Napier, January 30th, 1869.

Sir,—I have the honor to forward you, and enclose herewith, a tabular statement of the diseases which have been under treatment in the Provincial Hospital during the past year. I don’t know that anything in it particularly calls for remark, save that at the first glance the cases seem much fewer than in former years. The contrast with the two preceding years is explainable that in the year 1866 the wounded from Omarunui considerably swelled the figures, and in 1867 the immigrants per Montmorency added materially also. The working population of the Province has been, I have no doubt, thinned by a gradual exodus to the gold-fields in an adjoining Province. The greater difficulty which your Honor wisely interposed between the mere transmission of a patient and his actual admission, has had a wholesome restraint upon the then system of almost indiscriminate admission; and the system of payment also, made imperative except in cases of absolute need, has worked well in checking inordinate attempts of admission. I fear the latter is better in theory than practice, for do what we will we continually incur bad debts, and really very little reverts to the Provincial pocket.

There is one class of diseases which I may say is congratulatory to the Province generally to see represented by so small a figure, namely, consumptive cases, only one, and that an imported case, discharged from the Consumptive Hospital at Brompton, not as it were indigenous to our climate. The number of rheumatic cases far below the average. These two diseases alone added nearly 20 last year to the general number. We have to record two very severe cases of accident by machinery. The one, the boy Robert Willis, whose shoulder was completely denuded, the arm only hanging by a single tendon. He has since got completely well, the arteries at the time being promptly secured by the timely arrival of my friend Dr. Spencer, 18th Royal Irish. The other, one of the firemen of the s.s. St. Kilda, the hand was nearly taken all off—all the fingers were gone, the thumb alone remaining. It was made a case of conservative surgery; the metacarpal bones were cut with strong bone nippers near their articulation with the bones of the wrist, and a flap, as well as could be obtained under the circumstances, served to cover the divided ends of the bones. Several small vessels had to be secured. The man, whose wife and family reside in Wellington, has since gone thither.

The number of deaths were six during the past year. They were all cases beyond the remedial art. It is congratulatory that no cases of acute disease ensuing in death have occurred. I may mention, incidentally, that the year generally was free from such melancholy occurrences. The first was Robert Baxter, an old man, who had more than one attack of apoplexy, and was hopelessly paralysed. He never rallied from his last attack of apoplexy.

Charles Maxwell.—A case of cancer of the glandular and, indeed, all other structures beneath the lower jaw. The disease spread most remorselessly, until his very spine could be seen. A separate house had to be obtained for him, so horrible was the effluvium.

Stephen Gilbert.—This was the consumptive case previously alluded to. He was discharged from the Brompton Hospital for a warmer climate, and I think had been in New Zealand nearly two years.

Michael Finucane was sent from the Wairoa with dropsy and diseased liver, dying when he arrived. He lived five or six days.

Edward Roberts was sent from Poverty Bay with dropsy and, I suspect, with it cancer of the liver. I had some years ago extracted from him a cancerous eye.

Patrick Sweeney.—This man was subject to epileptic fits. It seems in one of these he fell (whilst sitting in his tent at the Pohui) into the living charcoal embers. He was dreadfully burnt. This, and the exposure during the three or four days it took to bring him to Napier, occasioned his death soon after his arrival.

RETURN OF PATIENTS TREATED IN THE PROVINCIAL HOSPITAL DURING THE YEAR 1868—

REMARKS.

The Hospital has accommodation for from 15 to 20 adults. The wards are lofty and well ventilated. The greatest possible care taken of every patient admitted. The rations and dietary is sufficient, and of the best quality.

Admission can only be obtained by application either to the Superintendent or Visiting Justices, whose recommendation has to be endorsed by the Provincial Surgeon. A charge of 2s. per diem will be made.

Accidents admitted without such order.

I have the honor to be,
Sir,
Your most obedient servant,
THOMAS HITCHINGS,
Provincial Surgeon.

To his Honor the Superintendent,
Hawke’s Bay.

P.S.—I have considered that the gunshot wounds, of which there have been so many admitted this year, and still under treatment, should form the subject of a future report.

Printed, under the authority of the Government of the Province of Hawke’s Bay, by James Wood, Printer for the time being to such Government.