PUBLIC HEALTH DEPARTMENT (ANNUAL REPORT OF THE).

Appendix to the Journals of the House of Representatives, 1910 Session I, H-31

H.-31

1910. NEW ZEALAND

PUBLIC HEALTH DEPARTMENT (ANNUAL REPORT OF THE).

Presented to both Houses of the General Assembly by Command of His Excellency.

CONTENTS. PAGE PiOE Chief Health Officer's report— Appendix I.—Statistical— continued. Section 83 of the Hospitals Act .. .. 2 Part . 2 - —Notification of infectious disease, — Tubercular diseases .. .. .. .. 2 Auckland District .. .. .. .. 25 Te Waikato Sanatorium .. .. .. 4 I Wellington, Hawke's Bay, and Marlborough Inspection of school-children .. .. .'.' 5 I Districts .. .. .. .. 29 Vaccination .. . . .. .. 5 Canterbury and Westland Districts . . .. 35 Otago and Southland Districts .. .. 35 . ~ T _ Part 3. —Meteorological report.. .. .37 Appendix L-Statistical,- Appendix ll—Reports of medical officers on the Part 1 —Vital statistics,— . sa nitary condition of the various districts,— £. s • • • • ■ ■ • • •'•'lα Part A.—Auckland District .. .. .38 Mar « a ges 9 Part B.—Wellington District 39 iJeatns .. .. .. . . 10 p art C.—Canterbury and Westland District .. 40 Infantile mortality 14 | Part D.-Otago and Southland District.. .. 41 Causes of death 15; Part E.-Report of Medical Officer, Te Waikato Sanatorium .. .. .. 42 Local vital statistics— ! Appendix lll.—The Sale of Food and Drags Act .. 42 Auckland .. .. .. .. 20 Appendix IV.—Laboratory reports,— Wellington .. .. .. .. 22 Part A.—Pathological laboratory .. .. 47 Christchurch .. .. .. ..23 Part B.—Government Analyst " .. ..51 Dunedin .. .. .. ..24 Part C.—Details of milk-analyses .. ..52

11 E P O E T . Department of Public Health, Minister's Office, Wellington, Ist November, 1910. My Lobd, — I have the honour to transmit herewith, for Your Excellency's information, the report of the Department of Public Health for the year ending the 31st March, 1910. L have, &c, t>. bud do, Minister of Public Health. The Eight Hon. John Poynder Dickson-Poynder, Baron Islington, Governor of the Dominion of New Zealand, Wellington,

I—H. 31.

2

H.—3l

The Chief Health Officer to the Minister of Public Health. SI R _ Department of Public Health, Wellington, 21st October, 1910. I have the honour to lay before you the report of the Department of Public Health for the year ending 31st March, 1910. The general health of the Dominion has been good. There has been a slight increase in the notifications of enteric fever—63s, as against 561 last year. This increase is almost entirely due to a smart outbreak of the disease in the Wellington District during the early months of this year, where the notifications were 278, as against 222 during the previous year. Of this number, 65 cases were notified in Wellington and suburbs. The District Health Officer could assign no special cause for this outbreak, but with good grounds suspicion fell on certain consignments of oysters. The notifications of scarlet fever were less by 917—1,266 as against 2,183 ; and of diphtheria by 46—578 to 624 in 1908-9. Section 83, Hospitals Act. It is to be hoped that local authorities will take advantage of section 83 of the Hospitals Act, and delegate to the Hospital Boards their powers and responsibilities under the Public Health Act, notably with regard to the control of infectious diseases. Such an arrangement would make for efficiency and economy, especially as the Hospitals and Health Departments are now combined under one head. It can hardly be gainsaid that the authority responsible for the care and treatment of the sick should be also conversant with those influences that are likely to cause sickness. As matters now stand, the Hospital Boards, though responsible for the accommodation and treatment of persons with infectious diseases, have tio official knowledge as to how these diseases are contracted or spread ; and, even if they have information as to the cause or causes that are filling their infectious wards, they are powerless to take any action that may be considered necessary. As the law now stands, notifications of infectious diseases have to be forwarded to the local authority in whose district the infectious case occurs, and also to the District Health Officer. In many instances the local authority has neither the machinery nor the staff to carry out the provisions of the Act, and the District Health Officer may be two hundred miles from the scene of the outbreak. Again, if one local authority has the machinery to take the necessary precautions, in all probability the local authority of the district adjoining has none ; consequently there is no uniformity of action on the part of local authorities either as regards sanitation or the control of infectious diseases, and this lack of uniformity is naturally more obvious when there are several local authorities in a district—and, speaking generally, their name is Legion. The country local authorities might very well waive all their responsibilities under the Public Health Act, and the larger boroughs those relating to the control of infectious diseases, in favour of the Hospital Board of the district. By this means the efficient and economical administration of the public-health laws would be assured, and the central Department, instead of having to deal with 380 local bodies, as is now the case, would only have to deal with thirty-six. The mutual advantages of such a system are surely obvious. Tubercular Diseases. There were 800 deaths from tubercular diseases—viz., pulmonary consumption, 588 ; other forms of tubercular disease, 212. A gradual decline is noticeable during the last twenty years in the mortality-rate from these the most noticeable " drop " being in the rate from consumption for the quinquennium subsequent to the initiation in 1903 of an anti-tuberculosis campaign. Mean Death-rate per 100,000. „ ~ . . Other Tubercular Phthisis. Diseaeeg--1890-94 .. .. • • • ■ • • ■ ■ ■ ■ 82 2 24 " 7 1895-99 79 3 2 5 1 1900-4 73 9 • 234 1905-9 62 -° 24 -° So far, this is satisfactory, but a great deal remains to be done before it can be said that the campaign against this, the most prevalent of all diseases, is being efficiently conducted. The Hospital Boards have loyally helped the Department, During the past six years four sanatoria have been opened, and annexes have been erected in connection with some of the principal hospitals, which, with the Government Sanatorhim at Te Waikato, provide a total of 160 beds for the open-air treatment of the disease,

3

H.—yl

Name. Opened. Controlling Authority. Beds. Te Waikato Sanatorium . . 1903 Public Health Department .. 60 Otaki . . ... ... 1906 Wellington Hospital Board ... 35 North Canterbury .. . . 1909 North Canterbury Hospital Board 35 Pleasant Valley .. .. 1910 Otago Hospital Board . . .. 30 In addition to the above, special annexes, providing in the, aggregate accommodation for some 100 patients, have been erected at various hospitals—notably, Wellington, New Plymouth, Nelson, and Palmerston—in fact, there are few hospitals where special provision has not been made for patients in the early stages, but little or no provision has been made for those in the later stages of this disease. This lack of proper provision for the chronic and " incurable " patient is the blot on what might otherwise be regarded as a satisfactory initial campaign. A working camp has also been established near Rotorua, where patients in whom the disease has been arrested, but who are not fit to resume their ordinary occupation, are engaged in tree-planting. Puring the past year the patients at the camp have practically supported themselves by wages paid them by the Lands Department for work done. The time is now ripe to press the campaign. The public is better informed as to the need for precautionary measures, and members of the medical profession are less reluctant to notify cases of the disease, than was the case in the early days of the Department. Moreover, with the new Hospitals Act it is possible for Boards, with the aid of the combined Departments (Hospitals and Health) — especially if the Boards assume the responsibilities of local authorities under the Health Act—to put into operation measures of a more far-reaching nature than was possible under the old law and the old organization, where Hospital, Health, and Charitable Aid matters were controlled by separate authorities. Briefly, the extended plan of campaign is as follows : — (1.) Rigorous enforcement of notification by the medical profession of all forms of tubercular disease. Though there were 800 deaths, there were only 556 notifications last year. (2.) A wider dissemination of literature as to the causes of the disease, and its prevention. (3.) Whole-hearted attempts to encourage the " early " case, and also those who had been in contact with consumptives, to seek treatment by means of— (a.) Extension of the out-patient departments of our generalj l hospitals, with a special branch devoted to the diagnosis and treatment of chest-complaints. From such a department the patient could be drafted for treatment to an institution suitable for his case. This department should also keep under supervision patients who have returned from sanatoria. (b.) District nurses, who will keep in touch with the patients treated in the outpatient department, and see that they conform to the rules of life laid down by the medical attendant, arrange for the examination of suspected cases or " contacts," and keep the out-patient department informed of those who have returned from . sanatoria. (c.) Medical inspection of school-children : A report on this subject is now before the Government. If put into operation it should prove of great value in detecting early cases among school-children. (4.) Extension of " sanatorium " accommodation for the educative treatment of suitable cases. The smaller Hospital Boards should combine for the purposes of erecting and maintaining such. (5.) Provision by all Hospital Boards of suitable accommodation for patients in the chronic and " incurable " stages of the disease, special wards being needed for these classes. (6.) Establishment of a " working" sanatorium, where patients could be taught outdoor occupations—farming, bee-culture, forestry, the planting of fruit-farms, &c. (7.) By co-operation between public and private philanthropic agencies, whereby a nursing system could be developed at a maximum of efficiency with a minimum of cost; and also a system of relief, whereby the dependants on those isolated would be well cared for during the absence of the breadwinner. (8.) By co-operation with the Agricultural Department, as heretofore, in matters relating to the control of dairies and dairy herds, and the storage, conveyance, and distribution of milk; nor must be forgotten the need for better supervision of the slaughtering and inspection of pigs. There is every reason for believing that Hospital Boards will gladly work in the direction outlined, and that the contributory authorities will cheerfully grant the money needed.

H.—3l

4

But there is one special danger, which was commented on by the Medical Superintendent of the Wellington Hospital in his report on the Otaki Sanatorium : " There is a tendency when treating patients in New Zealand to attempt to kill the germ of consumption by cultivating the germ of laziness and sluggishness." Dr. Hardwick-Smith then goes on to say that it is questionable whether it is better for a patient to survive the disease than " lose his moral fibre." In these remarks I heartily concur, and it should be the aim of all responsible to counteract the tendency referred to, especially if the early cases come forward, as it is hoped they will, for sanatorium treatment. If such patients do not do all they can to assist the Boards in an efficient and economical management of the institutions, they will not only act against their own interests, but against the interests of those who come after them. The public will not stand the expense that additional sanatorium accommodation will entail unless they feel that they are getting a measure of return for the expenditure, not only in the shape of persons cured of the disease, but of persons ready and willing to resume the battle of life. We know that the statistics of sanatoria where graduated labour under medical supervision is one of the features of treatment compare very favourably with those of institutions where the patients remain in more or less enforced idleness. In health, want of occupation is sure to lead to moral and physical degeneracy, and the same applies to the consumptive patient whose day is passed in discussing symptoms with his fellow-patients, or in criticizing the management of the various institutions in which he has been an inmate. Whether in the early or late stages of the disease, we should do everything in our power to improve the lot of the consumptive. For those who are fatally stricken let us provide the very best accommodation and treatment possible, and in this we must not be influenced entirely by the cost; but for those who are able, but unwilling, to make a dogged effort to keep themselves in a condition to resume the struggle of life, let no false sentiment be allowed to deter us from doing our duty. Te Waikato Sanatorium. Staff. When I took over the control of this institution in June last there were forty-five patients under treatment, with a staff composed as follows : Medical—A non-resident Medical Superintendent, who attended the institution from Cambridge ; nursing—a Matron, six trained nurses, and eight probationers ; domestic —two cooks, an assistant cook, two laundresses, six housemaids, five porters, a gardener, an engineer, and a carpenter ; clerical —a clerk and assistant clerk. Thus the true institutional staff consisted of thirty-seven persons. In addition to the above, there were employed on the farm a manager, two labourers, and a man in charge of the horses—a total staff of forty-one persons. In the conduct of this institution I have ever before me the example set by Dr. Patterson, of the Frimley Sanatorium, with regard to the employment of consumptive patients who are medically fit to undertake some of the lighter duties connected with the domestic and outdoor work of such institutions. The results of Dr. Patterson's work are widely known, and graduated exercise and work under medical supervision are now recognized by the profession and a large section of the public as essential concomitants to the open-air treatment of consumption. Having had personal experience of Dr. Patterson's methods when Home in 1906, and having seen and read what his results are —how he sends out a very large proportion of his patients fit to resume the battle of life, and, what is also of importance, confident of their powers to do so—l should be signally failing in my duty, and unworthy of the trust reposed in me by virtue of my office, if I did not use every effort in my power to follow Dr. Patterson's splendid example. My duty is clear, and, brutal as it may seem, I have no hesitation in saying that sanatorium treatment is of little avail if it is only to result in turning out the lifelong invalid. Is it wrong to aim at turning out the sanatorium patient as a whole man, ready to do his duty by his family and the State ? The reduction of the nursing staff may appear to need explanation. As it is now, there is one nurse for every 3 - 5 occupied beds —a very high average for such an institution, where the demands on the nurses' services are not to be compared with those in an ordinary hospital. Also, it will be seen that by a more careful selection of the patients —referred to in another part of this report—and the admission of patients in the earlier stages of the disease, there is no need for such a large nursing staff. Admissions. One hundred and five patients were admitted during the year 1908-9. Prom the representations of the Medical Superintendent it was clear that many patients were being admitted in such an advanced stage of the disease that they were not likely to derive permanent benefit from sanatorium treatment, and that they occupied beds to the exclusion of those who were likely to benefit by such treatment.

5

H.—3l

Hitherto, practically any patient who was the possessor of a certificate from a doctor to the effect that he was likely to benefit by treatment was admitted. This practice was neither fair to the patients nor to the institution. The forms for admission were altered accordingly, making it clear that only those patients would be admitted who, in the opinion of the Medical Superintendent alone, were likely to derive benefit from treatment, and that they would only be admitted for a period of three months, so that they might be educated as to how to look after themselves. The latter stipulation was necessary, as in the past some patients had remained in the institution for months, if not for years, to the exclusion of those in the early stages of the disease to whom the educative, methods of sanatorium treatment would have been of the utmost value. The Medical Superintendent very rightly pointed out that to be of any value the institution should be immediately available for early cases for educative rather than curative treatment, and with that end in view the institution is now conducted. Under existing conditions a patient can be admitted to the institution at once, provided that in the opinion of the Medical Superintendent he is a fit case for admission. Another defect as regards the admissions was due to the fact that many Hospital and Charitable Aid Boards sent their consumptives to the sanatorium, where they were admitted free of cost. That was scarcely fair to those Hospital Boards who had faced their responsibilities with regard to the consumptives of their district, and had at considerable cost erected sanatoria for their treatment ; consequently, it was intimated that no indigent case would be admitted unless the Hospital Board responsible would guarantee the patient's fee of £1 per week. Economics. For the year ending 31st March, 1910, the cost of this institution was £7,269 (vide table in appendix). Of this amount £5,337 was contributed by the Government, £1,604 by payments made on account of patients, and £328 by the sale of produce, &c. The total cost per bed was £164 Bs. 8d. —viz., — £ B . d. Provisions .. .. .. .. .. .. .. 49 19 11 Surgery and dispensary.. .. .. .. .. .. 5 18 0 Domestic and establishment .. .. . . .. .. 43 18 9 Salaries and wages .. .. .. .. .. .. 56 17 2 Administration .. .. .. .. .. • • 7 14 10 £164 8 8 We hope to do better next year. Considerable economies have been effected, but none that will militate against the efficiency of the institution or the comfort of the patients. From Dr. Roberts's report will be seen the return the country is getting for this expenditure. It will- be noted that, of 105 patients admitted, some 50 were discharged in a condition to obtain their own livelihood. So far this is satisfactory, but that we can do better yet is my sincere belief. During the year the institution has lost the services of Miss Rochfort, who, as Matron, has devoted six years of her life to the services of the institution. In the exercise of her duties she was severely handicapped by the fact that there was no resident medical man to help her in her work ; but she did all that could possibly be done to enhance the comfort and general content of the patients and staff committed to her care. After four years' service Dr. Roberts is also relinquishing his post —not only on account of the demands of an increasing practice, but also from the fact that he recognizes to the fullest extent the need for a resident medical officer if the administration of the sanatorium is to be conducted on duly recognized methods. It is hoped that his services as a consulting medical officer may still be retained. Inspection of School-children. The necessity for the above has been referred to in previous reports, and every year becomes more apparent. A scheme has been submitted, and only awaits the approval of the Government, as practically no special legislation is required to put it into force. Vaccination. The events that transpired subsequent to the arrival at Melbourne of the s.s. " Otway " with a case of small-pox on board should be a sufficient warning as to the need for a more vigorous enforcement of the laws governing vaccination.

a.—3i

6

Though some 26,000 infants are born every year in the Dominion, only about 5 per cent, are vaccinated. The majority of parents do not even trouble to apply for exemption. I cannot advise a repeal of the present law, but I would most strongly urge that, if it be decided that the law is not to be more vigorously administered than heretofore, it would be better to repeal the law, and, in the event of an outbreak, provide by Order in Council that all persons within a certain area be vaccinated unless they can show satisfactory evidence of recent vaccination. During the Department has lost the services of Dr. Purdy, who has been appointed Chief Health Officer for Tasmania, and Dr. Ogston, who had been District Health Officer for Otago since the initiation of the Department. The latter has been succeeded by Dr. Champtaloup, of Edinburgh University, who combines the duties of District Health Officer and Lecturer on Public Health and Bacteriology at the Otago University. The vacancy in Auckland has been filled by Dr. Makgill, who, in addition to his work as Government Pathologist, undertakes the duties of District Health Officer in that district. 1 have, &c, T. H. A. Valintine, Chief Health Officer for New Zealand. The Hon. the Minister of Public Health.

7

H.—3l

APPENDICES. APPENDIX L—GENERAL STATISTICS FOR THE YEAR 1909-10. PART I.—VITAL STATISTICS. For the following statistics relating to birth, death-rates, infant mortality, and causes of death, the Department is indebted to the returns of the Registrar-General. They relate to the year 1909. Births. The number of births registered during 1909 was 26,524, or 27-29 in every 1,000 persons living. The number is 584 in excess of that for the year increase of 2-25 per cent., but the rate lower by 0-16 per thousand. From 1882 until the year was a regular fall in the rate. The births registered in a year numbered 19,846 in 1884, falling to 17,876 in 1892, have risen to the number first stated above. The number of male children born during 1909 tJ was 13,502, and of female children 13,022. The following table shows the number registered, the birth-rate calculated on the total population, and comparison with the average rate for 1882-86 taken as 100. Indications of a gradual increase are apparent, the improvement since 1899 being 8-64 per cent, on the rate per 1,000 in that year.

Births, Number and Rate.

The average number of children to a marriage may be ascertained by comparing the number of legitimate births for a series of years with the marriages, but commencing with the marriages in the year preceding that for which the first number of births is taken. Calculating in this way the figures for the twenty-year period 1890-1909 show a decline from 4-87 to 3-13 as below :— Proportion of Birchs Marriages Legitimate to every Year. images. Births. Marriage solemnized in the Preceding Year. 1889 ... ... ... ... 3,632 1890 ... ... ... ... 3,797 17,675 4-87 1891 ... ... ... ... 3,805 17,635 4-64 1892 ... ... ... ... 4,002 17,283 4-54 1893 ... ... 4,115 17,514 4-37 1894 ... ... ... ... 4,178 17,824 4-33 1895 ... ... ... .... 4,110 17,711 4-24 1896 ... ... ... ... 4,843 17,778 4-32 1897 ... ... ... ... 4,928 17,911 370 1898 ... ... ... ... 5,091 18,154 3-68 1899 ... ... ... ... ... 18,066 3-54 1899 ... ... ... ... 5,461 1900 ... ... ... ... 5,860 18,640 3-41 1901 ... ... ... ... 6,095 19,554 334 .1902 ... ... ... ... 6,394 19,734 3-23 1903 ... ... ... ... 6,748 20,835 3-26 1904 ... ... ... ... 6,983 21,737 3-22 1905 ... ... ... ... 7,200 22,600 3-24 1906 ... ... ... ... 7,592 23,120 3 21 1907 ... ... ... ... 8,192 23,937 3-15 1908 ... ... ... ... 8,094 24,835 3-03 1909 .... ... ... 25,301 313

Year. 1882-86 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Birth-rate. Total Number of Births p er j QQQ Compared Year, registered. ' j with Bate in i. Population. ! . J 882 " 8 !' i 1 taken as 100. i I I _ J 1 " ~ " \ ■ ~ " " II . i 19,410 3540 100 1898 1899 19,135 32-09 91 1900 i 18,902 31-22 88 1901 18,457 . 30-07 85 1902 18,278 29-44 83 1903 18,273 29-01 82 1904 I 17,876 27-83 79 1905 I 18,187 27-50 78 1906 18,528 27-28 77 | 1907 18,546 26-78 76 1908 18,612 26-33 74 1909 18,737 25-96 73 Birth Total Number j of Births p , „„„ registered. l er £ lm Population. 18,955 25-74 18,835 25-12 19,546 25-60 20,491 26-34 20,655 25-89 21,829 i 26-61 j 22,766 26-94 23,682 27-22 24,252 27-08 2B.,094 27-30 25,940 27-45 26,524 27-29 j h-rate. Compared with Rate in 1882-80 talien as 100. 73 71 72 74 73 75 76 77 76 77 77 77

8

H.—3l

If the average result be taken out for the ten years 1890-99, it will be found to represent 4-22 births to a marriage. Dealing similarly with the figures for 1900-9 the result is an average of 3-22, so that regarded annually or decennially there is a decided fall to be observed. New Zealand had in 1880 the highest birth-rate in Australasia (40-78); in 1900 was reversed ; but in 1909 the New Zealand rate was higher than that of New South Wales, Victoria, and South Australia. Although New Zealand had in 1900 the lowest birth-rate in Australasia, the rate for 1909 was higher than the average for the Commonwealth, 26-40 per 1,000 of population. The movement over ten years is calculated as under : —

Birth-rates per 1,000 of Population.

Sexes of Children born. The figures show that during each year there has been a preponderance of births of male children. It would appear, however, that this excess of male births is not sufficient to compensate for the heavier mortality which occurs among that sex. Of the total population in 1871 there were 70.52 females to every 100 males, but in 1909 the proportion of the females to 100 males had risen to 88.89.

Twin Births. There were 265 oases of twin births (530 children) and 1 case of triplets registered in 1909. The number of children born was 26,524 ; the number of mothers was 26,257 : thus, on an average, one mother in every birth to twins, against 90 in 1908, 102 in 1907, 114 in 1906, and 97 in 1905. The proportion of plural births per 1,000 of all births during the past five years, was :— ™ , Plural Births Year. All Births. per 1,000 of all 1905 .. .. .. •• 23,682 245 10-35 1906 .. •• •• 24,252 215 8-87 1907 .. -. .. •• 25,094 244 9-72 1908 .. •• • ■ •■ 25,940 286 11-03 1909 .. .. ... ■■ •• 26,524 266 10-03 Illegitimacy. The births of 1,223 children were illegitimate : thus 46 in every 1,000 children born were born out of wedlock, against 43 in 1908.

Country. 1900. 1901. 1902. I 1903. i 1904. I 1905. 1906. j 1907. 1908. I j 1909. Queensland ... ... 130-21 New South Wales ... 2743 Victoria ... ... 25-82 South Australia ... | 25 - 78 Western Australia ... : 31-46 Tasmania . . ... 28-25 New Zealand .. ... 25-60 28-53 27-78 25-77 25-39 30-34 28-60 26-34 27-89 I 24-62 27'13 27-20 i 25-41 26-81 25-23 24-46 24-65 24-85 23-43 i 24-70 30-27 30-26 ! 3033 29-23 i 28-62 j 29-60 25-89 I 26-61 | 26-94 25-92 ; 26-31 | 26-98 I 26-99 26-79 ! 27-12 I 27-22 j 26-86 24-83 I 25-14 ! 25-16 24-71 23-82 ! 23-54 i 23-82 24-59 30-29 ! 30-01 29-40 I 29-25 29-33 I 29-82 | 29-50 30-90 27-22 ! 27-08 ] 27-30 27-45 27-52 27-26 24-55 24-57 28-06 29-86 27-29

Year. Number of Births of Males. Females. Proportion of Births of Males to every 100 Females. 1888 1889 L890 1891 .. —.. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 9,641 9,261 9,514 8,943 9,293 8,985 9,377 8,896 9,101 8,775 9,310 8,877 9,472 9,056 9,493 9,053 9,511 9,101 9,600 9,137 9,615 9,340 9,724 9,111 10,107 9,439 10,471 10,020 10,653 10,002 11,217 10,612 11,762 11,004 12,109 11,573 12,397 11,855 12,835 12,259 13,369 12,571 13,502 13,022 104-1 106-4 103-4 105-4 103-7 104-9 104-6 104-9 104-5 105-1 102-9 106-7 107-1 104-5 106-5 105-7 106-9 104-6 104-6 104-7 106-3 103-7

9

H.—3l

Proportion of Illegitimate Births in every 100 Births.

0 ™V™ to be Births and Birth-rates in the Four Chief Cities Birth-rates per 1,000 of Auckland City ... ... » and seven suburban boroughs... '" 97 , 1fi Wellington City ... ... .. ° A > U) « ' and three suburban boroughs ... " ' 9R . ±O Ghnstchurch City '" ,;•■ 'i"j.i 'V , ■"' •■• ■•• 28-o5 » and three suburban boroughs. Q7r ~ Dunedin City ... ... ... '" 00.04 , " and six suburban boroughs 26 26 , Births per 1,000 of Population. , . , 1 w ■ , 1905 - 1906 ' 1907 - 1908 1909 Auckland (without suburbs) ... 30-06 29-96 29-63 30-56 29-7^ g u° n v " •- 29 7 2 27 8 5 27-53 27-60 26-62 Chnstchurch 29-70 28-19 30-47 28-43 2« 65 Dunedm 23-90 28-96 25-69 25-48 28 34 Marriages. has been above the standardfdurmg each of the last fourteen years :— m rate, which

Marriages, Number and Rate.

2—H. 31.

i Year. | Queensland. I i New South Wales. I Victoria. South Auatralia. Western Australia. Tasmania. New Zealand. 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 5-97 6-40 5-93 6-04 6-76 6-89 7 -00 7-68 7-31 7-45 i i 7-15 7-01 7-16 6-60 6-71 7-12 7-37 704 7-04 6-89 I I i 5-49 5-91 5-58 5-51 5-73 5-74 5-61 5-58 5-62 5-76 3-95 4-24 3-98 4-36 4-18 4-01 4-37 4-00 4-10 4-33 [ 4-91 4-82 3-88 3-96 4-69 4 36 4-19 4-78 3-89 4 -35 I 6-08 §•43. 5-94 5-36 5-61 5'82 5-52 5-78 5-86 4-97 i 4-40 4-63 4-57 4-4fi 4-55 i;TA 4-57 4 67 4-61 4-26

Total Number of Marriages registered. Marriage-rate. Marriage-rate. Year. Per 1,000 Compared 0 £ j with Rate in Population. | t , 1882 - 8 fL [ taken as 100. Year. Total Number of Marriages registered. ] Per 1,000 ! Compared 0: f ; with Rate in Population. , 1882-86 taken as 100. 1882-86 3,663 6-68 100 5,091 5,461 5,860 6,095 6,394 6,748 6,983 7,200 7,592 8,192 8.339 8,094 6-91 103 7-28 109 7-67 115 7-83 117 8-01 120 8-23 123 8-26 124 8-28 124 8-48 127 8-91 133 8-82 132 8-33 125 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 3,563 3,617 3,632 3,797 3,805 4,002 4.115 4,478 4,110 4,843 4,928 5-97 5-97 5-93 6-12 6-04 6-23 6-22 6-15 5-94 6-85 6-83 i 89 89 89 92 90 93 93 92 89 103 102 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909

10

H.—3l

The marriage-rate, measured by the total population, does not show the true position, when, as in the case of New Zealand, the age-constitution of the people fluctuates considerably. A more satisfactory standard is found in the number of persons of marriageable age, denned as meaning the unmarried and widowed of males aged 20 years and upwards and of females aged 15 years and upwards. The rates are given for four census years : —

The total number of marriages solemnized does not include marriages where both parties are of the aboriginal Native race, such persons being exempted from the necessity of complying with the provisions of the Marriage Act, although at liberty to take advantage thereof. Twenty-five marriages m which both parties were Maoris were contracted in 1909 in terms of the Act: 12 by Registrars, sby clergymen of the Church of England, 1 by a Presbyterian minister, 2 by Roman. Catholic ministers, and 5 by ministers of the Church of the Latter-day Saints. Ages of Persons Married. Of the persons married in 1909, 143 bridegrooms and 1,309 brides were under 21 ytars of age. Of the bridegrooms, two were between 16 and 18, and six between 18 and 19. Of the brides, nine were between 15 and 16, and thirty-seven were between 16 and 17 years of age. The proportion of men married is greatest at the ages of 25 to 30, and of women at from 21 to 25 years. Deaths. The deaths in 1909 numbered 8,959, a rate of 9-22 in every 1,000 persons living, as against 9-57 in 1908 This is below the average of the previous ten years, 9-90 per 1,000. The following table shows the number of deaths, and the death-rate per 1,000 of the living population ; also a comparison with the average rate for 1882-86 : —

The death-rates of males and females for the last ten years are shown separately in the next table ; and also the number of male deaths to every 100 female deaths :—

T ~ _ Proportion of Unmarried per 1,000 of Total. Proportion of Marriages per ] ,000 of the Year of Census. Marriageable , Marriageable I Marriageable Total Men. Women. Persons. Population. Males. Females. 1891 .. 1896 .. 1901 .. 1906 .. 246-2 264-2 I 278-3 j 295-8 ! 267-8 308-3 330-6 326-9 46-22 49-11 53-56 54-09 48-10 47-09 49-96 55-15 47-14 48-08 51-69 54-62 6-04 6-85 7-83 8-48

Year. Deatl i-rate. Year. Total Number of Deaths. Death-rate. w1t°hTa a tein „ °\. 1882-86 Population. takenasl00 . Total Number of Deaths. Per 1,000 of Population. ! Compared j with Rate in 1882-86 taken as 100. ] 1882-86 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 5,944 6,137 5,708 5,772 5,994 6,518 6,459 6,767 6,918 6,863 6,432 6,595 10-84 100 10-29 95 9-43 ■ 87 9-44 87 9-66 89 10-35 95 10-06 93 10-23 ! 94 10-19 94 9-91 ; 91 9-10 84 9-14 84 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 i 7,244 7,680 ! 7,200 7,634 I 8,375 8,528 8,087 ! 8,061 j 8,339 | 10,066 9,043 8,959 I i 9-84 10-24 9-43 9-81 10-50 10-40 9-57 9-27 9-31 10-95 9-57 9-22 1 91 94 87 90 97 96 88 86 86 101 88 85 I _! !

11

H.—3l

Males of tender years are more delicate than females, and, later in life, more liable to accident. These disadvantages are partly compensated by the preponderance of male births, but the tendency of the natural increase is towards an equalization in the numbers of the sexes. For the purpose of considering the mortality in New Zealand more closely than can be done by means of crude death-rates, it is desirable to ascertain the rates at different age-periods of the population. The abnormally high rate in 1907, due to prevalence of epidemic diseases, is strikingly illustrated by comparison with the average for the previous five years.

Death-rates per 1,000 living at Various Age-periods.

Besides advantages of climate, New Zealand possesses a population younger in age-constitution than that of most other countries —conditions favourable to a low rate of mortality. Another table is given comparing death-rates at twelve age-periods for 1908 with those of England and Wales. Here the extremely low rate of mortality among children under five years of age is remarkable, and the difference at some of the groups at the more advanced ages is considerable. The New Zealand rate for males is higher than that for females at all groups excepting 10-15, 25-35, and 85 and upwards, while for England and Wales the female rate equals that for males at 5-10 and 10-15 years, and is lower in every other instance. ;

Death-rate per 1,000 Persons living, according to Sex, for the Year 1908, compared with England and Wales.

Deaths per 1,000 of the Total Population. Deaths of Male! to every 100 Females. Year. Males. Females. Total. 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 10-33 10-80 11-64 11-43 10-64 10-18 10-40 11-81 10-62 10-18 8-43 8-71 9-23 9-24 8-37 8-24 8-08 9-98 8-38 8-14 9-43 9-81 10-50 10-40 9-57 9-27 9-31 10-95 9-57 9-22 123 124 126 124 127 124 129 118 127 125

Ages. Average, 1902-6. 1907. 1908. I i Decrease per 1909 Cent, in 1909, compared with 1902-6. j Under 5 years 5 years and under 10 years.. 10 „ 15 „ .. 15 „ 20 „ .. 20 „ 25 „ .. 25 „ 35 „ .. 35 „ 45 „ .. 45 „ 55 „ .. 55 „ 65 65 „ 75 „ .. 75 and upwards All ages .. .. 21-75 2-07 1-64 2-64 3-69 4-55 6-30 10-35 20-26 47-06 124-65 9-81 27-1 2-11 1-8' 2-8! 3-8( 4-7: 6-2; io-4: 20-1' 47-91 145-41 10-94 27-14 2-15 1-84 2-85 3-80 4-73 6-22 10-41 20-17 47-93 145-45 10-95 L4 L5 U 55 SO '■A !2 :1 .7 13 :5 15 I 20-38 1-76 1-64 2-03 3-42 4-37 6-24 10-47 18-06 44-75 132-36 9-57 18-77 13-70 1-96 5-31 1-35 17-68 2-23 15-53 3-08 16-53 4-43 I 2-64 6-71 + 6-51 9-73 5-99 17-97 11-30 42-62 9-43 125-91 + 1-01 9-22 6-01

Deaths per 1,( Deaths per 1,000 Persons living. 000 P( 'fil raons living. Ages. New Zealand. Males. Females. England and Wales. Males. Females. Under 5 years 5 years and tinder 10 years 10 " „ 15 " „ 15 „ 20 „ 20 „ 25 „ 25 ., 35 „ 35 „ 45 „ 45 „ 55 „ 55 „ 65 „ 65 „ 75 „ 75 „ 85 „ 85 and upwards All ages j " ~~ [ 22-6 18-1 1-9 1-6 .. ! 1-6 1-7 .. 2-2 1-8 3-5 3-3 .. I 4-2 4-5 .. I 6-9 5-5 .. j 11-7 8-9 . . ! 18-5 17-5 .. ! 48-1 39-5 .. I 123-4 108-3 .. i 240-9 246-2 .. J 10-6 j 8-4 j I ■I 44-5 36-6 3-2 3-2 1-9 1-9 2-7 2-5 3-7 3-1 5-4 4-5 9-1 7-4 16-4 12-8 33-0 25-0 70-3 57-7 137-8 I 124-3 303-7 286-4 15-7 13-7

H.—3l

12

Index of Mortality in New Zealand for 1909.

A similar calculation for the States of the Australian Commonwealth has been made for 1908. The results when compared with the actual rates, exhibit to what degree the age-constitution of the population affects the death-rate. The figures for New Zealand are also given. Year 1908. Index. Actual. New South Wales ... ... ... ... ... 13-88 10-16 Victoria ... ... ... ... ... ... 15-24 12-53 Queensland... ... ... ... ... ... 14-56 1034 South Australia ... ... ... ... ... 13-15 9-84 Western Australia ... ... ... ... ... 15-80 10-86 Tasmania ... ... ... ... ... ... 1534 11-71 New Zealand ... ... ... ... 11-67 9-57

Comparative Death-rate for the Period 1899 to 1909.

Considering the range of this statement New Zealand is conspicuous as showing the lowest deathrate. The rates for the principal Australian States are a little higher, but, generally speaking, far below those for the United Kingdom or the European Continental States mentioned in the table. Ages at Death. The deaths occurring during 1909 are tabulated below in single years up to five years, and from, thence in groups, showing males and females separately : —

i ; i Ages. Population 1909. Estimated Mean Population, 1909. Number of Deaths, 1909. Death- Percentage of rate Population per 1,000, of Sweden, 1890 1909. (Standard). Index of Mortality in NewZealand per 1,000. ___J i Under 1 year 1 and under 20 years ... 20 and under 40 years 40 and under 60 years 60 years and upwards ... ... i 24,392 ... ! 357,422 ... ! 367,431 ... j 153,931 68,608 1,634 1,011 1,538 1,544 ■ 3,232 j 66-99 2-83 4-18 1003 47-11 j 2-55 39-80 26-96 19-23 11-46 1-71 113 1-13 1-93 5-40 Totals ... 971,784 8,959 9-22 10000 11-30 l

Country. 1899. ; 1900. J 1901. 1902. 1903. 1903. j 1904. 1907. ! 1908. 1909. 1905. 1906. !_ I I New Zealand Queensland . . New South Wales Victoria South Australia* Western Australia Tasmania England and Wales Scotland Ireland Denmark 10-24 9-43 12-O7 ! 11-73 11-82 11-16: 14-28 12-75 12-141 10-64 13-76 12-92 12-25 11-05 18-2 ; 18-2 I 18-1 i 185 17-7 '• 19-6 17-3 j 16-8 16-7 ; 15-8 17-7 : 16-8 25-6 25-3 27-2 I 26-9 17-7 j 19-3 ! 21-5 ! 22-1 ; 17-1 J 17-8 21-1 I 21-9 21-9 I 23-8 9-81 11-88 11-75 13-22 1111 13-36 10-52 16-9 17-9 17-8 15-8 14-9 161 j 24-0 25-4 180 20-7 17-2 201 22-0 10-50 12-08 11-97 13-40 11-79 13-63 11-00 16-2 17-2 ! 17-5 j 14-6 13-8 15-4 24-7 J 27-0 ! 17-2 19-5 ; 16-3 19-5 22-2 j 10-40 9-57 12-38 10-11 11-65 10-65 12-90 11-92 10-7l! 10-22 12-601 11-91 11-92 11-04 15-4 i 16-2 16-6 : 16-9 17-5 • 18-1 14-7 ■ 14-1 14-8 14-3 151 15-3 23-8 i 23-7 26-1 : 24-8 17-6 I 17-8 20-0 ! 19-6 15-6 I 15-9 19-2 I 19-4 ! 22-4 J 21-1 9-27 10-47 10-16 12-10 10-14 10-83 10-29 15-2 15-9 17-1 15-0 14-8 15-6 J 25-0 I 27-8 17-9 19-8 15-3 19-6 21-9 9-31 9-56 9-92 12-42 10-34 11-87 11-24 15-4 16-0 17-0 13-5 13 7 14-4 22-5 24-8 17-0 18-2 14-8 19-9 20-8 10-95 ! 10-35 10-58 11-66 9-72! 11-17 11-14! 15-0 ! 16-2 17-7 14-2 14-2 I 14-6 ; 9-57 10-34: 1016 12-53: 9-84 10-86 11-71 14-7 161 17-6 14-5 14-3 14-9 ' 9.22 9-79 9-84 11-24 9-37 9-98 10-00 Norway Sweden Austria Hungary Switzerland German Empire ... Netherlands ... Ao A I j 24-8 j France Italy 14-6 ! 20-2 20-8 I 15-3 19-0 22-6 j I • Excluding the Northern Territor; y.

Ages. Males. Females. Total. Under 1 month 1 month and under 3 months 3 months ,, 6 ,, 6 „ „ 12 „ Total under 1 year 469 160 151 172 952 325 125 107 125 682 I 794 285 258 297 1,634

13

H.—3l

The average age at death of persons of either sex , in each of the ten years 1900-9, was as follows :- Males. Ppmaloo „» 1900 ... 40-31 years. 36 lfvears 1905 Females - -1901 ... 41-64 S7-R8 tone " - ? d '° 3 years ' 39-13 years. 1902 41-07 " S-S8 " horn — M ' 39 " 39-35 „ 1903 "■' 39-56 J 35.43 " HSE KS " 36 6 6 - : 2-S : ISBS ::: £S : ITS ;; Z)e«<fo a»rf Death-rates of the Four Principal Cities and their Suburbs "**""* *" * he f ° Ur » 19 ° 9 2>123 in the forth B By;™e y ;™ t he SUbUrbS the death - rate fOT kst 1S lo — d at *oi the four centres. The rate, Death-rates per 1,000 Auckland City • of Mean Population. rr 7 „." ,-. and seven suburban boroughs .. oQn Wellington Guy ... '" Jii{) „,./'. , „ and three suburban boroughs .'" Qlll Chnstchurch City ... '" 9 'll r. " „. an< s three suburban boroughs Q . QQ Dunedin City ... ... "" _ 933 . and six suburban boroughs n nr -" •*• 9-y5 Too- -Deaths per 1,000 of Population. D ° he,ii " ■ ">■" 11-85 12-02 1050 »M Auckland (including suburbs) o 1 ??!' 1909 - Wellington ■•; 7 7-60 Christohuroh " '" •" °' 83 6-89 Dunedin "" •" •■■ 7 6 6 7-60 ... 8-66 8-67 I

Ages. i iiges. Males. Females. Total. 1 year 2 vears 3 ■'■„ 4 » 126 56 39 19 !_ 116 59 36 25 242 115 75 44 Total under 5 years 5 years and under 10 years 1! - 15 - •'•' 15 >, 20 „ 20 „ 25 , 25 » 30 30 ,, 35 „ 35 >, 40 ,. *0 „ 45 „ 45 „ 50 , 50 „ 55 ,. 55 „ 60 „ 60 „ 65 „ 65 „ 70 „ 70 » 75 ; 75 » 80 „ 80 „ 85 „ 85 „ 90 90 „ 95 95 „ 100 " 100 years 105 " „ ■•' ! ■ • i • • I i ■ ■ i .. i — 1,192 96 63 130 173 201 221 222 187 j 210 240 271 295 436 468 461 234 94 40 II 1 918 98 65 83 146 193 175 207 159 J 39 I 160 J 78 178 286 .272 217 128 76 27 7 2,110 194 128 213 319 394 396 429 346 349 400 449 473 722 740 678 362 170 67 18 1 1 1 Totals ..r 5,246 5,246 8,959 3,713

14

H.—3l

Infantile Mortality. Subjoined is a classified statement of the deaths of infants under one year during 1909, with the ratio of the deaths in each class to the 1,000 births during the year:—

Seventy-one out of every thousand of male children born, and fifty-two of every thousand females, are found to have died before attaining the age of one year. The mortality was thus one in fourteen of male children and one in nineteen of females in New Zealand, where conditions are far more favourable to infant life than in Australia, at least as far as relates to the cities. It will also be seen from the figures that the chances of living during the first year of age are greater for female than for male infants. Thus, during the year 1909 there were— 100 deaths of males to 72 deaths of females under 1 month of age ; 100 81 ~ from 1 to 3 months of age; jqO 73 from 3 to 6 months of age ; jqq 75 „ from 6 to 12 months of age; jqO 74 „ under 12 months of age. Dealing with the results'for ten years, the deaths of infants under one year are in the large proportion of three-fourths of the total deaths under five, as might be expected, the first year being the tenderest period. (See notes to tables.)

Deaths of Infants under One Year, and Proportion to Births.

Note.—The totaTnumber of deaths of infants for the period included in the table is 16,758.

Deaths of Children under One Year to 1,000 Births. rioo+Via npr , Deaths per Country. I 000 Births. I 1,000 Births. „,..,. ' 320 Scotland (1907) .. . . 110 S " " ..199 Denmark (1907) .. ..106 •• 183 Ireland 97 lon •• ■• 175 Victoria 86 i amalCa " 173 Western Australia .. ..85 l mssm ■■ •■ ;: 158 Sweden (1907) 77 T+T a " " •■ 155 New South Wales .. ..76 Italy (1907) Tasmania 75 iT n(l Xm" •" " 132 Queensland 70 sr7 ( i! ■ " " 125 South Australia .. -.70 Netherlands .. •• New Zealand 68 Switzerland (1901) •• •■ "*; ~„„,, fi7 England and Wales .. • • -120 Norway (1907) 67 Finland (1907) .. ■• • • 112

Year. Sex. Under 1 Month. 1 and under 3 Months. 3 and under 6 Months. 6 , anl * Total under *? L i 12 Months. Months. 1909 I Male ( Female Number of Deaths. 469 160 325 125 151 107 172 125 952 682 Deaths to the 1,000 Births. 1909 ... ( Male I Female 34-74 11-85 24-96 9-60 11-18 8-21 12-74 9-60 I 70-51 52-37

Year. Deaths of Infants ui each Year, a ader 1 Yeai ,nd Meana of Age. {1 >i 10 Years. ?otals for ) f Total Births P r °P o !* ,on , registered of Deaths of in elch Year, Infanta and Mean of under 1 Year in Ynarq to every 10 Years. lfiQ0 ■ . 1 Month Under and under 1 Month, i g Mon ths. 3 Months and under 16 Months. 6 Months ; and under 12 Months. Total under 12 Months. I 1900 1901 1902 1903 1904 1905 . •■■ 1906 1907 1908 1909 607 610 665 692 669 714 717 763 810 794 288 272 344 346 260 285 247 446 242 285 293 292 313 367 356 290 244 500 347 258 281 289 390 365 331 310 298 519 362 297 1,469 1,463 1,712 1,770 1,616 1,599 1,506 2,228 1,761 1,634 19,546 20,491 20,655 21,829 22,766 23,682 24,252 25,094 25,940 26,524 75-2 71-4 82-9 8-1-1 71-0 67-5 62-1 88-8 67-9 61-6 Means of ten years ... 704 301 326 344 1,675 23,080 72'6

15

H.—3l

Here, of European countries, Prussia, which has a birth-rate of 33 to 37 per 1,000 of population shows an infantile mortality of 173 per 1,000 births ; while New Zealand, with a birth-rate of 27 per 1,000 of population, loses only 68 infants per 1,000 births. So that, whatever may be the faults of ignorance or willulness in this country, from a statistical point of view it would appear that far better conditions obtain than elsewhere. The principal causes of mortality in children under one year for New Zealand are given, with the numbers ol deaths for five years from such causes. Premature birth stands first in order of importance diarrhoea and enteritis next, followed by marasmus or debility. Here it is seen how much mortality is attributed to these causes according to the medical certificates.

Causes of Deaths of Children under One Year —1905-9.

The proportions of deaths of children under one year of age to every 100 births for 1908 and 1909 at the chief centres are, — ~,,,.,,. , , 1908. 1909. Auckland (including suburbs) ... . ... g-19 g.^g Wellington „ "." 8 . 17 g. 42 Uhnstchurch „ ... ... g-78 6-28 ' Dunedin „ "; ;_" 7 . 45 4 . 86 The percentage of deaths of children under sto the total number of deaths is—in Dunedin 18-18 "■ in Christchurch, 22-35 ; in Auckland, 23-71 ; in Wellington, 29-53. CAUSES OF DEATH. A comparison of the causes of deaths in 1908 and 1909 arranged according to an abridged classification, the percentage of each group to the total deaths, and the proportion per 10,000 persons living is given in the following table : —

Number of Deaths from each Cause. | Percentage of Total. Causes. - J 1905. 1906. J 1907. j 1908. 1909. j 1905. | 1906. I 1907. j 1908. ; I i__ j_ _ j I i ~~ j i i r Whooping-cough .. ; 2 17 207 31 28 ! 0-13 1-13 9-29 1-76 Convulsions .. .. i 96 i 90 84 76 107 j 6-00 : 5-98 ' 3-77 4-32 Bronchitis and pneumonia! 207 j 170 269 148 i 168 12-95 : 11-29 I 12-08 8-40 Diarrhoea and enteritis 285 ! 232 557 418 [ 249 17-82 : 15-40 ! 25-00 23-74 Premature birth .. 360 [ 337 359 388 ! 347 22-51 ' 22-38 j 16-] 1 j 22-03 Marasmus, &c. .. 258 267 303 264 j 256 16-14 17-73 j 13-60 14-99 Other causes .. j 391 393 j 449 436 ; 479 24-45 j 26-09 } 20-15 ] 24-76 Totals .. .. 11,599 1,506 j 2,228 1,761 1,634 100-00 100-00 100-00 i 100-00 Percentage of Total. 1909. 1-71 6-55 10-28 15-24 21-24 15-67 29-31 1,761 1,634 100-00 1 100-00 100-00 j 100-00 J J 100-00

Number if Deaths. Proportion to Total j Proportion per Deaths. 10,000 living. Class. 1908. 1909. 1908. 1909. 1908. 1909. I. General diseases II. Diseases of the nervous system and of the J organs of special sense III. Diseases of the circulatory system ' .. J IV. Diseases of the respiratory system. V. Diseases of the digestive system VI. Diseases of the genito-urinary system and adnexa VII. Puerperal condition VIII. Diseases of the skin and of the cellular tissue IX. Diseases of the organs of locomotion X. Malformations XL Infancy XII. Old-age .. .. .. ,[ XIII. Violence XIV. Ill-defined causes Total. 2,206 930 I 1,251 830 1,042 387 119 37 Total. 2,187 920 1,369 784 843 407 135 50 Per Cent. | Per Cent. 2440 ; 2441 10-28 ; 10-27 13-83 i 15-28 9-18 I 8-75 11-52 > 9-41 4-28 : 4-54 1-32 J 1-51 0-41 . 0-56 I I 23-34 I 9-84 ! 13-24 i 8-78 ! 11-03 4-09 J 1-26 i 0-39 j 22-50 9-47 14-09 8-07 8-67 4-19 1-39 0-51 38 47 716 586 673 181 25 . 64 676 556 778 165 0-42 ! 0-28 0-52 j 0-71 7-92 J 7-55 6-48 ! 6-21 744 ! 8-68 2-00 . 1-84 0-40 I 0-50 7-58 ! 6-20 I 7-12 ! 1-91 I 0-26 0-66 6-96 5-72 8-00 1-70 Totals I 9,043 8,959 100-00 i 100-00 95-68 J 92-19 -™* *j **» I » y_f \j

H.—3l

16

The next table shows the number of deaths from each principal cause for the five years and the proportion per 10,000 of the population.

Typhoid Fever. Deaths from this cause numbered 55 in 1909, against 90 in the previous year, the average for five years being 58. Measles. There was an outbreak of this complaint in 1907, causing 101 deaths. In 1909 only 26 deaths were recorded. Scarlet Fever. The number of deaths from scarlet fever in 1909 was 26. The average annual mortality for the ten years 1900-9 was 35. Whooping-cough. There were 41 deaths in 1909, 42 in 1908, 307 in 1907, and 26 in 1906. Influenza. This was less prevalent in 1909 than in any other year of the period shown, only 47 deaths being recorded. Tuberculosis. Deaths from phthisis numbered 588 or 6-05 per 10,000 of the population, against 607 deaths or 6-42 per 10,000 in 1908, and 612 deaths or 6-66 per 10,000 in 1907. The average for the past ten years was 582, or 6-8 per 10,000. „ Deaths from Rate v , Deaths from Rate * ear - Phthisis. per 10,000. | Phthisis. per 10,000. 1900 .. ..577 7-56 1905 ... ..496 5-70 1901 .. ..596 7-66 1906 .. ..556 6-21 1902 .. 617 7-73 1907 .. .. 612 6-66 1903 .. 570 6-95 1908 .. .. 607 6-42 1904 .. 598 7-08 1909 .. .. 588 6-05 Reference to the following table will show that 340 persons known to have been born in the Dominion died during 1909 from phthisis, a proportion of 5-58 per 10,000 of the estimated native-born white population, and 163 persons resident for fifteen years or over succumbed to the disease.

Nui iber of Deaths. Propori ;ion of 10,000 of lean Population. Cause. I 1905. 1906. 1907. 1908. 1909. 1905. 1906. 1907. 1908. 1909. i j I typhoid fever tfeasles Scarlet fever i¥hooping-cough . . nfluenza Cuberculosis of the lungs . . )ther forms of tuberculosis 45 8 10 3 70 I 496 i 182 I 566 79 119 116 48 12 18 26 132 556 164 623 104 138 106 53 101 25 307 223 612 244 674 87 130 104 90 19 60 42 64 607 232 657 100 136 96 55 26 26 41 47 588 212 711 104 131 131 0-52 0-09 0-11 0-03 0-80 5-70 2-10 6-51 0-91 1-37 1-33 0-54 0-13 0-20 0-29 1-47 6-21 1-83 6-96 1-16 1-54 1-18 0-58 1-10 0-27 3-34 2-43 6-66 2-65 7-33 0-95 1-41 1-13 0-95 0-57 0-20 0-27 0-63 0-27 0-44 0-42 0-68 0-48 6-42 6-05 2-45 2-18 6-95 7-32 1-06 1-07 1-44 1-35 1-02 1-35 Cancer Diabetes Simple meningitis Convulsions of children under 5 years of age Apoplexy J'neumonia Gastritis and enteritis Diarrhceal diseases Cirrhosis of liver Appendicitis 3right's disease and acute nephritis Violence, suicide . . „ accident Dther causes 299 425 379 128 40 53 242 272 444 335 97 J 44 I 69 ! 241 330 572 518 I 314 42 86 268 341 453 478 198 52 81 263 316 458 362 102 47 66 261 344 4-89 4-36 1-47 0-46 0-61 2-79 3-04 4-96 3-74 1-08 0-49 0-77 2-69 3-59 6-22 5-64 3-42 0-46 0-93 2-92 3-61 3-25 4-80 4-71 5-06 3-73 2-20 1-05 0-55 [ 0-48 0-86 0-68 2-78 j 2-69 89 525 4,187 83 575 4,252 102 611 4,663 103 570 4,401 118 660 4,497 1-02 6-03 0-93 6-42 111 6-65 1-09 I 1-21 6-03 ' 6-79 Totals . . i i , 8,061 i : 8,339 10,066 9,043 8,959 92-66 93-11 109-52 95-69 92-19

H.—3l,

Deaths from Phthisis, 1909.

- The mortality from all forms of tuberculosis for the past ten years has ranged from 7-79 to 10-05 per 10,000 of the population, and the percentage of total deaths from all causes has fluctuated during the same period between 8-41 and 1044. Deaths and Death-rales from Tuberculosis, and Percentage of Total Deaths, 1900-9. Number Veal . Mean of Deaths from Bite £ c f o , er^ age 1 of Population. Tubercular per 10,000. , Total , Deaths Diseases from all Causes. 1900 ... y .. 763,594 752 9-85 10-44 1901 ... '... 777,968 775 996 10-15 1902 .... ... 797,793 802 10-05 958 1903 ... ... 820,217 769 9-38 9-02 1904 ... ... 845,022 799 9-46 9-88 1905 870,000 678 \ 7-79 8-41 . 1906 ... ... 895,594 720 8-04 8-63 1907 ... .. 919,105 856 931 8-50 1908 ... ... 945,063 839 887 9-28 1909 ... ... 971,784 800 8-23 8-93

3—H, 31,

17

Length of Besidence in New Zealand. © rH O r-t O 49 © 1—1 1O o T-t o Age at Death. ige at I id w> CO Dea [ ith. s J i s o O y5 — 50 -H T3 -a ea CM' t= Cβ * . O >ra S EH • Males. Under 1 month 1 to 6 months 6 to 12 months 1 to 2 years 2 to 3 years 3 to 4 years 4 to 5 years 5 to 10 years 10 to 15 years 15 to 20 years 20 to 25 years 25 years and upwards Not known Born in Dominion ..., J I 2 1 3 1 1 2 4 2 1 7 1 3 8 1 5 1 1 1 2 1 2 3 3 3 8 6 34 ... ; ... ! ... j ... 2 1 ! ... I I 6 ... j ... J ! 3 l I : 8 1 : ... I ... ; ... ' 5 ... I ... ! ... ... I 9 ... ■ ... i ... I .... 4 2 1 I 13 1 I ... 10 2 1 ... l ... 6 ... i 1 ... j ... , 7 16 15 12 4 59 4 8 2 ' ... •. 26 8j 2 J 2 ! ... ! 162 35 ! 29 16 J 4 320 ... ... 1 2 ... I 4 6 49 61 Totals -i_J -1 _-l 57 108 65 Females. Under 1 month 1 to 6 months 6 to 12 months 1 to 2 years 2 to 3 years 3 to 4 years 4 to 5 years 5 co 10 years 10 to 15 years 15 to 20 years 20 to 25 years 25 years and upwards Not known Born in Dominion ... Totals I .... ... ... [ ■■■ I ;;:! ."." : "i ..'. "i "i "i i i ! 8 . I j i 2 I i ... . 1 l I I ... 2 ... ; 1 ... j 1 I i ... : l ! 1 I ' ... ! ... 4 2 j 2 6 I 3. j 4 i 48 76 ' 2 ! 4 ! 2 I ::: ::: i ::: I :::' '•J i 1 ;: i :::! ::\ S I ••• J ■•• : 3 3 ... ... ; ... ; 6 11 9 9 i ... 42 2 1 3 J ... 14 4 2 i 1 ! ... J 178 21 13 13 ... ! 268 56 42 29 4 588 L_ I ... 7 1 38 ! ~_ ; 57 97 I I 57 ! Totals of both sexes . i 5 3 ; 8 114 ! 205 122 i

18

H.—3l

Ages of Persons who died from Tubercular Diseases, 1909.

In comparison with England and Wales and the States of the Australian Commonwealth the deaths from tuberculosis per 1,000 of the population was lower in Queensland and New South Wales than m New Zealand. Death-rates from Tuberculosis, and Percentage of Total Deaths, 1908. Date - r n a * e f Percentage (per 1,000) of - m J mm , • Total Deaths. Tuberculosis. England and Wales • 10-80 New South Wales .. .. •• •• 9/81 7-96 TT- j- ■ 1-14 y-io Victoria .. ■ ■ • • • • • • • ■ _09 Queensland °'JJ 'J? South Australia lo °° Western Australia °"'° Tasmania, , ,,; °™ 8^ NewZealandjJ o ' B9 9 28 Cancer. There were 711 deaths assigned to this cause in 1909, a proportion of 7-32 per 10,000 persons, the average number and rate for the five years 1905-9 being 646 and 7-01 respectively. Deaths of males numbered 383, and of females 328. The death-rate from cancer is not so great as that from tubercular diseases, but its increasing tendency is a matter of grave concern.

Number of Persons who died from Cancer, the Proportion per 10,000 Persons living, and the Percentage of all Deaths.

The part of the body mostly afieoted among males is the stomach, and among females the generative and mammary organs. Cancer : Seat of Disease. Seat of Disease. Males. Females. Total. Mouth, lip, tongue, throat, neck .. .. ■ • 81 18 99 Stomach ..110 38 148 Intestines, rectum .. • ■ ■ • . . 90 67 157 Kidneys, bladder, urethra, &o. . . • ■ . . 23 6 Zb Liver 45 f 1° Female genital organs .. .. • • .... 72 7^ Breast] ■■ « 46 Other organs .. . • • • • • .• 34 M 383 328 711

Males. ! Females. ; Total. Ages. Males. ! Females. Total. Ages. Under 5 years .. E5 years and under 10 .. 10 „ IB .. 15 „ 20 .. 20 „ 25 .. 25 „ 30 .. 30 „ 35 .. 35 „ 40 .. 40 „ 45 .. 45 „ 50 .. 40 10 5 30 48 58 63 44 36 19 31 11 11 32 45 65 48 37 29 16 71 21 16 62 93 123 111 81 65 35 50 years and under 55 ' 24 55 „ 60 ! 25 60 „ 65 9 65 . „ 70 15 70 '„ 75 5 75 „ 80 4 80 upwards .. 1 Total deaths ..I 436 j 10 6 8 10 4 1 34 31 17 25 9 5 1 364 i 800

Year. Ye; sai Lf, Deaths from Cancer. Total Deaths from Deaths, all j Cancer per 10,000 Causes. of Living Persons. __| __ Percentage of Total Deaths due to Cancer. : 1900 1901 1902 1903 1904 1905 1906 1907 1098 1909 ' 430 515 536 582 571 566 623 674 657 711 7,200 I 5-63 7,634 6-62 8,375 6-72 8,528 7-10 8,087 6-76 8,061 6-51 8,339 6-96 10,066:1 7-33 9,043 j 6 95 8,959 ' 7-32 5-97 6-75 6-40 6-82 7-06 702 7'47' 6-70 7-27 7-94

ft—3l

19

Ninety-five per cent, of the deaths were at the ages 35 years and upwards, and 57 per cent, at the ages 60 years and upwards.

Ages of Persons who died from Cancer, 1909.

The proportion of deaths from cancer to the 1,000 persons living in some of the principal European countries as shown below leads to the conclusion that there is a general tendency to increase.

Cancer Death-rates per 1,000 living in some Principal European Countries.

Diabetes. There were 104 deaths in 1909, a rate of 1-07 per 10,000, the average for the five years being 95 and 1-03 respectively. Simple Meningitis. This disease caused 131 deaths in 1909, equal to the average of the past five years. Convulsions op Children. It would appear that the mortality from this cause shows a decreasing tendency, although the rate, measured by the total population, was exceptionally high in 1909. The proportion of deaths per 10,000 children living under 5 years of age was 11-52 in 1905 and 11-65 in 1909. Apoplexy. The average number of deaths from this cause during the past five years was 312, and the rate per 10,000, 3-39. Last year the number of deaths was 316, and the rate 3-25 per 10,000. Pneumonia. There were, 458 deaths in 1909, against 453 in 1908, and 425 in 1905. Excepting occasional fluctuations due to exceptional climatic conditions, the rate per 10,000 remains fairly constant at about 4-9. Gastritis and Enteritis and Diabehceal Diseases. Although shown separately in the table, it may be advisable to consider these causes together. The number of deaths recorded in 1909 was 464, a rate of 4-78 per 10,000, as compared with an average of 582 and 6-35 respectively for the past five years. Cirrhosis op Liver. There were 47 deaths in 1909, as compared with an average of 45 for the five years 1905-9.

Ages. Males. Females. Total. Ages. Males. Females. Total. Jnder 5 years 5 years and under 10 . . .0 • „ 15 . . .5 „ 20 .. !0 „ 25 . . !5 - „ 30 .. 10 „ 35 .. 15 ,. 40 . . :0 ., 45 .. 3 1 4 1 1 2 1 .. 1 1 .. 1 2 2 4 2 15 7 4 |9 13 5 22 27 6 27 33 45 years and under 50 50 „ 55 55 „ 60 60 „ ' 65 65 „ 70 70 ,-, 75 75 „ 80 80 years and upwards 23 42 44 52 66 72 45 14 383 29 40 34 35 49 37 25 12 328 52 82 78 87 115 109 70 26 711 Totals

Country. Average 1901-5. Yeai's 1906. 1907. 1908. i Switzerland The Netherlands England and Wales Scotland Victoria Ireland New Zealand South Australia . . Prussia New South Wales Queensland Tasmania Italy Spain Western Australia Hungary 1-30 0'97 0-86 0-84 0-74 0-69 0-67 0-67 0'65 0'64 0-57 0-56 0-55 044 045 0-39 1-32 1-01 0-92 0-94 0-75 0-79 0-70 0-74 0-70 0-68 0-55 0-52 0-62 048 0-59 0-40 i-25 1-02 O91 0-96 0-80 0-76 0-73 0-70 0-73 0-70 0-65 0-63 0-61 0-47 O50 0-42 1-03 0-92 0-79 0-76 0-70 0-68 0-74 0-67 0-51 0-67 0-64 0-50 0-52 043

20

H.—3l

Appendicitis. There were 66 deaths ascribed to this cause in 1909, the average number for five years being 71. Bright's Disease and Nephritis. Of the 261 deaths last year 209 were certified as Bright's disease and 52 as acute nephritis. The rate per 10,000 living for 1909 was 2-69, against an average of 2-77 for the last five years. Puerperal Diseases. In 1909 the deaths certified to these causes number 135. Included in the number were : Accidents of pregnancy, 31 ; puerperal Septicaemia, 33 ; other accidents of childbirth, 71. The number of deaths to every 1,000 confinements for each of ten years is show. Deaths of Mothers Deaths of Mothers Year. to every 1,000 Year. to every 1,000 (jj£ Confinements. Confinements. 1900 .. .. .. 384 1905 .. . . .. 4-22 1901 .. .. .. 4-39 1906 .. .. .. 3-91 1902 .. .. .. 5-33 1907 .." .. .. 4-62 1903 .. .. .. 5-86 1908 .. .. .. 4-64 1904 .. .. .. 4-66 1909 .. .. .. 5-14 Violence. The deaths from external violence, apart from suicide, numbered 660 in 1909—males 528, females 132. The rate per 10,000 living was 6-03 in 1905, 6-42 in 1906, 6-65 in 1907, 6-03 in 1908, and 6-79 in 1909. Drowning caused 35 per cent, of the total, and 36 per cent, of the male deaths by accident. The various forms of accidental deaths in 1909 are shown in the following table :-—

Accidental Deaths, 1909.

Suicide. The suicidal deaths in 1909 were 118 —males 96, and females 22. The rate per 10,000 living was 1-21 in 1909, against an average of 1-07 for the past five years. LOCAL VITAL STATISTICS. [From the Reports of the District Health Offloers.] Auckland District. The statistics, as they relate to births and deaths, including those of infants, are taken from the returns of the Registrar-General, and deal only with the City of Auckland and the surrounding boroughs, Birkenhead, Devonport, Newmarket, Grey Lynn, Parnell, Mount Eden, and Northcote, and cover, as in previous years, the period from the Ist January to the 31st December. Population. The mean population for the year 1909 in the above-mentioned boroughs, upon which statistics referred to are based, is— Auckland City .. .. .. .. .. ~ ~ 43,021 Suburban boroughs .. .. .. .. .. .. 34,075 77,096 The inclusion of other contiguous boroughs and road districts—Arch Hill, Eden Terrace, Epsom, Mount Albert, Mount Roskill, One-tree Hill, Point Chevalier, Remuera, Ellerslie, Onehunga, and the Hospital Reserve —all of which are to be regarded as comprised in the area which may be known as " Greater Atickland," with the addition of 18-07 per 1,000 per annum (the natural increase during 1909) upon

Cause of Death. Males. Females. Males. Females. Total. I Fractures Shooting Other accidental injuries. . Burns, scalds Insolation Electric shock Accidental drowning Inanition . . Inhalation of noxious gases Other accidental poisoning Other external violence ..25 8 .. 19 1 208 15 30 25 1 1 1 189 45 .. j 1 1 .. I 14 3 10 10 .. 30 23 33 20 223 55 2 1 234 2 17 20 53 Total deaths .. ! 528 132 660 i

a.—si

21

the population of those districts at the census of 1906, thus adding 22,133 to the foregoing figures, produces a total of 99,229. But, as it is very well known that several of theTsuburban||districts have extended in a manner altogether beyond what can be accounted for by natural increase, the Town of Auckland has probably now considerably over one hundred thousand souls. [Note. —The figures relating to Onehunga, though that borough is practically within a Greater Auckland area, are not brought into the statistics which follow.] Birth-rate. The average birth-rates per 1,000 of the population for ten years 1900-9 are, — Auckland City . . . . . . .. . . .. .. 30-28 Auckland and suburban boroughs .. .. .. .. . . 28-28 Death-rate. The average death-rates per 1,000 of the population for ten years 1900-9 are,— Auckland City .. .. .. .. .. .. .. 12-97 Auckland and suburban boroughs .. .. .. .. .. 11-28 Natural Increase of Population. M . , Ditto per 1,000 Birth. Death. £«W .Population. Auckland City .. .. .. 1,279 484 795 18-48 Suburban boroughs . . . . .. 839 233 606 17-78 Auckland and suburban boroughs . .. 2,118 717 1,401 18-28 Both the death and birth rates are lowered in 1909 ; still, as compared with 1908, when the natural increase was 2-04 in excess of the previous year, 1909 shows an improvement. This improvement is only maintained by effecting reduction in the death-rate, and the due effect upon the population is almost neutralized by the continued fall in the birth-rate. Infant Mortality. In Auckland and suburban boroughs,— Deaths of infants under 1 year were ' .. .. .. ~ .. 131 Between 1 year and 5 years .. .. .. .. .. 39 170 Auckland Auckland and Deaths of children under 1 year per 100 births, —• City. Suburban Boroughs. Mean for 5 years 1900-4 .. .. .. .. 12-09 11-18 Mean for 5 years 1905-9 .. .. .. .. 9-34 8-37 Mean for ten years .. .. .. ... .. 10-71 9-77 Mean for the whole Dominion for 10 years 1899-1908 = 7-59. It will be noted from the above table that there is a satisfactory decrease in the infant-mortality rate in the Auckland District during the past ten years. The present year is the lowest in that period. In 1909 the deaths in the suburban boroughs were 35 only, and these are only 4-05 per 100 births —a very low percentage. Causes of Deaths. ' ' ] Zymotic Diseases. Deaths in Auckland and suburban boroughs .. .. .. .. 74 For the last five years: — Deaths. Deaths. 1905 .. .. ..45 1908 .. .. ..139 1906 .. .. .. 42 1909 .. .. .. 74 ! 1907 .. ... .. 103 These 74 deaths were from, — Diarrhoeal diseases .. .. .. .. .. .. .. 48 Influenza .. .. .. .. .. .. .. .. 2 Typhoid fever .. .. .. .. .. .. .. 5 Diphtheria .. .. .. .. .. .. .. .. 6 Whooping-cough .. .. .. .. .. .. .. 5 Croup .. .. .. .. .. .. .. 2 Other zymotic diseases . . .. .. .. .. .. .. 6 74 Cancer. Deaths in Auckland and suburban boroughs .. .. .. .. 76 For the last five years, — Deaths. Deaths. 1905 .. .. .. 35 1908 .. ... .. 55 1906 .. .. ..49 1909 .. .. ..76 1907 .. .. .. 50

Bt.t-31

22

Phthisis and other Tubercular Diseases. Deaths in Auckland and suburban boroughs .. ... ,; 58 J?or the last five years, — Deaths. Deaths. 1905 .. .. ..49 1908 .. .. ..52 1906 .. .. ..52 1909 .. .. ..58 1907 .. .. ..66 There seems to be evidence that tubercular diseases are, at any rate, not on the increase. The notifications for the departmental year are fewer ; while, having regard to the increase of population, deaths are apparently stationary. Wellington District. The statistics of births and deaths are taken from the records of the Registrar-General, and deal only with, the population of Wellington and the boroughs of Karori, Onslow, and Miramar. Population. The mean population for the year 1909 in the before-named boroughs, comprising Greater Wellington, was,— Wellington City .. ... .. .. .. .. .. 70,455 Karori Borough .. .. .. .. .. .. .. 1,345 Onslow Borough .. .. .. .. .. .. .. 1,558 Miramar Borough .. .. .. .. .. .. .. 1,685 75,043 Birth-rate. The average birth-rates per 1,000 of the population for ten years, 1900-9, are, — Wellington City .. .. .. .. .. .. .. 27-27 Wellington and suburban boroughs .. .. .. .. 27-15 Death-rate. The average death rates per 1,000 of the population for ten years, 1900-9, are, — Wellington City .. .. .. .. .. .. .. 10-44 Wellington and suburban boroughs .. .. .. .. .. 10-16 Infant Mortality. In Wellington and suburban boroughs, — Deaths of infants under 1 year in 1909 were .. .. .. 167 Between 1 and 5 years .. .. .. ... . • '35 202 Wellington Wellington and Year - City. Suburbs. 1905 .. • ■ 10-02 9-62 1906 7-11 7-19 1907 11-85 11-78 1908 •■ 8-24 8-17 1909 .. .. .. 8-48 8-42 9-14 9-03 Natural Increase of Population. „ . , Increase Births. Deaths. ~™ P« 1,000 of increase. Population. Wellington City .. .. .. 1,876 659 1,217 17-27 Suburban boroughs .. ..107 25 82 17-87 Wellington and suburban boroughs .. 1,983 684 1,299 17-31 The birth-rate is lower by 0-98 per 1,000 than in 1908, and the death-rate is 0-17 higher. Causes of Death. Zymotic Diseases. Deaths in Wellington and suburban boroughs .. .. .. .. 78 For the last five years, — Deaths. Deaths. 1905 .. .. -.65 1908 .. .. ..124 1906 .. .. -.55 1909 78 1907 .. .. •• 164 i

23

H.—3l

These 78 deaths were from, — Diarrhoeal diseases .. .. .. .. .. . . . . 48 Influenza ' .. .. .. .. .. .. . . .. 2 Typhoid fever .. .. .. .. ~ . . .. 7 Scarlet fever .. .. .. .. . . .. .. .. 3 Diphtheria .. . . , . . . . . . . . . . . 6 Whooping-cough , . . ■■. . . .. . . . , . . 3 Other zymotic diseases . . . . , . . .. ... .. 9 f 78 Cancer. Deaths in Wellington and suburban boroughs .. .. ~ 59 For the last five years, — Deaths. Deaths. 1905 .. .. .. 47 1908 .. .. .. 48 1906 .. .. ..53 1909 .. .. ..59 1907 ...... 50 ' Phthisis and other Tubercular Diseases. Deaths in Wellington and suburban boroughs .. . . . . 81 For the last five years,— Deaths. Deaths. 1905 .. .. .. 41 1908 .. .. .. 73 1906 .. .. .. 60 1909 .; .. .. 81 1907 ...... 68 Christchurch District. The statistics of births and deaths are taken from the returns of the Registrar-General, and deal only with the population of Christchurch and the boroughs of Woolston, New Brighton, and Sumner. Population. Christchurch City .. .. .. . . . . . . .. 56,210 Woolston Borough .. .. .. .. .. .. 3,388 New Brighton Borough .. .. .. .. .. .. 1,571 Sumner .. .. .. .. .. .. .. .. 1,606 62,775 Birth-rate. The average birth-rates for ten years, 1900-9, are, —- Christchurch City .. .. .. .. .. .. 27-09 Christchurch and suburban boroughs .. .. .. .. .. 27-40 Death-rate. The average death-rates for ten years, 1900-9, are, — Christchurch City .. .. .. .. .. .. ... 11-36 Christchurch and suburban boroughs .. .. .. .. 11-28 Infant Mortality. In Christchurch and suburban boroughs,— Deaths of infants under 1 year in 1909 were . . .. .. .. 109 Between 1 year and 5 years .. .. .. .. .. .. 22 131 Christchureli and Suburban Boroughs. Mean for 5 years 1900-4 .. . . . . .. . 11-50 5 „ 1905-9 8-30 10 „ .. ~ .. .. .. .. .. 9-90 Natural Increase of Population. Births. Dqaths. Natural Increase per 1000 Increase. of Population. Christchurch City .. .. .. 1,605 533 1,072 19-07 Suburban boroughs ' .. 131 53 78 11-88 Christchurch and suburban boroughs .. 1,736 586 1,150 18-32 Causes of Deaths. Zymotic Diseases. Deaths in Christchurch and suburban boroughs .. '.. .. .. 35 For the last five years, — Deaths. Deaths. 1905 .. .. ..42 1908 ... !. 52 1906 .. .. ..47 1909 .. 35 1907 .. .. ..155

H.—3l

24

These 35 deaths were from, — Diarrhceal diseases .. .. • ■ ■• .. 19 Influenza .. .. ■• ■ ■ ■ • ■ • ■■ .. 4 Typhoid fever .. .. • • • • • ■ • • .. 1 Whooping-cough . . .. • • • ■ • • ■ • .. 4 Other zymotic diseases . . .. .. • • ■ • • • .. 7 35 Cancer. Deaths in Christchurch and suburban boroughs .. .. .. .. 51 For the last five years, — Deaths. Deaths 1905 49 1908 42 1906 60 1909 51 1907 76 I Phthisis and other Tubercular Diseases. Deaths in Christchurch and suburban boroughs .. .. .. 46 For the last five years, — Deaths. Deaths. 1905 54 1908 66 1906 .. .. .. 41 1909 .. .. .. 46 1907 .. .. -.73 Dunedin District. The statistics of births and deaths are taken from the returns of the Registrar-General, and deal only with the population of Dunedin and the boroughs of Maori Hill Momington, North-east Valley, Roslyn, St. Kilda, and West Harbour. Population. Dunedin City 38,702 Suburban boroughs .. • • • • • • • • • • 23,227 61,929 -./ Birth-rate. The average birth-rates for ten years, 1900-9, are,— Dunedin City .. .. .. • -••• ■ • • 23-83 Dunedin and suburban boroughs .. . - .. • • • ■ 24-33 Death-rate. The average death-rates for ten years, 1900-9, are, — Dunedin City • • • • • • 1044 Dunedin and suburban boroughs .. .. .. .. •• 10-16 Infant Mortality. In Dunedin and suburban boroughs, — Deaths of infants under 1 year in 1909 were .. .. .. 79 Between T'and 5 years .. . . ■ ■ ■ ■ .. 33 112 Dunedin and Suburban Boroughs. Mean for 5 years 1900-4 .. .. • • • • ■ • • ■ 8-41 5 „ 1905-9 7-36 ;; io „ 7-88 Natural Increase of Population. N , Increase Birth, Death, «££ pe^OOOof Dunedin City 1,097 447 650 16-79 Suburban boroughs .. .. 529 169 • 360 15-18 Dunedin and suburban boroughs .. 1,626 616 1,010 16-31 Causes of Deaths. Zymotic Diseases. Deaths in Dunedin and suburban boroughs . . .. • . . . 33 For the last five years, — Deaths. Deaths. 1905 ' .. -.55 1908 .. .. ..62 1906 26 1909 33 1907 ~ ■. ..101

25

H.—3l

These 33 deaths were from, — Diarrhoeal diseases . . . . . . .. . . ~ .. 17 Influenza .. .. .. .. .. .. . .. 2 Typhoid fever .. .. . . .. . . ~ .. 2 Scarlet fever .. .. . . .. .. .. .. .. 2 Diphtheria ~ .. .. .. .. .. .. .. 4 Whooping-cough .. .. .. .. .. .. .. 3 Other zymotic diseases . . . . . . .. .. ~ .. 3 Cancer. 3,3 Deaths in Dunedin and suburban boroughs . . .. .. 62 For the last five years,— Deaths. Deaths 1905 .. .. ..60 1908 .. .. ..53 1906 .. .. ..55 1909 .. .. ..62 1907 .. .. .. 59 Phthisis and other Tubercular Diseases. Deaths in Dunedin and suburban boroughs . . . . . . .. 47 For the last five years,— ' Deaths. Deaths 1905 .. .. .. 66 I 1908 .. .. .. 69 1906 .. .. ..78 1909 .. .. ..47 1907 .. .. .. 77 I

PART 2—INFECTIOUS DISEASE. " Return showing the Number of Cases of Infectious Disease reported to the Public Health Department throughout the Dominion during the Year ending 31st March 1910.

Summary for Whole Dominion.

The following tables and remarks relating to the incidence of infectious disease in the Dominion during the year are taken from the annual reports of the Health Officers of the various districts :— Auckland District. Cases of Infectious Diseases notified. The cases of infectious disease occurring in the Public Health district during the departmental year exhibit no very special feature. The total number of notifications is 73. For five years, — 1905-6 .. .. ..616 1908-9 .. .. .. "37 1906-7 .. .. .. 642 1909-10 .. .. .V 731 1907-8 .. .. .. 1,071 j Comparing last year's notifications with those of the previous year, we find, — Increase. Decrease. Scarlet fever .. .. .. .. .. .. 47 Diphtheria .. .. .. .. . . .. 51 Enteric fever . . .. .. .. .. .... 13 Tuberculosis .. ... .. .. .. .... 69 Blood-poisoning . . ~ .. .. .. .... 22 98 104 98 Net decrease .. .. .. .. .. . . 6 The only variation to note is the considerable decrease in the notification of tuberculosis, which follows upon a decrease of 30 during the previous year. The following table exhibits the distribution of the cases ; —■

4—II. 31.

Health Districts. |___ . Nature of Disease. Wellington, ! Hawke's Bay, ,„ ,, , and Weetland. Marlborough. Canter- ,,, bury. Ota S° ; Total. Auckland. __j Scarlet fever Diphtheria Enteric fever Tuberculosis Blood-poisoning Hydatids Totals 189 153 226 107 56 731 I 495 249 278 230 69 I aj_ 1,329 36 179 367 1,266 5 76 75 578 5 55 71 635 7 I 78 134 f 56 1 3 44 143 8 54 391 681 3,186 I I I

H.—3l.

Summary of Notifications of Infectious Disease from 1st April, 1909, to 31st March, 1910.

26

Scarlet Fever or Scarlatina. Diphtheria. Enteric or Typhoid Fever. Tuberculosis. Blood-poisoning. 1909. 1910. 1909. 1910. 1909. 1910. 1909. jl910. 1909. 1910. Locality. I I ! ! 1 i g I 1MJ I t-i '- u .! 1 & o 1 i\4\i I O 125 . I I .1 .1 ] .| I H s Auckland City 3 2 4 1 . . i.. 11 16 6 7 2!.. .. |i 12 2! 3 ■•! x 3 1 1 2 Birkenhead Borough Devonport Borough Grey Lynn Borough Mount Eden Borough Newmarket Borough Northcote Borough.. Onehunga Borough.. Parnell Borough i I . .. 1 1 ! .. i 2 1 1 1 "I "I ..... . 1 1 2 1 1 i i i i i 1 i '2 '2 i i 1 2 1 1 i i i 1 7, i 10 2 •• 1 1 1 2 2 .: 1 ••1 1 ..! 1 2 'ij:: ::!'i 1 i .. I.. 1 '.'. 3 -■ i • • * * .. 1 .. 1 i i 7 3 'i 2 1 'i i 2 1 i i •• i *3 1 i * Arch Hill Road District Avondale Road District Ellerslie Town District Eden Terrace Road District.. Epsom Road District Mount Albert Road District Mount Roskill District Mount Wellington District .. One-tree Hill Otahuhu District Point Chevalier District Remuera District .. Tamaki West District ■ .. ..'.. 1 3 1 1 i 3 1 1 1 'it: .... ::i"i ::fi '{].'. 1 i 1 * I * 2 1.. :::: .... 1.. 'r i '. ij5 "Pi .. 3 .. 2 i 3 i i 1 i 2 '2 2 i i 1 5 1 I 1 i 1 1 'I 1 i i 1 1 2 6 4 '2 1 3 "2"! ..I.. 2:: 4 2 1 1 i i 1 'i 2 1 i 1 1 .. •■- 1 1 .. . . J . . 1 1 Bay of Islands County Coromandel County Hobson County .. Hokianga County Manukau County Mangonui County .. Opotiki County Ohinemuri County Otamatea County Piako County Rodney County Rotorua County Raglan County Taupo County Tauranga County Thames County -5 1 1 1 "i 1 1 'i i ■i] - i::ri::::-i ...... ........ ■ i it "i|::ri:::: "i:: 'i"i:: "i 4 1.... ......... :::::::: ..(.. 3 ll i 2 '2 i 1 ■•!•■ 2 1 3 .. 2 1 1 I ..|.... ...... '.'. 3 i 1.. .. 1 1 ii 1 1... 1 1.... 1 9 2 i .... '2'i 1 i i 1 1 i :::: ::c::::!:: ..1....! 1I..1 2:: 2 '2 'ii i .. 1 2 i 1 1 1 2 '2! 1 ■• 1 1 '2 2 3 Ill:: i '2 1 i 2 .•J 3 1 '2 : [-..

27

H.-31

Vaikato County Vaipa County Vaitemata County Vaitomo County .. Vhakatane County Vhangarei County i i "I ( II.. 3.. 'i 1 i 1 2 i 5 1 1! . J.. 1 1 1 2 1 II 1 2 2 3 i i!! .. 1 3 1 1 1 •1 i ■ 3 i 2 .. 2 Ti ■• .. i 2 2 1 * 6 _ I 2 i ; 3 5 "2! 1 1 I .... .. [.. Cambridge Borough lamilton Borough ?hames Borough Vaihi Borough ?e Aroha Borough lospital .. fental Hospital Shipping 2 i 2 1 2 8 'I ' 2 1313 5 3 ' 5 2 3 1 ' * 4 ' " i 1 l 4J13; 2 2 i 1 1 * 1 * 1 .. 1 I:::: I.. 'i 6 .. ••I • -I 2 i •• - •■!•• j • •! ■• " 2 . J . . 3 2 . ! ' *r • H •• - •I 22J 9 •• •I ..... •I •I i 7, 1635! M '' 'I •• •• 14) 4 * * Totals ! I H - I H- ; ■ 14 io! 11 10 16 27 21 22 1 - I I 11 9 13 -i 7 ! 7 7 7 H Hi 12 18 19 ' 9 I 7 |2|S| 10 82 5 6 ii 17 21 29 9 5^ 12 6' 4 i 5 3 3 3! 4 189 153 107 56

H.—3l

28

Summary of Cases as to Locality.

The following cases were sent to the General Hospital by order of the Department : — Enteric fever .. .. • • • • • ■ • • .. 84 Scarlet fever . . . • • ■ • • • • • • .. 41 Diphtheria . . • • • ■ ■ ■ • • • ■ • .. 29 Measles .. • • • • • • • • • • • • ■*■ Blood-poisoning 162

Rainfall and Temperature, 1909-10— Auckland Museum Observation.

Scarlet Fever. The cases notified from the health district during the last five years are,— 1905-6 .. ..240 1908-9 .. .. ..142 1906-7 ~ • • ..268 1909-10 .. .. ..189 1907-8 '. ..' • ■ 277 A very general outbreak of scarlet fever occurred during the last month of the departmental year , Onehunga and Waihi being so far specially visited. (Subsequently this outbreak assumed considerable importance, as will appear in the report covering the departmental year 1910-11.) Diphtheria. The cases of diphtheria recorded throughout the health district for the last five years are,— 1905-6 97 ( 1908-9 101 19 06-7 .. .. ..103 j 1909-10 153 1907-8 .. • • .. 165 Enteric Fever. The cases of enteric fever recorded throughout the health district for the past five years are,— 1905-6 -172 1908-9 241 1906-7 .. ..153 1909-10 226 1907-8 .. .. ..353

_ ■ - - - [Sty of Auckland . . Suburban boroughs Suburban road districts Country districts . . Auckland Hospital Mental Hospital .. Shipping Scarlet Biph- Enteric Fever. theria. Fever. i i 30 22 60 37 24 43 .. ! 56 23 24 .. 64 84 91 2 i •• 5 .. ; 2 J 1 Tuberculosis. 18 14 16 58 1 Bloodpoisoning. 18 9 8 21 * * Total. 148 127 127 318 2 6 3 Totals .. 189 153 226 226 107 107 56 731

Rainfall. Temperature. 1909-10. Average Previous Years. lQnn 10 Average Previous iyuu • Years. 1909. April May June July August September October November December 1910. In. 1-20 4-72 3-24 5-46 7-13 3-53 3-68 3-44 0-79 I In. 3-15 4-21 4-79 4-86 4-33 3-39 3-34 3-23 2-78 Deg. . 60-4 58-6 55-7 53-8 53-0 55-4 56-9 61-5 66-1 Deg. 61-6 57-2 53-8 52-0 52-2 54-8 57-0 60-4 64-4 January February March 4-52 6-05 7-61 2-65 3-66 2-42 68-6 70-7 67-1 67-1 67-4 64-3 Totals and means 51-37 42-81 60-6 59-3

H.—3l

TYPHOID FEVER. AUCKLAND AND SUBURBAN BOROUGHS. CASES 1909-10.

TYPHOID, TEMPERATURE, AND RAINFALL CURVES, APRIL, 1909, TO MARCH, 1910.

/SOO-11.10-BSB.

29

H.—Bl

As shown in the accompanying chart, the dry, warm weather in December does not appear to have been followed by any notable increase in typhoid. On the other hand, the earlier spring months, which showed a slightly higher rainfall and temperature than the average, were followed by an unusually high number of cases in November and December. Tuberculosis. The cases notified from the health district in the last five years are, — 1905-6 86 1908-9 .. .. ..176 1906-7 .. .. ..96 1909-10 .. .. 107 1907-8 198 j Blood-poisoning. The cases notified during the last five years are, — 1905-6 .. .. ..21 1908-9 ... 77 1906-7 .. .. ..19 1909-10 56 1907-8 76 During the same period the notifications of cases of puerperal septicaemia have been resnectivelv 3, 3, 23, 29, and 23. ' F ■ ' The 56 cases last year were—23 puerperal septicaemia, 25 erysipelas, 8 unclassified : total, 56. Wellington Distbict. Gases of Infectious Diseases notified. Wellington (including Hawke's Bay and Marlborough) :— 1905-6 .. .. .. 982 1908-9 .. .. 1812 1906-7* 1,127 1909-10 1329 1907-8 .. ..' .. 1,880 Comparing last year's notifications with those of the previous year and with the previous five years, we find, — Compared with Compared with Previous Years. Average of Five Years, bcarlet fever .. •.. .. .. Decrease 454 Decrease 212 Diphtheria .. .. .. .. „ 52 14 Enteric fever .. .. . . .. Increase 54 Increase 82 Tuberculosis .. .. .. .. Decrease 28 Decrease 17 Blood-poisoning .. ~ .. „ 5 Increase 17 Hydatids .. .. .. .. Increase 2 „ 2

Summary of Cases as to Locality.

Incidence per Thousand (Population), Boroughs.

The following tables give details of the infectious diseases notified. In the case of the figures for that portion of the district formerly comprised in Hawke's Bay Health District, the figures relating to deaths cannot be taken as reliable, as in some cases the result of the disease was not noted As regards tuberculosis, moreover, compulsory notification of this disease is not insisted upon and the only information in many cases that we receive is the notice of death from the Registrar of Deaths The number of deaths therefore in regard to tuberculosis must not be taken in relation to the number of cases. Another difficulty that has occurred in the past is that only a rough intimation of the locality has been given, and in cases in which the name of a borough and county is synonymous it has been difficult to determine under which locality the disease should be placed. * No returns from Marlborough.

Scarlet Fever. Diphtheria. Enteric Fever. : Tubercu- Blood- ! losis. Poisoning. Hydatids. Total. Vellington City )ther boroughs lountry districts 110 254 131 70 116 63 54 130 94 j 71 82 77 18 42 9 2 3 325 627 377 495 249 ■19 were tr< 278 230 rted in hospitals. 69 8 1,329 Out of the 1,329 cai ss notified,

Cases. Deaths. 1 Removed to . „ , Hospital. J Rates " Scarlet fever )iphtheria Enteric fever tuberculosis Jlood-poisoning 364 186 184 153 60 1 . 9 5 59 10 118 96 82 42 7 2-1 1-1 1-0 i 0-9 i 0-3 i

m— 3i

Infectious Diseases. — Returns per Month for Year 1st April, 1909, to 31st March, 1910, Wellington District, including Marlborough and Hawke's Bay.

30

Scarlet Fever or Scarlatina. I Diphtheria. Enteric or Typhoid Fever. Tuberculosis. Blood-poisoning. Locality, 1909. 1910. 1909. 1910. 1909. 1910. 1909. 1910. 1909. 1 1910. •i -i .1 1.1 1 I 1 "j I i <1 mote n I >> I # i a; O o i \i 4 11 l-a <). w O te flj hs! g !iljl|lii : ilil|ili|i|i i 1 ■ . . . . 1 . . .. 1 .. ... Boroughs, — New Plymouth .. Inglewood m .. Waitara Stratford Hawera Eltham Patea .. .. • Wanganui Marton Taihape.. ..; Feilding Foxton .. Palmerston North Levin Wellington Onslow .. .. Karori Petone Lower Hutt Miramar .. . Eastbourne Pahiatua Eketahuna Masterton Carterton Greytown Waipawa Dannevirke Woodville Hastings Napier Gisborne Wairoa Blenheim Pieton 1 1 2 3 i 'i 5 2 3 4 % 2 3 1 2 • • 1 4 1 1 1 -3 1 i i i '•2 i pa.;;;; pip;;; .... 1 "i 2 1 i '2: 2. 2 .. '2 1 1 1 1 1 1 2 i i : l! I" '3 5 k 1.. .. .. 1.. :: ::N 1 !;■• ■ ■!■ • ! pi;; .. 1 :p 2 i 15 '2! 'i 1 2 1 1 "3 ! 2 1 '2 7 1 1 1: '4 5 -I. 1 !. 1 .... 1 .. 12 ip... .. j.... .... i.. .... 1 1.... i 2 3 1 1 2 3 1 1 i i 1 1 '2 . . 'i 1 1 'i 1 ■ :::: - i j 1.... . . . . i 1 1 1 *i 1 3 2 1 1 "i "l ii 6 i 1 1 1 1 ■3 1 1 1 '2 *8!2i 2.. 2 3 2 2 io! 14 19 ~8 ■5 4 2 2! ii;; 2l 4j 1 .. i ! .. 1 7 0 9 i2 3 4 7 9 '8 i 2 3 .. 14 3 7 2 8 3 3 1 i 3 4 11 (3 '4 '2 3; i 7 k 4 's 9 1 4 1 9 1 1 '3 5 1 2 2;; 1 i i 1 1 i 2 2 1 2 i ; I I 1 2 .. ;. .. '2 5 1 1 1 i 1 1 .... '.'. '.'. i Pi'.. 1 3 1 2, 1 !;••;•• ..! 1... 1 1 1 .. .. .. ,..:.. .. 2 .J.. .. :::;:: .. I.. .. 1 1 5 2 1 4 ;;p2 12 '7 6 1 4 1 2 40 2 1 1 14 3 3 2 'l 4 2 3 1 - 2 1 ;; i .. 1 ; 1;; ;;;; 3, 2 ;; \'i ...... ;;i 1;; ;; 2 1 ii 1.. 5 1 .... 1 1 1 •• •• 3 2 1 2 6 2 "■ • 2 'I 3 2 1 2 i "I 1 11 1 1 1 3 2 .. .. . .1 .. .. .. i '.:'.'. .. 1.. ....... ..| I.... .. .. ..;.. 1 1 .. 1 .. 1 i 8 i 1 3 1 1 1 5 "2 1 '2 1 •••■•■ .. 1 1 .... 1 1 ! ! 1 1 2 1 ■■ 3 i 1 1 2 1 •• 1 1 '2 i 1 ....... ...... :;p; '2 4 1.. ■4 •■ 3 2 "4 5 1 3 2 2 4 3 •1 3 2 4 2 1 2 i 2 5 1 ■4 2 : 3 3 '4 6 1 2.... 1 2 i 1 ■• •• . _ j 1 Town Districts, — Mtzroy .. Opunake Normanby .. .. ;;;;! I I :::::: t i *i ::i*i ;;p;p; 1 ■ " I

31

H.—3l.

• Town Di striets — continued Manaia Kaponga Waverley Ohakune Castlecliff Gonville Lethbridge Bull's Huntervillc Halcombe Kongotea Upper Hutt Johnsonville Martinborough Featherston Ormondville Waipukurau Kaikora North Taradale Havelook i. ..;..!...: i| 1.. .......... 1........ .. .. .. . . i. ..!..! 2.. .. I • ■ 3 i'l; 1 .. .. i i i •• 1 . . .. ...... .... 2 ...... 11.... I • T i i ; j i [I IIjIIj; ;:; ;vt;i;;|;; .......... . . . . . ... . • ■ ■ ■ ■ -|. •■• • ■•;•■••!■• i I - ■ .. i.... .. .. .. .. :::::::: i i I , ■ i i I I. I I ........ j i I • • ...... i...... i ..!.. ! 4. 1. ........ 'i'iLL •[ ! :!::■:::: L.L * * * * 1.. • • • ■ .. . .1........ .. .. ...... 1 'l 1 ]'■■ ...... . . ; . . . . J . . . . 1 . . ::: :pi::::::::::!:: :::[::::,:::: i I ; _ . . . j* * i I .... 1 .. i I ..j.. 1.. ...... i ......... .. 1 .... :::::::: .. .. ...... .......... ...... .. i.. • • • • \"\" ••!•• I j i .. .. . ... i |.. I........ ■■!■••••••• Counties, — Clifton Taranaki Egmont Stratford Whangamomona Eltham Waimate West Hawera Patea Waitotara Waimarino Wanganui Rangitikei Manawatu Kairanga Oroua Kiwitea Pohangina _Horowhenua Hutt Makara Featherston Wairarapa South Masterton Maurieeville Eketahuna Castlepoint Pahiatua Akitio '.'Xμ 1 1 ..; 1 1.. i i '.'. 'ill .... 1 . .j. j. . 1 ...... 1... 5 2 .. .: .. 1!.. .... 1 ::!:::: .. 1.. .. i :: , 1 ■1 1 • ■! .. i i .. .... ...... ...... I ...... i i ' ...... .. 1 .. ::! - 3:: ....... :::::: 1.. ... j.. 1 1 i I ........ r ■ :::::::: ! t ■•!•• ••[••I 1 1 ..j.. I :::j:t:::r ill i ... ..: i i.. .. i :::::x.:±:: :*::t::::: l i i i '2 ■ 2 .. ..!.. 1 2 •• "I 'il*8 ..... ........ 8 *3.'! 2 1.. .. 3 .. ....... i i i i i it i :::::::: ::x::: 'i!!!.".! • •! I : ! ! : I ...... .. • ■■••••■ 1 ' j 1 I ' I ...... . . i 1 !-■!•• L. .. .......... ■ ■ * * 1 . .1.. _ '2 1 2] i ..I.. ...... .'. \'i 1 1.. " " • • • • ■ • • • i ...... .. : i±:: ..:::: i : .......... ' *!'' 1 .. i '.'. 1 |..| i .... .......... 1 2 2 1 4 1 1 4 1 2 2 1 i ' "I '■t'.\ 2 1 2..; 2J .... . j.. ........ ...... 1 ....1.... 1 i i i -1 1 i "i:: |i :::: 2 1 1 i .... i 4 3 "i 2 i '.'.]'•'■], i 1 2 i ..... i • •.

H.—3l

32

Infectious Diseases. — Returns per Month for Year 1st April, 1909, to 31st March, 1910, Wellington District, including Marlborough and Hawke's Bay — continued.

Scarlet Fever or Scarlatina. Diphtheria. Enteric or Typhoid J'ever. Tuberculosis. Blood-poisoning. 1909. I 1910. 1909. 1911 1909. " 1919. 1909. : 1910. 1909. 1910. Locality. i i .1 I .1 I I ' i:Z I %\£\o\g P 4& % < j CO c i 8 9 4 I o lilllllilililllili 4 1 ft =1 t flMi iliU Counties — continual. Woodville Weber .. Dannevirke Patangata Waipukurau Waipawa Wairoa Hawke's Bay Waiapu Waikohu Cook County Sounds County Wairau .. .. .. 1 JJ.il. "j"]'-T' 1 3 2i..j 4 ;:i:: ::■:::: i \..\..\:X..\.. 17'25|ll|l8 ie| •4' ..... .. j.. 'i-'-'i i i * * I ' ..2 3 I '*■.'" !•• •• ! ••>! j.. .. ■■•••• '.'.c.\'.: ...... .. .. 3! 2|::L i ...... 5JJ20J20 ................. :::::::::::::: ....... .j......,.. 1 21J12 12 21301914 22 ........ ......... . . e| 7! 5 1 8' 3| 7l] 1 1 1 I (•• 1 'i 4 i 3 1 fiL 3 3 2 .. 1 1 • •! 5 3 'i ! 20;4(X23 1 .. 1' 1 2 21 i i '2 i 3 i 1810 2 2 2.. ..... 23: i ..... " " ij •• •• * * I i..;.. •• •• 14I22I •■ H ill 14 ! 26'; H : 21 19 42 -i 4 1 7 - Totals JTi 41 36 31 13, |2l! Il8i 9 IS 26 7 22 s|: 9 10il6' 12 495 249 278 230 69

33

H.—3l

/Scarlet fever .. n.07 ■ ~ ~—" ''■ ' Diphtheria .. .. .'' " " 4 . 84 / Scarlet fever .. 0 . 0057 Case-fatality, per cent. -; Enteric fever .. o. fi2 „ . ~. ' , ~.. „, , . Diphtheria .. .. .. 0-0509 Tuberculosis 33.0 : Mortality-rate per 1,000 offpopulationj Enteric fever 0-0282 '.Blood-poisoning .. .'.' " 15 . 62 Tuberculosis .. .. ..0-3 Blood-poisoning .. ~ 0-0565

The Incidence and Mortality (both actual and at per 1,000 living) of the More Prevalent Notifiable Infectious Diseases in the Health Districts and in the Chief Centres of Population.-Returns for Period 1st April, 1909, to 31st March, 1910.

6—H. 31.

City or Borough. Scarlet Fever or Scarlatina. Population. — * Bemoved Hat Cases. iDeaths. to per 1 Hospital. livii Bemoved Hates to per 1,000 Hospital. living. Diphtheria. Removed J Bates to per 1,000 Hospital. living. Enteric or Typhoid Fever. Tuberculosis. Blood-poisoning. Cases. Deaths. Cases. Bemoved Deaths. to Hospital. Bates per 1,000 living. Cases. ■ Bemoved Deaths. to Hospital. Bates per 1,000 living. Cases. Bemoved jDeaths. to Hospital. Bates per 1,000 living. New Plymouth Inglewood Waitara Stratford Hawera Eltham Patea Wanganui Marton Taihape Feilding Foxton Palmerston North Levin Wellington .. Onslow Karori Petone Lower Hutt tfiramar Eastbourne .. ?ahiatua 5ketahuna .. tfasterton Jreytown Vaipawa )annevirke .. Voodville lastings (apier risborne llenheim Icton .. ! 5,414 ! 8 1,160 4 1,220 1 ■ ■ ! 2,300 i 11 .. i 2,300 i .. 1,500 ! 4 • • 900 I .. 8,857 , 18 1,500 ! 6 : 1,600 ! 1 .. j 3,300 ! 5 ■ • i 1,450 I 1 .. J 12,000 [ 9 .. J 1,500 ! 2 I •. I 71,553 : 110 ■ • ! 1,715 ! 2 ! 1,374 9 ! • • I 7,313 17 • • I 4,000 , 5 .. ; 1,748 : 1 .. 750 : .. .. i 1,360 ' 2 .. ; 800 2 .. j 5,500 i 22 .. ; 1,407 i 8 I .. . 1.200 ; 2 J ■ ■ i 1,050 3,500 ! 1 1,215 ! .. 5,000 I 4 10,788 i 86 7,000 i 16 j 3,520 1 .. [ 995 6 176,789 j 364 " ! i ■■J i I 6 3 is ; 6 ! 23 I 3 ; 1 1 i 15 ! 5 ! 1 1 : 32 i 118 I 1-5 3 3-4 i 2 0-8 4-8 2 2-0 i 8 40 1 0-6 1 1-5 3 0-7 6 0-7 3 1-3 1 1-5 70 1-1 i 1 6-6 2-3 10 1-3 5 0-6 1-4 .' '. 2-5 4-0 1 5-6 11 1-6 1 0-3 8 0-8 7 8-0 I 8 2-3 J .. 0-3 I 23 6-0 ! 10 2-1 I 186 1 2 1 4 . r i 2 1 2 6 1 1 39 4 4 0-6 1-7 0-8 0-9 0-7 0-6 0-9 4-1 0-2 0-7 0-9 0-6 1-4 1-3 4 3 4 1 3 35 1 3 1 6 6 54 3 4 2 i 2 I 1 I i 3 2 1 1 3 14 2 1 1 6 1 29 1 0-7 1-3 0-7 3-3 3-9 0-7 1-9 0-3 1-4 0-5 4-0 0-7 1-7 0-5 0-5 8 1 2 3 1 1 20 1 1 6 1 71 1 4 4 3 4 1 6 1 4 34 3 2 1 4 1 1 1 6 2 24 1 1 1-5 1 0-9 0-8 3 2 0-7 2-2 J 8 2 0-3 i 0-7 0-5 j 1 0-7 i 1-0 ! 18 0-6 J 2-9 J 0-5 I 0-8 i .. •• 5 I 5 1 0-2 ■ • I 1-3 "■ 2 I 0-9 1-3 .. 0-1 6 j 0-2 ■ ■ • -> •• 2 2-7 .. j :: 0-2 7-8 i i 0-2 5 1 1 1 0-9 J 'i 0-7 .. 1 ; 0-2 4 i 1-0 i i i " i 1-0 0-3 1 2 2 4 1 8 1 1 10 0-6 1 1-6 ! 0-8 2 0-1 10 11 6 0-3 2 2 0-3 6 0-9 0-9 1 0-6 2-0 7 0-3 4 6 6-6 1.4 0-7 5 35 1-0 0-7 5-0 i 5 14 8 6-5 10-1 •• • ■ i ■• I 11 184 5 82 1-0 153 59 42 0-9 60 10

34

H.—Bl

Notifications of Infectious Diseases from 1st April, 1909, to 31st March, 1910. Canterbury District.

Scarlet Fever or Scarlatina. Diphtheria. Enteric or Typhoid Fever. Tuberculosis. Blood-poisoning. 1910. 1909. 1910. 1909. 1910. 1909. 1910. I 1909. 1910. 1909. ' Local Authority's District. - .1 ■ I .1 .1 I .1 J I I & I t Si sj i<4 I -i ! til l!illlililllillli|lj 1 i <l| ijd-s I III It 11! o k . n' * 4 iii ii "i Amuri County Ashley County Rangiora Borough . . Kaiapoi Borough .. Selwyn County Christchuroh Suburbs Lyttelton Borough Ashburton County .. Ashburton Borough Geraldine County .. Geraldine Borough Temuka Borough .. levels County Timaru Borough Mackenzie County .. Waimate County Wai mate Borough .. Waitaki County Oamaru Borough .. 16! 7 II ..! 2 .. 3; 7 2 3i 3 1 ..2 2 ..ill I'a '2 '.'.\ 3 1 2 1 2 27 3313 ■3 1 3 1 1 1 • • I i 3 1 1 1 1 '2 I i 3 1 3 1 1 1 li. ■ 1 .. ... 1 2 7 2 1 . . . . ..:.. i:|i .. 2 3 2 .. 2 .... i "if 1 ...... 3 2 4 ■ .. 81 6 2i.. .. ! ...... "ill's .. 1.. " i| 11 .1 :::::: nub si 2 2> ! ! ! ! ! ! 'i"3I... ...... I! "ill "ill I 2 2.. 2 1 1 "2 r 11 ..;.. 1.. 1 l 1 1 i ...... .. .. L.I.. 2| 2 1 .. .. 1 l! 2 % 1|15 2 7 5 3! lj 1 ...... ..L. .... .. ..1 2I ii 5 ....[.. l! 2 2 ! 2'..!.. .. li.. 2: 1 ..-.. 1 :::::::..... 1.. 1...... i i ::: :::: ::: !S:i:::::::::: .. ..[ 1 ..!.. lj .. ■ • •■ 2.. .. ..|.. 1.. •• .... 2 :.. .. 2 li 6 4 6 271 4 ! 9ll3 : 9s 2 1 el i 1 1 : 4 5.. i.... ...... . . 11..!.. •• i i I III I 1 2iIIII .. 1.. lj ii-iij:: Ilj'i 1.1. .... II II 'ii.. . . j. . L i II I.I II II II iiiiiii; :i .......... I.J..I..LU . .1.. II i i 1 3 2 6 ' 1 .. : 2 1 2 .. 2 .. i.. ::.! ii 1 :•. 1 1 i ..!.. 1 2 ill .... ..;•• i 3 1 1 1 2 lj.. ...... ■1 1 i : 6 9 : 7' 1 ■ ! ■ • ■■■■;■■ ' l 2 1 It ■•!•• i 4! 715! 7 ■• !.. .... i.... •I j. ] 3 ll 1 21 Totals 15 - 4 I 1 111 14 8^ 5 819 U-9l 61210* 2 1 I 3 7.. il IlLI ..'■ 1 76 78 3 179 OU W: )ISTRICT. iii'.; ii'i'3iiliiiii|ii;;" i|i 1 11 1;;;; i.. ■;; ;;l; ;;;;;; "2;;;;;;;; ;;ii;.;;......... '.\.'.t.\ ....■..;............ iiili'i; II;; nil 11 11 illill II 11111111111 1111 1111 111111 — i— ESTLAND D Westland County .. Inangahua County .. Grey County Greymouth Borough Kumara Borough .. Hokitika Borough .. Brunnerton Borough Ross Borough 3 ..) 3! I li 6| 1 !..! li 1 .... 2 ...... 4l 7i 7 !.. . .1.. .. .. ' lj 1 .. 3.. I I ..:..;.. I.. ..; 1.. "il! IIIj"ijll!ll II;II ... J. . j........ . . .'. L. li.. .. 2|.. 1 ; , I i ■ ! 2 I 1 li e|.. I 2! 1 l' ••M-'j'i 'ill 1 1; i linilnjii 1 1 . J 1! 3 ::i::|$ ........ ...... ........ . . . I. . . . .. j.......... .. r.iirriibii li 3LLL.I..L .. ..!. .1 .. .. j.. " " " 771771.. IIII IHI'i ...... iiiiiii ;;rrl;; Ili-II IIII ..Gil. ........ . . .. j. . H 'I j* " I 1 I i Totals .-.!.. I.. I.. * .... I..I..U I 36 5 5 i 1

35

11.—31

Canterbury and Westland District. Cases of Infectious Diseases Notified. For five years,— 1905-6 .. .. ..385 1908-9.. .. ... .. 693 1906-7 .. .. ..406 1909-10 .. .. ..391 1907-8 ...... 536 Comparing last year's notifications with those of the previous year, we find, — Increase. Decrease. Scarlet fever .. .. .. .. .. .... 207 Diphtheria .. .. .. .. .. .... 23 Enteric fever .. .. . . .. .. .. 4 Tuberculosis .. . .. .. .. .... 8 Blood-poisoning .. ~ .. .. .. .... 68 4 306 4 Net decrease .. .. .. .. .. 302 Blood-poisoning other than puerperal not recorded in the latter year. The table on the opposite page shows the distribution as to locality. Scarlet Fever. < The number of cases notified in Christchurch and suburbs is the same as last year. In the Canterbury District there were 179 cases, as compared with 282 cases lastjlyear, which shows a considerable decrease. Diphtheria. There have been 24 cases in Christchurch and suburbs, as compared with 38 last year ; and 76 cases in Canterbury, as compared with 96 last year. Enteric Fever. There were 27 oases in Christchurch, as compared with 15 last year ; there being 55 in Canterbury District, as compared with 50 last year. There was a sudden outbreak in March in Christchurch, 15 cases being notified. This is the largest number of cases that have occurred in Christchurch for a good many years. The cases were not confined to any particular part of Christchurch, there being a good many in the outside suburbs. No common source of infection could be found, and it is almost certain that it was not water-borne or milk-borne. In two of the cases there was a history of oysters having been eaten at about the period of the infection having occurred, but in the rest of the cases there was no history of oysters having been eaten. Tuberculosis. Thirty-two oases were notified in Christchurch and suburbs, as compared with 46 last year. Seventy cases were notified in the Canterbury District, as compared with 86 last year. There were 58 deaths in Christchurch, as compared with 77 last year, and notices of 107 deaths were received from the Registrars in the whole district. Accommodation for Infectious Diseases. North Canterbury Sanatorium. —The Sanatorium was opened in the beginning of March, under the control of Dr. Blackmore, who was specially appointed by the Hospital Board as having had previous experience in the sanatorium treatment of consumptives. There is accommodation provided for 18 males and 13 females in the shelters, and 4 beds for special cases in the main building. Otago and Southland District. Cases of Infectious Diseases Notified. For five years,— 1905-6 .. .. .311 1908-9 932 1906-7 .. .. ..350 1909-10 .. . 681 1907-8 .. .. ..525 Comparing last year's notifications with those of the previous year, we find, — Increase. Deorea.se. Scarlet fever .. .. .. .. .. ~ ~ ' 239 Diphtheria .. .. .... .. .. 70 Enteric fever . . . . .. .. . . .... 99 Tuberculosis .. .. .. .. .. .. 49 Blood-poisoning .. .. .',. .. .. .. .. 34 119 372 119 Net decrease .. .. .. .. .. 253 The following table shows the distribution as to locality :

H.—3l

36

Notifications of Infectious Diseases from 1st April, 1909, to 31st March, 1910.

Scarlet Fever or Scarlatina. Diphtheria. Enteric or Typhoid Fever. Tuberculosis. Blood-poisoning. Local Authority's District. 1909. 1910. 1909. 1910. 1909. j 1910. 1909. 1910. 1909. 1910. tiUifli o i\ | §]■§ I I iiljiiijijl jm i? !§:3[ *; S i?j.° m!o i§ fl 4|S I a, A § i-sj <<; i I l|ljll| Waihemo County Waikouaiti County.. Port Chalmers Borough Dunedin and Suburbs Taieri County Mosgiel Borough Bruce County Milton Borough Kaitangata Borough Clutha County Balclutha Borough .. Tuapeka County Lawrence Borough .. Maniototo County .. Vincent County Alexandra Borough Southland County .. Gore Borough Mataura Borough .. Invercargill and Suburbs Bluff Borough Stewart Island County Wallace County Riyerton Borough .. Lake County 117 i 10 15 •■ 4 1 21 1 8 2 1 4 'i 14 1 3 3 8 5 1 1 1 9 1 6 1 10 1 1 'if! "i|'i • • • ■! 3 ; .. ...... .. .. .. :!: :: .. .j 4 5 5j 3 2 1| 4 4..! 6 . J 2 1 .. .. 1.. 1 :::::::: i 2 3 2 2.. 2 .. .. 1 3 ....... 2 .. *i| 4 "i|!!|!! ..: 2!.!fit!! .. 1 ..! l! 1 1 r..|..| 2 I::: :: :: 1 1L 1.. :::::::::: 21|...... :::::::::: '141141 6' 9I 7 :x:cc 1 ; l ...... . . j ■ ■ * I • • i 2 2 '.. 1 11.. ! I 5!'2 "i!! ..... !! 'i j 1 ..! i.... .... 1.. . .1...... ........ 3::: : i 131 3 .. .. :\\i:y:. .. .: 1 'it!! fi ...... i;:! i I : j * I* . . . . j j ...... ...... .. 3 3 'if!;; .. .. .. .. 1.... ....... IJ 31 4 1 1 :. '7 fi j . . .. 5 2 5 4 !! i 5 3 2 2 .. 1 .. 11 ■ifi 1 .. ::| : i if. 11013 I j if. 2 1 7 3 7 3 .. .. . . . .! iL. .. 1 3 3 .. 1 .. 1 .. 1 :::: .. 1 .. 3 2.. .. 2 3 7 8 1 ..It 1 1 6 ..: 2 .... .... !! i 4 .. .. .. .. 'if! .... j ...... j . .1. .j.. ,..... .. !!i!! ! !! !!'!!l!! !!fi 2 !!p!! j 1" i 1.1 v 2I 2!! .... 1 12 3 ■2 12 i 12 '2 i ■y 1 *2 1 1 '2 21 3 i 1 - 2 1 1 i - 6i!! :::: ••.••- 1!. ■ 'i - ■ 1 '2 1 .... 20 1 22 '3 4 1 7 7 2 1 4 1 1 .. I. . . . i i !! !! l 1 .. ..!.. 1 1 i 1 1 i 11 'ifi .... 20 1 9I • •■■• !!;'2 .. ........ 3 1 2 1 1 .. i .. .. — "ill I j 1 .. 1.... ..! j I 615113161 • • i ! . . 'if! .... I.. 1; 1 .. .. 19 9 1 1 1 I * • 2 • • •• 2L.I •• 3 i fi H : ! - 1414 I ' * 23' .I i ! I 1 1 1 . 10 •• 1 1 3' 2^ ••I 15 3 • • 8 1 12; - H •• - •1 H Totals 65 61 44 i34: 33: 1919' 20 '192523' 4l 5l 4! it 4 5! 2 4 ; 9 Isl lit I4I 367 J 71 iS V

H.—3l.

Accommodation for Infectious Diseases. Invercargill— The Southland Hospital Board, towards the end of 1909, discarded the use for scarletfever cases of the large rambling pile of buildings in Invercargill formerly occupied for many years as an old men's home, and the new isolation hospital, on 44 acres of land at Kew, near Invercargill was brought into commission. Diphtheria and enteric cases are treated in small wards in the General Hospital. An old isolation ward adjoining the latter is being fitted up to accommodate 8 incurable tuberculosis patients. Arrangements are being made to send all Southland curable cases to the Otago Hospital Board's new sanatorium at Pleasant Valley, Palmerston South. Gore,~A new hospital of 15 beds has been opened at Gore, some forty miles from, the base hospital at Invercargill. The accommodation is for non-infectious cases only. new hospital for scarlet fever, adjacent to the Wallace General Hospital, was completed during the year. Enteric cases are admitted to the main Hospital, diphtherias and incurable consumptives are treated in small isolation wards, and curables go to the Pleasant Valley Sanatorium Frankton and Arrowtoum.—FaMj suitable accommodation exists at both these hospitals for cases needing to be isolated, but fortunately the available provision does not require to be used often. PART 3.—METEOROLOGICAL REPORT. New Zealand Temperature and Rainfall. The following tables have been kindly supplied by the Government Meteorologist :—

Mean Annual Rainfall at Twelve Representative Stations.

Averages for a Period of Ten Years.

Mean Temperatures (in Degrees Fahrenheit) for the Seasons for a Five-year Period.

37

Station. Rainfall. Period. Station. Rainfall. : Period. North Island. Mangonui Auckland Napier New Plymouth Wanganui Wellington In. .. I 53-63 .. 43-09 .. 37-09 60-19 .. 38-11 .. 49-88 Years. 20 57 15 33 47 46 South Island. Nelson Hokitika Christchurch Dunedin Invercargill I Queenstown In. 38-02 116-09 25-24 37-43 46-43 29-36 Years. 27 31 21 50 13 19

Observatory. Auckland Napier New Plymouth Nelson Hokitika Christchurch Dunedin Wellington Days with Rain in Year. , Rainfall (Annual, in Inches). . J _ . Max. Miii. ; Mean. Max. Min. \ Mean. I ! I [ I I •• : 197 130 175 54-18 31-89 41-59 • ■ 143 75 92 45-36 27-01 35-57 .. I 251 191 j 228 82-93 52-04 64-79 .. [ 140 102 123 45-59 30-90 38-31 • • I 188 146 166 ! 133-97 | 93-83 l 111-82 • • J 148 I 103 126 35-30; 13-54 24-]4 .. j 184 ! 143 162 53-84 31-48 43-34 ■• j 201 141 167 60-40 34-93 45-70 54-18 31-89 45-36 27-01 82-93 52-04 45-59 30-90 133-97 j 93-83 35-30 13-54 53-84 31 -48 60-40 34-93 41-59 " 35-57 . 64-79 38-31 111-82 24-14 43-34 45-70

Station. Auckland tfew Plymouth iloumahaki deeanee (Napier) . . Wellington • felson lokitika.. Jhristcliurch. )unedin Summer. 65-2 63-4 60-8 62-6 60-7 62-5 60-7 59-7 57-2 Autumn, i Winter. 60-8 52-2 60-1 53-1 56-1 47-7 56-9 47-7 56-3 48-3 55-8 46-4 55-7 46-9 53-1 43-1 51-0 43-0 j J Mean Difference : Spring, j Annual. , Coldest and Warmest Months. i . 57-1 58-8 15-2 56-7 58-3 12-6 53-6 54-6 15-6 54-8 55-5 17-0 53-4 54-7 : 14-7 54-4 54-8 18-4 53-6 54-2 16-8 51-7 51-9 19-3 50-1 50-3 17-7

H.—3l

38

APPENDIX 11. — REPOETS OF DISTRICT HEALTH OFFICERS ON THE SANITARY CONDITIONS AND WORK DONE IN THEIR DISTRICTS.

PART A.—AUCKLAND DISTRICT. Owing to the departure of Dr. Purdy just before the end of the year, I am unable to furnish the usual report on this health district. For the following information lam indebted to Mr. H. Symons. Local Incidence of Infectious Disease. As the total number of notifications of infectious disease is normal, and practically the same as in the previous year, there is some basis for comparison. So we findjthat — Auckland City shows a decrease all along the line, which is as might be expected in view of the efforts made towards better sanitation. Suburban Bodies. Devonport, I regret to say, has 7 cases of enteric fever —the first since the installation of drainage in 1902. Grey Lynn suffered severely in November and December as regards enteric cases, a total of 17 cases occurring in these months. Newmarket. —Here the clearing-up process of 1907-8, '■ with subsequent increased attention to sanitary matters, have no doubt contributed to bring about the satisfactory result set forth in the foregoing table. Eden Terrace escapes with very few cases to its debit. Thames County has suffered from typhoid fever, where also, as in the borough, there have been too many cases of diphtheria. Whangarei County has again suffered from diphtheria. Water-supplies Examined. Thames County. —Sample was taken by Dr. Makgill on the 17th May, who reported, " The peculiarity about this water was the large number of moulds which grew in the plates However, even as it is, the result places the water well within the bounds of a good domestic supply, and shows that at present there is no serious pollution." Thames Borough. —Sample taken same day as above. Dr. Makgill reported, "We can class this water as a first-class supply at present, and it may be regarded with great satisfaction." Te Aroha. —Sample taken same time as the foregoing, and the Bacteriologist's report was highly satisfactory. Special Inspections. Pakatoa Island (Salvation Army Home for Inebriates) has been visited periodically in company with District Judge Kettle. Military camps at Morrinsville and the Domain, Cadet camps at Papakura and at Motuihi, were visited ; as also the Veterans' Home ; abattoirs at Westfield and Mount Roskill; manure and chemical works and boiling-down works ; jam-factories and vinegar-making plants, with a view to definitions and restrictions under the Sale of Food and Drugs Act. Inspections and reports were made regarding Cambridge Borough, Hamilton, and Whangarei (drainage scheme, &c), Hikurangi, Whitianga (proposed infectious-diseases hospital), Karere treeplanting camp (twice), Thames, Te Aroha, Te Awamutu, Taumarunui (several visits), Rotorua, Whakarewarewa, Waihi, Kerepehi, Waiheke, Taitukuri, Whakatemai, Kaiau, Miranda, Huntly, Otahuhu (drainage), Mount Albert, Kawakawa, and Kaikohe, and certain areas of the City of Auckland. Examination of Officees fob Public Depabtments. Four officers were examined for the Postal and Telephone Department, and one for the Department of Public Works. Applicants for admission to Government Sanatorium, Cambridge, examined, 50. Midwives Act. Five registered midwives have been suspended on account of the occurrence of puerperal septicaemia in patients under their charge, and three unregistered women have been warned not to attend any further case for the usual period of suspension. Labobatoby. The following is a summary of pathological specimens submitted to this office for examination :— i 133 sputums for examination for tubercle bacillus. 22 swabs „ diphtheria bacillus. • 45 blood „ typhoid. ; ' 13 urine „ general. 6 smears „ gonococci. 1 vaginal discharge for identification. 165 rats examined for pestis. Twenty-three specimens were received, and forwarded to the Bacteriologist, Wellington, for report.

39

H.—3l

Office. Letters outward, 3,222. Telegrams outward, 371. 164 orders for admission to Infectious-diseases Hospital. 295 tubes of vaccine lymph distributed to medical practitioners and public vaccinators. 274 accounts made out in favour of medical practitioners. R. H. Makgill, District Health Officer.

PART B.—WELLINGTON DISTRICT. Insanitary Buildings. During the year 13 condemnation certificates were issued, made up as follows : Dwellinghouses, 3 ; outbuildings, 5 ; stables, 2 ; lean-to, 3. Annual Hotel-inspections. The following table shows the total number of hotels reported upon :— Rangitikei .. .. .. .. 10 Egmont . . .. .. 9 Wanganui .. . . .. .. 15 Taumarun vi.. . . . . 4 Wairarapa . . .. 19 Pahiatua . . . . .. 17 Taranaki . . .. .. .. 10 Otaki .. . . 13 Patea .. .. .. .. 25 Wairau .. .. 3 Oroua .. .. .. .. 13 Wellington .... . . 2 Stratford ........ 11 Manawatu .. . . . . .. 14 Total .. . . 165

Legal Proceedings. The following is a list of the legal proceedings taken by the Wellington District Office during the year : —

Nelson.— At the request of the Nelson City Council an investigation was made by Inspector Middleton and myself into the condition of the sewerage system just completed. The sewers were found to be leaking to an extent pointing to serious structural defects, more especially in the wood area. Steps were taken by the City Engineer to uncover and relay portion of the system. The need for such reconstruction was subsequently confirmed by examination by Mr. Hay. M.I.C.E. Westport.— Plans and estimates were prepared by the Borough Engineer for a complete sewerage system. The main point in discussion has been as to the position of the outfall. The Borough Council has consulted the Engineer-in-Chief with a view to a final decision. J. P. Frengley, M.D., F.R.C.5.1., D.P.H., District Health Officer.

Besult of Proceedings. Offence. Under what Act or By-laws. Date of Heating. Name of thI Bemarks. £ Costs. Keeping pigs within borough Failing to notify case of infectious disease 8 per cent, of water added to milk I i Selling milk below standard I 10 per cent, of water added to milk ! Selling milk below standard 8 per cent, of water added to milk | Selling milk below standard I 6 per cent, of water added to milk j Milk containing a preservative r (boracic acid) I I With Borough ; Council, under by-laws i Public Health 1908 Sale of Pood and Drugs Act, 1908' 29/4/09 25/6/09 J.P.s A. D. Thomson 20/0 10/0 12/0 7/0 Persisted in keeping pigs on his hotel premises. Doctor's fee, 10/6. Ditto I I 9/7/09 9/7/09 Dr. McArthur ■ f 1 20/0 20/0 20/0 20/0 20/0 20/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 j-Two charges. ] i " 1 ) 9/7/09 9/7/09 ( 20/0 20/0 7/0, 5/0 7/0, 5/0 J 18 per cent, of water added to ilk 9/7/09 i W. G. Riddell j W. R. Haselden 40/0 20/0 40/0 20/0 20/0 20/0 10/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 7/0, 5/0 9/0 9/0 7/0 1 ! i Pleaded guilty. Selling adulterated milk i 15 per cent, added water / 4 oz. short weight in 4 lb. loaf . . 1£ oz. short weight in 2 lb. loaf .. Pepper adulterated by addition of 25 per cent, starch Bread 3 oz. short w r eight in 4 lb. loaf 25 per cent, starch in pepper 9/7/09 21/2/10 7/3/10 14/3/10 Dr. McArthur I 14/3/10 18/3/10 20/0 10/0 7/0 7/0 Pleaded guilty.

H.—3l

40

PAET C—CANTERBURY AND WESTLAND DISTRICT. Water-supply. The reticulation of the Central, St. Albans, and Linwood Wards has been completed all but two miles in the St. Albans Ward. The total length of mains to date is 96 miles 23 chains. In Sydenham also 22 miles are laid, and the completion is now being proceeded with. There are 2,sllflhouses in Sydenham connected with the old separate high-pressure water-supply in that district, and 1,241 houses in the rest of Christchurch connected with the new high-pressure water-supply. About 75 fresh connections are being made every week. Drainage. Thirteen miles of sewers have been laid during the year. There are now 8,000 houses connected with the sewers," of which 5,380 contain water-closets. During the year 1,363 houses were connected with the sewer, and 1,774 water-closets were fixed in 1,630 houses during the year. Owing to the installation of the water-supply there has been a, great increase in the number of house-connections and waterclosets installed. Steam Disinfector. The disinfector which had been installed at the Sanatorium has been removed to the Christchurch Hospital. It will now be possible to get clothing, &c, which has been exposed to infection properly disinfected. Lyttelton. The drainage scheme was completed during the year, and now every house in the borough is connected with the sewers. Inspector Kershaw had charge of the general supervision of the house connections. ASHBURTON. The installation of the high-pressure water-supply has been commenced. Timaru. All the houses in the northern part of the town have been connected with the drainage scheme which was put in last year. The septic tank and main outfall sewer in the south end of the town have been completed. Sewers are now being put down in the southern part of the town, and the houses are being connected. Greater Timaru. The extension of the boundaries of the borough to include the watershed and practically all the suburban houses is now an accomplished fact. This will enable the sanitary administration of the suburbs to be greatly improved in regard to removal of nightsoil and rubbish, and sanitary matters generally. Hokitika. The high-pressure water-supply has been completed. Plans for a drainage scheme have been got out, and, with some modifications which will considerably decrease the cost, have been approved by me. Greymouth. A report was sent to the Borough Council by me on the 26th November, 1909, copy of which was sent to the Chief Health Officer. This report recommended the Council to insist on the pulling-down of buildings which had been certified to by the late Chief Health Officer as being unfit for occupation ; to pass up-to-date by-laws on house connections ; to have the construction of house connections properly supervised ; to insist on the provisions of the Municipal Corporations Act with regard to space about building's being strictly complied with ; and other sanitary improvements. In Inspector Middleton's annual report he states that practically none of these recommendations have been attended to, and that the sanitary administration of the borough is still very lax. Sanitary Inspection of District. During the first half of the year Inspector Kershaw's time was largely taken up with the supervision of. house connections in Lyttelton and Timaru, arrangements having been made with these boroughs to pay the Department for his services. In September, after consultation with the Chief Health Officer, I commenced to approach local bodies with a scheme for the combination of local bodies to appoint joint Inspectors. As a result of these negotiations, Inspector Kershaw was appointed a Joint Inspector for the Borough of Sumner and the Road Boards of Heathcote and Spreydon. The other suburban local bodies did not agree to come into the scheme. Inspector McKenzie was transferred to Oamaru in November to act as Inspector for the Oamaru Borough Council, Waimate Borough and County Councils. Every endeavour has been made to induce the Waitaki County Council to administer the Public Health Act themselves, or to contribute to the salary of a Joint Inspector, or to delegate their powers to the Hospital Board under section 83 of the Hospitals Act; but the majority of the Council will take none of these steps. They cannot apparently see the advantage or necessity of taking any steps to carry out the administration of the provisions of the Public Health Act. This is a large district, with a population of about ten thousand ; there are several small townships in which cases of infectious disease often occur, and no steps are taken by the Council to prevent the spread of infectious disease, except to occasionally employ a person to disinfect the premises.

41

H—3l

In February, Inspector Paull, who had been previously in the service of the Department, was appointed as Special Plumbing Inspector in the Timaru Borough and as G-eneral Sanitary Inspector for Levels County. Under these arrangements cases of infectious disease can be more quickly visited and stricter precautions enforced against the spread thereof. The sanitary inspection of the district is being very much more efficiently carried out. Several of the local bodies have expressed themselves as being very pleased with the arrangement. It is to be hoped that during the next year complete schemes to provide for the whole sanitary inspection of the district will be able to be made under section 83 of the Hospitals Act. Inspector Middleton has continued to do good work as Sanitary Inspector in Westland. There are greater difficulties in administering the Health Act in Westland than elsewhere, partly owing to geographical and climatic reasons. Some of the local bodies are interested in the public health of their district, but others are not sufficiently progressive in these matters. Special Reports. Among the special matters dealt with by myself were —Inspection and report on the occurrence of diphtheria in Kaitangata, and the general sanitation of the town ; the depots used for the disposal of nightsoil in Christchuroh and district; the planning and construction of the shelters at the Sanatorium ; the ventilation of the Otira tunnel; the occurrence of adulteration of vinegar and lime-juice ; report to Chief Health Officer on private charities and homes in Christchurch ; report to Chief Health Officer on the medical inspection of the Fourth, Fifth, and Sixth Standards at the East Christchurch School. H. E. Finch, M.8., D.P.H., District Health Officer.

PART D.—OTAGO AND SOUTHLAND DISTRICT. Invercargill District. Inspector Cameron supplies the following matter : — Plans are being prepared for a sewerage system. Disinfection. —Seven public schools and one Roman Catholic school were disinfected after cases of infectious disease had occurred among children attending them. Disinfection of no one of them was absolutely necessary, but, the local committees concerned being anxious to have it carried out, we got the local inspectors to comply, especially as, even on only general grounds, all schools are the better of being disinfected at least once a year. Water-supply, Invercargill. —The present water-supply is pumped by steam from a well 100 ft. deep in one of the municipal reserves, up through aerating sprinklers emptying into reservoirs ; thence pumped again into a large tank on top of a tower 110 ft. high, from which it is reticulated to consumers in the main borough only, the supply being insufficient for any of the suburbs. Bores are now about to be sunk near the present well, to see if a further supply can be obtained. If not, probably an effort will again be made to get the sanction of the ratepayers to borrow £100,000 to bring in a first-class gravitation supply from the Oreti River at Dipton, thirty-six miles away. A poll on the question was defeated three years ago. This, however, was prior to the amalgamation of Invercargill and suburbs, which took place last year, making now the total population 14,000. RIVERTON. After many days the Borough Council at last has undertaken a nightsoil-removal service for the more thickly populated portion of the borough, and the service is proceeding fairly satisfactorily. The system, however, is the primitive open-pan method. Bluff. Drainage connections into the new sewers for liquids only are being enforced. Once the new bylaws are adopted, the work will be gone on with systematically. The sealed-pan system has been instituted, and excellent work is being done. The nightsoil is emptied from the pans in a closed shed into a septic tank. The purification done is not sufficiently effectual, owing to the tank-capacity being rather large and the filter being too small. These defects are to be remedied. Gore. The first-class sewerage system laid several years ago to serve all the then thickly built-on streets now needs to be extended to a number of other streets. The matter is to be considered shortly by the Borough Council. Otautau. The arrangements necessary to start a sealed-pan service are nearly completed. When this service commences, a service will be in operation in every borough and town board district in Southland. When the Department was inaugurated, only one borough had a service ; there are now fifteen services,

6—H. 31,

42

•H.—3l

Numerical Summary of Routine Work done. Number of towns and districts visited.. .. .-.. .. .. 62 „ visits paid .. .. .. .. .. .. 145 ~ inspections made .. .. .. .. .. .. 1,746 ~ defects remedied .. .. .. .. .. .. 640 ~ visits paid to infectious cases ... . . .. . . 366 „ disinfections supervised . . . . . . . . .. 262 ~ letters despatched .. .. .. . . .. 2,034 „ ~ received .. • .. .. . . .. . . 1,261 Frank Ogston, District Health Officer.

PART E.—REPORT OF MEDICAL OFFICER IN CHARGE OF TE WAIKATO SANATORIUM, Sir, — Te Waikato Sanatorium. I have the honour to submit the report of the work of Te Waikato Sanatorium during the year ending 31st March, 1910. At the close of the preceding year there remained in the Sanatorium 26 males and 16 females —42 patients in all. During the year under review there were admitted 60 male and 37 female patients, so that a total of 139 patients received treatment during the year. Fiftyfour males and 44 females were discharged, and 7 patients (6 males and 1 female) died during the same time. On the 31st March, 1910, 34 patients were under treatment in the institution, these consisting of 26 males and 8 females. Of those discharged, 35 males and 32 females left the Sanatorium with their health very greatly improved, most of them being in a fit condition to return to ordinary life with a fair prospect of maintaining the improvement resulting from their treatment. Six males and 5 females improved to some extent during their stay in the Sanatorium, but their improvement could not be considered to be of a permanent character. Thirteen males and 7 females showed no response to the treatment, receiving no apparent benefit to their health by their stay in the institution. The greater number of the deaths were due to haemorrhage, either from sudden profuse bleeding or from subsequent pneumonia and congestion of the lungs. One patient died of chronic nephritis, and one from a perforation of a tuberculous intestinal ulcer. Towards the close of the year the number of applications for admission to the Sanatorium appeared to have fallen off to a very considerable extent, and it is to be regretted that the institution is not now working to its full capacity. Were this due to a lack of patients requiring treatment it would be a matter for congratulation, but unfortunately lam afraid this is not the case. The falling-away of applicants is, in my opinion, due partly to the opening of similar institutions in other parts of the Dominion, to a more strict enforcement of the rule of only admitting cases showing a fair prospect of recovery, and, I am afraid, also to quite erroneous reports which have been freely circulated regarding the future administration of the Sanatorium. Your proposal to introduce in this Sanatorium a system of graduated labour is, I think, a most excellent one, and one which, if properly carried out, will result in greatly increasing the usefulness of the institution. I feel sure that when the true nature of the proposed change becomes more fully known and appreciated there will be no lack of patients eager to enter the Sanatorium and confident in the prospect of receiving lasting benefit from the treatment. The appointment of a resident Medical Officer will, I think, be essential to the success of the scheme, as, in my opinion, it is not possible for a visiting officer to efficiently prescribe the amounts, and supervise the proper carrying-out, of the work suitable for each patient individually. I have, &c, Edward E. Roberts, M.8., Ch., The Chief Health Officer. Medical Superintendent.

APPENDIX -lII.—THE SALE OF FOOD AND DRUGS ACT. The Department during the past year has gazetted regulations dealing with the labelling of jam, and manufacturers have been notified as to the new requirements. Regulations dealing with labelling in general have been prepared, and also for standards of purity of a number of foodstuffs. These, however, have not yet been gazetted, since it has been deemed better to wait the report of the Interstate Conference on such regulations held in Australia during May, since it is obvious that it would be of advantage to manufacturers if the regulations under which foodstuffs are sold were identical in all parts of Australasia. The report of the Conference is now under consideration, and the regulations will shortly be ready for gazetting. An investigation of an elaborate nature was conducted during the spring months —September, October, November, and December —as to the quality of milk-samples obtained actually at the farm. Samples were taken at both morning and evening milkings, the mixed product of from five to ten cows

43

H.— B\

being used. In all, 1,653 samples were examined, and a summary of the results is appended. From this it is obvious that there is no need tojalter the standard for milk-fat-of 3-25- per., cent., even in the spring months. To carry out the provisions of the Food and Drugs Act it will be necessary to retain the services of special .Inspectors, and increase the staff of the laboratory.

AUCKLAND DISTRICT. . . .Operations under the Sale of Food and Drugs Act, 1908, are as under :— Samples collected foe Analysis. Alcoholic Liquors. Whisky at Ngaruawahia, April 5, 1909. Kopu, April 26, 1909. Whangarei, April 20, 1909. Auckland (3), November 3, 1909. Hamilton, November 18, 1909. Beer at Hamilton West, April 5, 1909. Kopu, April 26, 1909. Whangarei, April 20, 1909. Brandy at Hamilton West, April 5, 1909. Kopu, April 26, 1909. Whangarei, April 20, 1909. Wine (Australian) : Four samples taken, and sent to Head Office laboratory for examination. Jam. Raspberry-pulp (4 samples), September, 1909. Raspberry-jam (3 samples). (For sulphur-dioxide and salicylic acid.) Lime-water. Six samples of lime-water by as many different makers were collected on the 17th September, and were submitted to Dr. Maclaurin, who reported that two were slightly below the standard as to lime (CaO), and that, whereas the Pharmacopoeia requires lime-water to be prepared with distilled water, all had been made with ordinary water. Foodstuffs seized. Meat. 6 cases of tinned meat, April 29, 1909 (destroyed). 2 pork pies, January 28, 1910 (destroyed). « 9 kegs of corned beef (returned from Apia), March 31, 1910 (destroyed). Fruit. 386 cases of oranges, March 30, 1910 (destroyed). Bread and Flour. 540 bags of rice-meal, March 19, 1910 (condemned as human food). 700 bags of flour, March 22, 1910 (containing weevils : ordered to be silk-dressed). . ' Cheese. 2,730| cases of cheese which were salvaged from the wreck of the s.s. " Kaipara " were seized and kept under observation until the results of the reconditioning process adopted by the buyers could be examined. Ultimately 2,034 cases were passed as fit for consumption, and the -remainder were condemned. Prosecutions. A milk-vendor at Devonport was fined £5, with costs, for selling milk to which water had .been added. Milk-supply. Samples of milk were taken from farms in various localities, as under, and were submitted to the Dominion Analyst for examination : — In October .. ... .. .. .. .. .. .... 108 ~ November.. .. .. .. .. .. . .. 125 „ December .. . . . . . . . . . . . . 198 ~' . . . Total .. '.. .. .. .. .... 431

H.—3l

44

WELLINGTON DISTRICT. Samples were collected by Inspectors as below set out: —

Samples. Where purchased. Besult of Analysis or Weighing. Number. Nature. By Chief Inspector Schauer, — Wellington (in and around) 79 Milk .. 42, complied ; 21, slightly deficient, or warned ; 12, prosecution advised ; 3, no preservative found ; 1, became defective in transit. Complied. Blenheim Picton Hastings and Napier .. Wellington 3 1 5 31 j, . . . . ); Napier Blenheim Picton Hastings Grisborne Wellington Napier 4 3 5 3 3 2 4 5 Bread .. Became defective in transit. 19, complied ; 8, slightly deficient, or warned ; 4, prosecution advised. 2, slightly deficient; 1, prosecution advised. 2, complied ; 3, slightly deficient. 1, complied ; 2, slightly deficient. 2, complied ; 1, slightly deficient. Complied. 4, prosecution advised. 2, complied; 3, prosecution advised. j, j> ,, . . Pepper. . ,5 . . . . Hastings 3 ,j . . 2, complied; 1, prosecution advised. Prosecution advised. Complied. Grisborne Blenheim Picton Wellington 1 3 1 7 ,, . . ,, . . Baking-powder .. 5, complied ; 1, slightly deficient; 1, prosecution advised. Complied. Napier Hastings Blenheim Picton Wellington " ! 4 4 3 1 1 20 i j) • • 5) ' ' J5 j, ' * 2, complied ; 1, slightly deficient. Complied. ») * * Gisborne 5 Lime-water Coffee .. 20 complied, but all were made tip with ordinary instead of distilled water. 4, added chicory, varying from 38 to 55 per cent. ; 1, not analysed. Added chicory, 5 and 46 per cent. Complied. Hastings Napier Hastings Wellington . . ,, . . ,, . . ,, . . Inspector Gardiner, — Taranaki 2 1 2 3 2 1 1 9 Mustard Spirits Jam Cream of tartar. . Lung-balsam ?> >, ,, .. 38 Milk Bread 7, complied ; 1, slightly deficient ; 1, became defective in transit. 15, complied ; 23, slightly deficient, or warned. Inspector Sargeant, — Wanganui (and district) ' * i 7 )? • • * • 1, complied ; 6, slightly deficient, or warned. Inspector O'Brien, — Palmerston North 3 Lime-water 2, complied (see reference above) ; 1, deficient, and warned. 2, complied ; 1, slightly deficient. 6, complied ; 3, slightly deficient; 1, became defective in transit. )) • * Feilding (and district) 3 10 Bread .. Milk .. By Inspector Miller, — South Wairarapa By Inspector Gray, — Wellington (in and around) 4 9 .. 2, complied ; 1, slightly deficient; 1, defective in transit. ,, .. 2, complied ; 5, slightly deficient, or warned ; 1, prosecution advised ; 1, examined as to labelling of bottle.

45

H.—3l

The following samples of milk were, taken as a part of the investigation made by the Dominion Analyst as to the reasonableness of the milk-standard required by the regulations under the Sale of Food and Drugs Act :— Chief Inspector Schauer, from 16 farms in and around Wellington, 448 samples, Inspector Hicks, from 17|farms in North Wairarapa,]ls7 samples. Inspector Gardiner, froml6 farms in Taranaki,*|3B3 samples. Total number of samples taken, 988. The results of this investigation are to be found in the Dominion Analysts' report for this year. Inspection of Food. The following list shows the amount of foodstuffs condemned :— Wellington. 1 sack pigs' cheeks. 13 dozen bundles rock-cod. 1 „ trotters. 2 „ fish. 21 pairs fowls. . 76 rabbits. 7 carcases pork. 6 kerosene-tins whitebait.. 3 cases eggs. 5 cases smoked blue-cod. 2 sides bacon. 80 lb. potatoes. 8 hams. 6 sacks tongues. South Wairarapa. Small quantities of vegetables and fruit. Feilding. Small quantities of fish and fruit. ["1 Levin. Small quantity of fish. ■?'■ Wcmgmui. 7 sacks potatoes. 1 case sultanas. 3 cheeses. 13 oases raisins. 20 lb. plums. Small quantity of vegetables. 12 lb. bananas. jt fruit, cases bananas. „ meat. 4| „ oranges. „ jam. Taranaki. 10 tins tinned fish. 15 cases bananas. 40 lb. dates. 6 lb. dairy butter. 4 sides bacon. Small quantity of vegetables. 14 pairs rabbits. CANTERBURY DISTRICT. ■ [% : j Milk. In accordance with instructions from the Chief Health Officer, investigations were made into the quality of the milk that was being supplied by Christchurch dairy-farmers. The samples were taken night and morning at the farm, each sample representing the mixed milk of about eight cows. The herds of nine farms were tested in October and November, and the milk of two farms was again tested in December. Altogether about two hundred samples were taken. The dairy-farmers gave every assistance to the officers of the Department, and took considerable interest in the results obtained. Bread. The weight of bread was tested twice in Christchurch and Oamaru, and once in Timaru. In Christchurch in April there were 16 prosecutions, and the fines totalled £20 10s., and the costs £24 10s. ; in October there were 5 prosecutions, in which the fines totalled £4 Is. In Timaru and Oamaru the weight of bread was found satisfactory on the whole, with the exception of a few small lines of fancy bread. Miscellaneous. The following samples were also taken :— Beer.. .. . . 5 samples. | Ammoniated tincture of Whisky •• •• 12 „ quinine .. .. 3 samples. Brandy .. .. 1 „ , Lime-juice .. .. 10 „ Vinegar .. .. 13 ~ Hop-beer .. .. 5 „

46

H—3l

OTAGO AND SOUTHLAND DISTRICT. .: Foodstuffs Condemned . and Destroyed. Close attention was given during the year, as usual, to the wholesomeness of fresh foods and fruit. Without having recourse to any legal formalities whatsoever, the following food-supplies were destroyed in various lots on pointing out to the owners or agents that the goods were unfit for human consumption, ;■ —, ■•••.• • i ■ ■ I-.. , --. 1 :..'.;..-...- ■ ■■ - - lb. i lb. 11 cases blue-cod .. ..696 13 hams .. ..162 14 „ flounders .. '-.. - -784 - 80 cases oranges r-:i. •.--': .-..320 2 sacks pigs'heads ..336 12 ~ apples .. ..480 Corned beef .. .. 264 14 „ cherries .. ..276 11 rolls bacon ....... 280 7 „ bananas .. .. 280 Milk. Forty-eight samples of milk, each sample representing from 6 to 10 cows, were taken on farms for analysis in order to assist in fixing a milk-standard for the whole Dominion.

47

H; -31

APPENDIX IV.—LABORATOKY EEPOETS.

PART A.—PATHOLOGICAL LABORATORY REPORT. SIE, — I have the honour to forward the accompanying report by Mr. Hurley upon the work of the Pathological Laboratory during the past year. My transference to Auckland limits the scope of my work in connection with the Laboratory to a general supervision, and some special subjects such as the reporting upon sections of solid tissues, tumours, and so forth. The whole responsibility of carrying out the rest of the work falls on Mr. who has in consequence been gazetted as Bacteriologist for the Department—a position for which the excellence of his work in the past shows him to be well fitted. My duties elsewhere have made it impossible for me to carry on the routine examinations of public water-supplies which was a feature of previous reports. The aggregate number of pathological specimens submitted by the medical profession shows yearly a steady increase, more especially of those subjects requiring special experience and apparatus for their examination. Thus a better class of work is demanded of us—which is a matter for congratulation. I have, &c, Dr. Valintine, Chief Health Officer, Wellington. . R. H. Makgill, Pathologist. I have the honour to submit the following tabulated, report of the work done in the laboratory during the past year. The total number of specimens examined shows an increase of 34. on those examined the previous year.. There is a decrease in the number of specimens of sputa, pus, and throat-swabs, and in waterexaminations. On the other hand, there is an increase in the number of specimens that require a more detailed examination—viz., spinal fluid and blood specimens. The blood-examinations are 130, as against 62 last year. The work connected with the stocking of sera and the distribution for the Health Department has largely increased, and has added much to the clerical work of the Laboratory during the year. Dr. Makgill, Pathologist. J. A. Hurley, Bacteriologist, •••

Table showing Results of Examinations of Pathological Specimens. From 1st April, 1909, to 31st March, 1910.

Result. Material. Objeot of Examination. Total. Positive. Negative. Sputum ! For tubercle bacillus „ other conditions ... j „ parasites 9< 1] 1( 94 11 10 235 14 10 329 25 20 Total for 1909 374 391 Pus For tubercle bacillus... ... 1 9 22 5 19 9 6 28 31 „ gonococcus ... ... I „ other pyogenic organisms... 22 Pleuritic fluid Spinal fluid ... 2 8 6 10 65 •■..■■ „ tubercle bacillus... 8 18- -■- 26 Urine Total for 1909 91 87 Chemical ... ... ... Bacteriological ... ... Microscopical 52 32 67 Total for 1909 ... j 151 171

48

H—3l

Table showing Results of Examinations of Pathological Specimens— continued.

Material. Object of Examination. Result. Positive. Negative. Result. Total. .fleeces „ ... Vomit Other discharges Chemical and microscopical ... 3 5 2 1 ... 2 2 8 i Total for 1909 15 14 Blood Typhoid 58 54 Estimation of leucocytes Other examinations ... 112 9 9 Total for 1909 1.30 62 Swabs For diphtheria ... ... 22 78 „ streptococcus ... ... 6 4 „ pneumococcus ... ... 5 „ other organisms... ... 15 2 100 10 5 17 Other specimens Total for 1909 Microscopical ... ... 11 5 Bacterioscopical ... ... i 19 2 132 161 16 21 Animals inoculated ... Total for 1909 37 19 Animals examined For tubercle bacillus... ... 6 11 „ other conditions ... ... 2 Eats, for plague ... ... ... 20 Insects, for bacteria ... ... ... 12 17 2 20 12 Foodstuffs, — Fish Milk Meat Fruit Butter Starch ... Vinegar ... Total for 1909 51 25 1 16 2 5 1 6 1 Total for 1909 32 44 Water Total for 1909 38 82 Air Total for 1909 22 Nil. Disinfectants Total for 1909 6 7 Tissues requiring section Total for 1909 184 180 Vaccine lymph For bacteriological examinations Total for 1909 ... ! 56 28 Total number of specimens examined Specimens received spoiled „ without name of sender 1,319 3 10 total number of specimens received 1,332 Total number of specimens received for 1909 1,291

H.—3i.

Details of Urinary Examinations.

Results of Examination of Tissues.

7—H. 31.

49

Method. Method. What sought. Negative. Positive. I Total. Chemical analyses— Quantitative ... Estimation of urea ... : 8 ,, sugar ... ,, albumen 13 8 13 5 26 I Qualitative ... For sugar ... ,, other substances ... I 7 2 5 12 2 12 26 Bacteriological ... For tubercle bacillus... ,, bacillus coli ,, gonocoeci ,, other organisms... 10 3 ...19 5 ... J 1 ... ! 4 3 5 32 Microscopical ... For casts, deposits, etc. ,, tubercle bacillus... 3 50 10 4 50 i 67 Total 151

Reproductive System. Digestive System. Res] to pira>ry tern. c It |l I* I. I! g'co Urinary System. u a >> Totals. Sysi Conditions found. I a q> _g m o H o 1 m o . =8 ■ i s" b" § s |.& a « § Hi O H co of f a? I m i 02 a fee CO © r-H I 2 i, 75 3 3 3 Carcinoma .. 7 Sarcoma . . i 2 Simple tumours .. 7 Simple inflammation; 25 formal . . . .jj 4 )thers . . . .J 3 3acterial, — For tubercle ba- j .. oillus ?or otter organisms ! .. deceived, — Spoiled .. j .. Un-named 9 1.. 3 1 I 3 15 II.. 2 .. 1 .. .. I 1 1 10 6 3 1 6 1 1 6 1 1 1 2 2 2 1 3 4 9 2 2 4 2 7 7 3 1 1 8 1 3 1 3 54 36 46 33 4 3 6 55 27 32 53 6 3 1 1 2 3 3 6 190 189

H.—3l

50

Public Water-supplies Examined.

Return showing Results of Vaccine Lymph for Year 1909-10.

Organisms per Cubic Centimeter. Source of Water. At Normal ,. «_ 0 ,-, Temperature. Bacillus coli. Bacillus spor genes. Oamaru, — Tap .. !i ";| Waimate, — Intake Tap .. Wanganui,— Tap .. Trentham, — Well 1 Well 2 2,658 750 0 0 240 294 32 25 0 0 0 0 314 265 0 0 8,500 580 100 20 0 0 0 0 Thames County, — Tap Thames Borough, — Tap .. Te Aroha, — Reservoir Tap .. Foxton, — River Artesian well .. Gisborne, — Tap .. Napier, — Artesian well .. Lower Hutt, — Tap .. 346 127 316 450 3,760 0 40 11 10 14 195 0 0 0 0 0 0 0 0 0 0 0 i 0 152 0 0 10 0 0 0 160 0 0 0

Number of Scarifications to which Lymph was applied. Remi irks. Series. Number of Tubes issued. Number of Vesicles obtained. Percentage. Cases done. Cases Persuccessful. centage. 56 57 58 59 60 62 63 64 66 68 69 73 516 645 441 358 706 174 252 378 725 107 372 294 243 138 188 159 594 76 25 134 214 69 228 153 172 82 165 143 554 37 4 99 155 37 164 103 70-8 59-4 87-8 89-9 93-3 48-7 16-0 73-9 72-4 53-6 71-9 67-3 76 45 64 51 191 28 7 42 71 22 73 49 68 894 37 82-2 64 j 100-0 49 96-0 184 96-3 17 60-7 2 28-6 37 88-1 59 83-1 15 68-2 63 86-3 39 79-6 Totals 4,968 2,221 1,715 77-2 719 i 634 88-2

51

H.—3l

Sbbi and Vaccines issued between Ist Apbil, 1909, and 31st March, 1910. Flasks. £ Val r - d Anti-diphtheritic serum .. .. .. .. ~ .. 590 63 2 6 Anti-streptococcus serum and vaccine . . . . . . .. 188 28 16 0 Anti-tetanus serum .. .. .. .. .. ~ 87 18 12 6 Anti-staphylo coccus serum and vaccine .. .. . . .. 55 510 0 Tuberculin, — New T.R 8 3 12 0 Azoules T.R. .. .. .. .. .. .. 76 415 0 Conjunctival test .. .. .. .. .. ~ 18 12 6 Total .. .. .. .. .. .. 1,022 £125 10 6 Ishigami toxoidin . . . . . . .. . , .... 30 0 0 Total value .. .. .. .. .. .. £155 10 q PART B.—DOMINION ANALYST'S REPORT. Sir — ] have the honour to forward herewith returns of analyses made in this laboratory for the Department of Public Health during the year ending 31st March, 1910. These returns show a total of 2,056 analyses of a varied character. They include 1,653 samples of milk taken by the Health Department Inspectors from a large number of dairies in various parts of the Dominion, with the object of determining the general composition of genuine milk in New Zealand. I have, &c, J. S. Maclaubin, The Chief Health Officer, Department of Public Health. Dominion Analyst.

Summary of Analyses made in the Dominion Laboratory, Wellington.

B—H. 31.

Material. Object of Analysis. Number of J Samples. For He* 'ealth Department. Brandy Whisky Wine Beer... ... Waters Milk ... I ... Quality ... ... ... ... 6 32 Alcohol ... ... .. ... 6 J ,, ... ... ... ... 9 j General analysis ... ... ... 27 125 Preservatives ... ... ... 6 Mineral poisons ... ... ... 1 Quality ... ... ... ... \ Acidity ... ... ... ... i j Poisonous metals ... ... ... 3 Phosphorous ... ... ... 12 General analysis ... ... ... H To be standardized ... ... ... l Quality ... ... ... ... 44 Preservatives . ... ... 8 Citric acid ... ... ... ... 4 Relative amount of heat absorbed by ... 2 Purity ... ... ... ... 6 Poisons ... ... ... ... 1 Nature ... ... ... ... 4 . Purity ... ... ... ... 14 ... 3 I ,, ... ... ... ... 17 Poisons ... ... ... ... 5 Methylic alcohol ... ... ... 3 Quality ... ... ... ... 3 Nature ... ... ... ... 1 Purity ... ... ... ... 7 jj • * ■ ... Tea ... Vinegar Butter Sprayed apples Matches Sewage Lactometer Lime-waters ... Fruit-pulp Lime-juice Milk-cans Water-glass Vomit Lung-balsam ... Baking-powder Mustard Pepper Pine-apples ... ... Ammoniated tincture of quinine ... Arsenate of lead Confectionery-colouring Coffee MilkAuckland District ... Wellington ,, Christchurch ,, Dunedin ,, ... j ... ... ... j For standard ... ... ... 453 ... 988 164 48 For Poh 'lice Department. Liquors Cordials ... ( 1 Quality ... ... ... ... 5 Alcohol ... ... ... ... 31 4 Beer... Total ... 2,056

H.—3l

52

PAET C—GOVERNMENT ANALYST'S REPORT ON MILK-STANDARDS. In February, 1908, the following regulation with regard to cow's milk was gazetted under the Sale of Food and Drugs Act: — " Milk shall not contain less than twelve (12) per cent, of total solids, not less than eight and onehalf (8-5) per cent, of solids not fat, not less than three and one-quarter (3-25) per cent, fatty solids (milk-fats), and not more than one (1.) per cent, of ash." Objections to this standard were at once raised by milk-vendors, who asserted that milk of the required quality could not be supplied during certain months of the year. In order to test this assertion the Public Health Department decided to have analyses of genuine milks made during the spring and early summer months (September, October, November, and December), the time of the year at which milk is poorest in quality. In carrying out this investigation herds were selected as being generally representative of the various districts (care being taken that the best herds were not chosen), and morning and evening samples were taken from the same herds each month of the experiment. The districts so represented were Auckland (including Thames and Waikato districts), Taranaki, Wairarapa, Wellington, Christchurch, and Southland. The cows were milked under the direct supervision of, and the samples taken by, the District Inspectors of the Public Health Department, who took every precaution to prevent tampering with the milk. Properly cleaned bottles containing a few drops of formalin were supplied by the Laboratory, and all samples.were securely sealed, and either forwarded by post or personally delivered by the Inspector. To make the test as severe as possible, samples were taken regularly, and regardless of weatherconditions, and the milk of the whole herd was not mixed, but each sample taken from the mixed milk of from four to ten cows (that being the quantity required to fill one of the ordinary cans). With the milk from each herd information was forwarded as to date and time of taking samples, yield of milk, number of cows represented by each sample, weather-conditions for previous twelve hours, and also as to the breed and general condition of the cows. In making the analyses the fat was determined in duplicate by the Leffmann-Beam process, the specific gravity by weighing in a bottle at 15-5° C, and the total solids and solids not fat calculated from Hehner and Richmond's formula. All samples below the standard were checked by gravimetric methods. On examining these tables it will be seen that a total of 1,598 samples were analysed, and, of these, 3-69 per cent, were below the standard in total solids, 4-13 per cent, were low in solids not fat, and 3-88 per cent, were low in fat. As will be seen, however, many of these were only very slightly below the standard. Moreover, these figures include analyses of the milk from several herds which the Inspector's report showed were in very poor condition at the time of taking samples, and therefore could not be expected to give satisfactory results. (Seventy-eight samples taken under such circumstances gave forty-six —or about 3 per cent, of all samples received —below the standard, some of them being low in all three constituents.) While the investigation was not comprehensive enough to prove beyond doubt the composition of New Zealand milk under present conditions, it was quite sufficient to show, — (1.) That the composition of the milk varies but little in different parts of the country. (2.) That the great majority of the herds gave only a very small percentage of samples below the standard, even when these were taken —ras stated above —from afjfew cows only. When the analyses were averaged so as to represent the mixed milkfjof the herd, in every case (except in the cases quoted where the condition of the cows was poor) the result was above the standard. (3.) A lack of sufficient good food, want of shelter, or any other cause resulting in poor condition of the cows was always followed by deterioration in the quality of the milk. It therefore follows that if cows be judiciously selected and properly fed there will be no difficulty in meeting the requirements of the regulations under the Sale of Food and Drugs Act.

A. Table showing the Number and Percentage of Samples under the Standard in Total Solids received during each Month of the Experiment.

T3 21 ■g > « u pj 02 i "' ' [ 12-0 ' 11-9 J 11-8 11-7 to i to to to 11-9 I 11-8 I 11-7 H-β I I __\ Hβ to 11-5 11-6 to 11-4 11-4 11-3 to to 11-3 11-2 11-2 to 11-1 September (morning), number of samples .. ,, ,, percentage October (morning), number of samples ,, ,, percentage November (morning), number of samples . . ,, ,, percentage December (morning), number of samples . . ,, . .,, percentage. . ■ 328 I 226 151 91 133 88-66 305 90-70 215 95-00 88 96-67 ! 18 11-34 23 9-30 11 5-00 3 3-33 4 ! -5 1 | 2 3-66 3-33 I 0-66 j 1-33 9 7 I 1 2 2-74 I 2-13 0-30 0-61 5 j 2 I 1 1 2-22 ! 0-90 J 0-45 0-45 1 ' 1 i Ml 111 j ..I .. 19 15 1 3 5 2-37 1-87 , 0-37 ! 0-62 .. .. 1 i 2 .. I .. I 0-12 '• 0-24 . 19 15 I 4 J 7 2 1-33 1 0-30 1 0-45 1 Ml 4 2-66 1 0-30 1 0-45 " I ■• i •■ 1 .. ! 0-30 J .. I 1 : 1 I 0-30 Whole period (morning), number of samples „ ,, percentage 796 741 93-13 55 6-87 5 0-62 6 : 0-75 1 0-12 j .. I 1 j 0-12 ,, (evening), number of samples ,, ,, percentage 802 798 99-50 4 0-50 1 0-12 1 ! .. ,, (morning and evening), number of samples ,, (morning and evening), percentage 1,598 1,539 59 5 7 1 " 96-31 3-69 1-19 0-93 ' 0-25 j 0-44 I 0-31 0-44 i 0-06 : .. j i 0-06

H.—Bl.

B. Table showing the Number and Percentage of Samples under the Standard in Fat received during each Month of the Experiment.

C. Table showing the Number and Percentage of Samples under the Standard in Solids not Fat received during each Month of the Experiment.

Approximate Cost of Paper.— Preparation, not given; printing (1,800 copies), .642 10s.

Price Is. 3d.]

By Authority : John Mackay, Government Printer, Wellington —1910

53

■as el GO 3-25 to 3-2 3-2 to 3-1 3-1 3-0 to to 3-0 2-9 ( "" " I 2-9 2-8 2-7 I 2-6 to to to to 2-8 2-7 j 2-6 2-6 \ 2-9 2-8 to to 2-8 2-7 September (morning), number of samples >> >, percentage October (morning), number of samples.. >> „ percentage November 'morning), number of samples » ., percentage December (morning), number of samples „ „ percentage 226 91 151 328 i 210 92-92 85 93-30 140 92-66 300 91-46 16 7-08 6 6-60 28 8-54 11 7-33 4 1-77 3 3-30 3 0-91 2 1-33 2 2-20 10 3-05 3-10 3 0-20 2 1 0-88 0-44 3 ! 1 0-20 I 0-66 9 2 2-74 0-61 J I I 1 ..1 0-66 i .. 0-66 j .. - 2 I 77J~y~ 0-61 : 0-30 J .. I 0-30 0-44 0-44 .. j .. .. i 1 .. I 1-10 4 ' 3 111 : 0-50 0-38 0-12 i 0-12 ■ . . . ■ • • • . I 4 3 1 ' 1 0-25 0-18 0-06 0-06 Whole period (morning), number of samples » ,, percentage 796 735 ' 92-34 61 7-66 12 1-50 22 2-76 14 4 1-76 ' 0-50 ,, (evening), number of samples " » percentage 802 801 99-88 1 0-12 1 0-12 14 4 „ (morning and evening), number of samples (morning and evening), percentage.. 1,598 1,536 62 12 23 96-12 3-88 0-74 1-44 0-88 I 0-25

•a $ > £ I £ 8-5 tk 2% ■3'S to H l «U «! 8 ' 4 <i eg I 35 8-4 to 8-3 8-3 8-2 to to 8-2 8-1 8-1 to 8-0 j 8-0 7-9 to to 7-9 7-8 September (morning), number of samples >> ,, percentage ,, (evening), number of samples >> ,, percentage 151 158 139 12 92-00 J 8-00 136 i 22 86-08 j 13-92 318 10 I 96-65 3-35 6 I 0-40 6 3-80 3 0-20 5-06 1 2 .... 0-66 1-33 1 0-66 6 1 1 3-80 0-63 0-63 .. I i 6 3-80 1 0-63 I I •■ October (morning), number of samples » ,, percentage 328 ! 6 1-83 2 2 .... 0-61 0-61 .. J .. 2 0-61 ,, (evening), number of samples ,, ,, percentage 311 299 i 12 96-15 3-85 4 1-28 4 1-28 3 .. 0-96 1 0-32 November (morning), number of samples >> ,, percentage 226 221 5 1 97-78 ; 2-22 0-45 247 j 3 ! 1 98-80 1-20 , 0-40 2 0-90 1 0-45 1 .. 1 0-45 . . 0-45 „ (evening), number of samples >> ,, percentage 250 2 0-80 I December (morning), number of samples ,, ,, percentage 91 91 100-00 I .. „ (evening), number of samples >> ,, percentage 83 81 2 2 97-50 I 2-50 i 2-50 Whole period (morning), number of samples .. ,, ,, percentage 796 769 27 , 13 96-63 3-37 : 1-62 5 0-62 4 14 1 0-50 0-50 0-12 I .. „ (evening), number of samples .. >> ,, percentage 802 763 ; 39 ! 13 95-13 i 4-87 I 1-62 1,532 66 ! 26 95-87 ; 4-13 1-63 14 1-75 119 [1-19 6 0-75 6 I 4 1 0-75 0-50 0-12 .. I i 0-62 0-50 0-12 !.' ( 1 0-12 0-06 „ (morning and evening), number of samples » ,, percentage 1,598 10 0-62