A.—3

Dental Clinic. —In conjunction with the school medical work, a dental clinic has been established at the hospital. This has proved of great convenience and benefit to both adults and children, the latter receiving particular attention. Attention is being directed particularly to the permanent teeth of the children, and it is hoped that by regular inspection dental caries will be nipped in the bud and the teeth of the younger generation will be preserved. Attention was also directed to the second teeth of the senior pupils. Only a mere fraction of the work requiring to be done can be carried out; but it will pave the way until a dental nurse, now in training in New Zealand, can be stationed on the island. The work done has been as follows : Fillings, 92 ; extractions, 67. Rounds : The outlying villages were visited twice weekly. 531 persons received treatment in their villages. Infectious Diseases. —The following infectious diseases were reported : Pulmonary tuberculosis, 15; tubercular peritonitis, 2; lobar pneumonia, 2 ; broncho-pneumonia, 1 ; influenza, 173 ; gonorrhoea, 52 : total, 245. Influenza. —During the second quarter there was a, mild outbreak of this condition. The attacks were not severe, and were not followed by any complications. The outstanding feature of the attacks were the gastro-intestinal symptoms. Gonorrhoea. —There were fifty-two cases of this condition, as compared with fourteen of last year. This increase was due to an outbreak after a visit of a steamer during the third quarter. The police brought thirty-five suspects to the hospital for examination. During the year seventy-six microscopial examinations were made for gonorrhoea—fifty-two positive, twenty-four negative. Yaws.—Sixty-one cases of this condition were treated. The following list shows the different manifestations of yaws that called for treatment: Tonas, 26 ; plantar dermatitis, 14 ; painful shins and knees, 13; hyperkeratosis, 2 ; gummations infiltration, 2; old scars, 3; throat-ulcers, 1 : total injections given for yaws, 183. The number of cases of yaws requiring treatment in the past four years were as follows : 1924, 288 ; 1925, 199 ; 1926, 199 ; 1927, 61. From the above figures it will be seen that yaws is a condition that is disappearing steadily from the island, and in the course of the next few years it will be entirely exterminated. Leprosy. —No further cases of this disease have been met with. Periodically the contacts of the two cases sent to Makogai Island parade for inspection. Filariasis. —Earlv in the year an inspection of the whole island was made for filarial manifestations. It was found to be fairly common. 4 per cent, of the population presenting clinical signs of this disease. They were as follows : Elephantiasis of the limbs, 55 ; elephantiasis of the breast, 2 ; elephantiasis of the scrotum, 6 ; pedunculated tumour of leg, 1 ; hydrocoele, 82 : total, 146. Goitre. —During the inspection for filarial conditions, four cases of simple enlargement of the thyroid gland were noted. All cases were of long standing, and were in females. House and Village Inspection. —This was carried out early in the year. The village areas as a whole were clean, the villages of Alofi and Hikutavake being outstanding in this respect. The results of the inspection were as follows : Houses to be cleaned or repaired, 73 ; houses to be destroyed, 30 ; W.C.s condemned, 94 ; cookhouses condemned, 4 ; pigsties condemned, 5. Houses. —With the view of increasing and maintaining the general standard of dwellings the following suggestions are offered : — (1) All leaf shacks belonging to deceased persons be completely destroyed shortly after the burial of the deceased. This is done in some cases, but it is not a universal practice. (2) Any lime house belonging to a deceased person be pointedout to the Medical Officer by the village police, and if in the consideration of the Medical Officer such a lime house be in poor repair it be condemned. This measure will prevent the young or relations occupying an old house and thereby avoiding the responsibility of building a new house for themselves. (3) It is found that it is a common practice for young couples to live with their relations. It is suggested that every young couple be compelled to construct a dwelling of their own. (4) All windows in lime houses be fitted with louvre ventilation, and the fitting of windows with close-fitting doors be strictly forbidden. (5) In certain parts there is a tendency to build dwellinghouses rather close together. A distance of at least 30 ft. should be between each dwelling. Mosquito Pest.—This pest has at times made conditions very uncomfortable at the hospital, but since there has been a periodic clearing of the bush surrounding the hospital grounds there has been a marked decrease in numbers of the mosquitoes invading the hospital building during the evening. Staff. —Under the matronship of Miss de Ridder the work of the staff has been highly satisfactory. It was necessary to make one change in the Native staff.

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