11

A.—4a

Lobar pneumonia and broncho-pneumonia between them supplied 108 cases, though the mortality of the former is far less than that of the latter. Many of our cases of broncho-pneumonia have been prolonged by undue delay in resolution of the inflammatory patches in the lungs, and this condition would appear from outside reports to have been prevalent in many parts of England as well. The admissions in the enteric-fever group are about the same as last year, the two fatal cases in the Europeans being entirely due to delay in seeking treatment, an ulcer in one of them having actually perforated some days before admission. Amongst Samoans these cases are practically mild. Yaws injections still show a marked decrease —over one thousand less than last year —whilst, on the. other hand, a marked increase in the number of third injections given still further proves the efficacy of our system. Treatment —Surgical. Major operations have fallen off considerably. As in previous years, filarial abscesses head the list, though they too are diminishing in number, many more being now treated in the wards than formerly. Gynecological work is increasing, and there is still much to be done in this direction, it being evident that Samoan women suffer considerably from the diseases peculiar to women. The difficulty lies in persuading them to undergo the necessary treatment. Two hysterectomies have been performed, one for fibroid disease of the uterus, which apparently is not uncommon, and the other for malignant disease. Chinese Coolies. The admissions show a marked increase on last year's figures. Septic wounds and sores figure largely, whilst infectious diseases are negligible. Apia Hospital—Attendance, Operations, etc., por the Year 1925-26. General attendance (includes out-patient attendance, out-patient dressings, N.A.B. injections, and injections for elephantoid fever) .. .. .. .. .. ..27,799 Out-patient attendance (Europeans and Samoans) .. .. .. .. .. 11,467 Out-patient dressings (European and Samoans) .. .. .. .. ..11,537 N.A.B. injections— First injections .. .. .. .. .. . . .. 2,157 Second injections .. .. .. .. .. .. .. 1,214 Third injections .. .. .. .. .. .. .. 768 4,139 Injections for elephantoid fever . . .. .. . . . . .. .. 373 European in-patients .. .. .. .. .. .. .. .. 144 Samoan in-patients .. .. .. .. .. .. .. .. 688 Chinese and Melanesian in-patients . . .. . . .. .. .. .. 315 Chinese and Melanesian out-patients .. .. .. .. .. .. .. 293 Operations— Major . . .. . . .. .. . . .. .. 11l Minor . . .. .. .. .. .. .. .. 266 377 Report on the Laboratory, Government Hospital, Apia, 1925-26. By V. J. Hawke, Bacteriologist. Early in December, 1925, Dr. P. A. Buxton and his assistant, Mr. G. H. E. Hopkins, of the London School of Tropical Medicine, left for England. This summary of work done in the laboratory cannot be considered complete, as it deals only with the routine specimens and does not include any of the specimens done in the course of the research work. The number of routine specimens recorded is 661, comprised as follows : — Blood specimens : Widals —positive, 14 ; negative, 17. Blood cultures —positive, 1 (B. typhosus); negative, 15. Cell counts, 22 ; differential counts, 19. Malaria —negative, 5. Micro-filaria— positive, 2 ; negative, 13. Blood-sugar estimations, 5. A considerable amount of blood-typing has also been done. Sputa, for T.B. : Positive, 4 ; negative, 38. Sputa, for organisms : Number examined, 18. A number of sputa are noted which showed slight haemoptysis, but in which no T.B. or bronchial spirochaetes were found. These will be further investigated. Faeces : Total specimens examined for ova, 102, of which 30 were positive for hookworm, 14 were positive for ascaris, 20 were positive for trichuris; 72 were completely negative. For dysentery bacilli: Positive, nil; negative, 27. For enteric group : Positive, 1 ; negative, 16. For amoebae: Number examined, 4; positive, 1 (Entamoeba hystolytica); negative, 1 (Entamoeba coli). (N.B. —One specimen of faeces yielded a good growth of haemolytic Staphylococcus aureus.) Urine examinations: Number examined, 170: positive for sugar, 24; positive for casts, 5. For T.B. : Number examined, 3 —all negative. For other organisms : Number examined, 15; positive, 3 (all showing streptococci). Puncture fluids : Positive, 3 (2 streptococcal, 1 staphylococcal); negative, 2. Cerebro-spinal fluids : 2 negative for organisms. Venereal disease (gonococcal): Urethral smears—positive, 15 ; negative, 8. Cervical swabspositive, 7 ; negative, 14.