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It will be observed that there is a great diminution this year in the number of cases of fever, dysentery, and neuralgic rheumatism, which is owing chiefly to the population having become acclimatised, and confirms the prediction contained in my first report in May, 1865, and the view I then took of the malarial origin of these diseases.

The prevailing disease is rheumatism in its multifarious forms, there being no less than 81 cases—or upwards of 17 per cent.; and this need excite no surprise when we consider the humidity of the climate, and the nature of the employment of the miners.

Of the total, viz., 475, 291 were medical cases, and 184 surgical. 101 of the latter were cases of accident, the most formidable of which were fractures, 36, and dislocations, 5. The chief causes of accident are the slipping of earth and stones from the faces of terraces in ground sluicing; the falling and felling of trees, and the breaking of ropes used in raising and lowering the men in shafts in deep-sinking claims.

The death rate is much the same as last year, a little over 7 per cent., but as usual a large number—12 or one-third of the whole—were admitted moribund and died within a few days after their admission. 7 arose either from hopeless injury, or incurable disease; and of the remaining 17 cases the disease had existed for periods varying from twelve months to a month before admission, except one case of the inflammation of the bowels, which was a fortnight old on admission. Most of the cases had not received any treatment at all before admission.

The sanitary condition of the Hospital is excellent. A number of patients were attacked in the house, in the previous year, with dysentery, two of whom died; but since the cesspool was closed up, and the earth closet system with the utilization of the night soil introduced, no case of dysentery has occurred in the house.

I cannot conclude my remarks on the Hospital at this time without congratulating the Canterbury and Westland Governments on the effect of their liberality which has enabled me to bring the Hospital to a state of efficiency second to none other in the Colony.

GAOL.

The health of the prisoners during the year has been remarkably good owing to the excellence of the site and sanitary arrangements. Only one death occurred, that of a prisoner committed for vagrancy, who died in May last, a few days after incarceration, of delirium tremens, it being to my own knowledge his fifth attack. The diseases consist chiefly of catarrh and rheumatism, and would be much diminished by the introduction of some regular system of heating, as that by hot air or hot water.

LUNATIC ASYLUM.

It will be seen from the tabulated statement that 34 patients have been treated during the year, 12 cured, 11 sent to Christchurch for want of accommodation; and 1 died shortly after admission from pulmonary dropsy. Five only of the cases treated were cases of Delirium Tremens or temporary insanity. The accommodation—viz., 5 cells, with offices—is wholly inadequate for the requirements of the district; and the absence of the necessary appliances for the treatment of the insane—especially a properly fenced yard for exercise—renders the asylum little more than a place for safe keeping.

PUBLIC HEALTH.

Since my last report no case of zymotic or infectious disease has, to my knowledge, occurred in the town or district, which, considering the almost total absence of sanitary regulations, is remarkable. Two of the deaths, which occurred in the Hospital, I have traced directly to miasmata arising from open privies, gutters, and trenches, reeking with fetid miasma. I took occasion in my last report, dated 1st May, 1867, to point out the probability of cholera—which was then raging at Panama, within 30 days’ sail—visiting these colonies at no distant date; and I have since observed from the Colonist that a public meeting was held at Nelson, on the 3rd May—two days afterwards—for the purpose of adopting sanitary measures for its prevention, which meeting was attended by three members of the medical profession, all of whom entertained my views on the matter. It has now been established beyond a doubt that cholera is a disease strictly preventable by sanitary and hygienic measures. In the report of the medical officer of the Privy Council the following passage occurs:—“It cannot be too distinctly understood that the person who contracts cholera in this country is ipso facto demonstrated with almost absolute certainty to have been exposed to excremental pollution; that what gave him cholera was medially or immediately cholera-contagium discharged from another’s bowels; that, in short, the diffusion of cholera among us depends entirely upon the numerous filthy facilities which are let exist, and specially in our larger towns, for the fouling of earth, and air, and water, and thus, secondarily, for the infection of man with whatever contagium may be contained in the miscellaneous outflowings of the population. Excrement-sodden earth, excrement-reeking air, excrement-tainted water, these for us the causes of cholera.”

I need not dwell on the fearful facilities afforded in this town for the spread of cholera; and would suggest that measures be taken immediately for the abolition of open privies, and the substitution of earth-closets. Those who could not afford to pay £6 or £7 for a patent self-acting apparatus, could by means of a pan of earth and moveable box fitted into the privy accomplish the object in view quite efficiently; and at a very small cost the contents of these closets might be removed daily or weekly, and the value of the material, as a commercial product, would go far to defray the expense of scavenging.

J. RUTHERFORD RYLEY,
F.R.C.S.E.,
Surgeon Superintendent.

Hospital, 28th May, 1868.