H.—4

2

Deaths. The percentage of deaths on the average number resident during the year was 587. In New South Wales (1891) the proportion was 739. Considering the great overcrowding in our four large asylums, caused by the delay in opening Porirua Asylum, this year has passed with a wonderful freedom from accidents. A great deal of anxiety in the public mind, however, was caused by the lamentable death of Ah Ching in the Wellington Asylum on the 9th November last. The coroner's jury returned the following verdict on 11th November : "That the deceased died of haemorrhage of the lung, being the consequence of fracture of the ribs, sustained while in a state of acute mania, but how or by what means occasioned no evidence doth appear to the jurors; but the jurors incline to believe that the fractures were occasioned by the patient dashing himself against the door of a cell in which he was confined." The next morning, before any public comment was made on this case, I instituted an inquiry into the facts; and on the 13th I reported to the Minister that no blame was attributable to the attendants for using any undue violence in placing the patient under the restraint which was necessary for his protection; and that, in my opinion, his injuries were caused by his throwing himself against the door, and from the window-ledge on to the floor. In coming to this conclusion, I was greatly influenced by the medical testimony as to the diseased and fragile condition of the man's ribs, for it is a fact well known to all asylum doctors that very slight degrees of force will cause injuries in these cases, such as would be unaccountable in ordinary circumstances. No prominence, however, was given to this fact at the inquest; and some other points were not sufficiently cleared up, chiefly, I believe, owing to the entire absence from the minds of the coroner a.nd the jury of any suspicion of improper treatment of the man. Some of the papers, however, were not satisfied, and gave expression to what appears to have been a strong feeling of distrust in the minds of the public, and the consequence was that a Eoyal Commission was issued to Mr. Eichmond Beetham, E.M., of Christchurch. He reported substantially that it was impossible to say with certainty when Ah Ching received the injuries which caused his death, but agreed with the coroner's jury in saying that " the injuries were probably received during his violent conduct when confined in room No. 10, before the strait-jacket was applied." He goes on to say that no unnecessary violence was used by the attendants in placing the strait-waistcoat on the patient. He was satisfied that restraint was properly used in this case; which, indeed, could not be doubted by any reasonable man. He pointed out, however, that the asylum rule about the use of restraint was not sufficiently explicit, and that for the future it ought to be made clear that the medical superintendent's authority should be required in each case. He further pointed out that the window-ledges and the top of the pads were so constructed as to make the room unsafe for such very violent cases, and, finally, that the medical superintendent ought to have an assistant, so that the asylum should never be without the presence of a doctor. The faulty construction of the rooms has been remedied so far as possible, and an assistant to the medical superintendent has been provided. With regard to the use of restraint in our asylums, I believe there has been quite as little, if not less, of it in our asylums for many years than in any other part of the world. Circulars have been sent to all our asylums, and books prepared for recording every case of restraint, on the model which has just been issued by the English Lunacy Commissioners. The only other occurrence which interfered with the harmonious working of the department during the year was an agitation got up by one or two discontented male attendants at Seacliff, which, after careful inquiry by myself, resolved itself into a complaint that often the meat was underdone ; a minority maintaining that it was not, and that they liked it so. The inquiry, however, disclosed a certain amount of negligence on the part of the steward in not personally seeing to it that a due rotation of joints at the attendants' table was kept up. This neglect I punished on the spot." New Buildings and Improvements. The two new blocks at Sunnyside are now occupied, and the long-delayed fire-prevention system has been completed, and is now in working order. The only urgent reforms now are a new laundry, to cost about £2,000; the replacing of the old and insanitary closets and urinals in the male block by new structures satisfying modern requirements ; and the introduction of a scheme to ventilate the single rooms and dormitories in the older parts of the building. Dr. Levinge is carrying out the plastering and papering of the female wing by employing artisans on the staff. At Seacliff I have succeeded in getting a separate doctor's residence, which will set free the whole front of the asylum for the use of patients, and give a certain amount of additional accommodation for the separation of special cases. Strenuous efforts are being made to avoid the necessity of any further additions to this building by urging on the completion of Porirua Asylum, and I earnestly hope that these will be successful. Dr. King and his staff are sorely put to it to carry on, in the face of the rapid influx that has recently taken place. We have at length succeeded in securing an abundant supply of water for this asylum ; but progress in other directions has had to be sacrificed to the necessity for diverting a very large part of the working strength of the institution to carrying out tiiis indispensable undertaking, which has been finished in a most satisfactory manner. The locks throughout this building were originally unsuitable, and are now so worn out that they must be replaced, and an order should be sent Home to have them sent as soon as possible.

* Since writing the above, the same persons who were at the bottom of this disturbance, having failed in their object by the total collapse of their case, have taken to writing letters in the Globe newspaper, making oharges against Dr. King of neglect and ill-treatment of his patients. Of these new charges not the slightest hint was given to me by any of those persons who are now making them. Under threat of criminal libel against the paper, the names of the authors have been given up, and one of them has been committed for trial at the next sitting of the Supreme Court.