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TE WAIKATO SANATORIUM. Sm, — Department of Public Health, Cambridge, 30th April, 1907. 1 have the honour to submit the annexed report of the work of Te Waikato Sanatorium for the year ended 31st March, 1907. During the year the number of cases admitted was 114, while during the same period 155 cases were discharged. Of those discharged, 48 left the Sanatorium apparently in good health, and exhibiting on examination no signs of active disease. These cases one might be justified in tabulating as cures, but personally I would prefer to record them simply as cases in which the disease was arrested more or less permanently. The remaining 107 cases discharged all received more or less marked benefit by their stay in the institution. Many were greatly improved, and would in all probability continue to improve after their discharge from the Sanatorium, provided that they still carried out the mode of life to which their residence in the Sanatorium had accustomed them. A small percentage gained very considerably in weight and improved in general condition, but showed little or no corresponding improvement in the condition of the diseased lungs. On the whole, I think the results may be considered very satisfactory, especially when it is considered that cases were admitted into the Sanatorium in all stages of the disease. On examining the charts showing the condition of patients on admission, one is struck by the evident fact that in the hirge majority of cases the disease had made very considerable progress. In more than half the cases both lungs were affected, and certainly not more than 10 per cent, of those admitted could be described truly as being early or incipient cases. This condition of things is due, I think, in a large measure to the reluctance of the average patient to admit that he or she is sufficiently ill to require sanatorium treatment, which leads to putting off application for admission until forced by evidently rapidly failing health to do so. I am convinced that a very large number of cases could be absolutely cured if treated early enough; but after a certain stage of the disease is reached the benefit of sanatorium treatment, though great, can only be temporary. The condition of the Sanatorium is in some respects not altogether satisfactory. Many, if not all, the shelters are badly in need of repainting and cleaning, while the fittings and furniture are in many cases worn out or in a bad state of repair; the blinds need replacing throughout; the stock of mattresses and bed-linen is very deficient and urgently needs replenishing. There is also a great need of lounges and chairs for the use op the patients in fine weather, so that they may rest in the fresh air outside the shelters. A considerable expenditure will be necessary to put the institution in good order in these respects. Very great inconvenience has been caused recently and the work greatly hampered by the difficulty experienced in obtaining suitable sisters for the nursing staff. This difficulty is, I think, due to the higher fees now obtainable for private nursing; the somewhat isolated position of the Sanatorium and the rather trying nature of the work, owing to the patients being scattered over a large, area, instead of being in one building. The nursing staff is, in my opinion, numerically insufficient, and I think it will be necessary to raise the salaries somewhot and to increase the staff in order to get efficient work. Regarding the patients, their pleasures and pastimes, I consider that, in addition to such outdoor games as croquet and miniature-rifle shooting, their thoughts should also be directed to the learning of useful but non-fatiguing work, such as they could follow when discharged from the Sanatorium. I refer to poultry-keeping and fruit and vine culture. A double end is thus served: occupation of the mind to the exclusion of morbid thoughts about ones-self and one's trouble is an important factor in assisting a cure; proficiency more or less in such occupations as I have mentioned would lessen in a large degree the difficulty that has been experienced by ex-patients in earning a livelihood oufof doors, the majority of patients having been employed indoors. The knowledge of light outdoor occupations will fit them better for the life before them: will enable them to live the outdoor life and to keep to the open-air treatment they have learned whilst under treatment at Te Waikato Sanatorium. It will mean, of course, a certain small outlay and expenditure in the way of tools, implements, &c.; but this will be amply repaid by the work that will accrue —a gain to the Sanatorium in such matters as repairs, which would otherwise have to be done by paid labour, and a decided gain to the patients themselves in the healthful and beneficial occupation it will afford them. Edward E. Roberts, M.D., Medical Superintendent. The Chief Health Officer, Public Health Department, Wellington. By Authority : John Mackay, Government Printer, Wpllinsrton. l<lo7