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which has already borne good fruit in the Lews — the starting-
point of most of our sanitary investigations and improvements,
will be the inquiry into individual cases of fevers and septic
illnesses generally.

No one can legally or even reasonably refuse the utmost
facilities to the Sanitary Officers to investigate the cause and
origin of such devastating diseases, nay, they will rather wel-
come their presence and second their efforts. But to make a
close scrutiny (and unless it be thorough it is not likely to
lead to any good result) of premises where no trouble has de-
clared itself would only lead to opposition and bad feeling. I
say this much because it may be alleged that we Officers of
Health should at once ferret out and extinguish every nuisance
existing within the County. This idea is both impracticable
and impossible.

The only serious epidemics that prevailed within the County
- if we leave that of influenza alone, as the greatest number
of cases will fall within the next year, and will then be better
discussed - were those of measles in the camp of the Inver-
ness-shire Militia at Muir of Ord, typhus in the Lews, and
whooping-cough also mostly confined to that district of the
County (at least in fatality), and typhoid at Achilty. With
regard to the outbreak of measles I went every day to the
camp for a week and can testify that all possible precautions
against the spread of the disease were taken by Dr Macfadyen,
the surgeon in charge, and by the P.M.O. for Scotland, Brigade-
Surgeon Dr Allan. It can scarcely be said that the War Office
authorities were sufficiently prepared for such an extensive series
of cases. Neither the hospital tents, the nursing nor the medi-
cal care was on a sufficiently generous scale. On the whole
the results were good considering the gravity of the type of
the disease, a gravity which at the time it was wisest not to
emphasise. The origin of the epidemic was distinctly traced
to Harris; and to the West it unfortunately was carried
afresh. There was no law, legal or martial, to keep them
apparently well - who had been in contact with the sick -
from travelling home and carrying in their bodies, the unde-
veloped seeds of the disease. Every possible precaution was
taken, but unless these men could have been forcibly detained,
the untoward result was sure to flow and infection to spread in
the poor fellows' homes. If some power of quarantine were
given to Local Authorities such difficulties might be met and

Whooping-cough was extremely fatal in Barvas; no doubt
a great reason being the bad atmosphere within and the un-

[Page] 41

fortunate dread of fresh air from without, which equally pre-
vail in the Lews. The hope of this result not again occurring
lies in the better housing of the people and the coincident spread
of wholesome hygienic knowledge. For these latter improve-
ments we look with confidence to the schools and schoolmasters.
It would be easy to prove almost to a demonstration the con-
nection between deaths from whooping-cough and bad air, or
the want of air; but I need not, I think, trouble the Council
with what they are well assured of. I pass on to consider the
epidemic of typhus, which prevailed in the Lews in the summer
and autumn of '91, and I fear I must enter at some length into
the subject, as it affords lessons for the future management
and the possible stamping out of such outbreaks.

On the 13th October I had a letter from the County Clerk,
enclosing a complaint from the Lews, and alleging that fever was
present in the Village of Limerva and elsewhere.

I immediately telegraphed to Dr Macaulay. the M.O.H. for
that parish, and received the following reply:-
"Some children and a young man in Limerva, had apparently
mild typhus fever - all now convalescent." In answer to a letter,
asking for further information, Dr Macaulay wrote to me as
follows - (l omit portions of the letter of no general interest):-
"I could find no evidence of its being introduced from
without. . . There had been 11 cases of typhus at Limerva
- all recovered. The Lews Sanitary Inspector had been to
Limerva to disinfect all the fever infected houses. The Public
School at Limerva has been closed by medical certificate."

In reply, I again wrote to Dr Macaulay, asking him to re-
port any fresh outbreak, and to try by further enquiries to
ascertain the origin of the epidemic, and directing his attention
to the fact that typhus fever had been prevailing recently, as
I myself knew, at Stornoway. Having no further information,
and having discussed the subject with the Chairman of the
Lews Committee, I considered the disease had ceased to prevail.
But on the 26th October I had a fresh complaint that typhus
fever had broken out at Eishken Lodge, and that efficient means
of disinfection had not been carried out by the district S. I. I
now considered it my duty to visit the locality and make en-
quiries on the spot in connection with the whole matter. I
went to Stornoway on the 1st November, and on the 3rd pro-
ceeded to Eishken Lodge, and went on also to the village of
Limerva, where Dr Macaulay was good enough to meet me.

I took very careful notes of what I saw and heard, but I

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