A. —4a

Hospital Statistics for Period 1st April, 1924, to 31st March, 1925.

'Nationality. Chinese and Europeans. Samoans. Melanesian Labourers. Tn hospital, Ist April, 1924 .. .. . . .. 5 35 12 Admitted during year .. . . . . . . . . 130 773 277 Discharged during year .. .. . . .. . . 122 701 263 Died in hospital .. .. . . .. .. 4 32 8 Remaining in hospital on 31st March, 1925 .. .. 9 15 8 Report on the Laboratory, Government Hospital, Apia.—April, 1924, to March, 1925. By P. A. Buxton, M.R.0.5., L.R.C.P., D.T.M. k H. (Expedition to Samoa from the London School of Hygiene and Tropical Medicine). The laboratory has been mainly busied with research into filariasis and other conditions, and the research work is not included in this report. We have also dealt with such specimens as have been sent in from the wards and out-patient department, and it is these specimens alone which are the subject of this report. The following examinations have been made : —- Blood Examinations. —For filaria, 23 ; for filaria—positive, 7. Red count, 1 ; white counts, 5 ; differential white counts, 25. Blood cultures —negative, 8 ; positive (B. typhosus), \. Agglutinations —negative, 30 ; positive (B. typhosus) 9, (B. paratyphosus A) 3, (B. paratyphosus B) 2. Ftiical Examinations. —For worm-eggs —negative, 53 ; hookworm present, 96 ; trichuris, 55 ; ascaris, 24. For protozoa —negative, 8 ; lamblia present, 1; Entamoeba coli, 3 ; Entamoeba histolytica, 1. For bacteria —Number plated, 26 ; B. pyocyaneus found, 2 ; B. paratyphosus (non-agglutinating), 1. Urine Examinations. —General, 133; for organisms, by smear, 3 ; for organisms, by culture, 2. Various Examinations. —For leprosy —total, 26 ; positive, nasal smears 3, skin-scrapings 3. Pus —cultures, sundry, 15; smears, sundry, 16; smears, urethral, 8; smears, urethral, gonococcus positive, 5. Gland-punctures, 3. Serous fluids examined, 4. Smears from yaws cases, 25. Sections cut, 12. Post-mortem examinations, 4. Fluids for percentage of alcohol, 9. Sputa for T.B.— negative, 32 ; positive, 8 ; streptococci, positive, 1. The following points deserve comment: There are a number of cases which clinically resemble typhoid, but from which no organism can be recovered by blood culture early in the disease : these cases give negative Widal-reactions later on. There is also a common type of enteritis, with or without blood in the stools, which cannot apparently be attributed to any of the organisms which generally give rise to these conditions. The two stools from which B. pyocyaneus (and no other abnormal organism) was isolated were those of mother and child, acutely ill at the same time. A second child died, apparently of the same condition, before the stool could be examined. There is much research yet to be done upon the intestinal bacteria in Samoa. The only case from which Entamoeba histolytica was recovered was a sailor, native of Manahiki, who arrived in port suffering from amoebic dysentery. As O'Connor has already reported, this disease is rare or non-existent in Samoans. He only found E. histolytica in 9-6 per cent, of 229 stools examined. Of the five urethral smears in which gonococcus was found, four were from pure-bred Samoan males. It is sometimes said that Samoans are immune ; but possibly they are infected more often than we realize ; but if so they certainly do not suffer from orchitis, strictures, and grave complications which would bring them into hospital. REPORT OF THE RESIDENT MEDICAL OFFICER, APIA HOSPITAL, 1924-25. Administration. This year we have been able to effect reductions in the clerical staff of the office, as the Treasury Department has taken over the collecting of all accounts for European patients after the bills have been issued. Samoan patients now receive free treatment, requiring no accounts. The European staff in the dispensary has been reduced, as we have now a Samoan cadet who, after five years training, is able to act as a dispensary assistant, making the employment of a European assistant dispenser

2—A. 4a.'

9

Hospitals. Dispensaries — . a 1 I J i \ _• a • - -S a i S -a % . 3.-3 % 3 ~i 2 ! c3 «3 Is .5 3 c8h ° H ■ to J O co >5 >- H In hospital, 1st April, 1924 .. 47; 3 2 j .. .. .. 52 Admitted during year .. 94! 72 16(i 36 j .. .. .. 1,215 Discharged during year .. 922 70 159 38 .. .. .. .. .. .. 1,189 Died in hospital .. .. 34 5 5 .. j . . . . .. .. 44 Remaining in hospital on 31st 30 2 .. .... .. . . .. . . 32 March, 1925 Outpatient attendances, includ- 24,489| 6,82S 10,353 1,363 4,758 3,777 2,513 4,034 3,583 1,186 28063,164 ing dressings Treatment for hookworm .. 87j 1,816 4,770 736 1,659 .. .. .. .. .. 7,491 16,559 Treatment for yaws (injections 5,843 2,589 4,017 39 2,123 .. .. ... .. .. 6,611 21,222 of N.A.B.) Operations— Major .. .. .. 170 3 17 190 Minor .. .. .. 215 68 157 2 110 550 Visits paid during period to 784 107 73 134 22 15 15' 233 134! 101 .. 1,330 patients in their homes