Dr Maclean, Chief Medical Officer of Health
In 1920, while still continuing as Medical Superintendent of the Seaforth Sanatorium, Dr Maclean took up the position of Chief Medical Officer of Health for Ross and Cromarty. The 1920s were a period of great change in the provision of public health care and Dr Maclean was to oversee the setting up of modern health systems for the Department of Health in Ross and Cromarty. He had just completed the two year task when he fell ill and died ‘in harness’ in December 1930.
The establishment of the Department of Health for Scotland, 1929, would provide better access to health care for all but especially for those who were poor or disadvantaged. It meant the end of the Poor Law with its dreaded Poorhouse or Workhouse and the re-organisation of health responsibilities in local government. The scheme of administration Dr Maclean set in place provided such a high degree of efficiency even in its initial stages, that the County Council expressed their confidence in him to ‘an extraordinary degree’. The analysis of data, the consideration of planning issues and the systematic re-organisation of the County’s health care provision would have appealed to what contemporaries described as Dr Maclean’s logical 'legalistic mind' and the social consequences of the Local Government Act would have struck a chord with his humanitarian instincts for 'he was known never to turn away anyone in need of help'.
His first task as Chief Medical Officer however was far more emotive. Although there had been a dramatic drop in the number of smallpox outbreaks in the nineteenth century, in the perception of the general public, it continued to be the most feared of diseases. In 1900 there were 524 cases reported with some 56 deaths. 1904/5 saw several outbreaks in Edinburgh then there were no further cases until an itinerant wood seller brought the disease from Glasgow to the Black Isle in 1920.
The Ross-shire Journal records ‘several cases of smallpox have been identified in the Black Isle Combination Poorhouse at Fortrose. Some time ago a man of Ross-shire origin arrived from Glasgow and was admitted to the Poorhouse. He was doing casual work there and moving about the district selling firewood, when, with others, he was taken ill. Instant steps were taken to isolate patients. Mr William Mackenzie, Sanitary Inspector, made arrangements for the reception of cases in the isolation hospital at Nigg. Five cases were removed to Nigg. Another four suspected cases came under observation and they were removed to Nigg. Two men, who had been in the Poorhouse were traced — one man to Kinlochleven, where he was detained, and the other to Mulbuie. The latter had the rash of the disease well marked on his body. Ten cases in all are being treated at Nigg.’
The Public Health Service had responded swiftly to minimize the damage but the system was becoming overstretched and Dr Maclean made the decision to set up an additional isolation unit in Dingwall. There was a great outcry from the inhabitants of Dingwall but Dr Maclean through his calm manner and quiet confidence, quickly restored harmony and the outbreak was brought under control.
The Loch Maree tragedy in 1922 brought countrywide fame and medical recognition to Dr Maclean for he was able to diagnose botulism as the cause of death of 8 individuals at the Loch Maree Hotel when no one else could recognise the symptoms. Dr Maclean had the advantage of being able to study German medical journals in the original language and he had read about a recent case of the newly identified pathogen, Clostridium botulinum.
The Loch Maree Hotel used to supply a packed lunch for visiting fishermen and the ghillie. In August 1922 the choice of sandwich included Lazenby’s wild duck potted meat. The case had the local police baffled as the deaths were spread out over several days but all the victims showed the same symptoms including blurred vision and muscle weakness leading to paralysis. It seems that the Loch Maree packed lunch was so generous that the fishermen shared their sandwiches not only with the ghillie but also their wives on their return to the hotel. In all four fishermen, two wives and two ghillie died. One fisherman is said to have had a lucky escape when he spat out his potted duck sandwich, not liking the taste.
The incident involved Dr Maclean in a great deal of evidence giving and report writing not only here in the Highlands but he was required to travel to Edinburgh and London to explain his findings. The Loch Maree Hotel remains the place with the highest number of botulism deaths in this country.
Photo: 'The Cottage', Maryburgh. Maclean's home whilst Superintendent of the Seaforth Sanatorium and Chief Medical Officer of Health