HH62/1/PREFAC/7

Transcription

[page] vi.

proceedings of some of our Local Authorities will compare
not unfavourably with those of any others in Scotland
I shall pass rapidly in review the points that I consider
of importance to deal with.
I shall touch, first, upon the sanitary organisation that
has been established in the County. This is two-fold - first.
Medical Officers, and secondly, Sanitary Inspectors.
With regard to the Medical Offieers, I am very pleased to
be able to state, as the result of eight months' experience,
that, in my opinion, the retention, meanwhile, of the Medical
Officers has proved an exceedingly wise step. I have re-
ceived very great assistance from many of them, and some of
the Inspectors bear willing testimony to the help they have
been to them in their work. I have been enabled to avail
myself of the experience and knowledge they possess of
their special districts, and they have rendered willing and
valuable assistance whenever they have been called upon.
With regard to the Sanitary Inspectors, a variety of
arrangements obtains in the County. In one respect this is
an advantage, as it has afforded an excellent opportunity of
observing and judging between different methods.
Passing from this, I shall consider the equipment that
each Sanitary District should possess to enable it to deal
efficiently with outbreaks of infectious disease. These
consist of (1) some means of isolation for first cases, whereby
epidemics are often checked; (2) the notification of infectious
diseases, so that all cases are notified without delay to the
Sanitary Authority, and measures can accordingly be taken
to check the spread of the disease; (3) a disinfecting
chamber, where bedding and clothes can be disinfected by
dry or moist heat.
I may state that the question of hospital provision is
receiving careful consideration from several of the Local
Authorities. The experience of the Aberdeen and Ellon
Districts, where such means are already provided, shows the
benefits that result from hospital isolation. In illustration
of this, I would call attention to the account in my Report
on the Aberdeen District of the outbreak of scarlet fever in
Newhills during last winter.
The Notification Act us undoubtedly a measure of the
greatest importance. The full benefits of the Act are felt
most where means of hospital isolation are at the command
of the Local Authority. Even where this is not present, the
more stringent isolation generally secured, the thorough
disinfection of the house, bedding, and clothes by the
Sanitary Inspector, and in many cases the discovery and

[page] vii

removal of insanitary conditions that produced the disease,
render the adoption of the Act strongly advisable in every
district.
With regard to the third requirement, viz., means of
disinfection, the experience of some of the sanitary districts
in England, as given by Dr. Thorne Thorne, in his Report to
the Local Government Board of England, is exceedingly
instructive, and shows, clearly the value of such provision
- a conclusion quite in keeping with all our most recent
knowledge regarding the permanence of the infective virus
viz., the micro-organisms which are the cause of most, if not
all, the infectious diseases.
The next matter I shall touch upon is one of very grave
importance. The housing of the working classes in the
County is not in a condition that any one can describe as
satisfactory. The chief fault lies in the damp condition of
walls and floors. The condition of some of these houses in this
respect, especially in winter, is exceedingly bad. The effect
of such a condition on health requires no explanation and no
comment. I have embodied in several of my Reports the
opinions of some of our experienced Medical Officers in re-
gard to these houses, and I cannot employ more emphatic
language concerning them than they have used. Much will
require to be done in this direction, and I hope that, within
a few years, we will see a very great improvement in the
condition of the houses of the working classes, and not least
in the cottar-houses provided for the married farm-servants,
and the sleeping apartments for the unmarried men.
In regard to the condition of the villages, much is being
done to improve the drainage and the water supply. This
is a matter of very great importance. It is universal ex-
perience that the introduction of good sewerage and a pure
water supply into town or village is followed by a general
diminution of disease and lowering of the death-rate.
Ashpits and privy middens are presenting sanitary
problems of great difficulty everywhere in Scotland. The
power for Local Authorities to scavenge villages, in terms of
the petition presented by the Council to the Secretary for
Scotland, together with the introduction of the system of
slop-water closets, a system which has met with much suc-
cess in England, may enable the Sanitary Authorities to deal
satisfactorily with what is most undoubtedly a fruitful cause
of disease, and always forms a menace to the general health
of a community.
I propose to have carried out in all the districts a uniform
and systematic system of inspection of all houses used for