3

H.—G

douches or massages, subject always to stringent rules, and regulations to strictly follow and never depart from the instructions given by the patients' consulting doctor. To start this special kind of treatment it would be necessary to procure some competent doucheur and douoheuse to train and instruct some of our local attendants. I spoke to the Director of the Aix-les-Bains establishment to know whether a married couple could be had to come to New Zealand. He informed me that some doucheurs and douoheuses had been sent from Aix-les-Bains to train and instruct the attendants of the new establishment at Bath, and he said that if such were wanted for New Zealand he would willingly assist in selecting a couple. The salary paid in France for doucheur or douoheuse is not very great—from 400fr. to GOOfr. (or £16 to £24 sterling) per season of six months ; but I was told that they receive a good deal in gratuity from patients beside. They all have some kind of trade or calling which they follow in the dead season, and it is somewhat hard to induce them to leave their home and habits for such a distant country as this. The introduction of douches and massage would require a large quantity of mineral water under pressure of about 50ft. to have all the advantage of it. This could be procured, and a system of douching arranged at Eotorua, by using the water of the Kuirau, which is equal to about 400,000 gallons in the twenty-four hours. As this, however, is a work of some magnitude, it will require a well-considered and matured plan of the whole proposed scheme to be drafted out and adopted, and afterwards to be carried out year by year as the demand for accommodation increases. In the meantime some improvements can bo effected to the steam-bath, the Eachel and Priest Baths, which would greatly improve them and increase, the present accommodation, which is being taxed to its full extent. These last improvements I have to some extent explained to Mr. 11. A. Gordon, Inspecting Engineer, on his last visit to this place ; and if instructed I will draft out plans of the respective works and submit them to you. In re management of establishment: Most of the thermal establishments of Europe are administered by a personnel consisting of a director or manager, one or more inspecting doctors, and a number of officers and attendants according to the importance of the establishment and the number of patients treated. Having procured a copy of the rules and regulations in force at Aix-les-Bains, I hereunder translate a few of them :— Chapter I. —Clause 1: A director or manager named by the Minister of Commerce is charged (under the supervision of the Prefect) with the direction of the thermal establishment and its dependencies. Clause 2 : The director supervises all parts of the service ; he sees to the execution of all measures of order and of administration prescribed by the rules and regulations, and consults with the inspecting doctm in all matters relative to the administration of the waters. He directs every person belonging toihe service, who is bound to obey him.* Chapter ll. —Clause 3 : The inspecting doctor, nominated by the Minister of Commerce, exercises, in a medical point of view, supervision over all parts of the establishment devoted to the administration of the waters and to the treatment of the sick, and on the execution and disposition of the rules and regulations bearing thereon. He directs also, in a medical point of view, the service of the employes attached to the baths, douches, &c. lie notifies to the Prefect or Minister all abuses or defects in the service. In case of urgency he will consult with the director upon any immediate action to be taken. He will be assisted in his duty by one or more assistant inspecting doel ors, nominated by the Minister. Clause 4 : Anything contained in the first paragraph of tl. ■ preceding article shall not be interpreted so as to restrain the liberty of patients to follow the p. scription of their own doctor, or to be accompanied by him if they demand it. Clause 5 : Patients are not bound to pay any remuneration to the inspecting doctors when these last do not direct their treatment and do not otherwise give them special advice or care. Clause 6 : Inspecting doctors treat gratuitously all indigent persons admitted to the use of the waters. [There is always a hospital and some kind of charitable establishment attached to the baths.] Clauses 7 to 19 deal with the mode of keeping and checking the accounts. Clauses 20 to 36 deal with the distribution and use of tickets for douches, baths, &c, and regulate the mode of admitting patients and bathers. Clauses 37 to 53 deal with the personnel of the establishment, and regulate their respective duties. Clause 54 deals with the rate of charge for the different baths, douches, &c, which are divided into two and even three classes, and range from 3fr. for first-class douche and bath to 50c. for the lowest (a simple public piscine bath). Independent of these, there is a rate for a family bath (half-rate granted to certain person under certain well-stipulated conditions) ; a rate for bath-chair carriers; a rate for extra linen provided (the linen being heated); a rate for special bath out of the ordinary bathing-hours, under medical advice, for patients requiring a number of attendants, complicated apparatus, or affected by contagious or repulsive diseases. Clauses 56 to 67 deal with the free or gratuitous bathing, which is here very liberal. Clauses 68 to 73 deal with the general rules applicable to the good conduct and behaviour of patients, visitors, and the personnel of the establishment. All these rules and regulations, being the result of many years' experience, are well calculated to insure the efficient working and perfect system of checking the accounts and revenue of the establishment, and could be applied profitably to the Eotorua and other Government establishments. Clause 59 reads, " According to usage in force, French and foreign doctors are admitted gratuitously by justifying their identity by legal documents, or on being presented by a doctor in exercise at Aix." This clause is well worthy of the consideration of the Government, as the granting of the foregoing privilege to all medical men would perhaps induce the medical men of

* This rule of having a non-medical director is generally adopted on the Continent, as it gives more scope and freedom to patients, and to outside medical men to exercise their own judgment in the treatment of each individual ■case.