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Having given an account of the present policy of the Mental Hospitals Department, and summarized what has been done of la*te, what it is proposed to do, and what we should like to be enabled to effect in the near future, it may be asked whether if all these various measures were duly carried out, through the instrumentality of the Mental Hospitals Department, acting in conjunction with the Health Department and the General Hospitals—granted all these things, can we be quite sure that there will ensue, as a matter of cause and effect, a great lessening of the incidence of actual insanity throughout New Zealand, and a great increase in true and permanent recovery' —not mere temporary improvement and discharge ? Before answering these questions, I may point out that (apart from the figures given in the report of each mental hospital) I am purposely making no reference whatever in my report to statistics of insanity for the past year, because the admission-rate and the so-called " recovery-rate " vary little from year to year, and such variations as the figures may seem to show in actual or prospective recoveries are of little or no value either for direct comparison within the Dominion or for contrast with other countries. The statistics of mental hospitals are generally of little value for comparative purposes, because everything depends on what basis is adopted for reporting patients on discharge as " recovered," "relieved," or " unrecovered." All of us are inclined to hope for the best when setting down and classifying the year's figures ; and the result is that the recovery-rate may be given as 50 per cent, of the admissions where 25 per cent, or 30 per cent, would be nearer the mark if due account were taken of the probabilities of relapse and readmission. Not infrequently the same paitent is classified over and over again as a " recovery," and, of course, a hundred such incurable patients admitted and discharged during the year would to that extent give the institution 100-per-cent. recovery rate. All one need say, or would be justified in saying, about our results and statistics is that they appear to be fairly up to the average for the white population of the British Empire. However, the aspiration everywhere is to do better in the future ; and taking everything into account there need be no doubt that there will be a gradual and steady improvement in this country when full justice is done along the lines set forth in this report. That is our answer to the question asked at the beginning of this section; but something more needs to be said. It does not lie within the power of any Government or State Department to ensure the health and safety of the community, whether the problem be considered from the standpoint of body, mind, or morals. The main function of the State, so far as health and sanity are concerned, is to deal wisely with the present and do its best, to safeguard the future of the race ; and much can be effected in these directions by sound, far-seeing legislation, and by making the necessary material and economic provisions. But, granted all such sensible prevision and provision by the State, the stability, health, and sanity of the population of every country must always rest mainly with the people themselves —primarily with the home and parents, and the training, rearing, and education of the children on sound lines, whatever part the State may play in school education. The following is an extract from my annual report on the Seacliff Mental Hospital made sixteen years ago (1910) : — " Reviewing the destiny of all patients who are brought to the Mental Hospital, it is clear that the average prospect of persons certified as insane in advanced states of mental disease (as is usually the case) is poor indeed. . Every year of experience impresses one more and more with the conviction that, while in the vast majority of cases early admission to mental hospitals affords the only means of doing justice to the insane, the main hope of keeping down the number of insane in our population lies ultimately in prevention. As long as the comparatively simple chronic degenerations of the spinal cord remain, as they still are, incurable, and for the most part little affected by ' treatment,' we have no reason to anticipate much success when dealing with organic affections of the infinitely more delicate, complex, and vulnerable brain-tissues —affections for the most part slowly and insidiously led up to by years of ill health and injudicious living, acting on nervous systems lacking the average of initial nutritive and resistive powers. " It appears to me that the efficacy and importance of preventive measures cannot be too strongly impressed on parents and guardians, since they can make or mar the power of control, and indeed the whole mental and moral destiny of the children entrusted to their care, just as surely as they can determine their bodily health and fitness —largely, indeed, by the same means. " How many parents realize that most cases of epilepsy in adults are found to have been preceded by convulsions in infancy, or by incontinence of uiine—in other words, by nervous irritability and explosions induced mainly by wrong feeding and otherwise careless or ignorant rearing ? How many parents grasp the fact that early indigestion (and gastric and intestinal catarrh) robs the organism of pow T er of control in every direction in afteryears, and is a prime factor in the sexual troubles of puberty and adolescence, besides rendering the individual an easy prey to vice and insanity throughout life ? Education in parenthood offers, I submit, the main hope for the reduction of insanity. " The clear conclusions bearing on the above, which are set forth in Professor Lugaro's remarkable and authoritative book (' Modern Problems in Psychiatry,' University Press, 1909) appear as hopeful as they are convincing. After dwelling on the widespread havoc wrought in the brains of children by parental alcoholism and syphilis —generally regarded as the leading scourges of the nervous system —Professor Lugaro says : ' The infections which arise in the first years of life, and especially the inflammations of the gastro-intestinal tract —the result of unsuitable alimentation during the lactational period'—are the most important factors in determining the majority of cerebropathies, and in this way a crowd of idiots, imbeciles, and epileptics is produced, who encumber asylums and are an enormous drain on the internal economy of the country, as also on public charity. All measures directed towards favouring natural maternal feeding, and providing the poor with the means for

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