XX PROCEEDINGS, MAY. 



of Tasmania was less than of the other colonies. But they must not 

 forget that a large birth-rate would mean a larger death-rate owing to 

 the number of deaths that occurred among children. He could 

 not attach the same importance as Mr. Johnston to cosmical influences. 

 There were always atmospheric influences at work, but these operated 

 as much towards health as disease. If they could bring their sanitary 

 arrangements up to a proper degree of efficiency they could afi'ord 

 to disregard cosmical influences. They had never yet obtained the 

 active and hearty co-operation of the people in the carrying out of 

 sanitary measures, but when they did it would be possible to reduce 

 the number of cases of zymotic disease even in summer to a minimum 

 and keep it there. If they had sanitary measures carried out with, 

 knowledge and spirit, the number of cases of typhoid fever might be 

 counted on the fingers of one hand. (Applause.) 



Mr. MoKTOisr, the secretary, also read the following communication 

 received from Dr. Agnew : — I much regret being unable to be present at 

 the discussion on Mr. Johnston's valuable and highly interesting paper. 

 It is satisfactory to note that it more than confirms the general 

 impression as to the salubrity of the Tasmanian climate, and proves by 

 the inexorable logic of recorded facts, that in no part of the world 

 from which we have statistics, is the prospect of a long life so good as 

 in this colony. Some of Mr. Johnston's observations on the present 

 epidemic of typhoid are worthy of careful consideration, and will, no 

 doubt, insure discussion. My own impression is that the cause and origin 

 of this disease are not yet clearly determined. No doubt the commonly 

 assigned causes, filth or dirt, and certain foul gases, generally play 

 a very considerable part in forming or fostering the disease, and there- 

 fore these noxious agents should unquestionably, in ail cases, be done 

 away with. But the question still remains, would the disease ever 

 arise were these agents absent ? Information, I venture to think, is 

 still wanting before a conclusive answer can be given. From my own 

 experience, however, and from the recorded experience of others, I 

 think the disease may arise at any time without any hitherto recognise i 

 cause, but that its diffusion is generally influenced to a large extent by 

 insanitary conditions. As these conditions, however, are frequently 

 present, even in an intense degree, without producing fever they cannot 

 be the sole cause, although they may constitute a great and palpable 

 factoj. But something more subtle appears to lie beyond. In the 

 course of at least 25 years of my practice I do not think I saw six cases 

 of typhoid, yet Wapping and other parts of the city were probably in 

 a worse sanitary condition than they are at present. The few cases I 

 saw, too, were quite solitary, and never acted as foci for the spread 

 of the disease. Why was the city not scourged, at least occasionally, 

 during all this time with fever if the real cause was persistently present ? 

 Again, like other epidemics, the present one has had its rise and fall 

 over vast areas of town and country, the insanitary conditions still 

 remaining a constant quantity. Weather, I am told, exerts little or no 

 influence. Now, speaking of a locality under our immediate observation, 

 if well-known noxious agents were (as frequently alleged) the sole 

 causes of the fever, why should a healthy person, if exposed to their 

 evil influence in Hobart to- day, be less liable to take the disease 

 than he was a month ago, and why, if he took it, should 

 it be of a milder type ? The sanitary conditions remain 

 virtually as they were. It cannot be said that the weak and puny 

 alone succumbed at the onset, and that the robust who are left 

 are better able to resist the poison. The disease, in fact, as far as age, 

 health, and physical condition are concerned, has been very impartial 

 as to its victims, nor does locality itself seem altogether to confer 

 immunity. If the usually assigned agencies too, were the sole cause 



