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17 deaths from diphtheria during the year. In all cases
where diphtheria has occurred the drains have been examined,
and in some cases found defective; but in the present condition
of medical knowledge, the origin of diphtheria is still
in doubt: and though sanitary defects of any kind are certainly
most conducive to the spread of the disease, in many
cases in this District it was impossible to discover the source
of the infection either from milk or drains. Though there
was a considerable amount of scarlet fever during the year
it was of a very mild type, as shown from tho fact that,
although there were 413 cases notified, there were only four
deaths The mildness of the type was to a great extent tho
reason of the large number of cases In several instances
on going to see cases in crowded neighbourhoods which had
been notified, I found other members of the family peeling
from the disease. The parents had not noticed anything the
matter with them, and had consequently allowed them to go
about and thus spread the disease. The notification of
infectious disease has been of the greatest assistance in
checking the spread of infection in such cases, and the longer
one sees the working of this Act tho more one sees its value.
During August and September of 1892, this country
was threatened with an epidemic of Cholera, which, however,
fortunately was averted by the prompt action of tho Port
Sanitary Authorities. All persons on arriving at our ports
from abroad were obliged to inform the Port Sanitary
Authorities as to their destination. The Sanitary Authority
then at once communicated with the Medical Officer of
Health of the district to which such person intended to travel.
It was then the duty of the Medical Officer of Health of this
district to keep himself acquainted with the health of the
suspected person; and in the event of his leaving that district,
to communicate his address to the Medical Officer of
Health of the district to which he was going. In this
manner several cases were traced, and isolated immediately
any signs of the disease showed itself, and the infection of
others prevented. This system is still at work, and will, I