H.—7a

5

few fitted with Rowcliffe's woven-wire mattresses. These things may be done gradually; but the painting and colouring of the walls and woodwork of the wards, bath-rooms, lavatories, and closets should not be delayed. It would be desirable also to coat the portion of the floors under and between the beds with paraffine-wax. A careful examination proved to me that the utmost cleanliness prevailed throughout the wards, and that good order and comfort were universal. At present no fever patients occupy beds in the hospital. The two central wards, usually set apart for this use, are occupied by ordinary cases of illness, for whom otherwise no room could be found except by making up beds on the floor. I have before remarked upon the risk of treating infectious diseases in the centre of the building; and, there being an urgent demand for more accommodation, it is highly desirable that a detached fever-hospital be erected as soon as may be. There can be no doubt that the increased use of this hospital is due to its present good reputation; for I was glad to find that most of the patients were very proper subjects for medical or surgical treatment, and that a material diminution had taken place in the number of " refuge cases "of the male sex. The small accident-ward is now occupied as a nurses' dormitory, and the " Board-room " forms their room for meals and other uses. Some better provision, however, is required; the more so if any attempt is to be made to establish here a training-school for nursing. Regarding the rest of the building I have not much to add. The small winding-staircases are worse than useless, and the space which they occupy might be taken advantage of for some good purpose. The kitchen is in good order, but a cool store or larder is badly wanted. The Medical Officer's rooms are still very bare and unattractive. Their proximity to the opening of the mortuary-tramway (facilis descensus Avemi) is a much more serious matter, demanding immediate attention on sanitary grounds. A detached mortuary ought to be erected at once. The operating-room is rendered almost useless by the want of proper appliances. Hot and cold water, with sink and basins, should be provided. The instruments ordered are expected to arrive shortly. The store-rooms are gradually being got into good order by the House Steward, who has effected an economy in the purchase of supplies. I examined his books and papers, and found that a very great and satisfactory reduction has taken place in the consumption of alcoholic liquors of late. A better form of register of patients is needed, it being very difficult at present to prepare any statistics, or to furnish the information required, in case of death, by the Registrar-General. The number of out-patients treated is small; at present there are seventeen only on the list for the week. I had the opportunity of seeing dinner served in the wards on two occasions. The provision appeared to me to be somewhat lavish, and I have recommended that a dietary scale, submitted to me by Dr. Bond, the Resident Medical Officer, be approved by the visiting staff and by the Committee, with some slight modifications. The erection of a disinfecting chamber is shortly to be undertaken. If it be contemplated to erect a fever-hospital this building should adjoin it. The staff of the hospital consists at present (in addition to the officers) of twelve nurses, two housemaids, and three porters, together with a cook and assistant. The Lady-Superin-tendent, Miss Crisp, possesses in an eminent degree the qualifications which are desirable for her present position, and is ably seconded by her assistants. I conversed separately with all the patients, ninety-three in number. With one exception, they were unanimous in their praise of the hospital arrangements as now existing. The old lady who differed from them in opinion made such extravagant statements to me that I could only regard her as non compos mentis. It appears that the visiting staff, the Medical Officer, and the Committee take deep interest in the welfare of the hospital; but I should not be doing justice if I did not here state that considerable progress towards the present improved state of things was effected during the tenure of office of Dr. McKellar. 14th December, 1883.

BLENHEIM. I have this morning been occupied -with my periodical inspection of this hospital, which is at present occupied by five patients, all of whom are men: three of these belong to the " chronic " or "refuge" class. On account of the occurrence of blood-poisoning, in a case of gunshot wound of the hand, it was recently deemed desirable to empty the hospital as far as was practicable. There have been as many as twelve in-patients under simultaneous treatment since my last visit. No women have been admitted, but two children were permitted to be nursed in the hospital during illness by their mothers. I found the whole establishment in excellent order, the wards looking particularly clean, tidy, and cheerful: in fact, the improvement since I last saw them is something remarkable. The bedding was beautifully clean, all the beds being made up with sheets and blankets. Linoleum has been laid down in the centre of the floors, American-cloth tablecovers and green-holland blinds provided, and dwarf muslin-blinds fixed, to replace the paint, which has been removed from the lower panes of the windows. I saw also a number of cut flowers in the wards; and there were proper appliances for personal washing. The kitchen has also been improved by laying down a floor-cloth, and a good supply of crockery is now provided. The walls throughout the building have been whitewashed, and some varnish used for the doors and woodwork of the passages. Outside the hospital, improvements are also noticeable. A yard has been gravelled and fenced in, to keep the fowls away from the building. Flowers have been planted, and the large kitchen-garden is neatly kept, and shows promise of good crops. Regarding bookkeeping and financial matters I have made inquiries, and have nothing new to relate. The Secretary appears to visit the hospital weekly, and these matters receive proper attention. The Medical Officer is very inadequately remunerated for his services, the more so as no instruments whatever are provided for his use. The Steward and Matron, Mr. and Mrs. Bax, have not yet held their appointments for six months. It is perfectly clear that the great improvements which I noticed are in a large measure due to their industry and ability. I regret to state that the building is still infested with bugs, which appear to escape through the timbers from any treatment which may be devised for their destruction, They are to some extent kept under by great cleanliness,