H. —31 A.

Graph A. —Death-rate from Tuberculosis per 10,000 Mean Population, 1872-1927.

In these figures no account is taken of the incidence of the disease among Maoris. The mass of the Maori population lives in remote districts inaccessible to doctors and inspectors, and in many cases medical certification of death is not made. Thus reliable information is not obtainable. It may be pointed out, however, that statistics relative to Maoris compiled for the quinquennium 1920-24 showed that during the five years 857 deaths of Maoris were recorded as due to tuberculosis of the respiratory system, and JO3 to other forms of tuberculosis. These figures correspond to annual rates of about 28 per 10,000 for pulmonary tuberculosis and 32 per 10,000 for all forms of tuberculosis, as against corresponding rates of 5 and 6-5 respectively for the general population. Incidence of Tuberculosis in New Zealand School-children. The total incidence of tuberculosis in 60,275 children examined by School Medical Officers in the year 1927 was 0-1 per cent., of which o'o4 per cent, was pulmonary and 0-06 per cent, tuberculosis of tissues other than pulmonary. This percentage is in accordance with that found in previous years. School medical reports forwarded show that tuberculosis (in a diagnosable form) is rarely found during the routine examination of school-children. These observations accord with those made in England. The annual report of the County Medical Officer of Health and School Medical Officer, London County Council, for the year 1926 says, " Pulmonary tuberculosis was detected in only 102 children (0-1 per cent.), and other forms of tuberculosis in 126 children. It is thus now quite rare to find tuberculosis at routine medical inspection in school."* Again, in Australia, the report of the Principal Medical Officer, Education Department, Victoria (year 1925-26), states : "In 1922, at the request of the Director-General of the Commonwealth Health Department, every School Medical Officer was asked for six months to keep careful notes of all cases of tuberculosis or cases suspicious of tuberculosis. Even when carefully looked for, only two cases of apparently tubercular glands and five cases of chest conditions, probably tubercular, were found among 7,000 children, but no case of tubercular joint disease was amongst this number, "f In view of the modern opinion that tuberculous infection is almost universal before adolescence, it is probable that a percentage of school-children now classified by School Medical Officers as of subnormal nutrition has latent tuberculosis. In the annual report for 1927 the number of New Zealand school-children showing evidence of subnormal nutrition is given as 7-14 per cent. Incidence op Pulmonary Tuberculosis in Different Districts. It has been suggested that the incidence of pulmonary tuberculosis is greater in the South Island than in the North Island, and Graph B supports this suggestion. In this graph incidence is determined by the number of notifications, and not by the death-rate. When notification is taken as the basis for estimating incidence, it shows that the incidence is also greater in Canterbury and Otago than in Wellington and Auckland. * Annual report of County Medical Officer of Health and School Medical Officer, London County Council, for year 1926. f Annual report of Principal Medical Officer, Education Department, Victoria, for year 1925-26.

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