On Wednesday, at the meeting of the Rushden Urban Council, Dr. H. S. Baker, Medical Officer of Health, presented his annual report, from which we take the following important extracts:-

The Rushden Urban District is situated about the middle of the Eastern boundary of the County of Northampton, being wholly situated within the county. On its Southern and Eastern sides it is bounded by the county of Bedfordshire.

The surface of the district is undulating and extends roughly about 5 miles from North to South and about 3 miles from East to West at their maximum limits, comprising a superficial area of 3,777 acres. A brook runs through the inhabited area from South to North, open in parts but closed in by culverts wherever it is necessary to carry the roads and footpaths across it, and having its bed bricked over, thus rendering it more easy of cleaning.

The High-street, divided at the Church into a North and South portion, follows mainly the course of this brook, and from this thoroughfare the streets on the Eastern side rise by more or less steep gradients, while on the Western side they dip slightly at first to rise eventually to the Wellingborough-road plateau. The surface of this street and of all the main roads are kept in excellent condition in spite of the heavy traffic they have had to bear since the advent of the motor buses; even the side roads and streets will bear healthy comparison with many main roads in the neighbouring districts.

The grasslands known as “The Meadows” on the Northern boundary which is formed by the river Nene, flooded largely in the rainy season by overflow from this stream, render an admirable grazing ground for cattle, or if laid for mowing, produce plentiful crops of hay. There are several portions of the area set apart as allotments for use of the work people, while the rest of the area not built upon is all used for the usual agricultural purposes; there is no waste or unproductive land in the area forming the district.

Social Conditions

The inhabitants of the district are almost wholly occupied in the production of boots and shoes, together with the allied and contingent industries of leather dressing and engineering machinery used in the manufacture of boots and shoes – which fortunately is one of the industries where the demands have been increased during the latter part of the year by large orders for our own and some of the Allied Governments, so that since August up to the present time unemployment has been unknown; indeed, many of the manufacturers have been hard put to it to get sufficient hands to replace those that have volunteered for the various military services of the country – and overtime has been the rule rather than the exception in most of the factories, a feature not to be desired for the physical well-being of the community at ordinary times, but which under present needs cannot be other than looked upon as necessary, for it is equally important for all of us to put in all we can and of our best as it is for those of military age and not otherwise under obligation to volunteer for the services of the nation.

The population of the district at the 1911 census stood at 23,334, to which it has rapidly risen in about a quarter of a century from a large village of about 2,000 inhabitants. For several years it rose at a relatively rapid rate. The last few years have not shown such a rapid rate of increase, though the town would appear to be steadily increasing in size and numbers – during the last two years a little more rapidly than during the previous seven or eight – a fairly large number of houses and several new and modern factories having been built or are now in the course of erection since my previous report.

The population is for the most part a stationary one. There are interchanges between it and the neighbouring districts, but larger portion is a settled one, it’s now steady increase being partly due to natural increase and partly to immigration. Apart from those concerned and engaged in the staple industry, private residents are few. The local interest being nearly wholly commercial the Local Authority does not feel called upon to cater specially for this class of residents, although, if any there be who contemplate and are looking for a healthy spot free from the excitement and dubious allurements of a modern health resort and are fond of field sports, hunting, shooting and the such like, they might do worse than pitch their tent in the Urban District of Rushden.

Water Supply

At one time a cause of concern to those responsible for the sanitary well-being of the district, there is now an abundant, excellent, and never-failing supply of this absolutely necessary requirement for a community.

From the gathering ground situated at Sywell, about 13 miles from the centre of the town, a constant and unlimited service is maintained to all the houses within reach of the mains. The nature of the gathering ground consists of pasture, arable, and wood land, comprising an area of about 1,747 acres, and the total estimated quantity available from this source is approximately 745,000 gallons per day.

There is a subsidiary source of supply from the original waterworks at Wymington, which was the only reliable source over and above the local wells before the construction of the works at Sywell, which were opened in July 1906. The area of the lands fenced in at Sywell is a little over 133 acres. Of this the storage reservoir occupies about 68½ acres when full, having a capacity of 230,000,000 gallons. In addition there are three filters with a total area of 1,970 square yards, and a covered-in clear water tank with a capacity of 144,000 gallons. The pumping station has duplicate gas engines and pumps, and there are three houses within the grounds for the employees.

From the Sywell reservoir the water is pumped to the main service reservoir, situated on the Bedford-road about 1½ miles from the town. This has a capacity of 826,436 gallons, and the top water level is 338.50 ft. above O.D. The smaller service reservoir situated on the Wymington-road is the original reservoir of the Rushden Local Board. From these reservoirs the water is delivered under good pressure to the Rushden Urban District and the Borough of Higham Ferrers, members from these local authorities constituting the joint Water Board that administers the supply, who may be congratulated upon having under their control such a valuable asset.

A bacteriological examination made by the Clinical Research Association on the 23rd July, 1914, shows the water to be of a high degree of bacterial purity.

The two reports would indicate the water being of excellent quality, fit for drinking and other domestic purposes.

Besides the supply to the two local Authorities owning it, supplies are being given to the neighbouring parishes of Irchester, Wollaston, Earls Barton, Mears Ashby, and Wymington.

Disposal of Sewage

The town is sewered on the “Partially Separate” system. The configuration of the district necessitated two outfall sewers, one 18 inches in diameter, the other 12 inches, both gravitating to the site of the works. These are situated on the North-west of the town, about one mile from “The Green,” that being the lowest available land not liable to floods, and have been completed since my last report. They have been constructed on the old site, with the addition of about 7½ acres of adjoining ground which allows of access to the Kimbolton main road. The new works are designed to deal with an amount of sewage for a population of 15,500, which, at our present rate of increase, should be a reasonable allowance for the near future.

Swimming Baths

During the year the Council have had under consideration the provision of Public Swimming Baths, and have been in negotiation with several landowners with a view to obtaining a suitable site. The matter is still under consideration. If and when these materialise, which I hope will be in the near future, for no exercise is much more beneficial in more ways than one to the general health of the individual and collectively to the community, especially to youth. I should like to see it a condition that it should be obligatory upon all, not otherwise advised by medical opinion, to acquire the art of natation or at least to make periodical endeavours to acquire the art. It would only be equitable contingent upon the expenditure involved, otherwise there may be danger of the baths being used only by an enthusiastic minority.

The Schools

Most of the public elementary schools are modern, well-built and equipped, the water supply and sanitary arrangements leave little to be desired; they have good playgrounds and plenty of air space around them.

The Alfred Street Schools have now been re-opened after almost complete re-construction at considerable expense and are good buildings with plenty of light and ventilation.

The Newton Road and North End Schools are also good buildings of modern construction as are also the Moor Road Infant Schools. The Church Schools are much less modern buildings and do leave something to be desired by comparison with the other Public Elementary Schools of the town.

There are two or three private schools which cater more for the preparatory class of education and are conducted in private houses not specially built for the purpose for which they are used.

Up to the end of December none of the schools have been closed on account of epidemics.

The Scholars

These are of the usual type attending the schools of an industrial community. They are examined periodically by the School Medical Officer of the County Council, and where it is thought necessary parents are referred to a private medical practitioner of the district for treatment and advice. This examination within my experience has shown its greatest use in the detection of defective eyesight and the provision of suitable glasses for the correction of errors of refraction, a systematic examination of the eyes revealing errors that would otherwise go unsuspected. Apart from this advantage little benefit accrues to the children as from the nature of medical practice in the district most of them are frequently under the observation of the medical men practising in the district.

In my remarks under this heading in my last report I called attention to the enthusiasm displayed in the matter of keeping up the “attendance,” I suppose in order that the registers might show as high a percentage as possible. This may be good from the view of getting a satisfactory grant, but it is not always so with regard to the well-being of the child; especially is this so in the infants schools. Children are frequently sent to school in inclement weather not properly equipped to withstand the elements when they would in consequence be much better at home, especially when they show the slightest signs of malaise or impending sickness. For by far the largest part of the children who attend our schools the paramount consideration is that they shall have in the first place a sound body, by far the larger proportion of them will have to earn their living by their physical powers rather than their mental and no undue risks should be taken that may handicap them in this direction. “Education” is an important factor, but in my opinion under existing circumstances secondary to sound physique. Therefore I would warn the authorities and teachers against a too enthusiastic endeavour to fatten the registers at the expense of danger to the health of the child and not to drag a child to school from fear of consequences in default of attendance, when there is any doubt about it being better at home and in bed. If my advice is to be considered, always give the child the benefit of a doubt. Give the children first a sound body, then teach them “how” to learn and the rest will follow as a natural consequence and our country be safe in the hands of its budding citizens – but do let those registers be of secondary importance to the general well-being of the scholars.

Some discretion should also be observed as to sending the children out in the playground during the interval, note being taken of the nature of the weather, nature of wind, etc. Even when the sun is well up and warm there is often a keen wind and children playing about perspire readily and in this condition their body surface readily chills. Also regard should be taken of their clothing; if a child is sent in inclement weather carefully clothed to school and then during the interval is sent out to play or stand about for a quarter-of-an-hour without head or extra body covering to what it has been wearing in the warm school rooms, it is running risks that it ought not to be called upon to encounter. There is a tendency at present to adopt Spartan measures in the up-bringing and training of children, but it should always be borne in mind that Spartan measures, will produce Spartan results.

I hear the word “coddling” being whispered by some of the great “Irresponsible,” but better to “coddle” and be well than “not to coddle” and be unwell.

I should like also to call the attention of those responsible for the training of the children to the necessity of instilling into them the necessity of their conduct and care upon the public highways, pointing out that the primary and chief function of the roads is for the transport of traffic, that they are not meant for public playgrounds.

I have laboured this question of the children because in view of the falling birth rate and the losses the Empire is incurring in the various battlefields of the war being at present waged of the best and most virile of our race it is desirable for the welfare of the nation, and, in a broader outlook, for the welfare of humanity at large that no single life should be called upon to run unnecessary risks.

Milk Supply

Generally, as milk supplies go, that of the district may be considered satisfactory. There have been no complaints as to its quality during last year, and all the samples examined were found to be up to standard requirements. The cowsheds are inspected periodically and kept in relatively decent order. Some time I hope, however, that it will be realised by authorities, cowkeepers, and all engaged in the dairy business, that buildings where the food of man is produced and stored for however short a time, should be built of impermeable non-absorbent material, have an abundant water supply, and in the case of animals have a change of litter made compulsory at short intervals or whenever desirable. It should be considered as necessary to groom and clean a cow as it is a horse, and no milker should touch a cow for milking purposes without first sterilising the hands and containers.

The Milk and Dairies Act 1914.

The operation of this Act which has been postponed until October 1st, 1915, will give local authorities more opportunity of controlling the milk supply. Under this Act the purposes for which the Local Government Board may make Milk and Dairies Orders, will include the registration with the local authority of all dairies, the inspection by persons duly authorised by the authority in which the dairy is situated, of dairies, and persons in and about dairies, and many other matters concerned with the milk supply. The County Council may be the Local Authority for some of these purposes.

Where milk from any dairy is suspected to be causing Tuberculosis it will be the duty of the County Medical Officer of Health to have the cattle in the dairy inspected and to make other investigations. Where the District Council is in default the Local Government Board may transfer all or any of its powers under the Act or the Milk and Dairies Orders to the County Council. Before the Act comes into force the Local Government Board will issue an explanatory circular setting forth the principal duties of the Local Authorities and their officers under the Act.

Sale of Food and Drugs Act.

Twelve samples of milk were submitted to the County Authority for Analysis during the year, all of which were found to be genuine.

Housing

Thirty-five new houses have been added to the town during the year, and 40 are being erected and nearing completion by the District Council. These are of a class suitable for workmen’s dwellings; they do not err on the side of internal space, but are well built with plenty of light and air space around them, and when ready for occupation will contain the necessary modern sanitary and hygienic equipment for the maintenance of good health, providing the equipment is regularly and intelligently used. A landlord may provide all that is necessary for the welfare of tenants but it is not a necessary corollary that the means available are used as they ought to be. I should like to see an obligation placed upon tenants as well as upon landlords, be they public or private, to make fit and proper use of the equipment provided. It is my lot to visit a large number of the houses in the town during the course of a year, and, in a row or street where the external appearance shows no difference, to find the internal conditions differ as daylight does from dark. One is “spick and span, clean as a pin,” while another is all that is undesirable, one fit to entertain an epicure, while in another one would postpone one’s gustatory obligations to the verge of dissolution; the latter class is fortunately rare and there are all stages between, but in the housing of the working classes, or in all classes for that matter, the human element is a factor that is never likely to permit of the attainment of the ideal.

Similar conditions prevail in regard to what is quite as necessary as cleanliness and well cooked food, that which is in fact a part of our necessary food, I refer to fresh air. In some houses all the doors and windows remain shut and every available crevice for the inlet of fresh air and the outlet for foul is stopped up; especially is this so with the bedrooms. This should always be the largest and airiest room available for sleeping purposes; it is not generally realised that this room is the one in which we spend by far the greatest portion of our lives. A third at least may be reckoned. The window should be always open when the weather conditions permit; if not, the both door and register of stove should be available for ventilation. No one should be shut up in a room for hours together, breathing the same air over and over again. If they do, no wonder there are headaches, dry throats, and no relish for breakfast in the morning. When not occupied, windows and doors should be thrown wide open to allow a free current of fresh air and sunlight through the room.

The “living” room should be the best and biggest available on the ground floor. All the rooms should be “living” rooms. The best room should not be kept shut up all the week and only used on Sundays. As it is, a good many of the rooms that are used for the most part may be more appropriately called “dying” rooms, any little room being used except on high-days, holidays, and bonfire nights. Many such customs are badly in need of reform. It is no use authorities, local or central, making regulations for the provision of suitable tenements if these are not made suitable use of by the tenants, and largely they are not.

The greater proportions of houses in the district are relatively fairly well-built tenements with brick walls and slate roofs. There are a few of the older type, built of stone and with thatched roofs; the remains of the old village, those that can be made habitable, in view of modern requirements, are repaired and brought as near to suitable habitations as is possible. Those that cannot are having closing orders made upon the owners and will eventually disappear. The Sanitary Department has the housing question in view, but do not press as they would if there were more houses available and reasonable requirements are carried out by the landlords.

No glaring cases of overcrowding have come under notice, but some of the houses in default of a sufficiency to meet requirements have more inmates than are strictly desirable in the way of lodgers and double families. This situation will be eased as soon as the new Council houses are ready for occupation.

Factory and Workshops Act

The factories and workshops are periodically inspected by the Sanitary Inspector, and where thought necessary reference has been made to me. This has occurred in very few instances. The requirements of the Act during the year have been fully met.

Bake-houses have been frequently inspected and the conditions in relation to them have been faithfully carried out, so that there is little if any, cause for complaint. Some of them indeed are beyond reproach. All are above ground, airy, and well ventilated for the most part.

Hospital Accommodation available for Infectious Disease

At present none is available beyond a wood and corrugated iron structure on the Bedford Road at the outskirts of the town. This was erected about 22 years ago for the reception of small pox patients, owing to a small epidemic that occurred then among the navvies engaged in the building of the railway line to the town. Since that period no case of this disease has occurred in the town, so that the building has been somewhat of a white elephant. In company with the Medical Officer of Health for the County I have inspected it during the year.

The question of hospital accommodation for infectious disease has been under discussion and consideration by the Sanitary Committee, which has been in communication with the Local Government Board and the County Authority, but nothing definite has yet materialised. It hardly seems to me that it is desirable for each Sanitary District to provide a suitable building for this purpose at large outlay and with considerable standing charges which would be for the greater part of its time only partially occupied by patients, and often not at all. A better plan, in my opinion, would be to have a building under control of the Central Authority for the County to serve combined districts.

A steam disinfector for the town has also been under contemplation, and I view the necessity for this in quite a different light from the provision of an Isolation Hospital. I look upon its provision as quite a necessity, especially so with the possibility of the billeting of troops in the town. So far we have had no troops here, but should they come we might feel its absence badly.

Acute Infectious Diseases

Ninety-nine cases of notifiable infectious diseases were reported in the district during the year which compares favourably with 124 in 1913, and 187 in 1912, being a little under 50% less that for the latter year. The end of a measles epidemic followed us from the end of 1914 into the beginning of 1915, but it soon subsided, and only one case to my knowledge has occurred in the town since then, and that occurred in my own household in December last, being imported from Bedford where an epidemic has been and still is I believe in being, no other case arose from this. No epidemic of any sort, as such, other than this, can be said to have existed in the town during the year, all of the other cases being of a sporadic character. Up to the end of December none of the schools have been closed on account of the prevalence of illness.

Scarlet Fever or Scarlatina

Twenty-eight cases of this disease were notified in 1914 in comparison with 52 in 1913, and 58 in 1912, a gratifying fall in the incidence of this malady, which would appear to be endemic rather than epidemic throughout the country, very few districts being altogether without some cases for any long period of time. All of the cases would appear to have been slight in character, leaving few complications. No deaths were reported as having been traceable to it or its complications.

All the cases are visited by the Sanitary Inspector, generally within a few hours of receiving the notification, and the source of infection traced if possible. This, in a goodly number of cases, is difficult to do. They are all isolated as far as it is possible to do in the type of houses in which they mostly occur, and in all those houses in which it appears the inmates are as careful as they can be not to spread the infection. They are liberally supplied with disinfectants and the rooms occupied by the infected persons are all fumigated, sprayed, and in a large number of cases the walls stripped and re-decorated before being again occupied.

Small Pox

No case has been reported in the district. It may be here noted that a very large number of the population are not protected against it by vaccination, and although there can be no doubt about the protection conferred by this process in the minds of those in the best position for weighing the evidence in its favour, I do not doubt that improved sanitation, cleanliness and general mode of living of the people is contributory to the immunity of the populace from its ravages.

Diphtheria, including Membranous Croup

Eighteen cases of the maladies included in this group have been notified during the year, an increase of eight over that of 1913. I am inclined to think from my own experience that some of these cases are closely related to scarlet fever, many of them exhibiting the same set of symptoms without the presence of the characteristic rash, or that the rash is of such an evanescent character that it is not observed. Most of the cases are treated early with anti-diphtheria serum, which the Sanitary Authority provides gratis upon the application of the medical men of the district, and, in my opinion, if the full value of this remedy is to be obtained, it should be used in the very early stages of the disease. My own experience has not been gratifying when it has been used after the symptoms are well marked. In eighteen suspected cases specimens were submitted for bacteriological examination. Ten of these gave what are called positive results while eight were negative. Three deaths were registered as occurring from this disease, two of them, which occurred in my own practice, from heart failure at least a fortnight after the disappearance of all throat symptoms. All these were over the age of five years and under 15.

Enteric Fever

No case was reported during the year, a fact upon which the town may be congratulated.

Erysipelas

Nine cases coming under this classification were reported, one more than occurred in 1913. None of these would appear to have been of a character to cause any alarm to the population generally.

Other Infectious Diseases

No cases of cholera, relapsing fever, continued fever, puerperal fever, cerebral spinal meningitis, or poliomyelitis were reported in 1914, being a continued immunity from 1913, showing a favourable comparison with immediate antecedent years. I am glad to report that it is now the custom of the head teachers of the various public elementary schools to notify the occurrence of any case of infectious diseases coming under their notice.

Ophthalmia Neonatorum

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A total of 41 cases of Tuberculosis were notified to the Sanitary Authority during the year, comparing favourably with 53 in 1913, and 57 in 1912, of these 21 were females and 20 males.

35 were of Tuberculous disease of the lungs (Phthisis). 6 were other forms of Tuberculous disease.

Nine deaths were registered from lung Tuberculosis and five from other forms of Tuberculous diseases. This does not mean that the 14 deaths were from the 41 cases notified during the year, as they may have been notified previously to the year under revision, or even before the notification of the disease was compulsory.

It would appear that not only is the incidence of this disease lessening in relation to population, but that the percentage of deaths among those affected is steadily decreasing. Taking the year 1913, the last available for comparison throughout the country, in comparison with the average for the decade 1891-1900, there is a recorded diminution of 33 per cent. from tuberculosis (all forms), and from pulmonary tuberculosis 28 per cent.

Most of the cases of tuberculosis or suspected tuberculosis are now seen in consultation with the County Tuberculosis Officer. Insured persons developing the disease are recommended for institutional treatment, either at the Tuberculosis Dispensary at Wellingborough, sent to a sanatorium when the case is likely to derive benefit from such an institution, or are recommended for domiciliary treatment. For some reason the Insurance Committee for the County have seen fit to withdraw the privilege at first extended to the private medical practitioner of ordering extra nourishment for insured tuberculous patients under his care. Though this may have been open to abuse, the ultimate trend of the privilege was distinctly in favour of benefit to the patient, and I am sorry that the option of doing so has been withdrawn, for just when a patient would need it most his resources are more crippled than when he is able to work.

All cases notified are visited, disinfectants supplied, and general instructions as to conduct and care of themselves and others in relation with them are given. Subsequent visits are made when and where necessary.

In addition to the Tuberculosis Officer, a trained nurse now visits these patients to instruct them and see that the general directions of the medical men are carried out as far as possible.

Where a death occurs the bedroom lately occupied by the patient is cleansed and disinfected, in most cases the paper stripped off and replaced, and the bedding destroyed. It is in the matter of proper disinfection of the clothes and bedding that a steam disinfector is both desirable and necessary, as in the absence of total destruction it is not possible to disinfect such articles efficiently.

Other Diseases

There are no special diseases incidental to the staple trade, nor is there any undue prevalence of such diseases as rickets, acute rheumatism, diarrhoea or enteritis, nor of diseases of chest.

Considering the large amount of machinery used in the staple trade, major accidents are few and far between, minor ones such as injury to fingers and hands are not unduly frequent.

Goitre or Derbyshire neck, an enlargement of the thyroid gland is endemic in the district, but since the institution of a different water supply and the disuse of the old wells, I think this is lessening in incidence.

Vital Statistics

Under this heading I should like to preface my remarks by recording a summary of the state of public health taken from the report of Dr. A. Newsholme, the Medical Officer to the Local Government Board. This refers to the year 1913 and for the whole country, in terms of reductions of death rates from all causes and from special diseases – “Comparing the experience of 1913 with the average experience of 1891-1900, the rate of Infant Mortality has declined 29 per cent., the death rate from Measles, 32 per cent., from Scarlet Fever, 64 per cent., from Whooping Cough, 62 per cent., from Diphtheria and Croup, 55 per cent., from Enteric Fever, 77 per cent., from Tuberculosis, all forms, 33 per cent., and from Pulmonary Tuberculosis, 28 per cent., from Puerperal Diseases, 27 per cent., Pneumonia, 17 per cent., and from Bronchitis, 41 per cent.

“The Death-rate from all causes has declined 25 per cent between 1891-1900 and 1913.”

This is eloquent testimony to the effect of State Medicine or the Preventive Treatment of Disease, ranging as it does from the high percentage of decline of 77 per cent. in the case of Enteric Fever to 17 per cent. in Pneumonia.

Local Birth Rate

246 births were registered during the year, of which 119 were males and 127 females. This corresponds to an annual birth rate per thousand inhabitants of 17.68, calculated upon the estimated population of the town in June, 1914. In 1913 the birth rate was 17.25 while in 1912 it was 20.8, so that there is a slight increase over 1913. The average birth rate for the last five years works out at 18.75, but in the year 1910, the first of the five years taken, the population was over-estimated to the extent of about 3,000, so that the quinquennial rate should be actually higher than is shown by these figures.

There were no transferable births.

Fourteen births were returned as illegitimate – 7 males and 7 females.

Although a little higher than last year, the birth rate is still a low one, relatively to the figures of a quarter of a century ago. Taking into consideration that the population is largely composed of young and virile married couples, these figures afford food for thought to those concerned about the future of the nation, especially at this time when there is such a wastage of the best and most potential physical elements of the population going on, on land and sea, and signs and portents viewed by those in the best position to judge do not tend to make one expect any other than, at the best, it remaining at or about the present figures. In view of these figures the importance of the figures taken from the report of the Medical Officer of Health to the Local Government Board given above cannot be over-estimated.

Local Death Rate

There occurred in the district 118 deaths, of which three were transferred to other districts as being the permanent place of residence of the deceased, and 12 were transferred to this district, leaving a net balance of 124 deaths credited to us, which gives an annual death rate of 8.9 per 1000 of inhabitants. Slightly higher than in 1913, the town may still be satisfied with its comparative lowness as a set off to the low birth rate.

Infantile Mortality

That is, deaths occurring under the age of one year, total 18, a decrease of one over 1913, equal to a rate of 73.1 per 1000 births. On reference to Table IV, it will be noticed that 12 deaths out of the total occur in the group of premature births, congenital malformations, etc., nine of these in the first four weeks of life, and seven on the latter in the first seven days; several even had only a few hours of existence. These 12 had very little, if any, prospect of continued existence from the outset, so that only six of the 18 deaths were due to preventable causes, not taking into calculation antenatal factors.

Zymotic Diseases

Twelve deaths are returned as having been primarily due to this group of diseases. In seven the primary disease was given as influenza, two between the ages of 24 and 45 years, and five over the age of 65.

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The death-rate from this form of disease would appear to be steadily decreasing. There are now better means of arriving at an early diagnosis, and in this the essential of successful treatment lies. After the stage of “easy diagnosis” arrives, the prospects of any form of treatment is not particularly promising.

Other tuberculous diseases are responsible for five deaths.

Cancer – Malignant Disease

Eighteen deaths were registered as occurring from this group, an advance of five over 1913 – two between the ages of 25 and 45, ten between 45 65, and four over the age of 65. The number is double that which were recorded in 1912, nine deaths from this cause being recorded in that year, but it should not be inferred that from this fact that this form of disease is necessarily on the increase. A large number of factors must be taken into consideration before arriving at this conclusion, our improved methods of diagnosis being an important one, and a longer period than comparison between one or two years is necessary to give a correct verdict.

Respiratory Diseases other than Tuberculosis

In this group Bronchitis is credited with eight deaths as the primary cause of death. Two occurring under one year, two between the ages of 5 and 15, one between 25 and 45, and 3 over the age of 65. This number is five less than in 1913, and is probably due to the mildness of the season, the old fashioned hard winters generally said to be so healthy finding out the young and old and those prone to Respiratory Disease.

Pneumonia and Broncho Pneumonia have one death each assigned to them as the primary cause of death. This form of respiratory affection occurs so often as a secondary cause, however, as a complication of Influnza and other acute specific fevers, that although the final cause of death, it is not shown in the tables.

No other deaths were registered from Respiratory Diseases.

Violent Deaths

Two only are accounted for in this way – one as suicide from drowning, the other being caused by accidental poisoning.

Incidence of Deaths in the Four Quarters of Year

1st quarter … 43 3rd quarter … 21

2nd quarter … 38 4th quarter … 22

This would follow pretty accurately the incidence of sickness, the first six months exacting the heaviest toll, the latter six months being generally that most free from illness. I attribute this to the fact that the populace at the end of the year are feeling the effect of having had more time in the open air, are less shut up in their houses, on the whole feed more lightly and generally on a more suitable diet largely the product of their work on their allotments, so that in the early winter they are better fortified, physically, to withstand the inroads of ailments which are prevalent in the early months of the year.

Thirty one deaths occurred at over 65 years of age, one of these at 100, one between 95 and 100, one between 90 and 95, two between 85 and 90, nine between 80 and 85, six between 75 and 80, twelve between 70 and 75, and five between 65 and 70. At the other end of the scale only 26 deaths occurred under the age of five years.