17

A.—4a

Black-boy Labourers admitted to Hospital in Year 1922-23.

All in the last six months. The totals of tho patients receiving treatment were as follows : — Chinese remaining in hospital on 31st March, 1922 .. .. 55 Chinese admissions during 1922-23 .. .. .. .. .. 353 Black-boys remaining in hospital .. .. .. ' .. .. 0 Black-boy admissions during 1922-23 .. .. .. .. 32 Total .. .. .. .. .. ..440 Three Chinese died in the wards, two from beriberi and one from cardiac disease ; one of the beriberi cases died directly after admission, and the other was complicated by chronic nephritis. 'Report op the Dysentery Cases admitted to the Apia Hospital during the Epidemic of 1923. History. —A few oases of dysentery were admitted to the hospital during the last three months of 1.922 and tho first four months of 1923, but it was not till May, 1923, that the numbers had increased to such an extent that it became necessary to make special. arrangements for dealing with them. At the end of May the isolation area fales were inadequate, to accommodate the number of Samoan cases, so the fales adjacent to these were used. The surgical activities of the hospital were restricted, except in the case of emergency, because of the risk of infection being conveyed to a convalescing patient, and also to decrease the number of patients in the hospital. The admission-rate reached its maximum in June, and then steadily declined, as the following table will show :—

Dysentery Admissions.

No cases of dysentery have been admitted to the Samoan wards for the first three months of 1924. Etiology. —lt became evident in April, 1923, that the sporadic dysentery cases that had been admitted to hospital during the last few months were still occurring, and would probably lead to an epidemic at the beginning of the dry season. The pathological records of the fseces of all the cases that had been examined showed the infection was probably bacterial, as no protozoan had been constantly found and the cell-contents were bacillary in type. At the end of May bacterial agglutinations were started, and by the middle of June they showed that the epidemic was caused by the bacillus of shiga, as is shown in the accompanying report (Appendix A.) Agglutinations were continued throughout the epidemic, and confirmed the original report, as is shown in the following monthly table : —

Dystentery Agglutinations.

December nil. Note. —The threatened typhoid epidemic mentioned in Appendix A rapidly died out; only six suspected enteric cases were agglutinated during the remainder of 1923, with the result that three agglutinated B. typhosus and two B. paratyphosus " B," one being negative.

3—A. 4a.

Disease. Number of Cases. Disease. Number of Cases. Abscesses .. Bronchitis 3 2 1 3 10 3 Gonorrhoea Injury Pneumonia Synovitis Yaws 1 2 5 1 1 Burns Colitis Dysentery (Bac.) Fever Total 32

1922. 1923. -« it 2 o o ft as P ■S d a xs ft M El 3 ft s h a ->i e3 Q . * ■«i Oh 02 © o ft o as n Europeans Samoans Chinese Melanesians } 5 3 I .. 2 1 .. 2 i 2 5 7 I 9 2 7{ J 3 2 3 3 3 2 2.. I 15 6 12 13 14 23 5 1 25 12 32 23 5 8 4 66 43 3 8 2 4 1 2 1 1 3 1 Totals 43 11 8 3 2 4

Jui ne. July. August. September. October. Nove rber. Cases exam. Pos. B. Shiga. Cases Pos. B. exam. Shiga. Cases I Pos. B. exam. I Shiga. Cases Pos. B. exam. Shiga. Cases exam. Pos. 11. Shiga. Cases exam. Pos. It. Shiga. liuropeans Samoans Uiinese 6 7 9 (i 5 4* 0 4 4 0 4 3 18 13 11 4 4 2 2 2 2* 8 8 1 i i i 2 2 i i l i 3 3 Totals 22 3 3 * One case included in ei srobably just a marked group as ich of theso groups had a !glutination. sis no cases weri slightly higher ag< ; seen of B. flexner i rdutinaton to B. Hi igglutination withou sxner than to B. it marked B. Shiga ihiga, but, iigglutinati this was on.