H.—3l.

Sanatokia. As you are aware, we are still without any hospital in which consumptives can be treated upon modern scientific lines. The necessity for the establishment of such institutions is every day becoming more and more clamant. The residents in the various resorts to which consumptives go have become alarmed. They have already had ocular demonstration of the infectivity of the disease, and they rightly refuse to expose themselves or their children to the undoubted danger of housing a careless or ignorant consumptive. The result is that the life of these unfortunate people has been in some cases made harder. In the scheme which I set out for your consideration it was pointed out that the establishment of even two sanatoria would not meet the requirements of colonial safety. From a public-health point of view there is more danger to be apprehended from those cases of the disease which are not suitable for treatment in a sanatorium. The incurable and the indigent incurable must be provided for, or otherwise, while we may benefit some, all hope of the exterminating the disease must be given up. To use a properly equipped sanatorium of the modern type for the reception of incurable cases of the disease would not only savour of using a razor to cut grass, but it would militate against the usefulness of the institution. The scheme which was recommended was to erect a sanatorium in the North Island and one in the South, to which all cases susceptible of cure or improvement should be sent. For the more unfortunate cases which offered little or no hope of cure special provisions in connection with one of the small country hospitals in selected districts should be made. A few tents or wooden sheds could be erected in the hospital-grounds. The cost of erection would not be great, and the supervision and maintenance would be small compared with the cost of installing a separate staff to look after the patients. Remembering that the great cause of the spread of the disease is the infected sputa, by placing these incurable cases under treatment all danger from this cause would be removed, and the patients would have the advantage of a modified hospital treatment. There is no doubt whatever that the adoption of some such scheme is a matter of the very greatest urgency, and should not be postponed another day. Since writing a splendid place has been bought near Cambridge in the Waikato. School Hygiene. The occurrence of a considerable number of cases of tuberculosis among the children attending a school in the South Island, referred to in Dr. Symes's report, while it emphasizes the necessity for at once making provision for consumptives, also illustrates some conditions which obtain in many parts of the colony. There is no question whatever that many of our State schools are overcrowded. There is no need in a country of unlimited space such as New Zealand why the most generous treatment should not be meted out to our children. It may be difficult in the larger towns where land is dear, but in the country districts—and it is there that most overcrowding is found—there is no justification whatever for not allowing each scholar at least 200 cubic feet. The standard adopted by the London School Board, which is often quoted, is a measure born more of expediency than of mature and untrammelled conviction. The Inspector-General of Schools (Mr. Hogben) is wisely insisting on greater air-space for the scholars. Another point of great importance is the regular disinfection of schools, especially where any of the scholars have suffered from an infectious disease. It would be a very great help to the officers of this Department if there was attached to each school a medical man, retained as consultant. Only the other day, in consequence of the prevalence of scarlet fever and diphtheria in Wellington, Dr. Valintine, Assistant Chief Health Officer, made a surprise examination of the scholars in one of the city schools. Out of ten swabs taken from the throats of children then in school Mr. Gilruth found the B. diphtheria in four. lam reluctant to add to the task already imposed upon the medical attendant on a case of infectious disease, but it would be of the very greatest assistance if, in the case of children, the school which they attended was mentioned. On the 16th June a circular was sent to all the local authorities and schoolmasters, pointing out that under section 87 of the Education Act members of a family in which a case of infectious disease existed could be prevented from attending school. This was of great service, but something more is required. There is now among the proposed amendments to the Public Health Act a provision whereby the District Health Officer may, if he considers it necessary, cause a school to be closed. This important matter was omitted from the main Act. Inspection of Daisies. This matter has been the subject of several reports to you during the last year. By the passing of the Dairies Inspection Act of last year the control and supervision of all dairies was removed from the local authorities and placed in the hands of the Agricultural Department. As the various District Health Officers point out, the condition of things at present is very much worse now than it was under the old law. Take Wellington, for instance. Prior to the passing of this Act the City Council employed an officer whose sole duty it was to inspect and report upon the dairies within their district. As soon as the new Act came into force that official was dismissed, and since then not a single dairy or milk-shop has been inspected except by an officer of the Health Department. At present our staff of Inspectors is too small to permit of systematic and thorough inspection. The supervision of the treatment of foodstuffs is naturally a work which the Health Department should be asked to undertake, but with the present staff it is impossible, and yet the present state of affairs ought not to be allowed to continue. I am anxious that the position of this Department should be made quite clear with regard to this matter, as we are constantly receiving complaints, not infrequently mingled with abuse, for our supposed want of attention to what appears to our correspondents to be our obvious duty. Septic-tank System of treating Sewage. As the result of an article written at the request of one of the leading newspapers in the colony, we have had hundreds of applications for information on the subject. A sketch-plan of an installation suitable for a house of about ten people was issued by the Department, and has been made 2—H. 31.

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