n.—i.

Financial Ebsults of the Yeak. The total gross expenditure for the year was £61,535 9s. 7d., and the total net expenditure £49,284 10s. Bd. The net cost per patient was 3s. 10d. less than the previous year, the figures being £22 9s. 10-Jd. for 1896, and £22 13s. B*,d. for 1895. Sunnyside Asylum again shows the best results for the year, the net cost per patient being £16 16s. Bfd. The large sum of £2,695 13s. 2d. was received for maintenance, and £1,109 15s. for sales of produce, &c. The following figures give the cost per patient at each asylum : — £ s. d. Auckland ... ... ... ... ... ■ ... ... 22 5 8$ Christchurch ... ... ... ... 16 16 8f Seacliff ... ... ... ... ... ... ... 23 13 l\ Hokitika ... ... . ... ... ... ... ... 24 10 9| Nelson ... ... ... ... ... ... ... 20 7 11* Porirua ... 23 7 8 Wellington 20 4 11*,

MEDICAL SUPEEINTENDENTS' EEPOETS. AUCKLAND ASYLUM. SlK,— I have the honour to submit my report on the Auckland Asylum for the year ending the 31st December, 1896. During the year a total of 102 patients were admitted, including 75 males and 27 females; 62 males and 19 females were admitted for the first time. There were 20 males and 11 females discharged recovered, and 1 male discharged relieved. The deaths numbered 27 males and 10 females, a total of 37, the cause of death being verified by post-mortem examination in twenty-seven cases. Included in these is one case of a man who when admitted was found to be suffering from rupture of the bowels, and who died ten hours after admission. A post-mortem examination showed the rupture to be due to perforation of a typhoid ulcer. While there were a total of 392 patients—246 males and 146 females —in the Asylum at the beginning of the year, there were in the Asylum on the 31st December 273 males and 152 females, a total of 425, showing an increase for the year of 33 patients. The recovery rate is low, but this is to some extent due to the high admission rate, which showed an increase of 50 per cent, on that of the previous year. This increase is no doubt due to the large influx of population consequent on the mining revival in the province ; indeed, a considerable number, of the men admitted were from the Coromandel Peninsula, whither they had been attracted in the hope of getting employment during the past year. Since I assumed charge of this Asylum I have been impressed with the difference in the type of patient most commonly admitted in Auckland as compared with that prevailing in the southern portion of the colony. Here we have a large number of partially-demented and congenitally-weak individuals, who, at their best, are barely able to maintain themselves under the specially favourable climatic conditions of this province, and who, losing ground by ill success in making their precarious livelihood, are arrested most likely for vagrancy, found to be insane, and sent to the Asylum. I have frequently had much difficulty in deciding in such cases which way my duty lay, whether I should discharge them or detain them in the Asylum. After a few months' care in the Asylum they usually improve sufficiently to gain their discharge; but one knows that immediately they are thrown on their own resources they will begin to lose ground, and sooner or later will be recommitted to this or some other institution. It is one of the drawbacks that Auckland must suffer from, as a result of its mild climate and other favouring circumstances, that it will always attract an undue proportion of incapable and defective individuals, whose presence is certainly not to the advantage of the community. The administration of the Asylum during the year has been, at least on the male side, mainly a struggle to provide for the care and safety of a large excess of patients with perilously inadequate accommodation. The new auxiliary building was occupied in the beginning of November, but, although this relieved the general overcrowding, it did little to relieve the strain of providing for acute and excited and dangerous cases. It is the grave deficiency in the number of single rooms that has been the chief anxiety for long past, and where, as was the case last year, there are a large number of new cases to provide for, the endeavour to secure the safety of the patients, to say nothing of their proper care and treatment, becomes a matter of extreme difficulty. The absence of a padded room and of observation-rooms on the male side was seriously felt, but, as provision has been made for these in the block now being built, things promise to be better in the near future. At the same time an increase in the number of single rooms on the female side is urgently needed. The almost simultaneous occurrence of three cases of typhoid fever in the autumn caused some alarm, owing to the crowded state of the wards, but I am glad to report that no further cases occurred, and those attacked made good recoveries. During the winter a course of lectures on asylum nursing was given to the staff, with fair results. Acting on my suggestion, the nurses have voluntarily adopted a uniform which adds much to the appearance of the wards, and tends to cultivate and preserve a healthy esprit.

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