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There is reason to believe that the disease died out about
the middle of the year. The causation of such an outbreak
of zymotic disease is of great importance to the inhabitants
of this sub-district, and the subject has given me no little
thought and concern. The inherent difficulty in tracing out
the causes of a disease, the nature and history of which are
not yet thoroughly understood is one which the medical profession
fully recognises. This difficulty is increased by the
obstruction to most sanitary operations on the part of
the public, and by the natural hostility of those whose
interests are likely to be affected by any inquiry or the
changes which may arise from it. One supposed cause
which naturally excited anxiety then and now was the
condition of the sewers in the district, but the careful examination
to which of course they were subjected, revealed no
serious defect in the system. No changes were required in
their construction or management, and yet the disease has
died out, a fact strongly bearing out the opinion that the
cause could not be traced to them. In every case as