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in both Tauranga and Rotorua. It has already been shown how the mortality in the city is largely also owing to this cause. In conclusion, I would again draw attention to the necessity for placing acute diarrhoea on the list of notifiable diseases, since it is only by chance reports that serious outbreaks are discovered. General Public Health Measures. Infectious Diseases Hospital. In last year's report, after describing the utter lack of preparation to adequately deal with infectious-diseases epidemics in Auckland, I expressed the hope that the action of the Department in getting the many local bodies concerned to combine for the purpose of establishing a wellorganized hospital for infectious diseases had at last put the matter on a sound basis. I must now confess that my opinion was founded on too sanguine a view of the methods of civic government in the district, and I regret to report that we are apparently as far off a satisfactory solution of the difficulty as ever. The Department believed that the meeting of delegates had unanimously agreed that a hospital was required, and that the details of the work—the site, plans, and assessment of rates — had been referred to a sub-committee and the Chief Health Officer. They were further encouraged in this belief by receiving a formal agreement to the resolutions passed at this meeting from each local body—in all but a few instances without questions being asked as to details, or protest made. In spite of this apparent unanimity of opinion last year, and in spite of seven months' subsequent acquiescence—during which the Department chose and gazetted a site, made plans for the building, and drew up a basis of rating with the approval of the sub-committee, and attempted to collect the subscriptions—we now learn that all this work would be wasted by the local bodies, and that, with a few exceptions, they repudiate their agreements. So unexpected an outcome of the negotiations necessitates a review of the position taken by the Department to discover, if possible, whether any misinterpretation on their part of the necessity for the work, or the previous public feeling, led to a misunderstanding. We will take first, then, the conditions which led the Chief Health Officer in April, 1902, to call a meeting of local bodies to consider the question. To put it shortly, we had at that time an epidemic of various infectious diseases —diphtheria, scarlet fever," &c, —and no proper provision for either their treatment or the accommodation of the nursing-staff, and the public safety, by lack of isolation of cases and disinfection of clothing, was endangered. Added to this, plague was at our doors, and one case had arisen in Auckland. We had, further, nobody responsible for the proper treatment of these cases, and the Hospital Board taking an unwilling charge, objecting to doing anything as regards plague, and threatening to repudiate the care of what they termed the minor infectious cases, taking advantage of the fact that they were not called on to do this work under the Public Health Act. The passing of this Act provided a convenient excuse to the Board for avoiding what had been their clear duty prior to 1901. Why they had neglected to face the question of proper provision for infectious cases long before opens up the question of whether the constitution of these Boards has proved satisfactory. It cannot be argued that hitherto there had been no need for such provision. To my personal knowledge they were unable, eight years before, to afford satisfactory accommodation when an outbreak of diphtheria occurred, and the cases had to be placed in what was supposed to be a special ward for major surgical operations. The recommendations of their medical staff on this matter were neglected, as also on the question of adequate means of disinfecting clothing, &c. When in 1900 plague broke out, their unpreparedness was again manifest, and a temporary hospital had to be hurriedly erected under pressure by the Government. This structure was placed in the public Domain adjoining the Hospital, and provided accommodation for about twenty cases, with a small annex for a medical man. There was a further building for contacts in the same portion of the Domain, erected by the City Council, the Government paying half the cost. This building was burned down early in 1901. Save, then, for the temporary plague-building, the only accommodation for infectious diseases was a small cottage in the Hospital grounds, containing four beds, with no special provision for nursing-staff. In the face of the above facts, it would seem strange that the Hospital Board should feel themselves in a position to blame the Health Department for not taking adequate steps to meet the epidemic of 1902. Yet this we find to have been done in a report by the Medical Superintendent, read at a meeting on the 28th October, 1902, the report being heartily indorsed by a majority of the Board. It is impossible to avoid contrasting the inaction of the Board after all these years with the fact that within six months of the establishment in Auckland the Health Department had already made efforts towards inducing the bodies concerned to prepare for emergencies in the matter of infectious outbreaks and the disinfection of clothing. That their representations were unsuccessful is the fault of the public bodies approached, and shows that the powers possessed by the Department are insufficient if they are to be held responsible for public health. An attempt made in 1901 to induce the City Council and the Hospital Board to combine and erect a steam disinfector, and provide a special ambulance for infectious diseases, proved fruitless. Again, in February, 1902, the outbreak of plague in Sydney offered a sufficient argument for the Department to press the sanitary needs of the district upon the local bodies, and it was proposed to increase the Hospital accommodation; but the only result was bitter opposition on the grounds of the presence of this Plague Hospital in the public Domain. This feeling grew, and when towards the end of March it was known that the City Council were calling tenders for a building on the site of the burnt Contacts Hospital a great outcry arose in the Press and among a section of the public. It is somewhat amusing to refer to the tone of the objections at that time, and contrast it with the arguments used later against the Point Chevalier scheme. Thus, in a leading article in April, 1902, the morning paper says, " Our contention that it is not advisable or usual for infectious diseases to be treated in buildings adjacent to a general Hospital is now indorsed by the