H.—3l

14

and sunlight, I proposed that the institution should consist of a brick administrative block, taining rooms for doctor, nurses, and all the accommodation necessary for the treatment of forty patients. So far there is nothing special in the character of the building. It is in the arrangements of the bedrooms, however, that the special feature of the building will lie. The plan I suggested was to arrange the corridor so that the rooms, which are movable, could be unhooked in the morning, turned round so as to expose the occupant to the sun, and yet shelter him from the wind. With grounds properly laid out, the patient could be wheeled about, and as night came on his bedroom would be taken back and hooked on the corridor again. The estimated cost of such a building would be somewhere about £10,000. This sum, though considerable, is small in comparison to what is being spent by many of the separate States in America. As an offset against this expenditure, the lessened number of patients now being treated in general hospitals would have to be considered, and, what is far more important, the segregation of those unfortunates who at present have added to their physical sufferings the constant dread of injuring those that are nearest and dearest to them. When we remember that, of a very truth, a nation's health is a nation's wealth ; when we come to consider the relative capitalised values of all wealth as against the capitalised value of a people as a working machine ; when we find that statisticians of such world-wide reputation as Mr. Giffen, tell us that the value of the people in Great Britain as working animals far exceeds the total wealth of the whole country,—it behoves us to inquire if it be not more profitable to expend money in order to keep our workmen well than allow them to drift into such a state of ill-health as will require the expenditure of all their energy and attention in order to prolong, it may be for years, a life which has little or no commercial value. I am, as you can see, discussing the question from a purely utilitarian point of view. Taking as truths, for truths they are —(1) That consumption in the early stages is curable ; (2) that treatment in a properly equipped sanitorium gives the best results; (3) that a nation's health is its greatest asset—the advantages to be derived from such a place are at once apparent. To cure a man of consumption—that is, to retain him for the State as a worker—is worth to his country, say, at least, £135. To allow a man to pass from the first to the second or third stage of the disease, and then attempt to cure him is, in nine cases out of ten, to simply transfer this £135 from the credit to the debit side of the ledger. Nor is this all. Humanitarianism has decided that we must strive to prolong the lives of these unfortunates, and this we do, knowing full well that they can never play their full part again in the work of the body politic. A common error is to suppose that the worst has been stated against a disease when the number of deaths which has been caused by it has been enumerated; but that is very far from the truth. If for every 100 persons who suffer from enteric fever one dies, that represents the case mortality ; but before one can estimate correctly what this disease has cost the country you have to put down, say, three months' abstinence from work for each of the sufferers. Nor is the sum complete even yet, for all that suffered from the disease do not return to the field in as good a condition as they were in before. The department has already entered upon the campaign against consumption by the issuing of leaflets and posters drawing attention to the nature of the disease, and the precautions which should be observed by those suffering from the disease ; but until some place has been erected where patients can be treated in accordance with the latest scientific manner, the best results cannot be hoped for. In accordance with your instructions careful and exhaustive inquiries are being made all over the colony, in order that the most suitable site for the erection of an open-air sanitorium may be selected. I have personally visited many of the suggested places, and each of the District Health Officers are actively inquiring into the matter. I hope to be able to lay the result of these investigations before you shortly. I trust that before another yearly report is made I may be able to inform you that, at least one such necessary institution has been erected. Native Apfaies. Profiting by the experience of other countries, realising to the full the danger to which the Native race here would be exposed should plague once find a footing, special precautions were taken. The Maoris were invited to korero, at which sanitation was the chief topic. These meetings were productive of great good, so much so that it was decided to continue the work of physical salvation amongst the Natives. Dr. Pomare has been appointed Health Commissioner for the Natives throughout the colony. His duties are to go amongst the Natives, visit their various pahs, inquire into their general health, condition of the water-supply, and the diverse ingenious, if not scientific, methods employed in the disposal of nightsoil. Already he has travelled over a considerable part of the North Island, and everywhere he has been received with open arms and enthusiasm. The advantage of having an adviser able by reason of his nationality to enter into their thoughts and minds, able to view objects from the Native point of view, is undoubtedly great. As is well known, that total disregard of most hygienic conditions which obtains in many Native settlements is responsible for much of the disease which, unfortunately, exists among them. Owing to the fact that death certificates are not required, it is difficult to arrive at absolute certainty as to the causes and number of deaths, but that chief among these is consumption cannot be denied. That this is so is not a matter for surprise, when one contrasts the picture seen on feastdays or race-days with that of ordinary times- Swarthy maidens, dressed fully and completely in ordinary attire in the early morning, in the evening can be seen sitting about on the damp ground with little else than a petticoat and bodice on, and these of the flimsiest nature. It is to this attempt to face both ways at once, so to speak, that not a little of the pneumonia, bronchitis, and consumption is due. Until the Maori becomes convinced of the necessity of living either as a Maori or as a pakeha, no great diminution of the death-rate can be hoped for. The practice of wearing warm