HH62/2/LANARK/72

Transcription

[Page] 71

directly due to some affection of the lungs or air passages,
consequently the mortality is highest when the epidemic,
as in this instance, occurs in the colder months of the year.
Of the 81 deaths (see Table VIII., p.76), 68 took place in
the Parish of Bothwell, only 3 of these being in children over
5 years of age. It was extremely fortunate that this, one of
the most infectious of diseases, was practically limited to
one part of this parish.
Taken according to divisions, the rate for measles was
nil in the First, 0·839 in the Second, and 0·169 in the Third.
These figures show, what has long been known to
medical men, that, contrary to the general belief, measles
is a dangerous and fatal malady unless the greatest
precautions are taken - precautions which, partly from
ignorance and partly from want of the necessary means
and accommodation, are rarely carried out among a large
section of the community.
Some health officers have urged that measles should be
included among notifiable diseases, but I am not yet con-
vinced that the advantages which might accrue would
repay the great expense and trouble that would be incurred.
The mere notification of a disease is of little or no value
unless the knowledge so gained can be made the basis of
preventive action. In the case of measles, the contagion is
given off from the patient at the earliest stage of the
disease, even before, in many circumstances, the nature of the
illness can be determined, and it is mainly for this reason
that we have so little control over epidemics of measles.
Again, many cases are so slight that no medical attendance
is deemed necessary, and many centres of infection would
escape observation.

Whooping Cough. - The deaths registered from this
disease number 48 (43 of which were in children under 5
years of age), giving a rate of 0·335 per 1,000. In the
divisions the rates were ·147 for the First, ·317 for the
Second, and ·435 for the Third.

[Page] 72

This also is a malady almost entirely affecting children,
and one over which sanitary authorities can exercise little
or no control, as, from its long period of infectiveness,
hospital isolation is practically out of the question. It
may surprise many to know that whooping cough is now
admitted to be over the country generally one of the most
deadly of all the infectious diseases in children under the
age of 5 years.

Diarrhœa. - This disease, especially among children and
during the summer and autumn months, has for some years
back attracted the special attention of sanitarians; but our
knowledge regarding its etiology is still far from being
complete.
Dr. Ballard, in his well-known report on the subject, *
gives the following "working hypothesis a provisional
explanation":-
"That the essential cause of diarrhœa resides ordinarily
in the superficial layers of the earth, where it is intimately
associated with the life processes of some micro-organism
not yet detected, captured, or isolated.
"That the vital manifestations of such organism are
dependent among other things, perhaps principally, upon
conditions of season; and on the presence of dead organic
matter, which is its pabulum.
"That, on occasion, such micro-organism is capable of
getting abroad from its primary habitat - the earth; and,
having become air-borne, obtains opportunity for fastening
on non-living organic material, and of using such organic
material, both as nidus and as pabulum, in undergoing
various phases of its life history.
"That in food inside of as well as outside of the human
body such micro-organism finds, especially at certain
seasons, nidus and pabulum convenient for its develop-
ment, multiplication, or evolution.
"That from food, as also from the contained organic
matter of particular soil, such micro-organism can manu-
facture by the chemical changes wrought therein through

* Supplement in continuation of the Report of the Medical Officer for 1887.