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day I have examined every part of it, and I have seen all the patients, none of whom were in bed but one old lady, who was unable to be about. The greatest skill, care, and kindness are exercised in treating each case according to the regulations and pecularities of the individual. A beautiful cottage has been built for such male patients as require separate treatment. There is a cottage also on the estate for such females as would be benefited by separation from the others. The staff is efficient, the diet generous, and a remarkable quiet prevades the whole place. All the statutory books are in order. As a whole the institution is in a very satisfactory condition. 16th February, 1905.—This Hospital has been examined by me this day in ali its workings. 1 find all the patients are carefully and intelligently studied and treated. The diet is good and abundant; their bedrooms well furnished and ventilated. All the accessories to health are earnestly considered, and some of the patients made rapid recoveries. No one is improperly detained, and I can find only evidence of kindness on the part of the atendants. A lady doctor has recently joined the staff. Her experience in the same capacity at Seacliff, where her work was known to me, has fitted her specially for her duties here. The voluntary patients are a special feature of this institution, and the results are gratifying lam very pleased with the results of my examination.

MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Sir, — I have the honour to submit the following report on the Auckland Mental Hospital for the year 1904. At the beginning of the year there were 576 patients (364 males and 212 females) under care and treatment. On the 31st December there were 584 patients (363 males and 221 females) in the Hospital, being an increase of only eight on the year, entirely confined to the female patients. This is a very satisfactory result, especially the fact that there is one less male patient at the end of the year than at the beginning. It is always much more serious to have an increase of the " breadwinners " as patients than of the opposite sex, for various reasons. The death-rate for the year has been 7.56 per cent. The principal causes of death were: chronic brain-disease, 3 cases; epilepsy, 5 cases; general paralysis of the insane, 7 cases; pulmonary tuberculosis, 6 cases; senile decay, 7 cases. In reference to general paralysis, one cannot but note a steady, though slight, increase iv this absolutely hopeless form of mental disease. In regard to deaths from tuberculosis, it is too often supposed that this disease in mental hospitals is due to surroundings. It has to be remembered, however, that the tendencies to tuberculosis and mental disease often coexist; that nervous degeneration so weakens the resisting-power of the organism that tuberculosis is particularly prone to intervene in spite of all precautions, and that tuberculosis is sometimes a direct cause of insanity. I think, however, that the time has arrived when a small sanatorium for tuberculosis cases should be erected in connection with each mental hospital, on account of the undoubtedly infectious nature of the disease. There were admitted during the year 129 patients (seventy-seven males and fifty-two females). The most marked feature is the predominance of melancholia over any other one form of mental disease, this accounting for 30 per cent, of the total number of admissions. There is also a considerable increase of delusional cases, many of them, unfortunately, of an intractable nature, so far as complete and permanent lecovery is concerned. There were six general paralytics admitted during the year. The recovery rate reached the very high level of 55.81 per cent. This is the highest on record in this hospital. The causes for this high rate can only be assigned with difficulty. The more effective methods of treatment which have come into vogue of recent years have undoubtedly helped ; but we have also had to deal with, several transient cases of mental disease. It is pleasing to note that there is an increasing desire on the part of relatives to take their friends out on probation, thus insuring their discharge at an earlier date than would otherwise be the case. The causes of insanity in the cases admitted during the year form an interesting study. Unfortunately, in our present causation table we can only give the predominant cause, owing to being compelled to give one cause only. This makes the table very inaccurate, as all contributory factors are overlooked. This is the more to be regretted, as this is probably our most important table. Hereditary predisposition, for instance, in the table for this Hospital onlyshows eleven cases in the admissions, whereas there were in reality thirty-nine cases. If neurotic ancestry were allowed to rank in the hereditary field this total would be very much larger ; and, in fact, in the vast majority of cases there is some congenital weakness of will or intellect, rendering them susceptible to comparatively slight causes. The number of alcoholics admitted during the year was 15 per cent, of the whole, but in this connection a sharp distinction between chronic and acute cases should be drawn. The latter are not habitual drunkards, as are the former, but occasionally indulge in a "blind spree," resulting in a transient attack of insanity. Eleven senile cases were admitted, as they had nowhere else to go; but there is too great a tendency to look upon this Hospital as a dumping-ground for the mental and physical wrecks who could be easily accommodated with proper nursing in the benevolent institutions. There were four epileptics and four imbeciles admitted during the year. It is interesting to note that tohungaism is assigned as the cause in two female Maoris. In one case the whole family became insane, though only one was sent here.