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and 34 females). The, total number under care was only 1 more than in the previous year ; the 1 number admitted for the first time (205) was the same as in the previous year (1917). The recovery-rate was low, the percentage on admissions being 29-80. This is largely due to the exceptional number of incurables admitted, including 20 suffering from general paralysis, 37 from congenital mental defect, and 21 from senility. The percentage of deaths was unusually high, the ratio to the average number resident being 9-88 per cent. It may be noted that in the 100 deaths, 21 were due to senile decay, 20 to general paralysis of the insane, and 22 to influenza. I have already reported to you on the severe epidemic of influenza as it affected the population of this Hospital, but I may be allowed to recall some of its more salient features. Altogether nearly 500 were prostrated by the disease -viz., 306 male patients, 104 female patients, 54 attendants and officers, and 29 nurses. The epidemic lasted a little over a month, starting at the end of October. Early in November it attacked patients in several wards, and rapidly spread notwithstanding various precautions taken. On the 23rd November 296 patients were confined to bed with the, disease. Then there was a rapid decline in the number of new cases. On the 7th December there were only 44 cases confined to bed, and after this date scarcely any new cases occurred. It is remarkable that the, first eases to contract the disease were outdoor workers employed in tin- garden oi- on the farm. The young and strong seemed to be more readily infected ; the old and infirm, escaped, altogether or were mildly attacked. The, women seemed to be less readily infected than the men. The most serious complication of influenza was pneumonia, which occurred in about 10 per cent, of the cases, and accounted for all the deaths except one, which was due to rapid heart-failure. Other complications were bronchitis and pulmonary congestion and bleeding from the nostrils. Most of (he deaths occurred in the young (under age 35). With a serious epidemic prevalent in the wards, and a large proportion of the staff also incapacitated with the disease, the institution passed through, the most trying time in its history. Those who were able had to work longer hours. Many of the usual activities had to be stopped, and our energies concentrated on the nursing of the sick. To tide over the emergency we were fortunate in obtaining the assistance of a number of R.H.M.C. orderlies. The whole staff deserve much credit for their devotion to duty at a most trying time. The work of diverting the Hospital sewage from the neighbouring stream carrying it past the township and discharging it into the harbour has taken longer to accomplish than I anticipated, ft involved the construction of a tunnel over 300 ft. long under the, ridge at the to]) of the orchard, and this took many months. The work is now complete, and the new sewers are in commission. With one exception the sewage from all the buildings is now discharged directly into the harbour, the exception being that from the, piggeries, which still discharges into the neighbouring stream. This drainage should be linked up with the new system. I have gratefully to acknowledge the consideration of the authorities in permitting me to exchange duties with Dr. Jeffreys, the Mental Superintendent at Nelson, thus allowing me a rest and change from the more arduous work at Porirua for nearly eight months during the year. There have been few changes in the higher grades of the stalf. Dr. Prins joined the medical staff early in January, and his,years of previous experience! as medical officer in the London County Asylums and elsewhere enhances his value. Dr. Macpherson joined in June in succession to Dr. W. Simpson. Dr. Macpherson's interest in his professional, work and his enthusiasm have always been noticeable, and were greatly appreciated during the influenza epidemic. There has been difficulty in procuring sufficient attendants and nurses. Even now, months after the war, the nursing staff is very seriously reduced, but I am hopeful that the recent increase of salary offered by the Department may attract more candidates for vacancies. SEACLIFF MENTAL HOSPITAL. Dr. Jeffreys reports : — At the beginning of the year there were 1,034 patients (605 males and 429 females) in the institution. Exclusive of transfers from other institutions, 170 patients were admittecV— 89 males and 81 females. Fifty-nine patients were discharged recovered (27 males and 32 females), 2 males and 6 females discharged relieved. There is no doubt that a number of our patients who have actually recovered while on trial have had to be, written off as unrecovered under section 80, subsection (8), owing to their failure to report themselves. At the beginning of the year there were 8 voluntary boarders. During the year 23 voluntary boarders (7 males and 16 females) were admitted ; 8 were discharged recovered, 6 relieved, and 3 were placed under reception orders, leaving 14 remaining. The general health of the, patients has been good if we exclude the influenza epidemic. There were 97 deaths, the majority being among patients between sixty and ninety years of age. Five of Ike male patients died of general paralysis, and 1 male patient committed suicide. During the influenza epidemic 10 male and 8 female patients died, and we also lost 3 of the male staff and 1 nurse. I should like here to record my appreciation of the work of the staff 1 and voluntary workers during this most trying period. 'The Camp Mental Hospital, Otago Peninsula, was definitely closed in October, and the patients now occupy a new ward built for their reception here. I trust that a purchaser may be found for this place. The plans have been prepared for building the new wards at Waitati, and this work will be gone on with as soon as possible. The plans for the new central baths at Seacliff have also been completed, and it is only owing to stress of other work that this has not been commenced. I have to gratefully acknowledge the good and conscientious work done, by Drs. Gray and Macpherson and by officers of the various departments of the institution. I also wish to record our indebtedness to Mr. Gumming, Patients' Friend, for his very real interest in the welfare of the patients and ex-patients, and for his organizing of recreations.