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Medical Officer of Health reports, 1891 - Morayshire (Elgin)

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HH62/1/ELGIN/3 Elgin, 1st February, 1892. To the County and District Council of the County of Elgin. Gentlemen, In conformity with the Regulations of the Board of Supervision, dated 1st May, 1890, issued under the authority con- ferred by Sect. 53 (1) of the Local Government (Scotland) Act, 1889, I herewith beg to present to you my Report for 1891, drawn up on the lines laid down in Sect. 1. of those Regulations. I have the honour to be, Gentlemen, Your obedient Servant, JAMES A. CAMERON, Medical Officer of Health.
HH62/1/ELGIN/5 ELGINSHIRE. REPORT BY THE MEDICAL OFFICER OF HEALTH FOR 1891. Population of the District at Census of 1891 -- 26,201 Population estimated to the middle of 1891 -- 26,179 Approximate Area of District in Acres -- 302,500 Approximate Density of Population, .086 persons to an Acre. Population. - The population has decreased during the last decade. This decrease is most noticeable in the upper and higher portions of the district, and in the purely agricultural parts of the lower portion. In some of the larger villages and suburban districts there has been an increase. Acreage. - Owing to the formation of two Police Burghs, and recent changes in the County and Parish Boundaries by the Boundary Commissioners, I am unable at this time to give the exact extent of the District and of the Parishes. 1. - GENERAL SANITARY STATE. In giving an account of the sanitary state of a District we have to take into consideration various points. We might judge of it theoretically from its geology, meteorology, and physical conforma- tion, taken in conjunction with its vital statistics; or we might judge of it practically by personal observation and investigation into the conditions under which the inhabitants live, their occupation, the diseases most commonly met with amongst them, and how far those diseases are due to insanitary surroundings. In this district the majority of the inhabitants are engaged in agriculture, living in detached cottages, but there is also a consider- able number of large villages and hamlets. Some of the larger villages are situated on the sea coast, and occupied by a fishing and seafaring population. We have thus very different conditions of environment to consider and to deal with. Since my appointment I have visited and inquired into the sanitary condition of the district generally, and especially of the villages, because it is in communities that insanitary conditions most
HH62/1/ELGIN/7 [page] 6 commonly exist and are most prejudicial to health. My attention was specially directed to their water supply, drainage, and the existence of such nuisances as were likely to prove injurious to health. The results of these inquiries were embodied in a report drawn up by the Sanitary Inspector and myself, which was sub- mitted to the Public Health Committee of the Council, and is now under consideration by them. In that report the general sanitary condition of the district, especially of the villages, was stated to be only fair, leaving room for great improvement. Since that report was drawn up I have, through the kindness of the Registrars, been furnished with returns of the births and deaths throughout the district for the past year - The Birth Rate = 27.16 per 1000 of population. The Death Rate = 15.81 per 1000 of population. The Infantile Death Rate = 95.6 per 1000 births. Judged from these data alone the sanitary state of the district is good, more especially when the number of deaths at sixty years of age and upwards is taken into account, viz., 202 out of a total of 414 deaths. The death rate alone, however, is not a fair criterion of the health of a district, because there may be a great deal of sickness and few deaths, or vice versa. From what I have been able to learn, the past year has been distinguished by the existence of much dishealth in the community. The adoption of the Infectious Disease (Notification) Act, which came into force in the district on the 1st of July last, has given us information as to the incidence of the diseases included under it for the latter half of the year. The information thus obtained will be referred to later. To form any definite conclusion, however, from the foregoing data for one year only would be wrong. We require to have similar data extending over a series of years, so that we may compare one year with another, and with the average of a series of years. In the following table the urban populations within the County of Elgin are included:- [table inserted] Had time and opportunity permitted, I should have liked to have inquired into the incidence of the various diseases in different dis- [page] 7 tricts for several years back, in order, if possible, to discover any connection between the locality and the diseases most commonly met with in it. Some inquiries in this direction I shall hope to make in the course of this year. 2. - General and Special Inquiries. As above mentioned, I have inquired into the sanitary state of the district generally, and especially into the condition of the villages, the result being embodied in the report already referred to. 3. - Advice Certificates, Offensive Trades, &c. No Certificates have been granted. The condition of the Slaughter Houses throughout the district is bad. Eleven have been visited, and, almost without exception, they are unsuited for the purpose either from their site, their con- struction, or both. An application was made for permission to erect a new slaughter- house at Hopeman, but the application was refused, the site being considered unsuitable. 4. - Bake-houses. The Bake-houses inspected within the district numbered twenty- one. The majority of them have been visited on more than one occasion. With a few exceptions, I found them well kept and suit- able for the purpose. The owners or occupiers were, in some instances, ignorant of the provisions of the Act. They expressed their willingness to adhere to these provisions, and to remedy any existing defects. In two or three instances structural alterations are necessary, and these I hope to find in progress at my next visit. 5. - Hospitals. The Local Authority possess no hospital of their own for the reception of infectious diseases, if we except three cottages, situated respectively at Kingston, Burghead, and Findhorn, which were provided by the late Local Authorities some years ago in view of cholera being imported into the district. In Gray's Hospital, Elgin, the benefits of which are open to the inhabitants of the whole county, the upper storey is set apart for the reception of cases of infectious disease, and a special nurse provided. A separate entrance, by means of an outside staircase, was provided some years ago. There are four wards - two large and two small - providing accommodation for about sixteen patients. At the time of my visit one of the smaller wards was being used as a dormitory for nurses from the general wards. I understand that a proposal for providing a proper ambulance in connection with this Hospital is now under consideration.
HH62/1/ELGIN/9 [page] 8 The rest of the district is at present without any hospital accom- modation for the treatment of infectious diseases. 6. - Infectious Disease. The annexed table shows the number of cases of infectious disease which have been notified to me since the Infectious Disease (Notification) Act came into force on the 1st of July last. Each case notified was visited by the Sanitary Inspector or myself, inquiry made as to its supposed origin, and printed instruc- tions as to the means to be taken for preventing its spread and carrying out disinfection were handed to the householder. COUNTY OF ELGIN. NOTIFICATION OF INFECTIOUS DISEASES. [table inserted] 7. - Causes, Origin, and Distribution of Disease. The table given at the end of this report shows the distribution according to registration districts of the various diseases which have proved fatal during the past year. The most prevalent zymotic disease has been scarlatina. Shortly after entering on my duties last spring, I became aware of the existence of a few cases in the neighbourhood of Elgin, and traceable to infection from there, where I believe it was very prevalent. Forty cases in all were notified after the Notification Act came into force. [page] 9 Next to scarlatina, diphtheria cases have been most numerous, There was an outbreak in St Andrew's Parish in July. Five cases occurred in four families, with one death. In December a more localised outbreak affecting really only one family and dependents occurred in the western part of Elgin Parish. The first patient seemed to have contracted the disease in Elgin. Typhoid fever cases come next in frequency. Of the four cases notified from Knockando Parish, two occurred in the village of Archiestown, where a system of drainage is much required. Two cases were notified from Elgin and New Spynie respectively. These cases occurred at Bruceland and Scroggiemill - the only water supply in each case being from the Lossie. It would be, I feel certain, of great benefit to the district were the Infectious Disease (Notification) Act adopted by the urban Local Authorities. 8. - Tabular Statements of Sickness and Mortality. On a preceding page (8) I have given a table of the sickness within the district for the latter half of 1891, so far as it has come to my knowledge through the operation of the Infectious Disease (Notification) Act, but this includes only some of the infectious diseases. The tables of mortality which follow show that eighty-two, or 20 per cent. of the deaths registered, were due to diseases which may be termed communicable. The occurrence and spread of these might be materially diminished, if not in time entirely removed, by proper precautions and improved hygienic measures. Of the 414 deaths registered, sixty-one, or nearly 15 per cent., were uncertified. Of these one-fourth were under five years of age. Fifteen deaths were registered as due to violence.
HH62/1/ELGIN/11 TABLE I. - Births and Deaths occcurring in the County of Elgin during the year 1891. [table inserted] [page] 11 TABLE II. - Density of Population, Birth-Rate, Infantile and other Death-Rates (Elginshire, 1891). [table inserted]