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Admissions. —Exclusive of 28 men and 79 women who were merely transferred from one mental hospital to another, the admissions numbered 716 (m., 419; f., 297). Of the 716 so admitted, 575 were placed on our general register for the first time, and of the 141 whose names had been previously entered therein all but 25 returned to the hospital whence they had been last discharged. Some of the 575 admitted for the first time had been insane before, but the 141 patients readmitted, while not representing the full number of relapses, sufficiently illustrate the well-known liability of mental disease to recur. Commenting on this in my last report, I said, — ''This tendency to recurrence is one of the anxieties surrounding the question of discharge. While some patients make an apparently complete and lasting recover}-, and some relapse after a long period of sanity, some, who remain well in an institution sufficiently long to justify their discharge, to claim it as a right, soon relapse when exposed to the influences of the larger world. During the past year we have been fortunate in the recoveries being to all appearance more stable, and in the relapsed cases of former years having been returned without any untoward event resulting from their insane conduct. Though naturally gratifying, it must be allowed that this is not a matter of skill but of good fortune." Shortly after the above report was presented, an ex-patient was responsible for a tragedy. Because his first attack was due to poisoning by alcohol and " pain-killer," the patient was kept in the mental hospital by moral suasion long after he could have claimed a legal right to be discharged. A question asked in the House last session elicited the fact that this patient had left in sound mind, that circumspection had been exercised in discharging him, and that the second attack followed quickly updn a relapse into intemperance. The public, naturally shocked by such an event, tends to desire a restriction of the liberties of the patients, and, on the other hand, requests are made for the discharge of patients against fte advice of the responsible medical officers. One must, as heretofore, pursue the only wise policy, that of reviewing all attendant circumstances and treating every case on its merits. The legal standard of a patient's fitness for discharge should be determined by considering whether he requires any longer to be under oversight, care, or control for his own good or in the public interest. The following is the return for 1909 of immigrants who became insane within one year of landing on our shores. The average for the three previous years is nearly 24: — „ ~ , No History of History of r ,, ~ Native ot Previous Attack. Previous Attack. iotaL United Kingdom ... ... 16 2 18 Commonwealth ... ■'■ ■ ■ • ■ 5 2 7 Other parts of Empire ... ... 1 1 Foreign countries ... ... ■•■ 1 ••■ 1 Total 23 5 28 Ratio of Admissions to Population. —Excluding the Native race (9 male and 4 female patients) and all transfers, the proportion of admissions (whether first or not) and first admissions 'to the estimated general population stands respectively at 715 and 5-76 per 10,000, or, in other words, every 1,398 persons in the general population contributed an admission and every 1,737 a first admission. Hereunder are tabulated the returns since 1899 :-r—

One has merely to glance at the ratio for 1908 to notice the improved position this year, especially with regard to first admissions.

Ratio to 10,000 of Population of Number of Persons iu Population contributing Year. Admissions. First Admissions. One Admission. ! One First Admission. ! 1899 1900 1901 1902 1903 5-93 6-39 6-83 6-48 6-78 4-71 502 561 507 5-60 1,685 1,565 1,464 1,542 1,473 2,119 1,990 1,774 1,971 1,783 Quinquennial average 6-50 5-22 1,540 1,915 1904 1905 1906 1907 1908 6-55 6-76 7-16 6-39 7-63 5-42 5-59 5-82 5-04 6-24 1,526 1,478 1,396 1,567 1,311 1,844 1,786 1,718 1,982 1,604 Quinquennial average 6-92 5-64 1,445 1,774 Decennial average ... 6-72 5-44 1,488 1,837 1909 745 5-76 1,398 1,737