H.— 31

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these cases that the " deck " beds became congested, with the result that during the latter part of the year we showed an unusual number of empty beds. This trouble, moreover, was aggravated by an epidemic of influenza that made its appearance in August. Comparing the numbers admitted in the different stages of the disease, the obvious criticism must be made—namely, that the number in stage 2 is far too high. It is repeatedly found that patients in thid stage have been on unsuccessful home treatment, and that the Sanatorium has been made the second, lino of defence instead of the first. With regard to the Sanatorium itself, the routine and general running of the institution has been on the whole satisfactory. The good work done by the nursing staff has largely contributed to the good results obtained, and the patients have for the most part been contented during their period of treatment. Few complaints have been received with regard to the food, and the difficulties met by the kitchen staff are likely to be largely overcome by the reorganization of the kitchen staff and the addition of a new range. The farm under the Department of Agriculture has done well during the. year, and the supply of mutton and milk has been ample and of good quality. Additions to the fowl-run have enabled us to increase the stock of poultry, with the result that there has been a good supply of eggs and poultry foe the table. Otaki Hospital--It speaks well for the results obtained that out of 173 cases treated 118 were discharged recovered, while a death-rate of 3-65 per cent, is a low one. SECTION 4.—PUKEORA SANATORIUM, WAIfUKURAU. Dr. Huuu Short, Medical Superintendent ; Dr. \V. Pulton, Assistant Medical Superintendent; Miss I. Whytu, (R,lU:.)(Modaille de la Rcine), Matron. General. —Throughout the year it may be stated that the morale of the patients, which was referred to in my last report, has continued very definitely to improve. As years go by it may be expected that all patients, both service and civilian, will realize that the discipline and routine of a sanatorium of this character has only one object in view—viz.", the improvement in health of those undergoing treatment--and consequently any animus which certain service patients may entertain towards any kind of discipline will gradually disappear. In fact, it may be stated now that the restrictions appertaining to military service and experience by such a large percentage of the patients have now no bearing whatever upon sanatorium routine. It is gratifying to be able to report that on the whole there has been a distinct improvement in the character of the cases admitted during the period. It is true that occasionally a case arrives where no hope of recovery or prospect of improvement can be given, but the number of such cases has relatively diminished noticeably during the year. Treatment. —Throughout the year all cot cases have been seen daily, as hitherto, and likewise the patients on exercise have been paraded prior to the exercise. In addition to the existing advantages of an up-to-date sanatorium for the treatment of the tuberculous, two new methods of treatment have been tried at this institution. In a few cases colloidal calcium has been exhibited, with, unfortunately, no definite evidence of success. The stated efficacy of this drug in hemorrhagic cases has not been confirmed at this institution. A very fair trial of Dreyor's vaccine was also given. In all some forty cases were commenced upon this treatment, but of these some six or seven wore taken off the treatment for various reasons before progressing to any material extent in the treatment. Speaking generally, in regard to the remaining patients it may be stated that no notable improvement has been observtxl in individuals. In regard to the pyrexial cases, of whom at least fifteen cases have been tried out, no improvement was noted at all. As regards the apyrexial cases, four patients have done very well indeed. Active signs have entirely disappeared, and tolerance to exercise has been increased considerably. All four cases showed very definite signs of tubercular infiltration, and the sputa were positive in each instance. I do not, however, consider that the officacy of the preparation is established very firmly by the progress made by these four patients, as with the ordinary sanatorium methods alone one must expect to find a percentage of moderately affected cases to improve without any outside assistance. One further note may be made regarding this preparation. It has been stated that in regard to its administration elsewhere complications have been frequent. I have not found that complications were an outstanding feature in the administration at this institution. A few have shown a minor degree of hiemoptysis ; one case contracted broncho-pneumonia, and has since done well; and one case, shortly after the administration of minute doses, died following a profuse heemorrage. In regard to the last-mentioned case, I do not consider that the vaccine had any effect whatever upon the progress of the case, as other pathological changes sufficiently account for the termination of the life of this patient. Throughout thu year it has been considered unnecessary to apply for a visit from the Dental Officer, as the policy of the Department in enforcing that all dental work is to be completed before the admission of patients has been successful in relieving the position so far as affects civilian patients. No difficulty has been experienced in the matter of dental treatment as regards the service patients, as it has always been possible for such patients to secure dental work locally wherever the need has arisen. X-Ray Department. —During the year the X-ray department has been at the disposal of the staff and patients during the visits of the X-ray Assistant, kindly loaned by the Medical Superintendent, King George V Hospital, Rotorua. This assistant has paid two visits during the year, ono in October and one in December, the total number of plates taken being sixty-one.