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at home, in conformity with the Native custom —the friends of the patients have a very deep-rooted objection to their dying elsewhere than at home. There are at present eighteen patients in the Hospital, several of whom will be fit to discharge before the end of the week. There have been fifty-seven operations, for which a general anaesthetic has been given. In spite of the tendency all wounds have towards suppuration, the results have, on the whole, been very satisfactory. Chloroform has been the anaesthetic invariably used, and the Natives take it and stand operations very well. There have also been many minor operations performed under local anaethesia, both in the outpatient and in-patient departments. I must tender my thanks to the, Administration for the ready assistance the Hospital has always received at its hands. During my stay here a most commodious, and withal inexpensive, operating-theatre has been thrown out from the casualty room. This has proved a great success. New beds and bedding of a very suitable quality have also been supplied. Also two Native huts have been put up in the grounds for use in advanced tubercular and other cases where isolation is advisable. Owing to the large amount of surgical work both in the in- and out-patient departments, the two nurses have been kept working at a very high pressure every day. Miss Nobbs, the Matron, and Nurse Easton (who I regret to say is leaving us in June) deserve the heartiest thanks both of myself, who have found their efforts so useful and helpful, and of the patients, whom they have always treated with the greatest kindness and attention. I must also acknowledge most gratefully the assistance I derived from Dr. Hilda Northcroft, now on a visit to the Islands. Whenever appealed to she was always ready to give most valuable assistance both at operations and consultations. During the past three months the work has been very heavy, more indeed than one man can manage properly, but with better weather coming on no doubt the pressure will be considerably relieved. As regards the other islands of the Group, I have had neither the time nor the means of communication to visit them. R. L. Norman, Acting Medical Officer.

Report on the Condition (Medical) of Aitutaki, May, 1915. My stay on this island extended from the 7th to the 24th May, 1915. During this time I was kept working at a very high pressure, as many as sixty patients being seen on one day on at least two occasions. Fifteen operations were performed under chloroform, with, on the whole, very beneficial results to the persons concerned. The whole island was visited, and practically all cases of sickness received treatment. One death (a baby) occurred, of bronco-pneumonia. The health of the Natives on this island is exceedingly unsatisfactory. The condition of affair? is accentuated by the tumble-down condition of all the Native dwellings, due to the hurricane of last year, and the poverty of many of the people, which cannot admit of their houses being put in proper re Dair. As in Rarotonga, the chief diseases responsible for the unsatisfactory condition of affairs are syphilis and tuberculosis. The former disease, having been practically allowed to run riot, has produced ravages which in many cases are truly appalling, and we may be assured that it has been, and still is being, transmitted to the children. The Women are the worst sufferers for the most part, and syphilitic disease of the rectum (a most intractable form of the malady) is very common here. Tuberculosis holds much the same position as it does in Rarotonga. Several cases of phthisis and disease of the cervical glands have come to my notice. I have also seen some bad cases of tubercular bone disease. There has been a great deal of so-called " fever " during the summer, but it appears to a large extent to have died down. I have seen about five cases. One was an ordinary pneumonia, which soon cleared up. All the others except one appeared to be of an influenza type, which was common enough about that time in Rarotonga. The remaining case has certainly puzzled me. The patient is a hoy of twelve, and he has suffered from fever for three weeks. At first his complaint was only of headache, and that soon passed off, but the fever, with temperature of 103° to 104° in the afternoon, has continued for a long time. A fair degree of intestinal catarrh combined with the continued fever at once suggested typhoid fever, but the other symptoms are absolutely at variance with this hypothesis, especially as the boy is otherwise well, and is with difficulty restrained from running about. The temperature is now coming down. Apparently this must have been the " fever " that has afflicted the island during the summer. It must he borne*[in [mind that the conditions of life as regards housing, nursing, diet, and general comfort are at a very low ebb here ; also the supply of drugs is very inadequate to cope with serious or, indeed, any real disease, so that all one can do in a medical case is to prevent the friends and relatives from doing wrong. Active treatment in medical cases, I repeat, is practically impossible. As regards the operation-work, there is no doubt that practically all patients will benefit—some of them to a great, others to a lesser, extent, but all more or less. Elaborate work was out of the question, owing to the extreme difficulties under which the work was carried on —the filth of the houses, the scarcity of water, and the necessity of going everywhere (in very hot weather) on foot with instruments and dressings.

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