H.—3l

50

and suburbs. Generally speaking, I cannot state that the high price of milk is having a deleterious effect upon health, but it is probable that certain families may be using other preparations, or certainly consuming a decreased quantity. It is imperative that the price be reduced at the earliest moment. SEOTION S.—CANTERBURY-WEST LAND HEALTH DISTRICT. Dr. T. F. Tki.kord, Medical Officer of Health. One of the special features regarding the infectious group of diseases was the very marked outbreak occurring in June under the headings " Pneumonic Influenza" and " Acute Primary Pneumonia." This period started with marked incidence in the middle of June, and. remained severe until about the end of August, after which it gradually died out. The pneumonic influenza was of a particularly severe type, in which those recovering remained invalided for a considerable period, recovery being very slow. Puerperal Sepsis. I consider it necessary to make a few remarks upon this disease. The cases have decreased 33>} per cent, on the previous year. The medical men in this district are in the majority of cases affording me considerable assistance in the control of this disease by notifying me promptly. This being the case, it allows of effectual steps being taken to provide the proper isolation. I find that in some instances undertakers have failed to notify deaths occurring under this heading, but on going into the matter I find that the death-certificate as filled in in some cases gives no indication whatever to the undertaker that the deceased died of a notifiable infectious disease. For instance, to give a single illustration : The medical man may notify a case as puerperal sepsis in the ordinary way, but in filling in the death-certificate the primary cause would be filled in as thrombo-phlebitis (pelvic veins), and the secondary cause as tympanites and asthenia. In order that there may be no confusion in this matter for the future', I think it desirable that the profession as a whole should be instructed to report the death under the condition primarily notified. Food Poisoning. An interesting case under this heading occurred in a family of eight. Unfortunately three of the members died as a result of this outbreak —twin children aged nineteen months, and a boy nine years of age. The infection was definitely established as due to the infection of milk by the bacillus aertrycke. This organism was recovered from the organs of the deceased, and also from the faeces of tho remaining patients. The agglutination tests were positive for the bacillus aertrycke. The probable source of the infection was due to the father contaminating his hands and clothing with water which received the drainage from pigsties located near the point from which he drew water. As the father prepared the meal, it would appear to me that some of these organisms dropped from his person or his clothing into the milk, thereby infecting it, these organisms increasing in number during the period of storage. The father subsequently prepared a custard for the family personally, and used some of the milk in the container for use with this custard when the family partook of the meal. Private Hospitals. A general improvement is noticeable in connection with the sanitary arrangements in most of these institutions. In regard to maternity hospitals, in most cases improvements recommended by instructions from the Director-General as to sink-rooms, &c, have been carried out. SECTION 6.—OTAGO-SOUTHLAND HEALTH DISTRICT. Dr. T. McKibuin, Medical Officer of Health. Administration. Health control by the local governing authorities has now been in operation for three years, and it may be said there is steady if slow progress in sanitary inspection and control, the installation of sanitary works, and the prevention of infectious disease. There are eight Health Inspectors placed throughout the two provinces, each working for a defined group of local authorities averaging seven per Inspector. Their services appear to be appreciated by the local authorities, so far as I can judge ; and, making due allowances for distances, reduced means of communication, and the call for economy, the Inspectors are in close and constant communication with their several local authorities to their mutual advantage. On occasions some of the smaller local authorities and a few County Councils are averse to making advances recommended by the Inspector and the Medical Officer of Health, but in several instances the mild if tedious process of repeated application has eventually effected the desired reform. Dunedin City and Invercargill Borough maintain steady, even rapid, progress in the installation of sanitary works ; and Oamaru Borough in addition to draining South Oamaru, has now prepared loan proposals for a complete sewerage scheme for the whole borough. General. Scarlet fever and typhoid fever show a steady reduction, in common with world-wide experience. The incidence and death-rate of both diphtheria and puerperal fever were exceptionally light. Hydatid