H.—3l

4

In 1902 the principal causes of this high zymotic mortality were : — Diarrhoea. —Sixty-seven deaths occurred in Auckland, out of a total of 125 in the four centres (536 per cent). Of these, 57 were among children under five years of age. Auckland always shows a high proportion of deaths from this cause, there being during the last five years 47 per cent, of the total in the four centres. This year the number is even higher than usual, owing, doubtless, to the outbreak of dysentery during the winter. This factor is, of course, especially responsible for the high infant mortality in Auckland. Including with diarrhoea all acute inflammatory states of the digestive tract, such as are notified as gastritis and enteritis, we find 92 deaths took place in Auckland among children under five years of age to 109 occurring in the other three centres together. Measles. —Measles caused 40 deaths in Auckland out of a total of 92 in the four centres. Wellington and Auckland shared alike heavily, Christchuroh and Dunedin almost escaping. Whooping-cough caused 18 deaths in Auckland —the total being 38 deaths for the four cities— Wellington and Auckland again sharing equally almost the whole number. Diphtheria was responsible for 12 deaths in Auckland out of a total of 19 ; Auckland's share, therefore, being 63 per cent, of the total deaths from this disease. Typhoid. —Auckland was responsible for 10 deaths out of the 17 occurring in the four centres, or 59 per cent, of the total. Scarlet Fever. —Auckland shows but 1 death out of a total of 11. Influenza. —Auckland 10 out of a total of 29. Plague. —The three deaths from this disease all occurred in Auckland. It is evident from the above that as regards the " dirt " diseases —typhoid, diphtheria, and diarrhoea —Auckland bore an unenviable share in 1902. As regards the death-rate from other diseases, Auckland appears rather favourably. Tubercular Diseases of all kinds caused in Auckland 53 deaths of a total of 252, being the lowest of the four centres. Cancer. —44 out of 165; not an unreasonable proportion. In deaths from diseases of the nervous system and of the circulatory system Auckland has about its fair share, but as regards the urinary system a somewhat higher proportion for some reason. Of diseases of the digestive tract Auckland shows 89 out of a total of 250, this high proportion being due to the inflammatory conditions, such as enteritis, noted above. In diseases of the respiratory tract Auckland again stands highest, with 109 deaths out of a total of 337. This is chiefly due to the numbers dying from pneumonia—s9 out of a total of 176, or 333 per cent. There, again, infants under five take a higher place than in the other centres, being 24 in Auckland to an average of 14 in other parts. This is somewhat interesting when we consider that pneumonia is so frequently a result of insanitary conditions, and seems to be further proof of the prevalence of dirt diseases in this town. The attached table is of some interest, giving the.monthly analysis of the death-rate for the year April, 1902, to March, 1903. In the column for zymotic diseases we see that Auckland had 439 per cent, of the total deaths from this cause, the highest return being in April and May. and again in November, December, and January. In the infant-mortality column we find Auckland had 38-1 per cent, of the total for the four centres, the highest months being November, December, January, and February. Deaths from acute digestive troubles in infants were highest in January and February.

INFECTIOUS DISEASE NOTIFICATION. Notification by medical men has, on the whole, been satisfactorily performed during the year. It would be well could the method be simplified, since in times of epidemic it no doubt throws a

To 1 ;al Mortality. Zymotii Diseases. Tnfant Mortality. Deat! i-rate per 1,000. laths. Deaths under Five Years. Data. Auckland and Suburbs. Meau of Four Centres. City of Auckland. Auckla Subi .nd and urbs. Total for the Colony. Auckland and „ Suburbs. Propor- i tion per j - Cent. ' . . , Auckland, , Ao , uto , x V" District. : Total. testinal Inflammatory States. Total Mean of F*°P°£ for the i other tl ™I )( " Colonv Three , < -'? nc - . colony. Centres Auckland District. Under Five Years. Over Five Years. 1902. tpril tlay 'une uly .. Lugust .. September )ctober .. November December 1903. January.. February tfarch .. 1-22 0-94 1-10 1-18 1-35 1-10 1-37 1-63 1-87 1-06 089 0-93 1-16 1-30 1-21 1-09 1-10 1-27 1-39 0-98 1-28 1-30 1-47 1-25 1-67 1-67 2-07 10 7 2 2 1 3 11 26 21 3 8 1 3 3 4 4 3 6 27 26 9 15 25 25 50 46 45 48-1 57-7 33-3 33-3 16-0 280 30-0 63-0 60-0 28 15 17 12 20 LO ■21 46 43 I I I 17 8 1 0 1 1 3 5 5 79 17-0 ! 35-4 56 13-7 I 26-8 45 9-3 37-7 65 17-6 ■ 18-4 66 11-5 : 30-3 72 20-7 13-9 83 18-7 32-5 87 13-7 53-0 84 13-7 512 1-55 1-43 1-12 1-18 1-00 1-13 1-65 1-27 1-27 26 9 9 3 3 5 51 31 44 56-9 38-9 31-9 55 88 29 23 19 12 I 93 12-7 59-1 77 13-0 ! 49-4 85 18-7 | 84-1 892 ; 15-0 ; 38-1 I 1-32 1-11 1-44 127 46 394 43-9 340 95