HH62/1/KIRKCU/41

Transcription

[Page] 40

But here, too, an organised effort to treat tuberculosis with the same
vigour as certain other diseases would result in a serious reduction of
cases.
(c) Circulatory and Respiratory Diseases. - These constitute a large
proportion of the total deaths - no less than 41·3 per cent. This indicates
certain defects of climate, which may operate on constitutions that are
pre-disposed to respiratory disorders by defective housing. The deaths
from bronchitis and pneumonia are proportionally many. From the
standpoint of public health the only effective remedy or mitigation of
such a condition of the death rate is to improve the houses by means of
drainage, and to inculcate better ventilation of the homes.

IV. - WESTERN DISTRICT.
According to the requirements of the Board of Supervision I now
present my annual report on the Western District of the Stewartry of
Kirkcudbright.
My duty as District Medical Officer began only towards the end of
June, 1891. My report, therefore, is in many respects imperfect; for my
time has been disproportionately spent in attending to irregular cases as
they happened to arise, and in organising the mere mechanical
preliminaries of an entirely new office. The time for systematic
inquiry and inspection has been very limited, and in this report my
chief aim is to direct attention to certain cardinal facts in the public
health, from these to frame a general programme of work for the com-
ing year, and, lastly, to indicate what practical steps the realisation of
my programme may involve.

I. - GENERAL SANITARY CONDITION.
With the sanitary condition of the district I deal from one definite
stand-point - viz., the stand-point of public health. The details of
sanitary arrangement, the record of nuisances, the steps taken for
removal, the proposals for betterment, all find their place in the
Sanitary Inspector's report. What I concern myself with are those
facts in the sanitary state that have a direct and palpable bearing on
the question of health in the district.

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A. - DISTRIBUTION OF POPULATION.
The district, which includes four parishes - Anwoth, Girthon,
Kirkmabreck, Minnigaff, and the quoad sacra parish of Bargrennan - is
in space large, in population small. The total acreage is 162,318 acres;
the total population by the census of 1891 is 5295, and therefore the
number of persons to the acres is decimal 032, or about one person to
thirty acres. Such a way of putting the fact, however, little indicates
the real distribution of people, for the people are not equally distributed
over the land. Large tracts of all four parishes are uninhabited or
uninhabitable moorland or mountain. The chief inhabited parts are
towards the sea, along the fertile valleys of the rivers Cree and Fleet.
Thus on the Fleet there is the considerable burgh of Gatehouse; on the
Cree there are the villages of Minnigaff, Creebridge, and Creetown.
In these, in a few minor villages and hamlets, and on the farms, the
people are housed. It follows that, for the purposes of health other
than those of a remote though possible future, this large area may be
reduced to a very few thousand acres.

B. - OCCUPATION AND INDUSTRIES.
The whole population is essentially agricultural; mining, once a
considerable industry in the district, is now extinct, and the amount of
manufacturing is too insignificant to reckon as a source of dishealth.
The farms, too, are mainly for stock-raising and milk produce. Accord-
ingly the sanitary question resolves itself almost entirely into this - the
proper housing of five thousand people that depend for their livelihood,
directly or indirectly, on agriculture. The full discussion of this would
involve important social questions, which, however, must be reserved
for discussion elsewhere. The practical ends of the District Committee
demand only a brief indication of sanitary features in the housing of
farmers, cotmen, labourers, and other dwellers in village or hamlet.
For clearness I touch, first, on the farmhouse, cothouse, and labourers'
houses, and these three under the heads of situation, water supply,
drainage, scavenging, ventilation; next on the general state of the
villages.

C. - FARMHOUSES, COTHOUSES, AND LABOURERS' HOUSES.
(a.) Situation. - The farmhouses generally are well situated, but
even in the better order there is sometimes a complaint of damp. It is
due less to situation as a rule than to atmosphere and soil. For example,
in such a triangle of fertile land as the Cree valley for some ten miles
up, the nature of the soil, which is mainly river and sea mud, and the
exposure to tidal rises and falls, must affect considerably the dampness