BMJ (Clinical Research Edition)
The number of persons, including dependants, in receipt of parochial relief on May I5th, 1902, was Ioo,848, an increase of 1,820 as compared with the previous year. In ratio to population, however, there was no increase of pauperism, the rate per I,OoO of the population standing, as in the three preceding years, at 22. Included in these figures are the lunatic poor, who numbered 13,849, being at the fate of 3.1 per i,ooo of the population, a rate fractionally higher than in the preceding year.
... he lunacy rate has risen slowly but steadily, and without intermission, from I.8 in i868 to its present level. O0 the ordinary poor, IO,865 were indoor, 76,oi9 outdoor. One very satisfactory feature in the Scottish system is illustrated in the fact that of 6,693 pauper children, 5.721 were boardedout in rural districts. Notification of Phthisis. Probably the most interesting and important part of the report is that in which the Board deals with the question of the notification of phthisis. The Board was approached by several local authorities during the year as to the desirability and competency of extending the application of the Tnfectious Disease (Notification) Act to phthisis. The Board's view on the subject was that while phthisis may be correctly classed as an infectious disease, it differs in important respects from the diseases scheduled in the Notification Act. The Board was doubtful how far the provisions of the Public Health Act are adapted to dealing with phthisis. The ordinary methods of dealing with infectious diseases are in large part directed against conditions of infectivity which do not apply in the case of phthisis, and it overlooks some conditions which do apply. Having regard to all the circumstances of the case, the Board's decision was that it would not at present be expedient to approve the proposal. At the same time, the Board urged that local authorities should not lose sight of the subject. It points out that coincidently with the application of general sanitation in the chief cities of this country, and without specific recognition of the infectivity of the disease, the mortality from phthisis has steadily diminished, in some cases as much as 40 per cent. in twenty-fi-e yeirs; and it insists upon the importarce of the perform-4ince of the ordinary statutory duties of local authorities in respect of the abatement of overcrowding, the improvement of ventilation, and the removal of insanitary conditions generally in the houses of the working classes. The Board was of opinion that in the first instance experience ought to be acquired rather by the voluntary than by the compulsory notification of phthisis, when the medical profession and the public would have the opportunity of learning what are the advantages and disadvantages of notiflcation. Infectious Disease and Vital Sta*istics. The report furnishes interesting information as to the incidence of infectious disease in, 'and as to the vital statistics of, Scotland in 190x. One point of interest which emerges in connexion with the prevalence of infectious diseases is that the mean scarlet fever case-rate in the rural districts of Scotland was nearly 2 per i,ooo higher than the mean of the principal towns. The mean rural death-rate was IS o as compared with i8.6, the mean burghal rate. The death-rate was higher in the burghal than in the rural areas of all the counties of Scotland, excepting in Fife, Kinross, Stirling, Sutherland, and Z Aland. It is noted that the deaths exceeded the births in the rural portions of the county of Bute, and in the burghal portions of Wigtownshire. The mean infantile death-rate in * ural Scotland was I03, as contrasted with 141 in burghal Scotland. The mean birth-rates in the classified divisions of Scotland were as follows: Principal towns, 30.7; large towns, 31.2; burghs under IO,OOO, 27.3; rural districts, 28.7. The mean death-rates were: principal towns, 19.4; large towns, 17.2; burghs under Io,ooo, I6.5; rural districts, 15.0.