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[Page] 14

more than possibly all other diseases taken together take out
of the pockets of the nation at large.

We pass on now to consider the highly important question
of the provision made for segregating the infectious sick. In
the Lews and many parts of the West Coast if there were an
organisation so well constituted as to meet this difficulty, very
little infectious disease should prevail. A great deal has been
said lately, and no doubt with truth, as to the dangers of
Militiamen and others introducing disease from the East Coast
to the Lews. But to be forwarned is forarmed. With a
proper staff of sanitary officials, guided by what Dr Ross allows
has done good service already, the notification of disease, no
difficulty should be experienced in at once stamping out most
fevers and allied diseases. I grant that with measles and other
complaints which incubate for long periods there would be
more risk of spreading. But even with them a very strict
system of quarantine would prove, I doubt not, effectual in
stopping the infection from extending. A great deal would
depend upon the zeal of the local doctor. It is evident that a
medical man on the spot has the best chance of extinguishing
incipient flames, so to speak, and hence the folly of not enlist-
ing every local doctor in the great army of public sanitarians,
instead of restricting the duties to a select few. No more
pernicious or defamatory doctrine could be preached than that
of defining the functions of the private medical attendant as
those of encouraging disease, his trade, forsooth, whereas every
such individual worthy of the name of physician, every day in
his life, and often it may be in the space of twenty-four hours,
does his best to stamp out and destroy all the seeds of
disease! Much might be said on the subject of domestic pre-
ventive medicine. But we hope, as we have already said, to
put the public on its guard by distributing ample printed
directions or leaflets on Scarlet Fever, Typhoid Fever,
Measles, &c. The second means of checking the spread of
disease is by hospitals built for that purpose. At present
we have only two - one at Dingwall, and another at Storno-
way, With regard to the latter, doubtless it has done good
service in its day, as hardly any retreat of the kind could be
set apart for its purpose without proving of much service.

[Page] 15

And yet, it is indeed a poor affair, and utterly unworthy such
a thriving, pushing, populous place and international shipping
town as Stornoway is fast becoming. The dangers of imported
disease into the town must be very great, especially at the
busy herring harvest season, and a means of segregating at
once a case of serious infection is a great desideratum. The
present infirmary is ill situated for a proper water supply, has
no thorough and safe system of drainage, is cold and ill ar-
ranged, and, above all, does not possess, I understand, any staff
- even the neucleus - of skilled nurses. The building should
be at once remodelled and extended, the walls doubled in
thickness, a proper system of heating adopted, and a trained
nurse with an assistant provided. Perhaps, in the circum-
stances, it would be most economical to add on a Surgical and
Medical ward, or wards, and thus to economise the nursing
staff when epidemics were absent, in ordinary nursing work.
This we find to answer in Dingwall with a little care and
extra trouble, and is to be tried, I am glad to say, at Cro-
marty. As yet no other hospital is spoken of, except it may
be, proposition to turn Fortrose Poorhouse into such an in-
stitution. This would be a mistake. It is not built as an
hospital should be from the foundation, for its own peculiar
purpose. It is by far too big, and would only serve a corner
of the Black Isle itself. Patients will only go so far when ill
from fever with safety to themselves, and without causing
danger to the public at large. What is wanted is a small
hospital in every corner of the County which is of sufficient
size to steadily support a resident medical man of good stand-
ing and experience. Properly speaking we want in this
County about 10 such Infirmaries. How are they to be built,
maintained, and staffed? The Public Health Acts enjoin on
every Local Authority to provide such retreats, and it is legal
to lay on rates for such purposes. Surely in these days of
equivalent grants there will be no difficulty, after Mr Dar-
roch has got his roads, in erecting and providing the expense
of what a moment's thought must convince anyone of the
need for such "pest-houses." The worse the dwellings the
more the necessity for the removal of the sick when labouring
under infectious disease of a severe kind, for the sake of the

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