BC Sessional Papers

REPORT OF THE PROVINCIAL BOARD OF HEALTH. British Columbia. Legislative Assembly 1906

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 6 Ed. 7 Provincial Board of Health. F 69
REPORT
-OF   THE-
PROVINCIAL BOARD OF HEALTH,
Provincial Board of  Health,
Victoria, B. C, March 5th,  1906.
To the Honourable the Attorney-General,
Victoria, B. C.
Sir,—I have the honour to submit the Ninth Annual Report of the Provincial Board of
Health, being for the year 1905.
Small-Pox.
It is pleasing to have to report absolute freedom from small-pox during the year.
Although this disease has existed in almost all parts of Canada and along the American border, yet we managed to escape infection. There were suspected cases at several points and
active precautions were at once adopted. Fortunately, in every case our fears were not
realised..
The principle followed is to treat suspects as actual cases till diagnosis is absolute. I
submit that the money expended by such action is not wasted, for one neglected case, outside
the danger to life, might cost the Province thousands of dollars.
The Dominion Government, in the main, have contributed their part in effecting this
protection, but in every instance it has done so only after strong representation from this
Department.
Diphtheria and Scarlet Fever.
Diphtheria and scarlet fever are diseases we may expect to have always more or less with
us. Our officers are active, painstaking and careful, and while this spirit remains many lives
will be saved, which, with the want of these qualities, would beyond doubt be lost.
I regret to have to report great negligence on the part of private practitioners and heads
of households in reporting cases of these diseases. It is virtually through this neglect that
epidemics are caused, and deaths following should appeal to practitioners and heads of families
in such a way as to compel them to recognise their responsibility in the premises. I have
before me reports of negligence in reporting from two municipalities. In each place a great
deal of suffering and disease and even deaths resulted. It is my plain duty to see that there
shall be no such repetition.
Quite recently I visited a house in which rumour said there was scarlet fever. I found a
mother and child very ill, with the disease well marked. I asked the physician in charge why
he had not reported. His reply was that he had only seen the case once and so early in the
development of the disease that he was uncertain as to diagnosis. In this case the results
might have been very serious, for the place was a sort of auxiliary dairy. They sold milk to
regular milkmen. F 70 Provincial Board of Health. 1906
When I reported this case to the Executive I was instructed to proceed legally against
the medical attendant, but his report that he was uncertain as to what was the trouble made
it difficult to bring home to him any charge of negligence, and in the circumstances it was
thought desirable to suspend legal proceedings. As a result I have recommended that the
Health Act be changed, and if this is done, physicians and householders, who not only know
but who suspect, or have reason to suspect, the presence of infectious disease, must report. I
beg to recommend that, when this amendment passes, the law be rigorously enforced. If this
is done it will be interesting to compare the number of cases occurring in the Province this
year and next.
The reported cases throughout the Province during the year were :—
Diphtheria,       146; deaths, 9;
Scarlet fever, 158; deaths, 3.
In the treatment of diphtheria a death-rate of 6.1 percent, is an excellent showing and is
most creditable to our physicians. It is quite evident that anti-toxin has been freely used, for
otherwise such a result would be impossible.
The principle of the serum treatment of this disease is now universally acknowledged as
being the best, and authorities recommend large and repeated doses to be given at the earliest
possible moment. Unfortunately, this remedy is very unstable, and unless kept under proper
conditions it quickly becomes inert. This and other reasons have raised the price to such a
point that I am satisfied it is not used as freely as it should be. In my opinion, this article
should be lifted from the field of commercialism, because, being such a potent factor in life-
saving, it should be available to all at the cost of production.
Under instructions, this Board has made provision to keep a small supply of anti-toxin at
three places. The price is placed at five per cent, over the cost of purchase. This is merely
tentative, and if it is found to work well will be extended. But, in my opinion, the Dominion
Government should take up this important matter and from a central laboratory manufacture
and supply all the Provinces with vaccine and all sera at present known to science.
Typhoid Fever.
Typhoid fever has been much in evidence during the year. This disease, like those above
named, is carelessly reported, and it has become epidemic in many places, because the source
of the trouble was not inquired into. It is sometimes difficult, and even impossible, to find
out the source, but in every case it must be tried, for if the source can be located the epidemic
can be checked.
Measles, Mumps and Whooping Cough.
Measles, mumps and whooping cough were very prevalent during the past year. This is
principally owing to the fact that physicians are rarely called to attend, and parents are slow
to report.
It is proposed to insist on reporting these diseases, and parents as well as physicians will
be made to observe the law.
Canneries.
An inspection by a competent and energetic officer was maintained during the fishing
season. He did his work well, and had a number of the cannery managers fined in the Police
Court for infringement of the law. The season was what is termed a " big run " season, and
the efforts of one man were ineffective. I think it will be conceded that it is a difficult matter
for one patrolman to see that the regulations are carried out, when it is considered that there
are about forty canneries operating on the Fraser River and Gulf from New Westminster to
English Bay.
Again, when it is remembered that over two thousand fishermen are scattered over a very
large area, and sometimes are over-loaded with fish which they find impossible to sell, it can
be well understood that one man, however active, would not be able to prevent the throwing
into the river of rejected fish.
I do not know whether the Dominion authorities are supposed to give any assistance in
this connection; but, so far as I can make out, they have taken no action to prevent the
pollution of our foreshores or river, or to assist in any way in carrying out regulations which,
no doubt, authorities having full control of fishery matters have enacted. 6 Ed. 7 Provincial Board of Health. F 71
I have many times seen fishermen taking in boats containing up to and over one thousand
in each boat. The Cannery Regulations prohibit the managers from accepting more than two
hundred from one boat, and the fishermen are often unable to get a market for the remainder.
Now, outside of a wanton waste of food, I have every reason to believe that these fish were
thrown into the river, to float around in all directions, in unsightly, unhealthy and decaying
masses. Surely it must be possible, by regulations, to prevent such" unnecessary and almost
criminal waste ; and while such conditions are allowed to exist, it will be practically impossible,
unless a special patrol is provided for each boat, to keep the river and foreshore and Gulf in a
sanitary, or even fairly healthy condition.
Darcy Island Lazaretto.
The Government took charge of the Leper Station at Darcy Island on January 1st, 1905,
and I was instructed to look over the conditions prevailing there and report.
I append copies of reports, also copy of report of visit to Tracadie and Ottawa, which will
fully explain the present status regarding leprosy in British Columbia.
Bacteriological and Chemical Laboratory.
The results of work effected at the Laboratory are now considerable, and practitioners are
taking more advantage of the opportunity offered. Specimens for examination have come in
in greater numbers for tuberculosis, diphtheria and typhoid fever.
The following are the returns :—
Tuberculosis—
Positive    14
Negative    26
Diphtheria—
Positive    21
Negative    11
Typhoid Eever—
Positive      4
Negative ,      6
Water—
Condemned    11
Approved    19
I have to thank Mr. Carmichael for his assistance in making a chemical examination of
most of the waters.
I again beg to recommend that the supervision of the registration of births, deaths and
marriages be placed under this office.
I have the honour to be,
Sir,
Your obedient servant,
C. J. FAGAN,
Secretary.
August 1st, 1905.
The Honourable the Attorney-General.
Sir,—Yesterday, in company with the Honourable Mr. Tatlow, I visited Darcy Island
Lazaretto. There are six patients at the station ; one has been there for nine years, one for
four years, and the other four were admitted during the present year.
Two of the cases are in the advanced stage of the disease, and are indeed pitiable sights ;
both eyes in one case are attacked, and the pain, now considerable, is bound to increase as
time goes on.    The other cases are in various stages of ulceration on different parts of the body. F 72 Provincial Board of Health. 1906
The patients are living in six cabins, contained on one building. These are the only
buildings available, so that should another case be sent to the Island, there would be no place
for him. The cabins are small, fairly well constructed, and opening on to a verandah. Each
is furnished with a bed, a chair, and a stove. The food supply is always generous, so that the
patients are never in need of food, clothes, or housing ; but when I have said this, I have said
all that can be said in favour of the system. There is no pretension made to give medical
treatment, or nursing, and no effort made to relieve pain. There is no bath, no closet, in fact,
no accommodation beyond what is barely necessary to live.
I will not go further into this question, as the Honourable Mr. Tatlow examined the
station and patients closely, and will be able to give the Council his experience. I will,
therefore, merely recommend what I think ought to be done with these patients.
I would recommend that an effort be made to send the patients to some place where
regular and systematic treatment is given ; and, failing this, I think the present location
should be changed so as to get these people nearer to Victoria. The present location is too
far away, and too expensive and difficult to reach ; a nearer site would make it possible to
grant reasonable medical superintendence and nursing.
It has been asked whether it is possible to cure leprosy. I am unable to give a definite
answer; but I know it is claimed some cases are cured, and I also know that by reasonable
attention the relief given to these unfortunates is very great, and life can be prolonged and
made bearable.
I have, etc.,
C. J. Fagan,
Secretary.
13th December,  1905.
The Honourable the Attorney-General,
Victoria, B. C.
Sir,—In accordance with instructions, I visited the leprosy lazaretto in New Brunswick.
Dr. Smith, the physician in charge of the Institution, extended to me every courtesy, and
gave me full information as to the general management of the institution and its inmates. I
was taken through the buildings, and the history and treatment of each particular case was
fully explained.
There are seventeen cases of leprosy at present in the lazaretto, eleven males and six
females, all in various stages of the disease. The youngest patient is about eleven, and the
oldest about sixty-five years of age. Twelve of the inmates come from New Brunswick, three
from Manitoba, one from Selkirk and one from Moosomin.
All cases receive active treatment, and show undoubted sign of the benefits claimed by
the administration of certain medical combinations. The medical attendant, Dr. Smith, told
me that he had now used chaulmoogre oil in combination for the past two years, with very
beneficial results. Even advanced cases yield markedly to its healing properties, and since its
use was made general at the institution, erysipelas and leproic fever—both frequent and painful accompaniments of the disease—are now almost unknown. While the good effects of certain lines of treatment are undoubted, it is not claimed that an absolute cure is effected; but
the medical attendant of Tracadie Lazaretto was so satisfied as to the results in one case that
he felt justified in allowing the patient to return to his home and friends.
Since the publication of a pamphlet by Dr. Jonathan Hutchinson, of London, in which he
advances the theory that leprosy is not contagious, but is caused by eating tainted and decomposed fish, the question has become a subject of discussion with many of our highest authorities, and the concensus of opinion is against accepting Dr. Hutchinson's theory.
While leprosy is not as contagious as some others of the infectious diseases, nor yet
deserving of the unbounded fear entertained for it by the public, yet it is thought that isolation is the best means to be adopted for stamping it out.
Dr. Smith related to me the history of a case which came under his own observation, and
which, I think, proves the communicability of leprosy by contagion. He relates that a young
woman, whose father was leprous, and who herself developed the disease after marriage, had
for some time in her employ a servant girl. This girl married a young man who, like herself,
was free from any family taint of leprosy.    After her marriage she became leprous and, with 6 Ed. 7 Provincial Board of Health. F 73
her husband, went to live in the same house with her husband's brother and his family. One
of this brother's children afterwards became a leper, and four more of the children subsequently became affected and died in the lazaretto. As Dr. Smith very truly says, " had the
disease been as promptly segregated then as is being done to-day, the parents would have been
spared the distress of seeing five of their offspring leaving them, one by one, to die of a loathsome malady, away from their house."
The expenses of the institution, as they appear in the Public Accounts for the year ending
30th June, 1904, are as follows :—
Medical Attendant $1,600 00
Sisters of Charity (salaries)    1,200 00
Maintenance    2,300 00
Chaplain for 9 months       150 00
Miscellaneous       102 19
Total $5,352 19
In the estimates for 1905-06, the proposed expenditure is $6,000, the medical attendant's
salary being increased to $1,700 per year.
I have, etc.,
0. J. Fagan, Secretary.
13th December, 1905.
The Honourable the Attorney-General,
Victoria, B. C.
Sir,—Acting under instructions from the Honourable the Premier, I visited Ottawa on
my return from the leprosy lazaretto at Tracadie, in order to consult with Dr. Montizambert
regarding the disposal of the lepers at present on Darcy Island. Unfortunately, when I
started for Tracadie I was far from being in good health, and the journey there at any time
is difficult and tiring. The lazaretto is eighty-five miles off the main line of the Intercolonial
Railway, and is arrived at over what I have no hesitation in saying is the worst line in Canada.
I had a relapse of inflammatory rheumatism when I reached Ottawa, and was in bed there for
twelve days.
I sent for Dr. Montizambert, but was told he was inspecting in the West. I then wrote
a line to the Deputy Minister of Agriculture, who came to my hotel. I gave him the full
history of Darcy Island Lazaretto, and represented as strongly as I could why it was felt here
that the Dominion authorities should take over the treatment and care of lepers in British
Columbia. The Deputy Minister took notes of what I said, and promised to lay the matter
before Mr. Fisher when he returned from the West. Before I left Ottawa, Dr. Montizambert
returned, and I had several interviews with him. He, too, promised to lay the whole question
before the Minister, and engaged that an answer would be sent at an early date.
I have, etc.,
C. J. Fagan,
Secretary.
victoria, b. C:
Printed by Richard Woleenden, V.D., I.S.O., Printer to the King's Most Excellent Majesty.
1906.

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