H.—l3

112

I may state that the reports I have presented to local authorities have in most cases been attended yvith good results, and that most of the local authorities have begun to put my recommendations into effect so far as they can be done. This work has kept Inspector Craighead very fully employed during the year in and about Dunedin, while Inspector Gladstone has been, attending to the same visitation in the country towns, not only in what I have assigned to him as his subdistrict —practically Otago—but also in the towns in the Southland Subdistrict, generally the province of Inspector Cameron, but which the latter yvas unable systematically to overtake, his duties, as being in practically the sole charge of the Town of Invercargill except from a visit by me four or five times a year, preventing him from being absent from his headquarters for the three or four days necessary for a thorough examination of a town without interrupting his work of the town and district. The close inspection thus being carried out I hope to have pretty yvell finished before the end of our next official year. From what we have thus seen I have reason to believe that the farms, &c, throughout the country are not without the need of similar inspection, a difficult matter, and one which would involve much time and travel, but I am in hopes that some day this also may be undertaken. Apart from the special work above referred to, you will see by my summary of " Matters looked into during the Year " that we have had plenty of small matters to occupy fully our time, on which I need make no special comment. These routine matters have involved the writing of numerous letters to local authorities and others, the numbers of yvhich I have set forth in a separate summary. And besides these letters, I have sent circulars to various public bodies, referring to such matters as the position of dry closets in relation to dyvellings, the yvater-supplies to towns in my district, the necessity of more systematic vaccination, the provision for infectious-diseases hopitals, &c. I, or my Inspectors, have had numerous interviews with local authorities and other public and private persons on sanitary concerns generally, yvhich are bearing fruit in bringing us to a mutual understanding and in tending to promote the sanitation of the district. Infectious Diseases. The incidence of infectious diseases is shown in the subjoined table. It may be noted, hoyvever, that, taking them generally, there is a considerable increase this year all round. Thus, — 1906-7. 1907-8. Increase. Scarlet fever ... ... .... ... 181 246 65 Enteric fever ... ... ... ... 23 36 13 Diphtheria ... ... ... ... ... 22 58 - 36 Tuberculosis ... ... ... ... ... 94 152 58 Blood-poisoning (erysipelas) ... ... ... 10 33 23 Scarlet Fever. In Dunedin this disease occurred in households with no apparent connection one with another, and at irregular intervals, some of the cases having been traced to the country places in yvhich the disease was raging more or less. In the latter half of the year it spread into some of the neighbouring counties having intercourse yvith Dunedin. In Invercargill itself the disease seemed to have come to an end, but in June it began again to appear, as well as in the counties connected yvith it, reaching to considerable numbers. In Vincent County, principally in the Toyvn of Cromwell, where it raged last year, it continued, in spite of the precautions taken, till September, dropped to almost nil for a time, and again increased slightly, and from that it appears to have spread into the Tuapeka County. Curiously enough, it would seem that the places yvhich took the most care, by prompt isolation of the cases —namely Cromwell and Invercargill—were those which suffered most. But in every case in Invercargill removal to the hospital prevented the infection spreading to any other person in the same household. Conversely, in several instances, yvhere no removal took place, the diseases did spread in the same home : in one case to five persons. The cases have been so mild, with such good recoveries that people treated the disease as being hardly worth taking precautions against. Diphtheria. —ln Dunedin the cases'were of the mildest description, mostly, perhaps mainly, ulcerated or aphthous sore throats, and were frequently due, apparently or evidently, to disturbance of old drains in connection yvith the laying of new ones by the operations of the Drainage Board. In Invercargill the disease appears to be endemic in certain parts of the town, low-lying and without drainage, pointing to the necessity of a proper system of drainage and water-supply for that groyving city, while at Riverton a considerable number of cases occurred in the months of August, September, October, and November, yvhich there yvas reason to conclude had been brought originally from Invercargill. Enteric Fever. —Several of these cases returned yvere of a doubtful character, turning out not to be true cases of fever, some of them at any rate being, in Dunedin, due to disturbance of old drains in laying new ones. Blood-poisoning, which was nearly always simply erysipelas, yvas the means of revealing sanitary defects in and around dwelling's. Hydatid Disease was notified to the number of eleven cases. Tuberculosis. —There is reason to conclude that this increase is partly due to better notification, partly to cases coming to the district from other districts for treatment at the Whare Flat or the Rock and Pillar sanatorium. Endemic Disease. —About the middle of December the local medical man at Papatoitoi, in Wallace County, sent in notification of several cases of disease which he stated to be suspected enteric fever, but which by another medical man called in consultation were diagnosed as gastro-enteritis.