H.—9

3

The second class will consist of those in whom degeneration has gone the length of actual disease, revealing itself by an explosion of Delirium Tremens. These must, in the first instance, be taken into a Eemand Ward attached to each of our larger hospitals. From there they should be removed on recovery to gaol, where they should be kept at work, on a liberal diet, for at least three months. The third class ought to consist of those in whom the degenerative process has gone so far that, even after the more immediate effects of the poison have been got rid of in the Eemand Ward, their minds are still so affected as to enable a doctor to give a certificate of insanity. These drunkards, and these only, should be admitted into our asylums, and once there they ought not to be set free like ordinary patients as soon as they have become sane. This, which is the existing practice, simply leads in our asylums to the same absurdity as I pointed out in our gaols. Time after time the discharged lunatic comes back, only to be made fit for another drinking bout, causing great expense to the State every time. Such persons ought to be kept at regular work for such a time as will give them some chance of recovering their impaired volition. But it will be said this is quite impracticable ; people will not send their friends where they can be treated in such a fashion. I grant it is so at present, and will continue to be so so long as we allow our fear of trenching on the liberty of the subject to stultify our State dealings with drunkards. The fourth class, Dipsomaniacs, I would define to be those persons whose insane drunkenness, whether caused by hereditary taint or latent insanity, disappears with the withdrawal of alcohol, lohich, even in small quantities, produces it. These persons at present constitute a class by themselves, distinguishable—but, of course, only roughly distinguishable—from the previous classes. Such persons are sent to our asylums by order of a Judge of the Supreme Court. The Act requires that they shall be kept "in a ward or division thereof in which lunatics are not detained." There is not one of our asylums in which this provision of the Act can be carried out. Feeling this difficulty, the Government have determined to make suitable arrangements for the reception of this class at the new Farm Asylum at Porirua. Here it is intended to gather these cases from the whole colony, for it is utterly impossible to afford special accommodation at each of our asylums. It is further intended that the patients shall work regularly on the farm, instead of being allowed, as heretofore, to live in destructive idleness. The number of dipsomaniacs confined in our asylums last year under a Judge's order was six. Assistant Medical Officers. —It has been urged on me, by some of the Deputy-Inspectors and others, that there ought to be assistants in all our larger asylums. I do not recommend this at present on two grounds : (1.) The time is not opportune for going to any expense that can possibly be avoided. (2.) I contemplate a general measure for the relieving of our asylums from the large population of chronic harmless cases, the merely feeble from age, and idiots and imbeciles, which at present so cumber our asylums, and prevent their true function—namely, the proper treatment of acute cases —from being fulfilled. lam sure that, if I can carry such a scheme out, the number of inmates in our asylums would be so reduced that a thorough-going treatment of acute cases, at present hopeless, will become possible—a thing very different from granting one junior assistant. Another reason which weighs with me is that, as things are at present in our asylums, the appointment of assistants w'ould mean simply this: the assistants, young under-paid men, would be left to treat the patients, while the senior, well-paid officers, would absorb themselves in merely administrative work. The reason of this is apparent, and it is this, that, so long as our asylums are so largely mere receptacles of the detritus of society, and not hospitals for the treatment of curable cases of insanity, the medical superintendents will find their proper work very unsatisfactory, and will be glad to escape consciousness of the fact by devoting themselves to the successful management of our asylums considered as places for the detention and kindly treatment of the insane. At present, therefore, I think that an assistant medical officer in each of our larger asylums would be a mistake, and that for the reason that when a proper system of classification is secured a much more effective and systematic treatment of acute cases, involving a much greater cost than the country is willing to face as yet, must be aimed at. The question of reducing our chronic asylum population by means of the boarding-out system, so largely resorted to in Scotland, must be considered as a part of the general scheme which I have indicated; and our experience of the working of the Hospitals and Charitable Institutions Act is still too short to enable me to obtain reliable data as yet. Another matter that I postpone for the present is the erection of such workshops as are indispensable in any properly-equipped asylum. It is more urgent that decent sleeping and feeding arrangements should be provided than that model workshops should be built. All in good time I hope to get them. Abolition op Napier Asylum. This asylum was closed on the Ist August, 1886. Its existence could be tolerated no longer. From its situation it could never be made anything better than simply a part of the gaol. The result of keeping open such a place as a lunatic asylum was that its inmates were the most intractable lunatics in the colony, and the cost per head for 1885 was £99 14s. s|d., as against £27 9s. in Wellington. To obviate any difficulty in dealing with remand cases, an arrangement was made with the Prisons Department that, in consideration of our handing over the asylum and all its accessories to them, and our continuing to pay the Gaoler £35 a year, the asylum accommodation would still be available for the care of such cases until the arrangements for providing a Eemand Ward at the hospital could be carried out. Admissions. On the Ist January, 1886, the nnmber of registered lunatics was 1,524 : males 981, and females 543. Those admitted during the year for the first time numbered 302: males 170, females 132. The readmissions amounted to 70 : males 37, and females 33.