BY JAxMES JAMIESON, M.D. 99 



Here we have in some respects the same thing seen as in 

 the previous table. With a large population, scattered over a 

 large area, the fluctuations of course are not nearly so great 

 as those shown for Hobart. But what is also apparent is 

 that, while on the whole the mortality has been lower in 

 Extra Metropolitan Victoria than in the Metropolis, this has 

 now ceased to be the case. Something has happened in the 

 last two or three years in Melbourne to make the rate lower 

 than in the rest of the State, though the same thing had 

 never happened in any other year of the period. 



To the casual observer the differences just pointed out may 

 seem trifling, but in a place like Melbourne, with a popula- 

 tion of about half a million, a lowering of a death rate by 

 even 1 in 10,000 of population represents 50 lives saved 

 annually, and these in turn may represent about 500 fewer 

 cases of typhoid. The value of 50 lives of persons in the 

 prime of life, as most typhoid patients are, and the cost of 

 500 cases of tedious illness, are not matters which can be dis- 

 missed as trifles. By themselves, in fact, they make in their 

 saving a considerable offset against the expense of sewerage. 

 And when, to these savings, there is added the comfort, almost 

 the luxury, of living in a sewered house, as compared with 

 another in which the night pan is ever apt to reveal its offen- 

 sive presence, and where foul water of every kind has to 

 trickle along from house drains to right-of-way and street, 

 it may well be a question whether the offset is not 

 a full one. It will be for the people of Hobart, who 

 have much to gain in the reputation of their city as a 

 health resort, in addition to the savings and gains just 

 mentioned, to decide whether it is not a grievous mistake to 

 alloAV present conditions to continue longer than is absolutely 

 necessary. I do not wish to refer specifically to other 

 sanitary defects which reveal themselves easily to the trained, 

 perhaps even to the untrained, observer. Many of them 

 would disappear with the completion of a proper system of 

 drainage. With these improvements accomplished, Hobart 

 should be second to no other place in the Australian Com- 

 monwealth as a health resort ; and it is hardly stretching 

 prophecy too far to express the conviction that, among 

 the benefits obtained, there would be complete, or almost 

 complete, immunity from outbreaks of typhoid. 



