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Wilson, the Medical Superintendent. He said that he and his colleagues would also benefit by a weekly conference with a mental specialist, concerning such of their hospital inmates as might present mental problems. He frankly recognized and stated that the benefits would be mutual, and this prophecy is amply confirmed by the following letters from Dr. Wilson, and Dr. Tizard, the Medical Superintendent of the Wellington (Porirua) Mental Hospital. Dr. Wilson writes : — Wellington Hospital, Bth July, 1926. Sir Truby King, Director of Department of Mental Hospitals, Wellington. Dear Sir, — Re Out-patients' Clinic in Wellington Hospital. I have much pleasure in forwarding the first annual report on the working of the out-patients' clinic connected with the General Hospital, and run in co-operation with a Medical Officer from your Department. The clinic has been held each Tuesday afternoon, and I much appreciate' the fact that the Senior Medical Officer from Porirua has always made a point of attending himself and interviewing the patients and relatives. I am convinced the public have a high regard for the advice and treatment given as a result of this. When the clinic *was first started I informed the local practitioners by memorandum of the aims and objects of the clinic, and I think this has had the effect of keeping up a steady inquiry by patients, as every week some fresh patients or relatives come up to see the officer from your Department. Speaking from the point of view of the Hospital, T find that as a rule there has been some one or more patients in the Hospital for whom the honorary physicians or honorary surgeons in charge of the cases have been only too anxious to have a consultation with the Medical Officer from the Mental Hospitals Department. Thus the organization of this clinic has been to the advantage of the General Hospital itself. Again, knowing that we can now have a regular weekly consultation, it is very rare that we consider sending a patient to the Mental Hospital, no matter how obviously suitable the case, without first letting your Medical Officer see him at the General Hospital. By making a practice of this I find we have more co-operation from the relatives of patients, and there is no feeling of injury done to their relatives. Practitioners have made considerable use of the clinic, as they refer patients or relatives to see the Medical Officer, and I also note that the Pensions Department utilize his services too. I think the success of the first year augurs well for the future, and that this clinic will be the means of doing a great amount of good. In conclusion, I have just to state how amicable have been the relationships between the staff of my hospital and the visiting Medical Officer from the Mental Hospital, especially Dr. Tizard, who has borne the brunt of the work. I am, &c., D. Macdonald Wilson, Medical Superintendent. Dr. Tizard writes : — Mental Hospital, Porirua, 6th July, 1926. The Inspector-General of Mental Hospitals, Wellington. Sir, — Re Weekly Clinic for Out-patients at the Wellington General Hospital. I submit the following short report on my attendance at the Wellington Hospital for the year 1925 :— During the year a weekly clinic has been held, attended by out-patients suffering from any form of nervous or mental affection. These patients are seen, and advice and treatment are given, as a part of the service of the General Hospital, without any mental implication or reflection whatever. In addition, patients on probation from the Porirua Mental Hospital are seen, advised, and helped from time to time, thus keeping us in touch with them during their probationary period, and (if required) after their formal discharge. The Pensions Department also avails itself of our services in connection with advice and reports on returned soldiers; and this applies to other Government Departments. In-patients of the General Hospital are also seen in consultation with the Medical Superintendent or his deputy. As a result of visiting the clinic, incipient mental or nervous cases often arrange for admission to the Porirua Mental Hospital as " voluntary boarders " —thus enabling us to get them under timely treatment with a reasonable prospect of early recovery. In this way they may avoid a complete breakdown, which in many cases would take place unless they had the present facilities and inducements for attending the clinic, and the advantage of consultation with doctors drawn from both services. From time to time patients with recurrent insanity, who have been previously treated in a mental hospital, avail themselves of the clinic and ask to be readmitted for further care and treatment at the onset of a fresh attack. Some of these patients are naturally glad of the assured privilege of being looked after in the best quarters for which they happen to be fitted. In such cases the severity of the attack may be lessened and its duration cut short, thus avoiding the need for certification as insane, which must assuredly have followed had they not been dealt with in due time. There can be no question regarding the great advantage of the weekly out-patient hospital clinics. They enable many persons with threatened or manifest nervous breakdown to obtain the right advice and information in the early stages who would otherwise let themselves drift, or be allowed by their relatives to drift, into a condition of incurability. I have to thank Dr. Macdonald Wilson for his courtesy and interest, and for the assistance he always gives me during my visits to the Hospital. To Dr. Lynch, Bacteriologist at the General Hospital, I am also much indebted for his reports on the examination of pathological material submitted by us to him —thus enabling us to clear up any doubtful clinical diagnosis. I have, &c., H. J. Tizard, Medical Superintendent. Dr. Wilson's keen personal interest in the successful establishment of the " out-patient clinic for nervous affections " was clearly shown by his sending a circular letter to all medical practitioners in Wellington, directly the preliminary arrangements had been made, giving them the necessary details and asking their help and support. Dr. Tizard assures me that the efficacy of this procedure is still manifested from time to time in letters brought by patients applying for advice, which refer back to Dr. Wilson's circular.

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