643
from Tsona, 3 weeks journey from Lhasa on the Assam border and he had been waiting in Lhasa
3 months for our arrival : he was instrumental in sending us another case from the same area.
Two other cases came from Khongpo in Northern Tibet—they had received news by the traders
that they could be cured in Lhasa and immediately came a month's journey post-haste.
Nevertheless it is curious to relate that no patient would give consent to have mole than one
eye operated upon : their excuses concerning the second eye were various—usually that a parti-
cularly holy lama told them that they could have one eye cured, but if the other was touched
then their life would be shortened ! But perhaps the real reason was that generally they
were so excited at having their blindness relieved, that their enthusiasm to get back to their
village or monasteries knew no bounds. Towards the latter part of our stay, all cataract cases
were allowed to see a cinema show on guest evenings before leaving for home, but their ama-
zement was such as to even dull their comprehension.
There was only a moderate amount of major surgery : there does not seem to be the glut
of abdominal work in Tibet, that one encounters elsewhere—in fact, there is very little. What
is more, whereas Tibetans have a greater fear of anaesthesia than they have of radical methods,
it is only when they feel they are faced with no other alternative that they will give consent
to operation. Of minor surgery there was an abundance and one always tried to do the neces-
sary work under local anaesthesia if possible : we found that under these circumstances they
very rarely demurred from surgical interference. Results fortunately were uniformly good
— b u t o w i n g t o t h e a p p a l i n g c i r c u m s t a n c e s f o r a t t e m p t i n g a s e p t i c s u r g e r y , o n e a l w a y s h a d t h e
feeling that one was only just " getting away with it."
The demand for vaccination was constant and the Tibetans have implicit faith in its effi-
ciency : Numerous tooth extractions were carried out, more particularly since the introduction
of painless dentistry.
I am informed that whereas on past occasions the choice of cases has been limited, this year
they are much wider than ever before : cases ranged from lamas who wanted their voices im-
proved to the pypical Lhasa lower class woman, who wanted her appearance improved by sur-
gical lifting of her upper eyelid. Again indigestion is a widespread minor malady in Tibet
and as constant attendance has made them familiar with our stock dyspepsia mixture, and almost
daily occurrence was the demand for medicine " from that bottle."
In the Tsangpo Valley, there are villages where most men and every woman beyond the
age of puberty is the subject of goitre : actually in Lhasa, it is common enough, but symptoms
are so few, that one only occasionally saw this type appear for treatment and unless the goitre
was of enormous dimensions, they responded very rapidly. During the latter part of . the stay
and as the result of requests by certain English-speaking Lhasa notables, we fitted up simple
medicine chests with the necessary full directions for use. They were greatly appreciated
and afford a simple means of emergency treatment in the event of our ultimate departure from
Lhasa.
Further activities extending to the training of a few Tibetan orderlies were prevented by
time and other circumstances, but the Lhasa people were keen that we should do so and in the
possibilility of the present medical mission being continued, this is an important work, which
should lie undertaken. Finally, all in all, one feels that the medical effort has teen a great
success, both from a diplomatic and professional standpoint : and I should like to thank R. S.
Bo Tsering (whose popularity with Lhasa people is immense) for his share in it.
Hospital and G eneral Statistics covering the period from August 29th, .1936 to February 16th,1937.
(1) Number of ‘new’ cases seen in the O. P. Department
.
.
.
3.850
(2) Owing to our slender clerical resources, the number of Out-patient “at-
tendances” cannot be given accurately, but easily exceeded
.
. 20,000
(3) Number of In-patients . . . . . . . . .
215
(4) Number of syphilis cases treated
.
.
.
.
.
.
1,320
(5) Number of major operations performed
. . . . . .
17
(6) Number of minor operations (excluding tooth extractions) .
128
(7) Number of ‘cases’ of tooth extractions .
.
.
.
. .
430
(8) Number of lens enucleations ( i.e ., cataract operations)—of which 31
were completely successful
33
(9) Vaccinations .
. . . . . . . . . .
560
(10) Cases seen and treated in villages en route to Lhasa .
.
.
.
210
Note.— No record was taken of the very considerable amount of “outside” work done by
the M. O. and the S. A. S. in the City : had there been any such. account kept then the present
figures for items (1); (2), (3), (7) and (9) would. have been greatly exceeded.
2 T