47

H.—3l

of operations he was discharged. When he was leaving the office I asked him what he was going to do. He said, "I am going back to my work as a electrical engineer." As a matter of fact, he is now working in a grocery-store, serving behind the counter. He wears no apparatus, has one stiff knee, and gets about with the aid of a stick. The point is that, from the point of view of the State, he started a " minus," because ho required attendance, and if he returns to his former employment he ends as a " plus " 75 to 80 per cent. Yet he is still a cripple, and I can estimate his functional improvement only as follows : Functional improvement with respect to the limb affected, 40 per cent. ; functional improvement with respect to the whole body, 50 per cent. Plaster Department. —Throughout tho year 1,420 plaster operations have been performed. Dr. Lumsden has taken over the treatment by corrective plaster jackets, &c, of those cases of functional and structural scoliosis that are from time to time admitted. In this connection one might add that for the past three years we have been carefully noting, filing, and studying all the literature that has come our way concerning the operative treatment of this hideous and disabling deformity (the cases here are usually severe), and being now satisfied that such progress has been made that the experimental stage is past, and that an operative treatment of scoliosis is now possible and commendable, it is probable that during this year wo will launch our own attack. X-Ray Department. — The X-ray examinations for the year total 647. This Department is being made more use of as time goes on by tho medical men of the district. Laboratory and Pispensary . —Laboratory : Tho greater proportion of the laboratory work is now sent to Hamilton or Auckland, and we will definitely continue to carry out this policy. Dispensary : The number of prescriptions dispensed during the year is 1,386. Surgical Bootmaker's Shop. —The number of surgical boots made during the year is 124, and the number of repairs is 631. Infectious-diseases Hospital. —We have been entirely free from anything in the nature of an epidemic among the children in this Hospital. Services rendered. —ln conclusion, I would record again the help I have received from my responsible officers, the Matron and the nursing staff, and acknowledge, our appreciation of the services rendered during the year by the Red Cross Society, the Rotorua Women's Club, and many other friends, who have contributed time, money, or its equivalent for the welfare of our patients. SECTION 3.—OTAKI SANATORIUM AND HOSPITAL. Dr. A. H. Curtis, Medical Superintendent; Miss Sealy, Matron. Results of Treatment. —In submitting the analysis of cases treated at the Sanatorium during 1922 I consider the results on tho whole satisfactory. Comparing the results for this year with those of 1921, in the latter year forty-eight cases were arrested, as compared with only twenty-three in 1922. The term " arrest " as used in 1921 was taken to mean " free from symptoms," but in the present report is restricted to those cases not only free from symptoms but with sputum free from bacilli. Those free from symptoms but with positive sputum are now included under the term " much improved."" The term " first stage " is also an arbitrary one, but is here restricted to patients whoso physical signs are limited to the area of the lung above the clavicle and spine of the scapula. It will be seen that the percentage of such cases (twenty-two per cent.) is low, and is likely to remain so under the present system of admission. On the whole, however, the class of case admitted during 1922, clinically speaking, has shown considerable improvement on the class previously admitted. Out of the fifteen cases " improved," six were admitted in an advanced stage and soon afterwards discharged. Administration. —With regard to the Sanatorium itself, the routine and general running of the institution has been for the most part satisfactory. Since October the management, from a business point of view, has been much improved by the advent of the house manager. The farm, under the Department of Agriculture, has done well during the year. The supply of milk has been abundant and of excellent quality, a good supply of eggs has been available, also of vegetables. Mutton obtained from fat sheep slaughtered on the premises has been much better quality than that supplied by local butchers, and quite appreciably cheaper. Drainage of bush swamp at the back of the Sanatorium has been undertaken in order to reduce the breeding-ground for mosquitoes. With regard, to the gardens, fresh ground has been brought into cultivation during the year, new beds and lawns having been formed at the Medical Superintendent's house and in front of the Sanatorium buildings. Olaki Hospital. —It speaks well that out of 178 cases treated 124 were discharged recovered, while a death-rate of 6-1 per cent is certainly not unduly high. SECTION 4.—PUKEORA SANATORIUM. Dr. Hugh Short, Medical Superintendent; Dr. W. Fulton, Assistant Medical Superintendent j Miss I. VV'hyte, R.R.C. (Medaillc de la Reine), Matron. General. —It is gratifying to be able to state that the general, morale of the patients has shown a marked improvement during this period, a state of affairs beneficial both to their health and to the smooth running of the institution. This improvement is put down to two main factors : (1) The sympathetic attitude of the administering Department; (2) passage of time, bringing with it a gradually improving mental attitude as compared with that previously evinced by the majority of patients —viz., service patients—and produced by military service with its attendant disciplinary restrictions. As time goes on these patients arc learning more and more the necessity, for their own health's interests, to conform with the routine laid down in a complacent and co-operative spirit. Treatment. —With regard to the character of the cases admitted during the year, it may be stated frankly that there still remains much to be desired in the selection of civilian patients. All too frequently cases are allowed to remain under treatment outside a sanatorium far too long before being advised to seek admission.