H.—3lA,

REPORT. In compiling this report the Committee has adopted the method of dealing separately with the various questions in the order in which they are set out in the order of reference. SECTION I. Question 1. —Past and present incidence of pulmonary tuberculosis in New Zealand. In New Zealand, as in other civilized countries, the incidence of pulmonary tuberculosis has declined steadily during the past fifty or sixty years. The fall has been, uninterrupted, and does not appear to have been influenced by any of the remedial measures introduced in the last thirty years for the direct treatment of the disease. The explanation usually given is that the decline has been brought about by education, by sanitary reform, and by improvement in economic conditions. In estimating the incidence of pulmonary tuberculosis in this country two sources of information are available—(a) notification returns, (b) bills of mortality. In New Zealand pulmonary tuberculosis has been a notifiable disease since 1901. In the earlier years notification was very incomplete, and even to-day it cannot be relied upon to give trustworthy information. In some cases patients and doctors alike are opposed to notification. Often doctors are careless and neglect to make returns ; and, on the other hand, patients who pass from doctor to doctor or from doctor to hospital are sometimes notified more than once. Notifications for the last ten years are shown in Table I. Table I.—Notieications op Cases op Pulmonary Tuberculosis, 1918-27. Y Number of v Number of Notifications. ' Notifications. 1918 .. .. .. 1,072 1923 .. .. .. 1.002 1919 .. .. .. 984 1924 .. .. .. 1.072 1920 .. .. .. 1,305 1925 .. .. .. 1.247 1921 .. .. .. 1,207 1926 .. .. .. 1,318 1922 .. .. ..1,129 1927 .. .. .. 1,343 The only inference that can be drawn from this list is that there has been a steady increase in notification in the last three years. It is probable that this increase is due to the greater activity of various administrative bodies resulting in a higher proportion of cases being notified. More reliable information is given by the death-rate. Tables II and 111 show that the death-rate per 10,000 of the population has fallen from 9-70 per 10,000 in 1872 to 3-88 per 10,000 in 1927.

Table II.—Deaths from Tuberculosis of the Respiratory System, 1872-1927.

4

Vpar j Number of Rate per 10,000|! Number of per 10,000 Year ' ! Deaths. M ® a " Year ' Deaths. v M ? a " Population. ; Population. 1872 .. .. 265 9-70 1900 .. .. 577 7-57 1873 .. .. 206 7-16 1901 .. . . 596 7-66 1874 .. .. 270 8-47 1902 .. .. 617 7-73 1875 .. .. 339 9-45 1903 .. .. 570 6-95 1876 .. .. 307 7-92 1904 .. .. 598 7-08 1877 .. .. 326 8-07 j 1905 .. .. 496 5-70 1878 .. ... 326 7-75 I 1906 .. .. 556 6-21 1879 .. . . | 399 8-90 1907 .. .. 612 6-66 1880 .. .. I 447 9-42 1908 .. .. 671 7-10 1881 .. . . 468 9-50 1909 .. .. 634 6-52 1882 .. . . 454 8-91 , 1910 .. .. 574 5-78 1883 .. .. 531 10-02 j 1911 .. .. 563 5-55 1884 .. . . i 530 9-59 i 1912 .. .. 553 5-32 1885 .. .. 514 9-02 1913 .. .. 640 5-99 1886 .. .. 500 8-59 : 1914 .. .. 564 5-17 1887 .. .. I 534 8-95 1915 .. .. 546 4-97 1888 .. .. 476 7-86 1916 .. .. 565 5-14 1889 .. .. 499 8-16 1917 .. .. 584 5-31 1890 .. .. 520 8-38 1918 .. .. 638 5-78 1891 .. .. 495 7-86 1919 .. .. 585 5-12 1892 .. .. 524 8-16 1920 .. .. 671 5-63 1893 .. .. 545 8-24 1921 .. .. 609 4-98 1894 .. .. 576 8-48 I 1922 .. .. 594 4-74 1895 .. .. 553 7-99 1923 .. .. 619 4-86 1896 .. .. 523 7-40 1924 .. .. 573 4-41 1897 .. .. 596 8-26 1925 .. .. 560 4-21 1898 .. .. 597 8-11 ! 1926 .. .. 592 4-38 1899 .. .. 593 7-91 1927 .. .. 533 3-88