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CAPE OF GOOD HOPE: REPORT ON THE PUBLIC HEALTH OF THE COLONY IN 1908.
669 action of the drug on the parasite inand relapses, (b) multiple infections and infestations, (c) cases of long-continued malarial infection and enlarged spleen, possibly associated with secondarily induced conditions. (6) The causes of haemolysis in vivo, the production of antibodies and the intimate pathology of malaria. (Such inquiries have a special bearing upon treatment and upon the origin of cases of blackwater fever.) (7) Conditions unfavourable to the life of the larvse of anopheles, including a study of the action of different kinds of fish. (8) A study of the epidemiology of kala-azar and of other conditions of splenomegaly not apparently associated with the parasites of either malaria or kala-azar. 19} The action of quinine. The effect of the quinine treatment of man in preventing the infection of mosquitoes. The effect of large doses of quinine on the production of gametes, &c.
of
malaria and the
(a) simple
cases
CAPE OF GOOD HOPE: REPORT ON THE PUBLIC HEALTH OF THE COLONY IN 1908. WE have received from Dr. A. John Gregory of Cape Town his recently issued report as medical officer of health for the Cape of Good Hope, presenting certain vital statistics for the years 1907 and 1908, together with the reports of the district surgeons on the state of the public health and the sanitary conditions of their respective districts during the year last mentioned. Constit2stlon of Department (If Public Health. In the year 1907 the office of the medical officer of health of the colony was constituted a separate "department of public healthunder the control of the medical officer of health as administrator of all matters relating to public health and sanitation. In the course of the year following the sub-department of the Cape Registrar-General was abolished, and the registration of births, deaths, and marriages, together with the preparation of statistics relating thereto, was transferred to the new public health department. To this department was likewise transferred the greater part of the local administrative work, including the oversight of public affairs of a purely medical character, the only matters relating to"public assistance"that were still retained in the office of the Colonial Secretary being those concerning State-aided hospitals, asylums, and institutions for the care of sick paupers. In a prefatory letter Dr. Gregory disclaims all attempt to analyse in the usual manner the vital statistics of the colony, for the sufficient reason that no trustworthy information is available respecting the population with which the births, deaths, and marriages may be compared. Although, for this reason, it is as yet impossible to make reliable deductions from the returns of birth, death, &c., Dr. Gregory has thought well to publish, as an appendix to his report, a tabular statement of the number of births and deaths registered in 1907 and 1908, so that calculations of ratios therefrom may be promptly made as soon as the results of the census, probably to be taken in 1911, are available. It will readily be understood that the organisation of the work of a newly constituted department has led to some delay in the publication of the director’s report ; but this is more than compensated for by the fact that, in consequence of the transfers already indicated, the report contains, for the first time, for the actual particulars of the births, deaths, &c., year to which it relates, instead of for the preceding As, however, the next annual year, as heretofore. report will be the last before the Act for the Union of South Africa comes into operation, the medical officer reserves for that occasion a comprehensive review of the work of his department, including, of course, complete statistics of marriage, as well as of natality and mortality, for the colony and its several subdivisions. From the reports recently presented to the Cape Government it is clear that the transfer of administrative work to the Health Department has resulted satisfactorily in all respects, and has received the approval of the central as well as the local throughout the colony. Under the Public Health Acts the duty of dealing with sanitary matters devolves on the local authorities, with a minimum of central interference. Inasmuch as most of the operations of the local authorities have more or less bearing on public health, it follows thai the Health Department necessarily comes in contact witt those authorities everywhere, so that the recent transfer ha:
authorities
merely in extension of the original functions of that partment. The arrangement, however, has certain special lvantages. In the first place, it coordinates under one head suited
ie work of local government, so that the local authorities ow deal with the centre through a single recognised aannel. Secondly, it conduces to efficiency, because, i dealing on the spot with insanitary conditions, the department becomes familiar with local peculiarities and local needs, nd consequently is able to manage satisfactorily as well s economically matters - requiring exceptional treatment. Lnd lastly, by regulating the work of local authorities on niform principles, conflicting decisions are avoided, and letter as well as more expeditious results are attained. In liscussing the various aspects of public health administration n the several districts of the Colony Dr. Gregory writes ,ppreciatively of the conduct of the local magistrates and ilso of the district surgeons, upon whom devolves much esponsibility in relation to matters of public health. especial mention is made of the zeal, tact, and discretion vherewith the important duties of the district surgeons are lischarged, in spite of the fact that the conscientious fulfilnent of those duties often conflicts with their private
nterests
as
medical
General
practitioners.
Improvement
in
Sanitary Administrat2on.
Commenting on the state of the general health of Cape colony in 1908 the medical officer of health draws attention :,o the carefully prepared reports of the district surgeons, on the health of their respective districts, which appear as ippendioes to his report. These local reports are scrutinised in the central office, and all matters referred to as requiring improvement are promptly referred to the proper quarter for attention. Dr. Gregory reports that the local authorities throughout the colony are gradually attaining a better standard of health administration, which cannot fail to be reflected in a diminished incidence of sickness and of mortality. "Nevertheless," he observes, "most of them have yet a long way to travel before they reach anything approaching a thoroughly satisfactory position. It must, however, be admitted that local authorities in South Africa. while they escape many of the problems which trouble local authorities elsewhere, are assailed with difficulties which more than counterbalance those from which they escapechief among which is the possession of a native and coloured population with its ignorance and its insanitary and uncivilised habits." PrevaZenee of Infectious Disease. has followed closely in the wake of the mother country with respect to legislation for the proIn tection of the people against preventable disease. the year 1907 an Act was passed requiring the notification by medical practitioners of specified kinds of infectious disease, notwithstanding which it is not surprising to hear that hitherto the returns of such cases have been very incomplete, by no means conveying an accurate idea of the extent to which the community suffer from these maladies. In the absence of information respecting the numbers of the population it is, of course, futile to discuss the relative prevalence of diseases in Cape Colony. Nevertheless, the report contains particulars of the reported attacks by the several notifiable diseases. Small-pox appears to be very preScarlet valent, especially among the coloured races. fever is noted as spreading irregularly from year to year, much in the same way as it does in this country. It appears that the most rudimentary precautions against the spread of infection are generally ignored. As a flagrant instance of this a case is cited in which some 30 persons were found attending a religious service in a small stuffy room in which was the corpse of a child dead of scarlet fever. Enteric fever also is much in evidence, and the report contains an interesting account of investigations by the Health Department as to the origin of several outbreaks of the disease in the year 1908. The disease appears to be commonly waterborne, and Dr. Gregory gives accounts of several epidemics traced to sewage-polluted water or to unboiled milk adulterated with water from specifically contaminated sources. Pulmonary tuberculosis is recorded as of frequent occurrence among the native inhabitants of the Cape, but for the reasons already given it is impossible as yet to
Cape Colony
compare its relative prevalence in that colony with experience of it at home. _
our
of
malaria and the
(a) simple
cases
CAPE OF GOOD HOPE: REPORT ON THE PUBLIC HEALTH OF THE COLONY IN 1908. WE have received from Dr. A. John Gregory of Cape Town his recently issued report as medical officer of health for the Cape of Good Hope, presenting certain vital statistics for the years 1907 and 1908, together with the reports of the district surgeons on the state of the public health and the sanitary conditions of their respective districts during the year last mentioned. Constit2stlon of Department (If Public Health. In the year 1907 the office of the medical officer of health of the colony was constituted a separate "department of public healthunder the control of the medical officer of health as administrator of all matters relating to public health and sanitation. In the course of the year following the sub-department of the Cape Registrar-General was abolished, and the registration of births, deaths, and marriages, together with the preparation of statistics relating thereto, was transferred to the new public health department. To this department was likewise transferred the greater part of the local administrative work, including the oversight of public affairs of a purely medical character, the only matters relating to"public assistance"that were still retained in the office of the Colonial Secretary being those concerning State-aided hospitals, asylums, and institutions for the care of sick paupers. In a prefatory letter Dr. Gregory disclaims all attempt to analyse in the usual manner the vital statistics of the colony, for the sufficient reason that no trustworthy information is available respecting the population with which the births, deaths, and marriages may be compared. Although, for this reason, it is as yet impossible to make reliable deductions from the returns of birth, death, &c., Dr. Gregory has thought well to publish, as an appendix to his report, a tabular statement of the number of births and deaths registered in 1907 and 1908, so that calculations of ratios therefrom may be promptly made as soon as the results of the census, probably to be taken in 1911, are available. It will readily be understood that the organisation of the work of a newly constituted department has led to some delay in the publication of the director’s report ; but this is more than compensated for by the fact that, in consequence of the transfers already indicated, the report contains, for the first time, for the actual particulars of the births, deaths, &c., year to which it relates, instead of for the preceding As, however, the next annual year, as heretofore. report will be the last before the Act for the Union of South Africa comes into operation, the medical officer reserves for that occasion a comprehensive review of the work of his department, including, of course, complete statistics of marriage, as well as of natality and mortality, for the colony and its several subdivisions. From the reports recently presented to the Cape Government it is clear that the transfer of administrative work to the Health Department has resulted satisfactorily in all respects, and has received the approval of the central as well as the local throughout the colony. Under the Public Health Acts the duty of dealing with sanitary matters devolves on the local authorities, with a minimum of central interference. Inasmuch as most of the operations of the local authorities have more or less bearing on public health, it follows thai the Health Department necessarily comes in contact witt those authorities everywhere, so that the recent transfer ha:
authorities
merely in extension of the original functions of that partment. The arrangement, however, has certain special lvantages. In the first place, it coordinates under one head suited
ie work of local government, so that the local authorities ow deal with the centre through a single recognised aannel. Secondly, it conduces to efficiency, because, i dealing on the spot with insanitary conditions, the department becomes familiar with local peculiarities and local needs, nd consequently is able to manage satisfactorily as well s economically matters - requiring exceptional treatment. Lnd lastly, by regulating the work of local authorities on niform principles, conflicting decisions are avoided, and letter as well as more expeditious results are attained. In liscussing the various aspects of public health administration n the several districts of the Colony Dr. Gregory writes ,ppreciatively of the conduct of the local magistrates and ilso of the district surgeons, upon whom devolves much esponsibility in relation to matters of public health. especial mention is made of the zeal, tact, and discretion vherewith the important duties of the district surgeons are lischarged, in spite of the fact that the conscientious fulfilnent of those duties often conflicts with their private
nterests
as
medical
General
practitioners.
Improvement
in
Sanitary Administrat2on.
Commenting on the state of the general health of Cape colony in 1908 the medical officer of health draws attention :,o the carefully prepared reports of the district surgeons, on the health of their respective districts, which appear as ippendioes to his report. These local reports are scrutinised in the central office, and all matters referred to as requiring improvement are promptly referred to the proper quarter for attention. Dr. Gregory reports that the local authorities throughout the colony are gradually attaining a better standard of health administration, which cannot fail to be reflected in a diminished incidence of sickness and of mortality. "Nevertheless," he observes, "most of them have yet a long way to travel before they reach anything approaching a thoroughly satisfactory position. It must, however, be admitted that local authorities in South Africa. while they escape many of the problems which trouble local authorities elsewhere, are assailed with difficulties which more than counterbalance those from which they escapechief among which is the possession of a native and coloured population with its ignorance and its insanitary and uncivilised habits." PrevaZenee of Infectious Disease. has followed closely in the wake of the mother country with respect to legislation for the proIn tection of the people against preventable disease. the year 1907 an Act was passed requiring the notification by medical practitioners of specified kinds of infectious disease, notwithstanding which it is not surprising to hear that hitherto the returns of such cases have been very incomplete, by no means conveying an accurate idea of the extent to which the community suffer from these maladies. In the absence of information respecting the numbers of the population it is, of course, futile to discuss the relative prevalence of diseases in Cape Colony. Nevertheless, the report contains particulars of the reported attacks by the several notifiable diseases. Small-pox appears to be very preScarlet valent, especially among the coloured races. fever is noted as spreading irregularly from year to year, much in the same way as it does in this country. It appears that the most rudimentary precautions against the spread of infection are generally ignored. As a flagrant instance of this a case is cited in which some 30 persons were found attending a religious service in a small stuffy room in which was the corpse of a child dead of scarlet fever. Enteric fever also is much in evidence, and the report contains an interesting account of investigations by the Health Department as to the origin of several outbreaks of the disease in the year 1908. The disease appears to be commonly waterborne, and Dr. Gregory gives accounts of several epidemics traced to sewage-polluted water or to unboiled milk adulterated with water from specifically contaminated sources. Pulmonary tuberculosis is recorded as of frequent occurrence among the native inhabitants of the Cape, but for the reasons already given it is impossible as yet to
Cape Colony
compare its relative prevalence in that colony with experience of it at home. _
our