HH62/1/KIRKCU/35

Transcription

[Page] 34

(b.) Tubercular Diseases. - These are more serious in amount.
Twenty-eight deaths have been due, to phthisis; seven to other forms
of tuberculosis. This gives a total rate of 2·625 per 1000 of population,
or about 260 per 100,000. This is above the average for Scotland,
which the rate in 1888 being 243 per 100,000. This high rate for
tuberculosis may indicate either a larger proportion of cases to pop-
ulation in the district or larger proportion of deaths to cases;
either way the rate is undesirably high. It is remarkable, too, that
the deaths indicate a special distribution of the disease. Thus Kelton,
which has the largest population, records only 5 deaths; Kirkcud-
bright, has the next largest population, records 16 deaths. This is
equivalent to 135 and 459 deaths per 100,000 respectively. On the
other hand, for respiratory diseases Kelton has a record of 15, equivalent
to 405 per 100,000; Kirkcudbright, only 1, equivalent to 28 per
100,000. The remarkable difference in these two classes of disease
will lead to a special investigation.
At the present time there is no systematic effort to mitigate
tuberculosis, which is essentially an infectious disease. If by any
means tuberculosis could be made to generate in the public the same
terror-stricken exclusiveness of treatment as small-pox or as leprosy
and even typhus already receive, I am satisfied that in ten years
tuberculosis could be reduced to one-third of its present prevalence.
The drying of damp soils and the improvement of damp houses will
become to a certain extent preventive; but sanitation with present
resources in the counties is powerless without the emotional support
of the public.
(c.) Cancer and Malignant Diseases. - These will also form the
subject of special research, though there is not the same interesting
distribution. Of 16 cases, including cancer and other malignant
diseases, seven (chiefly cancer) occurred in Kirkcudbright; 5 in the
parish of Rerwick; 3 in Kelton.
(d.) Circulatory Diseases. - These show a record of 36 deaths,
chiefly heart disease.
(e.) Respiratory Diseases. - These show a record of 32 deaths.
Until checked by the more extended figures of the past ten or
twenty years, these facts must be taken as indicating roughly the
condition of health in the district. The population has remained on
the whole very constant; the last census showed a fall of only 74 over
the whole area; Crossmichael, Kelton, Tongland, and Twynholm showed
a slight rise; the other parishes, a slight fall. The greatest rise has
been in Kelton, where the population rose from 3458 in 1881 to 3692
in 1891. Note. - In these figures, as to deaths, &c., the parish of Cross-

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michael is purposely omitted; a mistake arose regarding the returns
from the registrar. This correction will be made in the county report.
Prevention or Mitigation. - The only specific proposals I have to
make are indicated under the first head of the report - viz., special
inspections of the water, soil, and drainage of the chief centres of
population. These inspections should begin with the most unhealthy
areas, which are shown in the figures I have given. The detailed pro-
gramme to be drawn up by the Health Committee proposed should be
guided by the facts now submitted. Those facts that specially affect
the burgh of Kirkcudbright, I shall bring before the burgh authorities
in a special report.

III. - EASTERN DISTRICT.
According to the requirements of the Board of Supervision, I now
present my annual report regarding the Eastern District of the
Stewartry of Kirkcudbright.

I. - GENERAL SANITARY STATE.
A. My position as medical officer for each of the four districts has
enabled me to develop one point in one report and another in another.
The description of sanitary conditions made in the Western District
report is applicable in general terms to the Eastern District. To
the Eastern District Committee I have the same recommendations
to make, since I consider it advisable to unify the work all over the
county. My main recommendations I have detailed in the Southern
District report, to which I now refer the Board and the County Council.
Especially would I suggest that the villages of Newabbey, Crocketford,
Springholm, and Barnbarroch, be forthwith inspected and reported on
in the sense I have indicated.
B. This district includes the following parishes:- Colvend, Irongray,
Kirkbean, Kirkgunzeon, Kirkpatrick-Durham, Lochrutton, Newabbey,
Terregles, Troqueer, and Urr. The total acreage is 142,750; the total
population, 16,463; persons per acre, 0·115, or about one person to 11
acres. The chief centres of population are the burghs of Dalbeattie
and Maxwelltown. I have not been appointed medical officer for either
burgh.