MENTAL HOSPITALS OF THE COLONY (REPORT ON) FOR 1904.

Appendix to the Journals of the House of Representatives, 1905 Session I, H-07

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1905. NEW ZEALAND.

MENTAL HOSPITALS OF THE COLONY (REPORT ON) FOR 1904.

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

The Inspector-General op Mental Hospitals to the Hon. the Minister por Public Works. Sir,— Wellington, Ist July, 1905. I have the honour to lay before you the report on these special hospitals together with the usual statistical Appendix for the year ending December, 1904. It has been recognised for some time that the tables did not adequately provide data for investigation, but as the Medico-Psychological Association of Great Britain and Ireland had the matter under consideration, it was deemed wiser to postpone alterations until the association had come to a decision. The Statistics Committee has now prepared valuable tables, which, practically as they stand, will become the official tables of the association. We shall be in a position to take advantage of this work in the future reports of the Department. On the 31st December, 1904, the number of insane persons on the Department's Register was 3,038 (males, 1,801 ; females, 1,237), being an increase of 79 (males, 30 ; females, 49) over the returns of the previous year, when the increase was 111 (males, 56; females, 55) over the returns of the year before. These persons were distributed among the hospitals as follows :— Males. Females. Total. Auckland ... ... ... ... ... 363 221 584 Christchureh ... ... ... ... ... 293 244 537 Seacliff ... ... ... ... ... 433 261 694 Hokitika ... ... ... ... ... 133 43 176 Nelson ... ... ... ... ... 83 56 139 Porirua ... ... ... ... ... 330 282 612 Wellington ... ... ... ... ... 147 105 252 'Ashburn Hall (licensed hospital) ... ... 19 25 44 1,801 1,237 3,038 The number of patients admitted into the mental hospitals during the year was 580 (males, 340; females, 240) including 8 males and 4 females transferred from one mental hospital to another. The total admissions for the pre-vious year numbered 691 (males, 454; females, 237), including 99 males and 11 females transferred. The readmissions in 1903 numbered 202 (males, 148 ; females, 54), and therefore relapses accounted for more than a third of the persons becoming insane during that year. Of this year's admissions 475 (males, 284; females, 191) were received for the first time, and 105 (males, 56 ; females, 49) were readmissions. Thus more than one-sixth of the admissions have figured in previous statistics. Subtracting the deaths and discharges from the admissions minus transfers, there are left 67 patients. Some of these will doubtless be discharged, but a considerable residium will go to swell the population in the hospitals for a number of years. Thus it is year after year, and the numbers remaining on the 31st December rise accordingly. The percentage of deaths on the average number resident during the year was 638 (males, 6-74 ; females, 5-84) compared with 5-96 for the previous year, and 6-11 for the previous quinquennial period. The percentage of recoveries on the admissions was 45-34 (males, 46-18; females, 44-17) as compared with 42-17 (males, 40-56 ; females, 44-69) for the previous year, and 40-25 for the previous quinquennial period. While the recovery-rate continues to be satisfactory, the number of persons dischargedjas not recovered—namely, 36—is distinctly low. This is a very vexed question. In mental, more than in any other disorder, each case has to be considered on its merits, and no general rule can be laid down. In each unrecovered case apparently fit to be discharged, all that is embraced under the term " environment " has to be considered before judgment can be passed. The same public which is irritated by the exercise of caution blames the alienist for want of caution when I— H. 7.

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a district is alarmed by the insane acts of a relapsed case. The public is apt to forget tragedies ; the alienist, with a longer memory, is too apt to remember them. Happily untoward events are rare ; and I do not think that I should be wrong in saying that among the boarded-out cases in Scotland a tragedy is rarer than among an equal number of the general population drawn at haphazard from the same for a careful selection (and this is a sine qua non) there are every now and then a few patients who have not recovered but who could be discharged with advantage to themselves, and certainly no disadvantage to the public, had they friends to go to. We do not have the class with whom the insane are boarded in Scotland, at any rate in numbers sufficient to establish a system, and hence the extreme difficulty in discharging harmless patients who are friendless and unable to lend for themselves. In some cases people have interested themselves, and found a suitable home tor such patients, who are, I am glad to say, doing well. A society doing good work has been established m Dunedin for a quarter of a century—the "Patients' (Hospital and Lunatic Asylum) and Prisoner's Aid Society." I do not care about the conjunction, and think that an After-care Association for Hospital Patients (whether mental or otherwise) would be more in keeping. I would therefore urge the philanthropic to consider this very necessary sphere of usefulness, and to form After-care Associations in each centre. If these associations were affiliated their labours would be more productive, and would go a good way towards solving a very difficult problem. I need hardly add that the associates would have the willingly given advice of the Superintendents and the hearty co-operation of this Department. A few cases in illustration will point the moral:— X Q N.—Convalescent, about to be discharged. Confided to Inspector that he dreaded leaving the institution and re-entering friendless upon the old life which had proved too much for him. He felt, while the fact of his inferiority in the struggle for existence pressed heavily upon him, that in the outside world there was no helping hand to lighten his burden. _ F T —Has been judged fit for discharge on probation, and the necessary form which has been sent five times to her relatives has not been returned. It will probably be necessary for us to find her a home apart from them, and prosecute if necessary for her maintenance therein. D v.—A case somewhat similarly placed, but an ex-patient came to the rescue. V. G. L.—A case at first considered of doubtful fitness, but persons interested found a home, and he is reported to he gaining a good living. X. Y. Z.—ls a patient who has given us much anxious thought. He has typical symptoms ot chronic alcoholic insanity, and, with our knowledge of his mental state, and the weight of evidence on the file (including the finding of a Commission which cost £145), barring the experiment of discharging him unrecovered, we could not accept the responsibility of placing him unprotected in the world outside. His relatives will not have anything to do with him ; but under proper guardianship he could be liberated on probation, especially during the recurrent milder phases of his malady. Persons interested in him have, not appreciating his mental state, agitated for his discharge ; but on being told that they could take him out on probation, or nominate another capable of doing so, they have not come to the rescue. I have no doubt an After-cure Association could have found a guardian for this patient, when during a period of probation his self-control could have been tested. Recovery in this case is not to be expected; but as private care is possible, and, as in private care the patient may be more contented (for we have tried in vain transferring from one mental hospital to another), one feels the lack of an association of persons genuinely interested to whom one would not have to appeal in vain on behalf of such a case. ... ~ , ~ , . Of course there must be failures—one-sixth of the admissions last year, one-third the year belore, were relapses—and the possibility of failure is assumed in the technical phrase " leave of absence on trial." . , . . , , . With an after-care Association at work, there would be a material increase m the number ot patients discharged unrecovered. I have again to combat the alleged increase of insanity in the colony : — The proportion of the male insane to the male population is,— New Zealand (exclusive of Maoris) ... .. ' 393 per 1,000, or lin 254 New Zealand (inclusive of Maoris) ... ... 3-77 „ lin 265 The proportion of the female insane to the female population, — Exclusive of Maoris ... ... ■■■ ■•• 303 „ lin 330 Inclusive of Maoris ... ... ... ■•■ 2-92 „ lin 342 The proportion of the total insane to the total population,— Exclusive of Maoris ... ... ... •• 3-51 „ lin 285 Inclusive of Maoris ... ... ... ••• 3-37 „ lin 296 These are disquieting figures as they stand, especially if we observe the gradual upward tendency during the past few years —say the previous five : — Total insane to estimated population— 1899. 1900. 1901. 1902. 1903. Exclusive of Maoris 1 in 296 288 286 286 284 Inclusive of Maoris 1 in 311 303 300 299 296 Further, it must be remembered that there is a more or less constant ratio of insane persons whose existence is unknown to the Department. A glance at Table IV. in the Appendix shows that 91 out of 580 of this year's admissions had been cared for privately for more than a year, and that practically only a half of the admissions were within three months of the onset of the malady. Some patients are of course never admitted into the mental hospitals, and some are admitted on a second attack

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for the first time. These facts demonstrate that a large number in last year's comparisons were wrongly counted as sane; and the like error obtains this year. If only for the sake of complete data, I trust that provision for notification will be made in the forthcoming Bill; but better reasons, especially when a patient is kept for profit, will occur to most. I will now, adding the figures for this year, give the proportion of insane to population during each quinquennial period since 1878, and, as a contrast, the proportion of admissions to population during the same periods. Also, to explain the rise in the one and the fall in the other, certain other returns are added. Proportion of the Insane to the. Population. (1876) ... ... ... ... ... lin 509 or 1-97 per 1,000. 1878 ... ... ... ... ... ~ 471 ~ 2-12 1883 ... ... ... ... ... ~ 393 ~ 2-54 1888 ... ... ... ... ... ~ 361 „ 2-77 1893 ... ... ... ... ... „ 330 „ 3-03 1898 ... ... ... ... ... ~ 300 „ 3-33 1903 ... ... .. ... ... „ 284 „ 3-53 1904 ... ... ... ... 285 „ 3-51 Proportion of Discharges and Deaths on Patients treated. 1878 ... ... ... 23-33 1898 ... ... ... 18-39 1883 ... ... ... 18-64 1903 ... ... ... 16-39 1888 ... ... ... 18-27 1904 ... ... ... 14-16 1893 ... ... ... 14-22 Proportion of Persons over Fifty Years of Age in Asylums. 1878 ... ... ... 17-03 1898 ... ... ... 38-35 1883 ... ... ... 2108 1903 ... ... ... 39-07 1888 ... ... .. 28-77 1904 ... ... ... 42-13 1893 ... ... ... 3609 Proportion of Admissions to Population. 1878 ... ... 0-83 per 1,000 I 1898 ... ... 0-63 per 1,000. 1883 ... ... 0-78 ~ . I 1903 ... ... 0-70 1888 ... ... 0-59 „ 1904 ... ... 0-68 1893 ... ... 0-68 Percentage of Admissions over Ffty Years of Age on Total Admissions. 1878 ... ... ... 13-26 1898 ... ... ... 25-61 1883 ... ... ... 16-50 1903 ... ... ... 31-27 1888 ... ... ... 21-60 1904 ... ... ... 26-20 1893 ... ... ... 27-97 I need not repeat the arguments of my last report, but draw attention to the confirmatory figures supplied by the year under review. These statistics in a great measure explain the paradox of an apparently alarming increase of insanity coexisting with a decrease in the ratio of persons becoming insane. The solatium notwithstanding, it is vain to deny that with our selected population, our general evenly distributed prosperity and less strenuous life, there is too high a proportion of mental disorder in the community. The intelligent consideration of this complex problem does not begin with —nay, it ends with —the establishment of mental hospitals, which are, in truth, the monuments of failure. It should begin with prophylaxis, and prophylaxis should begin before birth. It would be too great an interference with the liberty of the subject to forbid the marriage of unsuitable persons ; and to preach the doctrine of heredity and stress is to speak to the deaf ; but with a State insurance system (suggestive of that which obtains in Germany, though wider in scope), one may, on the principle that the issue of such unions may become chargeable to the State, fix a proportionately higher j premium, and thus enlighten the contracting parties by the most forceful of arguments. Prominence has been given recently to questions affecting infant death-rate, and the initiation of the training of midwives and maternity nurses to work among the humbler and the less infoimed, should be productive of incalculable good. They will be the missionaries of the gospel of proper feeding, of fresh air, and of cleanliness. The next important period is the school age. Of the highest importance to the future of the State is the physical and mental wellbeing of school-children. They should be scientifically classified according to their abilities and disabilities ; and when the time comes for such knowledge should be taught to intelligently understand why Nature is unmerciful when her laws are violated. Thereafter failure would not be so frequent, and would be the fault of the individual, not the State. All of which is summed up in the direct, simplicity of the old proverb, " Prevention is better than cure." At present it is cure we have to deal with, and to that end important changes" have been made since the date of the last report. The Orokonui Estate has been gazetted an auxiliary to the mental hospital at Seacliff. There are three houses on it available for patients. To one of these male epileptic patients, unfit to be discharged, but sensitive to the influence of environment, have been removed. The other two are in use for the first admission of male patients, after the manner of the reception-

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cottage at Seacliff for females. Cases that are obviously unfit are received in the first place at or are immediately transferred to the main hospital; but others will spend the whole of their time under treatment in the reception houses. This is a good beginning on proper lines. It is hoped that provision will be made for the admission of voluntary patients in order that the incipient stages of mental disorder may be treated by persons specially qualified. The hospital treatment of incipient insanity, which has been so much spoken of and written about in older countries, takes for granted the presence of one or more experienced alienists on the staff. In the colony, the necessary knowledge, experience, and practice is almost confined to the medical officers of mental hospitals, and hence it becomes obligatory to work the reception homes in conjunction with mental hospitals. It must be remembered that reception houses are associated with the main hospital only in the matter of the Medical Officer and staff, and that the arrangement will further allow of the easy interchange of patients, as will from time to time be necessary. Suitable imbeciles and idiots will be transferred from the mental hospitals to the institution for defectives near Nelson, which should be ready for occupation in September. This will be a blessing both to the feeble-minded and the general body of the insane. Shelters for the treatment of phthisical patients have been sanctioned for Avondale, and will, it is hoped, be gradually erected at the other hospitals. The shelter will serve a double purpose, for in the event of the introduction of infectious fevers they will be converted into isolation pavilions. It is doubtless a matter of supererogation to advocate open-air shelters at this date ; but, as being very instructive, I quote the following from a note on sanatoria for the insane by Dr. Urquhart : " . . . . between 1880 and 1897 there were only ten cases of phthisis .... On the 15th April, 1897, however, a very bad case of phthisis was admitted from another asylum. This patient was very dirty in his habits, and it was practically impossible to induce him to adopt the sanitary precautions which are held necessary. Thereafter six male patients developed phthisis . . . . " The time has come to deal with the question of the criminal insane. Twelve cases were admitted last year, and there are at present 85 such cases in the mental hospitals, distributed as follows :— Male. Female. Total. Auckland .. .. .. .. ..7 1 8 Christchureh .. .. .. .. .. 9 .. 9 Seacliff ~ .. .. .. ..25 6 31 Hokitika .. .. .. .'. ..11 1 12 Nelson .. .. .. .. 2 .. 2 Porirua .. .. .. .. ..7 1 8 Wellington .. .. .. .. ..13 2 15 74 U 85 Though many of these are not of a degenerate type, no arguments are necessary to prove that, as a class, it is undesirable that they should be associated with ordinary patients. I would urge the construction of a special block for such patients at one of the mental hospitals, or, better, the adaptation of a portion of one of the prisons for the purpose. Of course provision would have to be made for the transfer of the occasional suitable case to a mental hospital. It is in the first degree necessary, both for the public sentiment and the patients' well-being, that crime and insanity should not be associated. To this end I would urge that the Magistrate's examination of a patient should not be conducted within the precincts of a Court. It may in justice be urged that a Magistrate cannot visit the abode of every patient, but it could be possible to use some centrally placed room for the purpose, preferably at the general hospital of the district. The misapprehensions of a patient in regard to the customary procedure are difficult to eradicate —the idea of being tried suggests the idea of unjust punishment, retards recovery, and often leaves a feeling of bitter resentment in after-life. Recognising this, the English Commissioners in Lunacy pubhsh a sort of black hst of places in which, contrary to their expressed wish, the examination of insane persons is held in a building used for the administration of justice. With the beginning of this year, new regulations as to the pay and hours of the nursing staff came into force. The following is a precis : — Salary, Nurses .. .. .. £40 per annum with all allowances, and £5 yearly rises to £55. Charge nurses .. .. £60 per annum with all allowances, and £5 yearly rises to £70. Matrons .. .. .. Present maximum, £120 with allowances. Attendants .. .. .. £70 per annum with all allowances, and £5 yearly rises to £95. Charge attendants .. .. £100 per annum with all allowances, and £5 yearly rises to £120. Head attendants .. .. Present maximum, £145. Married attendants .. .. House allowance not exceeding £20. I would here indicate my strong approval of Dr. King's scheme for the housing of married attendants at Seacliff. It bears the mark of sturdy self-respecting individualism, has been taken up enthusiastically by the married attendants there, and should be studied by the men in the other hospitals.

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New][hours of duty : 6.30 a.m. to 5.30 p.m., and 6.30 a.m. to 8 p.m. on alternative days. Holidays : Annual, twenty-eight days ; week-days, one a fortnight; Sundays,|'alternate (after 1 p.m. on, say, the second Sunday, and the whole day on the fourth ; with provision for the half Sunday to be exchanged for a whole week-day). The staff is to be examined at the end of 1907, and each year thereafter on their special work, when a Register of Qualified Mental Nurses will be instituted. The generosity of the new regulations has been spontaneously acknowledged by many, and the staffs are working harmoniously. The cost per caput per annum to maintain the patients was £29 15s. 4d. From the farm, garden, and other industries £1 13s. Ofd. of this was refunded. On account of payments for patients £6 2s. 3|d. was received. This last amount, considerably short of the cost of maintenance though it be, speaks well for the painstaking work done by the hospital clerks who act as receivers. The difficulty they have in collecting the payments is incredible. The statements made by persons liable to support an insane relation under the Destitute Persons Act frequently bear the imprint of evasion. Going over a set of maintenance papers recently we jotted down the alleged circumstances of twenty-five such persons, and found that their average income worked out at £1 ss. 9d. a week for the support of 3|- persons, exclusive of the patient! The following is a statement of the financial results of the year and comparisons with former years:— Financial Results op the Year. The following table gives the gross and net cost per patient for the year 1904, as compared with the previous year : —

The following shows the annual cost per patient from 1876 to 1904 :—

The receipts from produce, &c., sold from the asylum farms are as follows :— £ r. d. Auckland ... ... ... ... ... ... 589 12 2 Christchureh ... ... ... ... ... ... 1,323 0 4 Seacliff ... ... ... ... ... • ... ... 1,245 3 6 Hokitika ... ... ... ... ... ... 68 2 11 Nelson ... ... ... ... ... ... ... 168 19 7 Porirua ... ... ... ... ... ... ... 657 8 6 Wellington ... ... ... ... ... ... 166 0 6 Total ... ... ... ... ... £4,218 7 6

191 14. KB. 1904. 1904. Asylum. Total Cost per Patient, less Receipts for Maintenance, Sales of Produce, &e. Total Cost per Patient, less Receipts for Maintenance, Sales of Produce, &0. Total Cost per Patient. Total Cost per Patient. Decrease. Increase. Auckland Christchurch ... Seaclifi' Hokitika Nelson Porirua Wellington £ s. d. 25 6 10£ 29 4 Hi 32 6 6 26 3 11| 33 11 2i 29 8 9 35 2 3i £ s. d. 17 16 11| 20 9 3* 22 16 2f 21 3 8i 26 16 2| 23 14 7| 26 7 llf £ s. 24 4 29 17 32 19 29 0 34 18 30 1 32 8 d. 5i 8f 8 6f 9 1* £ s. 17 0 21 11 21 7 27 2 29 10 24 7 23 18 d. 2 if 6 Si £ s. d. 0 16 9i £ s. d. 1 2" 3f 1 9" 1 5 18 9f 2 14 1 0 12 llf 2 9" 8| Averages ... 29 15 4 21 19 114 30 0 1* 22 1 Of 0 1 1*

Year. Cost per Patient. Year. Cost per Patient. Year. Cost per Patient. 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 £ s. d. 46 1 5i 37 8 11* 36 0 11 31 5 9f 28 18 0i 25 18 4* 28 15 1 29 0 4 29 8 9i 25 19 5 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 £ s. 27 0 22 18 21 8 21 10 20 10 20 16 21 16 23 7 23 16 22 13 d. 9* H 1 4 3 2i 8f 4 H 84 1896 1897 1898 1899 1900 1901 1902 1903 1904 £ s. d. 22 9 10* 23 0 9i 22 7 8f 21 19 0 22 9 8 21 17 9i 23 11 5f 23 1 5 23 0 Hi

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Some'general facts have to be understood to explain the variations in cost. First, smaller hospitals expensive than larger because the salaries of higher officers (practically the same in either case) distributed over fewer patients work out more per caput. The ordinary staff is of necessity relatively more numerous. This latter is an important factor in the cost of institutions with many auxiliary buildings, like Seacliff. Cost of provisions is higher in Hokitika, Wellington, and Nelson. Farm-returns vary according to the quality of the soil and the amount of land available for cultivation. The maintenance-increase in Wellington is due to the increase in salaries and prices of provisions ; in Seacliff it is due to falling-off in repayments, for the actual cost has been reduced. The decrease at Hokitika is explained by the large increase the previous year for bedding and clothing of the patients thither transferred from Sunnyside, plus the larger amount received for maintenance during the year under review. At Nelson there has been a large increase in the repayments, and at Christchureh the decrease is divided between a reduction in total cost and an increase in repayments. At Porirua there has been a decrease in the general cost. At Auckland an increase in miscellaneous expenses. The figures here are based on Table XXI. in the appendix, and are therefore exclusive of the items under Table XX. Nor is there any allowance made for interest on capital, or, in other words, no rent is charged. The following works have been undertaken since the date of the last report: — Auckland. Extensive alterations and additions ; converting old laundry into dormitories, and furnishing same for females ; painting hospital wing ; extra accommodation now being provided for 105 males. Orders have been issued for a park to replace airing-court (male), similar to that on female side. Tenders will shortly be invited for the erection of a building for the treatment of suitable recent and recoverable cases —in other words, for a reception-house. Wellington. Nothing material: repairs, renovations, painting, &c. Porirua. Erecting, furnishing, and'fitting up auxiliary building, in which however, the day-room accommodation is insufficient in wet weather; erection of piggeries, food-store, fence, latrines, &c.; providing engine\and dynamo for electric lighting, and installing electric light and May-Otway's fire-alarms in auxiliary building ; additions to laundry and new machinery therefor ; formation of filter-bed and fencing off source of water-supply ; the properly jointed iron water-pipes laid bare, and the water thus placed beyond the remotely possible source of contamination from the septic-tank effluent percolating through the soil; meat-house placed out of the way from kitchen-court, and ventilated on the Ross's double-current system. Provision has been made upon the estimates for the erection of a reception-house. Nelson. Painting of bedrooms, construction of dam, erection of workshop and piggeries. Hokitika. Purchase of property adjoining, making a handsome and useful addition to our resources, also completing additions. Sunnyside. New auxiliary building, in which, however, the day-room accommodation is insufficient in wet weather ; Essex boiler, and radiators for heating same ; fire-extinguishing appliances ; erection of farm-manager's cottage ; repairs and renovations to North House ; towers being altered to take in new water-storage tanks. Provision has been made upon the estimates for the erection of a reception-house if a suitable building cannot be purchased adjacent to the mental hospital. Seaclipf. Erection of auxiliary farm buildings, and furnishing same ; additions to single rooms to accommodate thirty women ; shoring and underpinning north main buildings and rebuilding wall; repairing ceilings, dormitories, and day-rooms, female side ; new range with high-pressure boilers. The houses at Orokonui have been put in order for their new occupants. The epileptic pavilion will need a sittingroom. The Seacliff Auxiliary adds greatly to our accommodation (fifty patients) and resources ; but to provide day-room space for excited male patients at the main hospital will mean using dormitory now occupied by twenty-six. At this date there are six male patients in excess of accommodation and nine vacant beds for females, taking all the mental hospitals. The additions in progress at Avondale, the acquisition of the Home for the Feeble-minded at Richmond, near Nelson, and the reception-houses contemplated at Avondale, Porirua, and Sunnyside will add both to our accommodation and means of classification. The outbreak of enteric fever at Porirua and Avondale is much to be regretted, but happily the trouble is over. Its advent remains as inexplicable as its departure, for beyond excluding the sanitary fittings in and about the hospitals and the water-supply, we are no nearer a solution. At Porirua, as a result of frequent visits of the officers of this and the Public Health Department, and of consultations on the spot with Dr. Hassell and yourself, works were immediately carried out dealing with matters which may have had some remotely possible connection with the outbreak. These works (vide statement of works undertaken) were put in hand more in a spirit of not leaving a stone unturned than under conviction of their absolute necessity. When it is remembered that the pressure

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of water in the pipes is 100 lb. to the square inch, the theory of the filtered effluent from the septic tank penetrating the pipes against this pressure may, while affording subject for argument, when reduced to facts be regarded as practically impossible. At Avondale, the theory of the drain broken into in laying foundations for new buildings cannot be credited, because it was an old storm-water channel, and, as at Porirua, the storm-water and sewerage systems are separate. Dr. Roberton (whose advice and co-operation Dr. Barraclough has had), myself, and the Public Works Department's engineer have carefully examined the source of the water-supply and found it free from contamination. To complete our observations, I have asked for a geological survey to be undertaken by Dr. Bell. At Porirua there were eleven cases in all —six women and two men patients, and two nurses and an attendant. Two of the women died ; but fortunately in neither case was the prognosis as to mental condition good. A very sad event was the death of the attendant, who was much respected and esteemed. At Avondale there were nine cases, all male patients, with two deaths. In neither case was the prognosis good with regard to mental condition. The resignation of Dr. Levinge after long and faithful service is an epoch-marking event. Only those whose memory takes them back to the time when he was appointed to Sunnyside can appreciate the full worth of his services to the State. He is succeeded in office by Dr. Gow from Mount View. The vacancy caused by the resignation of Mr. Morrison in the office of Superintendent of the Mental Hospital at Nelson has been filled by Mr. Chapman from Sunnyside. Mr. Chapman's enthusiasm and kindliness will be appreciated in his new sphere of usefulness. During Dr. Beattie's absence on leave Dr. Barraclough has been officiating at Avondale. He is entitled to the credit of managing the institution under most trying circumstances connected with the extensive alterations and additions in progress, entailing the employment of temporary kitchens and the like. This state of affairs means on the part of the Superintendent constant watchfulness and powers of reorganization to meet the varying conditions. Dr. Truby King was granted six months' sick-leave, and we were pleased to welcome him back restored to health. The reception house and estate at Orokonui have been added to his charge, and could not be in better organizing hands. Dr. Crosby, whose work as Acting-Superintendent at Seacliff met with the entire approval of the Department, is now at Mount View. D. MacGregor, Inspector-General.

ENTRIES OF VISITS BY THE INSPECTOR-GENERAL TO THE VARIOUS MENTAL HOSPITALS.

Auckland Mental Hospital. 11th September, 1904.- -I have seen all the patients, examined all the buildings, was present at dinner twice, timed the distribution, tested the quality, quantity, and cooking of the food •supplied, investigated the sufficiency and comfort of clothing, boots, beds, &c, and found everything in order and good. The patients and attendants expressed themselves satisfied. In some instances sufficient care was not taken to see that the flannels, &c, were properly fitted and buttoned. Four females and four males confined to bed, and receiving every care and attention. Twenty-five males and forty-eight women wet or dirty. There are no bedsores. Four women were restrained at different times, and for sufficient reasons, as shown by the book kept for that purpose. The number of patients out on trial was six men and five women. Two male attendants and six nurses were engaged since last visit to replace two men who left to better themselves. Three of the six nurses left to join the Hospital staff, and two to be married. One nurse who was suspended for a month for striking a patient did not return, and was therefore dismissed. I was anxious to satisfy myself how things were going on in Dr. Beattie's absence on leave, in the hands of Dr. Barraclough and Dr. McKelvie. A good spirit pervades the staff, and I find the institution working well. A contract has been let to provide for the overcrowding on the male side. The new buildings on the female side have removed the pressure there. A great deal of painting has to be done, especially on the male side. I have instructed Dr. Barraclough to requisition for the necessary authority, specifying the money required. After careful consideration and inquiry, I think if the attendants received a rise of wages and another clear day a month they would be content with the present clear month's holiday, seeing the great difficulties in the way of reducing the excessively long hours at present unavoidable. 12th June, 1905. —This Hospital was inspected and found in good order in all its departments. It has been a task of very great difficulty that Dr. Barraclough had to face during the building operations that have been going on so long. It is hard to realise the confusion and embarassment implied in having to work an institution like this with an extemporised kitchen and the other offices attached thereto, and I desire to record my profound thankfulness to Dr. Barraclough and his staff for the wonderful way they have overcome these inevitable difficulties. The new buildings will in about two months be ready for occupation, and the relief will be verygreat. No Medical Superintendent within my experience has been called on to face such a task as Dr. Barraclough has successfully got through while acting as substitute for Dr. Beattie. Dr. McKelvie also is to be congratulated on the loyal way in which he worked in such difficult circumstances. I found the patients all suitably and warmly clad in this inclement weather. Their food and bedding are ample, and when the new buildings are available their comforts in many ways can be increased in a way that has not hitherto been possible at this Hospital. The number of patients in the Hospital is—males 354, females 227 ; eight males and eight females are out

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on trial; eight males and twelve females were confined to bed. There were no patients suffering from bedsores. There were no serious accidents or casualties. Since last inspection six males and nine females are shown by the restraint register as having to be restrained, mostly to prevent them from injuring themselves or others. Messrs. Ewington and Lawson call attention to this matter in the case of two women. I have inquired into it, and find that one of the women so restrained nearly killed the Matron, and the other tore the bandages off an ulcer. The number of patients discharged since last inspection was fifteen males and seven females. Nineteen males and five females have died. Thirteen males and sixteen females have been admitted to trial. Mr. Ewington continues his unwearied vigilance in all matters affecting the patients' and attendants' wellfare. I am glad to see that Mr. Lawson has been appointed as his colleague. The outbreak of sporadic typhoid which unfortunately prevailed for some time has not up to the present been satisfactorily accounted for. The explanation hazarded by Dr. Barraclough is to my mind inadequate, and I wish to say that I absolve him from any blame or neglect in this matter. ■ The care and attention with which the patients—the seven persons at first affected, and the two in the second attack —were nursed deserve commendation. Christchurch Mental Hospital. 13th August, 1904.-—To-day and yesterday I was engaged in inspecting this Hospital. I find everything going on in the satisfactory way which 1 have been used to see for so many years. _ In all essential respects nothing could be better than the administration of this institution, provided only separate accommodation were available for cases requiring hospital treatment, for imbeciles, idiots and epileptics, and for the separation of criminal lunatics. Usually this last class are capable only of amelioration, and it would be a great boon if one of our gaols were adapted for their treatment. This day the number of male patients is 285, and of females 242: total, 527. Two females and three males are under restraint. The unusual number of twenty-one are confined to bed, chiefly old heart cases and feverish colds; all are being carefully attended to. Dr. Crosby, who did his work so well as assistant medical officer here, has been promoted to take charge of Seacliff during Dr. Truby King's absence through illness. Dr. Campbell has taken his place till Dr Crosby's'return. The farm and gardens are in first-rate order. 25th February, 1905—This Hospital has been carefully inspected and found in excellent order in all its departments. The patients are well cared for in all respects as regards their food, their bedding and clothing; I found nothing to find fault with. Order and cleanliness are everywhere, and the untiring energy and care so characteristic of Dr. Levinge are reflected in every part of the institution. His successor will find it hard to maintain the high level to which this Hospital has been raised by him. Seacliff Mental Hospital. 17th August 1904—1 visited this Hospital at an unusual time to see how things were going on during Dr King's absence on sick-leave. Dr. Crosby has had a long and varied experience of dealing with the mentally diseased, and his knowledge of and faculty for administration were well known to me before his taking up such a responsible position as Acting-Superintendent of Seacliff I find he has taken a firm grasp of his various duties, and is eminently successful m his management of the patients, the staff, and the institution as a whole. I have discussed with him the recent and convalescent cases especially, and found that great care and attention are devoted to their varying necessities. A good spirit pervades the staff. The appointment of a lady medical assistant as a trial was resolved on, and Miss Baker, M.8., has been appointed It will be interesting to see how this progressive step results The male patients to-day are 434 femalVs 257- total, 691. I examined all the clothing, bedding, boots, &c., and found them suitable except that the boots do not wear as well as formerly, and special instructions have been Jiven to particularly watch the quality of these articles for the future, and if need be an expert will be called in to examine and compare them with the samples. The linoleum on both side of he building is worn out, and there is urgent necessity for laying down new material to replace it A good deal of painting requires to be done in the mam building, and two coats are required to paint the outside of Hie Simla auxiliary, as well as two or three of the rooms The IZ othis latter work will be about £70. There are sixty-nine patients over the statutory .commodation Thirty-six men of this number will be provided for shortly m the new building nearTe farmsteading. ' The new single rooms on the female side will give accommodation for thirtysfx pa Lnts As yef only the timber is ready. The need for a decent day-room for the male attendants_ I have so often pointed out, is urgent. The farming operations are well advanced, b t the roLds are in a worse state than I have ever seen them in, mainly owing to_ the loss of the "team crusher ail the time it was required at Waitati. I leave quite satisfied this institution will be Hospital is working very harmoniously. The "umber of patients . *oo i ' /orß fpmnles Three males and four females are confined to bed. There to-day is 433 males and farm, 104 men ; in garden and out of doors, are no bedsores in the Working on the J*™' Th cow§ a „ of the best lit 75 men and I*9o dozen a week of the best eggs, of which the of Ayrshire,,. is great demand for poultry and pigs, and a good Dunedin Hospital takes fi f > dczen , sold for £16; twenty-four pigs were sold in the same profit is made Last month 112 fowl. wey soldf Qf tune for £22 18i. 3d. and the W™™? lied to the amount of lj9 oolb. free to the has bf?.^* l^^ !££_ttri Dunedin Hospital, and Sunnyside. The average price of our Industrial School C^OT^ m > ( ; un , d UnC S; +he substitution of fi sh a saving of £30 a month is at b«J to the patients. Here, as in all our mental Hospitals,

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diversification of useful employment is held to be our greatest therapeutic agent, and I believe its efficacy is being utilised to the utmost at Seacliff. Our chief want at present is a refitted laundry. Our machinery is worn out, and the inconvenience is very great. The money paid for washing in Dunedin would pay interest on £1,200, and the work is not so satisfactorily done as it could be on the spot.* For No. 2 male-ward day-room accommodation is very badly needed, and we have long been waiting for authority to proceed with the alteration required in the windows in front and the building projected at the south-east end over part of the large male airing-court. The new auxiliary to accommodate thirty-six patients is now ready for occupation, and will greatly relieve the overcrowding. Dr. Crosby conducted this Hospital in a very satisfactory manner, and has well earned promotion in the Department. The place of assistant has been filled by Dr. Brett, who was lately chosen by the Agent-General to come out to Seacliff. Hokitika Mental Hospital. 28th November, 1904. —I have examined the whole of this Hospital, with special reference to the results of the change of administration which has recently taken place owing to the retirement of Mr. Gribben, whose firm yet beneficient and kindly rule has for so many years made this institution a credit to Westland. After over thirty years' service Mr. Gribben was retired at his own request. For faithfulness and ability in his work his equal will be hard to find, and Mrs. Gribben, the Matron, was a helpmate worthy of such a husband. Mr and Mrs. Downey, who have succeeded Mr. and Mrs. Gribben, are inspired by a high and honourable motive in their ambition to emulate their admirable predecessors, and only time can enable me to measure their success. I saw and examined all the patients, and found everything in satisfactory order. Nelson Mental Hospital. 3rd December, 1904.—This Hospital has been placed under the charge of Mr. George Chapman, who for many years has been head attendant at Sunnyside. He is therefore a man of long experience in dealing" with the insane, and, besides that, a firm but kindly administrator. I have the utmost confidence that the Nelson Mental Hospital will in his hands continue to prosper and improve. In my inspection to-day I approve of a great many suggestions, which seem to me valuable, and I have no doubt the" Minister will grant his sanction for carrying them out. The Matron, Miss Tibbie, and the head attendant, Mr. McLean, deserve my heartiest thanks for the efficient services they have rendered during the period of transition. The male airing-court in the rear of the building ought to be laid afresh, and a new floor laid in the corridor. A new dining-room can be provided on the male side, and a large bow window provided about the middle of the right wing, which would greatly improve the lighting of the whole day-room. The buildingneeds painting throughout, and I hope a vote will be taken for this purpose next year. I anticipate many improvements from Mr. Chapman's administration, and I have reason to believe that the Minister is thoroughly determined that nothing will be neglected which he is convinced will be for the good of the patients and attendants. The lack of a good farm is a great drawback to this institution, and I hope that no pains will be spared to utilise what land we have to the best advantage. A good spirit animates the staff, and I find the institution as a whole in good working-order. Owing to the high proportion of aged and infirm patients, there is not the same amount of labour available as in some of our other institutions, and there is no doubt that the greatest care will be taken to utilise what there is to the best advantage. To-day there are eighty men and fifty-six women. Two men are in bed, one suffering from the effects of a perineal abscess, which is being carefully attended to by Dr. Bett. Only one woman confined to bed. One woman is wearing canvas gloves to prevent her from injuring herself. Porirua Mental Hospital. 31st January 1905.—1 made a careful inspection to-day of the alleged inperfections of our sewage and drainage systems. In deference to criticism, the Public Works Department have opened the whole track of the main water-pipe, so that as far as the main building is concerned there cannot be any question entertained of its being a possible source of contamination of our water-supply The same simple remedy which has so easily rectified this objection to the supply of the main'building can be equally applied to the auxiliary. There remains, however, a simpler remedy still for any lingering doubt—namely, to cut off the supply of the main building, at any rate from any possible contact with the sewage area by limiting the two small and insignificant corners affected, and confining the sewage within the line of the water-pipes. As for the pipe to the auxiliary, it could be run along the surface, resting on and protected by a concrete channe . A model has been designed for testing the question as to whether organisms can penetrate welliointed pines under such a heavy pressure as 1001b. Apart from this possibility, no cause lias oeen discovered for the unfortunate outbreak of typhoid by which the Hospital was visited. Ihis Mental Hospital is this day in excellent order. . 6th Tuiv 1905 —I find this Hospital working well in all its departments. A good spirit seems to animate the whole staff. The quantity and quality of the food body-clothing beds and bedding are all good and suitable. The patients are carefully attended to by Dr Hasse 1 and his atsistent Dr. Johnston. The total number of patients is 592-324 males and 268 females Five males and twelve females are out on trial; nine males and five females were confined to bed all of whom I visited and examined. I also saw all the recent-cases, and inquired into the causation of their trouble There are no bedsores in the institution, nor has there been any case of restraint for a considerable time. The unfortunate outbreak of typhoid has passed away, and notwithtandinTall our inquiries, in which we were assisted by the officers of the Public Health Department no probable theory of its causation has been arrived at. The new extension of the laundry will be a great relief, but I regret that the building was not extended to meet the cross-walls jit

» A sum is plaoed upon this year's estimates to provide for up-to-date machinery.

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the end of the available space. No time ought to be lost in providing the day-room accommodation originally projected in connection with the new auxiliary building. The water-pipes which some persons thought were to blame for the outbreak of fever—to my mind, wrongly —have, by direction of the Minister, been made quite safe, and the catchment area securely fenced. The provision for properly constructed filter-beds for the drainage-settling tanks is being carried out at considerable cost. The cartage of metal and gravel for this purpose has cut up our roads to a dreadful extent during the recent bad weather, and has lost us the planting season till spring returns. It has not been possible, as I confidently hoped, to do anything towards properly laying out the grounds round the auxiliary. This gives a great handle to the kind of criticism with which this Mental Hospital has recently been assailed. The Official Visitors have been most assiduous in their care for the welfare both of the patients and staff. They have the fullest possible access to everybody and everything that concerns the interests of the patients, and have proved themselves frank critics of all that comes under their notice. One of our inmates has been the most difficult case to deal with I have ever met. He is an able and exceedingly plausible writer and speaker. He has been tried in three of our hospitals, and the result has always been the same. He is incurably insane, in my opinion, but has recurrent periods when to an ordinary observer he appears quite sane. His family and friends will have nothing to do with him. He has no property, and to let him go would, in my judgment, be quite, unjustifiable, except into the hands of some person who could be held responsible for the care of him. It is true that no person who is or appears to be sane while in the mental hospital ought to be detained ; but we have found by experience that here lies the most difficult of our problems. In circumstances such as ours we may make mistakes, but we do our best. In the mental hospital where every possible means is used to adjust the requisite control which supplements the diseased will of the patients, as well as the institutional environment as a whole, a man may appear to an ordinary observer to be sane, as legally regarded, so long as he is under control and in surroundings adjusted to his mental condition. Yet, let that control be once withdrawn, and let him be exposed to the full stress of the social struggle, without friends or any organization to shelter him, then to discharge him would be a criminal shirking of responsibility, and almost certain disaster would follow. I am proud to say that the Medical Superintendents and myself have no misgivings as to our duty in such cases. Wellington Mental Hospital. 30th January, 1905.—1 found this Hospital to-day working smoothly. The four male patients confined to bed and one female are all being properly treated. Two male patients refuse food, and are regularly fed by means of the tube. Seven of the patients require constant attention, being wet and dirty. Thirty-three are unfit for any kind of employment. All are properly clothed. I had for lunch a plate of the same soup as the patients got, and I never tasted better in my life. I heard no complaints from patients, except for want of liberty; and it was a great pleasure to me to find that the recent improvements authorised, as to higher wages and shorter hours, are received with universal satisfaction. Now, indeed, there is reasonable ground for hoping that the grievances in these respects, which of late years have been such a never-ending source of dissatisfaction, have been finally removed. These changes and the improved means of classification which we are gradually attaining, after much tribulation, are increasingly discernible, and are a cause of devout thankfulness to the responsible officers of the Department. The admissions to this Hospital have been for a considerable time suspended, all fresh cases being sent to Porirua. This will necessitate the consideration of statistical results here and at Porirua as a whole to get a view of the provincial results fairly. 4th July, 1905.—T0-day I have made an inspection of this Hospital, saw all the inmates, examined the'food, underclothing, &c, and the bedding, and found everything sufficient and of good quality. The female patients numbered 104, and the males 150: total, 254. I heard no complaints,"save of loss of liberty, for which nothing ever consoles. Three women are out on trial. One male was confined to bed. Two male patients were under restraint. Such cases should be relieved every day for some hours. I am satisfied that restraint is here used as sparingly as possible, and never except "when it is the least objectionable means of control, which in the patients' own interests is unavoidable. The only alternatives are the use of sedatives, which I have always disapproved, or to have three or even four attendants told off to secure control. This is often extremely undesirable and dangerous to the patients, as well as to the attendants. Besides all this, the cost of the increased staff which would be necessary if all restraint were abolished would be unjustifiable. Here our ordinary male attendants begin at £70; in England they get £30. There have been no accidents or casualties since the last inspection. Ten males and eight females were admitted. All these were seen and their conditions examined. Ten men and eight women were discharged, and three women were "let out on trial." Five attendants and three nurses were engaged since last visit. Four males and two females have resigned. None have been dismissed. Dr. Crosby has the institution thoroughly in hand, and lam satisfied that his rule will be at once both mild "and firm. A good spirit pervades the staff, and this mental hospital is in a satisfactory condition. A great deal of credit is due to Mr. Arnold, the Official Visitor, for his assiduous attention to everything that bears on the proper treatment of the patients. Ashburn Hall Licensed Mental Hospital 21st August, 1904.—Since my last visit this licensed mental hospital has been put under the charge of Di" E. H. Alexander. Dr. Alexander is well known to me as an able and experienced alienist 1 have the fullest confidence in him as Medical Superintendent of this institution. To-

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day I have examined every part of it, and I have seen all the patients, none of whom were in bed but one old lady, who was unable to be about. The greatest skill, care, and kindness are exercised in treating each case according to the regulations and pecularities of the individual. A beautiful cottage has been built for such male patients as require separate treatment. There is a cottage also on the estate for such females as would be benefited by separation from the others. The staff is efficient, the diet generous, and a remarkable quiet prevades the whole place. All the statutory books are in order. As a whole the institution is in a very satisfactory condition. 16th February, 1905.—This Hospital has been examined by me this day in ali its workings. 1 find all the patients are carefully and intelligently studied and treated. The diet is good and abundant; their bedrooms well furnished and ventilated. All the accessories to health are earnestly considered, and some of the patients made rapid recoveries. No one is improperly detained, and I can find only evidence of kindness on the part of the atendants. A lady doctor has recently joined the staff. Her experience in the same capacity at Seacliff, where her work was known to me, has fitted her specially for her duties here. The voluntary patients are a special feature of this institution, and the results are gratifying lam very pleased with the results of my examination.

MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Sir, — I have the honour to submit the following report on the Auckland Mental Hospital for the year 1904. At the beginning of the year there were 576 patients (364 males and 212 females) under care and treatment. On the 31st December there were 584 patients (363 males and 221 females) in the Hospital, being an increase of only eight on the year, entirely confined to the female patients. This is a very satisfactory result, especially the fact that there is one less male patient at the end of the year than at the beginning. It is always much more serious to have an increase of the " breadwinners " as patients than of the opposite sex, for various reasons. The death-rate for the year has been 7.56 per cent. The principal causes of death were: chronic brain-disease, 3 cases; epilepsy, 5 cases; general paralysis of the insane, 7 cases; pulmonary tuberculosis, 6 cases; senile decay, 7 cases. In reference to general paralysis, one cannot but note a steady, though slight, increase iv this absolutely hopeless form of mental disease. In regard to deaths from tuberculosis, it is too often supposed that this disease in mental hospitals is due to surroundings. It has to be remembered, however, that the tendencies to tuberculosis and mental disease often coexist; that nervous degeneration so weakens the resisting-power of the organism that tuberculosis is particularly prone to intervene in spite of all precautions, and that tuberculosis is sometimes a direct cause of insanity. I think, however, that the time has arrived when a small sanatorium for tuberculosis cases should be erected in connection with each mental hospital, on account of the undoubtedly infectious nature of the disease. There were admitted during the year 129 patients (seventy-seven males and fifty-two females). The most marked feature is the predominance of melancholia over any other one form of mental disease, this accounting for 30 per cent, of the total number of admissions. There is also a considerable increase of delusional cases, many of them, unfortunately, of an intractable nature, so far as complete and permanent lecovery is concerned. There were six general paralytics admitted during the year. The recovery rate reached the very high level of 55.81 per cent. This is the highest on record in this hospital. The causes for this high rate can only be assigned with difficulty. The more effective methods of treatment which have come into vogue of recent years have undoubtedly helped ; but we have also had to deal with, several transient cases of mental disease. It is pleasing to note that there is an increasing desire on the part of relatives to take their friends out on probation, thus insuring their discharge at an earlier date than would otherwise be the case. The causes of insanity in the cases admitted during the year form an interesting study. Unfortunately, in our present causation table we can only give the predominant cause, owing to being compelled to give one cause only. This makes the table very inaccurate, as all contributory factors are overlooked. This is the more to be regretted, as this is probably our most important table. Hereditary predisposition, for instance, in the table for this Hospital onlyshows eleven cases in the admissions, whereas there were in reality thirty-nine cases. If neurotic ancestry were allowed to rank in the hereditary field this total would be very much larger ; and, in fact, in the vast majority of cases there is some congenital weakness of will or intellect, rendering them susceptible to comparatively slight causes. The number of alcoholics admitted during the year was 15 per cent, of the whole, but in this connection a sharp distinction between chronic and acute cases should be drawn. The latter are not habitual drunkards, as are the former, but occasionally indulge in a "blind spree," resulting in a transient attack of insanity. Eleven senile cases were admitted, as they had nowhere else to go; but there is too great a tendency to look upon this Hospital as a dumping-ground for the mental and physical wrecks who could be easily accommodated with proper nursing in the benevolent institutions. There were four epileptics and four imbeciles admitted during the year. It is interesting to note that tohungaism is assigned as the cause in two female Maoris. In one case the whole family became insane, though only one was sent here.

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There has been of late a great cry for better accommodation of the insane, with which, in the main, 1 am in full accord. So far as this Hospital is concerned, classification has now reached its utmost limits, and, though by no means complete, could not be improved in the present building. One very great need, forming the foundation-stone of any successful system of classification, is a separate building for the reception of recent cases. In the early part of the year the conversion of the old laundry into a new female-wing was completed. This work has been most excellently done, entirely by our own labour, and has one large sitting-room and five dormitories, to accommodate seventy-one patients. This has completely removed the pressure on the female side. The new laundry, also built by ourselves, has been covered with a coat of cement outside, and has now a more finished appearance, and provides ample accommodation. There is, however, a need for laundry machinery, as with some seven thousand articles per week passing through it is self-evident that it is difficult to cope with the work entirely by hand. A proposal for a male-park, in lieu of the present inconvenient and barrack-like airing-court, has been laid before the Department, and when completed will prove a ver\' great boon. The new buildings, which were commenced in October, consist of extension of kitchen and dining-halls and an additional story, providing dormitory accommodation for 105 male patients. The work has caused great inconvenience to the working of the Hospital, as dormitories had to be used over the female side for dining-rooms, and stores, &c, had to be removed to the cellars. When completed, however, these additions will supply a long-felt need. Ample amusement in the shape of weekly entertainments was provided for the patients during the winter months. On Christmas Eve a Christmas tree was provided, when every patient who was in the least degree mentally fit was present The consequence was that in the main building only six female and eighteen male patients were absent. This is a very remarkable fact, and their good conduct was still more so. This would seem to form an argument in favour of a greater number of patients joining in the associated amusements, and when our male dining-hall has been enlarged we shall be able to take advantage of the means provided. The liberal increase of salary and leave for the attendant staff, which is to date from the Ist January, 1905, has given rise to a very great feeling of satisfaction, and will, I am sure, lead to greater contentment, and also to considerable extension, in individual length of service. The attendant staff has worked harmoniously, and I am particularly indebted to the attendants and nurses for the enthusiastic way in which they have laboured for the amusement and happiness of the patients, frequently giving up their leisure time for this purpose. The appointment of an assistant clerk on the Ist January will prove a great relief to the office, the work in which has long been too much for one man to satisfactorily accomplish. To the clerk, the head attendant, the farm-manager, and the Matron I have to offer sincere thanks for their loyal and unswerving support. To my colleague, Dr. McKelvey, I am greatly indebted for the devotion which he has shown to the best interests of the Hospital. His loyalty and absolute devotion to duty are worthy of the highest praise. I have, &c, Herbert Barraclough. The Inspector-General of Asylums, Wellington.

SEACLIFF MENTAL HOSPITAL. Sir,— .Seacliff, 27th March, 1905. I have the honour to forward herewith the annual statistics of the institution, and to submit the following report for the year 1904: — The number of patients admitted during the year viz., 105—is the lowest we have had for some years. There is no reason to regard this diminution as anything but accidental. The previous year's admissions —viz., 135 —were above the average, and it was to be expected that a low figure would follow in compensation. The discharges of patients relieved and recovered were 51, as against 66 during the previous year. Of the 786 patients who were cared for during the year, 51 died. It is interesting to note that of these only 14 were under fifty years of age, 8 were between fifty and sixty, 12 between sixty and seventy, 12 between seventy and eighty, and 5 were over eighty. The assigning of a particular cause for the insanity of each patient admitted is always extremely unsatisfactory, owing to the causation being practically always multiple. The necessity of selecting for purposes of statistical classification a single factor as the most prominent results in a somewhat arbitrary choice of causes, which varies greatly iv different institutions according to the weight attached by different individuals—firstly, to the parts played by heredity, period of life, and environment respectively ; and, secondly, to the subdivisions of these. In the list submitted I have set down " heredity "as the cause only in cases where that factor was known to be very marked ; but it should be noted that distinct hereditary tendency was known to exist in the cases of five males and four females where I have assigned some other cause as the most prominent. Inclusive of these, the total of known hereditary cases is brought up to thirty-five out of 105 patients admitted. There were, besides, fourteen congenital cases in which evidences of hereditywere not obtainable, and four cases with a family tendency to tuberculosis. Though the latter tendency alone scarcely warrants the assertion of a family predisposition to insanity, yet, being known to be accompanied by an increased liability to nervous breakdown, it should be taken into

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account. Unfortunately, there are many cases in which for various reasons either no family history can be obtained, or, when obtained, is unreliable and of little value. Important additions have been made to the sleeping accommodation at Seacliff, both for males and females, and this extra space, taken in conjunction with the accommodation provided at Orokonui, will relieve the previous congestion at night. What we most need now is a larger number of single bedrooms and more day-room space. The laundry is quite inadequate, and I trust that we shall be authorised to procure the necessary machinery as soon as possible. This is our most pressing want. The steady development of the resources of the estate continues. The garden provides a good supply of fruit, vegetables, <fee, and the following summary of returns from the farm shows how important an accessory this is to the institution, apart altogether from the fact of the healthy outlet it provides for the employment of the patients. Summary of Returns from the Farm for 1901). Dairy— £ s. d. & s. d. Butter, 13,727 lb., at ls. ... ... ... 686 7 0 New milk, 14,266 gals., at sd. ... ... 297 4 2 Skim milk, 33,580 gals., at |d. ... "... 69 19 2 Cream, 2,006 pints, at 6d. ... ... ... 50 3 0 1,103 13 4 Poultry — Eggs for setting and eating, 11,746 doz. ... 633 19 11 Poultry, 1,676 fowls ... ... ... 242 7 5 876 7 4 Cattle, sheep, and pigs— Beef, 12,0601b., at 2fd. ... ... ... 138 3 7 Mutton, 4,6381b., at 2fd. .. ... ... 53 210 Tongues, tripe, &c. ... ... ... 11 13 4 Pork, 7,5221b., at sd. ... ... ... 156 14 2 Pigs, 389 sold ... ... ... ... 435 1 4 Cattle, &c, sold ... ... ... ... 69 6 3 Hides, wool, tallow, &c, sold ... ... 135 14 10 999 16 4 Miscellaneous — Potatoes, 88 tons, at £2 10s. ... ... 220 0 0 Firewood and piles ... ... ... 142 1 8 Broken metal ... ... ... ... 264 19 9 Sundries ... ... ... ... 67 7 0 694 8 7 Total ... ... ... ... ... £3,674 5 7 In addition, the farm should be credited with over four hundred pounds' worth of carting. Haulage is now a specially heavy item, owing to the increased coal-supply needed for electric lighting. The fish received from the Karitane fishing-station during the year totalled 75,348 lb. About half of this has been used at Seacliff, and the balance has been sent without charge to various public institutions in Otago and Canterbury. The provision of an oil-engine for the fishing-boat promises to double the supply in future, and if we had a small refrigerating plant there would be no difficulty in providing fish dinners twice a week throughout the year. During the year my health broke down, and I acknowledge gratefully the considerate way in which the authorities relieved me of the responsibilities of my position, and granted me six months' leave of absence. To my former colleague, Dr. Edward Alexander, and to Dr. Arthur Crosby, who each in turn conducted the Hospital, I wish to convey my sincere thanks, both for their devotion to the institution and their services to myself personally. I have also to acknowledge the help of Dr. Eleanor Baker, who acted as assistant medical officer, and wish to convey to her and the other members of the staff my appreciation of their services. The thanks of the authorities are due to the Otago Daily Times and Witness Company and to the Evening Star Company for copies of their journals supplied free, and to private donors of books, periodicals, and other presents. I have, &c, F. Trcby King, The Inspector-General of Asylums, Wellington. Medical Superintendent.

PORIRUA MENTAL HOSPITAL. g 1B) _ Porirua, 29th May, 1905. I have the honour to submit the following report on the Porirua Hospital for Mental diseases for the year 1904. At the beginning of the year there were 572 inmates, and at the end 592, while 20 others were absent on trial. The average number resident was 580 (323 males and 257 females), and the total number under care 709. Of the 128 cases admitted, 57 males and 42 females were admitted for the first time, 10 males and 15 females were readmitted, while 3 males and 1 female were transferred from other mental hospitals. Fifty-two patients w6?e discharged recovered, 5 relieved,

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and 3 not improved were transferred elsewhere. The proportion of recoveries to the number admitted was slightly over 40 per ecnt. Thirty-seven patients died, making a death-rate of 63.8 per thousand on the average number resident. I have to record two epidemics which unfortunately visited the institution during the year. In the autumn and early winter a number of cases of influenza occurred. Altogether there were upwards of sixty cases, chiefly on the male side. A large proportion were of a severe type, and complications were not uncommon. In several, signs of pulmonary phthisis were developed; one had a severe attack of pneumonia, others bronchitis, cardiac symptoms, or disturbances affecting the alimentary canal. Two severe cases simulated typhoid fever, but they did not react to Widal's test, which the Pathological Department was good enough to carry out for us. Two cases terminated fatally--one from colitis, the other, who was an old man, from heart-failure after a few days' illness. Altogether eight attendants and four nurses were affected by influenza, and although no complications arose in their cases, convalescense was mostly protracted, and their absence from duty was most embarrassing to the efficient working of the Hospital. We had hardly got rid of the influenza epidemic when typhoid fever made its appearance. A series of cases, twelve in all, of whom three were attendants. Two of the female patients died — one old, the other young; both succumbed to toxaemia. It is very probable that the attendants acquired the disease from contact with the patients whom they were nursing. Unfortunately, one of them —attendant Robert H. Johnstone —died on the 17th November. Every case was isolated as soon as the diagnosis was made, and all other precautions were taken against the spread of the epidemic. It was remarkable that the cases developed here and there throughout the institution — sometimes in the male and sometimes in the female wards. It was evident that the cause of the epidemic could not be focused on any defective sanitary arrangement within the building. Careful inspections were made. The Chief Health Officer and others were so good as to assist in the investigation. The fact that cases occurred in which there was no possible contact with previous cases was sufficient proof that the cause of the epidemic was to be found in some widespread origin of general application. Possibly it, W&s due to some contamination of the water or food supply. No fault could be found with the milk or its handling. Our dairy arrangements were allowed to be a model of cleanliness. All the milk is pasteurised, the cream separated, and the butter made by machinery, while all utensils are efficiently scalded. In regard to the water-supply, there was a remotely possible cause of contamination, inasmuch as the 8 in. water-main traversed the vege-table-garden in ground which had been from time to time under irrigation by the effluent from the septic sewage-tank. However, as the pressure within the main has continuously registered 701b. to 1001b. to the square inch, it seems very unlikely that the Bacillus typhosus could anywhere work its way into the water-main (say, through an imperfect joint) against so great a force. Nevertheless, in order to eliminate this possible source of danger, the ground has been cut away and the water-main tarred and supported on concrete blocks, so that now it practically runs above "•round through the garden. Whether or not our water-supply could have been contaminated in the way just suggested is an interesting problem, which is about to be investigated by the Pathologicaf Department, to whom I have supplied an apparatus constructed by our chief engineer, and so designed as to enable experiments to be made under conditions closely approximating those we had here. The day-room in connection with the new auxiliary building was completed and ready for occupation last spring, and this enabled us to accommodate twenty more patients in the institution. Before the year ended we opened the cricketing oval, on which we have expended so much time and labour! It forms a pleasing feature in the outlook from the front of the main building, and is greatly appreciated by the patients, many of whom took a keen interest in the cricketmatches and other sports held during the past season. Mv colleague, Dr. Barraclough, left in August to act as Medical Superintendent of the Auckland Mental Hospital for twelve months, and Dr. Johnston was appointed to fill his place. To both I have to acknowledge my appreciation of their valuable co-operation. The other officers and members of the staff have carried out their duties harmoniously and well. I have, Sec., Gray Hassell, The Inspector-General of Asylums, Wellington. Medical Superintendent.

WELLINGTON MENTAL HOSPITAL. I have the honour herewith to submit the annual report and statistics for this Hospital for the year ending the 31st December, 1904. ... As I pointed out to you on your last visit here, the statistics as regards admissions, recoveries, and deaths are of little value in calculating the incidence and amount of insanity in the district, as owing to the Hospital being over-full, orders were given for all Wellington cases to be sent to Porirua, so that to get the actual state of affairs the statistics of the two places ought to be cornThere has been a large decrease in admissions of females, only 16 being admitted, as compared with 45 last year. The admissions on the male side show less difference—44, as compared with 47 last year. , . „ There have been 24 males and 20 females discharged recovered-that is, a recovery-rate ot over 50 per cent on the male side, but on the female side the rate is 125 per cent., which shows that statistics are not always reliable; as a matter of fact, it works out to be that we have had about eighteen months for patients to recover in and less than six months' admissions to calculate from.

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The death-rate has increased. Of the 22 deaths, 13 had been in less than one year, and 5 were old people who had been over twelve years. These numbers show that the general health of the patients was good, but that the state on admission of the recent cases was very poor. This is partly accounted for by the fact that although we were not admitting from Wellington, yet at times cases were sent here because they were too weak to stand the journey to Porirua, so that we got the weaklings and did not get the robust as a set-off. The numbers are slightly in excess on the female side, but the male side at present is very comfortable, and there is room for a few more patients. The chief want at present is some addition to the laundry in the way of washing machinery, as owing to the non-admission of females our number available for washing, &c, is running down, and the whole female side will soon be reduced to a home for the old and feeble or the refractory, from whom no assistance can be looked for. In fact, at present, on two days in the week a body of male patients have to be taken from the ordinary work to help with the washing of heavy clothes. I feel compelled to again bring before your notice the fire risk here, and would urge that dividing-walls be erected to hold a fire, should one unfortunately occur, in check even for a few minutes whilst the doors are being opened to allow the inmates a chance of escape. A feature which has been very prominent this year is the difficulty of getting rid of some of the patients who cannot be certified as sane, but who might be allowed out on trial. I find that some of their relatives or friends are often very unwilling to help us in this, and it would perhaps be a good thing if some arrangement could be made somewhat analgous to the Scotch boarding-out system, and the relatives charged with the maintenance of the patients as long as they are on probation. During the summer a cricket club was started, and has been a means of recreation both for the patients and attendants. By the courtesy of Mr. Firth, of the Wellington College, a pitch has been procured in a gully on the hill, and it is my intention to level sufficient to provide a good ground for next season. The new regulations respecting the hours of work»and the salaries of the staff have been greatly appreciated, and I look forward to a time of more contentment and fewer changes in the staff, which will have a most beneficient effect on the patients, as a discontented constantly changing staff cannot but be expected to react unfavourably on those under their charge. I regret to mention the loss of Mr. France, who for twenty-five years carried out faithfully and well the duties of carpenter here Mr. France retired from the service on the last day of the year, and on the following day was struck down with apoplexy, from which he never recovered. To my colleague, Dr. Ulrich, and to the members of the staff, male and female, I have to tender my thanks for a year of good work done under most pleasant and cordial relations. I have, <vc, The Inspector-General of Asylums, Wellington. W. Baxter Gow, M.D.

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APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1904.

Table II-Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, &c., per Cent. on the Admissions, &c., during the Year 1904.

M. F. T. M. F. T. 1,771 1,188 2,959 In Mental Hospitals, 1st January, 1904 Admitted for the first time Readmitted 284 56 191 49 475 105 I 340 240 580 Total under care during the year Discharged and removed — Recovered Relieved Not improved Died 157 24 9 120 106 13 2 70 263 37 11 190 2,111 1,428 3,539 310 191 501 Remaining in asylums, 31st December, 1904.. 1,801 1,237 3,038 Increase over 31st December, 1903 80 49 79 Average number resident during the year 1,780 1,198 2,978

Admissions in Total Number of Patients under Care. Asylums. In Asylums on 1st January, 1904. Admitted for the First Time. Beadmitted. Total. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson Porirua Wellington Ashburn Hall (private asylum) M. F. T. M. 364 212 576 66 271 233 504 ! 49 428 253 681 54 130 41 171 17 88 56 144 4 328 253 581 ' 57 142 120 262 34 20 20 40 i 3 F. T. M. 48 114 11 29 78 ! 16 33 87 6 8 25 .. 8 12 j .. 42 99 i 13 12 46 10 11 14 ! .. F. 4 12 12 16 4 1 T. ' M. F. T. M. 15 I 77 52 129 441 28 : 65 41 106 j 336 18 60 45 105 i 488 .. I 17 8 25 ! 147 ..| 4 8 12 92 29 I 70 58 128 I 398 14 j 44 16 60 186 1 3 12 18 23 F. 264 274 298 49 64 311 136 32 T. 705 610 786 196 156 709 322 55 Totals .. 1,771 1,188 2,959 j 284 191 475 j 56 49 105 j 340 240 580 j 2,111 1,428 3,539 Table II. — continued. Patients Discharged and Died. In Mental Hospitals on the Slst December, 1904. Asylums. Discharged recovered. Discharged not recovered. Died. Total Discharged and Died. M. Auckland .. - • " %a Christchurch .. .. ; 24 Dunedin (Seacliff) .. .. 17 Hokitika .. •• •• 5 Nelson .. • • ■• * Porirua .. • • .. 37 Wellington .. .. .. 24 Ashburn Hall (private asylum) 4 F. 30 20 15 3 15 20 3 T. 72 44 32 5 7 52 44 7 M. F. 5 .. 4 1 13 9 1 .. 7 1 3 1 3 T. 5 5 22 1 8 4 3 M. 31 15 25 9 4 24 12 F. 13 9 13 6 5 13 10 1 T. 44 24 38 15 9 37 22 1 M. F. T. 78 43 121 4S 30 73 55 37 92 14 6 20 9 8 17 68 29 97 39 31 70 4 7 11 M. F. 363 221 293 244 433 261 133 43 83 56 330 282 147 105 19 25 T. 584 537 694 176 139 612 252 44 33 15 48 120 70 190 310 191 501 1,801 1,237 3,038 Totals 157 106 263 Table II. — contk nued. Asylums. Average Number j ot - jj^ resident during Admi the Year. during 1 mtage veries on issions the Year. Percentage ol Deaths on Average Number resident during the Year. Percentage of Deaths on the Admissions. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson Porirua Wellington Ashbum Hall (private asylum) .. M. 369 279 431 130 85 323 145 18 F. T. 214 583 241 520 257 688 41 171 55 140 257 580 109 254 24 42 M. F. T. 54-55 57-69 55-81 36-92 48-78 41-51 28-33 33-33 30-48 29-41 .. 20-00 10000 37-50 58-33 52-86 25-86 40-63 54-55 125-00 73-33 133-33 25-00 46-16 M. F. T. 8-40 6-07 7-55 5-38 3-73 4-62 5-80 5-06 5-52 6-92 14-63 8-77 4-71 909 6-43 7-43 5-06 6-38 8-28 917 8-66 .. 4-17 2-38 M. 40-26 23-08 41-67 52-94 100-00 3429 27-27 F. T. 2500 3411 21-95 22-64 28-89 36-19 75-00 6000 62-50 75-00 22-41 28-91 62-50 36-67 8-33 6-67 Totals 1,780 1,198 2,978 46-18 44-17 45-34 6-74 5-84 6-38 85-29 29-17 32-76

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Table III.—Ages of Admissions.

Table IV.—Duration of Disorder on Admission.

Table V.—Ages of Patients discharged "Recovered" and "Not recovered."

3-H. 7,

Ages. Auckland.' Christchurch. Dunedin Un i -..-i „ (Seacliff). Hokitika. Nelson. Porirua. ] Wellington. Ashburn Hall (Private Asylum). Total. Under 5 years Prom 5 to 10 years ., 10 „ 15 , . 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ ,, 40 „ 50 „ , 50 „ 60 „ , 60 „ 70 „ „ 70 „ 80 „ Unknown.. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. .j M. F. T. M. F. T. M. F. T. M. F. T. 1 0 1 5 16 20 15 35 27 9 36 8 13 21 9 7 16 4 4 8 3 3 6 13 4 6 3 9 16 5 21 10 7 17 10 14 24 8 6 14 10 3 13 2 0 2 2 0 2 '.'. 110 1 11 2 .. 6 1 7 10 1 17 15 32 ! 5 1 6 11 12 23! 0 4 4 4 6 10 0 1 1 7 4 11 4 0 4 7 3 10 3 2 5 7 3 10 3 0 3 10 1 13 4 3 1 4 1 2 8 19 18 37 15 11 26 15 10 25 12 10 22 3 4 7 2 2 4 1 S 2 0 2 f 10 3 13 J 13 9 22 19 3 12 19 0 9 '112 .. 2 0 2 10 3 13 13 9 22 9 3 12 9 0 9 1 1 2 112 0 4 4 1 4 5 0 3 3 10 1 2 0 2 5 5 10 23 8 31 88 64 152 77 56 133 48 50 98 50 29 79 28 19 47 17 9 26 2 0 2 2 0 2 0 2 2 0 2 2 0 1 1 Totals 77 52 129 65 41 106 60 45 105, ,17 8 25 4 8 12! 70 58 128. 44 16 60 3 12 15 340 240 580

Anpklflnd ChristAuckland. churcn Dunedin (Seacliff). Hokitika. Nelson. Ashburn Porirua. Wellington. (p^» e Asylum). Total. M. F. T.JM. F. T. 51 32 83|24 14 38: 1 jM. F. T. 26 18 44 M. F. T. ! M. F. T. 14 7 21 ! 2 5 7 M. F. T.I 31 27 58| M. F. T. 27 10 37! M. F. T. 13 4 M. F. T. 176 116 292 First Class (first attack, and within 3 mos. on admission) Second Class (first attack, above 3 mos. and within 12 mos. on admission) Third Class (not first attack, and within 12 mos. on admission) Fourth Class (first attack or not, but of more than 12 mos. on admission) Unknown ; 7 7 14 8 4 12' 8 6 14 20 18 38 7 3 10; 16 15 31 1 0 l| 1 1 2 Oil 7 6 13 11 16 27 3 1 4 10 4 14 13 4 14 5 35 25 60 66 64 130 11 7 18. 6 5 11 7 0 7 77 52 129 65 41 106 11 9 20 2 0 2 12 3 21 9 30 4 15 0 2 2 56 35 91 7 0 7 Totals 60 45 105 17 8.25 4 8 12 4 8 12 70 58 128 44 16 60 3 12 15 340 240 580

Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Ages. Becovered Not . recovered Becovered| rec^red Becoverei , Not recovered Becovered | rec NO e * rea M. F. T. M. F. T. M. F. T. M. F. T. It. F. T. M. F. T. M. F. T. M. F. T. From 5 to 10 years „ 10 „ 15 . „ 15 , 20 „ . 20 „ 30 „ ,, 30 „ 40 „ , 40 „ 50 „ „ 50 „ 60 „ „ 60 „ 70 „ . 70 „ 80 „ Unknown 1 0 1 11 6 17 11 9 20 12 4 16 3 6 9 3 5 8 10 1 10 1 1 0 1 10 1 1 0 1 1 0 1 112 12 3 9 4 13 4 6 10 5 5 10 3 2 5 0 11 1 0 1 10 1 10 1 10 1 8 3 11 3 6 9 14 5 3 14 2 13 1 0 1 5 5 10 0 2 2 2 0 2 10 1 2 2 4 2 0 2 1 0 1 2 0 2 10 1 10 1 10 1 Totals 42 30 72 17 15 32 18 9 22 5 0 5 5 0 5 24 20 44 4 1 5 Ages. Nelson. Pori Be- . Notre- Becovered. I covered, covered. irua. Wei Ill igton. Ashbui | (Private iHall .sylum). To) .al. Not re- Becovered. covered. Not Be- Not rerecovered, covered, covered. Becovered. | rec ™ ed . 'rom 5 to 10 years „ 10 „ 15 „ . 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ ., 40 „ 50 „ „ 50 „ 60 „ ,. 60 „ 70 „ „ 70 „ 80 „ Jnknown M. F. T. 10 1 2 13 M. F. T. I M. F. T. .. 1 0 li 0 2 2 11 7 18 8 2 10 9 2 11 .. 7 0 7 2 2 4 M. F. T. 10 1 2 0 2 0 1 1 3 0 3 M. F. T. 112 8 6 14 8 6 14 3 3 6 12 3 3 2 5 M. F. T. 112 2 0 2 M. F. T. Oil 2 13 0 1 1 M. F. T. 0 1 1 0 1 1 0 1 1 M. F. T' 112 4 6 10 52 28 80 34 30 64 31 18 49 20 11 31 12 12 24 3 0 3 M. F. T. 10 1 10 1 7 8 15 6 3 9 4 2 6 6 0 6 4 2 6 4 0 4 10 1 10 1 10 1 0 2 2 1 0 1 Totals 4 3 7! 1 0 1 37 15 52 7 1 8 24 20 44l 3 1 * 4 3 7 0 3 3 157 106 263 33 15 4!

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Table VI.—Ages of the Patients who died.

Table VII. —Condition as to Marriage.

Ages. , . , , ChristAuckland. church S2£ Hokitil - Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). 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. 'rom 5 to 10 years „ 10 „ 15 „ ,, 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ ., 40 „ 50 „ „ 50 „ 60 „ „ 60 „ 70 „ „ 70 „ 80 „ Jpwardsof80 1 0 1 2 3 5 6 2 8 9 3 12 3 1 4 6 17 4 3 7 o i i Oil 3 0 3 2 0 2 2 5 7 1 2 3 7 0 7 0 1 1 3 2 5 3 14 4 2 6 4 4 8 8 2 10 3 1 4 0 22 3 0 3 13 4 5 0 5 i i" 2 Oil 2 0 2 0 2 2 1 1 2 10 1 2 13 5 2 7 6 0 6 5 4 9 3 3 6 2 3 5 2 3 5 1 3 4 1 2 3 4 15 4 1 5 oil 112 4 5 9 5 10 15 18 9 27 29 6 35 19 18 37 20 11 31 21 8 29 3 2 5 0 1 1 Totals 31 13 44 15 9 24 25 13 38 I 0 1 1 120 70 190 9 6 15 4 5 9 24 13 37 12 10 22

Admissions. Discharges. Deaths. Auckland — Single Married Widowed M. F. T. 56 22 78 21 21 42 0 9 9 M. F. T. 35 10 45 11 18 29 12 3 M. 18 8 5 F. T. 6 24 2 10 5 10 Totals 77 52 129 47 30 77 31 13 44 Chbistchubch — Single Married Widowed 45 14 59 19 24 43 13 4 19 10 29 9 11 20 8 6 1 3 11 5 11 1 2 Totals 65 41 106 28 21 49 15 9 24 Dunedin (Seacliff) — Single Married Widowed Unknown 39 25 64 13 17 30 6 3 9 2 0 2 23 10 33 5 12 17 2 2 4 8 10 7 2 10 7 17 4 11 Totals 60 45 105 30 24 54 25 13 38 Hokitika — Single Married Widowed 14 8 0 1 15 5 8 2 2 4 1 0 0 4 1 8 2 1 2 2 2 8 4 3 Totals 17 8 25 5 0 5 9 6 15 Nelson— Single Married Widowed 2 2 0 5 1 2 7 3 2 3 2 1 2 4 4 4 0 2 3 6 3 Totals 4 8 12 5 3 8 4 5 9 POBIB.UA — Single Married Widowed 40 19 59 24 34 58 6 5 11 26 18 0 8 34 7 25 1 1 11 9 4 3 14 6 15 4 8 * Totals 70 58 128 44 16 60 24 13 37 Wellington— Single Married Widowed 24 3 27 18 12 30 2 1 3 17 9 26 8 10 18 2 2 4 8 4 0 3 11 5 9 2 2 Totals 44 16 60 27 21 48 12 10 22 Ashbubn Hall (Private Asylum)— Single Married Widowed 2 10 12 10 1 0 2 2 3 1 0 5 0 1 8 1 1 0 1 1 Totals 3 12 15 4 6 10 0 1 1 Totals— Single Married Widowed Unknown 222 99 321 101 114 215 15 27 -42 2 0 2 130 53 183 55 60 115 5 8 13 63 22 85 39 30 69 18 18 36 Totals 340 240 580 190 121 311 120 70 190

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Table VIII. —Native Countries.

Table IX.—Ages of Patients in Asylums on 31st December, 1904.

Table X.—Length of Residence of Patients who died during 1904.

Countries. Auckland. Christchurcl ' (Km. HoMtika - Nelson, j Porirua. Ashburn Wellington. (p H £» te Asylum). Total. England Scotland Ireland New Zealand Australian States France Germany Norway Sweden Denmark Italy China Maoris Other countries .. M. F. T. 123 71 194 25 7 32 59 46 105 98 80 178 9 6 15 3 0 3 8 3 11 10 1 5 0 5 2 0 2 2 13 10 1 6 6 12 21 1 22 M. F. T. 98 91 189 35 24 59 59 54 113 72 54 126 7 3 10 1 0 1 4 15 3 0 3 M. F. T. 73 45 118 110 61 171 98 62 160 84 70 154 14 14 28 0 1 1 10 0 10 6 1 7 2 0 2 0 2 2 4 0 4 17 0 17 10 1 14 5 19 M. F. T. 27 9 36 14 2 16 45 17 62 28 11 39 14 5 2 0 2 3 0 3 M. F. T. 23 16 39 5 3 8 18 6 24 27 27 54 1 3 4 1 0 1 Oil M. F. T. 116 78 194 32 24 56 64 74 138 70 84 154 12 3 15 2 13 8 5 13 112 4 2 6 5 0 5 2 13 2 0 2 6 5 11 6 4 10 M. F. T. 46 26 72 17 13 30 25 15 40 45 38 83 3 3 6 13 4 15 6 3 0 3 2 0 2 1 0 1 M. F. T. 6 5 11 5 7 12 10 1 7 13 20 M. F. 512 341 243 141 369 274 431 377 47 36 8 2 35 12 12 8 17 2 15 2 14 2 25 0 17 18 56 27 T. 853 384 643 808 83 10 47 20 19 17 16 25 30 83 3 0 3 4 0 4 1 0 1 2 0 2 4 0 4 5 0 5 1 1 2 11 16 27 1 0 1 3 0 3 3 1 4 0 1 1 Totals .. 363 221 584 293 244 537| 433 261 694 133 43 176 83 56 139 330 282 612 147 105 252 19 25 44 1801 1237 3038

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. , Nelson. Ashburn Porirua. Wellington. , (Pr^te Asylum). 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. 1 to 5 years 5 , 10 „ 10 „ 15 „ 15 , 20 „ 20 „ 30 , 30 , 40 „ 40 , 50 „ 50 , 60 „ 60 „ 70 „ 70 „ 80 „ Over 80 „ Unknown 4 0 4 12 3 6 3 9 38 31 69 92 47 139 77 50 127 69 46 115 52 26 78 21 8 29 15 6 2 3 5 10 1 3 2 5 8 6 14 38 19 57 49 48 97 63 60 123 51 55 106 53 35 88 20 15 35 3 2 5 4 2 6 112 2 2 4 7 4 11 36 41 77 79 53 132 92 45 137 92 53 145 90 43 133 31 18 49 3 1 4 l i 2 112 15 4 19 18 8 26 17 4 21 25 11 36 29 11 40 14 1 15 0 1 1 4 15 9 8 17 12 10 22 16 11 27 17 12 29 18 11 29 7 18 Oil Oil 2 13 6 4 10 45 31 76 73 53 126 86 87 173 61 55 116 42 45 87 14 5 19 10 1 Oil 12 3 2 0 2 22 20 42l 25 31 56 37 22 59 43 23 66 13 5 18 3 1 4 1 0 1 10 1 13 4 2 5 7 6 8 14 3 2 5 4 5 9 2 2 4 7 4 9 10 35 19 204 157 350 255 394 287 361 257 301 181 112 51 9 9 19 7 11 19 54 361 605 681 618 482 163 18 26 13 2 15 Totals 330 282 612 147 105 252 19 25 44 363 221 584 293 244 537 433 261 694 133 43 1761 183 56 139 1801 1237 3038

Length of Besidence. Auckland. Christ- Dunedin church. (Seacliff). Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total M. F. T. M. F. T. 12 3 10 1 2 13 M. F. T. 112 2 0 2 4 15 M. F. T. 0 2 2 3 0 3 1 0 1 M. F. T. M. F. T. 14 5 4 15 3 14 2 0 2 3 0 3 10 1 112 3 14 1 2 3 3 14 Oil 10 1 112 M. F. T. 12 3 2 0 2 112 0 3 3 2 13 10 1 M. F. T. M. F. T. 4 11 15 19 5 24 14 6 20 2 4 6 9 2 11 17 5 22 5 4 9 12 8 20 2 5 7 7 4 11 3 2 5 6 17 19 12 31 112 Fnder 1 month 'rom 1 to 3 months .. „ 3 „ 6 . 6 „ 9 ,. 9 „ 12 „ 1 „ 2 years . 2 „ 3 „ „ 3 „ 5 „ „ 5 „ 7 „ . 7 „ 10 „ . 10 „ 12 „ » 12 „ 15 „ •ver 15 years )ied while absent on trial 7 4 11 3 2 5 Oil 2 0 2 5 0 5 10 1 5 2 7 Oil 112 10 1 3 0 3 3 14 Oil 10 1 2 0 2 0 2 2 2 13 Oil 10 1 6 4 10 2 0 2 2 3 5 oil 2 13 1 0 1 i i' 2 0 1 1 112 2 13 1 0 1 0 11 5 2 7 oil 1 1 2 10 1 3 14 10 1 4 2 6 2 2 4 10 1 1 3 4 15 24 25 13 38 9 6 15 4 5 9 24 13 37 12 10 22 0 1 1 120 70 190

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Table XI—Length of Residence of Patients discharged "Recovered" during 1904.

Table XII.—Causes of Death.

Length of Besidence. Auckland. Christ- Dunedin church. (Seacliff). Hokitika. Nelson, j Porirua. Wellington. Ashburn Hall (Private Asylum). Total. rnder 1 month 'rom 1 to 3 months . 3 „ 6 , „ 6 , 9 „ „ 9 .12 „ „ 1 „ 2 years.. , 2 , 3 , .. „ 3 „ 5 „ .. „ 5 „ 7 „ .. , 7 „10 „ .. „ 10 „12 „ .. „ 12 ,15 „ .. >ver 15 years M. F. T. 3 0 3 7 0 7 7 7 14 9 9 18 5 2 7 5 6 11 4 15 2 2 4 0 2 2 M. F. T. 6 4 10 9 8 17 2 4 6 2 2 4 2 0 2 1 1 2 10 1 10 1 0 11 M. F. T. 1 2 3 6 9 15 3 3 6 4 15 1 0 1 2 0 2 M. F. T. 2 0 2 1 0 1 2 0 2 M. F. T. 1 1 2 2 13 M. F. T. 4 2 6 3 3 6 7 3 10 2 3 5 6 17 7 2 9 M. F. T. 3 0 3 5 3 8 8 5 13 2 3 5 1 2 3 2 4 6 112 2 2 4 M. F. T. 2 0 2 2 3 5 M. F. T. 11 4 15 32 20 52 39 30 69 19 20 39 15 7 22 20 12 32 6 4 10 11 5 16 2 2 4 112 0 1 1 10 1 5 16 1 0 1 10 1 oil 10 1 1 '6 1 Oil Totals .. 5 0 5 j 4 3 7 157 106 263 42 30 72 24 20 44 17 15 32 37 15 52 24 20 44 4 3 7

Christchurch. Seacliff) Hokitika - Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. Causes. Auckland. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Oil M. F. T. M. F. T. M. F. T. M. F. T. 0 11 10 1 10 1 0 1 1 10 1 1 0 1 0 11 3 14 4 5 9 0 11 10 1 10 1 12 3 10 1 13 4 10 1 10 1 0 11 0 1 1 0 1 1 1 0 1 3 6 9 0 11 Oil 10 1 14 5 10 1 10 1 22 3 25 10 1 9 8 17 0 11 1 0 1 0 11 Acute broncho-pneumonia Anterior polio-myelitis Atheroma of arteries .. ..101 Atrophe paralysis Bronchial asthma Bronchitis Bulbar paralysis .. ..Oil Cancer Cardiac failure.. .. ..101 Caries of axis and atlas vertebrae.. Cellulitis Cerebral apoplexy .. ..101 Cerebral softening Cerebral thrombosis Chronic brain-disease .. ..033 Colitis and influenza Compression of the brain Diabetes Dropsy .. .. ..Oil Drowning . • . • .. Empyaemia .. .. Epilepsy .. . • ..235 Exhaustion from brain-diFease .. Oil Exhaustion from diarrhoea .. .. Exhaustion from lumbar abscess Exhaustion from mania Fatty-degeneration of kidneys .. 10 1 Gangrene of lung .. ..101 General paralysis .. ..707 Haemorrhage of brain Heart-disease Ileo-typhlitis Locomotor ataxia Malignant disease of the gall, bladder, and peritoneum Marasmus Melancholia with exhaustion Meningitis .. .. ..101 Necrosis and senile decay Organic brain-disease .. ..101 Peritonitis Phthisis Pleurisy . • ■ • ..101 Pneumonia .. .. ..213 Posterior mesenteric carcinoma and renal cirrhosis Pulmonary tuberculosis.. .. j 5 1 6 Pyaemia Renal cirrhosis .. ..101 Senile decay .. .. ..527 Suffocation Syphilite disease of pons varolii .. 10 1 Tuberculosis Typhoid fever Ulcerative colitis Uraemia Died while absent on trial 2 0 2 12 3 Oil 2 0 2 10 1 13 4 1 i' 2 1 0 1 1 0 1 1 0 1 Oil 4 0 4 101 o i i o i l oil i 6' l oil 101 10 1 112 0 1 1 Oil 10 1 oil i 6' i 1 o i oil 10 1 0 2 2 6 06 1 i' 2 1 6' 1 oil oil 10 1 3 3 6 oil 6 3 9 l i' 2 1 1 2 Oil 1 0 1 oil .. 1 6' 1 112 3 i 4 101 10 1 101 112 10 1 4 15 10 1 10 1 3 0 3 5 8 13 2 0 2 7 4 11 2 0 2 1 3 4 2 5 7 1 0 1 10 1 i 6 i 1 6' 1 2 0 2 o i' l 101 0 2 2 101 10 1 10 1 10 1 7 18 2 0 2 2 0 2 19 9 28 1 0 1 10 1 2 0 2 0 11 0 2 2 1 0 1 10 1 3 0 3 7 29 123 10 1 Oil 101 12 3 2 0 2 101 0 1 1 101 0 2 2 i 6' i 1 6' 1 Totals .. .. 31 13 44 4 5 9 24 13 37 12 10 22 Oil |l20 70 190 31 13 44 15 9 24 25 13 38 9 6 15

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Table XIII. —Causes of Insanity.

Causes. Auckland. I X» Dunedin I Hokuika | Nel80u Porirua. Wellington. Ashburn Hall (Private Asylum). Total. Adolescence Adverse circumstances Alcohol Amenorrhcea Anxiety Business worry Cerebral disease Child-bearing and puerperal Climacteric Congenital and hereditary .. Disappointment Domestic troubles Epilepsy Financial trouble Gonorrhoea Grief Hemiphlegia Ill-health Influenza ' Injury Jealousy Loss of occupation Love troubles Malaria Masturbation Mental worry Nerve-strain Organic Ovarian trouble Overstudy Overwork Phthisis .. Plumbism Pneumonia Previous attack Privation .. • .. Religious exoitement Rheumatic fever Senility Sexual excesses Shock .. Solitude Syphilis Tohunga Uterine disease Unknown Not insane M. F. T. 5 2 7 1 0 1 16 0 16 M. F. T. M. F. T. 0 3 3 M. F. T. M. F. T. M. F. T. 4 6 10 M. F. T. 2 0 2 M. F. T. 1 0 1 M. F. T. 12 11 23 10 1 54 12 66 0 1 1 Oil 10 1 3 0 3 0 24 24 3 24 27 61 45 106 3 2 5 4 15 13 10 23 3 0 3 10 1 2 2 4 Oil 11 5 16 0 2 2 16 2 18 10 1 10 1 0 3 3 10 1 28 1 29 18 15 33 10 1 1 0 1 Oil 2 3 5 12 3 1 0 1 10 1 1 0 1 22 26 48 2 0 2 6 6 12 0 1 1 15 14 29 12 3 15 6 10 2 12 11 1 12 0 2 2 0 2 2 26 11 37 1 0 1 7 i' 8 0 1 1 5 4 9 0 11 oil 17 5' 22 9 09 101 oil 2 0 2 0 3 3 0 6 6 8 7 15 3 0 3 0 5 5 0 2 2 15 9 24 0 5 5 0 3 3 25 15 40 0 2 2 oi'i ! 1 0 1 0 7 7 3 10 13 5 2 7 10 1 0 4 4 Oil 4 0 4 0 i' 1 1 10 11 2 24 14 5 4 04 4 15 4 15 2 0 2 10 1 0 i 1 101 0 i' ll 2 24 112 10 1 0 22 1 6 1 1 6 1 5 1 6 4 2 6 0 i' 1 0 2' 2 2 24 7 18 10 1 1 6' 1 1 0 1 1 i' 2 ! 4 04 2 02 oil 0 2 2 1 0 1 8 0 8 8 5 18 1 0 1 3 6' 8 6 6 12 3 03 6 1 7 262 1 6 i 12 3 .5 0 5 3 14 1 0 1 oil 1 6 1 i - i i' 2 1 1 ? 0 1 1 oil 112 oil 1 0 1 1 0 1 4 6 10 12 li' 23 10 1 161 15 6 •■ I 3 1 4 1 0 1 3 4 7 0 11 4 7 11 2 35 .. 0 i l 3 i 4 4 6 10 10 1 2 02 3 i 4; 1 6' 1 12 3 1 1 2 2 13 5 0 5 0 2 2 0 2 2 1 0 1 Oil: 2 0 2 1 1 2 3 0 3i 0 3 3 0 1 1 4 0 4 3 0 3 1 0 1 9 8 17 10 0 10 4 2 6[ 0 i' 1! 3 0 3 Totals i77 52 129 65 41 106 60 4; 105, 8 25! 28 44 16 60 3 12 15 341

H.—7.

Table XIV.—Former Occupation of Patients.

22

Occupation. 4 o 3 a g o s o 3 OQ C ■3 o a p 4 ■3 5 = .r ° 3 £ 'u W » Ph I ks d ft t? .H d " o Occupation. rd o H 3 r3 « 'C o S 0) CD a £ a 3 a eg js -a a> o 0 o QC a | el r\ * "3 ra<n £ 3 *- ■a GS 3 B •a a S 3 o 3 ■4 4 M s o X Ma r,ES. Aboriginal native Asylum attendants Bakers Bank-manager (retired) Bicycle-repairer .. Blacksmiths Boardinghousekeeper Boatman Boilermaker Bootmakers Bricklayer Bushmen Butoher Cabdriver Carpenters Carrier Clerks, accountants, &o. Coaohbuilders Compositor Commission agents, &c. Contractors Cooks Dairymen Drapers Engine-driver Engineers Farmers Farm-hands Fencer Firemen Fretwork machinist Gardeners Grocers Grooms .. Gum-diggerB i "h 1 I 1 i i .. 1 2 3 1 Hawker Hotelkeeper Hotel employees .. Interpreter Jewellers, &o. Labourers Lineman Mill-hand Miners No occupation Painters, &c. Pensioner Physicians Picture-framer PlaBterers Platelayer Plumbers Poultry-farmer Rabbiter Railway clerk Runholder Saddlers Sailors Schoolboy School-teachers .. Seed expert Shearer Shipwrights Signalman Solicitor Stockmen Storeman Student Striker .. Tailors Telegraphist Wheelwright 2 1 l l li 1 1 3 1 3 105 1 1 14 20 6 1 3 1 2 1 3 1 1 1 1 2 8 1 4 1 1 2 1 1 3 1 1 1 2 1 1 1 i 29 i 4 l 17 l 2 1 4 1 iti l io 24 1 1 1 i l .. i .. 3 !! i .. 1 1 5 1 2 1 1 12 1 14 2 5 2 2 6 7 2 6 1 1 1 5 1 1 1 2 i l i 1 •• i 2 i 1 l 1 1 1 2 3 4 1 7 3 •2 'i i l 1 1 1 5 1 2 1 ! 2 i • i 2 2 i 3 i 1 i 3 '.'. i 5 1 i .. 2 .. 2 5 2 2 1 4 30 9 1 3 1 3 2 4 12 i i i 1 1 1 3 2 1 1 i 1 1 l i 1 1 l l 6 i 5 3 7 i 2 1 8 2 i l i i i i 1 2 i i l i i 'i i i 2 1 1 1 i i 12 Totals .. 77 65 60 17 4 70 44 ! 3 340 2 Fe: UALES. Aboriginal natives Boardinghousekeeper Cooks Domestic duties .. Drapers' assistant Dressmakers Domestic servants Housewives Housekeeper Laundress Music-teachers Matrons 1 1 1 8 1 HI 6 i i 4 1 2 38 1 | .. i2 12 i ' •• l ! .. 3 1 4 134 1 3 15 46 1 1 2 2 Milliner No occupation Nurse Prostitute School-teacher Schoolgirls Storekeepers Tailoresses Washerwoman Waitress 8 1 2 2 5 2 1 1 i 1 2 1 1 1 14 1 1 1 2 2 3 1 1 6 9 2 .20 25 1 i 1 i 52 41 45 8 8 16 12 240 i Totals .. 58 l

H.—7

Table XV.—Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent. of the Admissions for each Year since 1st January, 1876.

M. P. T. In mental hospitals, Ist January, 1876 .. .. .. .. .. .. 482 254 736 In mental hospitals, Ist January, 1905 .. .. .. .. .. .. 1,801 1,237 3,038

23

Year. Admitted. Discharged. Died. Beinaining Hist December in each Year. Average Numbers resident. Percentage of Becoveries on Admissions. Percentage of Death! on Average Nu m beri resident. Becovered. Believed. Not Improved. 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 M. 221 250 247 248 229 232 267 255 238 294 207 255 215 230 230 234 231 281 320 379 296 300 355 264 335 373 352 454 340 F. 117 112 131 151 149 127 152 166 153 160 165 161 146 161 160 201 158 179 256 302 170 244 258 247 263 224 192 237 240 T. 338 362 378 399 378 359 419 421 391 454 372 416 361 391 390 435 389 460 576 681 466 544 613 511 598 597 544 691 5 80 M. 129 123 121 112 100 93 95 102 89 95 99 103 116 93 98 88 89 101 107 105 104 102 114 88 103 125 135 144 157 F. 79 57 68 76 67 65 59 78 77 76 60 78 92 53 88 74 76 89 76 77 70 73 110 99 96 104 ! 99 101 106 T. 208 180 189 188 167 158 154 180 166 171 159 181 208 146 186 162 165 190 183 182 174 175 224 187 i 199 229 234 245 263 M. 17 20 14 15 36 41 49 13 17 10 11 34 31 31 23 33 21 17 15 24 25 26 13 15 39 40 26 41 24 F. 8 9 14 13 25 36 32 20 9 5 17 17 28 30 17 24 17 12 11 19 16 32 23 25 10 17 15 25 13 T. 25 29 28 28 61 77 81 33 26 15 28 51 59 61 40 57 38 29 26 43 41 58 36 40 49 57 41 66 37 M. F. 6 6 7 2 3 3 8 I 3 5 ! 2 8 1 5 7 10 9 18 12 73 29 12 8 2 2 3 1 12 5 14 30 8 2 9 9 55 I 84 128 [ 139 20 | 12 17 31 104 47 7 42 25 65 33 3 10 9 84 I 12 9 2 T. 12 9 6 11 7 9 12 19 30 102 20 4 4 17 44 10 18 139 267 32 48 151 49 90 36 19 96 11 M. 36 42 51 55 54 49 60 65 68 73 57 74 78 70 76 79 74 78 64 101 86 105 88 114 99 102 120 129 120 F. | T. 12 ! 48 21 63 17 ' 68 16 | 71 20 j 74 14 63 19 I 79 18 I 83 24 ! 92 22 95 19 76 27 | 101 26 I 104 30 100 35 111 41 120 34 108 23 101 35 99 42 143 32 118 43 148 60 148 43 157 46 j 145 72 I 174 55 175 44 173 70 190 M. 519 581 638 695 729 769 827 892 938 981 1,009: l,053 f 1,041 1,074 1,095 1,115 1,154 1,229 1,308 1,329 1,390 1,440 1,472 1,512 1,581 1,654 1,715 1,771 1,801 F. 264 291 319 361 396 406 442 483 514 542 ! 604 , 643 640 687 702 734 763 810 860 885 925 990 1,008 1,045 1,091 1,119 1,133 1,188 1,237 T. M. F. T. 783 : 491 257 : 748 872 541 277 818 957 601 303 ; 904 1,056! 666 337 11,003 1,125 703 371 ! 1,074 1,175 747 : 388 1,135 1,269 796 i 421 1,217 1,375 860 475 j 1,335 1,452 911 497 11,408 1,523 965 528 !l,493 1,613 984 559 1,543 1,6961, 034 613 {1,647 1,68111,045 I 641 1,686 1,76111,046*: 660Ji 1,707 1,797 j 1,078" 685" 1,763 1,849 11,089 J, 699 J : 1,789 J 1,917:1,125 ' 714f|l,839| 2,039 1,172 758 1,980 2,168il,241 812 &,053 2,214 1,313 849 J2,162 2,3151,347 382 2.229 2,43011,411 944 12,355 2,480 1,438 973 [2,411 2,557 1,487 il,004 2,491 2,672 1,534 |l,049 2,583 2,7731,622 1,094 2,716 2,8481,671 1,114 2,785 2,95911,741 11,160 2,901 3,038ll,780 !l,198 2,978 M. F. 54-53 66-01 49-20 5080 48-98 51-90 45-161 50-33 43-66 44-96 4008 51-10 3558 38-81 40-00 46-98 37-39 50-32 32-31 47-50 47-82 36-36 40-39! 4875 53-95 6301 40-43! 32 92 42-61, 55 00 37-61: 36-82 38-58 48-10 35-94! 49-72 ' 39 63 4518 41-27 j 46-66 37-41 4402 35-92 37-82 44-88 j 51-89] 32-31 j 44 33 30-74| 36 50 39 06! 46-64 38 35 51-56 40-56 44-69 46-18 44-17 T. 57-56 49-72 5000 47-11 44-17 44-01 36-75 42-75 42-45 37-66 42-74 43-61 57-62 37-34 47-69 37-24 42-42 41-30 41-03 43-40 39-82 36-69 48 07 37-58 33-27 42-17 43-01 42-17 45-34 M. 8-21 7-76 8-48 8-25 7-68 6-29 7-53 7-55 7-46 7-56 579 715 7-56 6-69 7-05 7-25 6-58 6-66 516 7-69 6-38 7-44 6-12 7-67 6-45 6-29 7-18 7-41 6-74 F. 1. 3-58 6-70 7-58 770 5-61 7-52 4-74 7-07 5-39 6-89 3-60 5-55 4-51 6-49 3-78 6-21 4-82 6-53 416 6-36 3-39 4-91 4-40 6-13 405 6-16 4-54 5-86 5 11 6-29 5-86 6-71 476 5-87 303 5-23 4-31 4-82 4-94 661 3-63 5-29 4-55 6-28 6-17 614 4-28 6-30 4-38 5-61 6-58 6-41 4-94 6-28 3-79 5-96 5-84 6-38 8,132 5,382 13,514 ! 3,130 2,323 ! 721 539 1,260 i 695 577 1,272 2,267 960 3,227 • • •• .. .. ■• .. ..

24

H.-7

Table XVI —Showing the Admissions, Readmissions, Discharges, and Deaths from the 1st January, 1876, to the 31st December, 1904.

Table XVII.— Summary of Total Admissions: Percentage of Cases since the Year 1876.

Table XVIII. -Expenditure, out of Immigration and Public Works Loan, on Mental Hospital Buildings during the Financial Year ended 31st and Liabilities at that Date

Table XIX.—Total Expenditure, out of Immigration and Public Works Loan for Repairs and Buildings at each Mental Hospital from 1st July, 1877, to 31st March, 1905.

M. F. T. M. F. T. Persons admitted during period from 1st January, 1876, to 31st December, 1904 Readmissions 6,557 4,132 10,689 1,575 1,250 2,825 Total cases admitted Discharged cases— Recovered Relieved Not improved Died .. .. •• •• •• 3,130 2,323 721 539 695 577 2,267 960 5,453 1.260 1,272 3,227 8,132 5,382 13,514 Total cases discharged and died since January, 1876 6,813 4,399 11,212 Remaining in asylums, January 1st, 1876 482 254 736 Remaining in asylums, January 1st, 1905 1,801 1,237 3,038

Females. Both Sexes. Males. Recovered Relieved .. Not improved Died Remaining 38-49 8-87 8-55 27-87 16-22 43-16 10-02 10-72 17-84 18-26 40-35 9-32 9-41 23-88 17-04 100-00 100-00 100-00

Net Expenditure for Year ended 31st March, 1905. Liabilities on 31st March, 1905. Asylums. Auckland Wellington Porirua Christchurch Dunedin (Seacliff) .. Nelson Hokitika £ s. d. 2,413 12 5 235 5 9 5,387 11 3 3,266 1 7 3,229 0 10 526 19 10 890 16 2 £ s. d. 4,517 6 8 161 11 4 39 0 0 11 13 0 14 10 0 22 14 7 Totals 15,949 7 10 4,766 15 7

1877-97. 1897-98. I 1898-99. 1899-1900. 1900-1. Asylums. Auckland Wellington Wellington (Porirua) Christchurch Dunedin (Seacliff) Napier Hokitika Nelson £ a. d. 84,811 5 11 21,290 3 8 52,975 16 2 102,399 19 11 ,121,808 15 10 147 0 0 1,187 5 4 5,849 6 7 £ s. d. 3,177 14 6 133 11 4 8,655 10 0 821 18 4 222 13 6 £ s. d. 208 7 2 1,606 18 10 11,233 9 1 188 15 9 1,797 0 4 £ s. d. 1,553 11 4 1,823 17 0 11,095 9 6 £ s. d. 3,038 17 11 1,616 2 0 10,587 3 7 75 16 8 2,227 16 10 1,386 17 7 1,118 1 10 2,632 2 4 1,852 5 8 94 3 11 1,231 13 5 Totals !390,469 13 5 14,129 9 6 17,666 13 6 17,712 1 1 18,871 14 4 1901-2. s 1902-3. 1903-4. 1904-5. Total Net Expenditure; 1st July, 1877, to 31st March, 1905. Asylums. Auckland Wellington Wellington (Porirua) Christchurch Dunedin (Seacliff) Napier Hokitika Nelson £ s. d. I £ s. d. 2.119 12 6 ! 698 6 1 162 12 2 ' 1,468 10 2 8,560 18 8 2,144 19 1 43 2 6 ! 155 11 1 4,666 16 8 4,973 0 1 £ s. d. 1,284 4 1 532 1 10 6,377 15 0 4,238 4 11 1,360 17 0 £ s. d. 2,413 12 5 235 5 9 5,387 11 3 3,266 1 7 3,229 0 10 £ s. d. 99,305 11 11 28,869 2 9 117,018 12 4 111,189 10 9 141,672 18 8 147 0 0 3,289 1 7 16,029 1 8 3' 7 4 ! 238 17 2 1,186 19 9 j 487 .6 7 874 11 8 1,144 5 8 890 16 2 526 19 10 Totals .. 16,743 9 7 | 10,166 10 3 15,812 0 2 15,949 7 10 517,520 19 8

H.—7

25

Table XX.— Showing the Expenditure for the Year 1904.

Avimixtmate Cost of Paper.— Preparation, not given; printing (1,700 copies), £21 4s.

By Authority: John Mackay, Government Printer, Wellington 1905 4—H. 7.

[Price, 9d.

Heads of! Expenditure. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Wellington. Total. Inspector* Assistant Inspectors* Clerk* Medical fees* Contingencies* Official Visitors Visiting Medical Officers Superintendents Assistant Medical Officers Clerks Matrons Attendants and servants Rations Fuel and light Bedding and clothing Surgery and dispensary Wines, spirits, ale, and porter Farm Necessaries, incidental, and miscellaneous Totals Repayments, sale of produce, &c. Actual cost £ s. d. 742*10 6 268 15 0 150 0 0 100 0 0 4,459 11 11 4,438 16 4 945 5 10 1,235 12 8 128 10 2 18 15 6 452 19 11 1,834 18 4 .. 14,775 16 2 1 4,371 16 9 .. 10,403 19 5 1 £ s. d. £ s. d. 50 8 0 600 0 0 758' 9 4 231 15 8 ! 351 10 11 200 0 0 160 0 0 100 0 0 117 10 0 4,805 3 9 6,626 16 0 3,838 12 11 5,064 3 6 1,473 6 4 1,097 6 8 1,191 8 4 , 1,564 11 11 71 13 8 88 0 10 25 9 10 5 10 6 773 0 5 1,645 2 9 1,898 4 6 4,709 16 2 15,208 15 5 22,239 6 7 4,567 11 6 : 6,545 8 9 10,641 3 11 15,693 17 10 £ s. d. £ s. d. £ s. d. 12 12 0 12 12 0 25 4 0 150 0 0 175 0 0 300 0 0 193 11 0 600 0 0 250 0 0 153 15 0 95 0 0 82 10 0 100 0 0 1,451 12 6 1,307 5 0 5,464 11 0 1,794 13 1 1,282 15 7 4,590 7 7 51 14 1 394 16 10 1,036 11 7 226 5 10 184 10 10 1,139 14 11 14 8 4 56 7 4 173 1 9 2 6 6 17 12 6 50 9 7 337 9 11 948 1 4 381 4 4 653 16 2 2,541 17 1 4,479 16 8 4,698 7 2 i 17,073 13 10 857 6 1 915 0 1 3,309 8 2 3,622 10 7 3,753 7 1 13,764 5 8 £ s. d. 600' 0 0 208 6 8 176 0 0 100 0 0 2,660 2 8 2,461 10 0 650 3 8 591 19 0 45 15 0 21 19 0 286 19 7 1,116 3 11 £ s. d. 1,000 0 0 776 13 4 220 0 0 787 0 8 300 12 9 100 16 0 325 0 0 3,794 10 10 1,310 8 3 839 15 0 695 0 0 26,775 2 10 23,470 19 0 5,649 5 0 0,134 3 6 577 17 1 142 3 5 4,443 13 11 13,136 0 6 15,208 15 5 4,567 11 6 22,239 6 7 4,479 16 8 6,545 8 9 857 6 1 4,698 7 2 : 17,073 13 10 915 0 1 3,309 8 2 8,918 19 6 2,213 8 3 90,479 2 1 22,809 19 7 10,641 8 11 15,693 17 10 3,622 10 7 3,753 7 1 13,764 5 8 6,705 11 3 67,669 2 6 * Not in.-luded in Table XXI. Table XXI. —Avebage Cost of each Patient per Annum Mental Hospital. Provisions. Salaries. Bedding and Clothing. Fuel and Light. Surgery and Dispensary. Wines, Spirits, Ale, and Porter. Farm. Necessaries, m * i /-. *. Incidental, Total Cost and Mis- „ P?f . cellaneous. Patient. Bepayments for Maintenance. Total Cost rp„ tal „„_» j Total Cost per Head, less °j 6 * ' per Head, less Bepayments p6 Reeeir>ts I Heceipts of for Main- 'all kinds pre j tenauce. ot aJ1 Kin ds. | vioUB Yea r. ! Decrease Increase in in 1904. 1904. £ s. d. Auckland .. 7 12 3£ Christchurch .. 7 7 7f Dunedin (Seacliff; 7 7 2} Hokitika .. 10 9 lOf Nelson .. .. 9 3 3 Porirua .. 7 18 3J Wellington .. 9 13 9} £ s. d. 9 16 3 11 8 4J 11 14 5J 11 15 0 12 12 llf 11 7 4£ 14 14 10 £ s. d. 2 2 4J 2 5 10 2 5 5f 16 5} 1 6 4J 1 19 3} 2 6 7J £ s. d. 1 12 5| 2 16 8 1 11 10} 0 6 0J 2 16 4f 1 15 9 2 11 2£ £ s. d. 0 4 5 0 2 9 0 2 6J 0 1 8£ 0 8 0} 0 5 11} 0 3 7J £ s. d. 0 0 7} 0 0 11} 0 0 2 0 0 3£ 0 2 64 0 18} 0 18} £ s. d. 0 15 6J 1 9 8} 2 7 10 £ s. d. £ s. d. 3 2 11J ; 25 6 10J 3 13 0 29 4 11J 6 16 11 32 6 6 2 4 7 26 3 llf 4 13 4f | 33 11 2| 4 7 7f 29 8 9 4 7 10} 35 2 3£ £ s. d. 6 7 4J 6 2 9 7 9 04. 4 11 3 5 9 3 4 3 7 7 14 0 I £ s. d. I £ s. d. £ s. d. 18 19 6J 17 16 11J 17 0 2 23 2 2| 20 9 3J 21 11 7i 24 17 5f 22 16 2} 21 7 If 21 12 8J 21 3 8J 27 2 6 28 1 11J 26 16 2J 29 10 3J 25 5 2 23 14 7} 24 7 7* 27 8 31 26 7 llf 23 18 3J I £ s. d. £ s. d. 0 16 9i 1 2 3f 19 1 5 18 9} 2 14 1 0 12 llf 2 9 8J 0 1 lj 2 8 24 1 12 8J 1 2 7| Averages .. 7 19 lOf 11 10 6J 2 1 9| 1 18 5| 6 2 3f 23 13 04, 21 19 11$ 22 1 Of 0 3 11J 0 0 llf 1 10 3J 4 9 5f 29 15 4 Note —Including the fiist five items in Table XX., the net cost per patient is £23 0s. lljd., as against £23 Is. 5d. for the previous year, a decrease of 5Jd. per head.