H.—7

20

four cases, self-injury in one, and indecent exposure in one. In my opinion the occasions were necessary, the restraint not unduly prolonged, and the mechanical means employed the least irksome under the particular circumstances. No accidents have taken place during the period under review, and the four deaths enumerated above were due to natural causes —namely, one each to cancer, apoplexy, general paralysis, and scarlet fever. The last-named cause calls for comment. There have been this year three cases of scarlet fever on the women's side —none on the male side or among members of the staff. As soon as the symptoms were exhibited the patients were removed to the fever hospital. Two cases occurred in mid-February, the other towards the end of March. There were evidently two separate infections, and anything in the nature of an epidemic was averted by prompt action. Scarlet fever is prevalent in the locality, and the last case must have contracted the disease when absent in town on leave. The source of the first cases has not been traced. With these exceptions, the health of the patients has been good. None of the sick suffered from bed-sores. The average number of patients attending amusements is 85 (m., 50; f., 35), and that attending divine service is 47 (m., 23; f., 24), and 21 (m., 20; f., 1) have liberty on parole. The following return of employments is taken from the Medical Journal: — Males. Females. Total. Garden ... ... ... ... ... ... 61 1 62 Stores ... ... ... ... ... ... 3 ... 3 Wards ... ... ... ... ... ... 32 32 64 Workshops ... ... ... ... ... ... 11 ... 11 Laundry ... ... ... ... ... 14 14 Kitchen ... ... ... ... ... ... 12 ... 12 Needlework ... ... ... ... ... 1 13 14 Total employed ... ... ... ... 120 60 180 Unemployed ... ... ... ... ... 20 30 56 Total ... ... ... ... ... 146 90 236 The man returned as doing needlework is an old sailor whose nattiness suggested him as a fit person to manipulate the knitting-machine. He was taught the working, and showed me with pride the tale of the socks he had turned out, and the good quality of the work. The nursing staff consists of 35 members —21 attendants and 14 nurses—of whom 4 and 5 respectively have been in the service for five years and over. This reckoning does not include the Matron and Head Attendant, who have both many years of service to their credit. Seventeen members of the staff were eligible for examination to register as mental nurses, having been in the service for three years and upwards, and I was disappointed that only one presented herself for examination. The ratio of nursing staff to patients is as follows :— Day attendants ... ... ... ... ... ... 1 to 7"7 Night attendants ... ... ... ... ... ... 1 to 73 Day nurses ... ... ... ... ... ... ... 1 to 7"5 Night nurses ... ... ... ... ... ... 1 to 45 The wards during the visit were found to be clean and in good order, and the patients were neatly and suitably clad. The new exercise-ground, including the asphalt tennis-court, provides a relatively large open sunny space, which the women patients apparently appreciate. The laundry machinery has been a great boon, but the hydro-extractor requires additional power before it can be brought into action. A new engine is being installed. The statutory books and registers were up to date, and are neatly kept. About this old wooden institution there is a decided air of comfort, which Dr. Crosby's knowledge of, and consideration for his patients tends to foster. The inspection was a very pleasant duty. Ashburn Hall Licensed Mental Hospital. 2nd April, 1908. I inspected this Mental Hospital on the 27th March and to-day. Miss Maclean visited on the 12th February, when she examined in sick-nursing the two candidates for registration, and to-day Dr. Alexander and I conducted the viva voce part of the same examination. Since Miss Maclean's visit 2 patients have been admitted and 5 discharged or transferred, and 1 voluntary boarder has left. To-day there are 43 patients (males, 24; females, 19), and 8 voluntary boarders (m., 2; f., 6), making a total of 51 inmates (m., 26; f., 25). The following return gives the accommodation available in the various buildings, the distribution of the patients and boarders therein, and the number of vacant beds :— _ .... Accommodation. Number of Inmates. Vacant Beds. Building. Malea pemaieg Males Females. Males. Females. M ;i i n _Mitchell Wing ... ... 18 ... 17 ... 1 PinelWing ... 16 ... 10 ... 6 Clouston Cottage ... ... 3 ... 3 Ashburn Cottage .. 5 ••• 3 Conolly Villa ... 15 ... 12 ... 3 Tuke Villa 9 ... 6 ... 3 30 36 26 25 4 11 66 ~51~ ~~15~