un 2.

VICTORIA.

l}EP ARTMENT OF :PUBLIC HEALrrH.

REPORT OF THE BOARD OF PlTBLIC I-IEA_LTH

FOR THE YEARS 1908-9--10

TO THE

PRESENTED TO BOTH HOUSES OF PARLIAMENT BY HIS EXCELLENCY'S COMMA:\D.

<'§11 Jl,uthotitP.: J. KElii', GOVEH;>:)JENT PRINTER, lii!:LUOURNL

No. 20.-{ie. 3d.]-1342.

Preparation-Not given Printlng(2,000 copies)

APPROXIMATE COST OF REPOR'l'.

£ '· a. 28 0 0

GENERAL REPORT FOR THE YEARS 1908, 1909, 1910, BY THE BOARD OF PUBLIC HEALTH TO THB HONO,L\.BLl~ 1'11@ .cvUNI8rEH, OF HEALTH.

Department of Public Health, Offices of the Board,

Melbourne, 7th December, 1911.

To the Honorable W. L. Baillieu, M:L.O., Minister of Health. SIR,

We have the honour to submit to you our General Report as set out below; the ~wo previous Reports were for six years ending 1904, and three years ending. 1907 respectively. The delay in forwarding the Report is reg:;etted, b::t it ".'::'s wmv 'cL,ble owing to the fact that the preparation of such Reports involves much time and b.bo:1:r on the part of the staff of the Department.

HEALTH ACT 1890. I.-HEALTH AUTHORITIES.

Dr. Johnston, having accepted the position of Officer of Health at Williamstown, resigned his seat on the Board in April, 1908, and in July of that year Cr. W. H. Trega­nowan, of Williamstown Town Council, was elected to sucreed him as representative of the North Yarra Group. At the end of 1908, Alderman Willimn Burton, of the Mel­bourne City Council, and Cr. F. G. Wood, of Caulfield Town Council, were re-elected as members of the Board.

Dr. W. Perrin Norris, having been appointed Federal Quarantine Officer, resigned the position of Chairman of the Board in May, 1909, and was succeeded by Dr. Burnett Ham, late Commissioner of Health for Queensland, who took over the duties in August of that vear.

1~ December, 1909, Cr. W. H. Treganowan, of Williamstown Town Council, Cr. J. P. Carolin, of Bendigo City Council, and Cr. Herbert A. Austin, of Buninyong Shire Council, were re-elected as members of the Board for the North Yarra Group, Eastern Country Boroughs Group, and Western Shires Group respectively.

The election for representatives held in Novr-:mber, 1910, resulted in the re-election of Crs. James J. Brokenshire and Alexander H. Smibh for the ·vVestern Boroughs Group and Eastern Shires Group respectively. 1\:I:r. F. G. Wood having been appointed by the Governor in Council as the second Government nominee, Cr. John Baragwanath , of South Melbourne City Council, was, on the 16th December, 1910, elected to represent the South Y arra Group in his stead.

During the year 1908, 26 ordinary meetings of the Board were held ; the year 1909, 26 ordinary and 1 special meeting; and for the year 1911, 25 ordinary and 5 speciaL

The attendance of the members was as follows :·-

1908. 1909. 1910.

Dr. W. P. Norris, Chairman 25 11 Dr. Burnett Ham,

" .. 10 26

Honora.ble Jas. Styles 18 10 Alderman W. Burton 26 27 30 Dr. J. Johnston 7 Cr. W. H. Trega.nowan .. 13 27 30 Cr. F. G. Wood 26 27 23 Cr. J. P. Ca:rolin 23 26 29 Cr. J. J. Brokenshire 26 27 30 Cr. A. H. Smith 26 26 29 Cr. H. A. Austin 25 25 28

The following changes took place in the staff:-Dr. B. Burnett Ham, M.D., 1\LR.C.S., L.R.C.P., D.P.H.(Camb.), was appointed

Chairman o~ Boar~ of Public He~lth and Acting Medical Inspedor oa 17th August, 1909, and his a.ppomtment as Medical Officer was confirmed on 11th l\Iav, 1910.

Dr. J. C. Jobnston, who had bnen Health Officer and Supcrintend;~nt of Qna;ran­tine since 17th March, 1897, died on 17th April, 1908; the po;;;itiun wa; ihPn abolished, and Mr A. E. Keys, of this office, was appointed as Superintendent for the Quarantine Station.

4

Dr. John Johnston, M.D., C.1\L, D.P.H., was appointed temporary Second Assistant Medical Inspector on 19th May, 1908, and his appointment to the position was confirmed on 22nd February, 1909. On 24th August, 1909, this office was raised to Class " C," Professional Division.

Mr. William Trathen, who had been an officer of this Department since 14th March, 1890, was transferred to the Commonwealth Service on 13th September, 1909.

Mr. D. G. May was appointed as. a 5th Class Clerical Officer on 20th November, 1908. Approval having been given by the Governor in Council to the employment of

a shorthand writer and typewriter, Mr. J. Belcher was appointed to the position from 3rd July, 1908.

Messrs. E. J. F. Crawford and C. V. Lister were appointed Sanitary Building Inspectors on probation, on 19th July, 1909, and 8th December, 1909, respectively.

Mr. M. Heidy, who had attained the age of 67 years, retired from the Service on 31st December, 1908, on a pension.

Mr. G. M. May, Liquor Inspector, retired on a pension on the 31st May, 1909. This retirement was consequent on the continued ill-health of Mr. May.

Mr. Georgc Charles Hughes was appointed Inspector and Supervisor of Shipping, Ship Berthing, Disinfection, Fumigation, and Rat Destruction, on lOth September, 1909.

H.-DWELLING-HOUSES.

The administration of that portion of the Health Act relating to dwelling-houses (Part VI.) is in the hands of the local Councils.

Many of the Metropolitan Councils have been active in their endeavours to improve the sanitary conditions surrounding the housing of the poor, and, with a view to overcoming the deficiencies and want of power in the present Act, the Metropolitan Officers of Health recently had a Conference with our Chairman.

The chief difficulty which confronts Councils is that, although they may condemn a house as unfit for human habitation or occupation, they do not possess legal power to enforce the owners to repair or reconstruct the building and put it into a habitable condition.

The opportunity to give the Councils fuller powe:r: will probably be taken advan­tage of when the amending Health Act is under consideration.

The question of re-papering of rooms of dwelling-houses is also one that requires serious attention, and it is onr intention to endeavour to have legislation intro­duced that will provide that all old wall-paper shall be stripped from the walls of rooms of dwelling-houses before they are re-papered.

IlL-BY-LAws. By-laws made by Councils under the Health Acts, or containing proVIsiOns

authorized by the Health Acts, were confirmed as follows :-

Date ol Board's ConJlrma.tlon. Name ol CouncU.

----------------------------------------Number

of By·la.w.

8nbjecli.

--------------- ----- --------·--------------------------15th January, 1908 . . Bendigo 23 The provision of rat-proof receptacles for house

refuse .. " Richmond 61 Fixing the distance of fowl-yards from dwelling-

, , Geeloug 'Vest 29th January, 1908 . . Warragul

" "

, " 11th March, 1908 8th April, 1908

,, H

22nd April, 1908

" " 17th June, 1908 15th July, Hl08

"

"

Walhalla

Fitzroy . . Geelong . . Daylesford ..

Talbot (Borough) Bet Bet

.. Tungamah ..

. . Gisborne

. . Stawell (Borough) .. P!ahran

I

" 26th August, 1908 . . Collingwood

30 25 2

79 73 84: 7 3

26 5

21 116

117

51

houses Regulating the removal of nightsoil (double pan) Fixing fees for the registration of dairymen Fixing the distance of fowl-yards from dwelling­

houses ,

" " " " " " " Instituting a double pan service

" " " Fixing fees for the registration of dairymen

L1stituting a double pan service Fixing fees for the registration of dairymen Fixing the distance of fowl-yards from dwelling-

houses The provision of covered non-absorbent receptacles

for house refuse Fixing the distance of fowl-yards from dwelling•

houses

Daw of Board's Conflnna\lon.

29th October, 1908 .. "

, 18th November, 1908

" , 2nd December, 1908 .. lOth February, 1909 24th February, 1909 24th March, 1909 21st April, 1909 5th May, 1909

16th June, 1909 14th July, 1909

25th August, 1909

8th September, 1909 , ,

20th October, 1909 .. " " 17th November, 1909

" ,

15th December, 1909

" " 22nd December, 1909 lOth February, 1910

, " 9th March, 1910

23rd March, 1910 4th May, 1910

18th May, 1910

" , 15th June, 1910

" " 29th June, 1910

" " ,

13th July, 1910

,., ,, 27th July, 1910

lOth August, 1910 , " H

" , 24th August, 1910 7th September, 1910

" " " 19th October, 1910

, " " 30th ~ovember, 1910

H H

, " 14th December, 1910

"

" "

5

III.-B 'i-LAws-continued.

Name of Council.

Swan Hill Orbost Bright Daudenoug Narracan Portland (Shire) Bright Meredith Seymour 11ulgrave

Dandenong Echuca (Borough)

South Barwon

Portland (Borough) Omeo Hcidclberg Camherwell Preston

, Newham Donald Orbost Birchip 1\Iorwell Euro<t. Violet Town Creswick (Borough)

Bairnsdale Numurkah Northcote Charlton Ararat (Borough) Traralgon :\iaro11g Horsham

Port Fairy .. Gordon Borung

Port Melbourne Corio Moorabbin

Essen don

Yarrawonga Beech worth Nunawadmg Queenscliff .. Low an V{ angara tta

Swan Hill Hamilton Lexton

Traralgon Colac Lilydale

,

Ba.llarat East

Number of

By·l,.w. Subject.

----··------------24 i Instituting a double pan service 21 :Fixing fees for the registration of dairymen 14 Institutirtg a double pan service 16 Providing for a sanitary service at Carrum 8 Fixing fees for the registration of dairymen 8 Instituting a double pan service

15 Regulating the removal and disposal of house refuse 9 Instituting a double pan service

18 6 Fixing 'the hours 'between which uightsoil may be

deposited 18 Instituting a double pan service 17 Regulating noxious or offensive trades or busi-

nesses lO Amending by:law No. 6 as to construction of pan

closets 49 Re~-,rulating the carriage of meat

7 Reunlating the removal of ni2;htsoil 55 In~titntinf~ a don blc pan t;:;rvice 30 G,,n.,rd s;::,nih1ry matters 12 Fixing the distm,ce of fowl-yards from dwelling-

houses 13 General sanitarv matters 8 Fixing fees for 'the registration of dairymen

10 Instituting a double pc.:1 scrviee

6 7

10 5

41

27 22 16 6

51 9 3

16

5 11 9

89 7

35

31

28 30, 31

13

11 68

17, 18

::1 ::

" " "

Regul;ting the r;moval of nightsoil Prohibiting spitting and expectorating in certain

places

" ,

" "

, " , " "

" , " "

Instituting a d~uble p~~ servic'~ " Prohibiting spitting and expectorating in certain

places

', ,, " " " Fixing fees for the registration of dairymen Prohibiting spitting and expectorating in certain

places

Instituting a d~uble p;~ servid~ " Regulating noxious or offensiYe trades or busi·

nesses Prohibiting spitting and expectoratirtg m certam

places , " " " " " "

,

InstitCiting a d~uble p~;l servi~~ Prohibiting spitting and expectorating in certain

places Extending the area of the double pan service Institutin!-j a double pan service Regulating the rerr~vnl an0 rli:c('G~~J of n1g 'L\J;<>oil

a1:,\l rnbb~sh. Instituting a double pan serv1c~

" ,

" " " '~ u Prohibiting spitting and expectorating in certain

places Regulating marine stores and flock factonel'l

IV.-ORDERS MADE DURING 1908-9-10.

With few exceptions the orders were satisfactorily complied with.

Da~e of Order. On whom lsaned.

25th 1\Iarch, 1908 . . Kyneton Shire Council

6th 1\lay, 1908 Exhibition Trustees, Melbourne ..

20th May, 1908 . . Ballarat East Town Council

1st July, 1908 Coburg Borough Council

12th August, 1908 Echuca Borough Council

26th August, 1908 .. Wm. L. Edmanson

9th September, 1908 Moorabbin Shire Council

7th October, 1908 .. j Kyneton Shire Council.. '

29th October, 1908 . . Echuca Borough Council

2nd December, 1908. . Owner of Parslow's Hall, Malvern I

2nd December, 1903 .. ! Owners of Church of England Grammar Sehool, Melbourne

2nd December, 1908. . Owner of Methodist Church, i Brunswick

Horsham Borough Council Bellarine Shire Couneil Broadmeadows Shire Council

2nd December, 1908 Healesville Shire Council :\Iornington Shire Com1cil Violet Town Shire Council Y arra wonga Shire Council

lOth February, 1909 i'.Iornington Shire Council

28th July, 1909 . . John Fender ..

7th April, 1909 . . Moorabbin Shire Council

15th December, 1909 r I

i I

23rd February, 1910 l :J3ro1 Fehruarv, 1910 J . 1 l:&th M:nch, 1\HO

Alexandra Shire Council Ballan Shire Council .. Bulla Shire Council Gonlburn Shire Council Healesville Shire Council Karkarooc Shire Council Bulla Shire Council Karkarooe Shire Council

Owners of Seamen's Institute, :Melboun:e

l'ort ~lfl 1.bourne Town Council

126 To provide and maintain a separate service for typhoid excreta at Tren­tham

232 To provide safe and proper means of egress from Aquarium Biograph Room

279 To cause complaint to be made before

246 { ::nn

28

15 (of Teachers

and Schools Ac~)

28

254 and

252

279

232

232

232

279 \ 279 279

279 r 279 279 279 I

279

232

279

2791 279 279 279 ,

279 J 279 2~9 1 219 I

\ 232

254

a Justice in respect to a certificate of ten inhabitants re Elsworth's Bone Mills

To take measures as may be necessary to insure that Church-street, Co­bt.ug, is properly cleansed, and that all filth thereon is removed

To make a by-law providing for the regulation of noxious or offensive trades, businesses, or manufactories

To provide proper access, light, venti­lation and means for fire extinction at premises, 152 Elizabeth-street, Me)bourne

To make a by-law providing for the regulation of noxious or offensive trades, businesses or manufactories

To close night soil depot at Trentham, and to provide a machine or some process for rendering nightsoil in­offensive

Limiting the time in which Council makes bv-law referred to in Board's Order 12th August, 1908

To prov-ide safe and proper means of egress from hall

To provide safe and proper means of egress from Assembly Hall

To remove an obstruction from one of the exit doorways

To report in each case to the Board, in regard to the health, cleanlineBll, and general sanitary state of the district for 1907

Appointing an officer of the Board to perform duty which Council ne­glected to do

To provide safe and proper means of egress from public hall, Tinning­street, Brunswick

Limiting the time in which Council makes by-law referred to in Board's Order, 9th September, 1908

To report in each case to the Board in regard to the health, cleanliness, and general sanitary state of the Shire for 1908

Appointing an officer of the Board to perform duty which Council ne­glected to do

To provide sa,fe and proper means of egress from building

To cause the co;1dition of land used by Council as a refuse tip to be improved

7

IV.-ORDERS MADE DURING 1908-9-10---®ntinued.

Da."' ot Order.

29th June, 1910

29th June, 1910 13th July, 1910

21st September, 1910

r 2nd NovomOO<, 19!0 i

On WhOm Issued.

Romsey Shire Council ..

Romsev Shire Council .. Willia~stown 'l'own Council

Kyneton Shire Council

Alexa.ndra Shire Council Ballan Shire Council .. Bena.lla Shire Council .. Healesville Shire Council Karkarooc Shire Coucil Mortlake Shire Council

Under what

Section.

279

254 153

2H

279 l 279 279 279 j

279 J 279

Nature ot Order.

To construct main sewer at Riddell so as not to be a nuisance

To close up night soil depot at Riddell To direct the Chairman of the Board

to enter into an agreement for the reception of the infectious sick inhabitants of Williamstown at Infectious Diseases Hospital at Fair­field

To make a by-law to prohibit the discharging of offensive matter into the Coliban River within the boun­daries of the Shire

To report in eaeh case to the Board in regard to the health, cleanliness, and general sanitary state of the Shire for 1909

In addition to the foregoingt orders were issued during 1910 on several Councilst requesting them to forward for analyses the number of samples required to be submitted by Section 17 of the Pure Food .A.ct 1905.

V.-V A.CCINATION.

The following figures show something of the nature and extent of the work in administering the provisions of the Health Act as to vaccination. \Ve are persuaded that if the maximum penalty of £2 were imposed in all cases where parents are proceeded against for failing to have their children vaccinated, there would soon be a rise of from 5 to 10 per cent. in the present number of vaccinations :-

1908. 1909. 1910.

·- --- ·-

Public vaccinators-Number of appointments made during the year 34 39 36 Number at end of the year 236 242 248 Number of resignations, &c., during year 31 :34 31

Number of places at which public vaccinations were con-ducted 389 379 381

Total amount of fees paid for vaccinations, registrations, and travelling allowances £3,761 0 9 £3,537 0 2 £3,660 9 5

Number of calves inoculated at the Calf Lymph Depot-Successfully 56 57 50 Unsuccessfully 1 1 l

Number of children vaccinated successfully at the Depot with calf lymph 201 196 15~

Number of children vaccinated successfully with calf lymph at vaccination rooms in Swanston-street .. 198 196 168

Number of tubes of glyccrinated calf lymph received from the Depot for issue to public vaccinators and private medical practitioners 14,931 15,430 15,953

Number of cases of successful vaccination registered 20,924 21,:344 Number of births registered 31,101 31,549 :H,43'i Number of deaths of infants under SL'i:: months of age 2,055 1.772 l.!S:!:S Percentage of vaccinations to number of births after

deducting from the latter the number of infants who died under the age of sL'!:: months 72•03 71•67 72•07

8

VI.--BUILDINGS.

PUBLIC BUILDINGS.

During the three years ended 31st December, 1910, the number of plans of public buildings, including new buildings and alterations and additions to existing buildings, submitted to us and dealt with under Section 232 of the Health Act. was 660.

During the same period we approved o£ the opening of 467 public buildings, as follows:-

Churches . • 194 Public Halls 140 Mechanics' Institutes 57 Sunday Schools 37 Salvation Army Barracks 3 Hospitals and .Asylums 7 Grand Stands 24 Tents 5

In addition to the above, between 800 and 900 inspections of public buildings throughout the State were made by the Board's Building Inspectors; and the altera­tions and improvements required and based on such inspections have, in the majority of cases brought under notice, been attended to.

(a) Theatres. The Board's officers have from time to time given considerable attention to the

theatres in the city and country centres. A considerable number of inspections have been made of the several theatres, and various improvements have been effected in accordance with the reports issued by the Board. Recently the Board's officers have undertaken the inspection of the theatres in the city at night, and report that marked improvement has taken place with regard to overcrowding and obstruction of gangways.

(b) Legal Proceedings in Oonnexion with the Public Building, &c., Branch.

Defendant.

--···--···---------

John Gunn

C. G. Fitzgerald

Clemens, Rolfe and Chester

Thoma.s Moyle and Andrew McCrae

Ra.e J ohnston

Samuel Jones ..

Mary Phillips

W alter Ewer ..

W. Naracott ..

Agents of s.s. Franken. . . . Lessee of Town Hall, Melbourne .. John Fowles ..

Master of ship O.J.S Nurse Murphy

Henry Dew ..

J. L. Le Thlt.on

Oft'ence.

1908. Allowing passageways of Theatre Royal,

Melbourne, to be obstructed Failure to register his private hospital

premises, Seymour Opening of a Hall at Ballarat without

the Board's approval

Allowing passageways of Town Hall, North Melbourne, to be obstructed

Blocking up of exits, &c., Hall, Wan­garatta

Allowing passageways of Town Hall, l'rlelbourne, to be obstructed

Failure to register private hospital premises

Allowing passageways of Bijou Theatre to be obstructed on two occasions

Allowing passageways of ~Ia.sonic Hall, Melbourne, to be obstructed

1909. Breach of the ship berthing regulations Allowing hall to be overcrowded Depositing nightsoi1 at a depot ordered

to be closed by Bo::ud--Lauriston Breach of the ship berthing regulations Failure to register private hospital

premises Opening a hall at Hamilton without

Board's approval Opening a structure at Bendigo without

Board's approval Harry Brennan . . Allowing pass:1.geways of Gaiet? Theatre

to be obstructed

B.esnl~ of Prosecn~lon.

Fined £5

"

"

,,

"

"

"

"

" "

" "

"

"

lOs., costs £7 7s.

£1 and 5s. a day fo:r: 11 days building re­mained open

1s. each

£1

:£2

£1 Is., costs £3 38.

£5 for each occasion

£3

£1, costs £4 4s. £3 £1, costs £4 4s.

£1, costs £3 3s. £1

£2, costs 10s.

£5, cogts £2 2s.

£5

9

(b) Legal Ptooeedinqs ~n connexion with Pubric Building, &c., Branch-continued.

Defendant, Offence. Result of Proseru\:0n.

1910. Mary Phillips Conducting a private hospital at North-! !;1ned £5, costs £3 3s.

cote after registration thereof had i

John A. Wilson

Lessee, St. George's Hall, Mel­bourne

been cancelled Allowing passageways of Bijou Theatre , £5

to be obstructed Allowing passageways of hall to be £2

obstructed

(c) The Reqisttation of Teachers and Schools Act 1905. A large number of plans of new private schoolrooms and also plans of alterations

to existing schools have been submitted for examination by the Board's officers; numerous inspections of schools and buildings proposed to be used as schools have been made by the officers authorized, as required by the Act for this purpose, and reports have been forwarded to the proprietors in connexion therewith. Subsequently, a large number of these schools were recommended for registration under the Act.

VII.-CEMETERIES ACT. The nature of our administration of the Cemeteries Act is to some extent shown

in the following statistics :-

1908. 1909. 1910.

-·-----·~

Number of sites reserved for cemeteries 2 4 Number of previously existing sites extended I 2 Number of new Trusts appointed 5 2 4 Number of Trustees appointed to existi.'lg Trusts to fill

vacancies I72 I3I I61 Number of Trusts for which these Trustees were appointed 95 78 99 Number of cemeteries for which-

(I) Regulations were approved .. 5 IO 4 (2) Scales of fees were approved .. 7 11 4

Number of Trusts from which accounts and reports were received 399 375 367

VIII.-C&EMATION AcT.

1908. I909. I910 .

.... ~--- ·-- ·-·----

Number of cremations under the Cremation Act 5 2

IX.-ExoTIC CoMMUNICABLE DISEASES.

Melbourne ~elong The Heads Portland

Pori.

W arrnambool .. Port Fairy

Port Health omcer.

Drs. H. R. Maclea.n and H. Howard Dr. T. J. M. Kennedy Dr. J. Pollock Dr. J. H. Sleeman Dr. H. I. Holmes Dr. W. H. Orchard

1

Th.e following table show's th(j number of vessels which received medical clearancet during the period 1900-1908 :-

Year. Melbourne. Geelong. The Heads. Portland. Warmambool. Port Fairy.

--~- ---- -~--

1900 531 48 28 1901 611 70 29 1 1902 439 35 21 13 1903 48! 9 83 18 l 1904 461 93 41 7 1 1905 443 33 13 u

1906 469 21 11 1 1907 486 11 9 . ; 1908 480 7 4 1

This table indicates the number of vessels which were medically inspected on arr val at the several ports ; it is only a relative indication of the amount of m:>.ritime commerce,

X.-QUARANTINE.

During the period under review (1908-9) no vessel was placed in quarantine nor was any person suffering from a quarantinable disease brought to any port in the State, nor was any person so sufferjng dic;covered within the boundaries of Victoria.

On the 1st of July, 1909, the Federal Qua.rantine Act became operative, and thus the Board was rei eved from any further responsibility as regards sea quarantine.

XL-COMMUNICABLE DISEASES.

For the purpose of the Health Acts the Board has power to declare certain diseases to be-

(a) Malignant, infectious, or contagious. (b) Dangerousj infectious; or contagious.

Diseases under (a) are also c:Jassed as " quarantimtble/' and up to thc> present the following have been declared.---'

(1) Cholera. (2) Leprosy. {3) Plague. (4) Small-pox. (5) Typhus. (6) Yellow Fever.

Under (b) there have been declared­(!) Anthrax. {2) Cerebro-spinal fever. (3) Diphtheria. (4) Measles. {5) Puerperal Fever. (6) Pulmonary Tuberculosis. (7) Scarlet Fever or Scarlatina. (8) Septicremia. (9) Syphilis.

(1 0) Typhoid. (11) ·whooping Cough.

Under the provisions of the present Act a communicable disease cannot be declared " notifiable " until it is prevalent, u.nJ th~i1 01J.1y fo;; the particular place or places where it is epidemic. Consequently quarantinable disease3 are not notiilable l>ecause they are not, nor have they been, prevalent in Victona,:

The diseases which have been declared not1fiable are-

(1) Diphtheria. (2) Pulmonary Tuberculosi~. (3) Scarlet Fever. (4) Typhoid.

11

Pulmonary Tuberculosis is notifiable throughout the whole State, but as regards the other notifiable di,sea.ses there are still a few municipalities which have not been declared, owing to the fact that the Board has not been furnished with proof to the effect that such diseases existed within their boundaries.

It is obvious that amendments of the Act are required in regard to notification of disease. It is desirable in the interests of the community that the Board should have the power to declare any communicable disease as notifiable throughout the whole or any part of the State.

As matters now stand, the Board may declare any communicable disease as "a dangerous or infectious disease," whereupon persons suffering from such disease become subject to such restrictions and penalties as are imposed by the Act. The Act, however, gives the Board no discretion as regards the application of the restrictive provisions, so that a person suffering from a chronic disease is on the same level as one suffering from an acute disease. The incidence of the restrictive proviAions works out most inappropriately, as what is suitable for scarlatina. is most undesirable when applied to syphilis. Therefore, in any amendment of the Act, provision should be made so as to allow the Board to have discretionary powers as regards the application of restrictive measures.

XII-NOTIFIABLE DISEASES-WHOLE STATE.

The following table shows the number of reported cases of deaths from and case mortality due to. diphtheria, scarlet fever, and typhoid fever during the period 1905-1909 in the whole State:-

Year. Dlph~herla. 8oarle~ Fever. Typhoid Fever.

!···· ~--· ~··~~-· ·---·· ----···········--~--~--

Case~. Deaihs. Percentage. Case•. Deaths. Percen~ge. Cases. Deaths. Percen~ge. ~ --- --- ---

1905 .. 1,209 80 6•61 ·~745 10 1'33 1,336 121 9'06 1906 .. 963 50 5•19 '~ 62:1 4 0'64 1,806 162 8·97 1907 .. 1,670 98 5•86 } 251 2 o·so 1,04:1 89 8•55 1908 .. 1,628 z 6•81 1,047 21 2•00 2,119 17:l 8•16 1909 .. 1,590 89 5•60 3,003 42 1•39 1,557 132 8•48

--- --~- ---- -~---

Average 1,412 85 6•01 1,154 16 1•23 1,572 135 8•64

The following table shows the number of cases reported during 1909, and their comparative prevalence in the undermentioned places :-

DlpMheria. s-111\lnll. Typhoid. --·

Area. ·-· --~·-·~·-·--~~.

Cases. Compara"ve Cases, Compara\ive Cases. Compara\ive Prevalence. Prevlllence. Prevalence.

-~-- -----

Metropolitan . . .. 893 2•74 2,223 14•31 399 1 Ballumt and Suburbs .. 138 5·36 17 1•37 H 2•33 Bendigo and Suburbs .. 46 1·93 38 3•34 229 7•82 Geelong and Suburbs .. 119 7•21 8 1·eo 36 1•77 Rest of State .. .. 394 1•00 717 3•48 819 1•70

W1wlc State .. . . 1,590 . . 3,003 . . 1,557 ..

The figures for comparative prevalence are worked out on a basis of numbers ?f case~ and their ratio to the ~opulation. ~he pla?e where the lowest ratio prevailed Is considered as one. Thus, m regard to diphtheria, the "rest of state " furnishes the lowest figure and is represented as " one." Thus, diphtheria in 1909 was 7 · 21 times more prevalent Geelong District than in "re'lt of state." Scarlatina was 14 · 31 times more p;:eva.lent in the Metropolitan Area than in the Gee long District, where the comparative prevalence was the lowest. The Metropolitan Area has the lowest figure for typhoid, and Bendigo and Suburbs the highest.

12

The following table show.3 the numbr:r of de:'\ths from diphtheria, scarlet fever. and typhoid in the .,)Ietl'opolitan Area and the Rest of State :--

I ~fetrop,,Jit:>" Are~. Rost of St~>te. Whole State.

Year. ·-·---····-------··· -~

I -·---- -- , ............ ---

Diph- Scarlet Typhoid. Diph· Scarlet Typhoid. Diph· Scarlet Typhoid. iheria. Fever. theria. l:-ever. theri:.. Fcvor. -·-·-- ---- - ----~--- ------------ -·-- ----- --~~

1890-189-i .. 166 5 205 153 37 lOO 319 42 305 .........

----~-------- ----·------ ·--------- 1------·· --- ---- ··-

1905 . . .. 43 3 41 37 7 80 80 10 121 1906 .. . . :32 2 46 18 2 116 50 4 162 1907 . . .. 52 1 48 46 1 41 98 2 89 1908 .. . . 52 6 61 59 15 112 Ill 21 173 1909 . . .. 48 28 48 41 14 84 89 42 132

1--

Average, 1905---1909 .. 45·4 8 48·8 40·2 7·8 86·6 85·6 15·8 135·4

Diphtheria. During the last five years the average annual number of cases was 1,412. The

year 1907 furnished the greatest number (1,670) and 1906 the lowest (963). For the quinquennium 1890-1894 the average annual number of deaths was 319. For the period 1905-1910 the average annual number was reduced to 85' 6-a decrease of 233 · 4. The decrease in the Metropolitan Area ha.s been from 166 to 45 · 4, and in the " Rest of State " from 153 to 40 · 2. The decrease, therefore, in the Metropolitan Area and the " Re:;t of State " is about on the same level. The only new factor in the treatment of diphtheria has been the use of antitoxin, and to this. curative agent must be attributed th•) remarkably improved mort:tlity rate. The concrete result of the use of antitoxin has been the saving of 233 lives per annum.

In New York the case mortality rate for diphtheria in the four years prior to the use of antitoxin was 34·9 per cent. In the peri0d 1897-1900 the rate was 13'6 per cent.

In London, amongst cases treated at the M.A..B. hospitals in 1888, the mortality was 59'35 per cent. In 1900 the mortality rate was 12'27, and in 1909, the last year available, the rate was further reduced to 9 · 7 per cent. The annual average case mortality rate in Victoria during the quinquennium 1905-1909 was 6· 01 per cent.­considerably lower than that of London. The case mortality of diphtheria in Victoria prior to the use of antitoxin is not known as case statistics were not fully kept. The fall in the number of'deaths, however, is eloquent testimony to a considerable reduction in the case mortality rate.

PROPHYLACTIC MEASURES.

As this disease is transmitted from person to person by medium of some infected thing or directly by personal contact, it follows that, if the patient is sanitarily con­ditioned until uninfective, the disease should not· spread. Experience throughout the world shows that some perdons harbor the germs long after they are quite well physically. These " carriers " are, doubtless, responsible for carrying the disease from season to season. It is obvious that, if the disease is to be mastered, no person suffering from diphtheria should be released from sanitary control until he is declared uninfective by a competent bacteriologist.

In order to further reduce the fatality rate, it is imperative that fresh antitoxic serum should be IJ'lll.de available for every sufferer. Owing to the expense, antitoxin is not used as freely as it should be, and deaths are reported where the antitoxin not been used at all.

Serum treatment generally is in the ascendant and the sera have, up to the present, been imported. There is no reason why they should not be manufactured in the Commonwealth, preferably under Governmental supervision. Such products would be fresher, and hence better, than imported sera, which necessarily are some weeks old on arrival here.

Scarlet Fever. For the period 1905~9 the arJI•.ul:\1 average number of

prevalence of the disease varies consici.e1·ably from ye~r to y~ar. 251 cases reported, ~:t.Jreas in 1909 the tota.l reached 3,ooa.

cases was 1,154. The ln 1907 th'3re were only

13

The following table shows the e:~se mortality r.-tte in certain places:-

Place. }forway. Hamburg. B~ckbolm.

Period. 10 years. 21 years.

Case mortality 16·3

---------·----~---

It is evident that the virulence of the disease in Victoria is not of a high order.

Typhoid Fever. The annual avera.ge

period 1890-1894 was 205. to 49.

number of deaths in the Metropolitan Area during the For the quinquennium 1905-1909, the average was reduced

In the "rest of state" for conesponding periods, the :figures were 100 and 86 · 6. In other word.~, while the annual deaths in the Metropolitan Area have fallen

76 per cent., those in t.he "rest of state " have only fallen 13 · 4 per cent. Thus the ratio of fall in the Metropolitan A.rea as compared with the "rest oi state " is as 5t is to 1.

The principal factor in the production oi the improved death rate from typhoid in the Metropolit:::m Area is, undoubtedly, the installation of the sewerage system. No curative agent of any great value has been brought forward in the treatment of typhoid during the period under review ; eonsequently, the good results cannot be attributed to agencies of a therapeutic nature.

The average annual case mortality during the period 1905-1909 throughout t.he whole State was 8 · 64 per cent. As might be expected from the severity of the ty])e admitted, the fatality mte at the Melbourne Hospital was higher than the rate for the whole State. For the five .rears ended with 1907, the fatality rate at the Mel­bourne Hospital was 10· 6 per cent.

For the period 1871-1907, the fatality rate of the case:. treated at the hospitals of the Metropolitan A;;ylums Board, London, was 16" 3 per cent., which is nearly twice the Victorian r'1te. The available :,ta.tistics, as regards liability to uttack, show that the disease :s uncommon under 5. After that age the liability increases until the age of 15 is reHehed. From 15 to 25 tlH; attack ra.tc remains high, but is on the down grade, and after 30 the liability decreases fairly rapidly. Above 60 the disease i;:; rare. The fatality rate is lowest between the Hges of 5 and 10. As the age increases after 10 so does the fatality rate. The experience gained at the Metropolitan Asylums Board as regards age shows that the fatality rate between the ages of 5 and 10 was 7 · 6 per cent., whereas above 50 years the rate was 32.4 per cent.

The following table shows the death rate per 100,000 living m certain countries :-

Deaths per Deaths per C:ounuy. Period. 100,000 Country. Period. 100,000

Population. Population.

-·-·------------~~ -·~--·~ --·- -~--~~-~ ---~--------~ --·-

Western Australia 1906-8 36•0 South Australia 1907-9 9•8 United States .. 1905-7 I 30•2 Ireland 1906-8 8•3 Italy .. 1906-8 I 26•9 Scotland 1905-7 8•0 Tasmania 1907-9 20·] Bngland 1096-8 7•8 France 1905-7 17•7 Sweden 1905-7 7•5 Austria 1901-6 17•3 I Holland 1906-8 6·9 Queensland 1907-9 1()•8 . New Zealand 1906-8 6•9 New South Wales 1907-9 16•4 Germany 1905-7 5·6 Japan 1905-7 I 12•8 Switzerland 1905~7 4•9 Belgium 1905-7 12•6 Norway 1905:_7 4•2 Victoria 1907-9 10·4

PROPHYLACTIC MEASURES.

The two main factors in the spread of typhoid are infective material and flies. If all infective material were destroyed, the prevalence of the disease would diminish. As long as the patient is obviously ill, precautions are taken, but when the patient is apparently well precautions are relaxed. Usually no steps are taken to ascertain

14

whether the patient is uninfective. In the interests of the community it is essential that the discharges horn a typhoid-infected person should continue to be destroyed until uninfective. It may not be financially practicable to bacteriologically examine freces from all cases, but it certainly is to test the blood. As long as the blood reaction is positive, precautionary measures should be taken. So far, the Widal test is mainly used as a diagnostic agent, but it is not commonly used as a means to ascertain whether the patient is uninfective. Precautionary measures should be continued for at least a fortnight after the reaction is finally negative. If these precautions were insisted on in every case, and food protected from flies, there is good reason to anticipate a further reduction in the prevalence of the disease.

Pulmonary Tuberculosis. In 1901 the Board declared pulmonary tuberculosis to be a "dangerous infectious

or contagious disease," and, in consequence, all sufferers became subject to the pains and penalties of the restrictive provisions of the Health Acts as regards dangerous infectious diseases.

In 1903 the Board declared pulmonary tuberculosis to be a notifiable disease within the Metropolitan Area, and in 1905 the notification provisions were extended to Ballarat, Bendigo, and Geelong. In May, 1909, the Board declared the whole of the State to be affected with pulmonary tuberculosis, and, consequently, it is now obligatory on the part of all medical practitioners throughout the State to report all cases coming under their notice.

Pulmonary Tuberculosis.

Dea~bs per 10,000 of ~he Popula~ion. - -· .. - -··

Period. Melbourne Ballarat Bendigo Victoria. and and and

Suburbs. Suburbs. Suburbs. ----·~·-----------~---·- --------·-

1891-1900 . . .. . . 12•57 16•7 17•1 24•1 ~---..--.~-·-

1901 . . . . . . .. 11•76 15·5 16•0 22•0 1902 . . . . . . .. 11·66 14•3 15•6 27•0 1903 . . . . . . .. 11•09 14•0 16•4 20•4 190! . . . . . . .. 11•11 13•5 17•1 22•3 1905 . . . . .. . . 10·19 U·2 11•5 :n ·8 1906 . . . . . . .. 9·88 11•5 13•2 21•7 1907 . . . . . . .. 9•58 11•6 10•5 20•2 1908 . . . . . . .. 9•55 11•5 13•3 18•4 1909 . . . . . . .. 8·47 9•9 9•4 22•9

-----Average, 1901-1909 . . .. 10•36 12•7 13•7 21•9

I

Since the disease has been declared notifiable, the diminution in the death rate has been distinctly marked in all parts of Victoria, with the exception of Bendigo, which has double the death rate of the State taken as a whole.

Pulmonary Tuberculosis. Death Rates in undermentioned countries:-

Batoe per ;

Baloe per Country.

i CounV)'. Year. 10,000 YeA!'. 10,000

Population. l'opulatlon.

Austria. . . . . 1906 31•5 Holland .. .. ' 1908 12•0 8flrvia .. . . . . 1908 31•2 England . . . . 1908 l1•2 Norway 1907 20·2 Belgium .. I 1907 10•1 . . . . lreland . . . . 19Q8 19•5 Victoria .. .. j 1909 8•5 !:lwitzerland . . .. 1907 17 ·2 South Australia •• I 1909 8•3 U<lrmauy . . .. 1907 15•7 Western Australia "6: 1909 7•2 Japtm .. . . . . 1907 15•4 Tasmania .. • • i 1909 6•8 Soai11 •. . . . . 1908 13•5 New Zealand .. • • ! 1908 6•4 Scotland . . . . 1907 13•5 New South Wales .. 1909 6·3 Ontario I 1906 13•1 Queensland .. .. i 1909 5•8

I

15

It will be noted that the death rates in Australasia eompare very favorably with those of the countries mentioned.

Victoria has the highest rate in Australia, and Queensland the lowest. The rate in England in 1908 was 11·2, whils1j Ireland rea.ched the comparatively

high rate of 19 · 5-a rate suggestive of poverty and insanitary conditions.

Whooping Cough. The prevalence and fatality rate of this disease in Victoria are not accurately

known, as reliable data are not available. The death rate per 100,000 living was 9 · 6 for the period 1907-9.

The following table shows the rate per 100,000 living in certain countries: -

Deaths per Period.

Deaths per Country. Period. 100,000 Country. 100,000

Population. Population.

---- -~---

Servia .. . . . . 1906-8 179•9 Norway . . .. 1905-7 16•7 Scotland . . . . 1905-7 43•0 Switze~land . . .. 1905-7 16•6 Austl)ia . . . . 1904-6 39•9 Western Australia

. .. 1907-9 15·0 Hungary . . .. 1906-8 37•7 Sweden . . . . 1905-7 14•3 Belgium .. . . 1905-7 34•9 New South Wales . . 1907-9 14•2 Prussia . . . . 1906--8 27•3 New Zealand . . .. 1906-8 13·6 England .. . . 1906-8 27•1 Tasmania . . . . 1907-9 13•0 Germany . . .. 1905-7 27•1 Queensland . . . . 1907-9 13•0 Roumania .. . . 1906-8 23•7 United States . . . . 1905-7 12•5 Spain .. . . . . 1906--8 21•8 Victoria . . . . 1907-9 9•6 Ireland . . .. 1906--8 20•4 • South Australia . . 1907-9 9•4 Holland .. . . 1906--8 19•6 Ontario . . . . 1904-6 8•{) Italy .. . . . . 1906--8 17•6 Japan .. . . . . 1905-7 6·4

The case mortality of those treated in the Edinburgh Fever Hospital for a period of eight years was 18 · 11 per cent., and of those treated in the Glasgow Hospitals 18 · 3 per cent. It is probable that only the severe cases are sent to hospitals, so that the percentage of deaths of the total cases will be considerably less than 18 per cent.

Measles.

The case mortality for measles in Victoria is not known, as the disease Is not notifiable.

In Edinburgh, where the disease is notifiable, the percentage of mortality is 4. The mortality in hospitals is higher, as the type of case admitted is more severe. The fatality rate in the Edinburgh Fever Hospital for the past nine years was 6 · 75 per cent., and in Glasgow it reached 9 · 1 per cent.

The following table shows the death rate per 100,000 living from measles:-

'I Country. Period.

Deat~ 100

l'opiii&tion. li Country. Period.

Deaths per 100,000

Population.

Hungary .. . . 1906-8 45•0 , Japau .. . . . . 1905-7 5•9 Spain . . .. . . 1906-8 38·5 ' Sweden . . . . 1905-7 4·9 Belgium . . .. 1905-7 31·8 New Zealand . . . . 1906-8 4·8 Scotland . . . . 1905-7 30·0 Western Australia .. 1907-9 4·6 Austria . . . . 1904--6 29·4: Norwav .. . . 1905-7 3·8 Italy . . . . . . 1906-8 29·1 Queensland .. . . 1907-9 3·5 England . . .. 1906-8 28·7 Ontario . . . . 1901-6 3·3 Holland . . .. 1906-8 26·0 New South Wales . . 1907-9 2·4 Germany . . .. 1905-7 18·6 South Australia . . 1907-9 1·9 Switzerland .. . . 1905-7 17·5 • Victoria . . . . 1907-9 1·8 Ireland . . . . 1906--8 13·9 Tasmania . . .. 1907-9 1·1 United States . . .. 1905-7 10·1

!

16

BACTERIOLOGICAL EXAMINATIONS.

By arrangement with the University, medical practitioners may send to Dr. Bull specimens of sputum for examination for tubercle bacilli, blood for the Widal test for typhoid, and swabs for the detection of diphtheria bacilli.

As the examinations are done free of cost to the sender, practitioners need have IW hesitation in freely availing themselves of the opportunity thus provided.

The following table shows the extent of the work done by Dr. Bull on behalf of the Board:-

Year. Diphtheria. Typhoid. Tnberde. ToW.

1903 599 504 739 1,842 1904 712 725 9li 2,349 1905 655 723 1,261 2,642 1906 715 887 1,238 2,840 1907 1,141 461 1,254 2,856 1908 1,792 799 1,291 3,882 1909 3,956 654 1,337 5,947

It will be noted that the number of specimens examined in 1909 was far in excess of any previous year. The remuneration received by the University was at the rate of 1s. 2d. per specimen. The cost to the Department compares very favorably with the charges made in England by private institutions for similar work.

Accm·IMODATION FOR INFECTIOUS DISEASES.

Metropolitan Area. The Queen's Memorial Infectious Diseases Hospital is the only institution within

the Metropolitan Area which receives persons suffering from infectious disease, and its accommodation is limited to the treatment of two diseases-diphtheria and scarlet fever.

The permanent buildings have accommodation for 50 beds on a full allowance of cubic space. In addition, there is temporary accommodation for 80 more beds, giving a total of 130 beds.

During an epidemic this number is insufficient to accommodate all cases seeking admission. During the recent epidemic of scarlet fever, accommodation had to be provided for 252 patients. To meet this difficulty tents were hastily erected, and the epidemic fairly satisfactorily coped with.

The average number of cases of diphtheria and scarlet fever per annum in the Metropolitan Area during the last ten years is about 1,200. The greatest number of cases reported in one year was 2,260. If all these cases were treated at the Infectious Diseases Hospital, and each case occupied a bed for one month, 190 beds would be required. As a matter of fact, however, these diseases occur in epidemics during a much shorter period than twelve months, consequently beds must be provided on a maximum basis, and not on an average.

The greatest number of beds occupied at any one time was 252. During this particular epidemic, about half of the reported cases were admitted to the hospital. Had all cases been sent, the management could not, under existing conditions, have admitted them.

At the lowest computation, 200 permanent beds are required for the needs of the Metropolitan Area.

Typhoid fever is admitted at all the general hospitals, and no difficulty has arisen in regard to accommodation.

As private hospitals are forbidden to take in cases of infectious disease, consider­able difficulty arises sometimes in regard to accommodation for persons suffering from non-notifiable infectious diseases-measles, for example.

It frequently happens that a vessel arrives with measles on board, and there is no place where the pat,ients may be sent. The same remark applies to persons acquiring measles while at a hotel in the city.

17

XIII.-THE PuRE Foon AcT 1905. The Pure Food Act 1905 has been in full operation since the lst July, 1906. Up to 1908 the work was conducted by one Food and Liquor Inspector. In 1908, five acting food inspectors were appointed. In 1909, two of them were made permanent; one was transferred to quarantine

work, and the remaining two are still acting temporarily. Two meat inspectors also devote any spare time to food inspection, and a

certain amount of food inspection, as applied to liquors, has been done by the Liquor Inspectors.

In 1908, the operations of the food inspectors were confined principally to the Metropolitan Area, and involved a large amount of educational work. Most of the large manufacturing firms and business establishments readily fell in with the require­ments of the Act, and numerous prosecutions were instituted against firms which showed unwillingness to do so. The results have been eminently satisfactory. Not only are the various conditions as to standards and labelling generally observed, but many firms now regularly consult the Department on doubtful points, and are advised accordingly.

In many instances retail vendors, and more particularly dairymen, have them­selves submitted voluntarily samples of their goods to public analysts, and have reported to the Board's officers in cases where such goods were found not to comply with the standard. As a corollary to these precautions, adulteration or non­compliance with the standards or labelling regulations has been traced to the fountain­head, and radical improvements have been effected.

A large amount of time and energy has been directed by the food inspectors to milk inspection, and there has been in consequence i:lo considerable falling off in the number of prosecutions for milk adulteration. In only one instance has a herd been found to give a milk averaging less than the standard of fatty solids (3 · 5), and in this case it was clearly demonstrated that the land was unsuitable for dairying purposes, and the feeding of the cows conducted on lines not at all conducive to the production of a good milk supply. This dairyman has ceased to carry on dairying operations on this particular farm.

Systematic sampling has been conducted on the streets, from transport waggons on the roads, at the railway stations, and at shops, dairies, and farm>.

In recommending prosecutions, due regard has been paid to the season of the year, and to any other circumstances which might affect individual cases. It may be safely said that in no instance did prosecution follow which involved undue hardship on a defendant or in which any reasonable doubt existed.

Amongst the principal causes of non-compliance with the stan~ard were :-1. Improper bulking at the farm. 2. Insufficient mixing before sale. 3. Removal of cream from milk. 4. Addition of water to the milk. 5. Addition of skimmed milk.

It has been ascertained that certain milk vendors carrying tins of cream in the cart for sale also carry milk much below the standard in fat, and remedy this defect, on the approach of the inspector, by the simple expedient "of emptying one of the tins of cream into the milk can.

Another common practice among certain vendors of milk is to empty the cans on the street on the approach of the inspector, leaving insufficient milk in the bottom of the cans for the three samples required under the Act.

In 1909 one of the food inspectors was detailed for duty in the country. He was directed to visit every municipal district in the State, to instruct municipal officers in their duty under the Pure 11-.ood Act, and to distribute as much information as possible amongst local tradespeople both personally and by means of the local press. This inspector was also instructed to keep supervision on country abattoirs, more par­ticularly in reference to the abominable habit largely prevalent in outlying districts of feeding pigs on raw blood and offaL This educational work of the inspector was much appreciated both by council officers and traders, and an eagerness and willing·· ness to comply with the Pure Food Act and Regulations shown in many of the districts visited.

Dating subsequent visits sa.mples were freely taken with a view to prosecution. J34"2. n

18

In many country districts marked improvement has resulted from these inspec­tions, but the weakness in the administration of the Act undoubtedly lies in the apathy shown by a large number of the local councils. Local inspectors, appointed at ridiculously small salaries, are usually men without previous knowledge or experience in the sophistication of food inspection, and with almost a complete ignorance of the Pure Food Act and Regulations.

Councils are required under section 17 of the Pure Food Act to send three samples of food per annum per thousand of the population ; but the manner in which the statutory obligation is complied with generally completely stultifies the original intention of the Act. A circular was issued by the Board drawing the attention of Councils to the advisableness of sampling local products, but the easier, and, it is to be feared, the more diplomatic, method of sampling packed articles of known repute is largely adopted.

In many instances the samples are taken en masse at the end of the year, instead of distributing the sampling throughout the year. The district is thus practically neglected in so far as regular and continuous inspection is concerned, an extra burden is thrown on the departmental analyst,· and vexatious delays and inconvenience follow.

It is to be regretted that so little attention is paid by many local Councils to the regulations under the Pure Food Act providing for cleanliness and protection of food from dust and flies, whilst other regulations as to labelling, &c., intended to protect the public from fraud, as well as to provide for a pure and unadulterated food supply, are equally ignored.

Briefly stated, the administration of the Pure Food Act by many of the muni· cipalities has been a failure, and the principal factors contributing to this lamentable state of affairs may be summed up as follows :-

1. Inexperience and want of knowledge on the part of the local inspectors. 2. Lack of security of tenure of office. 3. Local influences. 4. The infliction of small fines, and in some cases no fines.

In this connexion it is only fair to state there are honora ble exceptions. Some Councils make every effort to carry out the provisions of the Act. There are also many Councils which would willingly relinquish their powers under the Pure Food Act to the Board, and would be prepared to subscribe to any scheme which would provide for the total administration of the Act by experienced and independent officers under the Board.

An amendment of the Act compelling Councils to furnish a proportion of the annual statutory number of samples during each quarter of the year is desirable. Councils not employing the Government Analyst should be required to send a copy of the analyst's certificate of every article analyzed immediately on completion of the analysis. At the present time such returns are only received in bulk with Councils' annual reports. Councils should also be required to furnish a return quarterly of the action taken by them each case of adulteration, of all prosecutions, and the results of such prosecutions.

Experienee has shown that the Pure Food Act, like other heeJth statutes, reveals certain vulnerable points, which should be remedied in an amended Act. Section 8 provides for a sample of any article of food seized under any provisions of the Health Acts being forwarded to consignor or consignee. This would be impossible in the case of a portion of a carcass of meat. If it were proposed to take action under section 16 of the Pure Food Act against the person named on the package, as well as against the vendor, a fourth part of the sample would be necessary.

Section 9 provides that articles of food proved by analysis to contain any prohibited substance may be seized. This should be amended to include any article of food not otherwise complying with any of the provisions of the Health Acts.

In section 21 the limit of time for prosecutions and summonses should be repealed, as it frequently leads to a miscarriage of justice and is, in fact, detrimental to the defendant in many cases, where a reasonable defence may be forthcoming.

Section 42 provides for the registration of ice cream and aerated water factories, but no provision is made for the inspection of such factories prior to registration. Many factories thus become registered by the Board which are afterwards discovered to be most unsuitable premises for the purpose.

19

Provision should also be made in an amendment of the Act for the inspection .and licensing or registration of restaurants, or other establishments in which public meals are served or food for human consumption sold.

The following are particulars of samples taken by the departmental inspectms in 1908, 1909, and 1910 :-

Number of samples taken Number adulterated .. Number of prosecutions for adulterations .. Number of prosecutions for breaches of la belling regulations

1908.

1,705 137 87 39

1909.

1,945 195 135 58

1910.

1,704 180 53 24

The following statement will serve to show to what extent the requirements of sub-section 4 of section 17 of the Pure Food Act were observed by Municipal Councils during 1908, 1909, and 1910 :-

1908. 1909. 1910.

Number of Councils in the State 206 206 207 Number of samples required to be taken, calculated on

basis of total population 3,500 3,552 3,615 Number of samples actually taken 3,173 3,544 4,552 Number of Councils which took the statutory number or

over .. .. 76 108 171 Number of Councils which took samples, but less than the

statutory number 34 38 19 Number of Councils which took no samples 97 61 l7 Number of samples adulterated or otherwise not in com-

pliance with the law 403 232 215

The following Councils have not complied with section 17, sub-section 4, of the Pure Food Act, by forwarding the requisite number of samples of foodstuffs for analysis:-

Boroughs-Browns and Sca.rsda.le Buninyong Carisbrook Chewton Da.ylesford

~shi:res-Alberton Alexandm Ara.piles Amrat Avoca. Avon Ballan Barrabool Bellarine Benalla Birchip Borung Bright Broadmeadows Bulla Buninyong Chiltern De akin Donald Doncaster Dnnm.unkle

1908.

No Samples Submitted. Boroughs­

Dunolly Inglewood Koroit :Majorca Malmsbury

Shires-East Loddon Ferntree Gully Flinders, Kangerong Frankston, Hastings Gisbome Goulburn Grenville Healesville How.qua Huntly Karkarooc Keilor Kerang Kilmore Korong Kowree Lancefield Leigh Lilydale Ma:ffra

Boroughs­Portland Port Fairy Raywood Rutherglen Smythesda.le

Shires­Maldon Mansfield Marong Meredith Merriang Metca.lfe Minhamite Mi:rboo Mornington Morwell Mount Alexander Mount Franklin Mount Rouse Newham &Woodend NewsttJad North Ovens Omeo Oxley

Boroughs­Stawell Tal bot Tarnagulla

Shires-Pyalong Rochester Rodney Romsey Rosedale Rutherglen South Barwon South Gippsland Springfield Stawell Strathfieldsaye Tal bot Tambo Upper Yarra Violet Town Waranga Winchelsea

Phillip Island, W oolamai Preston

Wodonga Woorayl Yea

Citv­Brunswick

Boroughs­Ararat Castlemaine

Shires­Beech worth Berwick Bet Bet Bunga.ree Creswick Dimboola

Boroughs-Browns and Sca.rsdale Buninyong Chewton

Shires­Alberton Alexa.ndra Arapilea Ararat Avoca

.Avon Ball an Baua.bool Belfast Benalla Bray brook Bright Bulla Bungaree Buninyong Chiltern Deakin Don caster

C~tv­Collingwood

Town-Kew

Rorough­Coburg

Bhires-Bacchus Marsh Bellarine Bez:wick Borung

Borough­Oakleigh

Shires­·Benalla. Broadford Howqua Huntly

City-St. Kilda

Shires­Ballara.t Berwick Cranbourne Dimboola Dona.ld :Frankston & Hastings

20

1908--continued. Samples Submitted. but not Full Number.

Borough­Echuca

Shires­Glenelg Glenlyon Kyneton Lawloit Lowa.n Mildura

City­Malvern

Borough­Hamilton

Shires­Mulgrave Mclvor Narracan Portland Ripon Seymour

1909.

Borough­Wangaratta

Shires­Shepparton Traralgon Tungamah W arrnam bool Yackandanda.h

No Samples Submitted. Boroughs­

Inglewood Malmsbury Port Fairy

Shires-East Loddon Flinders & Kangerong Frankaton & Hastings Goulburn Grenville Healesville Howqua Keilor Kerang Kilmore Korong Kowree Lilydale Maffra. Mansfield Marong Melton Merriang

Boroughs- Borougha-Rutherglen St. Arnaud Smythesdale Talbot Stawell Tarnagulla

Shires- Shires-Metcalfe Rosedale Mirboo Rutherglen Mornington South Barwon Mortlake South Gippsland Morwell Springfield Jl.iount Alexander Stawell Mou.'1t Franklin Strathfieldsaye Mount Rouse Talbot Mulgrave Upper Yarra Mclvor Violet Town Newstead Walhalla North Ovens W aranga. Oxley Winchelsea Phillip Island and Woo- W odonga

lamai Woorayl Pyalong Wycheproof Ripon Yackanda.ndah Romsey Yea

Samples Submitted, but not Statutory Number.

Town­Northcote

Borough­Cresv.>i.ck

Shires­Creswick Dim boo la Dunmunkle Huntly

Shires­Kerang Metcalfe Mirboo Moorabbin

City­Footscray

Town-Williamstown

Borough­Hamilton

Shires­Karkarooc Kyneton Lawloit Lexton

1910. No Samples Submitted.

Mornington North Ovens Springfield Strathfieldsaye

Samples Submitted, but not Statutory Number.

Shires­Korong Lowan Merriang Mulgrave Narracan N ewhair, & W _,:,deud

Shires­Numurkah Omeo Poowong & Jeetho Rochester Uodney Shepparton

Borough­Wangaratta

Shires-Newham & Woodend Omeo Portland

Shires­Wannon Yarrawonga

Shires­Swan Hill Waranga Whittlesea.

21

XIV.-Foon STANDARDs Co11rMITTEE. In June, 1909, Dr. Norris was appointed Director of Quanmtine, under the

Federal Government, and resigned from the Stute Service. Dr. B. Burnett Ha.m, Commissioner of Health for Queensland, succeeded him as Permanent Head of the Health Department, Chairman of the Board, and Chairman of the Food Standards Committee.

In June, 1910, Mr. C. Pleasance resigned from the Committee on account of continued ill-health.

Mr. ,V. Trathen also accepted an appointment under the Federal Government, and Mr. J. J. O'Hara, an officer of the Health Department, was appointed Secretary to the Committee.

The Committee resumed its duties on 18th August, 1908, and up to the end of 1910 had held 17 meetings, 3 in 1908, and 14 in 1910. For the convenience of manu­facturers, importers, and others, whom the Committee may wish to examine or consult, the meetings are held at night at the offices of the Board of Public Health.

A vast amount of information collected by the Board of Public HeB.lth was placed at the disposal of the Committee. This included the laws, regulations, and standards in force in many other countries ; official reports of the experience of bodies or officers administering such laws; works by the most eminent and recognised authorities, and records of analyses of samples of various foods taken for many years in this State and elsewhere. From time to time throughout the period in which the Committee was engaged in its work, the evidence and views of a large number of persons engaged in the production and manufacture of foodstuffs proposed to be dealt with were also taken. Scientific and practical experts were examined ; deputations from associations or other bodies interested were interviewed, and exhaustive precautions were taken with the object of formulating standards which would secure wholesome and genuine articles of food to the consumer without inflicting undue hardship on the producer.

During the period covered by this Report, a large number of standards were prescribed, the standards fixed in regard to milk, concentrated and condensed milks, and vinegar reconsidered, and the matter of prescribing methods of analysis for articles of food determined.

As stated above, the Committee did not resume its sittings until August, 1908. A reasonable period had thus been allowed to elapse for the Board to carefully consider the recommendations made to it, to translate them into regulations, and to determine the time when they should take effect. As the time fixed in some cases extended to 31st December, 1908, it was felt by the Committee that further time should be allowed for the regulations to have full operation. This seemed the more desirable as repre­sentations had previously been made, by a large deputation representing the principal commercial bodies and trade associations of the State, with regard to the difficulty of tracing the whereabouts of packages of food, and which were defective only in regard to labelling.

Moreover, experience had shown that the written assurances given by com~ mercial bodies, welcoming the introduction of the regulations, had been followed by active co-operation in securing their observance. The Committee, therefore, deter­mined to postpone the introduction of additional standards, and to allow time for the community to become thoroughly familiarized with those already in force.

As the result of a discussion in the Legislative Assembly during consideration of the Estimates, the Minister of Health referred the question of the standard for fresh or market milk to the Committee for further consideration. The retail vendors had objected that the standard of 3 · 5 per cent. of fatty solids was too high, and, in urging a reduction therein, advocated that a system of "average" sampling should be initiated.

After exhaustive consideration the Committee unanimously decided not to modify the standard. It also recommended the Minister to obtain power for the Board to prescribe methods of sampling. This has since been done, all Municipal Councils being apprised of the best methods for their inspectors to follow when taking samples for analysis.

Since the introduction of the regulation on the subject great improvement has taken place in the composition and the labelling of infants' foods. .

In May, 1908, the Conference of Premiers and Ministers adopted a resoluti<:-n that " uniform legislation for the standardization of Australian manufactured food

1342. ~

22

products is desirable." On 12th August, 1909, the Premier of New South Wales wrote that he had received draft standards from several of the States, which showed considerable divergence of views.

After some further correspondence, a Departmental Conference (Commonwealth and States of Australia) on uniform standards for foods and drugs, was held at Sydney in June, 1910. Vict0ria's representatives were:-

Dr. B. Burnett Ham . . Permanent Head of the Department of Public Health, Chairman of the Board of Public

Mr. P. Rankin Scott Mr. \V. Harper (of Messrs.

Robert Harper & Co. Ltd.)

Mr. A. R. Bailey

Health, and of the Food Standards Committee. State Government Analyst.

Commercial Member of the Food Standards Com­mittee.

Pharmaceutical Member of the Food Standards Committee.

During some months immediately preceding the Conference the Committee formulated several standards for submission to the Conference, and it is gratifying to know that the Report of the Conference reflects in no small measure the Viciorian regulations and recommendations.

XV.-MEAT SUPERVISION.

The original Meat Supervision Act came into force on 1st March, 1900, and applied only to the Metropolitan Area.

On 23rd December, 1901, an Amending Act was passed which gave power to the Governor in Council, on the application of a Council, to apply the provisions of the Meat Supervision Acts to a Municipal District, or part of such District.

The object of these Acts was to provide for proper inspection of meat intended for human consumption within a Meat Area. All animals killed within a Meat Area must be examined alive and their carcasses and viscera inspected after slaughter.

A provision in the Principal Act allows persons to bring to an appointed place in a Meat Area for inspection carcasses which have been fattened and slaughtered on their own premises outside a meat area. This provision was primarily intended for the benefit of farmers, but, owing to the ambiguity of the expression" fattening," butchers and dealers have taken advantage of it, with the result that there is a considerable quantity of meat consumed in meat areas which is limited to a carcass inspection only. Carcass inspection is not satisfactory and should be reduced as far as practicable.

To secure this desirable end, it is advisable that the Act should be amended so as to exclude dealers and butchers from participating in a privilege that was intended for bona fide farmers only, and limiting such inspections to calves only.

On 2nd March, 1909, the Meat Supervision Act was further amended so as to include bacon. Until this amendment was passed, bacon was freely admitted to every Meat Area without having undergone inspection. Now, however, no bacon (except imported bacon) is admitted into a Meat Area unless the animal from which the bacon is manufactured has been inspected while alive and the carcass and viscera examined after slaughter.

All bacon, except imported~ bacon, must now be branded in the same manner as fresh meat.

This amendment, bringing bacon under the provisions of the Meat Supervision Act, necessitated special arrangements being made for the inspection of bacon.

The following new Meat Areas were declared at the request of the respective Councils:-

Farmer's Bacon Factory N ewnham' s Bacon Factory Mitchell' s Bacon Factory Holman and Still's Bacon Factory Boyd's Factory

Ballarat East. Newham. Lilydale. Kilmore. Kilmore.

Hutton's and "\Vatson and Paterson's bacon factories, Prestont were already in the Metropolitan Meat Area.

23

The Municipal Councils waived their rights to appoint Meat Inspectors under the Meat Supervision Act, and the Board appointed five {5) qualified Inspectors to inspect bacon, and fixed fees to meet the cost of inspection. So completely has this arrangement worked out that, although the highest fee paid by any one is 6d. per carcass, the revenue has proved more than sufficient to cover all costs of inspection.

Fresh, frozen, and chilled meat may be brought into this State, provided it is accompanied by a certificate of soundness from a Government Inspector, and when exposed for sale it must be labelled " Imported." Imported meat in any other form may be sold, provided it is so labelled,

The onus of proof that unbranded meat is "imported" lies on the vendor, but often he is not in a reasonable position to furnish such proof, the Government certificate from the country of origin applying to the wholesale consignment and not to individual carcasses. It is thus possible for a butcher to sell the meat derived from an illegally­killed animal as imported and frustrate the intentions of the Act. The conditions governing the importation of meat are not satisfactory.

Imported meat in any form should be accompanied by a Government certificate of freedom from disease and on arrival here it should be inspected and branded, and so abolish the unsatisfactory method of labelling the meat "Imported."

Imported comminuted meat in any kind of receptacle should a1so be accompanied by a Government certificate, and subjected to such examination here as is practicable.

Section 7 empowers Councils to appoint Meat Inspectors, but the Act does not provide for the appointment of Meat Inspectors by the Board, except under Section 8, which gives the Board power to appoint where the Council fails to do so. In the case of isolated districts, or for export purposes, or for the purpose of inspecting a number of abattoirs by means of one inspector, &e., the Board is often in the best position to conveniently appoint an inspector. An amendment should be made giving the Board sole power to appoint [\nd control such inspectors.

Section 30, sub-section 1, clause 3.-The words " in the event .. of such meat being fresh, frozen, or chilled " should be repealed.

Section 30, sub-section 2, prohibits the sale of carcasses of calves less than 14 days old, or if less than 14 days old then: of less weight than 40 lbs. This should be amended to read not less than 14 days old and not under 50 lbs. weight.

Section 36 should be repealed.

Section 43 gives power to seize unbranded meat in a Meat Area, but no power is given to prosecute a person for having unbranded meat in his possession in a Meat Area, unless he sells, or attempts to sell, or exposes for sale. Section 30 should be amended to include under sub-section 1 "or have in his possession."

Section 44 empowers Councils, \\"i.th approval of the Board, to make regulations as to the conditions of inspection of meat, &c., and the Board may call upon Councils to make regulations, but cannot dictate to them the form which such regulations shall take. In order to secure uniform and efficient action, many of the powers provided for in section 44 should be transferred to section 45, which would transfer such powers from Councils to the Board.

Section 45 empowers the Board to make certain regulations confined principally to the conditions under which meat shall be inspected and branded.

This section should be amended in the direction of prescribing definite Regula­tions as to the quality of the meat to be inspected and the parts of the carcass necessary to condemn.

The section of the Act dealing with the ownership of brands is unsatisfactory. Councils under the present Act provide their own brands. These brands may become lost, discarded brands may come into the hands of outsiders, or imitation brands may be made by unauthorized persons ; and in the case of illegal brandina of meat the difficulty of proof is almost insuperable.

0

An amendment empowering the Board to own and register all brands used. in meat inspection would probably get over this difficulty. All brands would then become the property of the Board, and could be leased to, and would have to be accounted for by, the Councils to which they were issued.

24:

The Amende(l i"leat Supervision Act 1901 (No. 1774).

. Section 12 :rrovides tlu~t may r,pply to the Governor in Council to ~rthdraw from the ::\feat Area, and the Governor in Council may, by order published m .the Gorermnent Gazette, cancel the D.pplieation of such Acts to such District, &c. TJns should be amended to read "on ~tpplication of the Board." .

Section 15 gives power to seize and remove the carcass of a calf under the prescribed weight or age. This section should be amended that "such person in whose possession the carcass may be found shall be deemed to have committed a breach of the Meat Supervision Art, and may be punished accordingly."

Section 16, empowering the Board to make regulations under which meat may be exported without branding, should be amended.

Sub-section 1, "or an Inspector of Export Products" should be repealed. Sub-section 2.-" Inspector of Export Products" should be repealed, and ":Meat

Inspector " substituted. In the same sub-section the words " Exports Products Act " should be repealed, and the words " Commerce Act " substituted.

XVI.-GoVERNMENT SANATORIA.

I.-GREENVAJ.E SANATORIUM.

Official records show that the death-rate of phthisis (consumption of the lungs) has fallen from 11.11 per 10,000 in 190-1 (the year immediately preceding the estab­lishment of Green'Vale Sanatorium), to 8. 24 in 1910, the greatest reduction having taken place in 1909, when the deaths from the disease fell per 10,000 from 9. 55 to 8 .47. The influence of sanatorium treatment, and especially of its educational side, has, it is believed, been a distinct factor in the comparatively greater reduction during these years. The saving of lives at this mtc is a, great economic gain. Dr. Herman Biggs, in estimating the annual loss from tuberculosis in the United States of America, puts a value of £300 on each life at the average age at which deaths from tuberculosis occm. On the same basis of calculation, the totallQ:'>S to Victoria for 27 years, ending 1907, was £16,739,360, or an annual loss to the State dming that period of £619,796.

The total sanatorium accommodation available is as follows:-

Greenvale .. Amherst Daylesford ..

Total

Opened. Beds.

.. May, 1905 .. December, 1908

.. November, 1908

90 (60 males, 30 females) 32 (all females) 12 (all females)

. . 134 (60 males, 7 4 females)

Cases Treated \o Date,

31st December, 1910. ------ -----------

1,494 254 105

1,853

There is also accommodation for 20 advanced eases at Austin Hospital, for which the Government pays £800 per annum (20 beds at £40 eaeh).

The total expense of maintenance borne by the Government in connexion with the above cases to 30th June, 1910, was £25,098, or about £5,000 per annum.

On receipt of application full instruetiOJcS n.re forwarded to applicant and his medical examination arranged for. Should his case be adjudged suitable he is promptly admitted to Greenvale, a special cab being provided for conveyance of patients from :Melbourne to the sanatorium and back on their discharge.

Should there, however, be no vacant bed at Greenvale, the applicant, if a female, is sent to Amherst or Daylesford; all arrangements being made by the Department to facilitate the journey and admission to the sanatorium.

In the absence of accommodation for more advanced cases, the patient is notified that his case is not suitable for ihe sanatorium. He is, however, advised to apply in his home, as fa.r as practicable, the precautionary and curative measmes contained in the sanatorium booklet supplied to him. On the completion of the Home now being erected at Cheltenham the difficulty in connexion with these cases will disappear. So soon as a patient is admitted to a. sa.natorium, the local Council of the district where the patient resided is notified, in order that the necessary disirfection of the home, especially of the sleeping and sitting rooms, may be carried out forthwith.

25

"' Educational " cases are regarded as a very important class of patienf ; these cases, man? fairly advancPd, enter tl;_e for one month and lcmrn the treat~ 'nlent; heing thus taught how to prevent spread of the-disease themselves to •o th. P.rs.

The keynote sanatorium work is sympathy. This, allied to persua~i?n and advice, has produce?! results gratifying alike to the patient and to the admmiS­tration. .. . 1'he following medical practitioners kindly act as honorary medical examiners ~or State_ Sanatoria D. Grant, Dr. Janet Greig, Dr. Mary Henderson, Dr. J. F. Mackeddie; Dr. J. W. Springthorpc, Dr. R. R. Stawell, Dr. W. H. Summons, Dr. J. F . . \Vilkinson, Dr. H. W. Bryant, D:r. E. H. Emblcy, Dr. A. "\V. D. Robertson, Dr. D. S. MacColl, Dr. L. S. I.atham, Dr. S. A. Ewing, Dr. L Henry, Dr. W. E. Summons (Bendigo), Dr. P. H. Cunningham (Talbot), Dr. P. Liddle (Daylesford), Dr. W. A. Reid (Sale), Dr. P. G. Dane (Balhrat), and Dr. T. J. M. Kennedy (Geelong).

Nca..rly 1,800 cases have been examined by them since 1905. The whole of the annual Parliamentary grant is expended directly on treatment

and maintenance of patients, and on the general upkeep and improvement of the institution. The work performed by the e:xamining medical officers and by the officers of the Department involves no extra expense to the State.

Early in 1910, Miss Harkness, who had been matron since the opening of the Institution in 1905, resigned. She has left behind a record of earnest and valuable service. 'The Government was fort-unate in being able to fill the vacant position by appointment of 1\liss :M. Raye, who had just returned from England, after studying and practising sanatorium methods there. Tho Sanatorium is now recognised by the Royal Victorian Trained Nurses' Association as a special training school for nurses. It will be of advantage to the public as well as the r.ursing profession for nurses to have special sanatorium experience.

The medical nursing staff engaged at the sanatorium is 19, consisting of the medical superintendent, the matron, 1 sister, 1 staff nurse, and 6 assistant nurses. .

Certain of the domestic work of the institution is carried out as far as possible by ex-patients who, for a small wage, stay on and continue the treatment under super* vision, there being at present five of them on the staff-two females as wardsmaids, and three males.

IJ .-AMHERST SANATORIUM.

(Report of Dr. P. H. Cunningham, Medical Superintendent).

The Amherst Sanatorium in connexion with the Amherst District Hospit~l, is situated within 3 miles of the township of Talbot, which is on the line of railway con· necting Ballarat with Castlemaine. Talbot is distant from Melbourne 108 miles by Ballarat, and 121 miles by Castlemaine. The train service is very convenient, four trains daily arriving and four trains departing from. and to Melbourne.

The Sanatorium is placed at an elevation of 820 feet above sea-level. The grounds comprise an area of not less than 140 acres in extent. The soil is of a dry, sandy, and gravelly nature, with a reddish clay subsoil. The drainage is perfect, from the character of the surrounding country which is gently undulating and is more or less covered with timber.

This growth of timber within the grounds affords shelter and protection from the south, the direction from which the cold winds blow.

The month of February is generally looked upon as the hot month of the year but it is only at intervals of years and in particularly hot geasons that the nights ar~ hot. Such .hot night~ do not come oftener than two or three in any one season, and never come m succession.

The district is very free from fogs, and, as a matter of fact, could hardly be said to exist. Altogether, for the greater part of the year th-e climate is fine and bracing, and the district is considered as eminently suitable fo::: the treatment of consumptive patients. Since the date of opening on the 22rld December, 1908, to the 31st December, 1910, 263 patients were admitted to the Sa::atorium. Of this number 202 were discharged with the disease arrested or the lu.ag condition much improved; 30 were returned as incurable or as not l1av.ing :responded to treatment, and so lost ground; 3 left at their own request or on other grounds; while 28 remained in for treatment at the end of the year.

26

There were no deaths to record, which circumstance is considered a favorable factor in support of this district beir;.g a good one for the treatment of such cases as seek admission into Sanatoria.

Up to December, 1910, 32 was the greatest number of patients we could admit. Provision is now being made by which an additional30 patients may be accommodated.

III.-DAYLESFORD SANATORIUM.

Report of Dr. Percy Liddle, Medical Superintendent. The site-about 1,800 feet above sea-level-is situated on a hill, and has an

area of about 6 acres. There are two permanent wards containing twelve beds, but no tent wards.

Since the date of opening, 22nd December, 1908, until 31st December, 1910, 105 patients were admitted to the San:1torium. Of these, 72 were discharged with the disease arrested or their condition much improved, 10 were incurable, 6 were dis­charged at their own request or on other grounds, 6 died, and 11 were undergoing treatment on 31st December, 1910.

The early cases have done admirably, and I am of opinion that the Sanatorium here is well suited for treatment of such cases.

The comparatively large number of deaths was due to the fact that many cases, on admission, were in advanced stages of the disease.

The average stay of patients in the Sanatorium was 80. 68 days.

STATISTICS OF STATE SANATORIA FOR THE TRIENNIAD 1908-9-10.

Accommodation.

- Green vale. Amhers,, Dayl~~tord. Total.

----No. of Beds for InmD.tes .. . . No. of Tent Wards . . .. No. of Large Permanent Wards . .

No. remaining on 1st January, 1908 from 1907

Admissions

Discharged-Disease arrested or condition much i.'U-1

proved . . . . . . . . Incurable .. At own request or on other grounds

Deaths Remaining, 31st December, 1910

Total ..

. . .. 90

.. . . 9

. . .. 2

Patients.

Greenva!e.

Males. Females. -········~

15 17 559 389

---- --574 406

----

373 277 71 32 95 76

2 0 33 21

----574 406

32 12 134 5 0 14 I 2 5

Amhers,, Daylesfnrd. Total.

Total. Females. Females. ~-- --~-~

32 .. 948 263 105 1,316 ~- ---------~- ----- -----980 263 105 1,348 !~- ~-- ------

650 202 72 924 103 30 10 143 171 3 '6 180

2 0 6 8 .54 28 11 93

---- ---- ----- --~-980 263 105 1,348

The average stay of patients in Sanatorium was-Greenvale, 80 days ; Arnherst, 73 days ; Daylesford, 80.68 days.

Since its opening in May, 1905, until December last, 1,494 patients had been admitted to Greenvale Sanatorium ~ of these, 987 had the disease arrested or. thf;ir condition much improved, 180 were incurable, 5 died (4 men and 1 w.oJ?an), 268 we:e discharged at their own request or on other grounds, and the remammg 54 are still in the institution.

27

XVIL-RAT DESTRUCTION.

Report by Inspector Hughes. Notes on the above for period dating from 1st September, 1909, to 31st December,

1910:-The staff employed consists of three rat-catchers and a supervising officer. The areas worked comprise the north and south river wharves, Victoria Dock,

Port Melbourne foreshore, "\Villiamstown foreshore, &c., and the Yarraville wharves. The methods of destruction employed were trapping, poisoning, and hunting

with dogs. Bacteriological examinations of fleas taken from rats trapped alive have been

made by Dr. Tidswell of Sydney, who reported that only one specimen of the number examined was of the species " Pulex Cheopis."

Rats have been submitted to Dr. Johnston for examination at various times, and found to be free from any trace of plague infection.

The actual number of rats trapped was 6,703, of which 6,096 were of the Mus. Decumanas type, 547 Mus. Ratius, and 60 Hybrid.

The poison used, and with signal success, was "Rat-death."

CoNCLUSION.

The work performed by the Board during the period covered by this Report has been further instrumental in revealing the inadequacy of the Acts in enforcing requests or orders issued by the Board, which should have been promptly obeyed.

Municipalities in many instances display apathy or indifference in their dealings with the Board. It is respectfully submitted that if municipalities generally endeavour to meet the Board's requirements promptly, much unnecessary waste of time would be avoided, and the public wants generally be more satis:factorily attended to.

All of which is respectfully submitted.

B. BURNETT HAM, M.D., D.P.H. (Camb.),

T. W. H. HOLMES, Secretary.

FRED. GEO. WOOD.

W. BURTON.

IN. H. TREGANOWAN.

JOHN BARAGWANATH.

J. f. CAROLIN.

JAS. J. BROKENSHIHE.

A. H. SMITH.

HERBERT A. AUSTIN.

--------~---By Autllority1 : J. X:Dl'P, Gonm1111cal hmtct, :.bl!lolll'M.

Chairman.