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The general work of the Hospital is progressing fairly favourably, but one cannot fail to note, the increasing difficulty in getting patients to suitably employ themselves. This must act prejudicially upon the recovery-rate and upon the general health of the, patients. I have to thank the proprietors of the Herald for papers gratuitously supplied for patients' use, the District Inspector and Official Visitors for their consideration and help, and the Medical Officers for their loyal support. The work of the Matron and nurses on the female side has been specially gratifying. TOKANUI MENTAL HOSPITAL. Dr. Gribben reports : — The annual statistics show that our population at Tokanui -Mental Hospital increased from 251 (153 males and 98 females) on the Ist January to 264 (163 males and 101 females) at the end. of the year. Patients admitted for the first time numbered 18 (10 male and 8 female), while 1 male patient was readmitted. Transfers from other institutions totalled 4(3 male and 1 female). A total of 274 patients were under care during the year. Three male, and 3 female patients were discharged recovered, and I female patient discharged relieved. There were 2 deaths (1 male and 1 female) during the year, the causes of death being heart-failure a,nd acute peritonitis respectively. One female patient was transferred to another institution. The number of patients on the register at the 31st December, 1923, was 264 (163 males and 101 females). The average number resident during the year was 254 (156 males and 98 females). Voluntary boarders at the beginning of the year under care numbered 4, while 3 new cases were admitted during the period under review. Of this number, 4 were discharged, and 1 died of senile decay, thus leaving 2 voluntary boarders under care, on the 31st December, 1923. The general health of the patients has been excellent throughout the year, especially so considering the advanced age of many of them. We had some fifty cases of influenza last November, all of which made a good recovery. The musical people of the district have kindly provided us with concerts at intervals during the year. Fortnightly dances for patients during the cold weather, and occasional visits to the picturetheatre in Te Awamutu, help to relieve the monotony of their lives. The furnishing of the new male admission block was completed early in the year, and the admission of male patients was made, possible. The installation of an efficient water-supply is a matter of increasing urgency. The well which constitutes the'present source is becoming more variable and unreliable in its output. Extension of operations in the kitchen garden has made it possible to supply the patients with a greater variety of vegetables than was formerly available. Work on the farm has proceeded satisfactorily. Apart from the usual cropping operations, some 350 acres of new country have been cleared, ploughed, and laid down in grass. The extent of the work in hand now renders imperative the appointment of an assistant to the Farm-manager. The untiring energy of Dr. Macphorson and the, loyal co-operation of the stall' generally have made the work of the year a pleasure. PORIRUA MENTAL HOSPITAL. Dr. Jeffreys reports : — The total number of patients under care during the year was 1,361 (770 males and 591 females), including 6 transfers (4 males and 2 females) from other institutions. There were 238 admissions (134 males and 104 females), and of these only 33 (16 males and 17 females) were readmissions. The, average number resident during the year, including 31 voluntary boarders, was 1,124 (644 males and 480 females). Of the 122 patients who were discharged, 87 (51 males and 36 females) were recorded as recovered, making the recovery-rate 36| per cent, on the number admitted. The actual recoveryrate was, no doubt, considerably higher, but 33 patients who were on probation failed either to report themselves or to furnish a medical certificate at the expiration of their probationary period, and under section 85 of the Mental Defectives Act had to be written off as unrccovered. It is only reasonable to assume that a fair proportion of these had recovered. The deaths during the year were 83, or per cent, of the average number resident. The chief causes of death were senile decay 27, general paralysis 8, phthisis 8, cardiac disease 6. Eight deaths from tuberculosis was an exceptionally large number for this institution, but a majority of the cases were secondary to influenza, and one female patient was in an advanced stage of pulmonary tuberculosis on admission and died very shortly afterwards. On the whole, the general health of the patients has been remarkably good. The overcrowding is still a cause of great anxiety and added responsibility, but it is a relief to know that a substantial grant has been made for the erection of a number of villas, that the plans are prepared, and that in the course of a few months the work will be well under way. The longer one is associated with the mentally defective the more one realizes the inestimable value of suitable occupation, not only as a palliative, but as one of the most important curative means at our disposal. Every patient who is capable of working is encouraged to occupy himself in some useful way, and at present 56-8 per cent, of the male patients are employed, the majority of them outside—on the farm, in the gardens, or with one of the special working-parties. Considering the number of senile and feeble patients who are physically unfit to work, and the number who are mentally unfit, this percentage must be regarded as highly satisfactory and as reflecting great credit upon the staff, who have it constantly impressed upon them that the good of the patients, not the work to be done, must be the first consideration. There are rarely more than 14 or 15 male patients capable of employment who refuse to occupy themselves in any useful way. Only 42-| per cent, of the women patients are " workers," but there is not the same variety of occupation for them as for the men, and practically none out-of-doors, but a number of them get the benefit of open-air exercise in daily walks, and in the summer frequent picnics are arranged for them by the nurses, among whom there is a pleasing rivalry to give their charges a good time.