Two hundred and thirty-eight land patents were issued, covering a total area of 3,651,307 acres, valued at $126,235.05; 136 were issued on homesteads, covering a total area of 3,501,766 acres, valued at $76,115.64; 102 were issued on cash purchases, preference rights, land exchanges, sales on time-payment agreements, compromises, and equitable settlements, involving a total area of 149,541 acres, valued at $50,119.41.

Three land patents were issued confirming three land commission awards, covering a total area of 2,532 acres. One was in fee simple on an area of 0.95 acre and two were for an area of 1,582 acres, against which a Government commutation of $99 was paid.

Thirty-nine deeds were received conveying to the Territory lands for public purposes.

Population and immigration.—The population of Hawaii on January 1, 1920, as shown by the Fourteenth Census of the United States, was 255,912. Compared with a population of 191,909 in 1910, this shows an increase during the 10 years of 64,003, or 33.4 per cent. The population of the Territory was estimated by the board of health to be 307,100 on June 30, 1924, an increase of 51,188 in the four and one-half years since the Federal census. The Territory of Hawaii is an archipelago of nine inhabited islands— Hawaii, Maui, Oahu, Kauai, Molokai, Lanai, Niihau, Kahoolawe, and Midway-besides a number of small uninhabited islands. The island of Hawaii is the largest and was formerly the most important, and has thus given its name to the group. The population of the Hawaiian Islands by races is as follows:

The total number of steerage arrivals during the year ending June 30, 1924, was 12,609, as against 12,686 for the prior year. The number of departures from Hawaii was 10,231 as against 8,335 for the previous year, divided as follows: Chinese, 812; Japanese, 4,027: Filipinos, 3,769; Koreans, 26; Porto Ricans, 307; Portuguese, 368; Spanish, 242; Russians, 25; all others, 655.

Education. The rules and regulations of the department of public instruction were carefully revised, rearranged, published, and distributed to the schools on January 1, 1924. During the year there were maintained 176 public schools, with 1,556 teachers and 51,557 pupils, as against 1,525 teachers and 48,730 pupils the previous year. There were 64 private schools, with 471 teachers and 9,557 pupils, as against 8,470 pupils for the previous year.

The following is a comparative table, by descent, of pupils attending all schools in the Territory:

The following is a classification of pupils by birthplace:

25, 858 920 1,756

528

51,557

The department of public instruction has a big race problem not only among the school children of the Territory but in the teaching staff as well. All teachers, of course, are American citizens. The figures below show the racial descent of these citizen teachers:

The question of the labor turnover in the teaching profession is very serious. Many teachers, who are trained and prepared for teaching, leave the profession at a time when they have had only enough experience to make their work really valuable. Of the 1,566 teachers employed last year, 236 resigned at the close of school. Many of these returned to the mainland after having served in the Territorial schools one year or more.

Health. The general health of the Territory was good, the death rate being 13.93 per thousand as compared with 15.96 for 1923. There were 4,132 cases of communicable diseases reported as compared to 6,638 for the prior year. There were no cases of smallpox in the Territory during the year. Five cases, however, were present on vessels arriving from ports outside, and were handled by the United States Public Health Service. The board of health at its meeting in June adopted a regulation intended to prevent the introduction of smallpox from the Pacific coast of North America. The Territory is a valuable port of call for vessels crossing the Pacific, and its importance as such, as well as the volume of shipping, will increase from year to year. If infection from without is to be prevented, the enforcement of these reasonable precautionary measures is necessary. The records of the tuberculosis bureau show 1,394 cases, an increase of 275 over last year. This should not be taken as an indication that the disease is on the increase, but as an evidence that better work is being done in promptly reporting and early diagnosis of such cases. Credit for this work is largely due to the public-health nurses, as it is chiefly through their efforts that the early cases are brought in for examination. There was a decrease in the deaths among infants of one year of age over the preceding year. The races showing the highest and lowest infant mortality rate were respectively, the Hawaiian 291.25 and the Caucasian 33.11. In 1924 there were 12,194 births, an increase of 793 over the prior year. The birth rate was 40.05 for 1,000 population, and the increase of births over deaths for the year was 187.75. Increased birth rates are noted for all cities and counties. The routine of general health matters was carried out as in former years, except that it was necessary to give more attention to the vaccination of school children and to inspect the possible cases of trachoma. The total number of school children vaccinated during the year was 4,420. Special attention was given to potable water supplies, sewage, rubbish and garbage disposals, trade wastes, inspection of canneries, etc. A general campaign for better and safer milk and the consumption of more milk was instituted in which many citizens, organizations, and the press took a very active part. The activities of the food and drug bureaus have

been conducted along the same line as last year. Food conditions on the outside islands were very satisfactory. But few violations or faulty practices, such as were noted in prior inspections, were encountered.

The number of patients cared for at Oahu Insane Asylum was 470, of which 336 were male and 134 female. The physical condition of the inmates has been good. This has been attributed in a large measure to the liberty of the grounds given them. All inmates who are physically able are taken out of doors every day. The total number of persons cared for at the leper settlement was 521, of which 348 were male and 173 female.

The population of the Territory was estimated to be 307,100 as of June 30, 1924, an increase for the year of 8,600. Increases were noted among Japanese, Filipino, Chinese, Asiatic Hawaiian, Caucasian Hawaiian, Korean, Portuguese, and Porto Rican, and decreases among Hawaiian, Spanish, and the group included under American, British, German, and Russian. All the cities and counties showed a gain in population during the year.

ELEEMOSYNARY INSTITUTIONS

ST. ELIZABETHS HOSPITAL

On June 30, 1924, there were remaining in the hospital 4,207 patients, as against 4,108 on June 30, 1923, an increase of 99 patients. The total number of patients under treatment during the year was 4,917, as against 4,927, a decrease of 10. The number of discharges, including deaths, was 710. The daily average population was 4,114, an increase over the previous year of 132. The total number of deaths was 223, a decrease from the previous year of 59.

Movement of population, fiscal year ended June 30, 1924

Owing to the constant increase in the population of the several

sources which supply the hospital with patients, the hospital popu

lation has also continued to increase, and at the close of the fiscal year, as will be seen from the, above table, there were remaining 4,207 patients under treatment, with a daily average population throughout the year of 4,114. To treat this number of patients and give them sufficient care and individual attention taxes the resources of the institution, great as they are, so that it is becoming increasingly more obvious that additional construction will have to be asked of Congress, and that this construction, in order to best serve the patient population, will have to be specialized for the particular care of the acute medically and surgically ill. While such construction will give the additional beds that are necessary, it will further be a step in the direction of improved facilities for the classificaton of the patients and therefore will increase the ability of the hospital to serve them individually, which must of course remain its main objective.

The most important happenings of the year have been in connection with the increasing improvement in the medical care of patients and the scientific understanding of their disabilites. At the close of the year the Blackburn Laboratory had been completed for housing all of the clinical and scientific activities of the hospital.

The isolation building for the care and treatment of patients suffering from contagious diseases had been completed at the close of the year; it is arranged for the care of 50 patients and went into commission almost at once. It will undoubtedly continue to serve a very useful purpose, for it is to be realized that the hospital reservation contains some 5,000 people who contact at innumerable points with the general population of the District and that therefore occasional cases of contagious disease are inevitable.

Affiliations have been made with various training schools for nurses in the city so that the nurses may have the opportunity of a wider general hospital training and the nurses of the other hospitals have the opportnuity of a wider training in caring for mental illness. The training school has received recognition by the nurses registry board of the District of Columbia so that hereafter graduates will be on a par with those of other hospitals in general training, aside from the specialty which is particularly stressed here.

At the close of the year various other activities looking toward the better care and treatment of patients are in contemplation, such as the installation of extensive electro-therapeutic apparatus, the development of the laboratory through the acquirement of new personnel, etc. Preparation is also being made for adjusting to the reclassification by permitting the maximum possible number of officers and employees to live off the grounds, and providing means