47

H.—22

clearly that in afebrile cases of pulmonary tuberculosis, when the treatment is supervised with the exact knowledge of the capacity of each individual obtained by Dr. Paterson at Frimley, clinical observation may be trusted, and the continuous control of the opsonic technique is unnecessary. Nevertheless, even in such cases questions as to the true interpretation of certain symptoms do from time to time arise, and resort is necessary to the opsonic index, from which an immediate answer may be obtained, whereas it might take a month or more to arrive at a decision from observation of the clinical condition alone. As the result of the labour of these patients there is now to be seen at Frimley a reservoir 108 ft. long, 58 ft. wide, and 13| ft. deep, capable of holding half a million gallons of water. Its construction necessitated the excavation and removal to a variable distance in baskets or barrows of 4,175 tons of earth. Nearly 1,000 tons of concrete were required for the walls, the whole of which was made and placed in position by the patients. Much other labour of a less striking kind has also been performed. Of the 344 patients who during two years and a half were engaged in this work, 253 are earning their living, nine are not at work, eight are dead, and seventy-four have failed to report. The appearance of a large number of the old patients who were present at the sanatorium on the 4th July of this year was extremely satisfactory, and that of the men then actually engaged in the hardest labour was, if possible, even more so. Any one who will take the trouble to go to Frimley will agree that the best prescription in afebrile cases of pulmonary tuberculosis is ' graduated labour.' No one who has watched the change in the physical condition which in the course of six months or less occurs in these patients when daily engaged in graduated labour, a change so great that at the end of their treatment they look more like navvies than consumptives, can imagine that a like effect can ever be produced by the administration of any drug. Such individuals, it must be remembered, were often weaklings before they were consumptives, and if we merely arrest their disease, weaklings they will remain." The 80 acres surrounding the institution should certainly grow all the vegetables and produce all the milk necessary for the two institutions—indeed, I look forward to the time when the new Hospitals Bill becomes law and all the institutions of a district are under one Board, when, I trust, that the Old People's Home will be erected on this land, which is particularly suitable for agricultural work. The vegetables grown should be sufficient for all the institutions in the district. Particulars op those discharged during Year. Known to Number. have died since discharge. Health restored, able to resume employment .. .. .. 27 Improved considerably .. .. .. .. .. 6 slightly .. .. .. .. .. 6 2 Incurable .. .. .. .. .. .. .. 5 3 Incurable, transferred to Seddon Hospital .. .. .. 3 2 Deaths .. .. .. ... .. .. .. 3 Totals .. .. .. .. .. ..50 7 . !

ST. HELENS HOSPITAL, AUCKLAND. Governing body : Hospitals and Charitable Aid Department. Stipendiary medical staff : T. R. Inglis, M.B. Melb. Nursing staff : Matron, Miss Dora Peiper, and 1 registered midwife and 8 probationers. Domestic staff : 1 cook, 1 housemaid, 1 laundress, 1 gardener (occasionally). Number of beds (available for females only), 14. Average number of patients per diem, 9. Average number of patients to each of nursing staff, 0 - 9. In-patients : Number of patients on 31st March, 1908, 8 ; admitted during year, 217 ; discharged during year, 215 ; died during year, 1 ; in hospital on 31st March, 1909, 9 ; collective days' stay, 3,239 ; individual average days' stay, 14; average daily cost per head, 7s. 6Jd. ; average daily payment per head, 3s. sd. ; average daily cost per head after deducting in-patients' payments, 4s. ljd. ; weekly fee charged for maintenance, £1 10s. Percentage of cost of administration on maintenance-expenditure, 6-6. Localities, broadly, from which patients came : Auckland, 158 ; Waikato, 33 ; Waitemata, 13 ', Gisborne, 3 ; King-country, 16 ; Great Barrier, 2. Nationalities of patients : New-Z ealanders, 192 ; Kaffir, 1 ; Maori, 1 ; German, 1 ; Scotch, 2 > Fijian, 5. Number of out-patients treated during year, 149 ; number of attendances of such out-patients, 1,396. Result of confinements :—lndoor cases—male infants, 116 ; female infants, 101 ; stillbirths, 3 : total, 220 : infants' deaths, 2. Outdoor cases—male infants, 70 ; female infants, 75 ; stillbirths, 5 : total, 150 : infants' deaths, 1. For. notes on this Hospital, which is administered by the Department, see the Assistant Inspector's report, p. 11, Inspector-General's remarks, p. 7.