The Public Health.

We have the good fortune to live in a country the physical condition and climate of which conduces to the maintenance of a high standard of health and strength. That New Zealand is favourably situated as compared with other countries in this respect is shown by our low death-rate, which in 1903 stood at 10.40 per 1,000 of population, and by the fact that the mental and physical development of the people of New Zealand is second to that of no other country. If it is possible in any country to hold out the hope that by public measures they may approach what is called physiological old age and normal death that happy condition should be most nearly attained in a country so favourably situated as New Zealand.

Now, in order to reduce the death-rate to the lowest possible medium, and to maintain a high standard of physical development among the people, it appears to me that three factors are necessary. First, you should have a Government which is alive to all that concerns the health of the people. Secondly, it is necessary to have a highly educated and intelligent public who will adopt measures for the benefit of the public health by reason of their own conviction rather than by the compulsion of law. When the public recognise a truth in regard to public health they are quite willing to accept any inconveniences which the adaptation of that fact entails. This, I think, has page 3 been lately clearly shown by the ready manner in which the people were willing to be vaccinated when small-pox threatened the community. The third essential is a well-trained and scientifically educated medical profession. In New Zealand at the present time we have a Government which has always taken an active part in the public health of the colony, a Government which during its term of office has inaugurated a Public Health Department and a Pathological Laboratory, and I should here like to congratulate the Government and the Public Health Department upon the prompt and effective manner in which they have resisted the invasion of this colony by those two enemies to public health which so recently menaced our shores—namely, the plague and the small-pox. They are also to be congratulated upon having established at Cambridge a Sanatorium for the Treatment of Consumptives, and upon having determined to make provision for consumptive patients by means of annexes to various hospitals in different parts of the colony where the climatic conditions are favourable for the treatment of that disease. The Government has also instituted the very needful precaution of inspection of dairies and slaughterhouses, and through the Bacteriological and Agricultural Departments the inspection of dairying-cattle. More-over, to those who have spent the greater part of their lives in helping on the development and progress of the country, but who in their old age find themselves without the means of support, a pension has been provided for their declining days. It is gratifying to know that the Government has already done so much in the interests of the public health, and it is to be hoped that before very long it will be able to see its way towards establishing a much-needed institution, and that is a Home for Epileptics. Such a home, I feel sure, would confer a very great benefit on the community.

To enable one to arrive at a fair estimate of the average intelligence of the public it is necessary to consider the quality of the education that is being imparted to the children at the public schools, and it may be taken that the standard of intelligence of this colony is that which is reached by the majority of the children at the time of their leaving school. It may bo conceded that a large proportion of the pupils before page 4 leaving school have reached Standard VII. As you know, Standard VII. of our public-school curriculum, outside the ordinary compulsory subjects, which includes military drill, makes provision for the study of such subjects as geometry, algebra, elementary mechanics, physics, chemistry, botany, book-keeping, shorthand, agriculture, physiology, geology, handwork, and mechanical drawing, as well as Latin, French, and German. This standard, I maintain, includes a very high quality of general education. I take it that the object of a high standard of education is to enable the individual to appreciate his responsibility to the State, and to perform in the completest manner his duties of citizenship.

Speaking from a medical point of view, I say it thus becomes a duty of every citizen to endeavour to maintain in himself—not for his own sake only, but also for the sake of his fellow-citizens—the best condition of personal health. Further, if an individual becomes affected by a contagious disease—it does not matter what the nature of that disease may be, whether it be syphilis—that scourge of civilised countries which not only has a serious effect on the individual, but may become transmitted to his offspring—a disease which I fear can only be diminished by the general enforcement of the Contagious Diseases Act—whether it be phthisis or one of this exanthemata—it is a part of his duty to assist in preventing by every means in his power the spread of the disease to others.

In order that, the young men and women of the colony may on leaving school be given some idea of their public duties in this connection I would suggest that there be added to their final course of study a simple treatise which might be drawn up by the Chief Medical Officer of Health for the colony, a treatise which would place them in possession of a few of the fundamental laws of public health and elementary hygiene, a treatise in which the names of the diseases which cause the greatest mortality in New Zealand might be mentioned.