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The Actin(i Duusotok-Genkkal of Health to the Hon. the Minister of Health, Wellington. In tlie absence of the Director-General of Health I have the honour to lay before you the annual report of the Department for the year 1924-25. PART I.—GENERAL SURVEY. S MOTION 1. —GEN" E RAL. Public Health. The period under review has been marked by wider and more intensive activities, due in part to a strengthened personnel and in part to a growing interest displayed by the public in preventive medicine in general and the promotion of maternal welfare in particular. Vital Statistics. —So far as vital statistics are concerned, 1924 was a wonderful year. The crude (actual) death-rate was 8'29 per 1,000 of mean population ; the infant-mortality rate was 40-2 per 1,000 births ; the tuberculosis death-rate was 5-67 per 10,000 of mean population. These all constitute record figures so far as New Zealand is concerned, and compare more than favourably with corresponding rates for other countries. The low birth-rate (21-7 per 1,000 of mean population) and continued high rate of still-births (30-5 per 1,000 live births) arc disquieting features of the returns. There is no doubt that our population is best replenished and our empty spaces best filled by our own natural increase : the new-born infant, in other words, is our best immigrant. The maternal-mortality, rate (s'oo per 1,000 births) is almost as high as in. 1923, despite the very active campaign for its reduction embarked upon during the year. This is not wholly unexpected, as the measures initiated have as yet hardly had time to exert their influence. On the other hand, the mortality rate of infants under one month shows a gratifying and suggestive decline. As stated in previous reports, this first-month mortality has been relatively obstinate in responding to the measures which have proved so successful at later ages. The mortality rate of infants under one month for the year under review is only 24 per 1,000 births. It is hoped this decline indicates that the intensive measures of late years for safeguarding the lives of mothers and infants are at last being crowned with a certain measure of success. Tuberculosis. —The death-rate from tuberculosis (5-67 per 10,000 of mean population) is the lowest so far recorded in the Dominion. It has been estimated, however, that there are at the present time in New Zealand approximately 5,500 persons of all ages suffering from pulmonary tuberculosis in some stage or other. It is evident, therefore, that much remains to bo done in combatting this all-too-prevalent disease. With earlier admission to sanatorium, the further provision of special wards in our hospitals for incurable cases, and the closer supervision of cases and contacts in their own homes we can confidently look forward to better results. As a definitely forward step in its campaign against pulmonary tuberculosis the Department recently arranged for the Medical Superintendents of the two North Island sanatoria to visit near-bv towns at regular intervals for the purpose of consulting with any medical practitioner desirous of obtaining a specialist's opinion upon any case. In the same way the Waipiata Sanatorium Committee lias arranged for its Medical Officer to visit Timaru, Ashburton, Invercargill, anil other towns for a similar purpose. Acute Poliomyelitis.—A notable feature in the epidemic history of the Dominion was the outbreak of acute poliomyelitis, which had its origin in Petone in the declining stages of the year. It is not proposed to comment further on this outbreak, which is fully dealt with in the report of the Director, Division of Public Hygiene, except to express the indebtedness of the Department to the public for the manner in which they observed the precautionary measures introduced, and to the medical profession and the Press for their loyal support during a particularly onerous and trying period. In order to ensure that the measures adopted for the prove ition of paralysis and the alleviation of deformities were adequate the Department appointed Dr. W. S. Robertson, the Orthopsedic Specialist at Wellington Hospital, to report and advise upon the facilities available for the treatment of these cases in different hospitals throughout the Dominion. It is hoped that this step will prove of considerable value in eliminating the after-effects of this dread disease. Recognizing the need for quiet continuous investigation into the nature and mode of origin and spread of anterior poliomyelitis, the Government set aside a sum of £2,000 to enable a year's research work to be carried out at the Otago Medical School. Professor Hercus and Dr. Hector, late Pathologist of the Wellington Hospital, have been entrusted with this special investigation, and their reports will be awaited with extreme interest. Attached as an appendix to this report will be found a statement by Dr. Lynch, of Wellington Hospital, on the pathological anil bacteriological features of cases investigated by him on behalf of the Department. Cancer. —This disease looms large as a cause of death in New Zealand. The cancer death-rate (9-59 per 10,000 living persons) was higher than in the preceding year, the disease causing 1,245 deaths in 1924, as compared with 1,115 in 1923. While the extended use of X-rays and radium should prove of value in combatting this disease, the importance of early recognition and early surgical treatment cannot be overstresscd. The Department continues, by the circulation of suitable leaflets and through the aid of the Press, to give wide publicity as to signs and symptoms of the early stages of the disease. Venereal Diseases. —The clinics in the four main centres have now been handed over to the Hospital Boards, but otherwise continue to operate just as they did when under the control of the