H.—7.

The clinic at Dunedin Hospital has been attended weekly, while a monthly clinic has been held at the Southland Hospital; the latter is a new departure, and has been well worth while. Amusements and recreations have, as usual, formed a part of the hospital life. Pictures weekly, weekly dances in the winter, and occasional concerts being held ; while cricket, football, bowls, tennis, and croquet have been patronized. Selected parties have also attended the Summer and Winter Shows and the Waikouaiti races, while outdoor picnics have been indulged in when the weather was favourable. I would thank the nursing staff generally, and the Matrons and Head Attendants especially, for the way they have performed their duties during the year. Thanks are also due to other branches of the staff, especially the heads of the various branches. Mr. Cumming, the " Patients' Friend," has been absent through illness during part of the year, his place being taken by Mr. Syder. Mr. Cumming has been missed, but is now, every one is pleased to know, well on the way to recovery. My thanks are due to the clergy of the different denominations for their regular visits, and to the Red Cross for donations of tobacco throughout the year and for Christmas gifts to returned-soldier patients. The medical officers have ably assisted me during the year, and their work has been of a consistently high standard.

STATISTICAL. The patients on the register at the end of the year numbered 6,383 (m. 3,572, f. 2,811), or 290 (m. 173, f. 117) more than at the beginning ; and the daily average under treatment during the year was 5,932 (m. 3,342, f. 2,590), or 222 (m. 127, f. 95) more than in the previous year ; while the total under care was 7,363. Patients belonging to the Native race numbered 89 (m. 46, f. 43) at the end of the year. The admissions numbered 1,095 (m. 621, f. 474), or 139 more (m. 72, f. 67) than in the previous year. Of these, 162 had been previously under care, making the proportion of readmissions 14-79 per cent., and 933 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-57 (m. 8-45, f. 6-66) to 10,000, and of first admissions 6-44 (m. 7-33, f. 5-51), so that 1,320 persons in the general population contributed one patient, and 1,552 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 382, or 3 less than in 1929. 116 (or 20 more) harmless unrecovered persons were returned to the care of friends; and 266 (m. 138, f. 128) recovered —23 less than last year —representing a percentage of 24-29 (m. 22-22, f. 27-00) on the total admitted. With voluntary boarders added the percentage rises to 33-69. Altogether, 41-93 per cent, of the inmates admitted were able to leave institutional care. Of a total of 7,363 patients under care, 423 (m. 251, f. 172) died, or 7-15 per cent, on the average number resident. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table XII, and the following is the percentage of causes mainly contributing : Senile decay, 23-40; disease of the brain and nervous system group, 22-46; heart-disease, 22-46; tuberculosis, 4-73. In Table XIII the principal causes assigned for the mental breakdown in the admissions are stated ; but as a matter of fact they are merely approximations, and these, with the small numbers with which we have to deal, show such divergencies from year to year that the proportion assigned to any one cause in any one year cannot be assumed to be our average incidence. Causation is always complex, and the most potent factor is the individual. Hereunder the assigned causations in the table referred to are grouped and shown in their relative proportions :—• Males. Females. Total. Heredity .. .. .. .. .. 9-82 7-17 8-68 Congenital .. .. .. .. .. 21-58 19-83 20-82 Predisposed by previous attack .. .. 10-31 14-14 11-96 Critical periods .. .. .. .. 15-94 29-11 21-64 Child-bearing (puerperal, non-septic, and lactation) .. 1-48 0-64 Mental stress .. .. .. .. 15-46 12-03 13-97 Toxic, including M. f. Syphilis .. .. .. 4-83 1-05^| Alcohol .. .. .. 7-25 2-11 >■ 12-08 4-43 8-77 Drug habit .. .. .. 0-63 j Traumatic .. .. .. .. . . 0-64 .. 0-37 Disorder of nervous system, including— m. f. Epilepsy .. '.. .. 5-31 2-74 8-70 4-64 6-94 Other bodily affections .. .. . . 3-86 4-43 4-11 No definite cause assigned .. .. .. 1-61 2-74 2-10 100-00 100-00 100-00

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