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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, ard 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 1900 caused the death of 92, or 0-20 per 10,000 of the population. In the subsequent table are shown the number of deaths and the death-rate in each State since 1870

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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 Australasia. If croup and diphtheria he taken together, as they usually are, the rates generally have declined to the extent of over 4 per 1,000 during the last twenty years.

DIARRHOEAL Diseases.

Diarrheal diseases, comprising cholera, diarrhea, and dysentery, carry off mostly young children and old persons. In 1900 these diseases were fatal to 1,876 persons, equal to a death-rate of 4·16 per 10,000 living. The number of deaths and the death-rates in each State in quinquennial periods since 1870, are shown below.

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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 years, with the exception of Western Australia, where the rough conditions of life prevailing on the goldfields exert an adverse influence on the rates. The most noticeable improvement has occurred in Queensland, where the rate has declined from 24.15 to 7.62 during the last twenty years. That temperature and climate have an effect on the death-rates from these diseases is proved from 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 1900 typhoid was responsible for 1,054 deaths in Australasia, or at the rate of 2.33 per 10,000 living, as against the English rate of 1.99 for 1899, which was the highest recorded there for six years. 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

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It will be observed that the rates over the whole period covered by the table show a decline, and although the last quinquennial period

shows an apparent increase it was almost entirely confined to Western Australia. The disease is of an epidemic nature, but still the rates do not fluctuate greatly, and during the last five years the rates in all the States, excluding Western Australia, were fairly uniform, ranging from 1:39 in New Zealand to 3-03 in Tasmania. An epidemic occurred in the year 1889 in New South Wales, Victoria, Queensland, and Tasmania, and the disease seems to have since been more prevalent in the last-mentioned State than in any other. In Western Australia typhoid was almost unknown prior to the gold rush in 1894, when the disease may be said to have commenced. The maximum was soon reached, for in 1895 the death-rate was 35.46 per 10,000. With improved sanitation the rate is steadily declining, and although the table shows an apparent increase in the last quinquennial period, 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 1900 it had fallen to 7-29.

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 1.76 in 1896–99.

PARASITIC DISEASES.

The deaths from parasitic diseases in Australasia during 1900 numbered 172, equal to a death-rate of 0.38 per 10,000 living. The chief disease of this group is hydatids, which was responsible for 91 deaths, or 0.21 per 10,000 of the population, and was most common in New South Wales, where the rate was 0.30.

DIETETIC DISEASES.

Dietetic diseases in 1900 carried off 561 persons, or at the rate of 1.24 per 10,000 living, the chief contributing causes being privation and intemperance.

CONSTITUTIONAL DISEASES.

The next class of diseases is the constitutional, which caused in 1900 8,607 deaths, giving an average of 19-08 per 10,000 living. 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 the Australian climate is undoubtedly favourable to people suffering from pulmonary complaints, and that thereby many

persons afflicted with the disease, or predisposed to it, are attracted to this country in the hope of obtaining relief. It is estimated that of the total persons who die of phthisis in Australasia, 7 per cent. do so after less than five years' residence. In 1900 phthisis caused 4,011 deaths in Australasia, equal to a rate of 8.89 per 10,000 living. The following table shows the number of deaths and the death-rates in each State since 1870, arranged in five-year periods :

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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 over 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 it. Phthisis has always been most prevalent in Victoria, but the rate is fairly uniform throughout the rest of Australasia. In Queensland the rate is adversely affected by the peculiar liability of the Pacific Island labourers to contract the disease, while the Maori population of New Zealand is also extremely susceptible to its ravages. Western Australia has, on the whole, had the lowest rate, but there is little difference between it and several of the other States.

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