180 PRESIDENTS ADDRESS—SECTION H. 
of them are in fact either natural channels covered over, or 
made-drains which have been converted to the use of sewers ; 
and, as the manner in which house connections are made 
corresponds in point of defectiveness with the construction of 
the channels mentioned, each must judge for himself whether 
they are likely to be an advantage to the people using them, or 
the reverse. On the other hand, Melbourne has no system of 
sewers at all. Lastly, the age and sex distribution of the two 
populations cannot be compared (except by estimate, which in 
the case of any small area, at all events, is in my opinion more 
properly called a guess); but the birth-rate and the rate of 
natural increase are considerably higher in Sydney, and that, of 
course, gives her an advantage over Melbourne. So that in this 
comparison, while the two metropolitan areas are nearly on a 
level as regards population, specific population, and geological 
characteristic, Sydney has the general advantage of a higher 
birth-rate ; Melbourne has the great advantage, as regards fever, 
of a pure and copious water supply, and as regards diarrheal 
diseases, that of a colder climate. The balance between them 
may therefore be now struck. The difference as regards laws is 
as follows :— 
Victoria enjoys a very complete set of health statutes, the 
earliest of which dates from 1865; it has a Public Health 
Department, within which is a Board of Health not only well 
known to be composed of earnest gentlemen, but having the 
advantage of the sagacious advice of its permanent President, 
Mr. A. P. Akehurst; and it has local medical officers of health 
and local boards of health. New South Wales also has a Health 
Department, within which is a Board of Health, which my 
position precludes me from more than mentioning; but that 
province as yet has not any health statute at all, and of special 
laws relating to health has only a Quarantine Act, a Dairies 
Supervision Act, and an Infectious Diseases Supervision Act, 
which applies to small-pox alone. That board has statutory 
powers under other Act whatsoever. So I describe closely 
similar areas in two provinces, in one of which elaborate health 
statutes, administered by able officers, are operative, while in the 
other are (as regards the class of diseases especially referred to) 
absolutely no legal powers at all. I repeat once again that if 
executive sanitary organisation can do anything, it can reduce 
the prevalence of fever and of filth diseases, and theretore— 
unless there be something wanting—that class of diseases might 
be expected to be rife in the Sydney area, but should be nearly 
absent from the Melbourne area. I shall not be misunderstood, 
I am sure, yet I will say distinctly that the question now under 
examination is why these diseases, notoriously too prevalent 
amongst us, continue to prevail ; and although the circumstances 
detailed with regard to the two cities mentioned render their 
