HH62/2/SELKIR/9

Transcription

[page] 8

infected houses, the isolation may be as effectual as can be
secured in towns with the assistance of the best sanitary
appliances. There are only two small villages in the district,
and the population is scattered over an area of (approximately)
165,000 acres, more than 35 acres to each person. In many
counties the hospital question is being considered, and it is
naturally one of the first subjects to which a medical officer
turns his attention. The difficulty of forming a definite
opinion on the necessity for such accommodation, and the
amount required, is increased by the total absence of informa-
tion of the mortality caused by infectious diseases in past
years. We are entirely dependent on the few facts we have
been able to learn during the last five months, and, put shortly,
these are as follows - that although there have been cases of
scarlet fever at Galashiels, there has been no corresponding
amount in the county. Until fever, by spreading and becom-
ing epidemic, has forced us to the conclusion that our present
means of dealing with infectious diseases are inadequate, I do
not feel it to be my duty to advise the provision of an isolation
hospital. If, however, an arrangement could be made by
which a single bed in any existing hospital might occasionally
be placed at the service of the local authority it would not
often be occupied, but its existence would enable the sanitary
inspector, if his directions were not carefully observed, to
bring a careless mother to a sense of her responsibilities by
threatening to remove her child from home.
The method pursued at present in dealing with infec-
tious cases is as follows. On hearing of a case (the Act
for notification not being in force in 1891), the sanitary
inspector visits the house and commences by asking a
number of questions, which may possibly appear rather
unnecessary at the time, but which are useful in the event
of other cases of a similar nature occurring in the neighbour-
hood.
This is quickly done, the inspector carrying a small note
book, furnished with a fly leaf on which certain headings are
printed, so that the answers to the questions may be written

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on the line corresponding to the appropriate heading. This
leaf is reproduced below:-


Parish. Day. Date.
Address.
Occupier. Owner. Agent.
Patient's Name, Age, Sex.
Workplace or School (Standard).
Sunday School.
Earliest Symptoms and Date.

Disease Notified. Date on Notice.
By whom? Name of Medical Attendant.
Date of his First Visit.
Rest of Family. Names and Ages.

Workplaces and Schools.

Milk Supply.

Sources of Infection.

Afterwards the information gained is entered in a register
to allow of the details of a number of cases being readily
compared. By this means, if an epidemic occur, due to an
infected water or milk supply, or school, the repetition of the
name of the school, or other infected place can hardly fail
to direct attention to the place where investigation is required.