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The rooms and corridors are scrupulously clean, and all are brightly fitted up. The grounds are most beautiful. I heard no complaints, and manifestly the institution is in first-rate order. The additions to Tuke Ward are exceedingly convenient, and a great boon to the patients. The bowling-green is approaching completion. The staff is adequate and work well. It is a pleasure to visit the place.
MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND ASYLUM. Sir — I have the honour to forward you my report on the Auckland Lunatic Asylum for 1903. On the first day of the year we had a population of 538 patients ; on the last day we had 576 —a total increase of 38 patients, of whom 23 were males and 15 females. During the year a new laundry has been constructed entirely by Asylum labour. This is large enough, with the aid of washing-machines, which I understand will soon be installed to complete satisfactorily the washing of more than double our present population. On the site of the old laundry a two-storied brick building, part of which will be ready for occupation not later than the end of March, and the whole of which will be completed shortly afterwards, is being built by Asylum labour with the addition of one bricklayer. This will afford accommodation for ninety female patients, and, as stated above, will give sufficient space for five years or more. This will enable us also to classify the female patients into five divisions —a very fair classification and one which, with the exception of not more than twenty patients, should satisfy any reasonable expert. Classification as understood by the public is an impossibility excepting at a break-down cost. It is to me a matter for very great regret that no steps are being taken to provide for the present male excess, and for future accumulations. What we are to do shortly I really do not know. Every nook and corner is being utilised and no further classification is, in the main building, possible beyond division into two lots —the quiet and moderately tidy, and the noisy, destructive, and dirty. For the latter class the day-room space is terribly inadequate. All the dormitories are overcrowded. The number of admissions, 130—88 males and 42 females —is the largest on record, and the increase out of proportion to the increase in the population of the province. Seventeen cases were due to senile decay and some of the cases ought not to have been committed. Of the remainder, 48 males and 32 females were between the ages of twenty and fifty years, and therefore at the most robust period of life. Of the total of 88 males —55 or over 62 per cent, owed their admission to Alcoholism, heredity and congenital deficiency. Of the females—7 cases were directly due to childbirth, and in all seven cases there was an hereditary history ; 5 were due to the climacteric and 5 to domestic worry. The other cases were due to causes entirely outside the married life. The death-rate for the year was 6-09 per cent. —males 7-76 per cent., and females 3-37 per cent. This is the lowest rate for many years. Six deaths were due to tuberculosis. It is satisfactory to note in this connection that at the present time there is not a single case of tuberculosis in the Asylum. The recovery-rate was 43-84 per cent. —males 43-18 per cent., and females 45-24 per cent. This rate is above the average, which for the seven years —1897 to 1903—that I have been superintendent is 40-95. It is frequently stated that in the matter of recoveries our asylums are not doing adequate work. It may therefore be interesting to record the recovery-rates in the Asylums of Great Britain and Ireland as compared with that of the Auckland Asylum :— Per Cent* Auckland Asylum, 1897-1903 .. .. .. .. .. 40-95 Royal and District Asylums (Scotland), 1896-1902 .. .. .. 38-2 County and Borough Asylums (England), 1896-1902 .. .. .. 37-4 District Asylums (Ireland), 1896-1902 .. .. .. .. 36-4 In each case the figures are given for seven years, and in each case the average of averages are taken— the percentages stated are therefore only approximately correct. In the Royal Edinburgh Asylums which is presided over by one of the ablest Medical Superintendents in the world, and who is supported by four assistants and four resident clinical clerks all qualified medical men, the average recoveryrate for 1896-1902 was 35-7 per cent. The population for 1902 was 947. With more than half the number of patients and with only one assistant, and at a maintenance cost of approximately half that of the Edinburgh Asylum, our recovery-rate is considerably higher. Throughout the year I have had the hearty assistance of the staff. Unfortunately a number of changes have taken place on both sides. So long as there is no outlook —no inducement for males to remain in the service—it is only reasonable to expect that the majority are always on the look-out for some employment with better prospects, and that they should take advantage of every opportunity. I trust that my recommendation of last year respecting the salaries of the seconds-in-charge will soon be given effect to. Our thanks are due as usual to the proprietors of the Herald for a gratuitous supply of daily papers and mine are due to the Assistant Medical Officer, the clerk, and the staff generally for their sympathetic support during the whole year. I have, &c, R. M. Beattie, The Inspector-General of Asylums, Wellington. Medical Superintendent.
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