H.—3l.

Scarlet Fever. A fairly widespread epidemic of scarlet fever has taken place, and chiefly during the last four months. Out of a total of 117 cases, the city contributes thirty-five, which is perhaps the share one would expect from the most congested part of the district. Arch Hill.—A small road district of 1,600 inhabitants has too large a share (nine), owing to an outbreak amongst the scholars attending the district school (Newton Bast), which had to be closed in consequence. Altogether some fifteen children attending this school were affected. On my representation the Board of Education closed the school for three weeks, and had it thoroughly disinfected in the meantime. The epidemic was thus checked. In Whangarei County twelve cases occurred, chiefly in one small district (Kamo), where again the district school was chiefly to blame; as was the case also at Cambridge Borough (six cases) and Waitcmata County (six cases), where the scholars of the Woodhill District School were the sufferers. In these latter two cases the schools were disinfected at my request by the Education Board. The nine cases at Botorua were not traced to the school, but occurred among adults as much as among children. On the whole, the disease has been of a mild type, and has shown a lesser degree of infection than one has been accustomed to in epidemics in Britain. Diphtheria. Of a total of fifty-one cases, twenty-seven have been recorded in this city. This is an undue proportion, and may be taken as an index of the faulty drainage and lack of filth-removal. Every house in which a case occurred has been visited, and in all there were serious local sanitary defects—quite sufficient to account for the disease. Twelve cases of the twenty-seven probably originated at an old stable belonging to the Tramway Company, where the soil had for years been saturated with filth through the faulty flooring of the horse-boxes. The outbreak was coincident with the opening-up of this soil, and the cases occurred chiefly in the families of men employed about the stables. Their children all attended one district school (Bayfield), which as a special precaution was closed for a brief period to allow of a careful disinfection. The Tramway Company were directed to remove all polluted soil, and have it ploughed into a paddock within a specified time. This outbreak has now been checked. The remainder of the cases in the city and suburbs may be fairly traced to the very deficient drainage, as in each case the infected houses were situated near some open foul-smelling ditah in which slop-water sewage had accumulated. Cambridge Borough is the only other place where the number of cases require comment. The six cases here (too many for so small a place) probably are traceable to the lack of night-soii removal, judging by the report furnished me by Inspector Winstanley, who visited the spot. Measles. The fifty-four cases recorded have been fairly evenly distributed throughout the district. The type varies between the ordinary and German measles. ' Adults seem to be more affected by it than one is accustomed to expect. Tuberculosis. The sixty-nine cases cannot be taken to indicate the number of tubercular patients. The notification has been irregular, some medical men being much more thorough than others as regards this disease. A large proportion came from Waikato County and the Boroughs of Cambridge and Hamilton, owing to this district having acquired the reputation of possessing a climate suitable to the treatment of this complaint; and undoubtedly the atmosphere there is less humid owing to the geographical position and the porous nature of the soil. In few instances have I taken any special steps in regard to tubercular disease, as until we have some provision in the shape of a sanatorium it is difficult to see what can be done. The unfortunate patients are in evil case just now, as, owing to the spread of knowledge'of its infective nature, hotels and boardinghouses refuse to take phthisical cases in, and one can scarcely blame them. I regard the sanatorium for tubercular cases as one of the most pressing needs of the district. At the Chief Health Officer's direction inquiry was made as to a suitable site for such an institution ; and, taking into consideration accessibility, as well as climatic and telluric conditions, it is certain that Cambridge offers every advantage, especially with an improved railway service such as I understand will shortly be initiated. A very suitable property about five miles from Cambridge was visited by Dr. Mason and myself, and it is to be hoped that we shall not be without this most necessary institution much longer. Influenza. Twenty-four cases have been notified; these are probably mere catarrhal attacks; nothing in the shape of an epidemic of a specified type of the disease has existed. The appearance in the Eegistrar's returns of several cases of death from influenza is worthy of comment. It is to be questioned whether other conditions, such as typhoid, may not escape notice under this heading owing to the difficulties of diagnosis. Blood-poisoning. The twenty-four notifications included three cases of tetanus, all of which occurred about the same time in March, though widely separated, two being in Auckland and one in Opotiki It is worthy of comment that in previous years cases have arisen so concurrently as almost to be worthy of the designation " epidemic."

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