it.— si.

Infectious Diseases, During the past year my district has been comparatively free from infectious diseases. We have passed through an epidemic of measles, or German measles, for no distinction appears to have been made between them by the doctors who notified them, which was frequent and well spread when notification was regularly begun. The epidemic was at its height in and around Dunedin about the end of October or the beginning of November, and spread southwards, arriving at Invercargill and the surrounding country, and throughout my district generally, about a month later. In October 140 cases were notified ; in November, 171; and in December, 64 ; while in January they had fallen to 21, and in February to 15—nearly all in the country places, working southward—till in March they were practically only notified in the Invercargill district, 29 in number. The number of deaths in Dunedin, from which 440 cases were notified, was 6, or 1-36 per cent. Scarlet Fever. —During the progress of the measles epidemic a few cases of scarlet fever were notified ; almost without exception I visited these, but on no occasion could I find any contact with a previous case of scarlet fever, while in many I did find contact with cases of measles of an undeniable type, so I was forced to the conclusion that we had to do with German measles of the form which approaches the scarlet-fever rash. In all these cases, however, I directed precautions to be taken as if we had really to do with scarlet fever, and there has been no spread of that disease in this district. Diphtheria. —An epidemic of diphtheria occurred in the southern part of my district, beginning at Lumsden, apparently arising from a filthy lagoon at the back of the two principal hotels, in one of which it broke out, and spreading by direct contact throughout Southland, to terminate in the end of October. Thirty-two cases thus occurred, generally of a mild type, ending in recovery, except in two instances —one the first attacked; and the other, at Eiversdale, from the utter negligence of the patient to take the least care of himself. Since then we have had isolated cases in places remote from each other, all of a mild type, with no deaths, apparently due, so far as I could learn, to dirty gutters or general surroundings of a localised nature. Of the five cases in Dunedin, for instance, in one — that of a baby three months old, which died—the surroundings of the house were in a most filthy state. I had called attention to these premises some time before, but they had been allowed to relapse into an unsatisfactory condition, which I have now properly remedied. One or two of the cases were notified as possibly diphtheria, turning out to be aphthous throat; but I have encouraged the notification of these as tending to let us have early notice of what might require active interference, and which gives us notice of a locality requiring looking after. This disease gave for the whole district three deaths, or 73 per cent, of the cases notified. Enteric Fever. —We have been very free from this disease, but the return is rather imperfect perhaps. I have been able to hear of only seven cases, four of which were in Dunedin, one in the Clutha County, at an isolated farmhouse, and the other two in Southland. In all the cause was pretty well traceable to defective drainage, though, except in a case at Riverton, not to any previous occurring case. The fever which happened at Winton was traced to water from a dirty lagoon. Tuberculosis. —We are not having satisfactory returns of this, only 149 having been sent in from the district, of which sixty-nine were from Dunedin and the immediate surrounding country, including Dr. Stephenson's hospital, while we have from Dunedin Eegistration District forty-eight deaths. It is thus no use to try to estimate the percentage of deaths, as the returns have been too imperfect. Influenza. —A few cases have been notified—fifteen in number; with one exception, all in Dunedin or its immediate neighbourhood. But it is doubtful if these were of the true type of epidemic influenza, from which this district has been free for some time apparently. Blood-poisonivg has been noted in four instances, but of no definite type, and it has only occurred sporadically. Leprosy. —One case of this was notified at Murphy's Flat, and on investigation it proved to be a true instance of ansesthetic leprosy. As the man, a Chinaman, lived alone in a remote part of the country, and as the form of the disease from which he was suffering is held by authorities not to be contagious, or only so in a very advanced stage, he was left in his place, with strict directions for his isolation, which are now being carried out satisfactorily, by late accounts. I may mention that the case agreed in every respect with cases I have seen in Norway in the Leper House in Bergen, and that from the photographs taken by Dr. Mason on his visit with me the case was pronounced to be true leprosy by my brother, Professor Ogston, of Aberdeen University, who has studied the subject in Norway and elsewhere. I cannot at this time enter into a detailed account of the examination I made of the places visited within my district, as these visits were necessarily too hurried, and were more in the way of entering into relations with the various Councillors and local authorities than a close inspection; but during the currency of the present year I shall hope to make my visits more thorough, so that they may form the bases of full reports, which I may be able to send you from time to time, to form a catalogue of each, by which the district may be accurately known. We have had no bacteriological work during the year, except in the case of some of the surface material at the nightsoil depot at Tomahawk, which was examined to find out if any fecal remains were left. Cocci and a very thin bacillus were found. I have had to make a microscopic examination of a mutton-chop, in which I found a cheesy gland, which was full of tubercle bacilli, on staining and examining a smear under the immersion lens 1,200.

70