A.—4A

Treatment—Surgical. Major operations again show a falling-off, with abscesses heading the list. A large number of cases of hydrocele, &c., have been operated upon in Aleipata under local anaesthesia, a form which seems to be very popular with Samoans. The same routine is now being followed in this hospital, and it is expected that our returns will show a marked increase next year. With an improved technique, this form of ansesthe&ia appears to be ideal. Chinese Coolies. Although the total returns for the year are just below last year, there has been a decided increase in the number of admissions to hospital, some due to beriberi, of which we have had twenty-four cases, with one death. All these cases arrived by the Chinese transport in August, and most of the cases were mild, but even then recovery is often tedious, and diagnosis in the early stages is far from easy. Apia Hospital—Attendance, Operations, etc., for the Year 1926. General attendance (includes out-patient attendance, out-patient dressings, N.A.B. injections, and injections for elephantoid fever) .. .. .. .. .. ..27,479 Out-patient attendance (European and Samoan) .. .. .. .. .. 11,888 Out-patient dressings (European and Samoan) .. .. .. .. .. 12.044 N.A.B. injections — First injections .. .. .. .. .. .. .. 1,173 Second injections .. .. .. .. .. .. .. 1.116 Third injections .. .. .. .. .. .. .. 1,042 - — 3,331 Injections for elephantoid fever .. .. .. .. .. .. .. 21 European in-patients .. .. .. .. . . . . .. 150 Samoan in-patients .. .. .. .. .. .. .. .. 669 Chinese and Melanesian in-patients .. .. .. .. .. .. .. 384 Chinese and Melanesian out-patients .. .. .. .. .. .. .. 213 Operations— Major .. .. .. .. .. .. .. .. .. 95 Minor .. .. .. .. .. .. .. .. .. 156 Report on the Laboratory, Government Hospital, Apia, 1926. The following report covers a period of nine months (Ist April to 31st December). This is in order to come into agreement with the General Hospital report—viz., Ist January to 31st December (inclusive). The first three months of the year were included in last year's report. Several welcome additions to apparatus have been made, including a water-driven centrifuge and dark-field illuminator. We are still dependent upon kerosene-heating, but a Spenser's petrol-gas generator has just come to hand, and at time of writing is being installed. With this completed we shall be able to obtain a new incubator and autoclave to replace the present kerosene-heated ones, which are inadequate to cope with the demand, while the advantage of Bunsen burners on the working-benches will be inestimable. At the request of Professor Hercus, Otago University, New Zealand, samples of Samoan vegetable products were sent for iodine estimation in connection with his work on goitre. Unfortunately, samples of bananas and taro were unsuitable for analysis on arrival, but some of the results reported are very interesting. A sample of yam contained 6 parts of iodine per 100,000,000, which is a typical result for New Zealand vegetables of that type. Samples of garden-soil gave 240 parts of iodine per 10,000,000, while the plantation soil sent gave 200 parts per 10,000,000. Professor Hercus states that typical goitrous areas in New Zealand show a soil content of only 30 parts iodine per 10,000,000. It is proposed in future to send monthly supplies of vegetable products, &c., for investigation, to ascertain if possible any seasonable variation in the results. A number of sera from yaws patients have also been sent to the Dunedin Laboratory, where both Wassermaun and Kahn's Precipitin tests have been performed. All the sera from patients who came up for injection were positive in a very high dilution. Provision has now been made in this laboratory for carrying out systematic tests on these cases, especially with a view for observing results after treatment. The number of hospital " routine " specimens recorded is 1,341, of which twenty-nine were from patients seen by the visiting Medical Officer,' and one from the hospital at Tuasivi, Savai'i. The specimens comprise the following : — Blood specimens : Total cell counts, 54 ; differential counts, 54 ; hemoglobin estimations, 8; blood cultures, 2 (negative) ; filarial examinations, 6 (positive) ; Widals—positi ve B. typhosus, 14 ; positive paratyphosus B, 3 ; blood-sugar estimations, 3. Urines : Positive albumin, 139 ; positive sugar, 12 ; positive blood, 40; positive bile, 6 ; positive pus, 106 ; positive casts, 19 ; urea estimations, 1 ; quantitative albumin, 3 ; containing organisms—tubercle bacilli, nil; streptococci, 3 ; staphylococci, 3 ; B. Coli, 22. Faeces : For hookworm ova (positive), 57 ; for Ascaris ova (positive), 12 ; for Triohuris ova (positive), 28; adult worms —hookworms, 2; Ascaris, 2; for organisms—Bacillus dysenterice shiga, 18.

2—A. 4a.

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