fl.—7

10

ENTRIES OF VISITS OF INSPECTION TO THE VARIOUS MENTAL HOSPITALS.

AUCKLAND MENTAL HOSPITAL. •2;srd March, 1911. I visited this Mental Hospital on the 12th, 14th, 15th, 22nd, and to-day, seeing all the patients and going over all parts of the institution. The medical journal for the week ended on the 18th shows that there are 811 patients (in., 508; f., 303). Of this number 34 (m., 13; f., 21) are under special-observation notices, as suicidal; 65 (m., Tt ; i., 38) are labouring under epilepsy; 13 (m., 12; f., 1) are general paralytics; 69 (m., 27; 1., 42) are classed as dangerous— this figure, however, includes the majority of the epileptics. These, together with the sick and the feeble in body and mind, are the chief care of tiie nursing staff. Altogether, 351 patients (m., 185; f., 166) are unemployed. The remainder are usefully employed: over 200 men are working on the farm or in the garden; while the kitchen, laundry, and needlework are the principal outletß for the employment of women. Twenty-three patients are well enough to enjoy the privilege of parole, and only 12 are under special medical treatment for physical disorder, being testimony to the general good health of the inmates. The number attending divine service is 185 (m., 118; f., 67); and the number joining in recreations 24-5 (m., 80; f., 165). Yesterday 1 witnessed a large proportion of the patients playing bowls for the Mental Hospital team against the Mount Eden Club, and taking a keen interest in the game, and to-day all who are able are away at the annual picnic. I have, as usual, accorded special interviews to patients having any grievance, but the only complaint made was of detention, and 1 was satisfied in each case that such (Mention was necessary either for the patient's own good or in the public interest. On the 14th, in consultation with Dr. Makgill, Dr. Beattie and I went over the drainage system and into the question of the disposal of the septic-tank effluent. There was some odour at the exit into the creek, but not to be compared as a nuisance with that in the Arch Hill gully, much nearer town, through which I have passed several times on my way to and from the Mental Hospital. The prolonged dry weather will have accentuated the condition in each case. The creek receiving our effluent is tidal, and is therefore flushed naturally, and there are but four habitations near it. It is nevertheless desirable to hasten the application of the city drainage system to this district, and Dr. Beattie is going to see what can be done in this direction. During the present visit I have remarked on the absence of noise. A proportion of patients in all such institutions are by the nature of their malady excited and noisy, and in this respect this Mental Hospital is unfortunate in the original selection of its site and in the planning which places such patients near public roads, where their exclamations are heard and are, no doubt, misinterpreted by passers-by. This matter is more acutely brought forward now owing to the large number of new admissions, many of an unpromising kind, taxing the resources of the present buildings, while there is no outlet for extension on the present estate. The only solution is to build a separate institution for the disturbed cases on our reserve at the "Reef," about a mile away. Here they can be provided for in a specially designed institution, situate apart from private buildings, of which the natural extension of Auckland is placing a number near our main estate. I found the wards clean and orderly, and was particularly pleased with the appearance (if the Wolfe Bequest Hospital. I am convinced that it will prove a valuable addition to our classification, combining as it does a sentiment of freedom and comfort with the resources of hospital treatment It is, as far as the patients are concerned, separate from the main institution, and is very popular with the inmates. Miss Gibbons, the Sister in charge, is a registered hospital nurse and midwife, as well as a registered mental nurse. Dr. Beattie continues to take a keen personal interest in all details of the working of the institution and the treatment of the patients, a task which the large number of patients makes increasingly difficult. The new institution on the Reef with a resident medical officer will relieve him considerably. sth June, 1911. I visited this Mental Hospital on the 31st May, Ist, 3rd, 4th June, and to-day. I inspected the variouß parts and saw all the patients, who number 826 (m., 516; f., 310). The conditions ruling are not substantially different, from those on my last visit, when the various divisions of patients were fully gone into and recorded. Dr. Ramsbottom, who has had experience at the Stirling District and Perth Royal Asylums, is now assisting Dr. Beattie, and before long there will be a second assistant medical offier. I was very interested in the history of remission in a case of general paralysis following the administration by Dr. Milsom of the remedy popularly known as "606." The of this remedy on first publication having appealed to us. Dr. Donald, now in England, is studying its application, especially in snch cases as the above, with the intention of its employment if favourably reported on. It is pleasant to be thus forestalled, for thoueh there were previous indications of a remission in this case, and there is a danger therefore of falling into the post hoe fallacy, yet the subsequent course of the case has been so far stimulating that it modifies oneß pessimism. The question of the disposal of the septic-tank effluent, into which I entered when last here, deciding that the best course was to do something to accelerate the application of the town drainage system to the district, was again considered by Dr. Beattie and myself. On this occasion there was no odour perceptible at the outlet. Dr. Beattie has made inquiries, as a result of which I understand that it will be rather more than two years hence before thp Arch Hill sewer will be