H.—3l

47

It will be noted that while the death-rate in ante-partum eclampsia was increased, there was no mortality amongst the cases which started after delivery. I regret to see that accouchement force is still sometimes practised. There are two standard methods of carrying out the conservative treatment of eclampsia—Stronganoff's method and Tweedy's, or the Dublin, method. Both methods have been thoroughly tested, and have given excellent results in large numbers of cases. I think it would tend to improve the treatment of eclampsia in this country, and its results, if practitioners would familiarize themselves with one or other method, and adopt it consistently in preference to the somewhat heterogeneous mixture of methods which is at present popular. The Use of the Midwifery Forceps. The tendency to abuse the midwifery forceps, though confined to an ever-lessening number of maternity hospitals, is still sufficient to need careful watching. It is difficult to understand the mentality of the practitioner who adheres to methods which have been criticized and condemned in every obstetrical school in the world. Such people are impervious to suggestion, and I am afraid that, before we shall get away from the harm they do, a new generation must rise. The following figures taken from the monthly returns of maternity hospitals show how practice differs in different places : —

Table "B."

These figures represent tlie extremes. On the whole, the position is improving, and we can, I think, look forward to a time when all practitioners will realize that the proportion of women wlio cannot deliver themselves safely and satisfactorily is very small. The following table shows the position for the last three years as regards the country at large : —

Table "C."

, x , , Percentage of tt , Number of i?™JL H ™ I * tol - 43'„. St. Helens Hospitals .. .. .. .. 2,333 4-37 Whangarei Public Hospital .. .. . . 172 1-74 Stratford Public Hospital . . .. .. 145 5-52 Palmerston North Public Hospital .. . . 175 1-14 Private Hospital, Auckland .. . . . . 103 1-94 Private Hospital, Auckland .. . . .. 91 5-49 Private Hospital, Wellington . . . . . . 155 2-58 Private Hospital, Wellington . . . . . . 63 4-76 Private Hospital, Canterbury . . . . . . 112 5-36 Private Hospital, Canterbury .. .. .. 77 3-90 Timaru Public Hospital . . .. .. 103 0-97 Public Hospital, Inangahua . . . . . . 19 57-89 Public Hospital, Westport . . . . . . 65 30-77 Public Hospital, Rangiora . . . . . . 100 30-0 Private Hospital, Auckland District . . .. 19 47-06 Private Hospital, Auckland District . . .. 30 37-04 Private Hospital, Auckland District . . .. 14 46-15 Private Hospital, Wellington District .. . . 15 40-00 Private Hospital, Wellington .. .. .. 27 37-04 Private Hospital, Wellington .. .. .. 151 36-42 Private Hospital, Canterbury .. .. .. 22 36-36

Number of Full-term Labours. Percentage of Forceps Deliveries. Hospitals of ' 1927. 1928. 1929. 1927. 1928. 1929. 50 confinements and under .. 3,794 3,907 3,829 15-06 12-33 11-07 From 51-100 .. .. 5,589 5,162 4,880 12-63 11-43 10-7 From 101-150 .. .. 3,044 2,566 2,593 16-29 12-7 8-83 Over 150 .. .. .. 4,229 4,858 5,680 7-35 8-13 8-06 Dominion totals .. 16,656 16,493 16,982 12-51 10-87 9-6