iJ.—3l

12

1 am, further, glad to report the entire absence of friction in the carrying-out of my duties, and record with appreciation the courtesy I have received from the local authorities and the public generally. The popularity of the Department with the inhabitants of this health district, which 1 alluded to in my last report, has not diminished, and though I am not in a position to affirm that it has increased, Vet if it maintains its present level the District Health Officer may be assured of a very pleasant time in the carrying-out of his responsible duties. And though some of the local bo-die's have shown less energy in carrying out my recommendations than the interests of public health demand, it must be borne in mind that it takes time to educate the public to the fact that money spent in the preservation of health and the prevention of disease is a sound investment yielding high interest, that it pays to be clean; and the public fail to grasp the fact that these measures are all for their own good, but are apt to hold the reverse opinion, as the schoolboy did when they flogged him. When we consider the conditions that existed prior to the Health Department coming into existence —the defective plumbing-work, sewer-gas carefully and scientifically laid on to dwelling and bath-rooms, drains imperfectly jointed, laid in defiance of the laws of gravitation, or following such a tortuous cour.se that a snake's back would be broken if he attempted to crawl through them, ventilating-shafts either absent or placed where incompetence or ignorance advance is enormous and gratifying. The plumbers are now educated, capable, generally trustworthy, and their work can be relied upon. The drain-laying is supervised by competent persons, the work is tested before the trench is filled in, and excellence is insisted on. But though much has been done and the Department has made enormous strides, there is still more to Ik- done before the Department can take its ease and permit the wind to blow it whither it listeth. For many years to come the public must expect us to be up and doing, waging aggressive warfare against the many enemies of public health that flesh is heir to and that still exist in our midst. Up-country settlers and many others on the outskirts of the towns continue to seek my advice with reference to the disposal of their drainage and the general sanitation of their premises, and have shown a commendable disposition to act on the advice they receive. In all these cases the work lias been carefully supervised by Inspector Mnnro, and efficiency of construction insisted on. The local architects have shown their "sympathy with this movement by inserting in their specifications that the work must be completed in accordance with the requirements of the Napier by-laws. 1 regret to say that some of the builders have not shown the same spirit, and when intrusted with the erection of a building where no architect is employed have given no information to this office, and have constructed the sanitary arrangements in a manner that is not laid down in the textbooks on public health. When I have been able to hear of these cases 1 have made it my business to inspect the work at the first opportunity, and where, as is frequently the case, the work has been carried out in defiance of sanitation have insisted on a complete reconstruction. Even where architects are employed, and the specifications clearly lay down the manner in which the work is to be completed, there have been builders who have scamped their work, and endeavoured to complete it in an inefficient manner. They have always been hoist by their own petard by having U> reconstruct the work at their own expense. Owing to the distance of many of these places from the railway-line, and the time necessarily involved in travelling, Inspector Munro and myself are often hard pushed to keep abreast of the work. The following infectious diseases have been notified during the year : — Scarlatina- -Napier, 43; Hastings, 25; Woodville, 1; Gisborne, 12j other districts, 19: total, 100. Measles. —Woodville, 1 ; other districts, 2: total, 3. Erysipelas and Blood-poisoning. —Gisborne, 1 ; other districts, 2: total, 3. Diphtheria.— Napier, 5; Hastings, 14; Wairoa, 3; Gisborne, 15; other districts, 6: total, 43. Tuberculosis and Consumption.— Napier, 2; Hastings, 1: Dannevirke, 2; Wairoa, 29 (14 of these being Maoris); Gisborne, 2; other districts, 10: total, 46. " Enteric or Typhoid Fever. —Napier, 3; Hastings, 5; Dannevirke, 1; Wairoa, 9; Gisborne, 10; other distriots, 23: total, 51. For purposes of comparison 1 give the number of cases notified in the two previous years:- — 1905.—Scarlatina, 31 cases; diphtheria, 44; tuberculosis, 67; enteric or typhoid fever, 43. 1906. —Scarlatina, 25 cases; diphtheria, 44; tuberculosis, 73; enteric or typhoid fever, 55. Analysis of the above. —It will be observed that there are four times as many notifications of scarlatina as there were last year. This has very little sanitary significance. Few of the acute infectious diseases are influenced in their spread by sanitation. It it true that when they attack a community living under insanitary conditions the cases are more severe, and as a consequence the death-rate is heavier. But let a case be introduced where there is segregation, an epidemic will occur amongst the majority of those who have not been rendered immune from a previous attack. Of erysipelas and blood-poisoning, the cases in each year are too few to have any significance. Diphtheria is in statu quo: there have been 43 notifications this year, and 44 during each of the two previous years. Tuberculosis and consumption show a distinct drop—46 cases this year against 73 in 1906 and 67 in 1905. I hope that this drop is real and not fallacious, due to less careful notification. Enteric or typhoid fever remains about the same in this district—sl cases this year, against 55 in 1906 and 43 in 1905. Napier can boast of having had a record year, the smallest number of cases for more than thirty years —3. In 1906 there were 12, and in 1905, 6. I hope the day is not far distant when the number of cases notified in Napier during the year will be represented by a " duck's egg." Wairoa and Gisborne are at the other end of the scale with 9 and 10 cases respectively. Though Gisborne has one more case than Wairoa, in proportion to population the latter place takes the unwelcome " cake."