316
to 413 respectively. The neutrophilic leucocytes are always in excess as well, so that possibly assistance may be derived from this method which will help, taken of course in conjunction with the clinical history of the case. Unfortunately none of these "blood tests" are to my mind sufficiently positive to enable one to rely on them in doubtful cases-the only time a clinician wants help-as one of our dysenteric cases developed symptoms pointing to liver abscess and the blood count gave 16,000 white cells. The patient, however, recovered without any abscess and is now well. As with the Widal reaction for typhoid so with these blood counts it is to be wished they were "positivus aut nihil.”
Fractures.-The following were treated during the year :-
Thigh,
Leg,.
Arm,
Forearın,
Skull,.
Ribs.
Clavicle,.
Patella,
Scapula
Jaw,....
Finger,
Shoulder,
Elbow,
10
11
5
6
15, with 12, deaths.
3
3
1
1
1
1
Dislocations.-The following were under treatment :-
Jaw, Thuinb,
6
2
1
Injuries. 544 cases with 41 deaths. They were many and various, some very trivial and others serious. There were 7 cases of bullet wounds of which two were fatal, both patients being shot through the abdominal cavity. Dynamite explosion accounted for 4, one of which was fatal. They were all in fishermen.
Parasites.-The two of interest which came under our notice were the Disto- ma Ringeri and Rhizoglyphus parasiticus. The former occurred in a Japanese from Formosa who is still in the Colony and still the subject of the disease. The latter was found by myself for the first time in this Colony which adds to its in- terest as far as we are concerned. It is a somewhat unknown parasite and not mentioned in any of the standard works on Tropical Disease and is known as the "water itch." It occurred in 3 cases here all on the feet where it gave rise to superficial ulceration with a tendency to formation of burrow. The parasite is not very easily found as they are not numerous. An illustration appears in MAX BRAUN's work "Die Thierischen Parasiten des Menschen" and an account of one of our cases was illustrated in the "British Medical Journal" of November 11th, 1905.
Operations.
216 were performed during the year. Amongst the more important were:-
Liver Abscess.-3 cases, with 2 deaths.
Amputation of the Thigh.-3 cases, all recovered. They were done for severe compound fractures in which every endeavour was made to save the limb but as the patients were all sinking from septicemia the operation was done by Dr. Kocн, Assistant Superintendent, with, I am glad to say, a successful result in each case as far as life was concerned.
Lethotomy.-Two cases with one death. Both were in Chinese.
Strangulated Hernia.-One case, successful.
Abdominal Section.-Two cases for bullet wounds, both fatal, and one explo- ratory, which case recovered.
1