13

H.~- 7

(3.) If one of your patients were suffering from consumption (Phthisis pulmonalis), state in detail what precautions you would take to prevent the disease spreading. (4.) A ocuntry doctor says to you, believing that you are a thoroughly competent nurse, "I do not wish to prescribe sleeping-draughts until you have given more rational forms of treatment and management a fair trial; the patient is robust enough, but is practically sleepless " : what may he reasonably expect you to do ? (5.) You have been told that if those supervising a cunning or an impulsive patient become careless he may manage to poison himself in spite of being confined in a mental hospital: enumerate what harmful substances he may obtain and what methods he may employ. Visits of Inspection. In addition to visits paid by myself, by Dr. Gribben, and Miss Maclean from the Head Office, the District Inspectors and Official Visitors are in direct touch with the institutions. I have to express my indebtedness for many suggestions received from the ladies and gentlemen occupying these honorary positions, and for the work they have carried out. In addition it is intended to appoint persons in the capacity of patients' friends, at any rate in the larger institutions, whose duty it will be to spend the day in the wards, help the patients with advice in their troubles, to read to them, assist them when necessary with their correspondence, join them in their recreations, and encourage them in their occupations, while taking no part in their oversight or control. The office will need to be a stipendiary one, as it will occupy the working-day of the persons appointed, but I venture to believe, given persons of the necessary education and special capacity, that the expenditure will be insignificant when compared with the manifest advantages. Auckland. —Visited January, February, April, May, November, and December, and in June this year. The work here is being done under great difficulties. The Motuihi Island patients seem to enjoy the change, and the building when vacated will be much better fitted for its original purpose than when we entered into possession. The relief afforded is for well-conducted patients, and our want is for accommodation for the turbulent and others under special observation, for whom nothing material can be done until the new buildings are ready. Sunuyside. -Visited April, July, September and November, and February, April, May, and June this year. The epidemic of scarlatina referred to elsewhere was a serious impediment to the work of the institution, apart from the delay it caused in getting the new female ward into occupation, as this was used as an isolation hospital. Dr. Gow brought to my notice the zeal with which Dr. Eamsbottom performed his duties and the necessity for- a second Assistant Medical Officer. With this I concurred, and arranged for the necessary accommodation for this officer being gone on with. The institution is over full, and land has been purchased to erect a hospital and reception block with access from Martin's Eoad. Some relief can be given by transfer, but one cannot transfer cases requiring special observation, and buildings will be required for extra accommodation of this class. Seacliff. —Visited July and November, and February and June of this year. During Dr. King's absence on special duty, Dr. Jefferys' work as Acting-Superintendent has to be commended. The chief need here is relief for the female refractory patients. This is urgent, and I have dealt with what is necessary elsewhere. Some of the wards were beginning to look dingy, and have been painted with great advantage. The attendants should have a separate dining-room—a site for this was selected. The nursing staff examination results at this institution were very satisfactory. The Camp and Waitati were in the usual good order. Hokitika. —Visited July and October, and April of this year, and everything found highly satisfactory. The buildings are, some of them, old, but the best is being made of them. Nelson. —Visited in July, and in June of this year. Things are quite satisfactory at this institution. The kitchen, as stated elsewhere, requires to be removed from its present position. The Richmond Home continues to do good work in a very small way. Porirua. —Visited in March, June, and December, and January, February, and March of this year. The pinch is being felt in accommodation for women, otherwise things are satisfactory. The proposed admission and convalescent ward will be a boom. Tokanui. —Visited frequently. The work being done here is highly creditable to Dr. Crosby and the staff under him. Ashburn Hall. —Visited July and November, and February and June of this year. Everything found in good order, and the administration most praiseworthy. Voluntary Boarders, dc. The total number of voluntary boarders admitted during the year was 23 (m., 7; L, 16). Of these, 3 were discharged as recovered, 1 as relieved, and 2 as not improved, and 5 were transferred to the register of patients, leaving at the end of the year 12 (m., 1; f., 11) in residence. The provision for single patients under the Act was taken advantage of in one case, and three notifications have been received under section 122. The provision for minors was employed in two cases. When our buildings are what they should be one may expect a large number of voluntary admissions. In conclusion, I can but repeat what I said last year—that is, emphasize the necessity for building in advance, as 150, more or less, will be added to our patients yearly, and this increment will, of course, grow with the growth of population. I have, ite., Fkank Hay.