H.—3l.

these, 6-37 per cent, are known with certainty to have died. 1,114 service patients have been treated in the same period, and 9-33 per cent, of these are known to have died in subsequent years. The death-rate in the earlier years was heavier amongst service patients. Many of these were too ill to remain sanatorium cases in 1920 and were transferred to Trentham Military Hospital, and all of those so transferred died. The practical point from consideration of these figures is that 85 per cent, of the patients treated in this sanatorium during the seven years under review, and who have replied to our requests for information, are alive and well, and in a position to earn their own living to-day. When we consider that there is no attempt made at strict selection of early cases for treatment, that most of our cases treated here are type 111 of pulmonary tuberculosis, and that in addition the Pukeora Sanatorium has the shortest individual-treatment period of any sanatorium in New Zealand, the results of treatment, as shown by the after-history records, must be regarded as very satisfactory, and as a justification of the adoption of the sanatorium method in treating the disease. An occupational review of all patients treated in the same period of seven years is of interest in regard to incidence of the disease. Those following indoor occupations were 53-5 per cent, of the total, while the remainder, 46-5 per cent, were outdoor workers. Among indoor workers clerks largely predominated, representing 32 per cent, of the total, with storemen (3 per cent.), grocers (3 per cent.), and printers (2-3 per cent.) in the order given. Among the outdoor workers farmers (including farm labourers) top the list at 38 per cent., with seamen (firemen not included), 5 per cent., next in order. Buildings, &c. —Repair work is necessarily increasing every year, as is usual with wooden buildings. The original malthoid roofs of the main building and shacks have now become a constant source of trouble, and the question of reroofing in iron will need to be considered the next urgent work to be put in hand. Grounds.—The general appearance of the grounds is much more satisfactory than it was, but there is still ample room for improvement, and a steady effort in this direction must be maintained I am particularly desirous that the project of an entrance, with pillars in brick, the plans of which I procured some two years ago, will be completed this year. X-ray Work. —Three hundred and forty chest and other X ray films were taken during the year. The plant has given excellent service without the slightest working-fault. Dispensary.—The value of drugs used was £291 155., which, though a slight increase on last year's amount, is still low. Extensive trial was made on triple calcium products, but no advantage in the use of these was demonstrated over the ordinary calcium salts—chloride and lactate. For the latter half of the year this dispensary has been relieved of all work of dental clinics, but Maori school requirements are still supplied. The Dispenser's time is fully occupied with additional work, such as routine sputum-examinations and as an assistant in the X-ray department. Farm.—All our requirements, with the exception of milk and cream over a period of some ten weeks last winter, have been met. The shortage was investigated by the Director-General of Health and quickly remedied. Orchard and Kitchen Garden.—Vegetables to the value of £255 were supplied to the institution from the orchard and kitchen garden during the year, but the sum of £322 was paid out in wages, so that the return for wages paid is no better than last year. For the last two seasons a vegetable-patch nearer the sanatorium was, at my suggestion, worked by patients under the ornamental gardener, and the yield from this plot for the second year has come up to £27 9s. I feel sure that more could be done with this piece of ground, worked by the patients, and I would recommend that it be enlarged and made the kitchen garden of the sanatorium, under the supervision of the ornamental gardener, who grew vegetables before, so that the working-patients' labour may be turned to more avail in this respect. Stajf Changes.—The only staff change of note is the appointment of Mr. R. W. Wade as House Manager in October last. Mr. Wade is an exceedingly capable officer, and there is considerable evidence of much success in his work in the supervision of the outside staff and in the introduction of many noticeable economies. Red Cross Society.—Again the Red Cross Society has stood by us throughout the year, and regular visits have been made once a week by the various sub-committees of the society, and we have received for the patients a large amount of gifts in the way of food, fruit, and other delicacies. To Mrs. E. Rice and Mrs. Broad, who control the local centre of the society's activities, our especial thanks are also due for arranging all these visits. The Hastings Branch of the Red Cross Society has also interested itself in the matter of vocational training, and I am pleased to record that, as a result mainly of Mrs. T. H. Lowry's efforts, this work will be soon commenced once again amongst the patients. We are also indebted to Mrs. T. H. Lowry and her band of home workers at Hastings for a long list of gifts throughout the year, most of which were purchased from the proceeds of the Pukeora Shop-day in Hastings. The valuable articles received included a gramophone and records, vases, chair-covers, camp-chairs, cane wicker chairs, bedside-tables, and Christmas presents. In conclusion, I would record my sincere thanks to the whole of the staff for their loyal co-operation and support throughout the year.

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