REPORT OF THE PRESIDENT 
OF THE 
Board of Health 
* 
TO THE 
EXECUTIVE AND ADVISORY COUNCILS, 
To the Executive and Advisory Councils, 
Of the Provisional Government of the Hawaiian Islands. 
I have the honor to submit herewith the report of the Board 
of Health for the biennial period ending March 31st, 1894. 
The statute providing for the establishment of a Board of Health 
was amended February 24th, 1893. This statute provided for 
the reorganization of the Board so as to consist of seven members; 
three of whom to be laymen; three physicians, and the Attorney 
General ex-officio. Under this statute the following gentlemen 
were appointed as members of the Board: Dr. George P. 
Andrews, Dr. F. R. Day, Dr. F. L. Miner, Mr. John Ena, Mr. John 
T. Waterhouse, Jr. and Mr. T. F. Lansing. The work of the Board 
was divided among three committees; first, on Leprosy, con- 
sisting of Dr. Miner and Mr. Ena; second, on Quarantine and 
contagious diseases other than Leprosy, consisting of Dr. Day 
and Mr. Waterhouse; and, third, on Sanitation, consisting of 
Dr. Andrews and Mr. Lansing. This division has facilitated 
the work of the Board. Each committee has given especial 
attention to the matters within its province, and the Board has 
thus received the benefit of more careful and thorough in- 2 
vestigation and report. During tha past year the members of 
the Board have made two visits to the Leper Settlement at Mo- 
lokai, besides making visits in the city of Honolulu to inspect 
work under their charge. The reports of officers of the Board 
presented herewith will give more in detail the transactions 
during the period. The reports submitted are of the Executive 
Officer, Mr. C. B. Reynolds; Agent of the Board on Molokai, 
Mr. R. W. Meyers; Honolulu City Dispensary Physician, Dr. 
Henry W. Howard; and the secretary’s financial statement of 
expenditures of the Board by Charles Wilcox, Esq. These 
reports contain tables and statistics which will be of in- 
terest. 
LEPROSY. 
The subject of leprosy and the care and treatment of lepers 
has occupied much of the time and attention of the Board. As 
will appear by the report of the Executive Officer, the law 
providing for the segregation of lepers has been enforced during 
the period, and the number remaining outside of the Settlement 
is believed to be very small. It has been the endeavor of the 
Board to cause the enforcement of the law to be made with 
discretion and due regard to the feelings and comfort of the 
unfortunate patients. A number of lepers have been removed 
from remote parts of the Islands and some from places of hiding, 
where they had for years evaded the law. With the exception 
of the sad experience at Kalalau, on the Island of Kauai, the 
removal of lepers to the Settlement has been accomplished 
without friction or resistance. The circumstances attending 
the removal of the lepers from Kalalau are known to the members 
of the Honorable Councils, and it is unnecessary for me to 
rehearse the story; but I desire on the part of the Board to pay 
a tribute to the fidelity and courage of the lamented agent of 
the Board, Louis J. Stolz, Esq., who in the discharge of the duty 
of attempting to remove the lepers from that remote mountain 
gorge met his death at the hands of an assassin. 3 
The Leper Settlement at Kalaupapa and Kalawao, Island of 
Molokai, and the care of the patients have received the constant 
attention of the Board. The valuable report of Mr. R. W. Meyers 
will give the figures and data pertaining to the settlement 
during the past two years, but I will state generally that the 
wants of the inmates have been attended to with fidelity and 
their needs supplied, so far as it has been within the power of 
the Board, with the means at its disposal. The houses have 
been kept in repair and white-washed; the supply of food has 
been regular and sufficient; the diseases of the people have been 
attended to by the resident physician, Dr. Oliver; and special 
treatment of leprosy has been given by Dr. Goto. Bishop’s 
Home for girls and the Home for boys, under the care of the 
Franciscan Sisters, have continued to shelter a large number of 
the helpless ones and minister to their comfort. Additions 
have been made to the accommodations at the girls’ home and 
bathing facilities added. At the boys’ home the new buildings 
and accommodations, built with the means so generously given 
by Hon. H. P. Baldwin, are about completed. These accommoda- 
tions will be a great improvement over the old ones. The 
arrangement of the dormitories, school-room, bath-house, dining- 
room and kitchen and cottage for the Sisters have been made 
with a view to comfort and convenience. The usefulness of this 
home will be greatly enhanced and will, as the Bishop’s Home 
has, stand as a monument to the thoughtful generosity of the 
donors. 
LEPER SETTLEMENT. 
DR. GOTO’S TREATMENT. 
Dr. Goto arrived from Japan early in 1893 under an engage- 
ment with the Board of Health to give special treatment to the 
lepers. A hospital building was erected at his request at Kala- 
wao; also dormitories, bath-house, kitchen and dining-room with 
accommodations for about forty patients. All the details of the 
arrangement were made in accordance with Dr. Goto’s request, 4 
and since that time he has had under treatment all the hospital 
would accommodate. Besides these he has treated a large number 
of the girls at Bishop’s Home and a number of outside patients 
who had furnished their own facilities for heating water for 
warm baths. In all, he has had about one hundred and forty 
patients under his care. The hospital was equipped and 
patients were admitted in May of 1893. The following month, 
in June, the Board appointed Dr. Oliver and Dr. A. Mouritz a 
committee to examine the patients being treated by Dr. Goto. 
Eighty-five patients were examined by them very thoroughly 
and a record preserved of the physical condition of each patient, 
and the record was forwarded to the Board of Health and 
submitted to the medical members of the Board. After eight 
months of treatment the same physicians again examined the 
patients previously examined by them and reported to the 
Board their condition. About this time also the members of the 
Board, with other physicians invited to accompany them from 
Honolulu, made a visit to the Settlement, and they also exam- 
ined these patients. The result showed that the physical condi- 
tion of many of the patients was improved, some more than 
others. Whether this improvement will be permanent remains 
to be seen. The result, however, satisfied the Board that it 
would be best to continue the Goto treatment for a longer 
period. It is well known that the symptoms of leprosy often 
yield readily to treatment and in some cases disappear for a 
time. How far the cures claimed to be affected by Dr. Goto 
will prove to be effectual, can only be demonstrated by 
time. 
CONDITION OF THE SETTLEMENT. 
I desire to express the feelings of admiration felt by the 
member of the Board at the spirit manifested by the patients at 
the Settlement at Molokai. With few exceptions they have 
been law-abiding, patient and obedient. With all their hard- 5 
ships and sufferings they manifest a spirit of submission and 
forbearance and resignation which appeals to the sympathy 
of all. 
WATER SUPPLY. 
The present water supply for the Settlement is inadequate. 
With the growing needs of the Settlement the four inch wrater 
pipe leading from the valley of Waikolu is not large enough to 
supply all the demands, and this pipe after reaching the village 
of Kalawao is reduced to a three inch pipe and further on to 
one of two inch. Eventually a larger main will have to be laid. 
It is a pity that, with the large supply of pure water in the 
valley of Waikolu, more cannot be had at the Settlement. The 
Board is about to proceed to construct a reservoir on the high 
land between Kalawao and Kalaupapa, which will help very 
much in keeping a supply of water and preventing suffering in 
case of a breakage of the main pipe. This main pipe, as it 
passes along the cliff near the sea between Waikolu and Kala- 
wao, is exposed to the waves during heavy storms, and is in 
danger of being broken from falling rocks. If the supply of 
water at Kalaupapa could be increased, there is no reason wrhy 
groves of trees should not be grown, affording shelter from the 
high winds and a supply of fuel. The scarcity of fire-wood at 
the Settlement has been a cause of inconvenience to the patients 
and of great expense to the Government for many years. During 
the last winter, the Board, through the able Assistant Superin- 
tendent, Mr. Ambrose Hutchinson, caused a large number of 
seeds of the iron-wood and eucalyptus to be planted, and it is 
hoped that next winter many more will be planted, and that by 
growing these hardy trees in rows and groves other more tender 
trees and fruit trees may be grown under their shelter. If this 
work is proceeded with steadily, especially in the rainy season, 
it is hoped that in time there will be an abundant supply of 
fire-wood available for the people and that fruit may be pro- 
vided for them. 6 
KULEANAS. 
For years the Government has desired to obtain the kuleanas, 
or parcels of land, held by private owners, adjoining the Settle- 
ment at Kalaupapa. In former years many of the private 
lands were purchased, but twenty or more parcels remain in the 
ownership of private parties. These kuleanas have been a source 
of trouble, adjoining as they do the land of the Board, and, 
being entirely beyond the control of the Government, friends of 
lepers have resided upon them and others have frequently gone 
there and have been a disturbing element. It has been deemed 
of the utmost importance that all of the lands at Kalawao and 
Kalaupapa should be owned by the Government and controlled 
by the Board of Health. Various acts have been passed for the 
purpose of accomplishing this object, but not until the Act 
passed by the Provisional Government in October last, has there 
been any serious attempt made to take possession of these lands. 
They all now have been taken under the provisions of that Act, 
although the people residing upon them have not yet all been 
removed. When they are all finally removed, that disturbing 
element will cease and the enforcement of the law of segregation 
will be easier. 
HOSPITALS. 
The Malulani Hospital at Wailuku, Maui, has continued to 
be a most valuable public institution; presided over by Francis- 
can Sisters, and attended by Dr. George Herbert, the usefulness 
of the institution has increased. Mr. T. W. Everett, who for so 
many years has been a faithful agent of the Board on the Isl- 
and of Maui, has taken the greatest interest in this hospital 
and his services have been of marked value. The Cottage 
Hospital at Koloa under the care of Dr. J. K. Smith has been 
maintained during the period and has been very useful. The 
Kapiolani Home for children of lepers at Kalihi, Oahu, under 7 
the care of the Franciscan Sisters, has been maintained and 
afforded a home for a number of helpless girls and is an insti- 
tution which could not be well dispensed with. 
SMALL-POX. 
During the month of March, 1894, the whaling bark “Hora- 
tio” arrived at the port of Honolulu with small-pox on board. 
Fifteen of the crew in all had been afflicted, two having died 
and thirteen suffering with the disease on her arrival. Imme- 
diate action was taken in the matter. The sick were all re- 
moved to the Quarantine Station, the ship was carefully 
fumigated, and after a quarantine of three weeks, the disease 
having entirely disappeared, the ships and the patients were 
released from quarantine. One of the crew died at the Quarantine 
Station. Fortunately the disease did not spread, not a single 
case appearing among our people. Credit is due to Mr. Reynolds, 
the efficient Executive Officer of the Board, and to Dr. Robt. P. 
Myers, acting Port Physician, for the manner in which the 
quarantine was maintained and the community protected. The 
accommodations at the Quarantine Station have been kept in 
good repair, the water supply has been increased, and the 
facilities for quarantining cases of contagious diseases, are ample 
for all present needs. 
SCARLETINA. 
During the past winter a number of cases of scarletina occurred 
in the district of Hilo, Hawaii, and later one or two cases in 
Kohala and in Kau, but under the prompt and efficient steps 
taken by the health officers on that Island the disease was con- 
fined to those districts and soon disappeared. 
DIPHTHERIA. 
Several cases of diphtheria have appeared in Honolulu during 
the past year, and several were reported in the district of Hilo 
on the island of Hawaii. Great care was taken in the treatment 8 
and quarantine of these cases, and, fortunately, it was confined 
to the immediate locality where it appeared. But two deaths 
were reported from this cause. 
VACCINATION. 
The Board has endeavored to enforce the law of vaccination. 
The greatest difficulty has been in obtaining sufficient supplies 
of pure Bovine Virus. The Board made several attempts to 
establish a Vaccine Farm near Honolulu, but without success. 
Whether the locality or climate caused the failure, it is not 
known. While these attempts were not successful, the Board 
still plans to make further efforts in this direction. The best 
supplies of virus so far obtained have been from Australia and 
New Zealand. Larger supplies have been ordered, and it is 
hoped that before the beginning of the school year in September 
next, that all of the school children will be thoroughly vaccin- 
ated. The physicians of the Board have been carefully instructed 
to use great care in vaccinating, so that the objections of those 
who are opposed to vaccination may be as far as possible re- 
moved. With more frequent communication between Honolulu, 
Japan and China, the Board deemed it of great importance that 
vaccination should be thoroughly attended to, and that great 
care should be used to prevent the introduction of sm,all-pox. 
GENERAL HEALTH. 
It is gratifying to report that the general health of the various 
committees throughout the Islands during the past two years 
has been good. There have been no general epidemics, and the 
death rate has been moderate. 
GOVERNMENT PHYSICIANS. 
There are twenty-two physicians in the employ of the Board, 
as follows : 
Dr. D. Campbell Waimea, Kauai. 
Dr. J. K. Smith Koloa, Kauai. 9 
Dr. St. D. G. Walters Lihue, Kauai. 
Dr. John Weddick Kealia, Kauai. 
Dr. L. F. Alvarez Waialua, Oahu. 
Dr. N. Russel Waianae, Oahu. 
Dr. H. W. Howard, Dispensary Physician Honolulu, Oahu. 
Dr. E. McKibbin, Physician under Act to Mitigate Honolulu, Oahu. 
Dr. Kobt. P. Meyer, Acting Port Physician Honolulu, Oahu. 
Dr. A. Mouritz Molokai. 
Dr. K. Oliver, Physician to Leper Settlement Molokai. 
Dr. Charles Davison Lahaina, Maui. 
Dr. George Herbert Wailuku, Maui. 
Dr. P. J. Aiken Makawao, Maui. 
Dr. T. Allen Hana, Maui. 
Dr. B. D. Bond Kohala, Hawaii. 
Dr. C. B. Greenfield Hamakua, Hawaii. 
Dr. L. S. Thompson North Hilo, Hawaii. 
Dr. R. B. Williams South Hilo, Hawaii. 
Dr. E. le Blond Puna, Hawaii. 
Dr. V. J. Capron Kau, Hawaii. 
Dr. H. A. Lindley Kona, Hawaii. 
This body of able and qualified physicians render most effec- 
tive service in the interests of public health. 
CITY DISPENSARY 
The city dispensary of Honolulu has increased its sphere of 
usefulness. The number of patients has largely increased. Dr. 
Howard has proved to be an excellent physician for this impor- 
tant office. It is believed that the usefulness of the dispensary 
might he much extended if an assistant physician were employed 
to visit the sick and attend to the wants of the poor and 
neglected in their homes. Doubtless there are those who im- 
pose upon- the dispensary physician. Some who are able to pay 
undoubtedly go there for gratuitous treatment, but great good is 
done to a large class who would otherwise be unable to obtain 
the services of a properly qualified physician. 
OFFICE RECORDS. 
The records maintained in the office of the Board are valuable. 
The system heretofore inaugurated has been maintained. But 10 
it is much to be desired that more attention be given to this 
matter, and in this connection I would state that it is the desire 
of the Board to obtain more information and literature upon 
the subject of leprosy and public sanitary matters. If attention 
is given to this subject, in the course of time the office should 
contain a valuable library of works upon these subjects, and a 
fund of information which would be of inestimable value. 
CONCLUSION. 
In closing I would mention the faithful and valuable services 
rendered to the public by the members of the Board of Health. 
Both the professional men and the laymen have given their time, 
thought and attention to the matters affecting the public health 
and the public interest in these directions freely and cheerfully. 
The public owes much to these gentlemen and the public spirit 
which they have shown. 
Respectfully submitted, 
WILLIAM 0. SMITH, 
President Board of Health. 
Honolulu, May 31st, 1894. 
To His Excellency the President and the Honorable Members of 
the Board of Health. 
Gentlemen:—I beg to submit herewith for your consideration, 
my biennial report, relating to the affairs of the Leper Settle- 
ment from April 1st, 1892, to March 31st, 1894. 
In my last report of March 31st, 1892, I stated the number of 
lepers living at the Leper Settlement to be 1,115 
with a probable error of about 8 too many. 
Since then an accurate census, taken by Mr. Hutchin- 
son and Wm. Notley on the 25th of October following, 
this error has been ascertained to have been too many. . 7 
Leaving living on April 1st, 1892 ....... 1,108 11 
Addition to this number, during the period including 
2 male Kokuas, which were declared to be lepers have 
been—Males 196 
Females 138 
Total addition of 334 
Making in all 1,442 
Discharges. 
One female, not being a leper 1 
1,441 
There have died durifig the period—Males 199 
Females. . 90 
Total number of deaths 289 
Leaving living on the 31st of March, 1894 1,152 
Of this number there are—Males 683 
Females 469 
1,152 
This number shows an increase of lepers at the Settlement 
during the period of 44 
Deaths. 
These 1,152 are composed of Males. Females. Total. 
Native Hawaiians 586 425 1,011 
Half Castes 50 41 91 
Chinese 24 2 26 
Americans 5 .... 5 
Germans 4 .... 4 
English 3 .... 3 
Irish 1 .... 1 
Portuguese 4 1 5 
Nationalities. 12 
Males. Females. Total. 
Spanish 2 .... 2 
Canadians 1 .... 1 
Russian 1 .... 1 
Negroes...... 1 .... 1 
South Sea Islanders 1 .... 1 
683 469 1,152 
Kokuas and others living at the Settlement free from the 
disease. 
Males. Females. Total. 
Kokuas, proper 65 59 124 
Catholic Priests 2 .... 2 
Joseph Dutton Nurse 1 .... 1 
Dr. Oliver—Resident Physician 1 .... 1 
Sisters of Charity—in charge of 
the Bishop Boy’s Home 7 7 
Japanese Servants to the Sisters 112 
Children of these servants 1 1 2 
71 68 139 
Kamaainas and others living with them on their kuleanas. 
Males. Females. Total. 
Kamaainas proper .... .... 
Adults 12 .... 12 
Children v. 8 .... 8 
Adults 8 8 
Children 11 11 
Persons living with these Kamainas: 
Adults 27 27 54 
Children 12 11 28 
59 57 116 TOTAL POPULATION OF THE SETTLEMENT ON MARCH 31ST, 1894, IS 
THEREFORE AS FOLLOWS : 
Lepers, including their children of all ages 1,152 
Kokuas and other clean persons 139 
Kamaainas and others living with them 116 
Making a total of 1,407 
Showing an increase the last period just ended of. . . . 20 
Of the 1,441 lepers mentioned on the first page, there have 
died during the period 289, which if expressed in percentage 
would be 20.56 per cent, which is considerably less than it has 
been during the two preceeding years, which was as stated in 
my last report 24.58 per cent. 
DEATH RATE. 
BIRTH OF CHILDREN AT THE SETTLEMENT. 
Males. Females. Total. 
Born of parents, both being 
lepers 16 10 26 
Born of parents, only one being 
a leper 23 10 33 
Born of parents, both free from 
disease 2 3 5 
41 23 
Total number of children at the Settlement 64 
Most of these children if not all, are reported to be as not 
being afflicted with the disease and they are of all ages. 
BUILDINGS AT THE SETTLEMENT OWNED BY THE BOARD OF HEALTH. 
Superintendent residence at Kalaupapa 1 
Visitors house at Kalaupapa 1 
Superintendent office at Kalaupapa 1 14 
Chaplain to the Sisters at Kalaupapa 1 
Resident, Physician, Kalawao 1 
“ “ office, Kalawao 1 
Visitors house at Kalawao 1 
“ “ occupied by Dr. Goto 1 
House for Protestant Pastor, Kalaupapa 1 
The Beretania Hall, Kalaupapa 1 
10 
THE BISHOP HOME IS COMPOSED OF 
Dwelling-house for the Sisters 1 
Wards or Dormitories 11 
Hall for recreating, schooling and sewing 1 
Servants house 1 
Office, cook, eating, wash, bath and other necessary 
buildings 12 
26 
THE BOYS’ HOME AT KALAWAO IS COMPOSED OF 
Dwelling-house for the Sisters 1 
Dormitories or wards—old, 5; new, 11 16 
Hall for recreating, etc 1 
Servants house 1 
Office, cook, eating, bath-house, etc 10 
29 
SCHOOL HOUSES, 
One new, one old, Kalaupapa 2 
2 
THE HOSPITAL AT KALAWAO COMPRISES 
House for steward 1 
Dormitories or wards 2 
Cook, eating, bath-house, etc 7 15 
HOUSES OCCUPIED BY LEPERS 
Throughout the Settlement 151 
Unoccupied at the Settlement 1 
152 
229 
STORES AND WAREHOUSES. 
The Board of Health store (new) 1 
Cottage for store-keeper, unoccupied 1 
Old store at Kalawao, unoccupied 1 
3 
Storehouses for provisions 2 
“ “ oil, soap, salt 2 
“ “ salting hides . .... 1 
Boat house 1 
Other small buildings 2 
Slaughter house and distribution of meat 2 
10 
One carpenter shop, one blacksmith shop 2 
Dispensaries 2 
Other buildings 3 
7 
Total number of houses owned by the Board 249 
WORKSHOPS. 
BUILDINGS OWNED BY OTHERS. 
Protestant churches 2 
Catholic “ 2 
Latter Day Saints churches 2 
Total number of churches 6 
Catholic Mission owns 7 16 
Houses owned by lepers 231 
u “ “ kamaainas, etc., on kuleanas 38 
Total number of buildings at Settlement 531 
LIVE STOCK 
Owned by the Board consists in cattle, horses and jackasses. 
The cattle are owned exclusively by the Board of Health. 
Cattle. 
Bulls 6 
Steers 99 
Cows 331 
Heifers 140 
Calves 137 
Working oxen 40 
Total of Cattle 753 
Horses 7 
Mares 8 
Colts 3 
Asses 48 
66 
Total number of animals owned by the Board 819 
Horses, Asses and Mules. 
Horses 197 
Mares 267 
Colts 55 
Asses 13 
532 
Owned by Lepers. 
Horses 31 
Mares 18 
Owned by Kokuas. 17 
Colt 1 
Mules 2 
52 
Owned by Kamaainas. 
Horses 17 
Mares 11 
Colts 4 
Mule 1 
Asses 2 
35 
Owned by the Catholic Mission. 
Horses 9 
Total number of animals owned by others 628 
Total number of animals running on the pasture 
of the Settlement 1,447 
Total number reported March 31st, 1892 1,290 
Showing an increase of 157 
The nine horses, which I have reported as belonging to the 
Catholic Mission, I have to state that they are exclusively used 
for purposes of the Board and chiefly in connection with the 
two Homes. 
RATIONS. 
No changes have been made in the scale of rations, and the 
lepers and others entitled to receive food rations have received 
as follows : 
Beef, 7 pounds per week or in lieu thereof, if desired. 
Salmon, 5 pounds per week or in lieu thereof, or 
Fresh Fish, 7 pounds per week, if to be had. 
Pai-ai—1 bundle, weighing net 21 pounds or in lieu thereof, if desired. 
Bread, pounds with 1 pound of sugar, or Bice, 9 pounds with 1 pound of sugar, or 
Flour, 12)4 pounds with 1 pound of sugar. 
KATIONS ISSUED MONTHLY. 
Soap—1 bar, weighing 2 pounds to each adult leper. 
Salt, 5 pounds to each adult leper. 
Matches, }£ gross to each adult leper. 
Kerosene oil, 1 quart is given to each house if occupied by one family 
but 2 quarts if occupied by two families. 
Besides these rations of meat, food and other supplies, each 
leper living outside of the homes receives a so-called ration bill 
of $10 per annum, which is given out semi-annually in bills of 
$5 each on the 1st of April and on the 1st of October. 
For these ration bills each recipient receives at the Board of 
Health store, just such articles as he or she desires. 
These ration bills were originally intended to furnish the 
lepers with clothing only, but little by little, instead of drawing 
the amount in clothing, the greater portion is drawn in gro- 
ceries and other articles, and I am sorry to state that much of 
it goes for sugar which is used to a great extent by many for 
the manufacture of beer or other intoxicating drink. 
Distribution of meat, food, milk and other supplies is made 
in two places, one at Kalaupapa and the other at Kalawao. 
Each leper has a number and receives a corresponding tag, 
stamped on brass, which must be produced and left with the • 
distributing officer before any of them can receive his or her 
rations. This is necessary, besides keeping an account, to pre- 
vent the issue of anything more than once to the same party or 
parties. 
The various articles are carefully weighed or measured and 
reported in the weekly reports. And every week after the issue 
has been completed, all the balances of the various articles 
in the broken packages are again weighed or measured and 
reported. 
As the number of persons are constantly known and reported 
for every day, the above mentioned mode of distribution 19 
furnishes an easy and accurate check, and any irregularity in 
the distribution is impossible without its becoming known im- 
mediately. Thus, for instance, I will cite any one week taken 
from the weekly reports, say the week from March 20th to the 
27th, 1894. 
It will be seen that during that week the sum of lepers out- 
side of the homes has been 6398, which if divided by 7 days 
shows the daily average to have been 914 persons. 
They have received 
Weekly 
Ration. 
Daily 
Ration*. 
Rice, 
621 
lbs. at 
9 
lbs. per weekly ration. . . 
. 69 
Bread, 
9264 
CC 
CC 
84 
a u u 
.109 
Flour, 
384 
a 
CC 
12 
“ (210) 
. 32 
Sugar, 
210 
CC 
CC 
1 
lb. for the above ration 
. , 
Pai Ai, 
704 
CC 
CC 
1 
bundle per week 
.704 
Beef, 
5621 
CC 
CC 
1 
lb. per day 
5621 
Salmon, 490 
CC 
CC 
h. 
7 
CC CC 
914 
686 
6307 
This shows that 914 lepers outside of the Homes have received 
914 weekly rations, of which 704 were given out in pai-ai and 
210 in rice, bread and flour, with 1 pound of sugar for each of 
these 210 rations. 
In this particular week’s showing there is a slight deficiency 
in the beef and salmon account; these little deficiencies are 
caused either by, that a few persons did not care to get their 
meat, being sick perhaps, or by slight inaccuracy in weighing. 
An absolute accuracy can not he expected, and it often happens 
that there is an excess or a deficiency of one or two weekly 
rations. 20 
COST OF THE LEPER SETTLEMENT FOR PROVISIONS, 
SUPPLIES, MATERIAL FOR IMPROVEMENTS AND 
REPAIRS, RATION BILLS, MEDICAL ATTENDANCE, 
SALARIES AND WAGES FOR AGENTS, SUPERIN- 
TENDENTS AND OTHER EMPLOYEES OF THE 
BOARD IN CONNECTION WITH THE-SETTLEMENT. 
Purchases of Provisions. 
Rice, 1,100 bags or 110,000 lbs $ 4,396 00 
Bread, 2,140 cases or 160,956 lbs.. . . 6,774 22 
Flour, 1,005 bags or 49,245 lbs 1,224 88 
Sugar, 355 bags or 43,885 lbs 1,587 18 
Pai Ai, 85,592 bdls. of 21 lbs. net each 52,068 94 
Beef, 1,728 heads cattle or 696,748 
lbs. gross 35,696 90 
Salmon, 269f bbls. or 53,950 lbs... . 2,772 63 
Fresh Fish, 9,147 lbs 473 70 
Salt, 1,700 bags—87 tons or 170,000 
lbs 892 51 
Oil, 340 cases or 3,400 gallons 715 70 
Soap, 550 boxes or 27,500 bars of 2 
lbs. each 2,091 25 
Coffee and Bread—on emergency, 
May, 1893 3 00 
Matches, 22 cases or 636 gross 466 91 
Total for provisions $ 109,163 82 
PURCHASES FOR MATERIALS FOR IMPROVEMENTS AND REPAIRS. 
Painting and White-washing $ 421 33 
Waterworks 259 22 
Telephones 3 40 
Kalaupapa Landing 35 35 
Bishop Home at Kalaupapa 793 52 Boys Home at Kalawao. $3,239 06 
Less amount paid by Mr. 
D. B. Baldwin 2,861 16 
$377 90 
New Butchershop at Kalaupapa.... 223 10 
New store & cottage at “ .... 665 39 
Hardware for general use 136 66 
Lumber and other material for carts, 
yokes, tools and implements. . . 412 50 
Hospital improvements for Japanese 
treatment 667 73 
Total amount for material, etc.. $3,996 10 
Purchases for Sundries, Beds, Bed- 
ding, Utensils, Coffins, Etc., Etc. 
Superintendent’s residence and 
visitor’s house $ 53 09 
Distribution of food 22 73 
Burying the Dead, material for 
coffins, etc 434 60 
Medical Department, including store 
bills 189 12 
Bishop’s Home, clothing, store bills, 
etc 3,106 11 
Boys Home, clothing, store bills, etc 1,978 57 
Hospital, Jap. Treatment “ “ 597 47 
Quarterly store bills for general 
settlement 128 48 
Slaughterhouse 39 94 
Stationery 95 27 
Printing 100 25 
Government Realizations 31 56 
Sundries * 54 50 
Total amount of Purchases.... $ 6,831 69 To this sum should be added the 
value of cattle killed, which belonged 
to the Board, as well as the value of 
food received from Waikolu planters 
as Board of Health share. 
213 heads of cattle killed, 64,546 lbs. 
gross weight at the average price 
of beef during the period .$3,304 76 
Bundles of Pai at average price 192 78 
$ 3,497 54 
Total for purchases $ 123,489 15 
Salaries and Wages for Superin- 
tendent, Mechanic and Labor. 
Sup’ts, Wm. Tell, 7 months $ 700 00 
“ Ambr. Heutchis, 16^ 
months 1,722 00 
$ 2,422 00 
Ass’t. and Clerk 1,224 00 
Police Department 459 00 
Distribution of meat, food, milk, 
soap, etc 2,689 75- 
Medical Dep’t., running expenses. . . 373 00 
Bishop’s Home, “ “ ... 1,756 50 
Boys Home, “ “ ... 1,922 20 
Hospital, Japanese Treatment for 10 
months 539 75 
Burying the Dead, making coffins, 
digging graves, etc 455 00 
Nursing the sick 76 00 
Transport of money. ; 6 50 
Government Realizations, salting 
hides, etc 156 35 
Sundry Expenses 153 50 Works of All Kinds. 
Overseer $ 475 00 
Carpenter work 759 85 
Blacksmith work 182 70 
Mason work 37 90 
Water works, overseer 
and repairs 228 45 
Painting & whitewashing 271 10 
Teaming 446 50 
Telephone repairs 10 35 
Discharging vessels, labor 456 85 
Work of all kinds 2,868 70 
Pound for Estrays 6 00 
Sundry Work 208 00 
Waikolu Taro Planting, 35 00 
Labor with Stock Horses, 
Cattle, etc 51 00 
Total Cost of Works $3,168 90 
Total for Salaries and 
Wages $15,402 45 
Issue of Ration Bills. 
Issue April 1, 1892 979 Bills $4,865 05 
“ October 1,1892. ... 984 “ 4,718 60 
“ April 1,1893 962 “ 4,749 60 
“ October 1,1893. .. . 980 “ 4,852 00 
Total 3,905 Bills 19,185 25 
Dr. S. B. Swift, 2 months 583 33 
Dr. R. Oliver 5,500 00 
6,083 33 
Salary to Resident Physician. 24 
Sisters of Charity in Charge of 
the Homes. 
7 Sisters @ $20 each per month.... $3,360 00 
Freight. 
104 weeks at $50 per week 5,200 00 
Agency. 
Salary to R. W. Meyer 3,700 00 
Total Cost $ 176,420 18 
The grand total of lepers of all ages daily at the Settlement 
has been, during the whole period of two years, 821,948, which, 
if divided by 730 days, shows the daily average number to have 
been 1,126. 
If the total cost, as above stated, of $176,420.18 is divided by 
1,126, it gives the cost per capita of each leper for support, etc., 
as $156.68 for the two years just ended, which is $17.68 less than 
it has been the two preceeding years. 
COMPARATIVE COSTS OF LEPERS PER CAPITA, OUT- 
SIDE OF THE HOMES, IN THE HOMES AND HOS- 
PITAL, AND MEDICAL ATTENDANCE. 
As the medical attendance appears in each of these accounts, 
I will show this first: 
MEDICAL ATTENDANCE. 
Doctors’ Salaries have been $ 6,083 33 
Sundry Purchases, including Quarterly Store Bill 189 12 
Running Cash Expenses 373 00 
Provisions for the Doctor 163 00 
Total $ 6,808 49 
divided by the average number of lepers at the Settlement dur- 
ing the period, 1,126, makes the cost of medical attendance per 
capita $6.09, which is exclusive of drugs. LEPERS OUTSIDE OF THE HOMES. 
The sum total of lepers outside of the Homes daily has been for 
the period 681,833, which, if divided by 730 days, gives the 
average daily number as 934. They have consumed as follows : 
Lepers. Kokuas. Total. Av. Prices. Cents. 
Rice, lbs 80,242 7,608 87,850 .... 3.91 $ 3,434 93 
Bread, lbs 89,515 11,605 101,120 .... 4.20 4,247 04 
Flour, lbs 43,312 1,164 44,476 .... 2.49 1,107 45 
Sugar, lbs 23,028 2,341 25,369 .... 3.61 915 82 
Pai-ai, bundles.. 75,253 2.469 77,722 .... 60.83 47,278 29 
Beef, lbs 609,321 36,226 645,547 .... 5.12 33,052 00 
Salmon, lbs 44,445 2,287 46,732 .... 5.14 2,402 03 
Fresh Fish, lbs.. 8,220 392 8,612 .... 5.18 446 10 
Soap, bars 22,219 186 22,405 .... 7.6 1,702 78 
Oil, gallons 2,849 33 2,882 .... 21.5 619 63 
Salt, lbs 103,262 140 103,402 525 542 86 
Matches, gross .. 596 601 .... 73.4 441 00 
Total for Provisions, etc $ 96,189 93 
Medical Attendance, 934 persons at $6.09 5,688 06 
Ration bills 19,185 25 
Running expenses, distribution of food, etc., etc., proportional 
share, {%) 2,017 29 
Total $123,080 53 
This sum divided by 934 shows the cost of the Lepers outside 
of the Homes to have been $131.77 per capita for the two years. 
Cost of the inmates per capita during the period has been as 
follows: 
Number of Inmates on April 1st, 1892, were, females 75 
“ admitted during the period 77 
___ 152 
Of these have been discharged, females 20 
Died 24 
44 
Number of Inmates March 31, 1894 females 108 
THE bishop’s HOME. The total number of daily inmates during the period has been 
63,231, which if divided by 730 days shows the average number 
to have been 87 82-100. These have consumed as follows: 
Rice 2,800 lbs. at average prices $ 109 48 
Bread 18,484 “ “ “ 774 23 
Flour 1,666 “ “ “ 41 33 
Sugar 7,962 “ “ “ 287 43 
Paiai 5,086 bdls. “ “ 3,093 81 
Potatoes 1 bag “ “ 
Bananas 16 bunches “ “ 8 75 
Beef 46,925 lbs. “ “ 2,402 56 
Salmon' 2,609 “ “ “ 185 50 
Fresb Fish 265 “ “ “ 13 73 
Salt 6,368 “ “ “ 33 43 
Soap 2,126 bars “ “ 16158 
Oil 250 gallons “ “ 53 75 
Matches 44 grosses “ “ 32 30 
Total for provisions and supplies $ 7,197 88 
Purchases for Clothing, Utensils, Coal and Sundries, drawn 
at the Store bill 3,106 11 
Distribution of food, slaughtering, etc., proportional share %. 336 12 
Wages for employees, etc., including firewood cutting 1,756 50 
Medical Attendance 87 82-100 inmates @ $6.09 534 82 
Total Cost $ 12,931 43 
which if divided by 87 82-100 shows the cost per capita of the 
inmates of this Home to have been $147.25 for the two years. 
THE BOYS HOME AT KALAWAO. 
Number of inmates April 1, 1892 93 
“ admitted during the period 99 
192 
“ Discharged 33 
“ of Deaths 62 
95 
Number of Inmates March 31st, 1894 97 
The total number of daily inmates throughout the period has 
been 65,757, which if divided by 730 days shows the average 
daily number of inmates to have been 90.09. This Home has received in provisions and supplies as follows: 
Rice 14,900 lbs. at average price during the period $ 582 59 
Bread 25,439 “ “ “ “ “ “ 1,068 44 
Flour 2,107 “ “ “ “ “ “ 52 46 
Sugar 7,219 “ “ “ “ “ “ 260 61 
Pai ai 4,749 “ “ “ “ “ “ 2,888 82 
Beef 49,145 “ “ “ “ “ “ 2,516 22 
Salmon 1,400 “ “ “ “ “ “ 71 96 
Fresh Fish . 125 “ “ “ “ “ “ 6 47 
Salt 8,464 “ “ “ “ “ “ .... 44 44 
Soap »1,156 bars of 2 lbs. each “ “ “ “ .'... 87 85 
Oil 260 gals. “ “ “ “ “ .... 55 90 
Matches... 23 grosses “ “ “ “ 16 88 
Total for provisions and supplies $ 7,652 64 
Purchasing of clothing for inmates, Beds, Utensils and sundries 
from the Store as per accounts 1,978 57 
Running Cash expenses, wages for employees, nurses, etc., in- 
cluding cutting of firewood 1,922 20 
Distribution of meat, food, including slaughteries proportional 
share % 336 12 
Medical Attendance, 90.09 inmates at @ 6.09 548 56 
Total Cost $ 12,438 18 
which if divided by 90 9-100 inmates shows the cost per capita 
of this Home to have been 138.06 for the two years. 
The Hospital has been reopened and been in operation for 
310 days, or about 10 months. It was reopened on the 26th of 
May, 1894, for the purpose of testing the efficacy of curing 
Leprosy as claimed by Ur. Goto, a Japanese specialist of treat- 
ing this disease, in response to satisfy a clamor of the Lepers at 
the Settlement. 
The Hospital opened with, inmates 20 
Admitted since then 24 
44 
Discharged and left the Hospital : 7 
0 
Living at the Hospital March 31, 1894, 37 
all males. 28 
The total number of inmates daily for the 310 days has been 
10,482, making therefore the average daily number of inmates 
of the Hospital to be 33 81-100. 
The inmates of the Hospital receive the regular rations of 
food, like the lepers outside of the Homes, with the addition of 
five bundles of pai for the Hospital, in as much as they claimed 
that the Japanese treatment stimulated their appetites to such 
an extent that the ordinary ration of twenty-one pounds of pai 
did not quite satisfy their hunger. 
They have received during these 310 days : 
Rice, 1,900 pounds at an average prices during the period, $ 74 29 
Bread, 2,880 “ “ “ “ “ “ “ “ 120 % 
Flour, 123 “ “ “ “ “ “ “ “ 3 06 
Sugar, 558 “ “ “ “ “ “ “ “ 21 14 
Pai-ai, 1,062 bundles41 “ 44 44 44 44 “ 646 01 
Beef, 9,954 pounds 44 4 4 4 4 44 4 4 4 4 4 4 5 0 9 42 
Salmon, 33 0 4 4 4 4 4 4 44 4 4 4 4 4 4 44 16 96 
Salt, 1,60 0 4 4 4 4 4 4 44 “ 44 “ 8 40 
Soap, 242 bars 44 44 44 44 ' 44 44 “ 18 39 
Oil, 45 gallons 44 44 44 44 44 44 44 9 67 
Matches, 8% gross 44 “ 44 44 44 44 44 6 24 
Making the total for provisions SI,434 54 
Ration bills spent to thirty-four inmates—last issue 170 00 
Running expenses, salaries and wages for overseer, cook, 
stoker, etc 539 75 
Purchase of beds, bedding, utensils, coal, etc 597 47 
Distribution of food, proportional share 30 41 
Medical attendance for 310 days, proportioned 87 80 
Making total cost for support and care $2,859 97 
which if divided by 33 iVo makes the cost per capita for the 310 
days to be $84.59, or if produced to a whole year $99.60. 
This showing relating to the Hospital, does not include the 
salary of Ur. Goto, which has been $300 per calender month, 
nor the cost of importation of the Japanese drugs and fnedicated 
sharing. 
I have not the cost of these medicines so I am not able to show the cost of this treatment at the Hospital correctly, but if 
I add the probable cost at a low estimate, it would appear, divid- 
ing the doctor’s salary and cost of Japanese medicines in three 
equal portions and charging one-third to the Hospital, as follows: 
Doctor’s salary one-third $ 1,000 00 
Japanese medicine, one-third, estimated. 1,000 00 
Traveling expenses, estimated 50 00 
$ 2,050 00 
If to this is added the cost of support of the in- 
mates as previously shown 2,859 97 
The entire cost would be . $ 4,859 97 
which if divided by the average daily number of inmates, which 
was 33iVo, the cost per capita for the 310 days, would be $145.22, 
or if produced to the whole year to $171.00. 
Improvements at the Settlement were made chiefly during 
the latter half of the period and these consist in: An addition 
to the Bishop Home of two new hospital wards, a bath-house 
with heating apparatus to provide warm baths for the inmates, 
chiefly in connection with the Japanese treatment. The erection 
of a second butcher shop at Kalaupapa to lessen the distance for 
the people living at Kalaupapa, to obtain their meat supplies. 
The erection of a large new store near the landing at Kalaupapa, 
for the benefit of the people living there, with a new and com- 
modious cottage for the occupation of the chief store-keeper. 
But the most conspicuous improvement has been the com- 
pletion of the new home for boys and helpless men at Kalawao, 
which the Sisters in charge of this home, expect to occupy dur- 
ing the first week in May. 
For this home, the Hon. H. P. Baldwin donated the sum Of 
$5,000, of which there has been expended to March 31st, 1894, 
for material $ 3,718 02 
for wages, carpenters, painters, etc 501 85 
$4,219 87 
IMPROVEMENTS AND REPAIRS. 30 
The Hospital has had several buildings added to the wards or 
dormitories, a bath house, with heating apparatus, and some 
minor structures, to fix the same for the Japanese treatment. 
Repairs have been chiefly of a general nature: the Kalaupapa 
landing, the waterworks, the re-enclosing of the central grave 
yard, cart bodies and repairs on carts, have been the most im- 
portant matters, besides many of a minor nature on cottages, 
etc., which it would lead too far to separately mention. 
The waterworks have given greater satisfaction since the 
division of the line of pipes by several valves, and the employ- 
ment of an overseer to see to it, that portions of the settlement 
only receive water at stated hours, and a more careful super- 
vision, that taps are not left open upder penalty of being cut off. 
The new hall, or reading room, built from the donation of gener- 
ous English people, has also been finished during the period, 
and has been named in honor of the donors, the “ Beretania 
Hall.” This hall is quite an ornament to the place and serves 
for various amusements of the people during proper hours of 
the day. 
The Homes provided by the generous donors for the young, the 
unprotected and helpless lepers of both sexes, in charge of the 
Franciscan Sisters, and their usefulness and comforts to the 
sick, is now so well known and established through the testi- 
monials of so many visitors, foreign as well as residents of these 
islands, including the visits from the President of the Board of 
Health and the honorable members of the Board and legislative 
Committees, etc., that it is not necessary on my part to repeat 
what 1 have said on a former occasion, further than all that has 
been said in praises of the efforts of these Sisters was worthily 
and justly bestowed. 
The Bishop Home for girls and unprotected females did not 
have as many inmates during the first part of the period as it 
had during the latter half, after the change of the Superinten- 
dents of the Settlement. I mention this matter to show the 
true cause of the greater cost per inmate of this Home as com- 31 
pared with the other Home and the lepers outside of the Homes. 
Had the number of inmates throughout the period been what 
it is now or nearly so, it is plain that the cost per capita of this 
Home would have been materially lessened. 
The Boys’ Home at Kalawao for boys and helpless men has 
kept nearly the same number of inmates throughout the period. 
Since the transfer of this Home to the other side of the road, 
concentrating the wards and buildings, and having the whole 
nearer the dwelling-house of the Sisters, it is to be hoped that 
much hard work for the Sisters may be saved them, by not hav- 
ing to travel over such great distances as heretofore. The 
management of the Boys Home is really a hard task for the 
Sisters, and it is very fortunate that they have such excellent 
help as Mr. Joseph Dutton is ever ready to afford them. Mr. 
Dutton’s time is very much occupied with his own self imposed 
duties as nurse to the sick, in seeing to the cleaning of the sores 
of the lepers personally, and causing them to heal in many in- 
stances. 
The Hospital, as already stated, has been re-opened on the 
26th of May, 1898, for the sole purpose of giving the Japanese 
treatment by Dr. Goto a fair trial, which seems to have been 
held out to a former Board of Health to possibly effect a cure, 
as indeed, Dr. Goto himself has promised it would in certain 
cases. 
It is but natural that men afflicted with the loathsome disease, 
supposed to be incurable, should be exceedingly anxious to try 
most any remedy held out as producing a cure hymen who pos- 
sibly have faith in their own abilities, or perhaps quite as likely 
by impostors for the sake of gain. There is perhaps no other 
disease which opens such a field for impostors than leprosy. It 
can only he hoped that the great expectations and hopes which 
have been created in the minds of these unfortunates may not 
end in the direst disappointment. My own experience as lay- 
man, after observing the effects of this treatment, also by Dr. 
Goto during a period of nearly three years, about eight or nine 32 
years ago, allows me no hope at all, that any authenticated 
cure will be effected, although no one can say that such a thing 
is absolutely impossible. 
It must be confessed, however, that through the warm and 
medicated bath, to promote perspiration, with the use of tonics, 
the general health and the outward appearance of the lepers 
who undergo this treatment seems to have improved very much 
for the time at least. 
If a cure of leprosy through this treatment is at all possible, 
it would seem reasonable that it can only be expected in the 
earliest stages of the disease, and not in advanced cases of many 
years standing. 
MEDICAL ATTENDANCE. 
There has been throughout the greatest portion of the period 
an able, competent and kind hearted physician, and the people 
cannot complain on that score. If they have not availed them- 
selves of his services or followed his advice, it was probably 
their own fault. 
The general health of the Settlement seems to have been 
better than before, to which the previously shown smaller death 
rate may perhaps be partially attributed. 
Law and Order, which I stated in my last report as having 
been very lax during the preceeding period, has been very much 
improved, especially since the passage of the rules and regula- 
tions for the Settlement since July 15th, 1893; but there is 
much room left for further improvement in that direction. 
There is an inadequacy of police force at the Settlement which, 
with a population of over 1400 people, has only two very poorly 
paid policemen with the gratuitous service of the acting Super- 
intendent as Deputy Sheriff, and I need not say that the Super- 
intendent of the Settlement has quite enough duties to discharge 
without attending to police matters, which often consume much 
time and interfere with other work. 
In my last report I had to state that offenders, although guilty were seldom prosecuted and punished, I have to report 
this time that since the change of Superintendents a better state 
of affairs has prevailed, as the following cases, which have been 
prosecuted, found guilty and duly punished will show : 
Illicit Visitors, found guilty 14 
Larceny 2 
Opium in Possession. 3 
Assault and Battery 3 
Manufacturing Liquor 3 
Selling Liquor 1 
Fishing with Giant Powder 3 
Disturbing the Quiet of Night 5 
Escapes from the Settlement 6 
Lepers found living on Kuleanas 4 
Threatening Violence 1 
In all 45 Cases. 
KOKUAS 
are not as numerous as they have been. With the exception of 
instances no new ones have been allowed to go to the Settlement 
with their sick. Since the enforcement of the rules, that every 
kokua is to leave in two weeks after the death of their charges 
for which they were permitted to live at the Settlement, some 
have left on that account, others have left for reasons of their 
own, and some have died, and it is probable that their number 
will still further decrease. 
The Kamaainas at Kalaupapa are still living on their kule- 
anas. But the Government has now taken the necessary steps 
to have them removed. The Kuleanas, with houses and plant- 
ings, have been valued by a Board of Commissioners, and prac- 
tically speaking, the Government may take possession of them 
most any time. It is, however, confidently expected that with 
a little patience these people will leave in due time, without 
making it necessary for the authorities to take possession, or 
resort to ejectment forcibly. They have been given the choice 
to receive the value of these kuleanas either in cash or to pur- 
chase lands elsewhere. NON-LEPROUS CHILDREN 
born at the Settlement are becoming more numerous, and it 
■Would seem to be a matter of the greatest importance to give 
this subject an early consideration; for if allowed to go on it is 
likely to become a very serious matter in the near future. 
Many eminent medical writers consider it to be very doubt- 
ful that leprosy is hereditary, but rather believe that children 
born by lepers contract the disease from their parents during 
early childhood. There are certainly many reasons to believe 
so, if it is considered, how few of the children born at the Set- 
tlement, who have been taken away when young, have developed 
the disease. 
It seems also that the law of segregation to prevent the spread 
of leprosy does not only mean to separate the sick from the 
healthy, it certainly must also imply that the clean should not 
be left with the unclean, and thereby subjecting them to the 
dangers of also becoming lepers. It seems cruel to do so. For 
little girls this difficulty is partly met through the Kapiolani 
Home, but for little boys there is no provision made at all, now 
and then some near relative or grand parent conies and takes 
a child away. 
Another very important point to consider is, that in a very 
few years these children are likely to grow up, and considering 
the circumstances and the surroundings at the Settlement, what 
will become of them ? They will grow up probably a lawless 
and dangerous element. The Settlement is their home, they 
know no other; if they are not lepers they cannot be compelled 
to remain there, they will most likely go and come as they 
please, and may take the place of kamaainas which make so 
much trouble. There is no work for them, they have learned 
nothing, they have seen little else than idleness, drinking and 
gambling, and whatever else perfect hoodlums and tramps. 
It has often appeared to me that the erection of a ward in 
connection with the Reformatory school could be made to meet 
this want, of course to be returned to the Settlement, in case that any of them should develop the disease. This seems to me 
with proper precaution could be done without injury or prej- 
udice to the other inmates of the Reformatory school. How- 
ever, there may exist valid reasons why such an arrangement 
cannot be made. 
SEGREGATION. 
In my last report I mentioned in the last paragraph on Segre- 
gation, that it had now been practiced for about 26 years, and 
considering the natural decrease of the native population and 
the number of new cases, which annually occur, it would seem 
that in proportion, there is now as much leprosy as at the com- 
mencement, if not more. 
Through the kindness of Mr. Chas. Wilcox, the Secretary of 
the Board of Health, I was shown a statement of the number of 
lepers which have been sent to the Settlement annually since 
1866, when the Settlement was established, showing also the 
deaths and discharges and the number of lepers living at the end 
of every year. As it may be of some interest, I have condensed 
this statement in the following table for every six years, on 
which a census was taken, confining myself to natives and half 
castes only, as they are principally afflicted with the disease. 
The population for 1894, I have computed according to the pre- 
vious rate of decrease and for 4 years only, and the result is 
probably not far from the actual number. The number of 
lepers living in 1894 are not to the end of the year, only to 
March 31st. 
Year. 
1866 
Population. 
58,765 
50,531 
47,508 
44,232 
40,622 
38,412 
Sent to 
Settlement. 
Deaths. 
Discharges 
or Missing. 
Number Living 
Dec. 31, 
1872 
1878 
1884 
1890 
1894 
692 
1,154 
1,127 
1,454 
477 
247 
795 
1,079 
869 
501 
43 
51 
40 
91 
22 
402 
802 
717 
1,213 
1,152 
The pastures at the Settlement are becoming over stocked, 
through the greater number of animals especially horses running on them and under present circumstances of dry weather there 
is insufficient feed to support them all, and unless we get heavy 
and rather protracted rains, it is almost certain that stock 
especially cattle will become very poor. Waikolu is the only 
place which affords pasturage longer than any other place at 
■the Settlement. But the driving of cattle into that place is 
always connected with some loss, on account of the precipituous 
sides of that valley,- and cattle will get in such localities into 
places from where they can not get out again. 
There are too many horses altogether and it would be well if 
some plan could be adopted by which the uumber is lessened. 
Dogs at the Settlement have not diminished, the Superintend- 
ent estimates them at 400 to 500, and they roam about in packs 
and kill many calves at the Settlement which Mr. Hutchison 
estimates at no less than 50 yearly. 
The damages done by these dogs is not confined to the Settle- 
ment, they come up the sides of the mountains and are destruc- 
tive to sheep and also to calves occasionally. If the law that 
dogs must have collars and tags could be enforced at the Settle- 
ment, it might help the matter considerably. 
Government Realizations, derived from the sales of hides of 
cattle killed at the Settlement and tallow, and from sales of 
sundries by the Superintendents have been as follows: 
36 
Sales of 1932 Hides and 15 Barrels of Tallow $ 3,885 61 
“ “ Sundries as per account rendered 299 90 
Total amount $ 4,185 51 THE BOARD OF HEALTH STORE AT THE LEPER 
SETTLEMENT FOR THE ACCOMMODATIONS OF 
THE INMATES OF THE SETTLEMENT. 
The results of the Store during the period just ended has been 
as follows: 
Inventory of March 31st, 1892, including Cash at Store was $ 4,877 59 
Quarterly Store bills due the Store by the Board 68 30 
Cash in hands of Agent R W. Meyer, at the Bank 3,706 10 
Yalue of Goods purchased during the period 29,714 84 
Expenses of the Store 1,986 00 
: 
$ 40,352 83 
Inventory of March 31st, 1894, Goods in Store $ 4,643 49 
Cash on hand at the Store 325 92 
$ 4,969 41 
Cash at the Bank, Board of Health Store account 4,825 96 
Quarterly bills against the Board unpaid 58 60 
Sales at the Store during the period 32,830 38 
$ 42,684 35 
Subtracting from this the above 40,352 83 
Balance showing Net Profits for the period $ 2,331 52 
These profits of $2,331.52 do not appear to me to be as much 
as they ought to be, if compared with all former periods. The 
sales have not been as large as they were, fpr instance, during 
the last period. But the goods have been sold very much at 
the same rate and the profits should have been in the same pro- 
portion only less in amount. 
Taking for instance the sales of the last period, they amounted 
to $42,269.73, and the profits were $6,320.14, or expressed in per 
centage—about 15 per cent.—and the profits have always been 
at about that rate. During this period the sales as stated above 
have been $32,830.38 and the profits are only $2,331.52, which 
is but a trifle over 7 per cent, on the sales. That the sales have fallen of, is easily accounted for, there is 
not so much money amongst the people as there used to be, but 
why, the goods having been sold at the usual rate, the profits 
on the sales should have dropped from 14 or 15 per cent, to a 
trifle of over 7 per cent, only, is not plain to me thus far, but I 
may be able to explain this satisfactorily by and by. 
Respectfully Submitted, 
R. W. MEYER, 
Agent Board of Health for Molokai. 
Kalae, Molokai, May 15th, 1894. 
QUARTERLY REPORT OF DR. HENRY W. HOWARD, 
GOVERNMENT PHYSICIAN FOR THE DISTRICT OF 
HONOLULU, ISLAND OF OAHU, FOR THE QUAR- 
TER ENDING DECEMBER 31st, 1893. 
Disease. Total No. Treated. 
Cold 166 
Bronchitis 317 
Toothache 103 
Contusions : 25 
Syphilis 22 
Headache 28 
Constipation 424 
Rheumatism * 62 
Indigestion 99 
Pterygium 5 
Mastitis 7 
Weakmuscles 21 
Fractures 17 
Otitis Media Suppurative 18 
Incised Wounds 27 
Diarrhoea 47 Tuberculosis 6 
Locomotor Ataxia 3 
Abscess 7 
Parotitis 8 
Conjunctivitis 38 
Stomatitis 18 
Aphthae 2 
Cancnunoris : 5 
Furuncles 26 
Sprains 10 
Orchitis 3 
Pneumonia 3 
La Grippe • 54 
Pruritis senilis 1 
Enlarged glands 8 
Whooping cough 1 
Eczema 34 
Menorrhagia 8 
Amenorrhoea 19 
Dysmenorrhcea 10 
Trachoma 4 
Iritis 13 
Synovitis 2 
Teething 6 
Haemorrhoids 8 
Congestion of the liver 11 
Ulcerations 28 
Keratitis 8 
Pannus 6 
Simple fever 12 
Herpes Zoster 3 
Pharyngitis 36 
Laryngitis 10 
Proctitis 1 
Paralysis 1 Cysts 3 
Mitral insufficiency 2 
Alvolar abscess 2 
Dislocations 4 
Myopia 2 
Astigmatism 2 
Hypermetropia 3 
Aenae .’ 3 
Vagmitis 2 
Hysteria 4 
Asthma 15 
Dacryo cystitis 2 
Adinitis *. 1 
Gastritis 12 
Prurigo 2 
Diseased Antrium 1 
Septic wounds 28 
Difuse Otitis Externa 2 
Tallapes Equino-varis 1 
Sublinqual cyst 1 
Periostitis 14 
Otitis Media Acuta 10 
Mal-nutrition ... 3 
Irritation of the skin 3 
Vomiting of Pregnancy 1 
Lacerated wounds 9 
Foreign bodies in the eye. . • 5 
Foreign bodies in the ear • 2 
Hernea 2 
Cateract 5 
Confinement 2 
Bubo . 11 
Gonorrhoea • 65 
Pleurisy 9 
Debility 5 Pleurodenia 4 
Cystitis 5 
Scabes 125 
Pediculse capitis 53 
Psoriasis 5 
Abortion 2 
Rhinitis Hypertophic 6 
Rhinitis Intumescent 11 
Diabetes 1 
Croup 2 
Nephritis 4 
Dysuria 1 
Anorrexia 2 
Tonsillitis (Acute and Chronic) 21 
Intermittent fever 6 
Neuralgia 8 
Phymosis 3 
Cholera infantum 28 
Dysentery 11 
Leprosy 4 
Burns 27 
Dropsy 5 
Vennes 6 
Inanition 3 
Phthisis pulmonalis 5 
Optic neuritis 1 
Lencorrhcea 4 
Visits made outside • 38 
Total number treated 2,411 
Health certificates granted 175 
Lepers Apprehended 4 
Leper Suspects under Surveillance 63 
HENRY W. HOWARD, 
Government Physician, District of Honolulu, Island of Oahu. QUARTERLY REPORT OF DR. HENRY W. HOWARD, 
GOVERNMENT PHYSICIAN FOR THE DISTRICT OF 
HONOLULU, ISLAND OF OAHU, FOR THE QUAR- 
TER ENDING MARCH 31st, 1894. 
Disease. Total No. Treated. 
Asthma 7 
Stomatitis 11 
Cancrum oris 9 
Aphthae 1 
Amenonhoea 18 
Abortion 1 
Bubo 5 
Bronchitis 778 
Burns 2 
Cold 128 
Convulsion. 20 
Constipation 485 
Conjunctioitis 47 
Conjestion of liver 4 
Cateract „ 2 
Corn 1 
Chorea 2 
Cyst 2 
Cyslitis 7 
Delivery 1 
Diarrhoea.. 29 
Dysmenorrhoea 5 
Dysentery 3 
Dysuria 1 
Debility 9 
Dropsy 1 
Enlarged glands 13 
Eczema 44 
Simple fever 26 43 
Fractures 4 
Foreign bodies removed from eye 3 
Furnucles 15 
Gonorrhoea 97 
Gastritis 1 
Headache 1 
Hysteria 1 
Herpes 6 
Inanition 1 
Indigestion 77 
Incised wounds.... 23 
Iritis 11 
Intermittent fever 2 
Keratitis 8 
Tabes dorsalis 1 
La Grippe 66 
Laryngitis 4 
Lacerated wounds 1 
Leprosy 2 
Leucorrhoea 1 
Mastitis 1 
Menorrhagia 9 
Nasal polypi 2 
Neuralgia 39 
Neurasthenia 1 
Otitis Media Suppurative 6 
Ottis Media Acute 7 
Oedema 1 
Orchitis 1 
Parotitis 2 
Prolapse of rectum 2 
Pneumonia 2 
Pannus 3 
Pharyngitis 21 
Pterygium 2 44 
Pleurisy 5 
Paralysis 4 
Scabes 54 
Pediculae Capilus 43 
Pregnancy 4 
Phymosis , 2 
Pleurodynia 5 
Pmigo 1 
Pruritis senalis 1 
Rhinitis 9 
Rheumatism 195 
Stricture Urethrea 2 
Stricture of Oesophagus 1 
Syphilis 34 
Sprains 20 
Septic wounds 5 
Toothache 127 
Trachoma 2 
Tonsillitis 13 
Tuberculosis 3 
Vermes 11 
Typhoid fever 1 
Ulcurations 31 
Vomiting of pregnancy 1 
Vagmitis. 1 
Wrticaria 9 
Warts 2 
Vericose vems 1 
Ophtholmia neonatonun 7 
Visits made outside 23 
Total number treated 2,703 
Health certificates granted 97 
Lepers Apprehended 2. Leper Suspects under surveillance 60. 
HENRY W. HOWARD, 
Government Physician, Districtof Honolulu, Island of Oahu. STATEMENT OF THE EXPENDITURES OF THE BOARD 
OF HEALTH FOR THE BIENNIAL PERIOD END- 
ING MARCH 31ST, 1894. 
Appropriation. Expenditures. 
Salary of President of Board of 
Health $ 5,200 00 $ 2,600 00 
Balance unexpended.... 2,600 00 
$ 5,200 00 $ 5,200 00 
Salary of Secretary of Board of 
Health $ 4,000 00 $ 3,784 00 
Balance unexpended. . . . 216 00 
$ 4,000 00 $ 4,000 00 
General Expenses, Board 
of Health $13,370 00 
General Expenses, Board 
of Health, Act 61, 
P. G. Laws 500 00 
$ 13,870 00 
Advertising.. $ 792 15 
Agents, Board of Health 10,490 00 
Clerk, Messenger, and Copyist. . . 807 00 
Coffins and Burials 8 10 
Expressage and Cartage 46 75 
Incidentals 338 73 
Newspapers 39 00 
Postage and Stamps 126 35' 
Printing Blanks, Circulars, etc.. . 387 95 
Stationery 307 02 
Sundry Labor 368 00 
Telephones 153 00 
Balance unexpended.... 5 95 
$ 13,870 00 $ 13,870 00 46 
Support of Non-leprous Children of 
Lepers $ 3,130 00 
Dry Goods and Clothings $ 101 84 
Franciscan Sisters 480 00 
Furniture, Utensils, and Bedding 63 57 
Incidentals 69 99 
Provisions and Supplies 1,982 06 
Sundry Labor 432 00 
Balance unexpended 54 
$ 3,130 00 $ 3,130 00 
Debt due March 31st, 1892 $ 85 35 $ 85 35 
Free System of Removing Garbage. $ 12,000 00 
Horse Feed . 1,251 43 
Incidentals 124 92 
Labor Account 7,315 00 
Shoeing Horses 202 50 
Tools and Implements 231 10 
Balance unexpended. . . . 2,875 05 
$ 12,000 00 $ 12,000 00 
Buildings, Repairs, and Maintenance 
of Hospitals : 
Dispensary $ 16,000 00 
Ice $ 47 13 
Incidentals 85 05 
Salary of Dispenser . . . 1,890 00 
Telephone 72 00 
$ 2,094 18 
koloa hospital: 
Furniture, Hardware, 
and Crockery 75 19 
Incidentals 39 47 Labor Account $ 819 50 
Provisions and Supplies 373 33 
: $ 1,307 49 
MALULANI HOSPITAL: 
Dry Goods and Cloth- 
ings 101 46 
Coffins and Burials. . . . 229 00 
Franciscan Sisters .... 1,440 00 
Freight and Cartage. . . 228 12 
Furniture, Hardware, 
and Crockery 484 43 
Incidentals 500 14 
Labor Account 3,007 12 
Medical Supplies 175 76 
Provisions and Supplies 4,595 08 
Repairs 686 08 
Washing 282 10 
11,729 29 
Balance unexpended.... 869 04 
a 
$ 16,000 00 $ 16,000 00 
Debt due March 31st, 1892 $ 1,329 42 $ 1,329 42 
Medicines $ 8,000 00 
KAUAI. 
Waimea $ 257 26 
Koloa 149 06 
Koloa Hospital 59 55 
Hanalei 131 71 
Puna 302 88 
$ 900 46 
oahu: 
Waianae 189 27 
Waialua and Koolau. . 350 47 
Honolulu 1,709 45 
2,249 19 Molokai $ 170 44 
maui: 
Lahaina and Lanai ... $ 258 29 
Wailuku 456 60 
Malulani Hospital 1,072 04 
Makawao 105 79 
Hana 198 70 
2,091 42 
HAWAII: 
Kohala 286 81 
Waimea 37 59 
Hamakua 307 82 
North Hilo 199 80 
Hilo 273 69 
Puna 137 63 
Kau 254 29 
Kona 314 76 
1,812 39 
Miscellaneous 496 32 
Balance unexpended. .. . 279 78 
$ 8,000 00 $ 8,000 00 
Government Physicians, to include 
the sum of $1000 as pay of extra 
physician for the District of 
Wailuku $ 37,000 00 
oahu: 
Honolulu Dispensary.. $ 4,857 50 
Waianae 1,133 33 
Waialua and Koolau. 2,790 00 
$ 8,780 83 kauai: 
Waimea $ 1,506 67 
Koloa 1,506 67 
Hanalei 1,080 83 
Puna 1,506 66 
$ 5,600 83 
Molokai 1,506 67 
maui: 1 
Lahaina and Lanai . . 2,260 00 
Wailuku and Malulani 
Hospital 1,953 33 
Makawao 1,506 67 
Hana 2,260 00 
7,980 00 
HAWAII: 
Kohala 1,200 00 
Hamakua 1,506 67 
North Hilo 1,883 33 
Hilo and Puna 2,260 00 
Kau 1,506 67 
Kona 3,000 00 
11,356 67 
Balance unexpended.... 1,775 00 
* 37,000 00 $ 37,000 00 
Maintenance, Repairs, and Rent of 
Quarantine Station $ 8,500 00 
Ground Rent $ 2,000 00 
Incidentals 580 31 
Lumber and Building Material. . . 1,478 71 
Furniture, Bedding, and Crockery 565 14 
Sundry Labor 852 23 
Telephone 97 00 Wages of Guards $ 1,180 00 
Repairs to Quarantine Wharf. . . . 1,746 61 
$ 8,500 00 $ 8,500 00 
Debt due March 31st, 1892 $ 36 00 $ 36 00 
Expenses under the Act to Mitigate, 
to be disbursed in the discretion 
and under direction of the Board 
of Health $ 2,400 00 
Salaries 2,288 17 
Balance unexpended.. . Ill 83 
$ 2,400 00 $ 2,400 00 
t 
Expenses of erecting Monument to 
Father Damien $ 250 00 $ 40 25 
Balance unexpended . . 209 75 
$ 250 00 $ 250 00 
Propagation of Bovine Virus $ 500 00 $ 261 00 
Balance unexpended.... 239 00 
$ 500 00 $ 500 00 
Segregation, Support, and Treatment 
of Lepers $ 225,000 00 
Beef and Cattle 37,550 05 
BISHOP HOME. 
Dry Goods and Cloth- 
ing $ 972 30 
Franciscan Sisters .... 2,881 27 
Furniture, Utensils, and 
Bedding 339 90 Incidentals $ 278 07 
Provisions and Supplies 467 52 
Sundry Labor 1,361 00 
$ 6,300 06 
Board and Cartage of Lepers and 
Assistants 1,474 92 
BOYS HOME. 
Dry Goods and Clothings.$1,373 19 
Franciscan Sisters 1,488 00 
Furniture, Utensils, and 
Bedding 174 05 
Incidentals 226 16 
Provisions and Supplies. . 432 80 
Sundry Labor 1,650 60 
5,344 80 
Bread 6,774 23 
Butcher Shop Expenses 158 15 
Dry Goods and Clothings 75 
Firewood and Coal 69 86 
Fish 3,246 33 
Flour 1,224 88 
Freights and Passage of Lepers and 
Assistants 6,646 80 
Hardware, Tools, and Implements. . 639 80 
HOSPITAL. 
Dry Goods and Clothing. $ 40 90 
Furniture and Bedding.. 382 91 
Incidentals . . . 621 19 
Provisions and Supplies. 174 82 
Sundry Labor 594 05 
1,813 87 
Boiled Oil, White Lead and Turpen- 
tine 97 56 
Cement and Lime 271 95 
Doors ' 54 10 52 
Galv. Iron Roofing, Washers and 
Screws $ 1 80 
Galv. Iron Pipe 123 60 
Lumber Nor. VVest 1,230 88 
Lumber Redwood 459 64 
Nails 102 19 
Posts 5 95 
Shingles 369 00 
Window, Sashes and Glass 101 73 
Incidentals 419 72 
Kerosene Oil 820 70 
Labor Account 6,896 85 
Matches 466 91 
MEDICAL DEPARTMENT. 
Incidentals $ 157 20 
Dr. Goto’s medi- 
cines $ 2,435 21 
Medicines .... 2,185 24 
4,620 45 
Salary of Specialist for 
Lepers 3,842 00 
Salary of Resident Physi- 
cian 6,083 33 
Salary of Dispenser and 
Assistant 352 50 
Sundry Expenses, Special 
Treatment of Lepers.. . 324 59 
15,380 07 
Poi 54,697 16 
Printing Blanks, etc 82 25 
Ration Bills 19,185 25 
Repairing 216 00 
Rice 4,651 00 
Salary of Superintendent & Assistant 7,962 00 
Salt 892 51 Soap $ 2,091 25 
Stationery 144 22 
Sugar 1,539 80 
Telephone 4 40 
Taro Planting 40 00 
Visitors’ House. 89 96 
Water Works 427 07 
Traveling Expenses, Agent for Lepers 32 48 
Removing Lepers from Kalalau.... 4,492 95 
Salary of Agent for Lepers 675 00 
KALIHI RECEIVING STATION! 
Dry Goods and Clothing. . 371 96 
Examination of Lepers. . . 705 00 
Franciscan Sisters 960 00 
F urniture, Bedding and 
Crockery 765 38 
Ground Rent 432 00 
Incidentals 241 95 
Lumber and Building Ma- 
terials 54 57 
Medicine and Medical Sup- 
plies 45 92 
Milk 491 70 
Provisions and Supplies.. 3,686 72 
Receiving Cells on other 
Islands 35 00 
Sundry Labor 2,162 25 
Telephones 72 00 
Tools and Implements. . . 136 34 
Water Works and Water 
Rates 469 25 
10,630 04 
Balance unexpended 19,099 51 
$ 225,000 00 $ 225,000 00 Recapitulation. 
Salary of President of Board of Health $ 5,200 00 $ 2,600 00 
“ “ Secretary “ “ “ 4,000 00 3,784 00 
General Expenses “ “ 13,370 00 13,370 00 
U U U U 
Act 61, P. G. Laws /.... 500 00 494 05 
Support of Non-leprous Children of 
Lepers 3,130 00 3,129 46 
Debt due March 31st, 1892 85 35 85 35 
Free System of Removing Garbage. . 12,000 00 9,124 95 
Buildings, Repairs, and Maintenance 
of Hospitals 16,000 00 15,130 96 
Debt due March 31st, 1892.. . . 1,329 42 1,329 42 
Mediciues 8,000 00 7,720 22 
Government Physicians, to include 
the sum of $1000 as pay of extra 
physician for the District of Wai- 
luku 37,000 00 35,225 00 
Maintenance, Repairs, and Rent of 
Quarantine Station 8,500 00 8,500 00 
Debt due March 31st, 1892. ... 36 00 36 00 
Expenses under the Act to Mitigate, 
to be disbursed in the discretion 
and under direction of the Board 
of Health 2,400 00 2,288 17 
Expenses of erecting Monument to 
Father Damien 250 00 40 25 
Popagation of Bovine Virus 500 00 261 00 
Segregation, Support, and Treatment 
of Lepers 225,000 00 205,900 49 
Balance unexpended . 28,281 45 
$ 333,300 77 $ 337,300 77 STATEMENT OF AMOUNTS RECEIVED AND PAID INTO 
THE TREASURY AS GOVERNMENT REALI- 
ZATIONS FOR THE PERIOD END- 
ING MARCH 31st, 1894. 
From Hides and Tallow $ 4,511 35 
“ Malulani Hospital 5,023 26 
“ Koloa Hospital 872 00 
“ Sundries 470 99 
$ 10,877 60 Island. 
District. 
Physician. 
Period of 
Service. 
JLeper Suspects 
1 under Surveil- 
ance - 
Vaccina- 
tion. 
Inspection of 
Schools. 
House Visits - 
Office Visits-- 
Cases Treated . 
i 
Success- 
ful ... 
H 
0 
P 
p 
No. of 
Schools 
Inspected. 
Certificates 
Total . . 
Issued. 
Denied 
Aug. 1, ’87 to date 
5 
307 
303 
180 
637 
345 
Koloa and Koloa 
Oct. 1 ’87 “ 
1 
4 
195 
12 
207 
206 
1368 
1536 
Puna - 
Dr. St. D. G. Walters 
Aug. 1,’87 
1 
5 
43 
5 
437 
1 
438 
654 
1384 
677 
Hanalei 
Dr. H. P. Hugos— - 
June 1, ’92 to Sept. 
30, ’93 
16 
48 
U 
12 
68 
68 
427 
1 
428 
3 
69 
72 
Oahu ..... 
Waialua, Koo- 
lauloa & Koo- 
Oct- 15 ’88 
86 
9 
456 
8 
464 
2329 
3046 
1926 
Waianae 
Dr. N. Russel ...... . 
May 20, ’92 
5 
163 
173 
9 
288 
2 
290 
383 
2863 
797 
Honolulu 
Dr H. G. McGrew... 
Aug. 13, 90 to July 
1,’93 
4019 
<< 
60 
846 
846 
7245 
Molokai .. 
Nov. 20, ’90 “ 
9 
83 
138 
14 
170 
5 
175 
314 
996 
729 
Dr. M. Goto 
Mar. 7, ’63 “ 
- 
Aug. 25, 90 “ 
55 
55 
8 
426 
426 
409 
1130 
537 
W ailuku & Ma- 
lulani Hospital 
Dr. Geo. Herbert . 
Oct. 1, ’88 
1 
8 
11 
673 
6 
679 
674 
2130 
2253 
7 
22 
1498 
0 
1504 
165 
265 
325 
Dr. P. J. Aiken 
May 12, ’94 .... 
2 
41 
91 
16 
995 
13 
1008 
873 
1260 
835 
Hawaii ... 
Aug. 1, ’87 
13 
806 
806 
190 
1409 
1242 
Hamakua & S. 
Apr. 1. 89 “ 
6 
25 
11 
723 
1 
724 
174 
335 
192 
July 22.’90 “ 
3 
60 
60 
744 
Q7Q 
1572 
"A 
Hilo. 
Dr. R. B. Williams 
Jan. 15, ’91 “ 
4 
4 
4 
10 
729 
15 
744 
592 
1134 
716 
Dr. E.V. LeBlond 
2 
18 
3 
13 
Kau - - 
Dr. C. B. Cooper .. 
Aug. 13, ’91 to Mar 
31, ’93 
3 
14 
14 
350 
320 
260 
u 
5 
46 
212 
212 
370 
379 
314 
Kona ... 
Dr. H.A. Lindley 
Nov. 17, 91 “ 
6 
103 
189 
26 
1093 
9 
1102 
647 
1033 
1026 
Total 
137 
537 
940 
158 
10341 
79 
10420 
9382 
18776 
26678 
TABULATED STATEMENT OF WORK DONE IN THEIR DISTRICTS BY THE GOVERNMENT 
PHYSICIANS FOR THE BIENNIAL PERIOD ENDING MARCH 31, 1894. Year. 
Admissions. 
Deaths. 
Discharge or , 
Unaccounted for. 
Number 
December 31. 
1866 
141 
26 
10 
105 
1867 
70 
25 
7 
143 
1868 
115 
28 
2 
228 
1869 
126 
59 
11 
284 
1870 
57 
58 
4 
279 
1871 
183 
51 
9 
402 
1872 
105 
64 
4 
439 
1873 
487 
156 
21 
749 
1874 
91 
161 
8 
671 
1875 
212 
163 
14 
706 
1876 
96 
122 
3 
677 
1877 
163 
129 
1 
710 
1878 
239 
147 
0 
802 
1879 
125 
209 
1 
717 
1880 
51 
152 
10 
606 
1881 
232 
132 
0 
706 
1882 
71 
121 
6 
649 
1883 
301 
150 
15 
785 
1884 
108 
168 
8 
717 
1885 
103 
142 
26 
655 
1886 
' 43 
100 
8 
590 
1887 
220 
108 
4 
698 
1888 
579 
212 
28 
1035 
1889 
308 
149 
7 
1187 
1890 
202 
158 
18 
1213 
1891 
143 
212 
2 
1142 
1892 
109 
137 
19 
1095 
1893 
211 
151 
0 
1155 
LEPERS AT THE LEPER SETTLEMENT ON MOLOKAI. TABLE SHOWING RATIO OF DEATHS AMONG LEPERS 
AT THE LEPER SETTLEMENT ON MOLOKAI TO 
THE LEPER POPULATION OF THE SETTLE- 
MENT FOR THE BIENNIAL PERIOD 
ENDING MARCH 31, 1894. 
DATE. 
Average 
Leper 
Population. 
Deaths. 
Per Centum 
of Deaths. 
1892. April 
1128. 
8 
.71 
May 
1143.5 
20 
1.75 
June 
1134. 
4 
.35 
July 
1129. 
6 
.53 
August 
1120.5 
10 
.89 
September 
1109.5 
12 
1.08 
October 
1092. 
10 
.92 
November 
1079.5 
14 
1.30 
December 
1094. 
11 
1.00 
1893. January 
1086. 
13 
1.20 
February 
1073.5 
17 
1.58 
March 
1071.5 
10 
.93 
April 
1085. 
9 
.83 
May 
1095. 
9 
.82 
J line 
1097.5 
13 
1.19 
July 
1130.5 
6 
.53 
August 
1157.5 
14 
1.21 
September 
1155.5 
17 
1.47 
October 
1164. 
12 
1.03 
November 
1168. 
14 
1.19 
December 
1162.5 
17 
1.46 
1894. January 
1151.5 
15 
1.28 
February 
1157. 
13 
1.29 
March 
1158.5 
14 
1.21 
1122.6 
288 
25.65 
Apr. 1, 1886, to Mar. 31, 1887. .. 
612.7 
114 
18.60 
Apr. 1, 1887, to Mar. 31,1888. . . 
618.6 
112 
18.10 
Apr. 1, 1888, to Mar. 31,1889. .. 
921. 
230 
£5.00 
Apr. 1, 1889, to Mar. 31, 1890. . . 
1150. 
155 
13.48 
Apr. 1, 1890, to Mar. 31, 1891. .. 
1168. 
143 
12.24 
Apr. 1, 1891, to Mar. 31, 1892. . . 
1137. 
223 
19.61 
Apr. 1, 1892, to Mar. 31, 1893. .. 
1105. 
135 
12.21 
Apr. 1, 1893, to Mar. 31, 1894. . . 
1140.2 
153 
13.42 REPORT OF THE MALULANI HOSPITAL FOR THE 
BIENNIAL PERIOD ENDING MARCH 31; 1894. 
Total numbes of patients 339 
Hawaiians 146 
Foreigners 193 
Paying patients 185 
Non-paying patients 154 
Discharged 301 
Died 38 
Calls for medicines 1,430 
Hospital Receipts $5,023 26 
REPORT OF THE KOLOA HOSPITAL FOR THE BIEN- 
NIAL PERIOD ENDING MARCH 31, 1894. 
Total number of patients entered 83 
Hawaiians 24 
Foreigners 59 
Paying patients 49 
Non-paying patients 34 
Discharged 55 
Died 11 
In Hospital March. 31, 1894 4 
Hospital Receipts .$872 00 
Honolulu, March 31, 1894. 
To the Honorable Board of Health: 
Gentlmen :—As Executive Officer of the Board, I beg to sub- 
mit my report for the biennial period ending this date. 
SEGREGATION OF LEPERS. 
During this period, the Agents of the Board have displayed 
considerable energy in collecting and forwarding to Honolulu 60 
lepers and suspects from all parts of the Islands for examina- 
tion by the Medical Board of Examiners, and I think the Board 
can congratulate themselves on the fact that the Islands have 
not been so free from known lepers at large for the past ten 
years as at present. 
The gathering in of the lepers from Kalalau and Wainiha 
valleys, also from Niihau and Lanai, places that have been un- 
disturbed strongholds of lepers for many years, has added over 
60 to the number of those sent to Molokai this period, the total 
of which is 340, as against 333 for the period ending 1892, and 
798 for the period ending 1890. These figures go to prove that 
impartial and thorough segregation will eventually rid the 
Islands of this disease. 
The following tables show the number of persons examined 
by the Medical Board, with their conditions, former residence, 
sex, age, nationality, etc. 
PERSONS EXAMINED AT KALIHI RECEIVING STATION FROM APRIL ' 
1, 1892 to march 31, 1894. 
From. 
Lepers. 
Suspicious. 
Not Leper sr. 
Total. 
Oahu 
119 
37 
10 
166 
Hawaii 
78 
8 
4 
90 
Maui 
49 
14 
3 
66 
Molokai 
10 
2 
1 
13 
Kauai 
57 
11 
1 
69 
Niihau 
10 
10 
Lanai 
5 
5 
In Rec’g Station, 
March 31, 1892. 
t 
12 
12 
Total 
340 
72 
19 
431 LEPERS SENT TO MOLOKAI FROM APRIL 1, 1892 TO MARCH 31, 1894. 
Ages. 
Males 
Females .... 
Half Castes. . 
i 
Hawaiians . . 
Chinese 
.Japanese ... 
Portuguese . . 
American . . . 
English 
German .... 
S. S. Islands.. 
Total 
Under 10 
9 
4 
2 
10 
1 
13 
10 to 20 
73 
56 
14 111 
1 
2 
1 
129 
20 to 30 
37 
31 
4 
62 
1 
1 
68 
30 to 40 
27 
21 
2 
43 
2 
1 
48 
40 to 50 
19 
6 
23 
1 
1 
25 
50 to 60 
11 
12 
23 
23 
60 to 70 
12 
4 
16 
16 
Over 70 
8 
4 
11 
1 
12 
Died at K. R. S. 
1 
1 
2 
Sent to Japan. . 
2 
Escaped 
• • • 
2 
Total 
340 
KALIHI RECEIVING STATION 
One of the greatest drawbacks to this institution up to August, 
1893, was scarcity of water. This difficulty has been over- 
come by the erection of an Aermoter mill and force pump which 
draws the water from the artesian well of Mr. W. L. Wilcox, 
giving the station abundance of water for all purposes. There 
has been considerable sickness at the station during the period, 
quite a number of the patients from the other Islands suffering 
from neglected leprous sores, and other complaints brought on 
by rough living and exposure in the mountains. Influenza 
has appeared at the Station on several occasions, but owing to 
the careful attention and nursing by the Franciscan Sisters and 
Mr. W. L. Beku, keeper of the Station, only two deaths have 
occured during the period. 
KAPIOLANI HOME FOR NON-LEPROUS CHILDREN OF LEPROUS PARENTS. 
There are at present 13 girls at this Home, which is also 
under the care of the Franciscan Sisters. As there is every 62 
probability of these children living free from the taint of leprosy, 
they are instructed not only in the English language, but also 
in every branch of industry necessary to make them useful 
members of the community. A Home of this description for 
male children of leprous parents would, if established have 
good results. 
VITAL STATISTICS. 
The number of deaths for the period show a decrease of 181 
compared with last period. The accompanying tables give 
ages, nationality, and cause of death as correctly as can be as- 
certained with the present unsatisfactory system we have of 
getting the same : 265 deaths are registered as unattended, that 
number would he doubled if I counted the cases that have been 
attended up to perhaps a week of the time of death, and then 
either left without any treatment, or turned over to the tender 
mercy of the kahuna. A short time ago, I was asked by a 
medical man why I gave a burial certificate, without receiving 
a doctor’s certificate as to the cause of death. I could only 
answer by asking another question,—What was to be done with 
the unburied dead? Consumption continues to swell our death 
rate, about 12 per cent, of the deaths being from this cause. 
Influenza, although not appearing in the epidemic form as it 
did in the months of May and June, 1891, has still been with 
us most of the period adding 68 to the death roll, and a number 
of the deaths registered as fever was the result of “ La Grippe.” 
Diphtheria was reported in October, 1893, on School street. 
There were six cases in all, two of which died. A strict quaran- 
tine was placed on the houses infected and further spread pre- 
vented. 
SANITARY CONDITION OF HONOLULU. 
Upon this subject, I would respectfully call the Board to two 
existing nuisances in the town, with hopes that action will 
he taken to have them removed outside the settled districts. The MORTALITY REPORT FOR THE 12 MONTHS ENDING 
MARCH 31ST, 1893. 
AGES. 
April 
June 
July 
August 
September.. 
October 
November.. 
December . 
5 
C2 
P 
i 
February 
March 
Total 
Under 1 year 
7 
8 
12 
6 
9 
5 
11 
5 
4 
8 
6 
5 
86 
From 1 to 5 
“ 5 to 10 
1 
2 
8 
— 
4 
2 
2 
1 
4 
1 
1 
2 
7 
2 
2 
4 
1 
2 
1 
34 
11 
33 
“ 10 to 20 
7 
3 
4 
2 
2 
4 
2 
3 
2 
~~2 
“ 20 to 30 
9 
4 
7 
4 
7 
4 
8 
6 
9 
4 
6 
10 
78 
“ 30 to 40 . 
9 
5 
9 
11 
4 
5 
4 
3 
10 
3 
10 
11 
84 
“ 40 to 50 
6 
9 
5 
5 
n 
i 
6 
8 
7 
7 
4 
- 8 
5 
77 
“ 50 to 60 
5 
1 
3 
4 
3 
8 
3 
3 
5 
6 
3 
5 
44 
“ 60 to 70 
5 
3 
2 
3 
6 
1 
5 
3 
5 
1 
2 
5 
41 
Over 70 
4 
5 
3 
8 
8 
7 
5 
6 
2 
8 
4 
7 
67 
Totals 
55 
46 
45 
47 
50 
36 
51 
36 
54 
88 
46 
51 
555 
SEXES. 
Males 
35 
26 
25 
31 
33 
20 
29 
19 
32 
19 
31 
30 
330 
Females ...... 
20 
20 
20 
16 
17 
16 
22 
17 
22 
19 
15 
21 
225 
NATIONALITY. 
Hawaiians 
35 
27 
28 
23 
33 
23 
31 
22 
25 
26 
25 
26 
324 
Chinese . 
7 
6 
8 
11 
9 
5 
9 
3 
14 
8 
7 
10 
97 
Portuguese. .. 
2 
5 
3 
6 
3 
1 
6 
3 
5 
3 
3 
4 
44 
U. S. A.. 
2 
3 
1 
2 
2 
2 
1 
3 
2 
3 
21 
British 
3 
2 
1 
1 
2 
2 
3 
1 
4 
2 
3 
22 
28 
19 
i a i 
Japanese 
Other Nations 
4 
2 
1 
2 
3 
1 
3 
1 
» 
3 
2 
1 
2 
2 
2 
4 
1 
3 
2 
1 1 
IT nattended .... 
13 
1 i 
'■[ 5 
12 
15 
7- 
13 
7 
8 
11 
8 , 
Wards 1 
9 
9 
7 
5 
15 
5 
12 
6 
6 
6 
5 
4 
89 
“ 2. 
9 
11 
8 
9 
11 
13 
6 
10 
7 
14 
7 
12 
117 
“ 3 *. 
15 
10 
7 
18 
12 
9 
9 
12 
20 
7 
11 
14 
144 
“ 4 
14 
7 
15 
11 
7 
'5 
13 
5 
11 
io 
11 
12 
121 
“ 5. 
Outside 
7 
1 
9 
8 
4 
5 
4 
11 
3 
10 
1 
9 
3 
7 
2 
78 
6 
Non-residents 
2 
2 
... 
2 
1 
5 
2 
4 
— 
3 
= ----- 
2 
23 
Annual Death Rate Per 1000: 
Estimated Population. 
All Nationalities — 24.13 . _ 23,000 
Hawaiians 29.45 11,000 
Asiatics .. - 20.83 6,000 
All Others 17.66 6,000 
CAUSE OF DEATH. 
> 
r- 
P 
c 
• CD 
c 
d 
JQ 
cn 
c*- 
w 
CD 
c+ 
3 
Cl 
G 
o 
cr 
2 
o 
< 
2 
cr 
CD 
-s 
CD 
CD 
CD 
g 
CD 
P 
3 
p 
£ 
c 
Q 
P 
•-* 
O 
o 
<rf- 
P^ 
Apoplexy 
1 
1 
2 
1 
3 
8 
Asthma 
1 
1 
Aneurism 
1 
1 
2 
Accident 
2 
1 
2 
1 
1 
2 
-r -- 
1 
4 
14 
Alcoholism 
1 
1 
1 
1 
4 
Abcess 
1 
1 
2 
4 
Brights Disease 
1 
1 
1 
2 
5 
Beriberi . 
2 
2 
1 
1 
1 
3 
2 
1 
2 
1 
16 
Bronchitis 
2 
3 
1 
1 
2 
2 
1 
2 
3 
17 
Croup 
1 
1 
2 
Carbuncle- 
1 
1 
Consumption. 
9 
6 
4 
6 
5 
5 
5 
5 
9 
3 
7 
7 
71 
Convulsions 
3 
1 
1 
1 
2 
2 
10 
Cancer ______ ______ 
1 
2 
1 
2 
1 
7 
Childbirth _ _ _ 
1 
1 
1 
1 
4 
Diarrhoea 
1 
3 
3 
1 
2 
6 
2 
5 
4 
1 
2 
30 
Cholera Infantum 
1 
1 
1 
3 
Dropsy 
4 
2 
3 
1 
1 
1 
1 
1 
4 
1 
19 
I)iphtheria_ - 
1 
1 
Dysentery 
2 
3 
1 
2 
2 
1 
1 
3 
15 
Disease of brain 
1 
1 
1 
1 
1 
5 
Disease of heart 
7 
2 
1 
2 
4 
2 
2 
1 
2 
~Y 
3 
2 
30 
Disease of lungs 
l 
1 
Disease of liver 
1 
1 
1 
2 
5 
Debility — 
2 
3 
4 
3 
5 
1 
18 
Enters Colitis 
1 
1 
1 
1 
4 
Exhaustion . _ 
1 
1 
i 
3 
Fe ver - 
4 
6 
8 
5 
3 
3 
6 
8 
7 
3 
4 
57 
Epilepsy 
1 
1 
Drowned - _. 
1 
1 
1 
1 
4 
Hemorrhage 
1 
1 
1 
1 
1 
1 
1 
2 
9 
Hernia 
1 
1 
1 
1 
1 
5 
Inanition _ 
1 
1 
3 
1 
2 
2 
1 
11 
Injuries - 
1 
] 
1 
3 
Inflammation _ _ 
2 
1 
1 
1 
5 
Jaundice 
1 
1 
Influenza 
9 
1 
2 
5 
Locomotor Ataxia 
1 
1 
Obstruction bowels 
1 
1 
1 
1 
4 
Meningitis _ 
2 
1 
3 
Old age. 
4 
8 
3 
5 
( 
5 
3 
5 
2 
5 
9 
56 
Opium -. ... - 
1 
1 
1 
3 
3 
Paralysis _ _ - 
2 
4 
1 
1 
1 
1 
3 
13 
Pneumonia, _. _ 
2 
2 
1 
1 
1 
2 
12 
Rheumatism 
.... 
1 
1 
SyphiliR 
2 
2 
1 
5 
Septicaemia - 
1 
2 
3 
Suicide.. - . 
9 
1 
3 
Marasmus.- .. 
1 
2 
3 
Tetanus 
1 
1 
2 
Ovarian Cyst 
1 
i 
Unknown . _ 
6 
5 
4 
3 
8 
2 
3 
1 
4 
1 
37 
Peritonitis 
1 
1 
2 
Pleurisy . . 
1 
1 
1 
3 
Pyaemia 
1 
1 
Rupture 
1 
1 MORTALITY REPORT FOR THE 12 MONTHS ENDING 
MARCH 31 ST, 1894. 
AGES. 
April 
P 
1 
i 
i 
i 
1 
June 
July 
[ August 
| September.. 
c 
o 
C7+- 
o_ 
(t 
i 
•| November.. 
December . 
January 
1 February 
March .... 
Total 
Under 1 year 
10 
7 
15 
16 
12 
10 
14 
16 
13 
8 
6 
9 
136 
From 1 to 5 
1 
2 
t 
5 
1 
2 
6 
12 
6 
5 
2 
3 
52 
“ 5 to 10 
2 
1 
4 
1 
2 
1 
1 
4 
1 
17 
“ 10 to 20 
3 
1 
7 
2 
4 
5 
1 
3 
2 
2 
3 
1 
34 
“ 20 to 30 
6 
4 
7 
5 
7 
9 
7 
4 
4 
10 
8 
10 
81 
“ 30 to 40 
6 
6 
7 
4 
4 
13 
6 
7 
8 
4 
10 
2 
77 
“ 40 to 50 . 
3 
7 
5 
6 
8 
4 
5 
5 
4 
5 
4 
4 
60 
“ 50 to 60... 
2 
4 
4 
5 
5 
5 
5 
5 
6 
1 
2 
7 
51 
“ 60 to 70 
3 
8 
3 
1 
5 
4 
3 
3 
4 
1 
5 
40 
Over 70.. 
9 
4 
7 
4 
3 
9 
4 
4 
9 
8 
5 
3 
69 
Total 
40 
40 
68 
54 
46 
64 
52 
60 
55 
48 
45 
45 
617 
SEXES. 
Males 
21 
26 
48 
29 
31 
37 
36 
29 
32 
32 
25 
21 
367 
Females ...... 
19 
14 
20 
25 
15 
27 
16 
31 
23 
16 
20 
24 
250 
NATIONALITY. 
Hawaiians . 
28 
26 
43 
33 
26 
43 
24 
31 
34 
26 
29 
27 
370 
Chinese 
4 
6 
10 
6 
10 
9 
9 
16 
7 
10 
8 
7 
102 
Portuguese 
1 
2 
5 
7 
3 
4 
6 
6 
6 
2 
2 
8 
52 
U. S. A. 
1 
1 
2 
2 
3 
1 
5 
1 
16 
British 
2 
3 
4 
1 
2 
2 
2 
10 
Japanese 
4 
3 
4 
2 
5 
2 
~b~ 
3 
4 
5 
5 
2 
44 
Other Nations 
2 
1 
2 
1 
2 
5 
1 
2 
1 
17 
Unattended 
9 
8 
14 
9 
10 
15 
13 
13 
15 
15 
6 
7 
134 
Ward 1 
8 
1 6 
12 
11 
6 
8 
4 
7 
7 
4 
2 
84 
“ ' 2 
*) 
e 
22 
12 
g 
1 o 
1 0 
vn 
o 
A 
11 
1 
“ 3 
10 
12 
11 
14 
12 
15 
15 
12 
16 
14 
15 
19 
165 
“ 4 
11 
7 
14 
7 
15 
9 
12 
17 
6 
13 
12 
7 
130 
“ 5.... 
9 
7 
9 
10 
5 
20 
9 
12 
12 
5 
8 
6 
112 
Non-residents 
2 
1 
1 
1 
2 
2 
1 
3 
12 
Outside at Quarantine 
Station 
1 
1 
— 
— 
— 
Annual Death Rate Per 1000. 
Estimated Population. 
All Nationalities 26.82. 23,000 
Hawaiians — 33.63 11,000 
Asiatics 24.33 ; 6,000 
All Others 16.83 6,000 
CAUSE OF DEATH. 
April 
VJ 
i 
i 
i 
June 
July ■ 
August 
September.. 
October 
November.. 
December _. 
January 
February 
March 
Total 
Apoplexy _ 
3 
— 
1 
1 
1 
1 
1 
2 
1 
1 
1 
1 
9 
9 
3 
1 
3 
2 
2 
17 
16 
7 
1 
68 
8 
6 
2 
2 
17 
30 
23 
6 
3 
13 
4 
3 
10 
1 
5 
73 
1 
2 
19 
1 
63 
6 
4 
1 
22 
1 
1 
10 
59 
4 
12 
10 
1 
5 
1 
3 
8 
1 
1 
22 
1 
2 
4 
1 
2 
1 
8 
2 
1 
1 
Asthma. 
5 
Aneurism 
2 
Burns _ — 
1 
Alcoholism 
1 
1 
1 
— 
1 
Abcess 
1 
1 
Brights Disease . 
1 
3 
1 
2 
1 
2 
1 
Beriberi . 
i 
1 
2 
1 
2 
1 
5 
2 
1 
1 
2 
1 
3 
2 
2 
1 
1 
1 
3 
2 
Bronehit.is 
1 
C roup 
Ca.rhunole 
Consumption -- 
Convulsions 
4 
1 
3 
5 
2 
9 
1 
7 
1 
1 
1 
1 
. 5 
1 
8 
1 
1 
6 
1 
6 
1 
5 
5 
Cancer _ 
1 
1 
1 
1 
Childbirth _ 
1 
Collapse 
Cholera Infantum 
2 
1 
1 
1 
3 
2 
2 
1 
2 
9 
2 
5 
1 
3 
4 
4 
1 
2 
Dronsv . 
4 
2 
3 
2 
6 
3 
2 
1 
5 
2 
Diarrheea. ... -- -- 
1 
Dysentery 
Disease of brain 
Disease of heart 
Disease of lungs 
1 
1 
1 
1 
2 
1 
1 
5 
1 
- -- 
1 
1 
— 
1 
2 
1 
— 
Diphtheria 
1 
2 
2‘ 
Debility 
Fry si pel a.s 
1 
— 
1 
— 
1 
2 
1 
2 
1 
Exhaustion .. . - - 
1 
8 
1 
8 
1 
5 
1 
6 
1 
1 
4 
Fe eer . ._ . - - - 
6 
4 
4 
6 
9 
6 
7 
Fnt.ers (lolitis 
Gun Shot Wounds .. 
1 
2 
— 
1 
1 
Hemorrhage - 
Hernia, _ _ . 
2 
1 
3 
1 
3 
1 
— 
2 
3 
2 
— 
3 
Influenza.. - 
I n juries 
... 
1 
21 
17 
1 
4 
1 
3 
1 
— 
2 
1 
4 
1 
1 
5 
1 
3 
Inflammation .. - 
1 
l 
1 
Jaundice - 
Tna.n it.ion ... 
4 
1 
1 
2 
2 
4 
3 
3 
1 
2 
3 
1 
2 
1 
Drowned . . 
Leprous Exhaustion. 
Meningitis _ ...... 
1 
1 
8 
1 
4 
3 
3 
1 
2 
7 
1 
6 
2 
4 
Old age _ . 
2 
9 
1 
4 
4 
1 
1 
4 
1 
1 
n 
Opium - . . 
Paralysis 
Pneumonia 
— 
1 
1 
1 
1 
2 
1 
2 
1 
1 
1 
2 
Rheumatism . .. 
Syphilis ... . 
2 
1 
1 
1 
Locomotor Ataxia 
Suicide . 
1 
1 
1 
1 
1 
1 
1 
Serous Apoplexy .. . 
3 
.... 
— 
2 
Tetanus 
Teething _ . . 
1 
2 
Unknown 
3 
4 
2 
1 
2 
1 
5 
1 
1 
— 
1 
Marasmus . .. 
Rupture of Bladder — 
Obstruction of Bowels. 
Pyaemia, 
2 
.... 
1 
1 
1 
1 
1 
1 
Poisonimr 
1 
Pleuritis .. 
1 
1 
Peritonitis . . 
1 
— 
1 
2 
1 
1 
1 
1 
1 
1 
1 
Septicaemia ... 
Tumor 
Small-pox at Quaran- 
tine Station 63 
rirst of these are the poi manufactories. There is one or more 
in almost every block in the town, and it is well known that 
the starchy waste water from the pounding operation is in 
every case allowed to run through the floor to the surface of the 
ground, there to ferment, and become a menace to the public 
health. There are at present over forty of these places within 
a radius of one mile from the Post Office. The next danger 
arises from the fact that since a large portion of the Govern- 
ment washhouses was destroyed by fire, there are quite a num- 
ber of small washhouses being run in the settled parts of the 
town, and a number of applications from both Chinese and 
Japanese have been made for the same privilege, and the por- 
tions of the washhouse not destroyed by fire are so rotten that 
they are not fit for occupation. If new buildings for both wash- 
houses and poi manufactories were erected outside the settled 
parts of the town, the sanitary condition of the town would be 
greatly improved, and the investment would be reproductive. 
The law of 1890, relating to Victualling and Lodging House 
licenses is of great assistance to the Agents of the Board, more 
especially in the Chinese and Japanese quarters, as it gives the 
Agents the power to compel the applicants to put and keep theii 
premises in good sanitary condition before getting a certificate 
for license. 
The free garbage and excavator service is doing good work in 
keeping the town clear of offensive matter that would otherwise 
be a source of sickness, but it would be advisable for the Board 
to take into consideration the present system of disposing of the 
garbage collected. Previous to 1892, the garbage was cremated 
at the works of Mr. A. F. Cooke, but since that time it has been 
dumped into the old salt pits at Kalia ; if there was any way 
of getting a good top dressing of earth over it, the vegetation 
that would grow on it would probably absorb the malaria, but 
exposed as it is now, it is likely to become a danger to the com- 
munity, more especially in time of south winds. 64 
Visitors to this institution say that it compares favorably 
with any quarantine, station of the larger countries, not only 
for the pure air and splendid scenery, but for the care that has 
been taken to make the quarters as comfortable as possible for 
those who may be detained there. Some stations have more 
modern and expensive appliances for disinfecting purposes such 
as hot air and steam chambers, but taking into consideration 
the fact that during the past years, the personal effects of 35,000 
persons from places where small pox and cholera have been at 
times epidemic, and where at all times isolated cases of small 
pox exists, and that among those 35,000 persons, 45 cases of 
small pox have been landed, whose personal effects have in most 
cases been distributed among those of their friends to save them 
from being burned, and yet no disease has entered the country 
from the station. These facts prove that our comparatively 
primative methods have been as effectual as the more modern 
ones. 
The uumber of persons landed at the quarantine station for 
the period were as follows : 
MAULIOLA QUARANTINE STATION. 
Chinese. Japanese. Others. Total. 
From China and Japan . 1,013 3,870 2 4,885 
From whaling bark Horatio 6 6 
From the Colonies .... 7 7 
4,898 
Eight of the above had small-pox. Two died. 
I have the honor to be, 
Your obedient servant, 
C. B. REYNOLDS, 
Executive Officer, Board of Health.