LUNATIC ASYLUMS OF THE COLONY (REPORT ON) FOR 1903.

Appendix to the Journals of the House of Representatives, 1904 Session I, H-07

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1904. NEW ZEALAND.

LUNATIC ASYLUMS OF THE COLONY (REPORT ON) FOR 1903.

Presented to both Houses of the General Assembly by Command of His Excellency.

The Inspectok-Genekal op Asylums to the Hon. the Minister fob Public Wokks. Sib— Wellington, 27th July, 1904. I have the honour to lay before you the following report on the Lunatic Asylums of Ihe colony for the year ended the 31st December, 1903 : — The number of registered insane persons on the 31st December, 1903, was 2,959 —males, 1,771 ; females, 1,188, being an increase of 111 —males, 56 ; females, 55 —over the previous year. The insane of the colony are distributed as follows:— Males. Females. Total. Auckland ... ... ... ... ... 364 212 576 Christchurch ... ... ... ... ... 271 233 504 Dunedin (Seacliff) ... ... ... ... 428 253 681 Hokitika ... ... ... ... ... 130 41 171 Nelson ... ... ... ... ... 88 56 144 Porirua ... ... ... ... ... 328 253 581 Wellington ... ... ... ... ... 142 120 262 Ashburn Hall (private asylum) ... ... ... 20 20 40 1,771 1,188 2,959 The proportion of the male insane to the male population is,— New Zealand (exclusive of Maoris) ... ... 3-99 per 1,000, or lin 251 New Zealand (inclusive of Maoris) ... ... 383 „ lin 261 The proportion of the female insane to the female population,— Exclusive of Maoris ... ... ... ' ... 2-99 „ lin 334 Inclusive of Maoris ... ... ... ... 2-88 „ lin 348 The proportion of the total insane to the total population,— Exclusive of Maoris ... ... ... ... 3-53 „ lin 284 Inclusive of Maoris ... ... ... ... 3-38 „ lin 296 Admissions. On the Ist January, 1903, the number of insane persons in our asylums was—males, 1,715 ; females, 1,138 : total, 2,848. The number of those admitted during the year for the first time was —males, 306; females, 183 : total, 489. The readmissions numbered—males, 148 ; females, 54 : total, 202. The number transferred from one asylum to another during the year was — males, 99; females, 11 : total, 110. Deaths. The percentage of deaths on the average number resident during the year was 596, as compared with 6-28 for the previous year. The percentage of deaths on the admissions was—males, 36-34 ; females, 1947 : total, 29-78. Bkcoveries. The percentage of recoveries on the admissions was —males, 40-56 ; females, 44-69 : total, 42-17, as compared with—males, 38-35 ; females, 51-56 : total, 43-01, for the previous year.

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The following table gives the gross and net cost per patient for the year 1903, as compared with the previous year : —

Financial Results op the Year.

19i 18. 1902. 1903. 1903. Asylum. Total Cost per Patient. Total Cost per | Total Cost per Patient, less Patient, less Receipts for Total Cost Receipts for Maintenance, per Patient. Maintenance, Sales of Pro- ■ ! Sales of Produce, &c. duce, &o. Increase. Decrease. Auckland Christchurch Seaclifi Hokitika Nelson Porirua Wellington £ s. 24 4 29 17 32 19 29 0 34 18 30 1 32 8 d. 5i 8f H 8 61 9 1* £ s. 17 0 21 11 21 7 27 2 29 10 24 7 23 18 d. 2 n If 6 3i 7* 3i £ s. 24 7 28 3 32 15 27 16 33 0 30 14 34 11 d. 0* 6* 5* 0i 6£ 0 7i £ f. d. 17 11 31 19 15 21 23 6 8i 25 12 21 26 1 11 24 14 4 26 17 8 £ s. d. 1 16" ii 1 10 3i 3 8 41 £ s. d. 0 11 11 1 19 6£ 0 6 8| 2 19 4f Averages ... 30 0 1* 22 1 01 29 16 7* 22 6 10 0 5 9i The following shows the a: .nual cost per patient from .876 1903 :— Year. Cost per Patient. Year. Cost per Pat: ient. ! Year. Cost per Patient. 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 £ s. d. 46 1 5i 37 8 llcV 36 0 11 31 5 91 28 18 0| 25 18 4| 28 15 1 29 0 4 29 8 9£ 25 19 5 1886 1887 1888 1889 1890 1891 1892 1893 1894 £ s. 27 0 22 18 21 8 21 10 20 10 20 16 21 16 23 7 23 16 d. 9* 4* 1 4 3 2* 8| 4 4.1 1895 1896 1897 1898 1899 1900 1901 1902 1903 £ s. d. 22 13 8tJ 22 9 10£ 23 0 9£ 22 7 8f 21 19 0 22 9 8 21 17 9* 23 11 51 23 1 5 The receipts from produce soi >ld from the asylum farms are as follows :— Auckland Christchurch Seacliff ... Nelson ... Porirua ... Wellington £ s. d. 633 9 6 ... 1,371 2 6 ... 1,141 11 0 138 0 6 680 3 10 214 13 6 Total ... £4,179 0 10 Sle: iEPING-ACCOMMODATION IN ASYLUMS. _. i Number , , of Patients, Asylum. 1Mh 1904. j i Number - Statutory N b of Patients Common Accommoda- ; Number of to be Dormitory tion in Single Rooms, accommodated Accommoda- Common statutory , in Common r * ,on J . Domutoms: Acoom _ * t-. :+„„:„„ Cubic Feet. ; Number , ,. Dormitories. ; , _ ,. modation. of Patients. i Asylum. Number of Patients, 12th March, 1904. j Auckland Christchurch Seaclifi ... Hokitika Nelson ... Porirua ... Wellington 576 513 685 166 142 574 253 I 132 82 172 37 35 68 68 444 431 513 129 107 506 185 247,732 247,296 265,262 95,959 65,111 336,487 100,173 413 412 442 159 108 560 166 31 19 71 19 Totals 2,909 594 2 315 1,358,020 2,260

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Single Rooms.

At Auckland there are 576 patients, but only floor-space for 493 ; the asylum therefore is overcrowded to the extent of 83 patients. At Hokitika there appears to be sleeping-accommodation for 30 more patients, but the floorspace will only allow 20 more. At Porirua there appears to be sleeping-accommodation for 560 patients in the common dormitories, but the floor-space is only sufficient for 506. The number of patients in the dormitories at 12th March was 506. The following shows the amount of overcrowding at our asylums as at 12th March, 1904, and also the additional accommodation provided since June, 1903, to mitigate this evil : — Auckland ... ... .. ... ... 83 patients in excess. Christchurch ... ... ... ... ... 19 Seacliff ... ... ... ... ... ... 71 Wellington ... .. ... ... ... 19 192 Less room at Hokitika for ... .. ... .. 20 Total ... ... ... ... 172 patients in excess. The additional accommodation that has been provided since June, 1903, is as follows : — Auckland ... ... ... ... ... 79 beds, now in occupation. Porirua ... ... ... ... ... 50 „ „ Sunnyside ... ... ... ... ... 52 „ „ Hokitika ... ... ... ... ... 50 „ Total ... ... ... ... 231 „ 20 more beds at Porirua, 30 at Sunnyside, and 76 at Seacliff will be completed shortly, thus providing extra accommodation for 357 patients. The Government has authorised additions to the farm labourers' auxiliary building at Seacliff, auxiliary buildings at Sunnyside and Porirua, as well as a large addition to the Auckland Asylum. The old laundry at Auckland has also by the addition of a new story been converted into rooms for female patients. Provision has also been made at Sunnyside, Porirua, Seacliff, and Auckland, for observation-wards. So that I can see my way for the first time in the history of the Department to having a number of spare beds in excess of the statutory accommodation. The yearly addition to our numbers is about a hundred, and for a large proportion of these we shall have room, so that when all this building is finished, it will carry us over another year without any further additions being requisite. In every one of our hospitals for mental diseases there should be spare beds for new cases. This will make it possible, for the first time in our experience, to admit under a new Act voluntary patients in circumstances where privacy and comfort and freedom from the irritating contact with insane patients and imbeciles will be avoided. Thus giving them under the most favourable circumstances a chance to recover their mental balance, which in many of these cases is but slightly impaired. Every year several cases arise in which doctors are unable to certify that the patients are not compos mentis. I further hope that the effect of this beneficent provision will be that many persons may entirely escape the stigma of being " sent to an asylum," from which people shrink so much, and which is apt to stick to them all their lives affecting alike their social position and their mental equilibrium. In all those countries where the hurry and worry of business life is so urgent (as for instance, it is nowadays in the United States of America and even in England, accompanied as it is by a constant influx of the healthy and vigorous country population into the towns, where in the necessary struggle for wealth and comfort the nervous system of a vast number of victims is undermined until they become neurotics and neurasthenics) large numbers of private asylums where such people take refuge are being established. In Canada, where no such homes are being provided, there is a constant inflow to the United States, to take advantage of such institutions, all of which are established on a payingbasis. ;|: Before long, I believe it will be necessary to establish at each of our hospitals for mental diseases regular systematic teaching for attendants and nurses. It would be useless at present to do more than insist that the whole staff must attend such instruction, but the examinations should be voluntary. 11 should be made clear that no attendant has any chance of promotion except such as prove themselves to have profited by the instruction provided. The movement started at Larbert Asylum, which I carefully studied on the spot, for the staffing of the asylums mainly with female nurses for both men and women patients is, I think, likely to spread, and has, in fact, already spread to some places in America and England. Under this system, there is

* Ontario Asylum Report for 1903,

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Asylum. Number of Single Rooms. Total Space: Cubic Feet. Cubic Feet for each Room. Auckland Christchurch Seacliff Hokitika Nelson Porirua Wellington ... 132 82 172 37 35 68 68 119,280 69,651 141,421 29,071 29,589 63,217 61,280 903 850 822 768 842 929 901 Totals ... 594 512,863 6,012

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a great increase of nurses provided in the infirmary branch of asylums, and more especially is there an immense increase in the number of nurses who are in attendance upon patients during the night, the proportion given in this year's report is Ito 33 - 7, thereby securing a very much-needed increase of attention to such patients as would otherwise be very restless and noisy, thus disturbing the whole dormitory. Of course this would involve a very great increase in expenditure, especially if we insisted on such a large number of hospital-trained nurses being employed on the staff. Under this system, many of the single rooms are fitted up as sitting-rooms, so that the nurse may be constantly with her patient. For many years in my reports to the minister, I have drawn attention to the anomalous position of our lunacy statistics. In 1876 the proportion per 1,000 was l - 97, whereas last year it was 3 - 53. The proportion of discharges and deaths of the patients treated in our asylums was in 1878 23-33, and last year this had sunk to 16-39. That is, the proportion of admissions to the population was in 1878 0-83 per 1,000, while last year it was 0-70 per 1,000. I need not say that there is no more complex social problem than the question of an absolute increase of insanity in proportion to population, especially in a new country like this. We started with a select population, amongst which there were very few old people, all—or an immense proportion —were in the prime of life, and had undergone such a sifting and selection as was involved in immigration to begin with, and the numerous gold rushes afterwards. Since then our people have been steadily ageing. The first element that in my opinion must have the greatest weight attached to it, is the steady accumulation of chronic cases in our asylums, where safe keeping, good feeding, and suitable clothing has preserved the aged in a far higher degree than would have been the case even if they had been free men and women. It is impossible to say what proportion of our diminished deaths and discharges this cause accounts for. It is certain, however, that the increasing age of persons admitted is largely responsible for the fact that in 1878, as the following Table shows, 17-03 of the patients in the asylum were over fifty years of age; and that last year, by a steady progression through all the intervening years, the number of persons over fifty years of age was 39-07. The per centage of admissions of patients over fifty years of age was 13-26 in 1878, and has steadily increased to 3P27 in 1903. Proportion of the Insane to the Population. 1876 .. .. .. .. .. .. lin 509 or P97 per 1,000 1878 .. .. .. .. * .. .. „ 471 „ 2-12 1883 .. .. .. .. .. .. „ 393 „ 2-54 1888 .. .. .. .. .. .. „ 361 „ 2-77 1893 .. .. .. .. .. .. „ 330 „ 3-03 ' „ 1898 .. .. .. ~ .. .. „ 300 „ 3-33 1903 .. .. .. .. .. .. „ 284 „ 3-53 Proportion of Discharges and Deaths on Patients treated. 1878 .. .. .. 23-33 1893 .'. .. .. 14-22 1883 .. .. .. 18-64 1898 .. .. .. 18-39 1888 .. .. .. 18-27 1903 .. .. .. 16-39 Proportion of Persons over Fifty Years of Age in Asylums. 1878 .. .. .. 17-03 1893 .. .. .. 36-09 1883 .. .. .. 21-08 1898 .. .. .. 38-35 1888 .. .. .. 28-77 1903 .. .. .. 39-07 Proportion of Admissions to Population. 1878 .. . . 0-83 per 1,000 1893 .. .. 0-68 per 1,000 1883 .. .. 0-78 „ 1898 .. .. 0-63 1888 .. .. 0-59 „ 1903 .. .. 0-70 Percentage of Admissions over Fifty Years of Age on Total Admissions. 1878 .. .. .. 13-26 I 1893 .. .. .. 27-97 1883 .. .. .. 16-50 1898 .. 25-61 1888 .. .. .. 21-60 J 1903 .. .. .. 31-27 This it is that causes our discharges by death and recovery to be what it is. Another very important element in the case has been that for many years there has been a constant struggle on the part of those local bodies who are in charge of charitable aid, to get rid of persons suffering from senile decay, whose faculties are enfeebled, and who are often very troublesome, to cast the maintenance and care of such people on the asylum authorities. In fact, this has long reduced itself merely to a struggle between the representatives of the local ratepayers and the defenders of the consolidated revenue.

ENTRIES OF VISITS BY THE INSPECTOR-GENERAL TO THE DIFFERENT ASYLUMS. Auckland Asylum. 9th January, 1904.—As usual, I find this institution is administered in a most satisfactory manner. The care and treatment of the patients cannot I think be improved on until the old laundry is ready for occupation. In about three months this addition will give great relief on the female side. The delays in getting on with the building were caused by the bad quality of the old bricks, which we counted

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on being able to use in the new structure, so that a much larger extent of the old walls, which it was believed could carry a second story, had to be taken down. Next, it was for a long time impossible to get the bricks required, and bricklayers also could not be found. lam greatly disappointed to find that orders have been issued that—as I hope only for the present —no further steps are to be taken towards the extensions promised at the kitchen end of the Asylum. If some relief is not provided immediately, it will be a dismal winter for this institution on the male side. The number of patients this day total 579 —males, 366 ; females, 213. Two males are absent on trial, and one female. Six males are confined to bed. No one is so confined on the female side. The Auxiliary Asylum and the farm and the patients are admirably looked after. I examined the dinner and found it very good. The bedding and clothing are excellent, and the condition of the institution, considering the great strain caused by overcrowding, reflects the greatest credit on Dr. Beattie and his staff ; for nothing hut the most unremitting vigilance and care could have produced such results. The excess of males is forty. I say nothing about the females, for they will soon be relieved. Mr. Ewington, to whom this Asylum owes so much, has made suggestions about the ventilation of the female dining-hall and the workroom. The bad ventilation is due to structural defects in the windows of the old parts of the building, and would cost so much to remedy, that I cannot recommend that the work should be undertaken now, when matters much more urgent demand our attention. Christchurch Asylum. 7th December, 1903.—1 have found this asylum for the first time for many years free from overcrowding. The number of male patients is 268, females, 233. The overcrowding which prevailed for many years had many evil consequences ; it of course greatly affected the health of the patients and diminished the chance of their recovery ; it kept the whole staff in a state of constant anxiety, and the attendants found their service very harassing and their inevitable discomforts very hard to remedy. The number of patients exceeding the legal provision for their accommodation of course affected the cooking arrangements as well as the bathing and the laundry. In the existing state of the labourmarket, the changes in the staff for years were frequent. Changes caused by the inevitable worry of the daily duties, and the general rise of wages in other employments were very trying ; but we have great cause for thankfulness that we have got over this period so well as we have. Nothing but the care and vigour of the administration could have secured such a result. I hope that the new auxiliary building will at once be extended so as to provide a day-room and kitchen against the winter. The remaining dormitories can stand over for the present. If it should be decided not to pull down the old North House it ought to be thoroughly overhauled, especially as regards .the drainage, and then it can accofnmodate about twelve old people. I found five men and five women in bed for various causes, and all were very carefully treated. I was present at the dinner on two successive days, and the meals were good in quality, plentiful, and well cooked. The stock, for which the Steward, the Matron, and the charge attendants (more immediately) are responsible, is in excellent order and well looked after. To day I found every item I called for correct. The institution as a whole is in a very satisfactory state. Seacliff Asylum. 27th November, 1903.—1 have carefully inspected this hospital for mental diseases ; I have seen all the patients, finding only five males and two females confined to bed. All were being carefully looked after ; I saw two dinners distributed and eaten. The food was abundant and well cooked, notwithstanding the immense difficulties caused by inadequate and worn-out cooking apparatus. The ranges have been twenty years in use, and are fairly worn out; it has become a matter of great urgency that new ranges, &c, should be placed in the kitchen. The cook, Miss McMurdo, deserves the thanks of the whole institution for the way in which she has overcome very great difficulties. The old bakehouse is in process of enlargement, as a matter of real urgency. The buildings designed by Dr. King, for relieving the overcrowding (amounting to seventy-three over the statutory number) are under consideration by the Minister, as well as the provision for a male convalescent cottage and a male attendants' mess-room, all of which are imperatively necessary. The portion of the female wing which was thought no longer' safe has exacerbated the difficulties in that side of the building, and I am glad after examination of the work under the charge of Mr. Marchant, and carried out by Mr. Bailey, that the plan adopted promises success, and the space will soon he ready for occupation. The laundry machinery is entirely worn out, and beyond repair. Dr. King is now obliged to send some of the washing to town, and I need not say what an unsatisfactory state of things this fact reveals. Owing to Mr. Justice Chapman's elevation to the Supreme Court Bench, I feel bound to call attention to the invaluable services he has for so many years rendered to Seacliff. In and out of season his advice and extensive knowledge have been available as Deputy Inspector. He has indeed deserved well at the hands of the Government. The experiment of a fishing-boat whose headquarters are fixed at Puketeraki, is promising to turn out a great success. Last month 8,960 lb. of first-class fish was taken, of which, after reserving an abundant supply for two days' dinner in a week, to the great saving in meat, the surplus was distributed among the following : Christchurch Asylum, 1,675 lb. ; Burnham Asylum, 120 lb. ; Christchurch Hospital, 80 lb. ; Caversham Industrial School, 150 lb. ; Dunedin Hospital, 100 lb. ; Ashburn Hall, 100 lb. (paid for) ; Orokonui Home, 60 lb. ; Benevolent Institution, Dunedin, 200 lb. ; Salvation Army Refuge, 10 lb. ; Old Mens' Home, Ashburton, 100 lb. ; Samaritan Home, Christchurch, 1001b. Hokitika Asylum. 11th December, 1903.—A very heavy strain was put on this Asylum by the transfer of fifty patients to relieve the overcrowding at Sunnyside. By extraordinary efforts Mr. Gribben and his staff have minimised the great discomforts which had to be faced during and since the change. A new and

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suitable building has been well designed and carried out by Mr. Gribben, who has deserved the thanks of the Department. At an expense of about £750 accommodation has been provided for fifty people, showing an extraordinary triumph of skill and economy. Only one skilled artisan outside of our own staff was employed. The material for the building is of the best quality, and the workmanship is excellent. There is great want of day-room space on the female side, and I have instructed Mr. Griffen to provide an enlarged space by including a single room and store in the day-room. In less than two months the new quarters will be occupied, and the airing-court with a sunk fence will speedily be ready. The accommodation now provided will meet our requirements for a considerable time to come. Nelson Asylum. 9th May, 1904. —I have inspected every part of this building and its adjuncts. The main part of the Asylum is old, and some parts where white-pine was used are rotten. Originally insufficient space was left underneath, and dry-rot prevails especially in the kitchen and its neighbourhood. The whole needs painting all over. The drainage must he put right on an entirely new system, for which the resident engineer has promised to make an estimate of the cost. The male airing-court ought to be laid afresh. These defects give the whole building a dingy and unsatisfactory appearance. The reason for all this is mainly want of money, but I hope, now that they are bestirring themselves, we shall soon be able to get these things put right. I saw only one chronic in bed suffering from diabetes, and too ill to live long. The patients are suitably clad and fed. Their numbers this day are, males 87, and females 55. Porirua Asylum. 22nd November, 1903. —I have been all over the buildings, and have seen all the patients. Only one female patient is confined to bed —to prevent prolapsus recti. On the male side a few chronics are allowed to remain in bed. All are carefully looked after. I also saw the patients enjoy a good dinner, and I was very much struck with their fresh healthy look. I was relieved to find that no one had suffered from the recent long spell of such severe weather. The plans for laying out the grounds by Dr. Hassell are making rapid progress, and in a short time the cricket-ground and new airing-courts will immensely improve the comfort of the patients. Notwithstanding the long stretch of dry weather the recent rains have freshened up every thing in a marvellous way. I earnestly hope the laundry accommodation will be speedily extended, for the additional fifty patients transferred here are utterly beyond the power of the old laundry to deal with. The smokestack ought to be extended at once for it disfigures the buildings and spoils the drying-green. The institution is working harmoniously, and it is a great pleasure to visit it; and this will be increasingly so as the laying : out of the grounds progresses. 13th June, 1904. —To-day I find this institution working well in all departments. The number of male patients confined to bed is eight, some suffering from influenza ; nearly all are convalescent. Five females were confined to bed. I visited all these in company with Drs. Hassell and Barraclough, and found that they were all being carefully and kindly treated. I saw the dinner which was good. The patients' dresses and foot-gear were all suitable, both as regards material and quantity. The number of male patients to-day is 324, females 254. Eight males and eight females are out on trial. Every part of the building was clean, the day-rooms very bright and airy, and all the dormitories were in firstrate order. Good progress is being made in laying out the cricket-ground and airing-courts. A slight effort of the constructive imagination will make any but the dullest see how beautiful this place will be in a few years. I hope to see the enlargement of the laundry rendered necessary by the new auxiliary in working-order. It is urgently required. The additions to the auxiliary lately authorised are progressing. The administrative capacity of Dr. Hassell is everywhere apparent, and he is ably and faithfully seconded by Dr. Barraclough. The staff as a whole is working well, and the farm is well managed by Mr. Prebble. Wellington Asylum. 17th November, 1903.—1 have examined this hospital for nervous diseases and found everything going on well. The male side is now a pleasure to visit, since the removal of fifty male patients to Porirua. I regret to say, however, that there is an excess of twenty-five patients on the female side. I saw the dinner ; examined the clothes and building ; and found nothing to find fault with, except perhaps that the fish for dinner were so small that it was difficult, if not impossible, to prevent their being very much broken in distribution. I saw and examined all the recent and convalescent cases in company with Drs. Gow and Ulrich. I am satisfied that so far as the structural defects of the building admit of it, everything is well looked after. Had fire alarm : result, very good. 23rd May, 1904.—1 found this Asylum working satisfactorily. In company with Drs. Cow and Ulrich, I saw all the patients, and considered all the recent and convalescent cases. Only three women were confined to bed and three men. All were visited. The food, clothing and bedding were all examined. For my lunch I got a bowl of the soup as it was being brought in and served in the dininghall, and I never tasted better. Notwithstanding the age and patchwork character of the building, it has always appeared to me to have a look of homely comfort about it, and this it still retains. Dr. Ulrich's attention to his work is very satisfactory. lam sorry to find that the paper, with which the corridors, &c, were repaired about four months ago, is losing its colour and is already very patchy. I have called Mr. Holmes's attention to the matter, and he has undertaken to inquire into it. Ashbuen Hall, Dunedin. 29th November, 1903.—1 have seen every patient. Nobody was confined to bed. Seven of the patients —five women and two men —are voluntary. I examined the dinner and found it very good.

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The rooms and corridors are scrupulously clean, and all are brightly fitted up. The grounds are most beautiful. I heard no complaints, and manifestly the institution is in first-rate order. The additions to Tuke Ward are exceedingly convenient, and a great boon to the patients. The bowling-green is approaching completion. The staff is adequate and work well. It is a pleasure to visit the place.

MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND ASYLUM. Sir — I have the honour to forward you my report on the Auckland Lunatic Asylum for 1903. On the first day of the year we had a population of 538 patients ; on the last day we had 576 —a total increase of 38 patients, of whom 23 were males and 15 females. During the year a new laundry has been constructed entirely by Asylum labour. This is large enough, with the aid of washing-machines, which I understand will soon be installed to complete satisfactorily the washing of more than double our present population. On the site of the old laundry a two-storied brick building, part of which will be ready for occupation not later than the end of March, and the whole of which will be completed shortly afterwards, is being built by Asylum labour with the addition of one bricklayer. This will afford accommodation for ninety female patients, and, as stated above, will give sufficient space for five years or more. This will enable us also to classify the female patients into five divisions —a very fair classification and one which, with the exception of not more than twenty patients, should satisfy any reasonable expert. Classification as understood by the public is an impossibility excepting at a break-down cost. It is to me a matter for very great regret that no steps are being taken to provide for the present male excess, and for future accumulations. What we are to do shortly I really do not know. Every nook and corner is being utilised and no further classification is, in the main building, possible beyond division into two lots —the quiet and moderately tidy, and the noisy, destructive, and dirty. For the latter class the day-room space is terribly inadequate. All the dormitories are overcrowded. The number of admissions, 130—88 males and 42 females —is the largest on record, and the increase out of proportion to the increase in the population of the province. Seventeen cases were due to senile decay and some of the cases ought not to have been committed. Of the remainder, 48 males and 32 females were between the ages of twenty and fifty years, and therefore at the most robust period of life. Of the total of 88 males —55 or over 62 per cent, owed their admission to Alcoholism, heredity and congenital deficiency. Of the females—7 cases were directly due to childbirth, and in all seven cases there was an hereditary history ; 5 were due to the climacteric and 5 to domestic worry. The other cases were due to causes entirely outside the married life. The death-rate for the year was 6-09 per cent. —males 7-76 per cent., and females 3-37 per cent. This is the lowest rate for many years. Six deaths were due to tuberculosis. It is satisfactory to note in this connection that at the present time there is not a single case of tuberculosis in the Asylum. The recovery-rate was 43-84 per cent. —males 43-18 per cent., and females 45-24 per cent. This rate is above the average, which for the seven years —1897 to 1903—that I have been superintendent is 40-95. It is frequently stated that in the matter of recoveries our asylums are not doing adequate work. It may therefore be interesting to record the recovery-rates in the Asylums of Great Britain and Ireland as compared with that of the Auckland Asylum :— Per Cent* Auckland Asylum, 1897-1903 .. .. .. .. .. 40-95 Royal and District Asylums (Scotland), 1896-1902 .. .. .. 38-2 County and Borough Asylums (England), 1896-1902 .. .. .. 37-4 District Asylums (Ireland), 1896-1902 .. .. .. .. 36-4 In each case the figures are given for seven years, and in each case the average of averages are taken— the percentages stated are therefore only approximately correct. In the Royal Edinburgh Asylums which is presided over by one of the ablest Medical Superintendents in the world, and who is supported by four assistants and four resident clinical clerks all qualified medical men, the average recoveryrate for 1896-1902 was 35-7 per cent. The population for 1902 was 947. With more than half the number of patients and with only one assistant, and at a maintenance cost of approximately half that of the Edinburgh Asylum, our recovery-rate is considerably higher. Throughout the year I have had the hearty assistance of the staff. Unfortunately a number of changes have taken place on both sides. So long as there is no outlook —no inducement for males to remain in the service—it is only reasonable to expect that the majority are always on the look-out for some employment with better prospects, and that they should take advantage of every opportunity. I trust that my recommendation of last year respecting the salaries of the seconds-in-charge will soon be given effect to. Our thanks are due as usual to the proprietors of the Herald for a gratuitous supply of daily papers and mine are due to the Assistant Medical Officer, the clerk, and the staff generally for their sympathetic support during the whole year. I have, &c, R. M. Beattie, The Inspector-General of Asylums, Wellington. Medical Superintendent.

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SUNNYSIDE ASYLUM, CHRISTCHURCH. Sir, — I have the honour to forward the report on this Asylum for the year 1903. The subjoined statistical statement shows the admissions, discharges, and deaths for that period.

Percentage of discharges of first cases on admissions .. .. .. 3PB ~ ~ recovered and relieved on admissions .. .. 65-9 ~ deaths on admissions .. .. .. .. 31-7 ~ ~ on number under treatment .. .. .. 4"1 The admissions were fewer than for the last two years, being twenty-two less than in 1901, which would be more apparent if the committal of first cases only were taken into account, while there does not seem to have been anything unusual in the determining causes of the insanity. The type of insanity, however, appears to me to have considerably changed during the last twenty years, for we get comparatively few cases of acute mental disease, a much larger proportion being merely outbursts of excitement in those of congenital deficiency —many of them associated with epilepsy —and due to vicious indulgence, which to my mind indicates a lower standard of mental organization and degeneracy. As readmitted, it is exceedingly difficult to resist the constant importunity of relatives for the release of their friends, even after repeated attacks, and I fear I too often give way to such when my better judgment tells me the patient is not fully recovered, and is sure to relapse sooner or later. In addition to the grave responsibility incurred in recommending the release of such cases on account of the danger to themselves and others from renewed attacks, there are social questions of great importance involved, and I often feel that such a great responsibility should not he placed on one individual. That more serious accidents have not occurred in this way shows the discretion and great care exercised therein by the medical officers of asylums, but I think some tribunal should be established to relieve them of this anxiety, before which doubtful cases could be brought, and the medical aspects of the case represented. The discharges were very largely augmented by the transfer of forty-two men and eight women to the Hokitika Asylum in July, which accounts for so many under the heading " Discharged not improved ; " while it will be noted that the percentage of the cases discharged recovered, on the admissions, is unusually high —viz., 659. This, however, cannot be taken as a reliable guide to the regular recoveryrate of this Asylum, for it was much lower last year ; so that one year should be taken with another, or the percentage calculated over a longer period. The death-rate was remarkably low, and has been so for several years, so that, as previously pointed out by me, it must have a considerable effect on the accumulation in our asylums, as compared with those where the mortality-rate is higher. One death was accidental and due to a fall from a haystack on which the patient was working, whereby he sustained a fracture of one or more cervical vertebra), with resulting paralysis. The man was a labourer by employment, and had been accustomed to similar work for years, but he carelessly jumped from the stack on to a cartload of hay adjoining, from which he slipped, falling with great force on his head. There were no other serious accidents, or suicides, and this Asylum has enjoyed remarkable freedom from such, except for a comparatively short period of bad luck. The transfer of forty-two patients above mentioned, and the opening of the auxiliary building in November last, affording immediate accommodation for forty-five patients, reduced the overcrowding of the male division for the first time for several years to a trifling consideration, and when the remaining portion is completed, comprising living-room, dining-room, kitchen, &c, making it practically a separate institution, the accommodation for male patients should be sufficient for some years to come. The conversion of the old North House by repairs and alterations at a small cost, into quarters for about a dozen of the very old, feeble, and demented but harmless men, will be in the same direction,

M. P. T. Admissions. Admitted first time Eeadmitted 39 12 24 7 63 19 Totals 51 31 82 Discharges. Recovered and relieved Not improved .. .. 34 43 20 10 54 54 Totals 77 31 108 Number discharged who were admitted during year Number died ,, Number remaining ,, 19 2 30 12 1 18 31 3 48 Totals 51 31 82 Deaths 20 6 26

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and will remove a very undesirable class from the wards of the main building, while at the same time affording them the comforts and safety of a quiet home. The chief fault of the North House is that it will not accommodate half those old men qualified for such a building, and in this way it can only be looked on as a temporary makeshift till more extensive provision can be made for this class, including females, when it can be set apart for such an emergency as an outbreak of infectious disease. The changes in the staff were not so numerous as in previous years, being ten of each sex, and these were chiefly amongst the junior attendants for such causes as approaching marriage, to better themselves, or others satisfactorily explained ; but it is open to question whether the same degree of efficiency has been maintained, and it is certain that the applicants for the position of female attendant have not the same standard of qualification, in several respects, as those of former years. In reference to this subject I desire to make some remarks on the agitation by the attendants for the betterment of their position by increase of pay, shorter hours, &c, which I trust will not be considered out of place. I have reason to think that this has been almost entirely on the part of the male attendants, or a certain proportion of them, or at their instigation, and is due to interested but indiscreet interference and encouragement with its unsettling influence on them, which is reflected on the work of the Asylum. But, after all, supply and demand should largely regulate the matter in their case as in the general labour-market, and, judged by this standard, there is no justification for any grievance, at least as regards the male attendants, for the number of applicants is just as great as at any time during the last twenty years, and far exceeds the number of vacancies. Indeed I never remember any time in which I have had so many applications from young men of a good stamp seeking employment here, and very many of these are the sons of farmers or young farm-hands, who seem allured by the attractions of life near town and want to leave the country —the very thing, as I believe, statesmen here and elsewhere are seeking to counteract and discourage. Neither do I think the older attendants can show much ground for agitation, except the same laudable desire we all have to better our positions, especially when invited to formulate demands, for the changes are not amongst them, and they seem reluctant enough to try their chances again in the general labour-market, being apparently satisfied that they cannot do better. But this reluctance to move on causes stagnation in promotion and so fosters discontent, with its consequent indifference, slothfulness, and inefficiency, because the scale of increase is not progressive beyond a certain salary, unless on advancement. This, I think, a distinct grievance, for a good man, possibly better even than his senior and superior officer, is thus often kept back for many years on a comparatively low salary through no fault of his own, and all the time may possibly wish to get married, and is prevented from making a comfortable home. In my opinion the scale for increase of salary should not depend alone on promotion, but on the man's worth and length of service, irrespective of advancement to the position of charge attendant, and on the recommendation of his superior officers ; for very many of those employed in various ways outside ordinary ward duties are equally efficient and valuable to those more directly engaged in that way. The case of married attendants demands some special attention, for, though that condition is not, in my opinion, any particular recommendation —indeed it is often the reverse —their allowances cannot be considered of the same value to them as they are to single men, seeing that they must keep up homes outside. Men should not be encouraged to marry, till they are at least two years in the service, by which time, according to the present scale, their salary would have risen to £80 a year, with board, lodging, &c, and by that time the superintendent should have had sufficient experience of their work and be in a position to recommend whether it is worthy of further remuneration. I do not think this should take the form of house allowance, because in the first place such would be direct encouragement to marriage, and too many married men are a disadvantage and inconvenience to the service, and, secondly, because single men may be equally valuable and deserving of recognition, and would thus be penalised. To sum up, the increase of salary should be progressive up to £100 a year depending on the man's worth and length of service irrespective of promotion, but in the case of single attendants, after reaching £80 a year, it might be allowed to accumulate and be given as deferred payment, with interest, on getting married or quitting the service, or as a bonus after so many years. He would thus have something definite to look forward to and some savings effected. There should also be more elasticity in the estimates in the way of a vote for contingent increases of salary on the urgent recommendation of the Superintendent, for it is unreasonable that a tradesman who applies for an increase of salary, say in October, should have to wait nearly twelve months before he knows whether it will be granted ; in this way good men are often lost to the service who might be retained were the responsible officer in a position to say, within a reasonable time, that he would get this extra remuneration. The question of the length of hours is only being used, in my opinion, as a lever to obtain increase of salary, and I am satisfied it is not in itself any grievance with the attendants ; moreover, alteration being impracticable, it is not worth further consideration. If there was any serious cause of complaint or dissatisfaction —any injustice, harsh treatment, excess of work from " sweating " or long hours of duty —there would not be so many applications for reappointment from those whe have resigned from time to time, or, on the part of immediate relatives and friends of attendants, to join the service. As regards the female attendants, the difficulty assumes a different form, inasmuch as the supply is not equal to the demand, and thus it requires different treatment. I have already pointed out that there has been a deterioration in the class of applicant, and I have from time to time verbally and in writing drawn your attention to this and to the difficulty of replacing those who leave, which at times has been very embarrassing. In this way I have often been obliged to engage an obviously unsuitable applicant to fill a gap, and as there may not be any marked reason for discharging such person she is allowed to continue on, though it is quite plain she will never be fit fax the responsible position of charge

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attendant; but when her turn for promotion according to seniority arrives she expects it, and is indignant and grievously disappointed if passed over. Something should accordingly be done, not only to attract a better class of applicants, but also to retain them in the service; and the only inducement I can see to the former end, is an increase of salary to meet the exigencies of the labour-market. I would suggest that the salary commence at £50 per annum, and that there be no increase until the attendant is promoted to the position of charge of ward, but that, in lieu thereof, she should receive an amount of, say £50, as deferred payment at the expiration of five years' service, on the recommendation of her superior officers, and if in the meantime promoted that the salary should be raised to £60 per annum. There might be initial difficulties in the adoption of this proposal, but they could be readily overcome, while it would be a strong inducement to lengthened service and good endeavour, and would provide a substantial sum for many, not otherwise very thrifty, when about to marry and start housekeeping. The work of the institution, both indoor and out, has progressed as usual, and I do not think there is anything in it deserving of special mention here, especially as I have already dealt with it in many aspects in' former reports. To my colleague Dr. Crosby and my fellow-officers I desire to express my appreciation of their loyal support and ready co-operation at all times. I have, &c, Edw. G. Levinge, M.8., The Inspector-General of Asylums, Wellington. Medical Superintendent.

SEACLIFF ASYLUM. Sib,— Seacliff Asylum. 9th April, 1904. I have the honour to submit to you the following report on the Seacliff Asylum for 1903 : — The proportion of patients discharged, relieved, or recovered during the year —viz., 40 per cent. on the admissions, was below the average, but this may be regarded as mainly accidental and compensatory to a high discharge-rate during the previous year. It will be noted that the number of admissions during the year —viz., 135, shows an increase of nine over the previous year, but there is no special significance in this. It is unfortunate that a widespread opinion prevails among the public that insanity is increasing in the colony in spite of repeated assurances that such is not the case. This mistake arises from a confusion as to the meaning and significance of a mere accumulation of chronic patients, due to longevity, as compared with the graver question of cases arising de novo during the year. It was to be hoped that Professor Seager's remarks in his paper published in the transactions of the New Zealand Institute for 1901, and copied into some of the newspapers of the colony, would have finally cleared up the misconception ; but this has not been the case. Professor Seager said, after showing that our statistics proved "an undoubted falling-off in liability to insanity " in the colony : " But the concern about the increase of insanity, which inspires so many articles, is founded on the figures as roughly put in statistical works, and I have shown that these figures, properly interpreted, afford no justification whatever for the inference usually deduced from them, but rather indicate a strong tendency in the direction of growing sanity. If the reasons usually assigned to explain the commonly supposed increase in the tendency to insanity have really any force, if many are now classed as insane that would not have been so classed some years ago, and if many are now placed in institutions for the care of the insane that some time since would not have been so provided for, then there must indeed have been in recent years a very real and very marked diminution in the liability of the New Zealander to insanity, in spite of modern competition and the disadvantages of city life. In fact, explanations are now wanted to account for statistics indicating a falling-off, and not a growth, in the tendency of the race to insanity." Structural changes on the female side, rendered necessary by the slipping of the ground, have greatly handicapped us. To minimise the evil effects of the temporarily increased overcrowding, some thirty women had to sleep in the recreation-hall for a considerable period. Added to this, there was a prolonged epidemic of scarlet fever during the winter among both patients and staff. So many of the nurses were attacked, that it necessitated the employment of two additional nurses for a whole year to overtake the work, and provide for the usual holidays. Lately we have installed a nurse in the male division of the Asylum to take care of the sick patients. The change is greatly appreciated, and is working well. The fishing-station established at Karitane promises well. During the past month we have received 8 tons of fish, and have sent full supplies to the various public institutions throughout Otago and Canterbury, besides supplying our own needs. The food-value of this output of fish in a single month is equivalent to over £200, at the current contract rates for ordinary meat. The direct manifest saving to our own institution is considerable after paying all expenses, but when fairly estimating the economic results of the fishing-station, the supplies given to other institutions would have to be taken into account. An important aspect of the matter is the welcome change of dietary afforded by a full supply of fresh fish in all the varieties abounding on the coast, and if we could secure regularity of delivery throughout the year by having a small refrigerator on the premises, the utility of the station to ourselves and other institutions would be much enhanced. Apart from all other considerations, the fact of having several boats available for picnic parties from the Asylum is highly appreciated ; while the two patients directly employed on the coast are alive to the advantage of a more absolutely free life than would be possible in any large institution. The farm and garden continue to supply our needs satisfactorily. The value of eggs and poultry alone delivered during the year amounts to £650. A new building for men employed at the farmsteading will soon be begun, and will afford a welcome addition to our accommodation, besides' adding greatly to the comfort of the men.

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The contemplated addition to the women's side, for which the timber is also on the ground, will prevent the overcrowding from becoming more acute, although further accommodation will still be urgently needed, especially in the direction of increased day-room space. The thanks of the authorities are due to the Otago Daily Times and Witness Company and to the Evening Star Company for copies of their journals supplied free, and thanks are also due to the private donors of books, periodicals, and other presents. To my colleagues, Dr. Sydney Allen and Dr. Edward Alexander, who are both retiring from the service, I feel myself quite unable to adequately express my appreciation. I wish to convey my thanks to the various members of the staff for their cordial assistance in carrying out the work of the institution. There are several notable changes to record in connection with the male staff. Mr. John Pullar, our last remaining pioneer of the days when the site for the Asylum had to be cut out of the standing bush, retired on account of failing eyesight, with an allowance. It is impossible to speak of Mr. Pullar's twenty-one years of capable, energetic, and faithful work, without admiration, and such a life is the best answer to the common assumption that prolonged Government service necessarily stops energy and enthusiasm. The same reflection applies to Mr. T. H. Buckley, who is retiring from the management of the farm in order to take up a valuable holding on the Levels Estate. Apart from the energetic carrying-out of his assigned work, Mr. Buckley has throughout fifteen busy years taken the most prominent part in all the social amenities of the institution. Mr. Andrew Sutherland, who has been in the service for eleven years, replaces Mr. Buckley in the farmmanagement. I have, &c, F. Teuby King, Medical Superintendent. The Inspector-General of Asylums, Wellington.

PORIRUA ASYLUM. Slß,— Porirua, 28th March, 1904. I have the honour to submit the following report on the Porirua Asylum for the year 1903 : — At the beginning of the year there were 508 inmates, and at the end 581, of whom nine were absent on trial. The average number resident was 521 (273 males and 246 females), and the total number under care, 655. Of the 147 cases admitted, 54 males and 33 females were admitted for the first time, 5 males and 4 females were readmitted, and 50 males were transferred from Mount View, and 1 female from Sunnyside Asylum. Thirty-six patients were discharged recovered, 10 relieved, and 1 not improved, The proportion of recoveries to the number admitted being about 24 - 5 per cent. Twenty-seven patients died, making a death-rate of SPB per thousand on the average number resident. The recovery-rate, which is apparently low, is to some extent vitiated by the large number of transfers, of whom nearly all were chronic and hopeless cases. Of the 147 admitted, rather more than 100 were incurable, of whom 30 were senile cases, and 11 congenital imbeciles or idiots. Of those admitted, 10 have died, mostly old people, of whom 2 were brought to the Asylum in a moribund state, and died within a few days, while 3 others died within a few weeks. I have on previous occasions adverted to the tendency to shunt into the Asylum hopeless bedridden patients approaching dissolution. Unfortunately, no Superintendent can refuse to take in any patient whose admission-papers are in order. Cannot some amendment of the present law be devised to deal with this question, and prevent the Asylum being used as a dumping-ground for cases not in any way requiring treatment for mental disease ? Overcrowding has never been in evidence at this Asylum. The additional accommodation made from time to time, has for the most part not been for our own wants, but to relieve the congestion elsewhere, especially at Mount View Asylum. Fifty patients were transferred from there in October, for whom accommodation had been provided by the erection of the first pavilion of a new auxiliary asylum here. This pavilion contains two large dormitories of thirty-five beds each, but no day-rooms As a temporary expedient, I have reduced the number of beds, and screened off the larger part of one of the dormitories for use as a day-room. The building and occupation of the first part of the new auxiliary was the most important event of the year. Indeed, I cannot recall anything else of special interest. The year has however been one of satisfactory progress. As many patients as possible were induced to undertake some form of useful employment, and in December, I find that sixteen were daily employed in the various workshope at their several trades, under the supervision of the artisan attendants. Upwards of 150 worked outside in the grounds and gardens or on the farm. Our energies were largely directed to the improvement of the grounds about the institution. The number employed would seem to warrant great hope of much useful work accomplished, but it must be remembered that a large proportion of the patients do very little indeed, being really sent out with the working-parties for the benefit they derive from the fresh air and change of scene. Towards the end of the year about 50 women were daily employed in the kitchen and laundry, nearly 40 at needlework, and 70 at other household duties. About 70 male and 90 female patients were unemployed, owing to mental or physical disability. There was very little sickness in the wards, and no epidemic or serious accident to record. The staff has worked well, and I have again to record my thanks to my colleague Dr. Barraclough for his valuable assistance, and for the interest he has taken in organising amusements for the patients. I have, &c, Gkay Hassell, M.D., Medical Superintendent. The Inspector-General of Asylums, Wellington.

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WELLINGTON ASYLUM. Sib, — Lunatic Asylum, Wellington, 19th March, 1904. I have the honour to submit the annual report on this Asylum for the year ending the 31st December, 1903. The overcrowding which I spoke of last year has been still more accentuated, and as I formerly pointed out, has been followed by the natural resultant, a decreased recovery-rate. At the beginning of the year the numbers were 177 males and 104 females —46 males and 14 females over the statutory numbers. As the year went on, these numbers increased, until in July there were 50 males and at one time 29 females in excess of accommodation. These numbers do not seem very excessive until we take into consideration the small numbers provided for, and then the position is startling when we find that there was one-third more patients than the accommodation provided for. In October there was relief afforded by the transference of 50 male patients to Porirua, but the female side had no relief, and at present patients are having to be put to sleep on shakedowns in the corridors. There have been fewer admissions during the year, but this does not imply any decrease in the insanity-rate, but inability to accommodate patients, and they had to be sent elsewhere. The actual numbers are 47 males and 45 females admitted, five males and 11 females being readmissions. There were 18 males and 24 females discharged recovered, which gives a recovery-rate of 383 per cent, and 53-3 respectively. Of the 50 male patients sent to Porirua, 14 were transferred as relieved, and some of these besides some of the unimproved would probably recover, but we do not receive the benefit of these in our percentages. The death-rate has not altered much, although 5 more deaths for the year have to be recorded, yet the average number resident was much increased, and the percentage of deaths to the average number is 5-8, as against 4-5 for the previous year. In all there were 17 deaths, 15 of these taking place within two years of admission, showing the unsatisfactory condition of the patients when sent to asylum care, thus leaving only two patients who had been more than two years in residence, which shows a very healthy state of affairs among the ordinary asylum community. Since writing my last report, electric lighting has been installed, and has proved a great boon, both from the view of better lighting, and also from that of diminished fire-risk. But even with the electric light and the automatic alarms risk of fire is a great danger here, and with the memory of the fire in the wooden annexe at Colney Hatch Asylum still fresh, one feels that something more must be done here at Mount View. Owing to the long corridors, if a fire did get a hold, it would travel with appalling rapidity, and it would be well nigh impossible to save all the inmates. Some means should be adopted for holding the fire in check even for a few minutes, to give our own and the town fire brigade time to tackle the fire, and also time for the attendants to open the locked doors for the patients to escape; and I would suggest that the Public Works Department take this in hand, either by erecting brick dividing-walls or applying some fire-resisting substance, such as " Uralite," to the existing walls. There have been the usual dances and other amusements for the patients, and this summer the men have very much appreciated a game of bowls in the evenings. To Dr. Ulrich and the various members of the staff, I have to express my thanks for their hearty assistance in the carrying-out of the work of the institution. I have, &c, W. Baxteb Gow, M.D., CM. Medical Superintendent. The Inspector-General of Asylums, Wellington.

I feel that I must express my appreciation of the thoughtfulness that led the Minister to appoint Dr. Frank Hay as Assistant Inspector at a time when I was seriously ill, and I feel the benefit of so capable and experienced a colleague. Dr. Hay has had the advantage of being trained under Dr. Urquhart, one of the most sagacious and capable of British alienists, in Murray's Royal Asylum, Perth. Since coming to this country Dr. Hay's work at Ashburn Hall Private Asylum has passed under my own observation, and has met with my fullest approval. D. MacGbegor, M.A., M.8., Inspector-General of Asylums.

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Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Asylums during the Year 1903.

(a) 1 female transferred. 0>) 5 males and 1 female transferred. (°) 42 males and 8 females transferred. (<1) 50 males and 1 female transferred. (c) 1 male transferred. (') 99 males and 11 females transferred. (s) 43 males and 9 females transferred.

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APPENDIX.

In asylums, 1st January, 1903 Admitted for the first time Readmitted M. F. T. M. F. T. 1,715 1,133 2,848 306 148 183 54 489 202 I 454 237 691 Total under care during the year Discharged and removed— Recovered Relieved Not improved Died 144 41 84 129 101 25 12 44 245 66 96 173 2,169 1,370 3,539 398 182 580 Remaining in asylums, 31st December, 1903.. 1,771 1,188 2,959 Increase over 31st December, 1902 56 58 111 Average number resident during the year 1,741 1,160 2,901 Table II.—Admissions, Discharges, and Deaths, with the Mean Annual ', Proportion of Recoveries, &c, at per Cent, on the Admissions, &c, during t. 'Iortality and Le Year 1903. Admissions in 1903. Total Number of Patients under Care. In Asylums Asylums. 1st January, 1903. Admitted for the First Time. Readmitted. i Total. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson Porirua Wellington Ashburn Hall (private asylum) M. F. T. 341 197 538 317 239 556 430 235 665 88 32 120 84 54 138 258 250 508 177 104 281 20 22 42 M. 73 39 61 18 12 54 42 7 F. T. 35 108 24 63 41 102 4 22 5 17 33 87 34 76 7 14 M. 15 12 18 43 F. 7 7 15 8 T. 22 19 33 51 M. F. T. 88 42 180(") 51 31 82 79 56 185 (*) 61 12 73(o) 12 5 17 109 38 147( d ) 47 45 92(7 7 8 15(°) j M. 429 368 509 149 96 367 224 27 F. 239 270 291 44 59 288 149 30 T. 668 638 800 193 155 655 373 57 55 5 5 11 1 60 16 1 Totals .. '1,715 1,133 2,848 306 183 489 148 54 202 454 237 691 («) 2,169 1,370 3,539 Table II.— continued. Patients Discharged and Died. In Asylums on the 31st December, 1903. Asylums. Discharged recovered. Discharged not recovered. Total Discharged and Died. Died. M. Auckland .. .. .. | 38 Christchurch .. .. ! 30 Dunedin (Seacliff) .: .. 32 Hokitika .. .. .. 9 Nelson .. .. .. 1 Porirua .. .. .. 15 Wellington .. .. .. 18 Ashburn Hall (private asylum) 1 F. 19 14 13 3 1 21 24 6 T. 57 44 45 12 2 36 42 7 M. F. 1 47 17 13 9 4 .. 1 .. 6 5 50 2 4 3 T. 1 64(h) 22(e) 4 m 52 (<i) 7 M. 27 20 36 6 6 18 14 2 F. 7 6 16 2 9 3 1 T. 34 26 52 6 8 27 17 3 M. F. T. 65 27 92 97 37 134 81 38 119 19 3 22 8 3 11 39 35 74 82 29 111 7 10 17 M. F. 364 212 271 233 428 253 130 41 88 56 328 253 142 120 20 20 T. 576 504 681 171 144 581 262 40 Totals 144 101 245 125 37 162 129 44 173 398 182 580 1,771 1,188 2,959 Table II.— continued. Asylums. Average Number resident during the Year. Percentage of Recoveries on Admissions during the Year. Percentage of Deaths on Average Number resident during the Year. Percentage of Deaths on the Admissions. .uckland ihristchurch .. )unedin (Seacliff) lokitika Telson 'orirua Velljngton .shburn Hall (private asylum) .. M. 351 292 432 111 86 273 178 18 F. 207 237 245 35 54 248 113 21 T. 558 529 677 146 140 521 291 39 M. F. T. 43-18 46-34 44-19 58-82 45-16 5366 43-24 23-64 34-88 47-37 75-00 52-17 8-33 2000 11-76 25-42 56-76 37-50 39-13 53-33 46-15 16-66 75-00 50-00 M. F. T. 7-69 3-38 6-09 6-85 2-53 4-91 8-33 6-53 7-68 5-40 .. 411 6-98 3-70 5-71 6-59 3-63 5-18 7-87 2-65 5-84 11-11 4-76 7-69 M. 30-68 39-22 48-65 31-58 50-00 30-51 30-43 33-33 F. T. 1707 26-36 19-35 31-71 29-09 40-31 26-09 40-00 47-06 24-32 28-12 6-66 18-68 12-50 21-43 Totals 1,741 1,160 2,901 40-56 44-69 42-17 7-41 3-79 5-96 36-34 19-47 29-78

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Table III.—Ages of Admissions.

Ages. Auckland. Christchurch. Dunedin ■ (Seacliff). ' [okitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum}. Total. M. F. T. M. F. T. M. F. T. 0 1 1 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 0 11 112 4 2 6 22 8 30 90 61 151 101 53 154 72 50 122 64 29 93 56 17 73 32 13 45 10 1 11 2 13 Under 5 years From 5 to 10 years ,, 10 „ 15 , „ 15 „ 20 „ „ 20 „ 30 „ . 30 „ 40 , „ 40 „ 50 „ ., 50 , 60 „ . 60 „ 70 „ „ 70 „ 80 , Upwards of 80 years Unknown.. 1 0 1 7 3 10 11 8 19 24 13 37 13 11 24 14 3 17 13 3 16 4 1 5 1 0 1 112 1 1 2 14 10 24 9 6 15 11 9 20 10 2 12 4 15 112 1 0 1 6 0 6 16 14 30 19 12 31 8 11 19 8 5 13 11 7 18 10 6 16 7 3 10 6 2 8 14 0 14 8 3 11 7 18 8 19 oil 2 2 4 2 0 2 3 0 3 1 1 2 3 0 3 112 0 11 2 0 2 6 2 8 26 11 37 30 10 40 13 4 17 16 5 21 11 3 14 5 2 7 2 2 4 11 12 23 9 9 18 10 10 20 6 10 16 6 1 7 3 14 3 14 2 1 3 0 5 5 10 1 112 11 2 13 Totals J88 42 130 51 31 82 79 56 135 61 12 73 12 5 171 109 38 147! 47 45 92 7 8 151 454 237 691 Table IV.—Duratio: of Di: iorder on Admisi HON. Auckland. Christ- Dunedin church. (Seacliff). Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. First Class (first attack, and within 3 mos. on admission) Second Class (first attack, above 3 mos. and within 12 mos. on admission) Third Class (not first attack, and within 12 mos. on admission) Fourth Class (first attack or not, but of more than 12 mos. on admission) Unknown M. F. T.I 44 23 67 I M. F. T. 20 11 31 M. F. T. : 42 22 64 M. F. T. 28 8 36 M. F. T. 7 1 8 M. F. T. 64 19 83 M. F. T. 30 18 48 M. F. T. 0 3 3 M. F. T. 235 105 340 14 5 19 1 0 1 10 4 14 4 1 5 3 0 3 8 3 11 5 7 12 4 2 6 49 22 71 19 11 30 14 8 22 10 15 25 10 1 10 1 19 9 28 5 13 18 10 1 70 56 126 11 3 14 10 9 19 17 15 32 5 0 5 14 5 18 7 25 7 7 14 2 3 5 71 48 119 6 3 9 23 3 26 29 6 35 Totals 88 42 130 51 31 82; 179 56 135 61 12 73 12 5 17l 109 38 147| 47 45 92J 7 8 15 454 237 691 Table V. —Ages of Patients discharged " Recovered " and " Not recovered." Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Ages. Recovered| re ™ red | Recovered| Ie *°* Ied Not ' recovered Recovered Not ,, recovered. Recoverei M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. From 5 to 10 years „ 10 „ 15 „ „ 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ „ 40 „ 50 „ „ 50 „ 60 „ „ 60 „ 70 „ „ 70 „ 80 „ Unknown 5 16 6 3 9 7 5 12 8 6 14 8 2 10 3 2 5 10 1 10 1 8 4 12 8 2 10 4 5 9 7 0 7 1 3 4 10 1 0 1 1 0 2 2 6 17 6 4 10 15 4 19 10 4 14 9 1 10 10 1 3 14 3 4 7 8 4 12 6 2 8 4 15 5 16 3 0 3 10.1 4 0 4 4 2 6 2 4 6 112 10 1 0 2 2 2 2 4 1 0 1 3 14 2 0 2 2 0 2 o i' l 10 1 10 1 10 1 Totals 138 19 57 0 1 1 30 14 44 47 17 64 32 13 45 13 9 22 9 3 12 4 0 4 Ages. Nelson. Re- j Not recovered, j covered. Nelson. I Pori: Wellii Ashburn Hall (Private Asylum). ■ua. igton. Tol lal. i Recovered. Not re- I Re- Not covered, covered.| recovered. Re- Not recovered, covered. Recovered. Not . j recovered. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T, From 5 to 10 years „ 10 , 15 „ . 15 , 20 „ , 20 „ 30 „ , 30 „ 40 „ „ 40 „ 50 . ;, 50 „ 60 „ , 60 „ 70 „ „ 70 „ 80 „ Unknown 112 10 1 10 1 5 5 10 3 8 11 5 3 8 14 5 Oil 0 2 2 0 2 2 10 1 10 1 2 0 2 2 18 112 4 7 11 4 2 6 4 8 12 5 5 10 Oil 10 1 3 0 3 14 1 15 11 1 12 6 0 6 7 0 7 6 0 6 2 0 2 Oil 1 1 2 0 1 1 0 2 2 10 1 112 Oil 10 1 10 1 Oil 11 4 15 29 26 55 32 23 55 30 27 57 25 12 37 10 9 19 6 0 6 10 1 1 "l 2 4 2 6 27 4 31 22 10 32 27 9 36 20 5 25 19 2 21 5 4 9 oil Totals 112 1 0 1 15 21 36 6 5 11 18 24 42 50 2 52 16 7 4 3 7 144 101 245 125 37 162

15

H.—7

Table VI. —Ages of the Patients who died.

Table VII. —Condition as to Marriage.

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. [Wellington. Ashburn Hall (Private Asylum). Total. M. F. T. M. F. T. M. F. T. 0 1 1 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 0 11 From 5 to 10 years , 10 „ 15 „ . 15 „ 20 „ » 20 „ 30 „ , 30 , 40 , „ 40 , 50 „ „ 50 „ 60 „ , 60 , 70 „ , 70 „ 80 „ Up wards of 80 112 4 0 4 3 0 3 3 14 7 0 7 6 4 10 10 1 2 13 2 1 3 4 1 5 1 2 3 4 0 4 3 0 3 6 2 8 5 1 6 4 3 7 9 3 12 9 4 13 9 4 13 10 1 1 0 1 2 0 2 2 0 2 Oil 3 0 3 1 0 1 2 0 2 0 1 1 112 10 1 4 0 4 2 13 5 16 3 4 7 2 2 4 10 1 2 0 2 3 14 6 2 8 i i' 2 3 2 5 9 1 10 21 5 26 20 9 29 28 4 32 27 12 39 19 9 28 2 13 2 0 2 101 Totals 2 1 3 129 44 173 27 7 34 20 6 26 36 16 52 6 0 6 6 2 8 18 9 27 14 3 17

Admissions. Discharges. Deaths. Auckland— Single Married Widowed M. F. T. 54 13 67 24 20 44 10 9 19 M. F. T. 25 6 31 12 10 22 14 5 M. F. T. 17 1 18 4 2 6 6 4 10 Totals 88 42 130 38 20 58 27 7 34 Christchurch — Single Married Widowed 30 14 44 19 13 32 2 4 6 52 17 69 22 12 34 3 2 5 10 9 1 2 12 3 12 1 2 Totals 51 31 82 77 31 108 20 6 26 Dunedin (Seacliff) — Single .. Married Widowed 52 23 75 25 25 50 2 8 10 33 7 40 11 12 23 13 4 21 14 1 8 29 7 21 1 2 Totals 79 56 135 45 22 67 36 16 52 Hokitika— Single Married Widowed Unknown 38 9 3 11 4 42 4 13 2 5 2 13 10 3 1 11 2 5 4 1 1 0 0 0 4 1 1 Totals 61 12 73 18 3 16 6 0 6 Nelson— Single Married Widowed 7 4 1 3 10 0 4 2 3 1 1 1 0 2 1 2 4 0 1 0 1 3 4 1 Totals 12 5 17 2 1 3 6 2 8 Porirua— Single Married Widowed 65 11 76 36 24 60 8 3 11 14 9 23 7 15 22 0 2 2 12 5 1 6 18 2 7 1 2 Totals 109 38 147 21 26 47 18 9 27 Wellington— Single .. Married Widowed 26 16 42 18 21 39 3 8 11 43 6 49 20 13 33 5 7 12 8 0 0 2 10 0 6 1 1 Totals 47 45 92 68 26 94 14 3 17 Ashburn Hall (Private Asylum)— Single Married Widowed 4 3 0 4 2 2 8 5 2 3 2 0 5 2 2 8 4 2 0 2 1 0 1 2 Totals 7 8 15 5 9 14 2 1 3 Totals — Single Married Widowed Unknown 276 88 364 138 109 247 29 38 67 11 2 13 181 52 233 78 66 144 10 20 30 74 21 95 45 14 59 10 9 19 Totals 454 237 691 269 138 407 129 44 173

H.-7

16

Table VIII.—Native Countries.

Table IX.—Ages of Patients in Asylums on 31st December, 1903.

Table X.—Length of Residence of Patients who died during 1903.

Countries. Auckland. Christchurch Dunedin (Seacliff). Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. England Scotland Ireland New Zealand Austral'n Colonies France Germany Austria Norway Sweden Denmark Italy China Maoris Other countries .. Unknown M. F. T. 125 69 194 28 8 36 65 48 113 93 69 162 12 5 17 1 0 1 6 3 9 3 0 3 1 0 1 4 0 4 3 0 3 2 2 4 10 1 3 7 10 17 1 18 M. F. T. 97. 85 182 31 26 57 54 54 108 61 49 110 7 3 10 1 0 1 3 14 M. F. T. 85 44 129 115 73 188 103 67 170 66 49 115 10 13 23 0 2 2 10 0 10 M. F. T.' 27 9 36 1 14 1 IS 47 19 66; 23 8 31 1 3 4 2 0 2 3 0 3 |M. F. T. 125 12 37 j 6 4 10 1X8 9 27 !30 26 56 1 4 5 10 1 1 0 1 1 0 1 M. F. T. 118 73 191 31 22 53 61 70 131 66 67 133 10 3 13 2 0 2 10 3 13 0 11 1 1 2 4 2 6 5 0 5 2 2 4 3 0 3 8 5 13 7 4 11 M. F. T. 41 26 67 15 16 31 29 19 48 44 37 81 4 9 13 M. F. T. 6 4 10 6 6 12 10 1 7 9 16 M. F. T. 524 322 846 246 156 402 378 286 664 390 314 704 45 40 85 7 2 9 33 14 47 4 1 5 12 5 17 17 3 20 14 2 16 13 4 17 26 0 26 16 13 29 46 25 71 0 1 1 0 7 7 3 0 3 2 0 2 6 17 3 0 3 0 2 2 4 0 4 17 0 17 10 1 8 2 10 3 0 3 10 1 3 0 3 5 0 5 0 11 2 0 2 10 1 13 4 3 0 3 10 1 1 0 1 112 11 14 25 1 0 1 Oil 2 0 2 3 "o 3 0 3 3 0 "l 1 Totals .. 364 212 576 271 233 504 428 253 681 130 41171 88 56 14 328 253 581 142 120 262 20 20 40 1771 1188 2959

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. M. F. T. M. F. T. M. F. T. 0 11 10 1 12 3 13 7 20 53 45 98 85 56 141 107 55 162 73 55 128 72 25 97 18 6 24 5 16 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. 0 1 5 3 8 10 37 26 2 1 3 214 157 2 4 6 350 255 6 6 12 411 281 3 2 5 341 253 5 5 10 283 147 2 2 4 92 43 10 6 20 6 T. 1 8 18 63 371 605 692 594 430 135 16 26 1 to 5 years 5 „ 10 „ 10 , 15 „ 15 „ 20 , 20 , 30 „ 30 , 40 „ 40 , 50 , 50 , 60 , 60 •„ 70 , 70 , 80 . Over 80 Unknown 3 0 3 12 3 4 4 8 40 28 68 81 49 130! 89 44 133 ! 67 46 113 62 25 87| 13 9 22 2 3 5 1 2 2 i\ 10 1 3 2 5 5 4 9 32 23 55 50 49 99 59 54 113 47 55 102 46 28 74 21 14 35 3 2 5 4 2 6 o 'i l Oil 12 5 17 17 4 21 19 4 23 26 10 36 29 11 40 13 3 16 0 1 1 7 3 10 9 5 14 12 13 25 19 11 80 19 10 29 14 12 26 8 19 0 1 1 2 0 2 6 5 ll 1 41 25 66 1 78 50 128 1 78 78 156 70 56 126 39 34 73 14 4 18 0 11 12 3 2 3 5 25 25 50 25 30 55 34 29 63 36 19 55 16 7 23 3 4 7 14 2 16 Totals ;328 253 581 20 20 401771 1188 2959 364 212 576 271 233 504 428 253 681' 130 41 171 88 56 1441 142 120 262

Length of Residence. Auckland. Christchurch. Dunedin j Ho1 .; tijl . n (Seacliff). ±1 ° KltlKa " Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. Jnder 1 month i'rom 1 to 3 months .. „ 3 „ 6 „ 6 „ 9 ,. 9 „ 12 „ 1 „ 2 years „ 2 „ 3 „ „ 3 „ 5 „ „ 5 „ 7 „ „ 7 „ 10 „ „ 10 „ 12 „ „ 12 „ 15 „ •ver 15 years )ied while absent on trial M. F. T. M. F. T. M. F. T. 2 0 2 4 2 6 3 14 3 14 Oil 7 2 9 2 0 2 2 4 6 10 1 10 1 10 1 2 13 8 4 12 M. F. T. 10 1 M. F. T. 10 1 M. F. T. 4 15 10 1 Oil M. F. T. 2 2 4 2 0 2 M. F. T. 1 12 M. F. T. 11 4 15 13 5 18 7 2 9 10 2 12 2 2 4 21 5 26 11 0 11 10 6 16 6 17 5 4 9 3 3 6 9 2 11 21 8 29 5 '2 7 112 3 0 3 1 0 1 2 0 2 2 0 2 112 3 3 6 6 0 6 2 0 2 3 0 3 2 0 2 2 13 2 0 2 112 0 11 2 13 4 15 10 1 1 0 1 2 0 2 3 1 4 10 1 4 0 4 10 1 10 1 2 0 2 0 1 1 0 1 1 1 1 2 3 0 3 3 2 5 2 13 Oil 4 0 4 4 0 4 1 '6 1 2 3 5 10 1 2 0 2 Totals 27 7 34 20 6 26 36 16 52 6 0 6 6 2 8 18 9 27 14 3 17 2 13 129 44 173

H.—7

17

Table XI.—Length of Residence of Patients discharged "Recovered" during 1903

Table XII.—Causes of Death.

Length of Residence. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. IWellington. Ashburn Hall (Private Asylum). Total. M. F. T. M. F. T. 1 0 1 13 5 18 5 3 8 4 2 6 4 15 3 14 0 1 1 0 1 1 M. F. T. 2 4 6 13 5 18 9 1 10 4 3 7 M. F. T. 3 14 2 0 2 2 2 4 M. F. T. M. F. T. 10 1 4 4 8 12 3 2 4 6 15 6 10 1 112 12 3 2 13 0 11 10 1 Oil M. F. T. M. F. T. M. F. T. 7 5 12 41 26 67 40 16 56 17 25 42 12 12 24 14 7 21 6 3 9 2 4 6 2 13 112 2 0 2 0 1 1 fnder 1 month 'rom 1 to 3 months „ 3 „ 6 „ ,, 6 „ 9 „ „ 9 „12 „ „ 1 „ 2 years .. „ 2 „ 3 „ .. „ 3 „ 5 „ .. „ 5 „ 7 „ .. „ 7 „10 „ .. ■ „ 10 „12 „ .. „ 12 „15 „ .. 6 5 11 14 2 16 5 5 10 4 3 7 5 2 7 3 14 0 11 1 1 2 3 5 8 7 5 12 2 7 9 13 4 3 4 7 0 2 2 10 1 0 4 4 2 0 2 2 0 2 2 0 2 10 1 10 1 10 1 Totals .. 38 19 57 30 14 44 16 7 32 13 45 9 3 12 112 15 21 36 18 24 42 |144 101 245

Causes. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. M. F. T. M. F. T. M. F. T. 0 1 1 Oil M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 0 11 0 11 10 1 1 0 1 10 1 5 16 0 11 12 3 10 1 10 1 5 0 5 6 0 6 10 1 2 0 2 10 1 10 1 13 4 14 2 16 1 0 1 Abscess of thigh Addison's disease Alcoholic paraphlegia Apoplexy Bright's disease (chronio) Cancer Carcinoma of liver Cardiac failure.. Cerebral congestion Cerebral meningitis Cerebral softening Chronic brain-disease Colitis Congestion of lungs Cystitis Diarrhoea Enteritis Epilepsy Exhaustion following delirium tremens Patty-dfgeneration of heart Fracture-dislocation of spine GJeneral paralysis Heart-disease Haemorrhage of intestines Hypostatic pneumonia following erysipelas Intestinal obstruction Mania wiih exhaustion .. Meningitis, tubercular .. Necrosis of tibia Organic brain-disease Peripheral neuritis Pneumonia Phthisis Puerperal septiccemia Pulmonary apoplexy Pycemia Pvcemic abscesses of kidneys Rupture of urethra Scarlet fever Senile decay Senile dementia Softening of the brain Stuperose melancholia Suffocation by food Syncope luberculosis lyphoid fever 10 1 i 6' i 0 22 10 1 2 0 2 101 5 0 5 4 0 4 112 2 0 2 2 0 2 3 i' 4 10 1 1 0 1 10 1 oil 10 1 10 1 Oil 2 0 2 2 0 2 12 3 1 0 1 7 0 7 11 5 16 101 2 02 10 1 10 1 10 1 10 1 i o' 1 101 oil 101 1 o 1 10 1 10 1 10 1 oil 2 0 2 0 11 4 04 0 3 3 101 2 i' 3 4 04 Oil 101 2 13 1 0 1 22 0 22 12 9 21 0 11 0 11 1 0 1 2 i' 3 10 1 2 13 0 11 0 1 1 2 0 2 10 1 16 7 11 4 15 0 1 1 10 1 10 1 1 0 1 1 0 1 10 1 17 5 22 10 1 10 1 1 0 1 1 0 1 2 13 2 13 1 0 1 oil 101 oil 10 1 0 2 2 5 3 8 0 1 1 101 3 0 3 0 1 1 oil Oil 1 i' 2 3 0 3 o i' i 1 0 1 10 1 10 1 1 6 1 10 1 3 0 3 4 2 6 10 1 6 17 10 1 123 2 02 1 6' 1 101 i i' 2 101 112 1 0 1 1 6' 1 1 6' 1 Totals 27 7 34 20 6 26 36 16 52 6 0 6 6 2 8 18 9 27 14 3 17 2 13 129 44 173

H.—7

18

Table XIII.—Causes of Insanity.

Causes. Auckland ch ristAucKianu. cnurch (SeTctffl" Hokitika. Nelson. Porirua. Wellington. Ashburn Hall (Private Asylum). Total. M. F. T. 2 0 2 4 0 4 20 2 22 M. F. T. M. F. T. M. F. T. M. F. T. 3 14 M. F. T. M. F. T. 5 16 0 4 4 8 19 M. F. T. M. F. T. 10 2 12 16 6 22 74 10 84 10 1 1 0 1 0 16 16 0 1 1 5 24 29 75 50 125 2 0 2 0 2 2 10 1 0 1 1 3 0 8 4 15 19 16 3 19 112 6 0 6 0 1 1 0 2 2 7 6 13 10 1 3 2 5 12 3 0 11 31 3 34 0 11 4 15 0 1 1 1 0 1 10 1 7 0 7 0 11 4 3 7 10 1 10 1 10 1 0 11 1 0 1 17 20 37 2 13 10 1 1 0 1 5 2 7 0 11 0 1 1 54 13 67 0 11 15 6 9 1 10 0 11 3 0 3 112 10 0 10 4 3 7 0 11 1 0 1 8 5 13 58 25 83 Accident Adolescence Alcoholism Apoplexy Brain strain Child-bearing and puerperal Chorea Climacteric Congenital and hereditary .. Constipation Death of husband Developmental Diabetes Dissolute life .. Domestic worry and anxiety Epilepsy Exposure Financial worry Heart disease Hysteria Ill-health Infantile paralysis Influenza Injury to head Love affair Masturbation Meningitis Mental worry Middle-ear disease Nervousness Opi.um-smoking Organic brain-disease Ovarian trouble Overwork Paralysis agitans Phthisis Plumbism Poverty Prenatal trouble Previous attack Privation Progressive muscular atrophy Puberty .. : Religious excitement Scarlatina Seduction Senility .. Sexual excess Shock .. Solitary life Spiritualism Sunstroke Surgical operation Syphilis Traumatic Tumour Typhoid fever Worry Unknown 11 i 12 14 3' 17 5 16 12 2 14 15 2 17 10 1 101 0 7 7 101 0 1 1 0 33 0 3 3 0 2 2 Oil 0 5 5 3 2 5 0 55 23 10 33 0 55 5 6 11 Oil 24 20 44 2 0 2 2 i 8 12 3 5 7' 12 14 5 19 oil 347 101 Oil 0 2 2 3 0 3 0 1 1 2 13 oil 3 14 189 2 0 2 0 2 2 1 0 1 112 101 10 1 2 35 5 0 5 112 101 2 02 Oil 0 2 2 13 4 1 0 1 1 6 1 1 6 1 161 1 6' 1 2 0 2 1 6' 1 2 13 3 3 6 10 1 1 0 1 oil 0 22 3 i' 4 7 i' 8 6 0 6 4 0 4 0 1 1 5 16 0 1 1 4 15 5 0 5 1 0 1 0 l' 1 10 1 5 0 5 2 02 101 0 i' 1 0 r 1 4 0 4 10 1 10 1 10 1 0 2 2 oil 437 2 13 4 3 7 7 3 10 10 1 2 9 11 022 101 1 6' 1 2 0 2 10 1 2 2 4 0 i' 1 8 3 11 oil 14 8 17 4 i' 5 10 0 10 10 1 13 5' 18 4 15 0 1 1 0 2 2 2 02 1 i' 2 1 0 1 0 1 1 Oil 3 0 3 0 i' 1 3 0 3 1 0 1 1 0 1 oil 1 0 1 3 0 3 0 1 1 1 i * 2 202 4 0 4 4 2 6 1 0 1 0 1 1 161 0 3" 3 6 2 8 4 2 6 10 13 23 31 5* 36 4 0 4 101 8 2 10 2 3 5 Totals .. 88 42 130 51 31 82l 79 56 135 61 12 73i 12 5 17 109 38 147 47 45 92 7 8 15, 454 237 691

H.—7.

Table XIV.—Former Occupation of Patients.

19

Occupation. ii :- 3 c :/: "fi 33 B £ 2 X 3 13 3 3 a a o CJO 3 % 3 > Si Kg a s g* 1^ at Occupation. A o ■* 3 A ■/. a 5 § "a 3 £ a a 3 a 3 o *J a > £ a l 2 >> 31«! to ■a a d 3 a 3 3 c a a o ■J! V i. 3 u o 3, 4-* o •0 a 3 3 3 o W d o BQ "3 IE A 3 u o ■3 o Ma; D.ES. Aboriginal native .. Bakers Bill-stickers Blacksmiths Boilermaker Bootmakers Bottle-gatherers .. Brewer Bricklayers Brickmakers Bushman Butchers Canvasser Carpenters, cabinetmakers, &c. Carters, expressmen, &c. Chairmaker Chemist Clergyman Clerks & accountants Coach-builder Compositors Cooks Contractor Coopers Cycle-maker Dentist Draughtsman Dredgemaster Drover Engineers Engraver Estate-manager .. Farmers Fisherman Firemen Fitters, moulders, &c Frenoh polisher .. Gardeners Gentleman Grocers Grooms Gum-diggers Hawkers Herbalist Horsedealers& trainers Hotel-boots 1 2 1 1 i 1 2 1 1 1 1 3 1 1 1 1 1 1 1 1 i 1 3 1 1 i i 1 i i 1 4 4 2 1 1 4 2 1 1 1 1 i 8 5 2 1 2 1 8 2 1 2 1 1 4 1 13 3 1 1 1 11 1 2 5 I 1 I 2 j 1 I 1 I 1 1 1 3 1 1 : 44 ; 1 I 3 2 1 15 1 2 5 10 3 1 Hotelkeepers Labourers Maori interpreters Master mariner Mechanic Merchant Millwright Miners Music-teachers No occupation Old-age pensioners Painters, &c. Paupers Photographers Plasterer Plumbers Police-sergeant Porter Rabbiter Railway stationmaster Ropemaker Sailors Saddler .. Salesman Sawmiller Schoolteachers Sheep-farmers Soldiers Station hands, shearers, &c. Stonebreakers Stonemason Storekeepers • Storeman Sugarboiler Tailors Tanner Telegraphist Telegraph-messenger Tinsmith Tramdriver Traveller Umbrella-maker .. Warder Warehouseman Unknown 1 25 1 2 3 1 1 2 1 i 29 3 1 1 1 1 1 22 5 2 3 2 1 1 1 1 8 1 24 ii "al 6 3 i 1 1 2 2 1 'i 2 1 10 1 2 1 i 1 4 147 2 1 1 1 1 24 3 14 3 5 2 2 1 4 1 1 1 1 1 10 1 1 1 2 2 3 1 1 1 1 2 i i '2 i 1 i 1 i i 2 1 1 1 3 2 1 3 1 1 4 1 1 1 1 1 1 1 1 1 17 l i i 12 8 4 1 1 13 8 1 1 i 2 •• i 1 "1 i 1 1 '3 i l l l 3 1 3 i i 1 i 5 i l 1 1 i i 3 1 i 10 2 i i i i l 10 7 1 1 1 2 1 Totals .. 61 12 454 88 51 79 109 47 7 Aboriginal natives Barmaid Canvasser Charwoman Cooks Domestic duties .. Factory-hand House duties Housewives Milk vendor Milliner.. No occupation ALES. 1 Fe: 9 1 3 23 1 1 1 16 1 1 37 1 *5 i 3 2 88 i 86 8 2 1 1 3 1 147 1 16 39 1 1 7 Old-age pensioner.. Prostitute Refreshment - room keeper School-teachers .. Seamstress Straw-worker Waitresses Unknown 2 i 1 1 1 2 1 4 1 1 4 4 1 10 2 2 1 i 1 3 12 i i 3 Totals .. 42 31 56 12, I 5 38 45 8 237 i 2 1 i 2

.—7.

Table XV.—Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent, of the Admissions for each Year since 1st January, 1876.

20

Year. Admittt d. Discharged. Died. Remaining 31st December in each Year. Average Numbers resident. Percentage of Recoveries on Admissions. Percentage of Deaths on Average Numbers resident. Recovered. Relieved. Not Improved. 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 M. 221 250 247 248 229 232 267 255 238 294 207 255 215 230 230 234 231 281 320 379 296 300 355 264 335 373 352 454 F. 117 112 131 151 149 127 152 166 153 160 165 161 146 161 160 201 158 179 256 302 170 244 258 247 263 224 192 237 T. 338 362 378 399 378 359 419 421 391 454 372 416 361 391 390 435 389 460 576 681 466 544 613 511 598 597 544 691 129 123 121 112 100 93 95 102 89 95 99 103 116 93 98 88 89 101 107 105 104 102 114 88 103 125 135 144 F. T. 79 208 57 180 68 189 76 188 67 167 65 158 59 154 78 180 77 166 76 171 60 159 78 181 92 208 53 146 88 186 74 ' 162 76 165 89 190 76 183 77 182 70 174 73 175 110 224 99 187 96 199 104 229 99 234 101 245 2,217 5,190 M. 17 20 14 15 36 41 49 13 17 10 11 34 31 31 23 33 21 17 15 24 25 26 13 15 39 40 26 41 F. 8 9 14 13 25 36 32 20 9 5 17 17 28 30 17 24 17 12 11 19 16 32 23 25 10 17 15 25 T. 25 29 28 28 61 77 81 33 26 15 28 51 59 61 40 57 38 29 26 43 41 58 36 40 49 57 41 66 M 6 7 3 8 5 8 5 10 18 73 12 2 3 12 14 8 9 55 128 20 17 104 7 25 33 10 84 F. 6 2 3 3 2 1 7 9 12 29 8 2 1 5 30 2 9 84 139 12 31 47 42 65 3 9 12 T. 12 9 6 11 7 9 12 19 30 102 20 4 4 17 44 10 18 139 267 32 48 151 49 90 36 19 96 M. 36 42 51 55 54 49 60 65 68 73 57 74 78 70 76 79 74 78 64 101 86 105 88 114 99 102 120 129 F. 12 21 17 16 20 14 19 18 24 22 19 27 26 30 35 41 34 23 35 42 32 43 60 43 46 72 55 44 T. 48 63 68 71 74 63 79 83 92 95 76 101 104 100 111 120 108 101 99 143 118 148 148 157 145 174 175 173 M. 519 581 638 695 729 769 827 892 938 981 1,009 1,053 1,041 1,074 1,095 1,115 1,154 1,229 1,308 1,329 1,390 1,440 1,472 1,512 1,581 1,654 1,715 1,771 F. i 264 291 319 361 I 396 406 442 483 514 542 604 643 640 687 702 734 763 810 860 885 925 990 1,008 1,045 1,091 1,119 1,133 1,188 T. 783 872 957 1,056 1,125 1,175 1,269 1,375 1,452 1,523 1,613 1,696 1,681 1,761 1,797 1,849 1,917 2,039 2,168 2,214 2,315 2,430 2,480 2,557 2,672 2,773 2,848 2,959 M. 491 541 601 666 703 747 796 860 911 965 984 1,034 1,045 1,040* 1,078 l,089f 1,125 1,172 1,241 1,313 1,347 1,411 1,438 1,487 1,534 1,622 1,671 1,741 F. 257 277 303 337 371 388 421 475 497 528 559 613 641 660J 685 699J 714| 758 812 849 882 944 973 1,004 i 1,049 1,094 1,114 1,160 T. 748 818 904 1,003 1,074 1,135 1,217 1,335 1,408 1,493 1,543 1,647 1,686 1,707 1,763 1,789J l,839f 1,930 2,053 2,162 2,229 2,355 2,411 J2,491 2,583 2,716 2,785 2,901 M. 54-53 49-20 48-98 45-16 4366 4008 3558 40-00 37-39 32-31 47-82 40-39 53-95 40-43 4261 37-61 38-53 35-94 39 63 41-27 37-41 35-92 44-88 32-31 30-74 3906 38-35 40-56 I F. ; 66-01 ' 50-80 ; 51-90 50-33 44-96 51-10 38-81 46-98 50-32 47-50 36-36 ! 48-75 6301 32-92 55 00 36-82 48-10 j 49-72 j 45-18 46-66 44 02 I 37-82 51-89 j 44 33 36 50 | 46-64 ; 51-56 i 44-69 T. 57-56 4972 5000 47-11 44-17 44-01 36-75 42-75 42-45 37-66 42-74 43-61 57-62 37-34 47-69 37-24 42-42 41-30 41-03 43-40 39-82 36-69 48 07 37-58 33-27 42-17 43-01 42-17 M. 8-21 7-76 8-48 8-25 7-68 6-29 7-53 7-55 7-46 7-56 5-79 7-15 7-56 6-69 7-05 7-25 6-58 6-66 516 7-69 6-38 7-44 6-12 7-67 6-45 6-29 7-18 7-41 F. 3-58 7 58 5-61 4-74 5-39 3-60 4-51 3-78 4-82 4-16 3-39 4-40 405 4-54 511 5-86 476 303 4-31 4-94 3-63 4-55 617 4-28 4-38 6-58 4-94 3-79 T. 6-70 7 70 752 7-07 6-89 5-55 6-49 6-21 6-53 6-36 4-91 613 6-16 5-86 6-29 6-71 5-87 5-23 4-82 661 5-29 6-28 614 6-30 5-61 6-41 6-28 5-96 7,792 5,142 12,934 2,973 697 526 1,223 686 575 1,261 : 12,147 3,037 i I 890 • • ■• •• •■ •■ •• •• -. •• •• In Asylums, 1st January, 1876 In Asylums, 1st January, 1904 If. F. T. 482 254 736 .. 1,771 1,188 2,959

21

H.—7

Table XVI. —Showing the Admissions, Readmissions, Discharges, and Deaths from the 1st January, 1876, to the 31st December, 1903.

4—H. 7.

Persons admitted during period from 1st January, 1876, to 31st December, 1903 .. .. .. .. .. 6,273 3,94110,214 Readmissions .. .. .. .. .. .. 1,519 1,201 2,720 M. F. T. 6,273 3,941 10,214 1,519 1,201 2,720 M. F. T. Total cases admitted Discharged cases— Recovered .. .. .. .. .. .. 2,973 2,217 5,190 Relieved .. .. .. .. .. .. 697 526 1,223 Not improved .. .. .. .. .. .. 686 575 1,261 Died .. .. .. .. .. .. .. 2,147 890 3,037 7,792 5,142 12,934 2,973 2,217 5,190 697 526 1,223 686 575 1,261 2,147 890 3,037 6,503 4,208 10,711 Total cases discharged and died since January, 1876 Remaining in asylums, January 1st, 1876 482 254 736 Remaining in asylums, January 1st, 1904 1,771 1,188 2,959 Table XVII. —Summary of Total Admissions. Percentage of Cases s: ince the Year 1876. Males. Females. Both Sexes. Recovered Relieved .. Not improved Died Remaining 38-15 8-95 8-80 27-55 16-55 4312 10-23 11-18 17-29 18-18 40-18 9-46 9-75 23-48 17-18 100-00 100-00 100-00 Table XVIII. — Expenditure, out of Immigration and during the Financial Year ended 31st March, J Public Works Loan, 904, and Liabilities on Asylum Buildings ! at that Date. Asylums. Net Expenditure for Year ended 31st March, 1904. Liabilities on 31st March, 1904. Auckland Wellington Porirua Christchurch Dunedin (Seacliff) .. Nelson .. Hokitika .. £ s. d. 1,284 4 1 532 1 10 6,377 15 0 4,238 4 11 1,360 17 0 1,144 5 8 874 11 8 £ s. d. 280 16 1 313 18 2 1,130 7 9 2,115 4 2 1,277 4 3 100 15 3 194 11 10 Totals 15,812 0 2 5,412 16 8 Table XIX. —■ Total Expenditure, out of Immigrat and Buildings at each Asylum from 1st J Table XIX. —■ Total Expenditure, out of and Buildings at each Asylum fi lion and Public Work uly, 1877, to 31st M: :s Loan, for Repairsaxch, 1904. Asylums. 1877-96. 1896-97. 1897-98. 1898-99. 1899-1900. Auckland Wellington Wellington (Porirua) Christchurch Dunedin (Seacliff) Napier Hokitika Nelson £ 3. d. 75,246 1 7 21,114 13 8 48,101 19 4 101,230 8 10 121,528 4 10 147 0 0 1,187 5 4 5,510 9 4 £ s. d. £ s. d. 9,565 4 4 ' 3,177 14 6 175 10 0 133 11 4 4,873 16 10 8,655 10 0 1,169 11 1 821 18 4 280 11 0 222 13 6 1 11 j £ s. d. 208 7 2 1,606 18 10 11,233 9 1 188 15 9 1,797 0 4 £ s. d 208 7 i 1,606 18 1( 1,233 9 j 188 15 < 1,797 0 '. d. ; 2 0 1 j 9 4 £ S. 1,553 11 1,823 17 11,095 9 1,386 17 £ s. d. 1,553 11 4 1,823 17 0 11,095 9 6 1,386 17 7 338 17 3 ; 1,118 1 10 2,632 2 4 2,632 2 i * 1,852 5 1,852 5 8 Totals 374,066 2 11 16,403 10 6 14,129 9 6 17,666 13 6 17,712 1 1 Asylums. Asylums. 1900-1901. 1901-2. 1902-3. 1903-4. Total Net Expenditure, 1st July, 1877, to 31st March, 1904, Auckland Wellington Wellington (Porirua) Christchurch Dunedin (Seacliff) Napier Hokitika Nelson £ s. d. 3,038 17 11 1,616 2 0 10,587 3 7 75 16 8 2,227 16 10 94 3 11 1,231 13 5 £ s. a. 2,119 12 6 162 12 2 8,560 18 8 43 2 6 4,666 16 8 £ s. d. 698 6 1 1,468 10 2 2,144 19 1 155 11 1 4,973 0 1 £ s. d. 1,284 4 1 532 1 10 6,377 15 0 4,238 4 11 1,360 17 0 £ s. d. 96,891 19 6 28,663 17 0 111,631 1 1 107,923 9 2 138,443 17 10 147 0 0 2,398 5 5 15,502 1 10 37 4 1,186 19 9 238 17 2 487 6 7 874'11 8 1,144 5 8 Totals .. 18,871 14 4 16,743 9 7 10,166 10 3 15,912 0 2 501,571 11 10

H.—7

22

Table XX.— Showing the Expenditure for the Year 1903.

Approximate Cost of Paper not given; printing (1,675 copies), £21 9s.

By Authority: John Mackay, Government Printer, Wellington.—l9o4.

P»-ic« is.]

I i " I Heads of Expenditure. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Wellington. Total. Inspector * Assistant Inspector* Clerk* .. .. .. .; Medical fees* Contingencies* Official Visitors Visiting Medical Officers .. .. Superintendents Assistant Medical Officers .. Clerks Matrons Attendants and servants Rations Fuel and light Bedding and clothing Surgery and dispensary Wines, spirits, ale, and porter Farm Necessaries, incidental, and miscellaneous £ s. d. 25 4 0 600 0 0 270 16 8 147 10 0 99 11 8 4,319 1 4 4,171 3 6 904 10 4 1,069 13 5 46 17 4 12 0 0 551 19 6 1,297 6 3 £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. - £ s. d. 579' 3 4 240 11 9 174 6 8 98 15 0 2,675 7 1 2,653 18 11 739 0 11 689 3 3 39 11 5 14 10 6 319 0 2 1,206 15 8 £ s. d. 1,000 0 0 257 10 0 220 0 0 1,093 1 10 338 13 5 126 0 0 367 9 6 3,479 3 4 1,282 5 ; 1 926 0 0 667 10 0 25,675 10 5 23,231 5 9 5,809 13 2 6,434 17 4 484 11 2 78 9 6 5,250 17 11 12,065 12 3 .. .. • •• ■■ .. • • .. 50 8 0 12 12 0 150 0 0 600 0 0 300 0 0 270 16 8 156 13 4 109 3 4 I 85 0 0 6,689 2 8 1,294 13 0 5,259 4 3 1,508 1 9 1,169 6 7 48 14 2 1,517 .2 0 511 14 5 125 4 3 2 10 6 7 10 0 0 18 0 1,791 18 5 4,572 6 2 324 12 9 12 12 0 25 4 0 217 9 6 200 0 0 600 0 0 250 0 0 247 10 0 75 0 0 100 0 0 1,271 1 11 4,875 14 6 1,278 7 8 4,502 2 4 507 10 3 973 7 10 180 16 0 979 3 11 47 11 2 126 16 5 13 19 0 14 0 0 401 5 4 903 1 0 684 7 2 2,078 10 1 600 0 0 250 0 0 200 0 0 100 0 0 4,550 9 11 3,858 7 4 1,467 3 1 1,487 4 4 96 0 1 15 12 0 1,283 13 6 1,901 14 2 Totals Repayments, sale of produce, &c. .. 13,515 14 0 .. I 4,025 2 6 15,810 4 5 22,318 1.5 8 4,394 7 1 7,860 3 11 4,238 16 7 278 6 7 4,890 0 0 15,675 10 1 758 1 1 2,973 3 3 9,430 4 8 2,471 10 5 88,788 10 8 22,760 14 10 Actual cost 9,490 11 6 11,415 17 4 14,458 11 9 3,960 10 0 4,131 18 11 ; i I 12,702 6 10 6,958 14 3 66,027 15 10 I * N. Dt included in Table XXI. Table XXI. —Aveka .ge Cost of each Patient per Annum. Asylums. Provisions. Bedding „ , , ! Surgery Wines, Salaries. : and t?L» and Spirits, Ale, Clothing. Ljlgat - Dispensary. &c. i i Farm. Total Cost Totft.1 Cost ! "£5jj§S,- \ Total Cost B„ents pe |g|J s 1-Head.less cegus. ™.ent. tenance. Decrease in 1903. Increase in 1903. £ s. d. £ s. d. Auckland .. 7 9 6 9 15 9J Chrislchurch .. 7 5 10J 10 15 6| Dunedin (Seacliff) 7 15 4| 11 12 8J Hokit'ka .. 10 6 7 12 12 4J Nelfon .. .. 9 2 7J 12 13 8| Porirua .. 8 12 10 11 14 1J Wellington .. 9 2 4| 12 18 llf £ s. d. £ s. d. £ s. d. £ s. d. 1 18 4 1 12 5 j 0 1 8£ 0 0 54 2 16 2f 2 15 54 ' 0 3 7J 0 0 7 2 4 9| 1 14 64 0 3 S£ 0 0 2} 3 10 l| 0 6 8 0 0 4} 0 0 1} 1 5 JO 3 12 6 0 6 94 i 0 1 11} 1 17 7 1 17 44 0 4 10J ! 0 0 64 2 7 44 2 10 94 0 2 8} 0 10 £ s. d. £ s. d. £ s. d. 0 19 94 2 6 6 24 4 5§ 2 8 6J 3 11 10f 29 17 8} 2 12 ll| 6 15 1 32 19 4| 2 4 5| I 29 0 8 2 17 4 j 4 17 91 I 34 18 6| 1 14 8 3 19 9| : 30 1 9 111!' 42 ll| 32 8 1J £ s. d. 5 19 10J 5 11 9J 7 12 64 1 14 8} 4 8 7 4 1 4f 7 10 5J £ s. d. ' £ s. d. £ s. d. 18 4 7 17 0 2 17 11 3} 24 5 114, ] 21 11 7£ 19 15 2| 25 6 9} 21 7 If 23 6 8£ 27 5 ll| 27 2 6 25 12 2} 30 9 llf ; 29 10 34; ! 26 1 11 26 0 4| : 24 7 7J 24 14 4 24 17 8| 23 18 3£ 26 17 8 £ s. d. £ s. d. 0 11 1} 1 16 44. 1 19 64 1 10 3J 3 8 4 0 6 8J 2 19 4} 0 5 9J Averages .. 8 2 4 11 7 34 2 4 11| 2 0 71 0 3 4| ' 0 0 6i ■ 1 16 8J 4 4 3j 30 0 14 24 3 9J 22 1 Of 22 6 10 5 16 4 Note.— Including the first five items in Table XX., the net cost per patient is £23 Is. 5d., as against £23 lis. 5}d. for the previous year, a decrease of 10s. Ofd. per head.