Remarks on the Lists.
It has been stated that smallpox and typhus have both existed in New Zealand, and there are in the Registrar-General's reports lists of deaths due to the latter disease. After careful enquiry, I think that typhus, true typhus as English physicians call it, has not yet appeared. I think the statement that deaths arise from typhus is due to three causes: (1.) Errors in diagnosis. (2.) Inability to distinguish between typhus and typhoid by certain men on the register of practitioners. (3.) The fact that foreign doctors use the terms typhus and typhus abdominalis for the two diseases, and hence a not infrequent source of error.
About rotheln there seems some doubt.
Ague never springs up de novo in any one in New Zealand, it is always imported by the sufferer in his own person.
Other diseases, as beriberi, pellagra, cholera, yellow fever, starvation fever, have not yet shown themselves. True dysentery is, like ague, imported in the person of the sufferer and is not acquired in the colony.
The only epidemic diseases which trouble us are scarlet fever, typhoid, measles, diphtheria, croup, whooping-cough and influenza. Of these, scarlet fever epidemics are usually mild. Diphtheria is very common and fatal, as elsewhere. Typhoid, sometimes recognized and very often not, goes by many names, e.g., colonial fever, low fever, gastric or bilious fever, blood poisoning, swamp fever, etc. It is a pity that this disease is not called by the graphic name “filth” fever. It spreads so much because New Zealand colonists have scant objection to drinking diluted sewage or having reeking cesspits either directly under or close to their houses. Of this disease no more need be said; deaths and illness from it should not be charged against the climate or soil, but rather to the folly of the people.
Chest diseases.—Of all our diseases, phthisis is the worst, the most deadly. It is more prevalent and severe in the cold wet south than in the drier hotter north. Phthisical immigrants, whether in the north or south, invariably receive great benefit, and many are perfectly cured. As the immense majority of these immigrants come from Great Britain they find the climate most mild and soothing. Their coughs grow easier and less frequent; they gain weight and strength, and even those who are not cured almost invariably have their lives much prolonged.
The deaths from phthisis are high, partly because British physicians strongly recommend these patients to try our climate; but as against this increase we must put on record the fact that thousands of people were imported at public expense and from these many thousands all phthisics were excluded.
Among the New Zealand born, however, phthisis is rife and very fatal. Young colonists when attacked nearly always die.
Cardiac affections appear in the same proportions as in Great Britain.
Liver affections, so prevalent in tropical climates, are here unknown. The commonest form of liver disease is cirrhosis arising from abuse of alcohol.
Nervous disorders.—All forms exist except perhaps two or three of the rarer kinds. Insanity prevails largely; but statistics are not trustworthy, because the unfortunate practice long prevailed in this colony of sending to the asylums all persons suffering from delirium tremens, a class of cases which at home are treated in hospitals.
Parasites.—None peculiar to the colony have been observed. All have been imported. It is doubtful if the tapeworm has gained a hold on the colony. Like hydatid it is probably brought hither in the person of the
sufferer and is not acquired here. It is singular that hydatids should not exist here, for they are very prevalent in Australia, and dogs are numerous and live in intimate communion with man.
Skin diseases.—Owing to the well-to-do character of the people, the small amount of segregation and the abundance of good food, skin diseases are far lesś common in the colony than at home. A little acne, eczema or psoriasis and liver compose the bulk of the cases.
Constitutional.—The tubercular diathesis is abundant and perhaps assumes a greater prominence because the others are rarer. In young New Zealanders this diathesis far exceeds all the others. Struma exists but in modified forms. The population are so well off, and so abundantly supplied with good healthy food and ample shelter, and lead such healthy out-door lives that they beget a healthy offspring; and to this offspring they give the best of food and raiment. For the same reasons rachitis is but little seen.
Syphilis for some reason or other is of a very mild type. The true hard or Hunterian chancre is but seldom seen and when it is seen is usually imported. Though gonorrhœa is abundant and soft chancre not uncommon, the Maoris, who suffer much from gonorrhœa, very rarely present symptoms of syphilis.
Gout.—A rare disease; one which will probably be almost or quite unknown to young New Zealanders, who in appearance and build show scant tendency to the gouty diathesis, and in habits and mode of life do little to promote the spread of this most unnecessary malady. When gout does appear it is always in the person of an immigrant.
Rheumatism in all shapes is the great scourge of the colonist. Whether the wide spread of the disease and its severity is due to climate, or rather to the hardships and exposure of the settlers, is a question which can be solved only by time and the elimination of those things which specially tend to produce it.
Goitre appears in two mountainous districts. Tabes mesenterica, so-called atrophy, and other childish diseases of defective nutrition are comparatively rare, as is shown in the small mortality.
Dental affections.—The chief feature is the very rapid decay of the teeth, a decay which may be called almost universal among the New Zealand born. This premature decay is seen in the milk and permanent teeth. Its early beginning and its steady progress till all the teeth are affected leads to much pain and indigestion through “bolted” food. The early decay of both sets of teeth is one of the most noteworthy features in New Zealand medicine. I am quite convinced that statistics would show an amount of disease of the teeth that would startle European physicians.
Alcoholism is a disease that is happily dying out before the spread of civilization, the absence of hardships, the easy attainment of comforts, and the lessening dulness of colonial life.