CROUP,

Croup, although classed as a disease of the respiratory system, was formerly classified with the zymotic diseases, and is included here on account of its similarity to diphtheria, and the confusion which often arises between them, and of the deaths set down to a combination of both. It is a disease that may be said to affect children only, and in 1903 caused 63 deaths in the Commonwealth and 17 in New Zealand, equal to rates of 0.16 and 0.21 per 10,000 of the population, the rate for Australasia being 0.17. In the subsequent table are shown the number of deaths and the death-rate in each state since 1870 :

Generally speaking, deaths from this disease show a steady and consistent fall from the earliest period, although in some of the states, especially Victoria and South Australia, the rates fluctuate slightly. The greatest decline has taken place in New South Wales, Victoria, Queensland, and South Australia, until at the present time croup is about equally prevalent throughout the Commonwealth. In New Zealand the rate is somewhat higher than in Australia, but is considerably lower than in any preceding period. If croup and diphtheria be taken together, as they usually are, it will be found that the rates in the Commonwealth generally have declined to the extent of over 5 per 10,000 during the last twenty-seven years.

DIARRHOEAL DISEASES.

Diarrheal diseases, comprising cholera, diarrhoea, and dysentery, carry off mostly young children and old persons. In 1903 these diseases were fatal to 1,795 persons in the Commonwealth and 184 in New Zealand, equal to death-rates of 4.59 and 2.24 respectively per 10,000 living, the rate for Australasia being 4.18. The number of deaths and the death-rates in each state in quinquennial periods since 1870, are shown below.

The high death-rates of earlier years are not surprising, and may be ascribed to the hard fare and exposure incidental to the development of the pastoral and mining industries. This will be evident from a comparison of the present rates in Queensland, South Australia, and New South Wales with those of former periods. In all the states there has been a marked improvement during the last twenty-three years. The most noticeable improvement has occurred in Queensland, where the rate has declined from 24.15 to 6.74. That temperature and climate have an effect on the death-rates from these diseases is proved by the fact that they are much more prevalent and more fatal in summer than in any other season of the year, and that in Tasmania and New Zealand,

where the climate is mild and genial, the rates are much lower than in Queensland and Western Australia, where the climate is very warm, and in some parts tropical, while the other states, whose climates are fairly temperate, show rates between the two extremes.

The decline in the number of deaths from diarrhoea may be in part due to the fact that of late years more skilful diagnosis in some cases makes possible the ascription of death to ailments of which diarrhoea may be only a symptom

TYPHOID (ENTERIC) FEVER.

Seeing that typhoid is entirely a filth disease, the poison of which is propagated by sewage, and that it yields readily to sanitary precautions, it is a matter of very great regret that the annual mortality, although steadily declining, should still be so heavy. In 1903 typhoid was responsible for 1,145 deaths in the Commonwealth and 61 in New Zealand, the death rates being 2.93 and 0.74 respectively per 10,000 living. The rate for Australasia was 2.55 per 10,000 of the population, as against the English rate of 155 for the year 1901. The table below shows the number of deaths from this disease, and the death rate in each state, arranged in five-year periods since 1870:—

State.

1871-75. 1876-90. 1881-85. 1886-90. 1891-95.1896-1900. 1901-3.

It will be observed that the rates over the whole period covered by the table show a decline. The disease is of an epidemic nature, but still the rates do not fluctuate greatly, and during the last three years in all the states, excluding Western Australia, were fairly uniform, ranging from 87 in New Zealand to 3.06 in Queensland. An epidemic occurred in the year 1889 in New South Wales, Victoria, Queensland, and Tasmania. Typhoid was almost unknown in Western Australia prior to the gold rush of 1894, when the disease may be said to have commenced. The maximum was soon reached, for in 1895 the deathrate was 35-46 per 10,000. With improved sanitation the rate is steadily declining, and although the table shows an apparent increase in the quinquennial period, 1896-1900, it must be remembered that, as previously stated, the disease was comparatively unknown prior to 1894, and this accounts for the lower rate of the period 1891-1895. The rapid decline of the death-rate may be seen when it is stated that in 1895 it was 35-46 per 10,000, for the period 1896-8 only 25.38, while in 1901-3 it had fallen to 7-08, considerably less than half the rate for the preceding five years.

In England and Wales since the measures which have been taken to improve the drainage and water supply the rate has steadily fallen from 3.74 in 1871-75 to 1.73 in 1897-1901.

PARASITIC DISEASES.

The deaths from parasitic diseases in the Commonwealth during 1903 numbered 139, and in New Zealand 10, the death-rates being 0.36 and 0-12 respectively per 10,000 living, and for Australasia 0:31. The chief disease of this group is hydatids, which was responsible for 158 deaths, or 033 per 10,000 of the population, and was most common in South Australia, where the rate was 0.39.

DIETETIC DISEASES.

Dietetic diseases in 1903 carried off 483 persons in the Commonwealth and 67 in New Zealand, the death-rates being 1-23 and 0.82 respectively per 10,000 living, and for Australasia, 1·16. The chief contributing causes were privation and intemperance.

CONSTITUTIONAL DISEASES.

The next class of diseases is the constitutional, which caused 7,963 deaths in the Commonwealth and 1,534 in New Zealand during 1903, the death-rates being 20-35 and 18-70 respectively per 10,000 living, the rate for Australasia being 2007. Of these diseases, phthisis and cancer stand out most prominently, and deserve special consideration.

PHTHISIS.

Phthisis claims more victims in Australasia than any other disease, but notwithstanding this fact the death rates are lower than in the other countries of the world. This is all the more gratifying when it is considered that many persons afflicted with the disease, or predisposed to it, are attracted to this country in the hope of obtaining relief, as the Australian climate is undoubtedly favourable to people suffering from pulmonary complaints. During 1903 phthisis caused 3,571 deaths in the Commonwealth, and 570 in New Zealand, equal to rates of 9·13 and 6.95 respectively per 10,000 living, the rate for Australasia being 8.75. The following table shows the number of deaths and the deathrates in each state since 1870, arranged in five-year periods :

For the first half of the period covered by the table, phthisis seems to have been on the increase; but since 1885 it has steadily decreased, and the mortality rate is now lower than that of England-where the rate is nearly 13 per 10,000 living-or of any European country. The decline is general, and is evidence of the more skilful treatment of the disease and the effectiveness of the preventive measures taken against