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XXXI

the amending Act should be interpreted liberally and in such a manner as would not bear unfairly upon those who had been engaged in the work for some time. I suggest, however, that the time has now come when it should be insisted upon that every one holding a license should either be a medical man or a registered nurse, or that a medical man or registered nurse should be in charge; further, if mental cases are to be allowed to be treated in private hospitals, that special regulations should be made for such institutions. There is a natural reluctance, both on the part of the medical man and the patient's friends, to send a case which is likely to recover soon to any of the public or private hospitals for mental diseases; but this should not be allowed to operate unfairly against the patient's welfare. No system of inspection short of an actual residence in the hospital would have averted the untimely death of the young lady in Christchurch; but if it were required that all holders of a license were of the character I have indicated, such an accident could hardly happen. Provision for Ex-patients of Sanatorium. As the result of our work in connection with the treatment of consumption it has gradually been borne in upon me that to get the best results we must set up some sort of an after-treatment. Many of those who have gone through a course of treatment at Cambridge have left the institution to all intents " cured," but they are still unable to take up ordinary work, or if they do a relapse will be the consequence. The difficulty of finding these "cured" patients work is a daily anxiety and cause of worry. It has to be remembered that a person " cured "of consumption is somewhat in the same position as a person whom the surgeon has cured of sarcoma by amputating the limb. He cannot in many instances take up his ordinary work again, and unless all the beneficial results of a course at Cambridge or any other open-air sanatorium are to be stultified, something must be done to obtain for them work in the open air. When annexes have been put up by the several Hospital Boards, occupation might be got for a small number of the " cured " in connection with them, but this at best will only provide for a few. If some scheme whereby they could be employed on a State farm, vinery, nursery, or poultry-farm could be arranged for, these poor maimed but willing workers might be able to do some good for themselves, and at the same time advance the economic weal of the colony. Pending the setting-up of some such farm, employers of labour in the country could help greatly if they would give these poor fellows a chance. One thing which occasionally deters a farmer or employer of outdoor labour from taking the "cured" person on is the fear of infection. We have tried in every way possible to dispel this fear, but still it remains. Consumption is—at least among grown-up people —mainly spread by means of the material coughed up by the sufferer. Apart from the fact that most of the " cured " have ceased to spit up an infective material before they are discharged, the education they have received at the Sanatorium is such as to entirely free them from causing any harm. They are there told of the danger which lies in the sputum, and are taught that in their own and every one else's interest all matter coughed up must be destroyed by fire. They are in this way not only harmless to produce evil themselves, but they exhibit a striking object-lesson to the careless, if healthy, expectorator. Many are able to take up their old work, but a goodly number must for ever live and work in the open. Till adequate provision is made by the State will employers of outdoor labour lend us their aid? Leave op Officers. Looking to the nature of the work which the scientific members of the Department are called upon to perform, bearing in mind the ever-changing nature of medical and sanitary science, I strongly recommend that each at regular periods should be permitted leave of absence in order to visit the laboratories of the older countries. A month's leave on full pay is usually granted to responsible officers in other Departments every year. If it could be arranged that each District Health Officer could "pool" his yearly leave, and, say, once in five years be permitted to take a five months' holiday I am sure it would make for the mental satisfaction of the officers, and at the same time the interests of the colony would be greatly advanced. " Things seen are ever greater than things heard," and no amount of private study can compensate for a prolonged absence from the scientific workshops of the Empire, or equal the seeing at first hand the later methods of sanftary work. The questions which the District Health Officers are called upon to answer are as many as they are varied —from the construction of a privy to a septic-tank installation; from the diagnosis of chicket-pox to that of small-pox; the disinfection of a house to the establishment of a hospital