LUNATIC ASYLUMS OF NEW ZEALAND (ANNUAL REPORT ON).

Appendix to the Journals of the House of Representatives, 1880 Session I, H-06

H.—6

1880. NEW ZEALAND.

LUNATIC ASYLUMS OF NEW ZEALAND (ANNUAL REPORT ON).

Presented to both Houses of the General Assembly by Command of His Excellency.

No. 1. The Inspector of Lunatic' Asylums to the Hon. the Colonial Seceetaey. Sie,— Inspector of Lunatic Asylums' Office, Wellington, 6th July, 1880. I have the honor to lay before you my fourth annual report on the lunatic asylums of the colony. The number of registered insane on the 31st December, 1879, was 1,056. Their distribution is shown in the following tabular statement; —

Compared with the numbers at the end of the previous year, there was a decrease at Christchurch of 2, at Napier of 4, at New Plymouth of 3 ; atd an increase at Dunedin of 50, at Auckland of 33, at Wellington of 19, at Hokitika of 7, at Nelson of 1; and a total increase of 101. The increase at the end of each of the last seven years was as follows : — 1873 ... ... ... ' ... ... ... 55 1874 ... ... ... ... ... ... 77 1875 ... ... ... ... ... ... 56 1876 ... ... ... ... ... ... 61 1877 ... ... ... ... ... ... 81 1878 ... ... ... ... '•' ... 85 1879 ... ... ... ... ... ... 101 Total ... ... ... ... 516 The proportion of the insane to the estimated general population at the end of the year (Maoris being excluded) was lin every 445. This, as might be naturally expected, compares favourably with the proportions found in older countries. For the year 1878 it was, in England, lin 360; in Scotland, lin 392 ; in New South Wales, lin 362; in Victoria, lin 304. There are, however, so many circumstances by which these proportions are liable to be influenced that they cannot be acknowledged as the data of very reliable inferences. The total number of patients admitted during the year was 399, of whom 248 were males and 151 were females. Among this number were 79 re-admissions. The admissions exceeded those of the previous year by 21 ; the increase consisting of 1 male and 20 females, or of 7 in the number of the new cases, and of 14 iu the re-admissions. I—H. 6.

Patients. Asylums. Males. Females. Total. Auckland ... "Tew Plymouth Napier Wellington ... felson lokitika Christchurch Dunedin 156 13 83 34 57 146 206 73 6 53 26 20 86 97 | 229 19 136 60 77 232 303 Total 695 361 I 1,056 n crease over previous year 58 13 101 I

H.—6

2

The proportion which the annual admissions bear to the population is generally taken as the most accurate measure of the prevalence of insanity; but this must be also admitted to be, for many reasons, far from trustworthy; and there can be little doubt that, in this colony at any rate, persons suffering from transient and comparatively trifling affections of the mind are sent to asylums who would not be treated so in other countries. The admissions were to the general population in the proportion of lin 1,162. The proportion in England in 1878 was lin 1,854 ; in Victoria, it was lin 1,324 ;in New South Wales, lin 1,,636: so that this comparison does not tell in favour of New Zealand. The causes of insanity in the admissions, so far as they could be ascertained by the Medical Officers of the asylums, are shown in Table XVIII. In 98 of the whole number the cause was not known. With reference to the causes in the remaining cases, it is of course to be understood that they are given only with approximate correctness, and that, in addition to the physical or moral disturbance alleged to have been the cause of insanity, there was, in most cases, a predisposing peculiarity of constitution or insane temperament, which, after all, played the chief if not the most conspicuous part in the production of mental derangement. Intemperance in the use of alcohol figures very largely in the table, being assigned as a cause in 84 of the admissions. It is right to point out, however, that (as can be gathered from the returns from the Dunedin Asylum, which are given with unusual minuteness) this dreadfully prominent cause of insanity was, in many instances, combined with others equally powerful, and was often itself an inherited malady or symptom of disease. In the report of the English Commissioners for 1878 intemperance in drink appears as a cause, exciting or predisposing, in 21'8 per cent, of the male, and 7*9 per cent, of the female, and 14'0 per cent, of the total admissions into asylums for the year. It undoubtedly has a much larger share in the production of insanity in this country, having been a cause in 27 per cent, of the male, 11 per cent, of the female, and 21 per cent, for the total admissions for the year. As regards individual districts, whatever may be the explanation of the fact, it seems to be a much more frequent cause of insanity in some than in others. Thus, in Auckland (where, however, as at Christchurch, no cause was ascertained in large numbers of cases) it was the cause iu 8 per cent, of the males, and in none of the females admitted ; whereas the percentage of cases among the male admissions due to this cause in Wellington was 24, in Christchurch 27, in Dunedin 32, m Nelson 40, and in Hokitika over 50. Parturition or the puerpural state was the " cause "in 19 cases, or 12 per cent, of the women admitted, which also is a large proportion. No less than 12 cases are ascribed b} r the Medical Officer of the Dunedin Asylum to " emigration and congenital weakness." In 18 cases the disease was congenital. That hereditary predisposition was only ascertained to exist in 40 cases is rather a proof of the difficulty of getting information than a reason for supposing that it was not present in a great many more. As will be seen from Table IV., by far the greater number of the patients admitted belong to the most curable class of cases —that is to say, that they had not previously been insane, and their disease had not lasted for more than three months ; while comparatively few belonged to the fourth or least promising class, consisting of those who had suffered one or more previous attacks, and had been insane for more than a year on admission; but, compared with the admissions of the previous year, there was a smaller proportion of first- and second-class cases, and a larger one of third and fourth. Six of the admissions were under 10 years of age, and 15 were over 60. When people are sent to asylums at these ages it is often quite as much because they are poor and friendless, as because of their insanity, which is not always of such a nature as to require or benefit by treatment in a lunatic asylum ; and this, indeed, might be said of many others. Included among the admissions are 4 males and 6 females committed as habitual drunkards to tho asylums at Christchurch and Dunedin by order of Judges of the Supreme Court, under the provisions of the 21st section of " The Lunatics Act, 1568." /Discharges and Deaths. —The total number under care during the year was 1,354; of these, 188 were discharged as recovered, 31 as not recovered, and 7.1 died. The recovery rate, calculated as is usual on the admissions, is 47*11 per cent., being higher, as the nature of the cases would lead one to expect, than that in county and borough asylums in England, which for 1878 was 40'3, and which averaged 39'98 for the ten years ending 1878. The proportion of recoveries varied very greatly in the different asylums,, and ranged from 72'22 at Christchurch to 28'80 at Dunedin, where it has hitherto been fully twice as high. The difference is almost entirely explained by the nature of the cases admitted, and by the strictness with which the term " recovered "is applied. Most of those discharged as recovered had been resident for less than six months, and 46 had been resident for less than one. The fact that so many recovered within such very short periods, after having for the most part been" treated on principles which are chiefly remarkable for their extreme simplicity, naturally suggests the idea that some of them at least might have recovered equally well without having been removed to an asylum at all. And no doubt this is true to a very considerable extent; but, unfortunately, however simple may be the treatment of ordinary insanity, it implies such formidable expense that it cannot generally be secured, except by comparatively rich people, anywhere but in a special institution such as an asylum. The death rate was 7'09, or slightly lower than it was the previous year, and lower than the average rate, for the ten years ending with 1878, in county and borough asylums in England, which was 10'63. Out of the 71 deaths, 38 were caused by diseases of the nervous system, 12 by diseases of the lungs, and 5 by the decay of old age; the remainder were due to various other causes, as shown in Table XII. Eortunately there were no violent deaths, although some exceedingly suicidal patients were under treatment. Thirteen of those who died were 60 years of age ; twelve had been resident for upwards of 5 years, and 11 for less than a month. The ages and nationalities of the 1,056 patients left at the end of the year are shown in Tables X. and XL: 6 of them were children under 10 years of age, and 54 were over 60; 48 were born in New Zealand, and 92 were natives of foreign countries. Expenditueb. The total expenditure on the management and maintenance of the insane for the year 1879 was, as shown in Table XVI., £35,360 6s. 5d., which is £93 Is. 10Jd- more than that of the previous year. J3ut the amount received for the maintenance of patients and from the sale of asylum produce >vas

3

11.—6

£3,975 13s. 2d., or £1,294 14s. more than it was the previous year, and, this being deducted from the above sum, leaves £31,384 13s. 3d. as the actual expenditure by the Government, which is £1,201 12s. IR less than it was in 1878, although there was an increase of 101 in the average number of" patients resident, and of 106 in the total number under treatment. The cost of maintenance per head in the various asylums is shown in Table XVII. The average was £33 9s. 10d., or, deducting repayments, £29 10s. 6R, being less than that of the previous year by £3 10s. lid. Although the cost per head did not differ so much as in former years at the several asylums, it still did so to a very great extent. Allowing for the repayments, it was —at Auckland, £26 Bs. lOf-d.; at Christchurch, £27 lis. 6R ;at Dunedin, £27 12s. 6|d.; at Nelson, £31 19s. OR ;at Napier, £33 lis. OR ;at Wellington, £34 lis. lid.; aud at Hokitika, £40 ss. Bd. Except at Dunedin, where there was an increase of £1 13s. 10R, there was, as compared with the preceding year, a reduction at every asylum, which ranged from £3 6s. 3d. at Hokitika to £9 Os. 9R at Wellington. There are many reasons why there is such a difference in the cost of maintenance at the various asylums, and to a certain extent these are explained by Table XVII., which brings out the dill'erence under separate items of expenditure. One chief cause is the difference in the number of inmates, which greatly affects the cost per head for salaries, wages, fuel, light, &c, as, within certain limits, the staff of servants, quantity of fuel, &c, which are sufficient for a given number of patients, are sufficient for a greater. Another leading cause is the difference in the wages given, which, for male attendants range from £60 at Nelson and Auckland to £120 at Hokitika. Others are to be found in such things as the following: The plan of the building, which affects the number of servants required to maintain supervision; the price of provisions, which differs considerably —meat, for example, being 4d. a pound at Wellington, and 3d. at Dunedin ; the price of bedding and clothing, winch is also less at Dunedin Asylum than at others, and which is very high at Hokitika ; the quantity of boots and shoes used, which is much greater, for example, at Hokitika, where almost all the male patients are employed at out-of-door labour, even in bad weather, than at Dunedin, where crowds of them saunter about the airing-courts doing nothing, in clothes which would stand little exposure without leading to more; the price of fuel, and of many items under the heading of " Necessaries and Incidental," which varies greatly ; and the quantity of these things required, which may be greater one year than another; the standards of comfort aimed at; the administrative ability and thrift of tho Superintendent, which exercise much influence on expenditure which it is difficult to trace in detail; and the quantity and quality of land attached to the asylum, which, for example, at Christchurch, enable the patients to grow their own potatoes, while at Wellington these are bought at 4s. 6d. per cwt. There is not, however, so great a difference in the cost of maintenance iu the several asylums as there was at the time they came into the hands of the General Government, there having been an increase of expenditure in certain items in some asylums, and a decrease at others in the same or different items. Thus there has been, at Auckland, au increase of 10s. sfd. a head for bedding and clothing, and of £1 3s. 4d. for salaries and wages (owing chiefly to an increase in the number of servants) ; whereas there has been, at Wellington, • a decrease of £10 15s. 6R. for salaries and wages, and of £2 17s. 5R for provisions ; and, at Christchurch, of £4 os. 7R for salaries and wages, aud of £6 lis. 2R for provisions ; while the unnecessary consumption of alcoholic liquors has been so generally diminished that the total amount paid for this item was less by £1,009 17s. 4d. last year than in 1876, notwithstanding an increase of 275 in the number of patients. The disparity in the wages of the attendants, to which the difference in the rates of maintenance is so largely due, existed to a still greater extent when the management of the asylums came into the hands of the General Government, and doubtless resulted from the difference in the prevailing rates of wages in the several provinces. At that time the wages of the attendants were as follows : —■ Men. Women. £ s. d. £ s. d. Auckland Asylum ... ... ... ... 60 0 0 42 0 0 Nelson „ ... ... ... ... 60 0 0 30 0 O Dunedin „ ... ... ... ... 100 0 0 50 0 0 Christchurch „ ... ... ... ... *127 15 0 73 0 0 Wellington „ ... ... f... ... 147 0 0 50 0 0 Hokitika „ ... ... ... ... *173 7 6 65 0 0 The wages of the male attendants were reduced —at Wellington to £100, and at Hokitika to £120 (rations being given). At Christchurch the wages of female attendants were reduced to £63, and no alteration was made with regard to the men; but instructions were given that for the future new male attendants were to be engaged at £109 10s., instead of £127 15s. At Auckland the wages of seven of the men were raised to £70, and five of them got an increase of £5 per annum to act as musicians, which was a part of the duties of the higher-paid attendants at some of the other asylums. At Nelson the wages of the female attendants were raised to £40. Besides the inequalities which still exist in the rates of wages, there is another reason why the outlay in this item varies so greatly, and that is that, on account of the unusual difficulties in the way of supervision which are experienced in some asylums owing to their faulty construction and overcrowded condition, a much larger proportion of attendants is required than at others. So great is the difference in the relative numbers of attendants to patients at Auckland and Dunedin, for instance, that, despite the enormous inequality in the rates of wages, the cost per head for salaries and wages is almost the same at both institutions —it is, in fact, less at Dunedin than at Auckland. Inspection. It is not possible for one General Inspector to maintain such a system of inspection over the asylums of the colony as is really necessary, and I had the honor some time ago to recommend that Deputy-Inspectors and Official Visitors, as provided for by the Lunatics Act, should be appointed for each asylum. This recommendation was parti} carried out. Mr. Thomas MacfEarlane was appointed

* The men at these wages not found in rations,

H.—6.

4

Deputy-Inspector at Auckland, and Major Lean at Christchurch, and Mr. Joseph Mackay at Nelson, where also Mr. Acton Adams, M.H.E., was appointed Official Visitor. It is highly desirable that similar appointments should be made at the other asylums. Deputy or Local Inspectors are almost indispensable for the carrying out of the Lunatics A"ct; but the amount of good which they may do cannot be measured merely by the provisions of the Act. The same remark applies to Official Visitors, and I think several should" be appointed to each asylum. Such institutions can hardly be subject to too much inspection, either in the interests of the lunatics, or of the public, or of the officers in charge, to whom, if they are properly performing their duties, it is particularly welcome. Asylum Accommodation. The amount of asylum accommodation which existed at the end of the year at the several districts, and its deficiency, are shown in the following tabular statement: —

Prom this it will be seen that there were, in all, 259 patients over the number for which there was accommodation. Actual overcrowding will be remedied when the additional buildings, now being provided, are ready for occupation. These are : Ist. The new wing of tho Auckland Asylum. This is almost complete, and is intended for the male patients, being much larger than the old wing, which they at present occupy, and which will be given up to the women on their removal from their temporary quarters in the old hospital. It is designed for 107 patients, and the old wing is designed for 50, so that there will still be a want of accommodation for about 50 men and 20 women ; and the chapel and some of the dayrooms will require to continue in use as dormitories till further provision is made here or elsewhere. 2nd. A new wing to the Wellington Asylum for 50 women, which is also almost ready, and will completely relieve the crowded state of that Asylum. 3rd. The male wing of the new Christchurch Asylum, a portion of which, for 50 patients, is to be ready in September of this year, and the remaining part, for 100, in May, 1881. This, together with a part of the old buildings still fit for occupation, will provide for the male patients of that Asylum for some time to come, even allowing for an increase. 4th. The Asylum at Seacliff, Otago, for 300 patients. This, according to contract, should be completed in April, 1882, but, owing to delays which have unavoidably arisen, it will probably not be ready till long after that time. Supposing it to be ready by April, 18833, there will then be, altogether (exclusive of the old hospital at Auckland, the " cells" at New Plymouth, and the old Christchurch Asylum), accommodation for 793 men and 492 women, which will be sufficient, even allowing for the annual increase, which is not likely to be so great as within the last few years, now that prosperity is on the wane. It is to be feared, however, that, before the Seacliff Asylum is ready, overcrowding will have increased to such a degree that it will be impossible to avoid putting up temporary buildings of some kind. But, although the works already undertaken are calculated to increase the accommodation for the insane so as, in all probability, to make it sufficient for the requirements of three years hence, it must be remembered that, for various reasons, which have been sufficiently dwelt on in previous reports, several of the present buildings —namely, the Dunedin, Wellington, and Napier Asylums, will soon require to be relinquished : in other words, permanent buildings for 390 patients will have to be provided, in addition to those already undertaken. The first of the old buildings which should be relinquished is the Dunedin Asylum, a sort of poorhouse, badly situated on a reserve within the city boundaries, which is wanted for a high school. In order to compensate for the loss of this building, which holds about 208 patients, it will not be necessary to enlarge the Seacliff Asylum on tbe same expensive scale on which it has been begun. The building already contracted for is for 300 patients, and that will be quite sufficient for a long time for the treatment of such cases as really require or benefit by the costly arrangements fc a modern asylum. What will be wanted is accommodation of a simple,

Amount of Accommodation at 31st December. Nun o Patiei 33st Dec aber »f uts at member. Excess over Accommodation. Asylums. M. F. M. P. M. V. lttckland — Asylum at Whau ... Old Hospital in the city Iapieb—Asylum (within gaol grounds) Iew Plymouth— Cells in hospital Vellimoton— Asylum fELSON— Asylum Iheistcuurch — Old Asylum New Asylum [okitika — Asylum )UNEDIN— Asylum on High School Reserve Seacliff Farm buildings 50 17 6 82 30 0 50 6 3 27 30 156 13 83 34 0 73 6 53 26 106 -4 -6 1 4 0 23 0 -3 26 -4 60 80 146 86 86 6 51 23 57 20 6 -3 132 74 76 132 74 07 21 Totals 502 295 695 361 193 66 r. r 7! >7 156 2r I .9 i;

5

H.-6

homely, and inexpensive kind, for quiet, harmless patients of a chronic class who will employ themselves in the fields; and this can best be provided by means of detached houses of various sizes, which, like a great part of the Hokitika Asylum, can be built by tho patients with wood got from the Asylum grounds. The splendid reserve which has been made at Seacliff affords unusual facilities for extending the Asylum in this manner, which is so well adapted to suit both the patients and the taxpayers. But a beginning can hardly be made in this direction until the main building already under contract has been completed. With reference to the Wellington Asylum, although it also is a merely temporary building, occupying a site in many respects disadvantageous for an institution of the kind, yet there are many reasons for utilizing it as long as possible; but, as it is only too evident that it must after a time be abandoned, the earliest opportunity should bo taken to get, at a reasonable price, a good piece of land conveniently situated as a site for a permanent asylum, even though building operations should not be commenced for several years. Meanwhile, its situation in proximity to the new hospital might be taken advantage of to carry out the views of eminent writers on insanity, who have deplored the unnatural line which has been drawn between insanity and other diseases, making it a speciality of which the medical profession in general is supposed to know or care nothing. I would propose to place it and the hospital under charge of the same resident surgeon, and invite the medical practitioners in town to give their voluntary attendance to it as well as the hospital. It seems certain that, in the long run, the greatest good would result from the carrying out of such an arrangement. As to the Napier Asylum, which has accommodation for 23 patients, it also had better be retained in use and made the best of until a larger and permanent one is required for the district; the necessity of adding to it the meantime can be avoided by the removing of chronic cases to other asylums. In the Appendix will be found tables supplied from the Colonial Architect's Department, giving details of contracts in force during the year for asylum buildings, the expenditure on these, and the liabilities for them, at 31st March. Prom these it appears that the total contract cost of new buildings in course of being provided was £122,055 lis. 5d., and that the expenditure on them was £27,438 15s. 4d., and the liabilities, £103,189 2s. 6d. Asylums. Wellington Asylum. —-The numbers in this Asylum on Ist January, 1879, were —69 males and 48 females. During the year there were admitted 33 males and 16 females, 9of the males and 2of the females being readmissions ; and the total number under care was 166, of whom 102 were males and 64 were females. Of these, 12 men and 7 women were discharged recovered; 5 men and 1 woman as relieved ; and 2 men and 3 women died ; and at the end of the year there were left 83 men and 53 women —in all, 136, being an increase of 19. The recoveries were in the proportion of 38'77 to the admissions; and the deaths of 3'96 to the average number resident. The recovery-rate was not so high as has been recorded in some previous years, but that appears to be due to greater accuracy .in the returns, a larger number than usual of those discharged having been notified as only relieved. The death-rate is also low. The causes of death were general paralysis, exhaustion from melancholia, epilepsy, erysipelas, and senile decay. The general health throughout the year was good. The condition of the asylum in many respects is now much improved, or in course of being improved. It was mentioned in last report that, in consequence of the excessive crowding of the male department, an additional block of building for 50 was being erected. This was finished and occupied by July. It consists of two spacious and well-arranged wards, one above the other, which have been nicely furnished, and are already to some extent supplied with pictures and other ornaments. A very fine billiard-table, bought by subscriptions contributed by a number of friends of the institution, has been placed in one of the dayrooms, and is a never-failing source of pleasure. This additional accommodation has given an immense relief to the male side of the house ; but it must be added that, owing to the increase in the number of patients, it is already fully occupied. The female department has also long been suffering from overcrowding, which has latterly existed to such an extent in the ward occupied by the more excited patients as manifestly to affect their mental if not their bodily condition, fostering excitability and quarrelsomeness, and rendering it well-nigh impossible for the attendants to maintain orde» T or to keep their own tempers. An extension of the female side also has therefore been seen to be absolutely necessary; and this is now being provided by means of a detached wing for 50 patients, similar to that which has been put up for the men, and connected like it by a covered passage to the main building. This will not only do away with all crowding in the female department, but will also enable a few cases to be transferred from the Napier Asylum, now more than full. Next to the insufficiency of ward space, the most serious defects in this Asylum have consisted in tho absence of proper bath-rooms with hot water supply—a want which has been increasingly felt with the growing numbers, and the isolated position of the single rooms for the use of the excited and troublesome patients, who more than any others require to be within reach of easily-maintained supervision. These defects are also now being overcome. The decaying blocks of building in which are situated the present dark and ill-arranged bath-closets are being removed and replaced by new ones, containing roomy and well-lighted bath-rooms, an adequate number of baths, and the means of readily supplying abundance of bot water; and tho isolated rows of single rooms are being connected w*ith the main building by means of closed-in passages. Two or three single rooms are also being added on both sides of the house. The renewal of the roof of the central portion of the Asylum, formerly reported as being urgently required and about to bo undertaken, was duly effected, galvanized iron being substituted for the worn-out shingles; and, this having been done, the principal dayroom of the male side, which had suffered from roof leakage, and acquired a somewhat dilapidated appearance, was completely repapered, and made to look very well. A nice approach leading up to the front of the Asylum from Adelaide Eoad, the construction of which has long afforded abundance of healthy and invigorating employment for the patients, is now nearly finished, and will be much more convenient than the roundabout back entrance hitherto in use.

H.—6

6

The grounds in the neighbourhood of this new road, and iu front of the Asylum, have been plentifully planted with pines obtained from the Botanic Gardens, and which are already beginning to make a considerable show. At my visits to the Asylum I have always found it in thoroughly good order, and felt reason to be well satisfied with the general management, which is both enterprising and careful. Except occasionally in the crowded female ward above referred to, the inmates were invariably found quiet aud orderly, and exhibiting no trace of excitement. They are well fed and comfortably clothed. A large proportion of the men are actively employed. There are generally 45 men to be seen working in the grounds at levelling, road-making, and gardening ; and, besides these, some 9 or 10 are more or less occupied keeping the courts and back premises in order. A fair proportion of the women also are employed, but many of them have been very useless, even when sane, and can be got to do nothing. Most of the men got sufficient exercise, only a few being restricted to the airing yard. Hitherto the opposite has been the case with the women; but this is about to be remedied to a great extent, by setting apart for their use a well-situated piece of ground adjoining the new wing. Neither restraint nor seclusion appear to be used more frequently than is rendered justifiable by the dangerous or strongly suicidal tendencies which are occasionally manifested by the recent and acute cases. Divine service is held every Sunday, and generally attended by about 60 men and 25 women. Por recreation there is a weekly dance, at which about the same numbers are present; and for which amateur theatrical performances or other entertainments were occasionally substituted during the year. ChristcJiurcJi Asylum. —On the Ist January, there were 234 patients in this Asylum —151 males and 83 females. During the year 58 men and 32 women were admitted, 9of each sex being readmissions ; and the total number under treatment was 324 —209 males, 115 females. Of these, 44 males and 21 females were discharged as recovered, and 8 males and 3 females as relieved; 11 males and 5 females died; there remained at the end of the year 146 men and 86 women —in all, 232, or 2 less than at the beginning of the year. The recoveries were in the high proportion of 72'22 per cent, to the admissions. The death-rate was 6'85 of the average number resident, and 493 of the total number under treatment. Of the 16 deaths, 9 were due to brain disease, 3 to lung disease, 2 to heart disease, 1 to the disease of the mesenteric glands, and 1 to general dropsy. In the above statistics are included those of a few habitual drunkards committed to the Asylum for curative treatment under the provisions of the 21st section of the Lunatics Act. Three of each sex were in the Asylum at the commencement of the year, 2 males and 3 females were admitted for the first time, and 1 female was readmitted; making 12 in all. under treatment. Two males and 4 females were discharged as recovered, and 2 males and 1 female as not improved, and 1 male and 2 females remained at the end of the year. In every case but one the Judge's order of committal directed that the patient should be detained in the asylum for twelve months (being the full term allowed by the Act), unless ordered to be discharged before the end of that time. Only 1, however, of those discharged during the year had remained for that time : 1 stayed under 2 months, 3 under 4 months, 2 under 6 months, and 1 under 7 months. It can hardly bo supposed that, when a man's moral powers have so utterly broken down under the influence of drink as to justify his being placed in confinement, two or three days' repentance, or a few months of rebellious grumbling, are likely to secure his recovery. A year's seclusion does not seem a day too long ; but the patient can seldom be got to take this view. Shortly after being placed in the asylum the more immediate effects of drink disappear; nothing is left but what cannot be seen ; impatience and self-confidence daily increase, the patient bewails that his family are in destitution, and that his business is being ruined through his prolonged detention; and he protests that he is all right, and determined to drink no more. His wife believes it; and the doctors on whose evidence he was committed are called in to re-examine him. Ten to one he is looking as fresh as a daisy, and there is nothing remarkable about him except his resolve not to drink. So he is discharged as "recovered," which no doubt he is from the acute symptoms which may have principally led to his being placed in the Asylum ; but in many cases tho tendency to drink remains, and reasserts itself almost as soon as liberty, is regained. In all cases the patients'maintenance is ordered to be paid for at a certain weekly rate, and in the cases in the Asylum during the year this had been fixed at 40s. in 1, at SOs. in 2, and at 255. in 3, and at 20s. in the six others. In 7 cases payment was made as directed, and in 1 it is still expected ; but in the remaining 4 no payment was made at all, nor seems likely to be forthcoming. It can hardly have been the intention of the Act that habitual drunkards should be maintained gratis in asylums, and at the same time be at liberty to spend their time in absolute idleness. Yet this is what actually happens when, although an order for payment for board has been made, it turns out there are no funds from which the payment can be got. These patients will rarely work—they are not working-men, to begin with —and they object to do anything inconsistent with their dignity as drunkards, and calculated to confuse them with those who are really insane. Even when their maintenance is paid for, their presence has generally an injurious influence. They spend all their time in amusements or grumbling ; their superior airs hurt the feelings of their insane companions, and their determined idleness sets a bad example. But in the case of those who pay nothing, mere broadcloth paupers, this lordly idleness is peculiarly offensive both to the patients and the officers of the asylum. There is no proper accommodation in the asylum for this class of patients. A separate house was, indeed, built for them, but owing to overcrowding it cannot be reserved for their exclusive use. Moreover, they could not possibly be confined to it and the small garden attached to it, nor could it be occupied by both sexes. As it is, the male inebriates reside in a small part of it, and the females in the ordinary wards of the Asylum. Great as are the annoyances which result from the reception of habitual drunkards into this Asylum, and small as may be the benefits of such generosity, it does not appear desirable altogether to rescind the law which provides the only means of recovery to a class of people who are a misery to themselves and others, many of whom are undoubtedly anxious to get rid of their infirmity, and some of whom certainly do, and through these mean3. The disadvantages of the present system will

7

fi.-e.

perhaps be diminished when a Medical Superintendent is in charge of the Asylum ; and in a few years the experience of the "retreats" for inebriates which are about to be established in England may justify the adoption of a similar plan of treatment here. It is unnecessary to repeat in this report what has already been said about the excessive crowding and dilapidated condition of the male wards of this Asylum. These evils remain much as they were ; but great relief will very soon be obtained by the opening of a portion of the new building. I inspected the Asylum on the 6th, 7th, and Bth January last, and reported upon it as follows: — " There is a marked improvement in the state of the male department since last inspection in June. It has all been internally oil-painted by one of the attendants, assisted by patienfs. The flooring of the bath-room in D Ward, which was rotten, has been completely renewed. Bedsteads have been supplied to the single sleeping-rooms, where there were formerly only shakedowns. A large new boiler has been placed in the kitchen yard, and there is now an abundant supply of hot water both to the kitchen and to the wards for baths, and a very considerable saving is being effected in the consumption of coal, as two fires formerly in constant use are not now required. A small blacksmith's shop has been put up at a trifling cost by one of the attendants, who, being a blacksmith by trade, has made almost all the requisite tools, and, with the help of one or two patients, performs a large amount of jobbing and necessary work. The hitherto disgusting earthclosets attached to the airing-courts are at present in course of complete alteration, and urinals are being provided. This work also is being done by an artisan attendant, employing patients under him. The asphalt pavement of the airingcourts, which had got into a very broken condition, has been repaired. The male patients were found in a more satisfactory state than at any previous visit, the utmost good order and tranquility prevailing in every ward. The number confined to the airing-courts has been reduced to 18 ; the number usefully employed is 118, and of these about 50 are working out of doors. The great majority now take their meals together in the recreation hall. They were twice seen at their dinner, which was very good, consisting of roast and boiled mutton, potatoes, bread, cabbage, and cauliflowers. They are all supplied with ordinary knives and forks, and earthenware dishes. The tables were neatly laid, and decorated with flowers. The female department was also found in good order, looking bright and comfortable. The inmates were, generally speaking, quiet and well conducted; but some of them are very troublesome, requiring great care and tact in their management, and five had been placed in seclusion on account of their excitement and tendency to violence. A fair proportion are usefully employed. Several have lately been taught to knit, and now make stockings vastly superior to those which are bought. The earthclosets adjoining the convalescent ward, which used to be an insufferable nuisance, have been abolished, an outside one having been put up instead. A number of the sleeping-rooms have been nicely oil-painted. The asphalt pavement of the airing-court has been completely renewed. An additional drying-room, the want of which had long been felt, has been erected at the laundry. The north house is in good order ; but the drainage from the scullery and bath-room should be discharged, before it begins to decompose, on to a portion of the grass field near the house, instead of, as at present, being conveyed into an open ditch, where it stagnates and becomes extremely offensive. A new range has recently been got for the kitchen. Water has been laid on to the kitchen and bathroom, and the bath-room has been supplied with a boiler. The garden attached to this building is very well kept, and is full of flowers and vegetables. The kitchen-garden, which is about three acres in extent, is well attended to, and contains a great abundance and variety of vegetables. In addition to this, there are eight acres of potatoes, six of oats, and some four of peas, beans, carrots, and parsnips. A new piggery was put up some time ago by one of the patients, a carpenter by trade, and the keeping of pigs is found to be very profitable. There are at present eighty-six, and during the past year upwards of two tons of pork w*ere supplied to the establishment. Gas is now being laid on to the women's building, the new building in course of construction for the men, and to the recreation-hall, and other portions of the old house now occupied by the men. The building of the new wing for men —or, rather, a portion of it sufficient for the accommodation of 50 patients—is progressing rapidly. It is exceedingly desirable that the remaining part of it, for 100, should be begun immediately. A contract for the remainder of the male wing was let about the time of my visit for £19,227 12s. Id., and the building is to be finished by March, 1881. The contract price of the other portion, which is to be ready in September of this year, is £1.0,690 12s. lid., and that for gas fittings mentioned above, £398 lis. Gas was laid on to the Asylum by the middle of February. I have much pleasure in bearing testimon}^ to the good which has resulted from the appointment of Mr. Lean as Deputy Inspector. The Asylum has been regularly visited and reported on by him each month, and most of the suggestions which he has made from time to time either to the Superintendent or myself have been duly carried out. It is also extremely satisfactory to be able to state that a Eesident Medical Superintendent has at last been appointed, in the person of Mr. Walter E. Hacon, M.E.C.S.E , formerly Assistant Physician to the Warwick County Asylum, a gentleman with high recommendations and extensive and varied hospital experience. He enters upon his duties on the Ist August, but no suitable residence is yet provided for him. /Dunedin Asylum. —There were 253 patients in this Asylum on. Ist January —T77 males and 76 females. During the j^ear 125 were admitted, 76 males and 49 females, of whom 14 males and 11 females were readmissions ; the total number under care was 378, 253 males and 125 females ; of these, 21 men and 15 women were discharged as recovered, 5 men and 10 women as relieved, 21 men and 3 women died; and there remained at the end of the year 206 men and 97 women: total, 303. The number discharged as recovered is much smaller than usual, being only 28'80 per cent, calculated on the admissions, and the number discharged as relieved was larger than usual. The death rate was somewhat high for males, being 10 8S of the average number resident, and low for females, being 3'33 per cent. Eleven of the deaths were due to disease of the brain or nervous system, 3to consumption, 3 to inflammation of the lungs, 1 to heart disease, and inflammation of the spinal cord, and 1 to.

H.—6.

8

dysentery, 1 to obstruction of the bowels and intestinal paralysis, 1 to Bright's disease and disease of the base of the brain, and 2to senile decay. The comparatively high mortality among males appears to result from the large proportion of acute and necessarily fatal diseases of the nervous system which are received into this Asylum; the proportion of deaths from lung disease is the same as at Auckland. This Asylum was last inspected in January of this year. The following is the report which was then made regarding it: — " 20th January, 1880. " This Asylum has been under examination since the 14th instant. There are now 305 inmates, of whom 207 are males and 98 females. Great relief has been obtained in the male department by the opening of the temporary building at Seacliff, to which 55 patients have already been removed, and which is soon to receive 20 more. But the increase in the numbers continues so steady and rapid that the total accommodation now available for men is barely more than sufficient for existing requirements ; and the female department, from which only three kitchen-women have been removed to Seacliff, is so full that it is necessary for the patients to sleep in the day-rooms, and even in the recreation hall, which, it is feared, will soon have to be given up entirely for their use as a dormitory. " The wards were found, as usual, in excellent order, and the patients quiet and contented to a degree which is quite remarkable considering the disadvantages under which they are treated. Their general health is good. None was found in seclusion. Pour men were under restraint, one because of his suicidal tendencies, the others on account of their being extremely dangerous. Since the overcrowding has been reduced by removals to Seacliff it has not been found necessary to resort to the use of seclusion nearly so much as formerly. " About 80 men and 50 women are industrially employed. Pour men are generally occupied in the shoemaker's shop, where all the boots and shoes required for the institution are made and repaired. Two are assisting in the bakehouse, where bread for about 800 people is now made, and a few others are employed in house-painting, carpentry, and smith-work. " The clothing of the patients is, for the most part, satisfactory ; but some of the men are shabbily dressed, and are permitted to display a contempt for the use of buttons which is quite behind the age. Since last visit in June night attendants have been appointed, and the increase in the number of male patients, together with the opening of the Seacliff establishment, have rendered it necessary to engage another cook and three additional attendants. " The registers and other books are kept with great care and accuracy, and are all fully written up to date. " The arrangements for the safety and comfort of the patients in the building at Seacliff are very satisfactory, and bear evidence to the anxious thought which Mr. Hume has bestowed upon them. This branch establishment, situated in the midst of the bush, is a source of no small trouble. It is under the immediate charge of an experienced attendant and his wife, assisted by four other attendants and a cook. The inmates are healthy and cheerful. About half of them are employed in a variety of occupations out of doors. Some six acres of laud have been cleared, and are now bearing beautiful crops. Much more than than this would have been accomplished had it not been that the labour of the patients has been required in other directions. " The site on which the temporary building has been placed has unfortunately not proved so good as it seemed. Great trouble has been caused by the continual slipping downwards of a bank in the rear of its north wing, wdiich has at last got seriously injured, the concrete walls on which it rests having been partially pushed from underneath it. The engineer in charge is causing a series of deep drains to be made, so as to stop further slipping, and piles are being substituted for the damaged concrete. It appears that over a large area in this district the ground frequently turns out to be of the same treacherous nature as this piece which has given such a disagreeable warning. Instead, therefore, of commencing to build the central block of the new asylum on the piece of ground already prepared, it would be much better to clear and drain by paid labour eight or ten acres, in order that the nature of the ground may be definitely ascertained, and a thoroughly satisfactory site fixed upon with confidence; and then proceed to erect the whole building without delay. It is to be hoped that, if this precaution be taken, not only a safe foundation will be secured, but also a better aspect than the eastern one, which is stated to be unavoidable, if the building is put exactly on the site which has been chosen. It is an object of great importance that the principal dayrooms should face as nearly north as possible, and it was distinctly settled that they would at least have a north-eastern aspect." The measures which were taken to put a stop to the slipping of the ground at the temporary building proved sufficient, and the north wdng has been restored to its position and made safe. A further survey of the reserve having been made, it was found that, by selecting a site about five chains southward of the one which had been previously chosen, a very large amount of cutting would be avoided, as well, apparently, as all risk of slips. A clearing of about ten acres of the surrounding bush and tho excavations of the foundation were arranged for by contract, the patients being relieved of this work, which it was evident they could not overtake with sufficient rapidity. As to turning the front of the building to the sun, the Engineer in Charge of the Middle Island reported that this could not be done to the smallest extent without increasing the cutting at the north end of the site ; and that, having carefully examined the plans with the architect, he was satisfied that the aspect which the building was to have would get as much sun on the main apartments as it was possible to give. Although it was a matter of extreme importance to proceed with this Asylum as quickly as possible, it seemed to me rash to do so without making positively sure of the safety of placing so large and expensive a structure on ground wdiich had so bad a reputation for unsteadiness, and I therefore strongly recommended that, before building operations were sanctioned, the opinion of the Director of the Geological Survey should be obtained as to the nature of the ground and the risk of its slipping. Erom Dr. Hector's report, which has been referred to the architect, it is evident that these risks are not altogether imaginary, and that some delay and expense will be incurred in effectually guarding against them. I understand that it is the intention of the Government to appoint a Eesident Medical Superintendent to this Asylum, and lam strongly of opinion that such au officer is much required. There are

9

IL—6

now upwards of 300 patients, about 70 of whom are lodged in the farm buildings at Seacliff. No one can shut his eyes to the absurdity of 300 diseased brains being under charge of any one but a resident physician. Hokitika Asylum. —There were 70 patients on Ist January —51 males and 19 females. During the year 27 were admitted —17 males and 10 females, 1 male and 2 females being readmissions. The total number under treatment was 97, of whom 68 were males and 29 were females. Of these, 7of each sex were discharged as recovered, and 1 female as relieved ; 4 males and 1 female died ; and there were left, at the 31st December, 57 males and 20 females —fn all, 77, being an increase of 7. As many as 9of the 17 males admitted had apparently gone insane from drink. The insanity of 3 other males and of 3 females was ascribed to hereditary predisposition. The recoveries were in the proportion of 51 per cent, to the admissions. The death rate was 6'66 of the average number resident. All the deaths were due to nervous disease, 2 resulting from epilepsy, 1 from chronic brain disease, 1 from softening of the brain, and 1 from exhaustion from melancholia. The Asylum has had the misfortune to lose the services of its kindhearted physician, the late Dr. Dermott, who died in September. He has been succeeded by Mr. David Philip James, M.E.C.S.E. The Asylum was inspected on the 27th January, and in all respects found in a very satisfactory condition. The whole building has been re-painted externally. A. fine large dormitory and three single rooms have been added to the female side of the house, and a small bedroom, formerly occupied by three patients, has been turned into a store. All this additional building has been put up by the patients and attendants, who cut and prepared the whole of the wood, except the lining and flooring, which had to be bought, and made even the doors and window-sashes. Excellent accommodation has thus been got for 17 patients at a very trifling cost. It is suitably furnished; and the bedsteads, which are very substantial, were also, with the exception of their turned legs, made on the premises. The large amount which is saved in the way of building at this Asylum should be borne in mind when its rate of maintenance is contrasted with that of others. The detached house, which has been built by contract, for the men is now occupied by 13 patients and one attendant. It is a comfortable and pleasant-looking building, with nothing to distinguish it from an ordinary dwelling, except that it is clean and well ventilated. Its cost was £815 95., or about £67 6s. lOd. per bed, which is very moderate. The ground round about this house has been tastefully laid out by the patients, who accomplished a great deal of work in preparing a site for it; upwards of an acre of very uneven ground having been cleared, levelled, and drained. The cottage that was on the 5-acre section, which was bought as a site for the'above building, contains sleeping-rooms for 8 patients; and there is now almost sufficient accommodation for the men in this Asylum ; while there is room for 3 more women —a state of matters which is not likely to last very long. Great attention continues to be given to the employment of the patients, and at the time of the visit nearly all the men were found busily engaged in various occupations out of doors. There were only 8 of the 54 males and 1 of the 21 females then in the Asylum who were not workers ; and these few were idlers because of mental or physical incapacity. The bush-land of which the reserve is composed affords abundance and variety of healthy employment; and, what with felling timber, sawing it into planks, rooting up stumps, levelling, trenching, draining, fencing, and cropping, almost every patient finds something at which he can be induced to work ; and, if he does not recover, his downward progress is at least retarded. The patients appeared to be in very good health, and were comfortably and tidily dressed. They were seen at their dinner, which was abundant and nicely served ; they all ate decently with their knives and forks, and maintained the utmost good order. No one was in bed. There was one very suicidal patient, who wore locked leather-gloves, without fingers, during the night for fear of injuring himself, but during the day he went without them, and in fact was a good worker. Eor upwards of a year no patient had been placed in seclusion, nor had restraint of any kind been used, excepting gloves in the above case. The registers are neatly and correctly kept. Nelson Asylum.. —There were 59 patients on the Ist January—3B males and 21 females. During the year 19 were admitted —10 males and 9 feWiales (2 of the latter being readmissions) ; and the total number under care was 78—48 males and 30 females. Of these, 8 males and 3 females were discharged as recovered, and 2 females as relieved ; 4 males and 1 female died ; and there were left, at the end of the year, 34 males and 26 females —or 60 in all, being an increase of only 1. The recoveries were in the proportion of 80 per cent, to the admissions among males, and of 33 per cent, among females. The death rate was 11'76 of the average number resident for males, and 434 for females. The causes of death were —diseases of the brain in 3 cases, disease of the liver and diarrhoea in 1, and erysipelas in 1. The Asylum was inspected on the 30th August and Ist September, and reported on as follows: — " The present number of patients is 60—34 males and 26 females. Their health appears to be good, and their condition is, generally speaking, satisfactory. There are, however, two very helpless and degraded females, who might be improved by assiduous attention on the pa»t of the matron. In the--treatment of the patients seclusion seems to be very little resorted to, and restraint still less. All except 10 males and 12 females are recorded in the medical journal as employed in one way or another ; but, owing chiefly to the want of ground, the number of males who steadily engage in any occupation worth mentioning is comparatively small. " It was found that 2 male patients, one of whom is by no means good-tempered, occupied the same sleeping-room. The Superintendent was warned against the danger of this arrangement, and instructed at once to discontinue it. " The house was very clean, and in good order throughout. A few tables and chairs have been added to the scanty stock ot furniture, with good effect; and linoleum is in course of being laid down in the corridors, which will greatly improve their appearance. There is still an almost utter absence of 2—H. 6.

H.—6

10

ornaments and objects of interest in the wards. On the male side there is not so much as a picture or print of any kind: and there are no books to speak of. If the Superintendent were allowed a small sum —of, say, £20 —he could do a good deal towards remedying these glaring defects. "The defect formerly complained of in the water-supply still continues: that is to say, although there are ten tanks of 400 gallons each, which are filled during the night, so that there is sufficient water for the requirements of the patients —though at present it has all to be carried into the house — jet the pressure is so weak during the day that no water is then delivered, and even at night it is too feeble to allow of the hydrants being serviceable in the event of a fire breaking out. "Although the present number of patients is perhaps not large enough to render it actually necessary that there should be some one in regular attendance on them during the night, yet, in a building of this kind, there will always be some danger of fire in spite of every precaution. I think, therefore, that, as already recommended by the Deputy Inspector, a night attendant or watchman should be engaged." In the month of October Mr. Heffer, the Superintendent of the Asylum, died. He was succeeded •by Mr. Mills, who had for upwards of nine years been senior attendant in the Hokitika Asylum. The subject of the deficient water-supply was referred to the District Engineer, who reported that abundance could be got from a neighbouring creek; but the cost of bringing it into the house was estimated at between £500 and £600, and there appeared likely to be a difficulty or further expense in acquiring the right of monopolizing the stream. The Engineer has therefore been asked to report on the subject again. I visited the Asylum again in March, and the following is the entry made in the Inspector's book regarding the condition of the Asylum at that time: — " On the 9th and 11th March I inspected the Asylum, and was much impressed by the marked improvement which has taken place under the vigorous and intelligent management of the new Superintendent, Mr. Mills. It was particularly pleasing to see the great success which has attended his efforts to increase the number of patients engaged in occupations of a genuine, healthy, and enlivening description. There were 35 male patients, and all of them except 4 were found busily employed on both days of the visit in the following manner: 15 were digging up the male court (which, as formerly recommended, is being turned into an ornamental garden), 5 were at work in the vegetable garden, 2 were building a summer-house, 4 were cleaning the wards, 1 was doing tailor-work, 1 was engaged in the kitchen, 2 were painting the female wards, and 1 (a private patient) was reading a book. The only idlers were an idiot, a demented old man with one leg, another demented old man, and one who is paralytic. " Among the busiest of those seen employed were several who had been obstinately idle for years, and who, since they have been induced to work, have very much altered for the better. An improvement has also been effected in the female side of the house, both as to the number of patients employed and the importance of the work they engage in. " The whole premises were found in excellent order. The wards have a much more cheerful appearance than formerly, their furniture having been considerably increased, and the walls painted or varnished by the inmates, and decorated with a number of coloured and other prints, most of which were framed by the patients. " The patients were very quiet and orderly, and suitably and neatly dressed. " The Superintendent has striven to ameliorate the condition of the two almost mindless and very helpless females alluded to in my last report. They were not found, as hitherto, lying in the ba.ck yard apart from the others. One of them was seated in an easy chair in the ward; and the other was walking about in front of the house between two other patients. " Only one person was in bed. This was an exceedingly suicidal woman, who was suffering from an extensive scald, which she had produced by deliberately tumbling backwards into the boiler of the washing-room at the end of the ward, the door of which had been left open. She was much excited, obstinately refusing food, and altogether in a very unpromising condition. She was occupying a room by herself; and thick leather gloves without fingers were fastened on her hands, to prevent her attempts to injure herself. I instructed the Superintendent to engage an extra nurse, so as to admit of some one being in constant attendance on her, as it did not appear to me safe to leave so suicidal a patient unobserved for a moment, night or day. " On an average about 25 men and 15 women attend Divine service in the hall on Sundays. About 30 men and 20 women are present at the weekly dances, in which a good many of them join. Parties of from 12 to 15 women take frequent walks beyond the Asylum grounds; and the majority of the men get a walk on the Saturdays. " Night attendance is now arranged for by each of the male attendants taking the night duties for a week. Since this has been done, the more helpless patients on the male side have been much better looked after, and all their beds are now kept dry. Their dormitory was found as fresh and clean as any of the others. "Six women were recorded in the medical journal as being of 'wet or dirty habits,' and 1 male ;and 6 females as being ' unable to wash, dress, or feed themselves.' The proportion of helpless and •dirty women is large, and might be lessened if greater attention were bestowed on them. " The Superintendent complained of the general, inefficiency of the matron ; and especially that she had on a recent occasion left her ward without any officer in charge of it while it contained several patients, among whom was an extremely violent one and the suicidal one above referred to. "My own observations had satisfied me as to the truth of the first of these charges; and she herself admitted the second. I therefore advised her to resign, which she did. " The statutory registers were examined, and found neatly and correctly written-up to date. A case-book has been opened by the Medical Officer, and the cases of all patients admitted since last (inspection have been entered in it. The Inspector's book contained an entry, of date 17th January, by Mr. Acton Adams, M.H.R., Official Visitor, suggesting that the patients, when out walking, should avoid the central part of the town, and expressing satisfaction with the state in which he found the Asylum; also an entry by Mr. Joseph Mackay, Deputy Inspector, referring to four inspections which he had made, in which he speaks very highly of the system of management pursued by Mr. Mills."

11

H.—6

Auckland Asylum. —There were 196 patients on Ist January—l32 males and 64 females. During the year 79 were admitted —47 males and 32 females, 11 of the males and 7 females being readmissions ; and the total number under care was 275—179 males and 96 females. Of these, there were discharged as recovered 13 males and 20 females, as relieved 1 male ; 9 males and 3 females died ; and there remained at the end of the year 156 males and 73 females —in all, 229, being an increase of 33. The recoveries were in the ratio of 41'77 per cent, to the admissions. The death rate was 5'76 of the average number resident. The causes of death were meningitis in 2 cases, chronic brain disease in 2, exhaustion from mania in 1, chronic chorea in 1, consumption in 2, bronchitis in 1, erysipelas in 1, and senile decay in 2. In September last a farm of 139 acres of good land adjoining the small piece belonging to the Asylum, and regarding which negotiations had been going on for some time, was purchased for the sum of £4,200 ; but it was not till towards the end of the year that actual possession was obtained. There can be no doubt that this land will prove an immense benefit to the institution by promoting economy, and outdoor employment and exercise, which have hitherto been exceedingly limited. The new wing of the Asylum, which, by contract, was to have been completed in May, will be soon ready for occupation, and the female patients will then be removed from their temporary quarters in the old hospital. In addition to this new wing it is absolutely necessary for the efficient and economical working of the establishment that there should be a good laundry. Hitherto the washing has been done at the gaol, but that is a most unsatisfactory arrangement. It is, intact, impossible that all the daily laundry work of a large lunatic asylum can be performed at a distance of several miles from it, even if there were adequate appliances, which apparently there are not at the gaol. The Medical Superintendent has also urged the necessity of erecting a dining-hall for the women, the present one being hardly large enough for the men, and quite incapable of accommodating both sexes at the same time. Instructions were given to the architect in charge of the new building to prepare plans for a laundry and female dining-room for approval. These have been received and referred to me, but, before definitely reporting upon them, I shall require to go over them with the architect and the Medical Superintendent on the ground. It will probably be better to have the laundry at some little distance from the main building, than forming a part of it, as designed. It seems doubtful whether the inconveniences resulting from the present dining-hall being too small for the use of both sexes at the same time —a defect which, unfortunately, exists also at other asylums in the colony —are sufficient to require the erection of an additional one at present. A matter of greater importance is the laying-on of gas to the Asylum, without which means of lighting there will always be such fear of accidents as to interfere with the comfort and good treatment of the patients. When this matter was taken up two years ago by the Government it appeared that the Gas Company would be willing to supply gas at 10s. per 1,000 feet if the Government would pay £310 of the £810 which was calculated to be the cost of a main to the asylum, or to supply the "gas at 12s. per 1,000 feet, and lay the main at their own cost. This offer was afterwards withdrawn, but probably much the same terms could now be got. I have delayed for some time sending in my report, in the hope that before it would be necessary to do so I should be able to include in it as usual an account of this Asylum from personal inspection; but I find, with extreme regret, that this is now impossible. Towards the end of the year, when prepared to start for Auckland, I was detained in Wellington by official instructions ; and since, shortly after my last return from the Middle Island, I have been unable through illness to travel. Frequent communications from Mr. Thomas Macffarlane, the Deputy-Inspector, recording the results of his inspections, and other sources of information, make it evident that the institution continues steadily to improve under the energetic management of Dr. Voung, the Eesident Medical Superintendent. Napier Asylum. —There were 17 men and 6 women in this Asylum on Ist January. During the year 3 men and 2 women were admitted for the first time, and 1 of each sex was readmitted, making a total of 30 under care —21 men and 9 women. Of these, 6 men and 3 women were discharged as recovered, and 2 men died —1 of dysentery and lof atrophy —leaving 19 at the end of the year. New Plymouth Hospital. —On Ist of January there were 3 patients in the cells allotted to the insane at this Hospital, and euphemistically called an Asylum. During the year 3 more were admitted ; 1 was discharged as recovered, 2 died —1 of apoplexy and lof atrophy—and the other 3 were transferred to the Nelson Asylum in June, since which time the place has remained empty. It will be better, in future, whenever possible, to remove all cases of insanity occurring in Taranaki to Nelson or Wellington, until it becomes necessary to provide a small local asylum in which they can be properly treated. I have, &c, Peed. W. A. Skae, The Hon. the Colonial Secretary, Wellington. Inspector of Lunatic Asylums.

H.~- 6

1

APPENDIX.

Table 1., showing, the Admissions, Readmissions, Discharges, and Deaths in Asylums during the Year 1879. M. F. Total In Asylums Ist January, 1879 ... ... ... ... ... 637 318 955 M. F. Total. Admitted for the first time ... ... ... 203 117 320 Readmitted ... ... ... ... ... 45 34 79 Total admitted ... ... ... 248 151 399 Total under care during the year ... ... ... ... 885 469 1,354 Discharged or Removed. M. E. Total. Recovered ... ... ... ... ... 112 76 188 Relieved ... ... ... ... ... 15 13 28 Not improved ... ... ... ... ... 8 3 11 Died ... ... ... ... ... 55 16 71 Total discharged and died during the year ... —■ —■ 190 108 29S Remaining in Asylums 31st December, 1879 ... ... ... ... 695 361 1,056 Increase over December, 1878 ... ... ... ... ... 57 42 99 Average number resident during the year ... ... ... ... 666 337 1,003

Table II., showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, &c., per cent. on the Admissions, &c., in Asylums during the Year 1879.

Table II., showing Admissions, Discharged, and Deaths., &c. — Continued.

Admii isioNs in the Yeab 1879. Asylums. Intl Asylu] 1st Jam 1871 lie ms, nary, rj Total Number of Patients under Care. Admitted foi Time. Pirst 9. Re-admiti ;ed. Total. Luckland lew Plymouth ... papier Wellington lelson lokitika Jhristchurch )unedin 132 2 17 69 38 51 151 177 M. 64 1 6 48 21 19 83 76 P. T. 196 3 23 117 59 70 234 253 M. I 36i 3! 3 24 10 16 49 62 I F* j 25 2 14 7 8 23 38 T. 61 3 5 38 17 24 72 100 M. 11 1 9 F. 7 1 2 2 2 9 11 T. 18 2 11 2 3 18 25 M. P. 47 32 3 ... 4 3 33 16 10 9 17 10 58 32 76 49 T. 79 3 7 49 19 27 90 125 M. 179 5 21 10'2 48 68 209 253 p. 96 1 9 64 30 29 115 125 T. 275 6 30 166 78 97 324 378 1 9 14 Totals 637 318 955 203 117 320 I 45 34 79 248 151 33)9 885 469 1,354 ■:-

'ATIENTS DlS' jhakged and Died. Remaimn ' in Asylums. ■Asylunrt 31st Dec., 1 i, 879. Discharged Recovered. Di not ischarged Recovered. Total Disch and Die irged i Died. 1. oickland lew Plymouth ... 1apier Wellington lelson lokitika Ihristchurch )unedin ...| M. 13 1 6 12 8 7 44 21 F. 20 3 7 3 7 21 15 T. 33 1 9 19 11 14 65 36 M. 1 2 P. 1 T. 1 3 M. 9 2 2 2 4 4 11 21 P. 3 0 3 1 1 5 3 T. 12 2 2 5 5 5 16 24 M. 23 5 8 19 14 11 63 47 P. 23 1 3 11 4 9 29 28 T. 46 6 11 :-0 18 20 92 75 M 156 13 83 34 57 146 206 P. 73 6 53 26 20 86 97 T. 229 19 136 60 77 232 303 5 2 1 1 3 10 6 2 1 11 15 8 5 39 55 16 71 190 298 695 361 Totals 112 70 188 23 16 108 1,05

H.—6.

2

Table II., showing Admissions, Discharges, and Deaths, &c. — continued.

Table III., showing the Ages of the Admissions in the different Asylums.

Table IV., showing the Duration of Disorder on Admissions during the Year 1879.

ivera !uml lent le Y ige ber during Pei Recov miss t! rentage of reries on Ad'ionH during he Year. Perceui on Av< resic tl tage of' irage N Lent du: le Yeai Deaths rumber ring Pei Deatl :centag< is on Ni ider cai j of jmber Pei T •centag' >eaths c Imissioi e o£ in as. Asylums. Resir tl 1 A' ear. *e. M. P. T. M. p. T. M. F. T. M. F. T. M. F. T. Auckland few Plymouth ... Iapier Wellington lelson lokitika Jhristchureh )unedin 145 63 208 27.65 62.50 41.77 6.20 4.76 5.76 5.02 3.12 4.36 19.14 9.37 15.18 15 76 34 55 148 193 7 50 23 20 84 90 22 126 57 75 232 283 150.00 36.36 80.00 41.17 75.86 27.63 100.00 43.75 33.33 70.00 65.62 30.61 125.57 38.77 57.87 51.85 72.22 28.80 13.33 2.63 11.76 7.29 7.43 10.88 00.00 6.00 4.34 5.00 5.95 3.33 9.09 3.96 8.77 6.66 6.85 8.48 9.52 1.96 8.33 5.88 5.21 8.30 11.11 4.68 3.33 3.44 4,33 2.40 6.66 3.01 6.41 5.15 4.93 6.34 5.00 6.06 40.00 23.52 18.96 27.63 33.33 18.75 11.11 10.00 15.62 6.12 28.57 10.20 26.31 18.51 17.77 19.20 Totals 666 337 1,003 45.16 50.33 47.11 8.25 4.74 7.07 6.21 3.41 5.46 22.17 10.59 17.79

ickli id. Nc Plymoi Napir rr. Wellii ton. '£* Nelso: ,kiti! :a. Ihrisi aurc! med: in. 'otal. rtb. l. Ages. Jl F. T. M. P. T. M. P. T. M. F. T. il. P. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 yrs.... Frm5tolOyrs. „ 10 „ 15 „ „ 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ „ 40 „ 50 „ „ 50 „ 60 „ „ 60 „ 70 „ „ 70 „ 80 „ „ 80 „ 90 „ Unknown ] 1 1 2 1 2 1 7 30 36 36 8 2 1 1 2 1 6 55 80 71 20 6 2 1 2 2 7 30 63 28 10 6 1 13 12 1 8 1 1 2 1 3 8 6 4 5 2 2' 1 3 21 18 15 13 3 1 1 2 i 2 i 0 1 "3 1 5 1 6 15 9 1 2 3 7 3 2 9 22 12 3 2 3 4 o 2 5 1 5 9 4 7 8 1 1 "7 1 14 8 1 2 1 15 22 12 4 3 2 3 15 11 1 l 2 18 37 23 5 3 6 16 16 27 6 1 1 14 20 9 2 2 13 85 143 99 30 12 1 1 "2 i i 1 2 i 1 1 i "i 1 "i "i Totals ... 47 82 79 3 3 4 3 33 16 49 10 9 19 17 10 27 58 32 76 49 125 248 151 7 90 1391

Auckland. NewPlymouth. Napier. Wellington. Nelson. Hokitika. Christ, church. Dunedin. Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. First Class— First attack, and within 3 months on admission ... Second Class— First attack above 3 mos. and within 12 months on admission ... Third ClassNot first attack, and within 12 months on admission ... Fourth ClassFirst attack or not, but of more than 12 months on admission ... Unknown ... 2S 20 48; 14 19 ... 13i 16 44: 16 60 45, 28 73 14 156, 20 w 20] 231 10 10 15 12< 27 32 28! 9 5 14 1 1 10 2 12 2! 3 5 1 3 4 10 12 22 8 3 11 40 29 69 Totals ... 47 32 79 ... 3 4 3 7 33 L i 49 10 91 19 17 10 27 58 32 90 76 49125 'AS' 151: [99

3

H.—6

Table V., showing the Ages of Patients Discharged during the Year 1879.

Table V., showing the Ages of Patients Discharged during the Year 1879— continued.

Table VI.—Statement of Expenditure on Asylum Buildings during the Financial Year ended 31st March, and Liabilities for the same.

Table VII.- Contracts for Asylum Buildings.

Aue land. New IT mouth. Nai rier. Welli: igton. Ages. Not Not Recovered. Not Not Recovered. Recovered. Recovered. Recovered. Recovered. Recovered. Recovered. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. F. M. T. 'rom 5 to 10 ... ,, 10 „ 15 ... ,, 15 „ 20 ... „ 20 „ 30 ... „ 30 „ 40 ... ,, 40 ,, 50 ... ,, 50 ,, 60 ... „ 60 „ 70 ... ,, 70 „ 80 .. ,, 80 ,, 90 ... Jnknown 4 5 3 1 1 5 7 2 2 1 1 1 1 9 12 5 2 2 1 1 i 1 i i i 5 i s 5 6 T 2 5 "i ii i 2 2 2 3 i i i i i" 2 Totals ... 13 20 33 1 i 1 1 2 i 3 6 3 9 12 7 19 5 1 6

Nelson. Hoki itika. Christchurch. Duni idin. Ages. Recovered. Not Recovered. Recovered. Not Recovered. Recovered. Not Recovered. Recovered. Not Recovered, M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Vom 5 to 10 ... „ 10 „ 15 ... „ 15 „ 20 ... „ 20 ,, 30 ... ,, 30 ,, 40 ... ,, 40 „ 50 ... ,, 50 „ 60 ... „ 60 „ 70 ... „ 70 „ 80 ... „ 80 „ 90 ... Fnkno wn 1 4 3 2 1 6 3 2 3 4 1 1 4 1 1 7 4 i 15 18 8 2 1 1 6 9 5 1 21 27 13 2 1 1 5 2 X 8 2 2 7 6 6 1 7 4 3 3 14 10 9 i" i 3 1 3 4 1 1 l 2 3 4 4 1 i 1 i 1 Totals ... 3 11 2 2 7 7 14 1 l 44 21 65 8 3 11 21 15 36 5 10 15

Asylums. Expended to March 31, 1880. Liabilities, March 31, 1880. luckland ... Iheistchuech )unedin (Blueskin Reserve) lOKITIKA ... Wellington ... £ s. d. 11,559 7 6 7,255 17 3 6,447 10 10 722 1 11 1,453 17 10 £ s. d. 8,224 0 0 21,366 0 0 08,755 0 0 4,844" 2 6 Totals 27,438 15 4 103,189 2 6

Buildings. Tender Accepted. Date fixed for Completion. Contract Price. Extras. 3!hbistchuech (No. 1 contract) „ (gas fittings) ... ,, (No. 2 contract) Auckland Seacliff Wellington (alterations) ... ,, (new west wing) April 3, 1879 Dec. 6, 1879 Feb. 5, 1880 Nov. 5, 1878 Oct. 10, 1879 Mar. 31, 1880 Mar. 8, 1880 Sep. 30, 1880 Feb. 6, 1880 Mar. 31, 1881 Mav 21, 1880 April 10, 1882 July 25, 1880 July 8, 1880 £ s. d. 10,690 12 11 398 11 0 19,227 12 1 16,933 0 0 69,971 19 9 2,143 13 2 2,700 2 6 £ s. d. 1,000 0 0 660 0 0 500 0 0

H.—6

4

Table VIII., showing the Ages of Patients who Died during the Year 1879.

Table IX., showing the Condition as to Marriage of Patients Admitted, Discharged and Died during the year 1879.

icklai id. New Plymouth. Napiei Wei llingl elsoi rkitika. Cl cl iristrurch. medi in. ion. Ages. M. FT. M. P. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. MP. T. M. F. T. 30 to 15 yrs .5 „ 20 „ !0 „ 30 „ iO „ 40 „ 10 „ 50 „ >0 „ 60 „ iO „ 70 „ '0 „ 80 „ i0„90 „ Unknown ...5 1 1 1 1 2 3 1 1 2 1 1 1 2 3 2 2 3 "i "i "i l "i l "i "i "i "i l 1 1 1 1 1 "i 2 "i "i 3 "i "i 2 "i "i "2 2 4 2 1 1 1 2 1 2 2 5 4 1 1 1 1 4 8 5 1 2 "i i 1 1 5 8 6 2 2 3 12 19 9 4 5 2 3 4 3 3 1 515 23 12 ... 1 "i "i "i "i "i "2 "2 Totals... 9 3 12 2 2 2 2 3 5 4 l 5 4 1 5 11 5 16 21 3 24 55 16 71

Imissio: is. Dii ichargr !S. Deaths. M. P. T. M. F. T. M. F. T. Auckland— Single Married Unknown Widowed 27 19 12 18 39 37 7 7 7 12 14 19 6 3 i "2 6 4 "2 i 2 "3 i 1 Total 47 32 79 14 20 34 9 3 12 New Plymouth—■ Single Married Widowed 3 3 2 1 "l 2 2 2 2 Total 3 3 3 1 4 2 2 Napier— Single Married Widowed r 4 2 4 5 1 1 3 1 3 3 4 s i i Total 4 3 7 6 3 9 2 2 Wellington— Single Married Widowed 23 10 5 11 28 21 13 4 2 6 15 10 1 1 1 2 2 3 Total 33 16 49 17 8 25 2 3 5 Nelson—■ Single .3. Married Widowed 6 3 1 9 6 12 1 8 2 2 1 8 4 1 2 2 2 2 1 4 4 1 Total 10 9 19 10 3 13 4 5 Hokitika— Single Married Widowed * ... 13 2 2 3 7 16 9 2 6 4 4 10 4 1 3 1 i 3 2 i Total Cheistchcrch— Single Married Widowed 17 10 27 7 8 15 4 1 39 17 2 8 22 2 47 39 4 40 11 1 8 15 1 48 26 2 4 6 1 3 2 7 8 1 Total 58 32 90 52 24 76 11 5 16 i Dunedin— Single Married Widowed Unknown 43 25 5 3 17 24 8 60 49 13 3 18 7 1 7 17 1 25 24 2 6 10 1 4 1 "2 7 10 3 4 Total 76 49 125 25 51 21 3 24 26 Totals— Single Married Widowed Unknown 157 77 11 3 45 94 12 202 171 23 3 98 34 3 28 60 4 126 94 7 25 23 3 4 7 8 5 32 31 8 4 248 151 399 135 92 227 20 75 Total 55

5

H.—6

Table X., showing the Native Countries of Patients in Asylums at 31st December, 1879.

Table XI., showing the Ages of Patients in Asylums at 31st December, 1879.

2.—H.6.

M. F. T. Total. I At ickli lnd' Plymouth. T. M. P. T. apier. lii Welngton. Nelson. Hokitika. Christchurch. Dunedin. M. F, P. T. M. F. T. il. P. T. M. P. T. M. P. T. M. F. T. M. F. T. 348 131 379 England 77 30 107 5 7 2 22 51 16 17 6 23 63 42 105 28 72 48 64 22 70 332 76 208 Scotland 15 4 19 2 8 28 8 11 7 2 9 16 12 47 111 .83 105 288 Ireland 33 25 58 5 18 10 28 13 22 20 12 32 48 24 47 6 24 71 26 22 48 New Zealand ... 13 7 20 1 3 7 10 2 5 1 4 5 1 7 ... ... 12 1 13 Australia 2 2 1 21 3 3 6 7 Prance 1 29 Germany 2 4 4 8 5 7 21 4 Norway 1 2 2 10 Sweden 1 l| 2 4 2 13 Denmark 1 4 2 2 3 11 8 Italy 1 5 ... 8 China 21 6 15 Maoris 7 6 13 1 1 1 1 Russia 1 India Finland 1 1 1 2 1 3 2 2 7 America 3 Wales 1 Jersey "l Nova Scotia ... 1 1 1 South Sea Isles 1 3 Tasmania 5 ... Turkey 1 Holland 2 2 2 Unknown 1 1 1 1 ... ... 361 1056 Totals ... 156 73 229 13 6 19 83 53 34 20 60 57 20[ I 77 146 S6 232 206 97 303 i95 136

Auckland. New Plymouth. Napier. Wellington. Nelson. Hokitika. )hristhurch. Dunedin. Total. Ages. M. F. T. M. F. T. M. F. T. M. P. T. M. F. T. M. P. T. M, F. T. M. F. T. F. T. 1 to 5 years 5 „ 10 „ 10 ,, 15 ,, 15 „ 20 „ 20 „ 30 ,, 30 „ 40 „ 40 „ 50 „ 50 „ 60 ,, 60 „ 70 „ 70 „ 80 „ 80 ,, 90 ,, Unknown 1 1 25 52 35 29 10 1 1 1 1 1 4 10 19 20 11 5 1 1 2 5 35 71 55 40 15 2 1 2 2 6 3 2 2 2 1 4 8 4 2 1 1 14 38 18 9 1 1 1 9 16 19 2 5 1 1 1 1 23 54 37 11 6 2 1 2 4 14 7 5 1 2 2 14 6 1 1 4 6 28 13 6 1 "i 4 21 25 5 1 "i 12 3 "i "5 33 2S 5 3 1 19 37 61 21 7 i 2 3 7 26 30 13 3 1 1 ! 3 ! 3 26 ! 63 i 91 34 10 1 1 2 1 5 26 52 75 34 7 2 I 2 10 40 32 9 4 1 2 ! 3 5 36 92 107 43 11 2 1 ! 4 ! 5 8 94 220 224 105 27 4 1 2 1 r 2 5 9 41 129 111 36 19 3 2 6 10 17 135 349 335 141 4« 7 I 7 2 1 i 1 i "i 60 2 2 i i 5 Totals ... 150 73 229 13 6 19 83 53 136 34 26 57 20 77 146 86! 232 206 97 303 695 361 1050

H.—6.

6

Table XII., showing Causes of Death.

Total Auckland. New Plymouth. Wellington. Nelson. Hokitika. Christchurch. Napier. Dunedin. Causes. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. P. T. !— I— — — — I — I — H I I I I I I I I I — I 5 3 2 3 2 2 6 2 1 3 1 1 4 1 3 6 6 2 3 2 2 8 3 1 3 1 1 7 1 2 1 1 3 1 2 1 1 1 1 3 1 2 5 General paralysis Epilepsy Apoplexy ... _ ... Exhaustion from mania Exhaustion from melancholia Myelitis ... ... Chronic disease of brain Softening of brain Chronic chorea Chronic meningitis Inflammation of brain membranes Alcoholism ... Phthisis pulmonalis Bronchitis Pneumonia ... Pleuro pneumonia Disease of lungs Cardiac disease Cardiac disease and myelitis ... ... Dysentry Disease of liver and diarrhoea Disease of mesenteric glands Obstruction of bowels and intestinal parai} sis Bright's disease and disease of base of brain Erysipelas General dropsy Atrophy Senile decay 1 1 1 1 1 "2 4 1 4 1 ... ... ... ... "i ... "2 "2 "2 1 ... ... "i "i "i ... "i ... ... ... "2 "2 "i "i ... "i ... "i ... ... ... "i ... "2 "2 "2 1 "i "i "2 i" 1 l "i "i "i 1 "3 1 "i "4 1 ... ... ... "i 2 "i 2 ... ... ... ... ... "i "i ... ... ... ... 1 1 2 1 1 3 ... ... ... ... ... ... "3 "i "2 "2 ... ... ... i 1 ... ... "2 "2 ... "i ... ... .... ... ... ... ... ... "2 ... ... ... ... ... ... ... ... ... ... "2 "2 1 ... ... ... ... ... ... ... "i 1 3 1 2 1 1 1 1 2 1 2 2 ... ... ... "i 2 "i 2 ... ... ... ... ... ... ... ... 1 1 1 ... 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... "i "i ... ... ... ... i "i ... ... ... ... ... ... ... "i "i ... ... ... ... ... i ... ... ... ... ... ... "i 1 "i 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... "i "i "i "2 ... "i "i "1 ... "i ... ... ... ... ... ... ... ... ... ... ... .„■ "i ... "i ... .... ... ... "i "i ... ... ... ... ... ... ... "i ... "i .... ... "3 "i "i "2 ... "i "i 5 I ... ... ... ... ... ... ... ... ... ... "i "i "2 ... ... ... Li 1 ... ... ... ... — — — — — — — — — — — — 55 16 71 Totals 9 3 12 2 2 2 3 I 4 1 4 1 5 11 5 16 2 ... 2 a 3 24

H.—G

7

Table XIII., showing Length of Residence of Patients who Died during the Year 1879.

Table XIV., showing Length of Residence of Patients Discharged Recovered during the Year 1879.

Table XV., showing the sums received on account of Lunatic Asylums during the Year ended 31st December, 1879.

* These sums are not included in amount of repayments for maintenance, &c, as sliown in Table XVI.; but these are deducted from cost of rations in Dunedin Asylum.

icklai .d. New Plymouth. ipir :r. We3 lling! ;on. Nei in. ikitil :a. !hris1 hurcl Dunedin. rta! ..... Ages. M. F. T. M. F. TM. F T. M. 3F. T. M. F. T. M. JF. T. M. F. T. M. F.rT. ..J 4 o M. F. T. "Onderl month... IFrom 1 to 3 mos. .1 3„ 6 „ „ 6„ 9 „ „ 9„12 „ „ 1„ 2 yrs. 91 2,, 3 „ „ 3„ 5 „ „ 5„ 7 „ ., 7,. 10 „ ,. 10„12 „ ,. 12,,15 „ Over 15 ,, 1 2 1 1 2 1 1 1 1 1 1 1 1 1 1 2 1 2 2 4 2 3 1 10 6 6 2 2 7 9 5 4 2 1 1 1 11 6 6 5 4 10 11 6 5 2 1 2 2 "2 "i ... 2 '.'.. 3 ... 1 1 1 1 3 2 "i l "i 1 "i i 1 1 "i "i i "2 2 "i "i "i "i l 3 1 2 1 1 l l l 4 2 3 1 1 2 4 2 1 ... 2 1 5 ... 2 1 2 2 3 "i 1 1 "i "i "i "i "i "i "i "i "i 1 ... 1 ... 1 1 1 "i 2 9 3 "i "i 21 Totals ... 12 2 2 2 2 2 3 5| I 4 i 5 4 i 5 5 21 3 24 16 71 16 55

icklai id. New Plymoui [Uni ion. rlsr Hokitil :a. c: cl lll'ir ran it3h Duned: in. 'otal ;h. Eength of Residence. M. P. T. M. P. t. : M F T M. P. T. M T M. P. T. M P T M. P. T. M. F. T. Under 1 month From 1 to 3 mos. ti 3 ,, 6 „ „ 6 „ 9 „ „ 9 „ 12 „ „ 1 „ 2 yrs. j» 2 ,, 3 „ .* 3 ,, 5 ,, ,, 5 „ 7 „ „ 7 „ 10 „ ,, 10 „ 12 „ „ 12 „ 15 „ Over 15 „ 3 2 5 1 1 1 1 2 6 3 4 3 4 4 11 4 5 4 1 1 2 1 1 1 1 i l 2 2 2 1 1 1 "7 2 2 1 1 1 1 1 3 1 8 1 S 5 1 l 5 1 "i 2 1 3 6 3 "i 5 1 "i 1 2 2 2 6 3 2 3 16 9 12 3 1 2 3 5 7 2 3 19 14 1!) 5 4 2 9 6 3 1 1 1 3 7 2 2 12 13 5 3 1 2 35 32 22 9 6 6 11 18 19 11 10 4 1 1 46 50 41 20 16 10 1 1 "i "i "i i ••• ... "i "i • ••I ... "i "i 1 "i "l "i 13 320 1 6 3 9 12 19 8 3! 7 7 14 ... ... 05 15 30 112 76 188 Totals 33 11 44 21 21

Asylums. Maintenance Fees. Produce or Articles Sold. Bread supplied to Gaol. Bread supplied to Hospital. Totals. luckland !hristehurch )unedin) lokitika Japier Jelson few Plymouth ... Wellington £ s. d. 5S6 13 4 1186 1 9 681 13 10 165 12 4 98 0 5 537 4 8 £ s. d. 67 12 11 £ s. d. £ s. d. £ s. d. 654 6 3 1186 1 9 1140 18 7 179 12 4 98 0 5 546 16 10 14" 0 0 *306" 2 11 ♦153" 1 10 912 2 617' 6 6 11*15 3 629" 1 9 Totals 3872 12 10 103 0 4 306 2 11 153 1 10 4434 17 11

H.—6

8

* General expenses not included in Table XVII.

Table XVII., showing Average Cost of Maintenance of each Patient per Annum.

Table XVI., showing the Expenditure for the Year 1879.

Total. Items. Auckland. Christchurch. Dunedin. Hokitika. Napier. Nelson. New Plymouth. Wellington. ! £ s. d. 800 0 0 250 0 0 478 6 6 50 0 0 188 17 11 1,247 16 7 1,780 2 2 423 6 8 515 0 0 8,231 7 2 11,345 4 0 2,040 14 11 2,815 3 7 163 10 3 261 16 7 3329 6 8 4,439 13 5 ( Inspector ... ... ... ... j Record Clerk and Accountant ... *-j Medical fees | ... j Local Inspectors LGeneral contingencies ... Medical officers Superintendents Clerks Matrons Attendants and servants Rations Fuel and light... Bedding and clothing ,.. Surgery and dispensary... Wine, spirits, ale, &c. ... Furniture Necessaries, incidental and miscellaneous £ s. d. 2o" 0 0 380 18 10 75 0 0 70 0 0 1,438 11 6 2,602 12 5 312 17 10 468 13 2 23 1 3 13 0 6 158 0 11 586 17 11 £ s. d. 25 0 0 300 0 0 350 0 0 150 0 0 100 0 0 2,585 10 6 2,362 18 9 552 19 10 283 16 5 49 7 10 21 16 6 £ s. d. 300 0 0 400 0 0 93 6 8 100 0 0 1,754 16 8 2,705 8 5 493 0 8 865 6 3 21 0 8 136 0 11 101 4 3 1,524 4 5 £ s. d. 197 16 7 275 0 0 75 0 0 730 11 3 1,178 9 8 44 6 0 312 2 0 20 17 0 8 13 7 £ s. d. 56" 0 0 £ s. d. 200 0 0 150 0 0 70 0 0 372 6 8 720 5 0 197 12 11 200 11 9 9 3 3 14 17 3 70 1 6 364 12 3 £ s. d. 24" 3 4 £ s. d. 200 0 0 200 0 0 100 0 0 100 0 0 1,099 10 7 1,485 10 5 377 6 8 558 S 7 34 10 3 67 17 10 250 0 0 289 19 4 62 11 0 126 5 5 5 10 0 797" 8 2 354' 6 6 52*' 3 0 76o" 1 2 35,360 6 5 3,975 13 2 Totals ...fc4 ... Moneys received for maintenance and produce sold 6,154 14 4 654 6 3 7,578 18 0 1,186 1 9 8,499 8 11 681 13 10 3,197 2 7 179 12 4 j 836 8 9 98 0 5 2,369 0 7 546 16 10 24 3 4 4,983 5 6 629 1 9 31,384 13 3 Total actual expenditure 5,500 8 1 6,3592 16 3 7,817 15 1 3017 10 3 i 738 8 4 ! 1,822 3 9 24 3 4 4,354 3 9

Asylums. Provisions. Salaries. Bedding and Clothing. Fuel and Light. Surgery and Dispensary. Wines, Spirits, &c. Necessaries, Incidental and Miscellaneous. Total Cost per Patient. Repayment for Maintenance. Cost per Head, less Payments. Cost per Head previous Year. Decrease in Cost, 1879. Increase in 1S79. Auckland... Christchurch Dunedin ... Hokitika ... Napier Nelson New Plymouth Wellington £ s. d. 12 10 3 10 3 83j 9 11 2J 15 14 3 13 3 7i 12 12 8J £ s. d. 9 8 10J 15 0 5| 9 7 6 17 0 lOf 13 12 8* 13 18 0 £ s. d. 2 5 Of 1 4 51 3 1 1| 4 3 21 5 14 9 3 10 41 £ s. d. 1 10 1 2 7 8 1 14 10 0 11 9| 2 16 104 3 9 4 £ s. d. 0 2 2£ 0 4 3 0 1 5| 0 5 6* 0 5 0 0 3 2J £ s. d. 0 13 0 1 101 0 9 7J 0 2 3j £ s. d. 3 11 71 3 8 8S 5 7 Si 4 14 5| 2 7 4| 6 7 11 £ s. d. 29 11 91 32 13 4 30 0 8 42 12 6| 38 0 44 41 10 101 £ s. d. 3 2 10| 5 1 9j 2 8 If 2 7 10| 4 9 3| 9 11 104 £ s. d. 26 8 lOf 27 11 64 27 12 OJ 40 5 8 33 11 01 31 19 04 £ s. d. 31 0 3J 31 3 11 25 18 Ti 43 11 11 40 13 5 40 14 3| £ s. d. 4 11 5 3 11 71 3 6 3 8 15 31 7 2 41 £ s. d. 1 13 10J 0 "5 04 11 15 9J 13 9 9 4 "8 71 2 19 101 2 0 *5 5J 0 ib 94 6"'0 71 39 i'6 llf 4 19 104 3 19 34 34 i'i 11 43 i'i 11 9 "6 91 Averages ... , ! ! ! ' 33 9 10 ... ... ... . ... ■ 29 10 OJ 33 1 6f 3 10 11 ...

9

H.—6

TABLE XVIII. showing Causes of Insanity in the Admissions.

By Authority : George Didsbuet, G-overmnent Printer, Wellington.—1880. Price Is.] t

Total. a d ■9 H o § s rD fc I SO B *o rM "-Cr i rd O r,4 0 '33 S 'r3 a ft Causes. to O 'Ph a o *o3 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 24 ' GO 4 2 1 5 2 9 3 2 2 1 1 5; 3 1 1 4 1 & 1 2 2 16! 2; 12 1 3 1 7 1 7 5 5 j " 2J 1 1 2 "l I 40 2 72 5 5 2 12 2 9 6 10 7 7 1 3 6 4 2 1 2 4 1 4 2 3 3 2 1 7 5 ] 6 3 • 19 1 3 1 1 10 6 18 98 Hereditary Predisposition „ and Domestic Troubles Intemperance „ and Congenital Weakness „ and Sexual Excess ,, and Losses and Calamities Emigration and Congenital Weakness... Excitement and ,, „ Self Abuse Solitude (and probably self abuse) Domestic Troubles ... Bereavements Anxiety Disappointment 111 Treatment Religious Excitement Love Disappointment Seduction Remorse Fright Pecuniary Losses ... Loss of Sight Poverty and Want... Exposure and Overwork Debility Fever Hysteria Malignant Tumour Injury to Head Sunstroke „ and Rheumatism ... Epilepsy Meningitis Puerperal Condition Pregnancy Uterine Disease Heart Disease Syphilis Organic Disease of Brain Climacteric Changes Senile Decay Congenital (Decay and Imbecility) Unknown 4 4 1 3 1 2 5 1 2 9 4 1 3 3 1 2 1 1 i i 1 i 1 "2 1 1 1 l 7 8 1 1 4 1 1 i 4. i 8 9 5 1 4 1 "l 1 "2 ... "e ... 3 "9 2 1 3 i 6 io "2 1 2 16 1 2 1 1 1 "2 1 5 3 1 1 "l 3 21 i o 4 "i i 2 i 2 7 18 4 2 1 £ 2 6 2 2 1 1 i 1 6 2 2 1 2 1 7 1 3 3 1 i i 13 2 20 5 4 2 12 2 6 3 5 4 "l 2 1 1 1 1 1 1 9 "z "1 1 "i 3 "1 "l "l 1 1 i ... l "l i i "i 1 4 4! 2 1 1 3 1 i i . i 1 "1 2 3 i "2 i i 8 1 "2 '4 3 3 1 "2 3 i 1 i i "2 1 1 3 1 5 1 5 i "l 3 19 1 3 2 2 "3 1 "a i 1 "l 1 1 i i 1 1 1 1 1 8 "4 4 3 5 "l 1 2 2 2 34 i i 8 9 66 2 2 3 9 32 "2 43 1 i 2 1 24 2 1 10 1 8 7 2 5 3 13 7 27 2 16 1 1 "4 1 1 1 5 "2 "4 6 1 i "2 151 399 Totals 47 32 79 3 3 3 7 33 16 49 10 9 19 17 10 27 58 32 90 76 49 125 248