H.—3l.

It has always been an important cause of death, but results show that nowadays submission to skilled treatment at an early stage is worth while. Particularly after the age of thirty-five we should seek medical examination for any unusual condition which might be cancer. Violence, 928. Violence has now assumed third place as a cause of deaths in New Zealand ; 663 of these deaths were due to accident, 240 to suicide, and 25 to homicide. The number of deaths from suicide increased from 226 in 1931 to 240 last year. In the last five years the number of deaths annually from motor-vehicle accidents has averaged 178. Chest-diseases, 762. Pneumonia .. .. .. .. .. .. .. 278 Pneumonia secondary to influenza, whooping-cough, and measles .. 51 Broncho-pneumonia .. .. .. .. .. .. 226 Bronchitis .. .. .. .. .. .. .. 207 762 There is reason to believe that many of these deaths could be prevented. In some countries the experiment has been tried of making every pneumonia case compulsorily notifiable, and attempting isolation. Apparently the results achieved have not justified the expense and trouble thereby involved, but the fact remains that probably a large proportion of these illnesses are infectious. All associated with epidemics of influenza, measles, whooping-cough, or diphtheria certainly are. Again, when in the absence of a recognized outbreak of such common infectious diseases, groups of pneumonia or broncho-pneumonia cases occur in a community, affecting in considerable measures virile young adults, adolescents, and children, of which it can be said the infecting agent is virulent, then measures can be taken which give promise of considerably reducing the death-rate from these lung-ailments. Such measures are complete case-isolation to be practised by doctor and nurse, and convalescents to be restrained from close contact with other persons, attendance at indoor public gatherings, &c., until they have completely recovered. Tuberculosis (all Forms), 615. The following table indicates the course of this disease since 1928 : —

New Zealand has the lowest death-rate from tuberculosis in the world. In common with many other countries, including Greal Britain, it has steadily reduced in the last half-century. This year , rate is remarkably low. Tuberculosis, however, still takes fifth place as a cause of death in New Zealand and disables temporarily or permanently many more than it kills. Of 615 deaths from tuberculosis last year, 488 (= 3-35) were assigned to pulmonary tuberculosis, and 127 to other forms of this disease, comprising tuberculosis, meningitis, and peritonitis, and tuberculosis of the bones, joints, glands, &c. Pulmonary Tuberculosis. The pulmonary cases are regarded by most authorities as conveyed from human sources. There were 904 notifications of fresh cases during the year. Other Forms of Tuberculosis. The 127 deaths last year from other forms of tuberculosis were made up as follows : — Tuberculosis of meninges and central nervous system .. .. .. 47 Tuberculosis of intestines and peritoneum .. .. .. ..22 Tuberculosis of vertebral column.. .. .. .. .. 12 Tuberculosis of bones and joints .. .. •• ■• •• ..1 Tuberculosis of skin and subcutaneous cellular tissue .. .. .... Tuberculosis of lymphatic system .. .. .. .. ..2 Tuberculosis of genito-urinary system .. .. .. .. ..12 Tuberculosis of other organs .. .. .. .. ■• ..4 Disseminated tuberculosis .. •• •• •• •■ ..27 127 A small proportion only of these latter deaths, particularly those of children, are deemed by recognized authorities to l>. , possibly due to infection from the cow, and bacteriological tests of milksupplies in New Zealand have shown the milk-supply to be remarkably free from bovine tubercle.

10

Number of Deaths Death-rate from Tuber- Number of Deaths Death-rate from TuberYear from culosis per 1(1,000 of ; Year. from ouloaia per 10,000 of Tuberculosis. Mean Population. Tuberculosis. Mean Population. 1928 .. 699 5-02 1931 .. 617 4-27 1929 .. 642 4-56 1932 .. 615 4-22 1930 .. 649 4-55