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MEDICAL SUPEEINTENDENTS' KEPOETS.

AUCKLAND ASYLUM. Sib, — Auckland Lunatic Asylum, 22nd April, 1900. I have the honour to submit the following report for 1900 : — At the beginning of the year there were 456 patients in the Asylum. On the last day of the year the number had reached 487. This large increase taxed our accommodation to the utmost, and made the work of the Asylum at times exceedingly difficult and anxious. The number of admissions —119—is very high for Auckland, and the number of new admissions—ninety-seven— the largest for which I can find any record. It must be noted, however, that this does not represent the actual increase in the insanity of the community, for a considerable proportion of those admitted during the year have been insane for years, although the statistics do not disclose this fact, whilst other cases are congenital. The relatives of these patients have either a growing faith in the advantages and conveniences of our asylums, or they are becoming more intolerant of the mentally inflicted in their own homes. A few have been admitted who had been previously insane, but who then had been treated privately. Allowance, too, must be made for a natural increase in proportion to the actual increase in the population of the province. Apart, however, from all this, there has been a most regrettable increase of insanity during the year. The recovery-rate for the year was—Males, 36-7 per cent.; females, 294 per cent. In my last report I complained of the character of the cases admitted during the previous year, and therefore anticipated a low discharge-rate for this year. The rate, however, is reduced more than I expected, owing to the larger number of cases admitted towards the close of the year, when time was too limited for successful treatment. The death-rate is slightly lower than for last year. Five of the deaths were due to cancer. Three of these cases were admitted shortly before death, insanity having supervened during the progress of the disease; the other two cases arose within the Asylum. In both cases the cause was clearly defined. About 16 per cent, of the deaths were due to tuberculosis. The number of deaths from this cause is reduced, but so long as we have to deal with the Maori element it will be difficult, if not impossible, to reduce it much further. A considerable proportion of the Maoris are phthisical upon admission, whilst others acquire the disease with remarkable facility. Two Maori patients were admitted during the year in whom careful examination failed to reveal any evidence of phthisis. One became acutely melancholic, the other was a typical instance of the power of "suggestion." Both were, in the language of the other Maoris, tapu. Both developed acute phthisis, and died within a few weeks, neither having spoken a word after the so-called tapu. The amount of sickness during the year has been, as usual, surprisingly small, although a large number of the male patients and about one-third of the females have had during the whole year to be kept on special diet. In this connection I desire to draw attention to the disposal of the Auckland City night-soil, which has been going on for a considerable period within a comparatively short radius of the Asylum. During the year tons were deposited within a couple of hundred yards of our male hospital, and for weeks, especially during last winter, the stench throughout the greater part of the Asylum, particularly in the mornings, was almost intolerable. There must always be some nuisance inseparable from the disposal of night-soil, and it is difficult always to prove that this nuisance is dangerous to the public health. In dealing with the question there will necessarily be considerable diversity of opinion, and in this case I am not prepared to assert that any danger has so far arisen ; but I am bound to affirm that sickness has occurred in the Asylum during the year for which I can assign no other cause. It seems to me most unfortunate and most extraordinary that the city should permit a nuisance, whether dangerous or otherwise, in such close proximity to a building where they house nearly five hundred of their most helpless and most wretched people. The usual outside work has progressed fairly. The farm results have been the best on record. The new wing for males will be opened about May, when the overcrowding will be relieved. On the female side accommodation is urgently needed. This, I believe, can be best met by building a new laundry—the present one being far too small—and converting the present one into a dormitory. The Asylum at the present time has a splendid body of officers and staff generally. All have worked well, and shown great interest in the welfare of patients. For weeks at a time I never hear a complaint from any patient respecting any member of the staff, and I must regard this as the surest indication of kindly treatment and the faithful discharge of duty. Our thanks are again due to the proprietors of the Herald for daily papers supplied gratuitously for the use of patients, to the United Fire-brigades' Band, and to many others who have contributed to the amusement of patients, or have given gifts for picnics and entertainments. I have, &c, R. M. Beattie, The Inspector-General of Asylums, Wellington. Medical Superintendent.