitutional disturbance, and high temperature.
There was seldom much cough. Headache was usually present;
sometimes it was agonizing. Pain in the back was often com-
plained of. This epidemic appears to have differed in many
respects from former epidemics. There appears to have been a
greater tendency to gastro-intestinal catarrh. Diarrhoea and
vomiting were very troublesome in some cases. Some observers
noted that children were more affected than in former epidemics.
One careful observer states that he considers influenza closely
allied to rheumatism and malaria. I am still engaged in investi-
gating this important subject, and hope to return to it in my next
annual report.

HOSPITALS.
In a former report I pointed out the necessity for the pro-
vision of hospital accommodation for the treatment of infectious
diseases. Several of the District Committees have now moved in
this matter. The 1st and 2nd District Committees have appointed
sub-committees to confer with the Local Authority of Burgh of In-

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verness, as to the advisability of erecting a joint fever hospital. The
South Uist and Barra District Committee have had the question
under their notice, and have made temporary arrangements. The
Badenoch District Committee have not as yet made any arrange-
ments. The Lochaber District Committee have no hospital, but
they have the right to send fever patients to the Belford Hospital,
Fort-William. There is no fever hospital in Skye District. The
Medical Officer of this district draws attention to the necessity
of providing small cottage hospitals for the treatment of infectious
disease, and ambulance waggons for conveying patients to such
hospitals. This, he states, is urgently required on account of the
limited accommodation of the dwelling-houses. Dr Mackenzie,
North Uist, recommends that the district should provide itself
with a moveable hospital, to which infectious cases might be re-
moved. In Harris there is no hospital of any description. I
would suggest that several small hospitals be erected in the
Long Island, and that each hospital be under the charge of a
trained nurse, whose services would be available for any case of
sickness in the district when not required at the hospital. I con-
sider that a trained nurse constantly going among the people
could do very much towards teaching the advantage that would
accrue by attending to the ordinary rules of sanitation. Attached to
each hospital there should be a covered wheeled litter, with stretcher,
for the removal of patients. I consider such a vehicle more suitable
for the circumstances of the district than a horse ambulance. It
could be taken to those townships which have no roads leading to
them, and could be placed in a boat when it was necessary to re-
move a patient by sea. Dr Mackenzie's suggestion as to a moveable
hospital deserves consideration. There are, however, difficulties
in giving effect to it. I fear such an hospital would not be very
comfortable; there would be difficulties in the way of transport,
difficulties in the way of getting skilled labour to erect it, and on
each occasion when it was moved I fear there would be disputes
about the new site. Through the kindness of Mr Carruthers, I have
been enabled to exhibit the accompanying sketch plan of a small
hospital, which gives a good indication of the class of building
which I should like to see adopted for the treatment of infectious
diseases in districts where there is no hospital accommodation.
From a glance at the plan it will be seen that the building con-
sists of two wards, separated by the nurse's apartment and the
kitchen. In connection with each ward, but separated by a
passage ventilated from end to end, is a bathroom, w.c., and a
chamber for disinfecting clothing. Separate entrances at each
end of building give access for patients to the wards. A very
thorough cross ventilation is secured by having the windows
placed opposite each other. The beds are placed round the room,
heads to the wall, and separated from each other by a considerable
space, so that the attendant may have free access to both sides
and end. Two attic bedrooms are provided over kitchen and
nurse's room. In the nurse's room there is provided a closet for