HH62/2/WIGTOW/5

Transcription

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Dairies under the Dairy Regulations, and he assists the Public Health
Office in the isolation of infectious cases and disinfection of infected
premises. In the Upper District there is a definite understanding for
sanitary purposes between the Local Authority and the police constables
- an understanding that so far has worked admirably. In the Lower
District a resolution was passed to give assistance for certain groups of
parishes.
The resources of this organisation have not been tested to the full,
for the Infectious Diseases (Notification) Act has only recently been
adopted. But there is the best ground to expect that the present
organisation, when completed, will be found in every way satisfactory.

II. - VITAL STATISTICS.

A. - DEATH-INCIDENCE.

In the District Reports I have given the details of deaths and rates
for the year 1891. Those deaths and rates by themselves, however,
give little information.
In the County Report, therefore, my design is so to tabulate the
facts of the past years as to provide a system for a critical estimation of
the present. This year neither the matter at my disposal nor the time
for its elaboration permitted more than the part realisation of such a
system, which, however, as a system must embody in its parts the main
principles of the whole. This is not the place to give a full exposition
of the plan that governs the details of a public service. I expound only
that part of it concerning the vital statistics of the year.
The tables that form the body of the report are designed to exhibit
in serial exposition the varying populations, the incidence of death, and,
through deaths, the incidence of disease within the county. The last
ten years have been chosen for a basis of averages, and for beginning
the construction of a system that shall gather in new facts to itself, and
give them their scientific meaning. Unrelated facts are meaningless
and worthless. A careful study even of these tables will show whether
things are going forward or backward, how the case stands with the
divisions of the county relatively to each other, and how the case for the
whole county stands in the general comparison with all Scotland.
In the arrangement of this table-series I have followed the great
generalities of Time and Space. In the time-incidence of deaths certain
facts, as the part that climate plays, are to be learned from the monthly
deaths; certain others again from averages over longer periods. I have,
therefore, followed the division into months, into years, and into
decennial periods. Yet other facts are to be learned within the county

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itself, others from the comparison with larger areas. Tables, therefore,
are given to show the local deaths and rates, and others to show the
comparative deaths and rates. Once more, deaths arranged according
to age give us many important indications of the health or dishealth of
a people, but tables for this purpose are not yet ready.
Similarly, in the space-incidence of deaths, tables are designed to
show local and comparative facts and averages. The local tables give
the facts within the major and minor divisions of the county, showing,
so far as the death-rate can, the relative healthiness or dishealth of the
areas. Each major division or district has a table showing population,
deaths, and averages within its parishes. For a full estimate of the case
the Burghs should be calculated separately, but for the ten years this is
yet to do. But the figures for each Registration District are given, and
those districts where a burgh or royalty is the chief contributor of
deaths I print in large letters, A little manipulation will, therefore,
quickly discover any contrast between burgh and landward figures. In
this county the contrast is seldom so marked as where burghs are larger,
for the conditions that tend to make burghs unhealthy in the specific
way of large towns as yet hardly exist in this county. For the burghs are
essentially small rural towns, only better organised than the villages.
Lastly, under the Local space-head I give a small table to show the rates
in the districts. The comparative facts for Space are readily got from
the comparative table for Time.

B. - DISEASE INCIDENCE.

The assumptions at the basis of all inference from death-rates are
these:-
First. - Death-rates are disease-rates; for the causes of death may
all be classed as specific diseases or not, and, therefore, causes of disease
are à fortiori causes of death. Second. - It is also true that disease-rates
are death-rates; for some diseases are directly fatal, and the prevalence
of others not directly fatal always accompanies a high death-rate. The
tables for Disease-incidence, then, follow the same plan as those for
Death-incidence.