Papers Past | Parliamentary Papers | Appendix to the Journals of the House of Representatives | 1884 Session I | HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR...

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1884. NEW ZEALAND.

HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS.

Presented to both Houses of the General Assembly by Command of His Excellency.

The Inspector of Hospitals to the Hon. the Colonial Secretary, g IE Wellington;, 9th January, 1884. The number of colonial hospitals remains unaltered since my last report. There are thirty-eight, including the sanatorium at Rotorua. The establishment at Patea was closed at the time of my visit, but has since been reopened. Improvements. A number of enlargements, alterations, and improvements have been effected in the buildings. These are dealt with in the individual reports herewith, and need not be dwelt upon in this place. I would, however, express my satisfaction with the great change for the better which has occurred in the condition of the hospitals since my first visit. The result in many instances has surprised me ; and the favourable manner in which the local Committees and Medical Officers have received and carried out my suggestions has been very gratifying, and has certainly greatly exceeded my expectations. We have now many establishments which, in their arrangements, order, and comfort, will bear favourable comparison with any of the numerous European hospitals with which I am acquainted ; and a spirit of emulation has sprung up in the colony which cannot fail to have a wholesome effect. Some few still lag behind the rest, as may be gathered from my reports ; but I am satisfied that their managers, with so many good examples to copy, will not long be content to allow them to remain as they are at present. Nursing. A very excellent system of nursing is in full operation at the Wellington and Auckland Hospitals, where well-educated ladies may be seen serving their apprenticeship with other " probationers." Trained nurses from these two schools will gradually become distributed in various parts of the colony. The example so well set might with advantage be followed by others of the larger hospitals, whose present nursing arrangements are not in accordance, by any means, with modern ideas. Admission of Patients. I have little to say upon this subject, which was fully dealt with last year; but I would point out a new departure at Dunedin. Here a system has been introduced of charging Is. for each prescription dispensed for out-patients. Although many cannot pay, and others evade payment, yet the result is an addition of about £10 10s. a month to the hospital funds. Great care, I am told, is taken to see that applicants are proper objects of charitable aid, and "not in position to employ a private medical practitioner. This subject is now occupying the serious attention of the authorities of the London hospitals. The following extracts from the " British Medical Journal" of the 19th May, 1883, will be read with interest, and some of the hints given might be taken advantage of in this colony : — I—H. 7a.

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HOSPITAL AND DISPENSARY MANAGEMENT.

Sir,— Hospital Patients and thbie Payments. Your excellent article on the subject of the distressed financial condition of the chief of the London hospitals, and your plea for the general adoption of a system of patients' payments by all the great medical charities, induces me to offer my experience of what has been accomplished at two institutions where the plan has been introduced—in one case for twelve years, and in the other for two years and a half. The Bolingbroke House Pay-hospital was established in 1880, and is exclusively a "payhospital." Every patient admitted is required to pay such a weekly fee as his means will allow, the minimum charge being 10s. 6d. weekly, rising to three guineas for a bed in a private room. A register is kept of the occupation of the patients admitted, and it is extremely satisfactory to find that they are just the class of persons for whom the hospital is intended—viz., the lower middle and artisan classes. Those who are able to pay a fee slightly above their actual cost, which in the second year was £2 os. lid. each, help towards the deficiency incurred upon those who can afford no more than 10s. 6d. weekly. The result of this has been that, in the first year, the patients' payments supported the institution to the extent of 67 per cent, of the cost to maintain it. Last year the percentage advanced to 73 - 5 per cent., the number of patients increasing from thirty-four to sixty-five ; while the total fees for the year increased from £202 to £652. During the past seven months fifty-seven patients have been admitted, while in the corresponding period of the first two years the numbers were twelve and twenty-four respectively. It is, therefore, expected that the third year of this interesting experiment will show a continuing success ; it may then fairly be said to have passed through its experimental period, and the experience gained will be valuable to the managing bodies of purely charitable hospitals who may bo studying the question how best to provide against diminishing exchequers. What the general hospitals can hope to accomplish is the saving of expenditure, and not the making of a profit. By admitting the class of patients received at Bolingbroke House, who can pay 73 per cent, of their cost, the hospital would be saved the necessity for, and the expenses of, appealing for charitable donations of an equivalent amount. The general admission to ordinary charitable hospitals of patients from whom an appreciable profit could be made would be generally disapproved. In fact, this would necessitate new wards, fitted and furnished as private bedrooms ; and the fear would be that the treatment of the necessitous poor in the old true spirit of charity would gradually become of secondary importance in the anxiety to become financially flourishing. Small payments can and will be cheerfully made by almost all the patients who atttend our hospitals, either for in- or out-door treatment. The greater proportion of applications I receive for admission to Bolingbroke House are from those who express their willingness to pay all they are able, usually ss. or 7s. 6d.. a week, in preference to entering a general free hospital. Hitherto we have been unable to deal with such cases, although there is a plan under consideration for insuring in-door treatment by regular weekly payments. At the second institution, the Chelsea Hospital for Women, both in- and out-patients have, for the past twelve years, been required to pay a small weekly fee, unless they are fit objects for charity, in which case gratuitous treatment is freely given, and they are treated in all respects as patients who are able to contribute. Out-patients also pay sixpence for medicine, if they are unprovided with a subscriber's letter. Calculating every free and contributing patient who has entered the hospital, I find that each one has paid an average of 16s. 2d. weekly; while every one of the 26,701 out-patients, also allowing for those who are treated gratuitously, has paid an average of threepence on every visit Taken as a whole, the amounts received from contributing in- and out-patients represent over a third of the entire cost to maintain the institution. Ordinary expenditure being so far assured, has allowed of efforts being devoted to raising funds to provide a new building of sixty-five beds. Nearly £20,000 have been accumulated in five years and a half, and the new building will be opened in July, with an exceptionally small proportion of debt for its construction. I am, Sir, your obedient servant, Woodville, Upper Tooting, April 30th, 1883. J. S. Wood.

A Step in the Eight Direction. The fourteenth annual report of the Croydon General Hospital differs notably from most pamphlets of the kind which find their way into our hands. The chairman, in moving the adoption of the report, spoke with satisfaction of the diminished number of out-patients, and said the governors might look forward to a still further reduction, for they could not fail to observe the great amount of good that was being done by the Croydon Provident Dispensary. We are so accustomed to hear hospital authorities boast of the great increase of out-patients from year to year, and to see the figures paraded in reports and advertisements, that it is quite refreshing to meet with a committee who are pleased that their out-patients should diminish in numbers, because it shows that provident habits are spreading among the poor of the neighbourhood. In seconding the adoption of the report, Dr. Alfred Carpenter said that with regard to the out-patient department he felt in some little difficulty, because, as they were aware, he had taken a prominent part in the establishment of the counter-institution in Katharine Street. He did not do it in antagonism to the hospital, but his object had been one which ho thought would commend itself to all those who were anxious for the welfare of their fellow-men. His object had been to promote the interests of that dispensary, and to urge upon the governors of the hospital the wisdom of connecting their own work with the work of the Provident Dispensary. His wish was to see the dispensary so arranged that the medical officers attached to it should have the first opportunities of getting upon the medical staff' of the hospital. He should like to see an arrangement between the hospital and dispensary authorities,

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whereby those patients who belonged to the dispensary and could not be properly treated in thenown houses should have priority as to admission into the hospital. He should like to see the officers of the dispensary seeking assistance from the medical officers of the hospital in consultation, and then, if it was considered that a patient could not be properly treated at home, he or she, as the case might be, should be transferred to the General Hospital. This course would, he was sure, promote the principles of providence; for they would be encouraging the working-classes to provide for themselves, to some extent at their own cost, medical assistance. It was hoped before long to have all the hospitals of London connected with provident dispensaries. Those persons who subscribed a penny or twopence a week to the Provident Dispensary did not have to wait until they had got a letter for the hospital; but, upon the appearance of illness they were able to run at once to the dispensary. He thought the committee were to be congratulated upon the present condition of the hospital. As Dr. Carpenter was subsequently elected a trustee of the institution, in the room ot the late Baron Heath, we may feel assured that the committee have full confidence in the principle which he enunciated, and which he has done so much to recommend. The attitude which has been taken by the Croydoii Hospital towards the Provident Dispensary deserves the highest praise, for it is decidedly a step in the right direction. Maintenance-payments and Donations. Payments for maintenance continue to show a serious decline, and subscriptions are falling off. Refuge or Chronic Cases. Incurable patients, and those who are old and feeble, impair the efficiency of the hospitals by crowding out sufferers from illness who might derive benefit from treatment. Stimulants. I beg to draw attention to the great expenditure which occurs for wine, spirits, and other alcoholic liquors in the hospitals of this colony. The amount consumed is, in my opinion, very excessive, and might, without detriment to the patients, be greatly curtailed, as has Ion"- since been done in the lunatic asylums with good result; the death-rate in these institutions being extraordinarily low, and the percentage of recoveries high. Last year I made a quotation from the report of the Inspector of Hospitals of the Province of Ontario; and I will again draw upon his report of 1882 for information on this subject. In that year 6,032 patients were under treatment in the provincial hospitals, while last year 6,056 persons were in-patients in the New Zealand hospitals. Ontario expended about £431 on beer, wine, and spirits ; for New Zealand, £2,570 16s. 2d. was required. The rigoiws climate of the former country might have been regarded as some excuse for a larger expenditure ; and the comparison is rendered the more unfavourable for New Zealand by the fact of the population of Ontario numbering two millions, the hospital patients being therefore, presumably, of a more serious nature. Visits of Inspection. I have, since my last report, paid sixty-seven visits to the various hospitals in this colony, my plan being to see the more important ones at least twice annually, and the others once. Mileage. The distance travelled with this object (including the inspection of asylums) was 6,650 miles. I have, &c, George Wallington Grabham, M.D. Lond., M.R.C.P., M.R.C.S., The Hon. the Colonial Secretary. Inspector of Hospitals.

SPECIAL EEPOETS ON HOSPITALS.

AKAKOA. I have to-day inspected this hospital and its surroundings. There are now two male patients occupying beds : one of these is suffering from a severe fracture of his arm. Being in good circumstances he will no doubt defray the charges made for his maintenance. The other inmate is an old man who suffers merely from the debility of old age. He has resided in Akaroa some thirty-eight years and is much attached to the place; otherwise he would have been transferred to the Old Men's Home at Ashburton. I regret to find that this man has money given him at times, which he spends in drink; becoming, in consequence, troublesome and dirty in habits. The hospital is m good repair, and well kept by the warder and his wife. In January last there wore seven patients under treatment, two of these being accommodated in the neighbouring immigration barracks, 18th April, 1884.

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AKEOWTOWN. This hospital I inspected on the 11th October, 1883. There were only two beds occupied at the time, the patients both being males. The buildings remain as described in my former report. No laundry or wash-house, and no mortuary, exists. The washing is done in the detached fever-ward, which fortunately has not been required for its special use. Before being inhabited by patients a porch, with an outer door, ought to be erected here. A stable is necessary for the use of the Medical Officer when visiting the hospital, which is situated a distance of one mile from the town. The Wardsman or Steward is quite competent to execute such works as these, and might be employed thus with advantage while his patients are so few. The condition of the wards, rooms, and kitchen was such as to reflect the greatest credit upon the management. The hospital is a model of good order, comfort, and cleanliness. I was given to understand that as many as ten in-patients had been under treatment at one time, but this was a very exceptional number. I regretted to find that Dr. "Webb, who has done good work here, had resigned his appointment.

ASHBUETON. The hospital is this day occupied by twelve patients of the male sex and one female. They may all be considered fairly suitable cases for hospital treatment, and they appear to be kindly and judiciously cared for. I conversed with each one separately, and found general satisfaction prevalent :in fact no single complaint was made. The internal arrangement of the building are as set forth in my last report; but a number of small improvements, and additions to the furniture, have been made. The large male ward, the entrance-hall and staircase, and some of the smaller rooms have been coloured and whitewashed by the Master, Mr. Madden, who also painted some of the internal woodwork. The cost of the necessary materials was about £1 10s. The box-lockers and commodes have been neatly stained and varnished in the same way, and, with the assistance of the Matron, his wife, he has picked and remade a number of the hair-mattresses, with much advantage in the matter of comfort. Six new iron bedsteads, of neat pattern, with paillasses and mattresses (four of them filled with hair), have been added to the furniture. A harmonium has also been purchased by subscription, and is employed with good effect at religious services held in the large ward. A floor-cloth has been laid in the hall, and a carpet in the Master's and Matron's room. The establishment I found throughout in very creditable order, especially when the smallness of the working staff is taken into consideration: a servant girl, and a washerwoman occasionally engaged, render all the assistance which is available, and the work must at times be very heavy. There have been as many as fifteen patients resident at one time since my last visit, and the total number treated during the half-year amounted to sixty-six. Maintenance-money is collected wherever possible, over £20 being forthcoming under this heading for the present month. The charge made is £1 weekly, or £2 for private accommodation. One or two persons have paid the higher amount; but practically the private wards are often needed for, and occupied by, ordinary patients. It would be well if some of them could be converted into a second large ward. I was glad to find that a good nucleus of a library had been got together: in fact, books and papers were in general use by the patients. Eegarding the structure of the hospital, nothing has been done to remedy the permeation of wet through the walls on the western side. Experience of the matter tells me that great good would result from the application to the bricks of the " silicate solution " made by the Liverpool Silicate Paint Company, if this be obtainable in the colony. This material has also the advantage of not disfiguring the appearance of a building when used upon it. Under present conditions, dampness and mouldiness prevail, and these are by no means conducive to the welfare of the patients. The whole exterior woodwork requires painting. The kitchen-garden has, I regret to find, become disused for want of labour. That the advantages of the hospital are so extensively made use of is, to my mind, evidence of the popularity and skill of the Medical Officer, Dr. Trevor, and of the industry and ability of the Master and Matron. 23rd October, 1883.

AUCKLAND. I have devoted a portion of several days to a thorough inspection of this hospital and its belongingsSince my last visit radical changes have taken place, both as regards the staff and the managementThe result is that a vast improvement has taken place throughout the establishment. The wards are gradually becoming well furnished. The old paillasses have been burnt, and new ones provided. The whole of the hair-mattresses have been remade, or are in course of being renewed, by an upholsterer-patient, as suggested in my last report. This work is being very satisfactorily performed, assistance in picking the hair being obtained from the neighbouring refuge. New bedclothing, including excellent blankets of colonial manufacture, has been purchased; and the objectionable slate-coloured rugs have given place to neat white counterpanes. The pillows still demand, and will receive, attention. Linen-presses have been placed in the entrance-lobbies and in the wards. Well-designed tables serve for washstands, bookshelves, and receptacles for medicines and dressings. A good bed-table has been procured, and some capital light folding-screens provided. These are filled in with the material called " Turkey-red," which is both ornamental and admits of washing. I saw also two very convenient and comparatively inexpensive wheeled chairs, which are much appreciated by the convalescent patients. Cut flowers abound in the wards; and a commencement has been made in supplying pictures and ornamental objects. There are now a large number of suitable chairs, the uncomfortable camp-stools having been banished from the wards. It still remains, as opportunity presents itself, to supply a better kind of bedside locker. The bedsteads themselves are of an inconvenient construction for hospital use, and it would be well to get a

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few fitted with Rowcliffe's woven-wire mattresses. These things may be done gradually; but the painting and colouring of the walls and woodwork of the wards, bath-rooms, lavatories, and closets should not be delayed. It would be desirable also to coat the portion of the floors under and between the beds with paraffine-wax. A careful examination proved to me that the utmost cleanliness prevailed throughout the wards, and that good order and comfort were universal. At present no fever patients occupy beds in the hospital. The two central wards, usually set apart for this use, are occupied by ordinary cases of illness, for whom otherwise no room could be found except by making up beds on the floor. I have before remarked upon the risk of treating infectious diseases in the centre of the building; and, there being an urgent demand for more accommodation, it is highly desirable that a detached fever-hospital be erected as soon as may be. There can be no doubt that the increased use of this hospital is due to its present good reputation; for I was glad to find that most of the patients were very proper subjects for medical or surgical treatment, and that a material diminution had taken place in the number of " refuge cases "of the male sex. The small accident-ward is now occupied as a nurses' dormitory, and the " Board-room " forms their room for meals and other uses. Some better provision, however, is required; the more so if any attempt is to be made to establish here a training-school for nursing. Regarding the rest of the building I have not much to add. The small winding-staircases are worse than useless, and the space which they occupy might be taken advantage of for some good purpose. The kitchen is in good order, but a cool store or larder is badly wanted. The Medical Officer's rooms are still very bare and unattractive. Their proximity to the opening of the mortuary-tramway (facilis descensus Avemi) is a much more serious matter, demanding immediate attention on sanitary grounds. A detached mortuary ought to be erected at once. The operating-room is rendered almost useless by the want of proper appliances. Hot and cold water, with sink and basins, should be provided. The instruments ordered are expected to arrive shortly. The store-rooms are gradually being got into good order by the House Steward, who has effected an economy in the purchase of supplies. I examined his books and papers, and found that a very great and satisfactory reduction has taken place in the consumption of alcoholic liquors of late. A better form of register of patients is needed, it being very difficult at present to prepare any statistics, or to furnish the information required, in case of death, by the Registrar-General. The number of out-patients treated is small; at present there are seventeen only on the list for the week. I had the opportunity of seeing dinner served in the wards on two occasions. The provision appeared to me to be somewhat lavish, and I have recommended that a dietary scale, submitted to me by Dr. Bond, the Resident Medical Officer, be approved by the visiting staff and by the Committee, with some slight modifications. The erection of a disinfecting chamber is shortly to be undertaken. If it be contemplated to erect a fever-hospital this building should adjoin it. The staff of the hospital consists at present (in addition to the officers) of twelve nurses, two housemaids, and three porters, together with a cook and assistant. The Lady-Superin-tendent, Miss Crisp, possesses in an eminent degree the qualifications which are desirable for her present position, and is ably seconded by her assistants. I conversed separately with all the patients, ninety-three in number. With one exception, they were unanimous in their praise of the hospital arrangements as now existing. The old lady who differed from them in opinion made such extravagant statements to me that I could only regard her as non compos mentis. It appears that the visiting staff, the Medical Officer, and the Committee take deep interest in the welfare of the hospital; but I should not be doing justice if I did not here state that considerable progress towards the present improved state of things was effected during the tenure of office of Dr. McKellar. 14th December, 1883.

BLENHEIM. I have this morning been occupied -with my periodical inspection of this hospital, which is at present occupied by five patients, all of whom are men: three of these belong to the " chronic " or "refuge" class. On account of the occurrence of blood-poisoning, in a case of gunshot wound of the hand, it was recently deemed desirable to empty the hospital as far as was practicable. There have been as many as twelve in-patients under simultaneous treatment since my last visit. No women have been admitted, but two children were permitted to be nursed in the hospital during illness by their mothers. I found the whole establishment in excellent order, the wards looking particularly clean, tidy, and cheerful: in fact, the improvement since I last saw them is something remarkable. The bedding was beautifully clean, all the beds being made up with sheets and blankets. Linoleum has been laid down in the centre of the floors, American-cloth tablecovers and green-holland blinds provided, and dwarf muslin-blinds fixed, to replace the paint, which has been removed from the lower panes of the windows. I saw also a number of cut flowers in the wards; and there were proper appliances for personal washing. The kitchen has also been improved by laying down a floor-cloth, and a good supply of crockery is now provided. The walls throughout the building have been whitewashed, and some varnish used for the doors and woodwork of the passages. Outside the hospital, improvements are also noticeable. A yard has been gravelled and fenced in, to keep the fowls away from the building. Flowers have been planted, and the large kitchen-garden is neatly kept, and shows promise of good crops. Regarding bookkeeping and financial matters I have made inquiries, and have nothing new to relate. The Secretary appears to visit the hospital weekly, and these matters receive proper attention. The Medical Officer is very inadequately remunerated for his services, the more so as no instruments whatever are provided for his use. The Steward and Matron, Mr. and Mrs. Bax, have not yet held their appointments for six months. It is perfectly clear that the great improvements which I noticed are in a large measure due to their industry and ability. I regret to state that the building is still infested with bugs, which appear to escape through the timbers from any treatment which may be devised for their destruction, They are to some extent kept under by great cleanliness,

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but their presence deters many eligible patients from entering the hospital at all. The building is in good and substantial repair, but must be painted externally to preserve it, unless it be replaced by a smaller and more suitable hospital. 14th November, 1883.

CHAELESTON. Tijis hospital was inspected by me on November 4th, 1883, and was found to be untenanted, save by the Steward. There has been no in-patient under treatment for upwards of a fortnight, and the number at any one time since my last visit has not exceeded two. I have very little to add to what was stated in my last report. The buildings were found clean and in good order. One or two old and worthless pillows, which I saw stowed away, might with advantage be destroyed. The drain which was alluded to on the former occasion has not been enclosed or altered. The whole work of the establishment, with the exception of the washing, is performed by the Steward, who also cultivates the garden. There can be no doubt of his industry and efficiency, Payment is expected from patients at the rate of £1 per week, but is not often received.

CHEISTCHUECH. I visited this establishment on the 27th September with the Colonial Secretary, and completed my inspection on the 28th. Since my last visit the wards in the new building have been cleaned and distempered, with great advantage to their appearance and sanitary condition. They now look very cheerful and comfortable, the only drawback being the large fireplaces, which take up so much of the floor-space. The wards irrthe old building require renovating; and a better sort of distemper should be used, which would not crack and peel off in a few months. The whole of the office, closets, lavatories, and bath-rooms I found in good order. The earth-closets, however, are unsightly; and apt to become offensive if neglected by those who use them, as will often be the case. It is intended shortly to make a connection with the city sewers, and to discontinue the pollution of the neighbouring creek with the liquids from the laundry, baths, sinks, and urinals : when this has been accomplished there should be no difficulty in replacing the earth-closets by well-constructed water-closets, for flushing which an abundant supply of water exists. The defective kitchen-ranges have been repaired, and, though the consumption of fuel is still too large, I am informed that it has been very materially reduced. A new kitchen, with scullery, servants' room, &c, is much to be desired; but, failing this, the present one should be cleaned and distempered, the lime-wash formerly used having peeled off and left the boards bare. The laundry is in good condition, but requires painting. The mortuary, which will now also be used as a public one, should have some dwarf curtains on each side, over the shelves. The main corridor connecting the large new wards of the hospital has a concrete floor, much out of repair, and not altogether safe for cripples to walk upon with their crutches. No alterations have been made as regards the furniture and fittings of the wards. Everything, including the bedding, I found perfectly clean and in good order. The single woven-wire bedstead in use seems to be appreciated, and it might be well to provide a few more of the same kind for special cases. Those with an iron framework would be preferable. There is also here a want of two or three good basketwork perambulators or Bath-chairs, for use in the corridor and garden. At the time of my visit forty-eight male and nineteen female patients occupied beds in the hospital. I spoke to them individually and found that they were all contented; and that, with few exceptions, they were proper subjects for hospital treatment. Out-patients are seen twice a week, the number attending this morning being twenty-three. This is about the usual number. Since my last visit arrangements have been made for a church service every Sunday morning in the servants' hall. There is also a service conducted by ladies on Friday afternoons. I examined the books kept by the Steward and by the Dispenser, and requested the latter to obtain fuller particulars of the previous history and residence of patients when admitted; so that, in case of death, they might be more readily identified by distant relatives. It was satisfactory to find that a considerable decrease has taken place of late in the consumption of stimulants, the cost of which was becoming a serious item in the hospital expenditure. No inventory of hospital properties is yet kept. Patients, as a rule, retain their own valuables while in hospital: these are rarely handed to the Steward, as elsewhere, for safe custody. No increase appears in the amount of patients' payments which is worthy of notice. The charge has been raised from 3s. to 4s. a day. Private patients, occupying separate rooms, are rarely received. The hospital grounds are kept in excellent order, and the kitchen-garden is said to be very productive. Throughout the establishment there is evidence of careful and skilful management. 29th September, 1883.

I have again visited this hospital to-day, and have inspected every portion in company with Dr. Robinson, the Resident Medical Officer, and Mr. Bell, the Steward. There are to-day sixty-five inpatients : fifty-five of these are of the male sex, and fourteen females. In November last seventyJive beds were simultaneously occupied. The wards were in good order, but I noticed some untidiness, more particularly in the bath-rooms and lavatories. More chairs are needed in the wards, as the patients are in the habit of sitting on their beds, and thus soiling the counterpanes. Some very good invalid wheel-chairs have recently been purchased, and are found very useful. At some future time it would be very desirable to remove the present unsightly fireplaces, which form obstructions in the wards, and smoke very badly. Two fireplaces in the wall would answer every purpose, and the existing flues could be utilized. I noticed that a shower-bath has been added to the male surgical ward. The kitchen has been cleaned., and rearranged. An excellent new range with two boilers has been substituted for the old one, and I am informed that a great saving in fuel is the

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result. Some amount of renovation is needed in the old wards, which form very comfortable rooms. The operating-room adjoining these is not well placed, and is badly lighted. A room used for Divine service and other purposes is now a dining-room for the servants. It is small, and not very suitable, but the best that could be made available for this purpose. The concrete floor of the main corridor has been recently repaired. By means of a new gateway to the public road the mortuary is now available for the use of the city : no inconvenience is likely to result from this arrangement. There is no disiniecting-chamber at the hospital. The padded room is occasionally used for fumigating clothing. The daily maintenance-charge for patients has been increased from 3s. to 4s. per diem. lam glad to notice that the consumption of alcoholic stimulants, though still high, has been reduced considerably. 23rd April, 1884.

COEOMANDEL. The hospital situated near this town was inspected on the Bth December, 1883. I found two inpatients occupying beds. One of these was suffering from fracture of the leg ; the other was a little boy affected with disease of the hip-joint. The whole establishment I found in good order, and very clean. Since my last visit a notable improvement has taken place in this respect. New mattresses and bed-clothing have been provided for three beds. Bedside-lockers and a good commode have been purchased. . The walls have been papered and distempered, and the woodwork, both internal and external, painted. A table has also been procured for operations and examinations. In the Warder's room shelves have been provided for lineal, of which I saw a good stock. The kitchen-range is being fitted with a new boiler, and a filter has been procured. The garden is now well cultivated, and shows excellent crops of vegetables. The privies have been removed from an objectionable position near the stream, and placed behind the old cottage in the rear of the hospital. They are provided with pails, the contents of which are frequently buried. Since my last visit there have been as many as five in-patients on one occasion. The whole of the domestic work and nursing being performed by the Wardsman, Mr. Dunlop, the good condition in which I found everything is a certain proof of his industry and ability. The washing is taken away and done by an old woman in the neighbourhood ; but, beyond this, the Wardsman gets no assistance. Dr. McMullen having resigned his appointment, Dr. Langdon has succeeded him as Medical Officer. I had the pleasure of meeting him, and also a member of the Committee, at the hospital. .1 find that surgical instruments are provided by the Medical Officer. He appears to require a Mclntyre's splint for fractures, which should, I think, be procured by the Committee. My visit gave me much satisfaction. Bth December, 1883.

CEOMWELL. I have this day made my periodical inspection of the hospital, finding it occupied by three male patients only. One of these is convalescent from some trifling ailment, while another is simply feeble from old age, but endeavours to make himself useful about the place. The largest number of inmates at any time since my last visit has been eight. The hospital I found in good order throughout, and the patients made very comfortable. Some repairs are needed to the internal plastering of the wall; the woodwork also would be the better for painting. I noticed that two porches had been erected outside the outer doors at the back of the principal wards: these, when properly finished, will be improvements. A new stove also has been placed in one of the smaller wards, the fireplace ret giving sufficient warmth. Some good red rug-counterpanes have been procured, and the bedding may be stated to be very good. I saw some feather-pillows, two hairmattresses, an air-bed, and a water-pillow. The dinner to-day consisted of boiled mutton, carrots, potatoes, and sago pudding. Some of the more expensive vegetables are grown in a small kitchengarden, which is irrigated. The dryness of soil and want of water prevents more being done in this direction at present. A few trees have been planted. 13th October, 1883.

DUNEDIN. I have inspected every part of this large establishment, and conversed individually with all the patients. There are to-day 130 beds occupied: 82 by males and 48 by females. Twelve of the latter are inmates of the lying-in wards, where I also saw four infants. In addition to these numbers there are five chronic cases (male), who are boarded out by the hospital authorities at a cost of 10s. each per week. I regret to find that this class is (as might be expected) an increasing one, numbering, at present, twenty-five individuals. There would be no difficulty in inducing a much larger number to leave the hospital upon an allowance of 10s. weekly; but this system of outdoor relief is bad in principle, and should be kept within very narrow limits. It would be more judicious, and more economical in the long-run, to provide a, refuge where such cases could be maintained for about 6s. per head per week; and this establishment should not form part of the hospital, nor be situated in its immediate vicinity. The total number of hospital beds is nominally 168, but the practice is to keep one ward vacant, so as to enable a system of cleaning and disinfection to be constantly at work. At the present time painting and colouring is going on, two of the wards being nearly completed. The defective flooring is being thoroughly cleaned, the joints raked and filled with paraffine-wax. There can be no doubt that this is a wise precaution to take. I was pleased to notice a variety of improvements since my last visit. The large entrancehall has been rendered less draughty by the provision of folding-doors, and has been warmed by steam-coils of very good construction. The whole hospital benefits by this change. The basement of this hall has, moreover, been opened out, levelled, and rendered much drier by ventilation than

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it formerly was. American cane-bottomed chairs have replaced the wooden forms in the wards, where I also noticed an excellent new six-fold screen on castors, and two new children's cots. In the male surgical ward a movable table, with spray-apparatus for washing wounds, has also been added. The consulting-room has been improved by the removal of the bookcases to the readingroom ; and case-books have been provided for use by the visiting medical and surgical staff. Telephonic communication now exists with the city, and thereby with nearly all the individual members of the staff. Warning of accidents is frequently given in this way, and preparations made accordingly. The utility of such a system might at some future time be extended by providing an ambulance-van, to be always in readiness at the hospital. Some outside painting has been done, the carpenter's shop enlarged, and some new gates provided for the garden. Forbidden articles were formerly often passed in here. The out-patients' waiting-room and consulting-room have also undergone improvements, though still not what could be desired, I found the patients very contented and comfortable. The wards, with their various offices, were scrupulously clean, and the bedding in good order. Tea was being served during my visit. The medicines are placed at the bedside of each patient, which is not a plan to be commended. Poisonous applications are kept in a locked cupboard. In some parts of the hospital the beds are too closely placed for safety, the lying-in ward being the most noticeable in this respect. Additional room is here much needed. The number of children who are to be seen in the hospital suggests the desirability of a special ward for this purpose. Another want is a proper hot-air disinfecting chamber. This might be an adjunct to the laundry, and used also in wet weather as an ordinary drying-closet. At the Cumberland Street laundry may be seen a construction which is very good for this purpose, and which has two drying-chambers. One only is here needed. The operating-room is small, and the light not very good. An ordinary daylight reflector suspended over the table at an angle of 45 degrees would much improve it, and might be close to the ceiling. I have examined the registers and other books, and suggested that some further particulars be recorded on the admission of each patient, which would be useful in establishing his identity in case of death. A monthly medical report is now presented by the Eesident Surgeon to the Committee, and contains useful information. Eepayments for maintenance and treatment continue to be looked after as before, the amount charged being 2s. 6d. a day, but to seamen 3s. The sum of Is. is also charged, where practicable, for each outdoor prescription dispensed : from this source about £10 10s. monthly is derived. The outpatients are carefully scrutinized. Thirty-eight were seen this morning. The total for last month was 705, and for August 755. The consumption of wine, spirits, and ale does not appear to be large at present. Only English malt liquors are used. The hospital is (in the absence on leave of Dr. Roberts) under the charge of Dr. Davies, who appears to be able and energetic in his duties. New rules have been made for the regulation of visitors, and for preventing the introduction of unsuitable articles of food and drink. It is certain that something was needed in these matters. Mr. Burns conducted me through this well-managed establishment, and gave me valuable information. I have a high opinion of his capacity for the office of Secretary and House Steward. sth October, 1883.

Visited 12th April, 1884. Found 100 patients occupying beds, viz., 71 males and 29 females. There was the usual proportion of chronic cases, and the above numbers do not include five old men who are boarded out at the cost of the hospital. Out-patients are seen daily. Under this category 300 new cases and 465 reapplications were dealt with during the month of March. All are required to sign a declaration of inability to pay for advice or medicine; nevertheless there can be no doubt that there is great abuse in this matter. All parts of the hospital were clean and in good order. The lying-in wards I found empty. These are improperly placed and ill provided. The single room for noisy patients is just opposite, and no bath-room exists. It would be well to provide a detached building for this special use. Dr. Davies continues to act as Resident Surgeon, in the absence of Dr. Roberts in England : of his zeal and efficiency there can be no doubt.

DUNSTAN. Every part of this establishment and its surroundings has been inspected by me this day. At present there are four in-patients, three males and one female, who is attended to by her daughter. All may be looked upon as chronic and incurable cases, with the exception of one who will shortly be discharged. One large ward is unoccupied except as a lumber-room. Here two cases of scarlatina have been treated since my last visit. The total number of patients in hospital at one time has not, since that time, exceeded nine. A few out-patients attend, and are prescribed for in a book kept for the purpose. The dispensing is performed by the Wardsman. All the patients told me that they were very well attended to, and made very comfortable. I was glad to notice a good many improvements. Some ornamental flower-beds have been formed, and some trees and shrubs planted : this will very much improve the look of the grounds. The hospital has been painted externally, and the male ward cleaned and coloured. The kitchen would be all the better for the same treatment. The water-closets have been converted into well-kept earth-closets, in which, however, dry ashes are used. Drain-pipes have been ordered for enclosing the open drain from the kitchen. A basketwork Bath-chair has been procured, and two good bed-rests. I also saw three very excellent hairmattresses, just procured and not yet used. The bedding and linen are of good quality, and this together with the whole establishment, I found very clean and orderly. Dr. Lewis has succeeded Dr. Wardale as Eesident Medical Officer. 12th October, 1883.

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GISBOENE. I have this day inspected the hospital, and had the advantage of a long conversation with the Treasurer, and also with the Medical Officer, Dr. Pollen. Three beds are at present occupied by patients, two of whom have had mild attacks of fever, while the third is suffering from fracture and other severe injury to the leg. A fortnight ago the in-patients numbered eight; and I learn that fourteen beds were simultaneously occupied last year. The hospital appears to be in good and substantial repair, the esterior having been recently painted, and the interior of the wards distempered in a light-blue colour. The ward's were very fresh, and well ventilated, but had a bare appearance when compared with those of many other hospitals in the colony. The bedsteads are neat, and the bedding very clean; new pink mosquito-curtains have recently been hung above them; but there is a scarcity of comfortable furniture, and the walls are perfectly bare, there being no pictures, and the texts of Scripture having been removed when the walls were coloured. I saw some good and suitable books, and learned that newspapers and periodicals are regularly supplied. The earth-closets have been enlarged and improved: I found them well attended to, and perfectly free from smell. The rest of the establishment was in good order, with the exception of a considerable degree of untidiness in the private ward, now occupied by a payment case, and which might to a great extent be obviated by a little more attention on the part of the Steward. I find that very few drugs are kept at the hospital; but that they are procured, as required, of a local chemist. A good " general " case of surgical instruments has been purchased since my last visit. The fever-hospital is quite finished, but has no furniture, and has not yet been occupied. I would recommend Kowcliffe's iron bedsteads, with woven-wire mattresses, as the most economical and suitable, when this matter is under consideration. Eainwater is in general use, and a good concrete tank has been made for storing it and keeping it cool. The hospital grounds (some six acres) have been let to a tenant for five years, he supplying all vegetables required for use in the establishment. A portion is reserved immediately in front of the building, and contains a flower-bed; but there is very little done to keep it in order, and the spare time which the Steward must have, with the present paucity of patients, might well be devoted to this object. I formed a high opinion of the services rendered by the Matron, who is evidently well acquainted with her duties, and very industrious. Ist February, 1884.

GBEYMOUTH. I inspected this hospital on the Ist November, 1883, and found twenty-three patients occupying beds : of these, seventeen were males, and six of the female sex. The largest number on the register since my last visit was thirty-one; but this number was an exceptionally high one. Several of those now in the hospital are of the chronic or " refuge " class. No fever cases have been admitted. The out-patients numbered about seventy last quarter: they are permitted to attend upon any day except Sunday, and their prescription-book is well kept. The same may be said of the register of in-patients, which gives very full particulars. I also saw a book in which are entered directions for the night attendant. The inventory is at present undergoing correction to date, and was submitted to me for inspection. An invoice-book, very neatly kept, was also examined. In the dispensary I saw some new surgical instruments which have cost about £70; amongst which were ovariotomy apparatus, a galvanic Scraseur, and a very complete case for minor operations. Everything in this department was kept in the best possible order and condition. The wards appeared, as usual, homely and cheerful. A few items have been added to the furniture, such as looking-glasses, a large framed engraving, and a clock. These rooms, with the adjoining closets, bath-rooms, and lavatories, I found to be perfectly clean. No fault could be found with the bedding, and the whole of the patients expressed their satisfaction to mo. One of the large rooms, originally intended for " benevolent " cases, is now used as a sitting-room and dining-room for convalescents. It is not at present made obligatory on those who are able to take their meals here, and the room is not largely used. It will be practicable by degrees, however, to add to the furniture and make it more attractive : at present it contains only two tables, with high-backed benches : —the bookcase might be removed hither from the operating-room. In the kitchen, which was very neat, I was glad to see that good crockery had taken the place of enamelled ironware. The laundry continues in the same state as formerly reported; but the drying-ground has been improved by the removal of old stumps, and by levelling; a number of young trees have also been planted along the boundaryfence, and a piece of ground has been enclosed in front of the Steward's cottage. The kitchengarden is admirably kept, and a good many flowers are to be seen in the beds surrounding the hospital. The roof of the older portion of tho building is becoming leaky; I learn, however, that it is intended to place an iron roof upon the shingles. It is also intended to erect a better mortuary at the bottom of the kitchen-garden. As regards financial matters, I find that very few patients pay for their maintenance and treatment. The subsidies formerly granted by the County and Borough Councils have been withdrawn ; but subscriptions in outlying districts have been better looked up, and show some increase. Dr. Morice appears to give much time and attention to the patients, and Mr. Williams, the Steward and Dispenser, takes great interest in the work. He seems also to be supported by a good staff. Ist November, 1883.

GEBYTOYVN. This hospital contains to-day two patients, both of the male sex. One of them is convalescent from a very severe scalp-wound, and will shortly be discharged. Five beds were occupied simultaneously in December last. I am glad to observe that many changes for the better have taken place since my last visit. The wards are now suitably furnished, and the whole of the bedding has been 2—H. 7a.

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renewed. There is a spring-mattress, another filled with hair, and the rest with flax. A straw bed is kept in readiness for any case- of infectious disease, to be destroyed after use. Good paillasses are on all the bedsteads, and the linen and clothing was beautifully clean. I noticed a number of pictures on the walls, some of them being framed; and a bookcase well filled with books and magazines. Strips of carpet are laid on the floors, and the windows have dwarf muslin-blinds, in addition to those on rollers. In the surgery I found that a good general case of instruments had been purchased. The floor of this room is now laid with floor-cloth. The kitchen has been fitted with a suitable range, containing oven, and boiler. The meat-safe has been removed to a shady place under the verandah, and the sink-drain is being properly trapped. The two cottages have been thoroughly cleaned. One is reserved for fever-treatment, while the other forms a capital laundry and storeroom. The mortuary and other out-buildings are in good order, and an open stable has been erected for the use of the Medical Officer. The drainage from the bath and washhouso is being conducted through earthenware pipes to a distance from the hospital. There is no kitchen-garden, as no labour is available for cultivation ; but I noticed a good flower-bed in front of the building. The Steward and Matron, Mr. and Mrs. Wells, have held office for two months only. There can be no doubt that they are industrious and efficient, as no assistance whatever is provided for them. The condition of the hospital reflects groat credit upon them. I found the patients thoroughly satisfied with the treatment they experience. Dr. Bey, whom I had the pleasure of meeting, evidently gives them his best attention. The whole of my suggestions appear to have been acted upon, and the hospital is now a suitable one for its position, and in excellent order. 17th January, 1884.

HOKITIKA. I have this day gone over this hospital with its surroundings. The number of in-patients is unusually small, viz., twenty-two males and live females. The highest number was reached (since my last visit) in April last, when forty-nine beds were occupied. The average number is about thirty-six, and there is accommodation for about fifty-four. There are several chronic cases which might more properly be housed in a Eofuge; but no establishment of the kind exists in the district. One or two cases of typhoid fever have been treated this year in the ordinary wards. The outpatients number about twenty weekly, and are prescribed for at the town office of the hospital. The arrangements of the establishment are as described in my last report. No structural or other alteration has been carried out. The patients ara well attended to and perfectly satisfied. The wards and bedding are very clean, but there is a want of smartness in those, occupied by the males. In No. 2 I noticed boots, a saucepan, and other articles put away in improper places ; and in No. 1 the want of some comfortable chairs causes the beds, with their white counterpanes, to be used as seats. The internal painting, especially in the baths, lavatories, and closets, is in a very bad state, never having been touched since the hospital left the builder's hands. Some valuable additions have been made to the stock of surgical instruments, such as a steam-spray apparatus, a Salter's fracture cradle, and a constant-current battery. The books are exceedingly well kept, but the long-continued illness of the Secretary has rendered the inventory imperfect. The leaky tanks over the store-room have been replaced by new ones, and the supply of water is ample. I have to repeat my recommendations that two small wards be erected for special cases, and that better accommodation be provided for the Steward and for the servants. The internal painting should bo renewed without delay. The stores which I saw were good ; the bread especially so. The cooking is well done by a Chinese cook ; all vegetables, except a portion of the potatoes, being grown in the garden. Some good pigs are kept, and attended to in such a manner as to cause no nuisance whatever. The hospital throughout shows evidence of careful management. 30th October, 1883.

HOKITIKA. This morning I met the Committee, by arrangement, and proceeded with them to the hospital. Certain suggestions for new wards were submitted for my opinion ; and, after viewing the premises and discussing the subject fully, conclusions were reached which, mot with our approval and. that of the hospital Medical Officer. It is intended to provide two new small wards, which will be available for any cases demanding separate or special treatment. They will accommodate three and two beds respectively, and will supply an urgent want; I afterwards made a general inspection of the building, which is at present occupied by twenty-six male and thirteen female patients. The register shows that on and about the 26th February, 1884, fifty-two beds were occupied at the same time. I learn also that a considerable increase has occurred in the number of out-patients. Everything was found in fairly good order, but much requires to be done before this establishment can compare with some other of the colonial hospitals as regards internal appearance, comfort, and general furnishing and decoration. It is satisfactory to learn that there is now a likelihood of the whole interior being repainted, a work urgently required. On some future occasion funds may be forthcoming for more comfortable chairs and bedding. It is right, however, to state that no single complaint was made to me. The patients are well and kindly treated; and the dinner, which I saw served, was well cooked and liberally supplied. The large majority of the patients are proper occupants of a hospital. No change has been made in the books (which are always admirably kept here), or in the mode of obtaining supplies. The Committee evidently devote much attention to the institution, and are supported by good officers. sth April, 1884.

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INVBECAEGILL. On the Bth October I made an inspection of this hospital, and also visited it again on the 9th, with the view of considering the proposed additions and alterations. The Committes were good enough to arrange a special meeting in the town, so that they might discuss the matter with me. Dr. Wardale attended, and submitted some useful suggestions. lam able to report favourably of the condition of the hospital. The grounds have been cleared up since my last visit, and arrangements have been made for painting the exterior of the building and repairing the boundary-fences without delay. Advantage is being taken of a temporary decrease in the number of patients for the purpose of cleaning and purifying the wards, one of which I found empty for this reason. The in-patients now number seventeen only : the average lately has been twenty-two. There are in all twenty-six beds, but some of the rooms are small and scarcely suitable for wards. All the present inmates are proper objects for hospital treatment, for at any rate a short period. No addition or alteration has been made to the buildings. The old asylum portion has been occupied by five or six cases of fever since I was here, and nothing further requires to be said as to its unsuitableness for such a purpose. The patients whom I conversed with appeared to be considerately and skilfully treated. I cannot approve of the practice in vogue here of dispensing with the use of sheets on the beds : the blankets get very dirty in consequence, as I found to be the case in one or two instances ; aid the. plan is not good, from either a sanitary or an economical point of view. I was glad, however, to find that a small supply of sheets had been procured. I have suggested that the paint be removed from the upper row of panes of glass, which are;thus obscured in the lower wards : this will improve their cheerfulness without interfering with their privacy. No additions have been made as regards furniture and ornamental objects, and no inventory is regularly kept up. I have made the usual inquiries, and find that maintenance-money is charged where practicable ; but, as a rule, the poor only are admitted to the benefits of the hospital. Subscriptions do not here entitle to admission. The outpatients number about thirty-six weekly. The Committee continue to take great interest in the institution, which they visit daily. They have been fortunate in securing the services, as Medical Officer, of Dr. Wardale, formerly of the Clyde Hospital, Dunstan. The town and district of Invercargill are growing rapidly, and some increase of hospital accommodation becomes a necessity. By removing a central chimneystack from a group of four rooms, two wards may be constructed to contain six beds each. The kitchen and its offices require rebuilding without delay; and at the same time, a dining-room, bath-room, two warders' rooms, a larder, and a washhouse should be erected. The Committee have no funds available for these purposes. 9th October, 1883.

KUMAEA. The hospital was visited by mo this day. The buildings, which were in progress, are now completed, but the new ward has never yet been required for use. It contains only the proper cubic space for three beds, and has been quite spoilt by the cutting-off of a portion of it for a warders' room and a store. This I pointed out before it was too late to be altered. The ward is not yet furnished, and would scarcely appear to be required at present. The wardswoman's room is too small, and. should be enlarged by including in it an otherwise useless recess in the neighbouring passage. I found six patients in the hospital, all of the male sex. Care is taken to exclude chronic cases whenever practicable. The wards looked bright and cheerful, and beds and bedding were good and beautifully clean. The whole of the establishment shows signs of industry and good order, the domestic work being all done (washing included) by the Wardswoman. The laundry is nothing but a shed, entirely open along one side, and having no fittings but a portable copper. Some improvement is needed here. A garden is being formed round the new building; and vegetables continue to be grown in the kitchen-garden by the Wardsinan, who appears but rarely to got any help from the patients in this work. The books are, as usual, well kept, and a proper order-book is now used for obtaining supplies. The out-patients number sixty or seventy yearly, and are seen on any day of the week. Payments by in-patients are seldom made ; and those who subscribe to obtain admission often commence to do so after illness has overtaken them. I have no doubt that the hospital is often used by those who could well afford to pay a private medical attendant. Dr. Porter, who has done good work here, has resigned his appointment, being about to leave the district. The whole of the patients I found to be quite contented with their treatment.

I visited this hospital on the evening of the 7th April, 1884, and found everything in its usual good order. Beds were occupied by eight males and one female. They all appeared to be comfortable and well attended to. The kitchen has been enlarged, and much improved, by throwing into it a useless passage, as recommended in my former report. I also noticed that a garden has been formed adjoining the hospital: there is a grass plot and some long flower-beds. This is a great improvement. Dr. Porter has been succeeded by Dr. Monckton as Medical Officer. I learn that the maximum number of patients simultaneously treated has been ten. 11th April, 1884.

LAWEENCE. -A visit of inspection was paid by me to the hospital this day. The number of in-patients is just now exceptionally low, and advantage has been taken of the opportunity for cleaning and whitewashing the wards. I found beds occupied by eight males and three females. One of the former is a feeble old man, who makes himself very useful in the kitchen. Two of the females could be properly treated as out-patients, did not the fact of their residing sixteen miles from the town render it impracticable to do so. With these qualifications the patients are all proper hospital cases. I spoke to them individually, and found them content and grateful for the treatment they experience.

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The hospital can accommodate a total of thirty in-patients, and as many as twenty-seven havo been under treatment at one time since my last visit. The out-patients number about thirty monthly. The district served by this establishment is very large, and many serious accidents have been successfully treated. The fever-ward has been occupied by several patients since my last report. The alterations then suggested in this detached building have not yet been carried out. Much, however, has been done in the way of additions to the furniture, and in structural and other improvements as regards the hospital generally. I noticed that the condition of the grounds had been much improved, and that a good flower-bed now occupies the hollow over which formerly stood the Medical Officer's house. Two new detached closets have been erected, and the soil is regularly removed from the premises, instead of being buried, as was formerly done. Two good bookcases, and some enclosed bedside lockera, also some commodes, have all been made by a patient suffering from an injury to his ankle, and form a valuable addition to the ward furniture. It has not been possible at present to do away with the old and objectionable wooden bedsteads; but the wards present an appearance of comfort and cleanliness. There are cut flowers and plants in pots ; a good many books and papers are also provided for the patients' use. Some pictures (unframed) adorn the walls. The kitchen, bath-rooms, and various offices I found in excellent order. A night-attendant has been engaged, and, when not otherwise required, he works in the garden, with any patients who are able to assist. The kitchen-garden is admirably kept, and well stocked with vegetables. No alteration has' been made in the water-supply, but a connection with the town mains is talked of. The books, as is usual here, are well kept. The inventory is regularly kept up, and a medical casebook has been introduced. No addition has been made to the limited stock of surgical instruments, many of which are the private proverty of the Medical Officer. The buildings are in good repair, but some of the cement has fallen away from the brickwork footing. The kitchen-range is becoming worn out. Some alterations are desirable in the rooms adjoining the laundry, so as to provide bedrooms for the male servants. The immediate want is a medical officer's residence in the hospital grounds. A heavy rental is now paid for a house which is not very conveniently situated for properly controlling the establishment; and a considerable portion of this expenditure has to be contributed by the Government. With this fact in view, the erection of an inexpensive residence would be an economical procedure. I had the pleasure of meeting the Hospital Committee, with the Secretary, the Medical Officer, and the representative of the constituency. From them I gained much useful information as to the resources of the hospital, and as to the difficulty of procuring contributions in the distant parts from which patients are sent. The Committee, and the inhabitants generally of the town, are greatly interested in the establishment, of which they are very justly proud. No doubt can be entertained of the ability with which it is managed. 16th October, 1883.

MASTEBTON. I have this day, In company with the Chairman of the Committee, visited the hospital. There are at present no patients under treatment. Five have occupied bods simultaneously since my last report, and the hospital could accommodate three times that number. The building has been painted externally, and the wards coloured in distemper. The female -ward now contains a handsome bookcase, which is well stocked with books and periodicals. The cupboards beneath are used for keeping medical comforts under lock and key. A number of handsomely-framed pictures arrived during my visit, and will be hung without delay: they have been procured by means of a special subscription, originated, lam told, by Mrs. Hoskings, the Medical Officer's wife. The baths and commodes have been newly painted, and the latter fitted with earthenware receptacles. The beds and bedding are in their usual good order. In the kitchen a new and suitable range has been fitted. It has a high-pressure boiler, but funds have not been available for connecting it with the bath-room. The walls have been painted, and all that is now wanted in this department is a new floor-cloth, the serviceable portions of the old one being made use of elsewhere. The hall, passage, and warders' rooms require to bo re-papered, and the fencing should bo painted. Tiie fever-ward and all the outbuildings are well kept. In a word, it would bo impossible to exceed the general order and cleanliness of the whole establishment. The grounds have a very striking and attractive appearance, being laid down in grass, which is kept well mowed, and planted with a variety of trees and shrubs. A broad carriage-drive has been made, with excellent gravel, in which no weed is suffered to remain. The kitchen-garden contains two beautiful flower-beds, in addition to excellent crops of fruit and vegetables. There is everywhere to be seen abundant evidence of the zeal and industry of Mr. and Mrs. Bullpitt, the Steward and Matron. 18th January, 1884.

NAPIEE. The hospital was visited by me on January 21st, 1884, when I had the pleasure of meeting the members of the Committee recently elected. I found that there were twenty-live in-patients—fourteen males and eleven females. Only one or two of this number could be objected to as being of the chronic or refuge class. The hospital was recently overcrowded, additional beds having to be placed in the centre of the male ward. No cases of fever have been under treatment for some time past, and the convalescent-room, formerly in use for a fever-ward, has reverted to its original and proper use. The wards had a very bright and cheerful look ; everything was beautifully clean, and the patients perfectly satisfied with their treatment. Very important additions to the hospital have recently been completed. The kitchen and scullery have been much enlarged and improved. A new block of buildings has likewise been erected, containing a children's ward, a ward for women, two rooms for the matron, nurse's room, kitchen, and the usual offices. The children's ward will

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contain four beds and two cots. In it are two tables, a wardrobe, rocking-chair, and a handsome scrap picture-screen recently presented. A well-ventilated lobby gives access to the bath-room and closet, the latter of which contains a well-constructed dry-earth commode. The bath is much too large and occupies too much room. A lavatory basin is fitted up in this room. The doors leading into the ward from this portion of the building are made to swing in either direction, but are so much too small for their frames that draughts will be inevitable. The large ward for women is a handsome room, in which great attention has been paid to ventilation. Two fireplaces (back to back) are placed in the centre of the floor, and are so compact as not to occupy too much room, as is often the case with this arrangement for heating. Good bedding, with hair-mattresses and white counterpanes, is in readiness for use. There will be twelve bedsteads, and between each pair a small chest of two drawers will be placed, instead of the usual lockers. The bath-room and closet are fitted as mentioned in describing the children's ward. The ward-kitchen is a suitable little room, fitted with earthenware sink, American kitchener, dresser, and cupboards. The new buildings are exceedingly well planned, and will prove a very valuable addition to the hospital. The old ward for females will in future be available for male patients. I found every part of the establishment, together with the outbuildings, in the best possible order, and reflecting great credit upon those who are responsible for the management. The number of out-patients is considerable. They attend on three days each week, the number to-day reaching twenty-three. Drugs should be procured in a less expensive way than at present, from some wholesale firm. 21st January, 1884.

NASEBT. My periodical inspection of this hospital was made on the evening of the 19th October, 1883, when I went over the whole establishment. There were only three beds occupied by patients, two of whom were men with rheumatic ailments, nearly convalescent; while the third was a girl, who had sustained a severe injury to the eye. I spoke to them all, and found the men very grateful for the kindness and treatment received during their stay. As might have been expected from my last favourable report of the hospital (no change having occurred in the staff), I found everything clean and orderly, and noticed that several articles had been added to the furniture of the wards. Two good feather-pillows and a large framed engraving, I was informed, were gifts ; there were also three new cane-seated chairs. In the dispensary I noticed that a very useful diary is now kept by the Medical Officer. The kitchen has been improved by the provision of a concrete floor under the American kitchener. A portable copper and a washing-trough, with wringer, have been added to the washhouse ; an additional rainwater tank has also been brought into use. A number of trees have been planted, and the appearance of the ground improved. The kitchen-garden continues to supply all the vegetables required except the potatoes. The fever-ward has not been required for its special use at present. The outdoor closets are most creditably kept clean, and free from any offensive smell. Inquiries made soem to show that payments for maintenance are the rule at this hospital: the charge to non-subscribers has been increased to £1 ss. weekly. In examining the books, I noticed that one patient, who was unable to pay in money, had worked off his maintenance charges, on his recovery, by labouring in the grounds. The hospital can accommodate ten patients; but not more than five have been resident at any one time since my visit in February last. The whole establishment is kept in its present excellent condition by the Wardsman and his wife, without any other assistance. With a larger number of patients this would not not be possible, and some help should be given on washing-days. I was glad to find that so much interest is taken in this hospital by the residents in the district, who appear to subscribe liberally to its funds. 19th October, 1883.

NELSON. This hospital was inspected on the 9th November, 1883, every part of the establishment being seen by me. There were twenty-three in-patients at the time, of whom fifteen were men and eight women. Of this number four belonged to the " chronic " class, one of them having been for many years an inmate of the hospital. The present number of patients has not been exceeded during the past year. No case of fever has required, admission, and the large back ward has remained unoccupied. I was glad to observe that the interior of the building had been neatly painted and papered wherever necessary : this has very much improved its general appearance. A large shed had also been erected since my last visit, and serves as a receptacle for drags and other goods in the bulk. The patients" reception- and waiting-room had been newly lined with wood and varnished. Gas had been - laid on to the fever-ward. The wart's of this hospital are very large and airy; they present an appearance of great comfort. The bedding I found to be good and scrupulously clean. A number of American reclining-chairs were in use, some of which, however, are becoming worn out. There was a profusion of cut flowers to be soon, as well as numerous plants in pots. A well-filled bookcase exists in each ward, and new books are occasionally added.; five pounds' worth were recently presented by a discharged patient. Papers and periodicals are provided and paid for out of the " convalescent fund." Some additional pictures have been hang on.the walls. The lavatories, baths, and closets were all very clean; the latter being supplied with well-dried earth, and emptied four times a week. I have nothing to add to my former remarks regarding the books kept, and the collection of maintenance-moneys from the patients: these matters continue to ■ receive proper attention. The average attendance of out-patients appears to be ten daily. lam glad to be able to speak in high terms of the management of this important hospital, and of the very creditable condition in which I found every portion of the establishment. Amongst the patients general satisfaction prevailed.

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This hospital was again visited by me on the 14th May, 1884, when I found sixteen men and two women under treatment as in-patients. The wards were, as usual, bright and clean, and I had no fault to find. An excellent tubular bed, for water or air, has been recently procured. The season has been a healthy one, and no case of fever has been under treatment during the past year. - I found the books properly kept. The drugs are procured direct from London annually. This system of laying in a stock for the whole year in advance is found to work well, as might be expected where the whole of the prescribing is performed by the medical practitioner, who orders the drugs. Where the medical staff is numerous and changeable waste would be a sure result. 14th May, 1884.

NEW PLYMOUTH. I inspected this hospital to-day, and found that it was occupied by twelve patients—eleven males and one female. Several of these were sufferers from severe accidents, and all, without exception, had been very properly admitted into the hospital. The largest number resident on any one day since my last visit was fifteen, and some of these were accommodated in the old single rooms, formerly used'by the lunatics. It being now the practice to send to this establishment any sick members of the Armed Constabulary, the pressure upon the limited resources of the hospital has been increased, and an urgent demand exists for increased space in the wards. The building is so old, dilapidated, and ill arranged, that I should be unwilling to recommend any large alterations short of rebuilding it entirely. It will be possible, however, to make some inexpensive arrangements which will, for a time, meet the present difficulty. The plan proposed is to remove the Steward and Matron to the detached cottage now used by the female patients, and to convert the vacated portion of the hospital into a good ward. The cottage will need an addition of two rooms. The washhouse must be rebuilt. It is very small, and scarcely high enough to stand upright in, being also in the last stage of decay. As regards the condition of the establishment, I have little to add to the remarks which I made in my former report. The wards and other rooms are clean and orderly, but, as regards furniture, appliances, and ornamental objects, a long way behind those of the majority of the colonial hospitals. Some properly-made paillasses should be procured, and a few good hair-mattesses. Additional chairs would do away with the necessity of using the beds for seats; and some attempt should be made to procure pictures, ornaments, and books for the patients' use. Bedside tables and lockers are also wanted. All these things would form part of the furniture of the new hospital, when erected. I inquired of the patients as to their comfort, and obtained satisfactory replies. The books are well kept, and I was glad to find that the receipts this year from payment-patients will reach £200. There is now a large case in the surgery fitted with a great variety of surgical instruments, recently procured. The kitchen-garden is well stocked, and an additional portion of ground has been brought under cultivation. A portion of the water-supply is now derived from the town mains. 17th December, 1883.

OAMAEU. I have this day inspected the hospital, of which I have seen every portion. The alterations and additions which wore in progress at my last visit have now been completed, and the consequent dirt and discomfort then existing have come to an end. The new kitchen is good and commodious, but there is no scullery separate from it. This might very well have been arranged for, as the adjoining store-room is unnecessarily large. A large American kitchener is in use, but there is no highpressure boiler, and, consequently, no hot-water supply laid on to baths and sink. The old kitchen has been converted into a lying-in ward with one bed, but this has not at present been used. Near this room a temporary earth-closet has been erected for the use of female patients. The new dispensary, which serves also as an operating-room, is commodious and well lighted; it contains a new cabinet for surgical instruments. The old dispensary has not at present been put to any use. Seven patients, all males, at present occupy beds in the hospital. One of these is convalescent from scarlet fever, for which he has been treated in the detached building. The other cases call for no particular remark. The highest number of in-patients on any one day since my last visit was nine. Outpatients are few in number; one or two attend occasionally. I have pleasure in stating that a marked improvement has occurred in the condition of the hospital generally. The whole establishment has now an appearance of smartness and cleanliness. The bedding is good and very clean. Many feather-pillows are provided. The walls are painted in a sort of duck's-egg green colour, and have a cheerful appearance. The furniture is plain and substantial: chairs of old pattern with wooden seats might, with advantage, be gradually replaced by others of a more comfortable character. The closets are of the dry kind, and are supplied with ashes; they are well attended to, and perfectly free from smell. The fever-ward is at present undergoing disinfection, and is consequently in disorder. Only one patient has been under treatment, and yet the whole five rooms have been used and require cleaning : this would appear to me a somewhat unnecessary proceeding. A portable bath (so called) has been provided for this building, but it would require four men to carry it away to be emptied. No closet has yet been provided, but I learn that there is some intention of greeting one, and, if so, a bath-room might at the same time be arranged for; the portable bath could then be fixed and provided with water-supply and outlet. The washhouse has been fitted with a good washing-trough and wringer. There is a fine meadow at the back of the hospital, occupied by one cow; churning was being performed, the yield of butter for the week being 81b.: the milking and dairy-work is performed by the Matron. The staff has been reduced of late by the dismissal of the "Wardsman, and now consists of Steward, Matron, and cook. A washerwoman is employed occasionally. The condition of the hospital is at present very creditable to those con-

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cerned in its working. It is, however, a very straggling and large building for the number of patients which it is calculated to hold, and the work of keeping it in order cannot be easy : with a larger number of patients under treatment some additional assistance will probably be needed for thia purpose. Eegarding the books and collection of maintenance-money I have nothing special to remark. Dr. Garland is at. present the Visiting Medical Officer. 22nd October, 1883.

The hospital is to-day tenanted by ten patients, of whom eight are males and two females. All are proper cases for hospital treatment, and appear to be well and kindly treated. No complaint of any kind was made to me. I noticed several small improvements which have been carried out since my last visit. The passage leading to the bath-room and closet, through the male ward, has been permanently screened off, and the slop-sink removed from the bath-room to the water-closet. Additional fittings have been provided in the dispensary, which is also used as an operating-room, and is well suited for this purpose, having an excellent top-light. Two mechanical beds have been purchased. The garden in front of the hospital, and at its side, is being remodelled, and cleared of the large shrubs which obstructed the windows to some extent. The fever-hospital is now empty. A lobby has been erected at the back, and fitted with an earth-closet. There is now a broad band of cement concrete laid round this building, which will doubtless remedy to a great extent the dampness of its walls. A small flower-garden is in course of formation in front, and the whole has been enclosed with a neat barbed-wire fence, to keep out the cows, of which two are now kept. At a distance of some 25ft. from the fever-hospital a deep well has been sunk in the clay, and fitted with a timber cover and trap-door. This is intended for the disposal of excreta, rubbish, and ashes. A thick layer of earth should frequently be thrown in upon these matters, which may otherwise prove offensive, if not dangerous. The working staff remains unaltered, with the exception of a gardener temporarily engaged. The hospital is doing good service, and is well looked after by the Committee and Medical Officer. There is, however, a want of smartness and order in the wards and in the store-room, which makes it compare unfavourably with some other establishments of the kind. This is a matter easily within remedy. 17th April, 1884.

PIGTON. This hospital was visited by me on the 15th November, 1883, in company with the Eev. W. A. Whyte, one of the members of the Committee, and Dr. Scott, the Medical Officer. The number of patients' beds occupied was found to be eight. All the occupants were males, three being simply old and infirm. The largest number of patients on any one day has been nine. One woman only has been admitted during the last twelve months. I found the whole establishment and its belongings in excellent order. Additions have been made to the ward furniture in the shape of twelve comfortable chairs. I also saw two excellent new hair-mattresses, twelve new rug-counterpanes, and also some new blankets, linen, and personal clothing. The garden has been much improved, and is abundantly stocked with vegetables, flowers, and fruit. One pig is kept in a distant part of the grounds. All the work is done by the Warder and Matron, Mr. and Mrs. Hall, who ara thoroughly efficient and very industrious. They get very little assistance frerm the patients, and it has been found necessary, on account of the severity of some of the cases under treatment, to engage the services of a washerwoman once or twice weekly. Dr. Scott continues to render valuable service; and I saw one patient who is convalescent after an important operation, and another recovering from very severe injury to the leg. The bridge which gives the only means of approach to the hospital is dangerously rotten ; but steps are being taken to rebuild it without delay. I have to report that the hospital itself is in a very unsafe condition. The floor of the two lower wards are worm-eaten and perfectly rotten. The Matron recently had a narrow escape from severe accident, while carrying a patient, from this cause. On inspecting the piles beneath the floor, I found that many had entirely gone. The building is, I believe, supported in position by the verandah-posta only. This matter urgently demands attention, and I have requested that the Committeo obtain and forward an estimate of the cost of necessary repairs. 15th November, 1883.

QUEENSTOWN (FEANKTON). Inspected on the 11th October, 1883. Dr. Douglas accompanied me on my visit. The number of in-patients was eight, all of whom were males and proper objects for hospital treatment. I found the whole establishment scrupulously clean, as also the linen and bedding. An appearance of smartness and good order existed, improvement in this respect having taken place since my last visit. The patients are well cared for, and the Medical Officer is highly spoken of by them. Eegarding the buildings I have little to add to my last report. An entirely new hospital is very desirable. This need not bo on a very large scale to begin with, but should be so constructed and arranged as to be capable of future enlargement. Wards containing sixteen or eighteen beds in all would suffice, with the other necessary rooms and offices. It might be found practicable to retain some portion of the existing building for a time, as the new hospital might be erected on a different spot. The roofing is almost new, and could doubtless be utilized. The institution is a very popular one in the district, and is very well supported.

KEEPTON. This hospital I inspected on the sth November, finding it occupied by five in-patients. These were all proper hospital cases. The largest number at any one time has been ten. There are fourteen

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available beds. Out-patients can attend daily, but are few in number. There are at present four on the list. Payments are fairly collected, but many of those admitted are destitute at the time. The expenditure is met by subscriptions, entertainments, and the Government subsidy. No appeal for pecuniary assistance has been made to the County Council since January, 1882. The books are well kept, and were examined by me. The hospital in every part was found in excellent order. The wards looked particularly cheerful, having received a. number of new pictures, which the Steward , mounts on stretchers and varnishes. Every patient expressed his gratitude to me for kind attention received from the staff. Outside the building I noticed that the garden was beautifully kept, and that some improvement had been effected by.levelling a portion of it. Two large additional rainwater tanks have been fixed ; and I was pleased to find that the outdoor closets had been altered, in accordance with my suggestions. They were perfectly clean and inoffensive, the soil being now collected in pans and buried. The whole establishment shows signs of industry and good management, and supplies an undoubted want.

ETVEBTON. The hospital here situated I have this day visited, finding it occupied by seven males and three females, all proper subjects for hospital treatment. For some time past there have been as many as eleven patients ; and the hospital only contains nine beds : it has therefore been found necessary to place two men in the detached fever-ward, their only furniture (in addition to bedsteads) being a small form and a box. The Warder and his wife continue to earn the good-will of the patients by their kind attention and treatment, and it is very evident that the Medical Officer, Dr. Young, is thought highly of. One young man is convalescent from the severe operation of excision of the knee-joint. It is evident that additional accommodation is required here, if the hospital is to remain on its present footing, and not become merely a receiving-ward ; in which case the establishment at Invercargill must be very much enlarged. An additional ward for six beds, with a small single ward, a bath-room, nurse's room, and water-closet, should be erected on the ground adjoining the present ward for male patients. No funds arc available for this object. The whole establishment I found in good order. One or two beds had only a single sheet, as I pointed out to the Warder. He informed me that a sufficient stock of linen was provided. The water-supply is small, and consists of rainwater. It has been contemplated to clean out and use the well. Before this is done the neighbouring drain should be diverted from its present dangerous position. I took the opportunity of having an interview with the Secretary, Mr. Cassells, and with Dr. Young, from both of whom I derived useful information. 9th October, 1883.

BOSS. This evening I made a careful inspection of this hospital. There are now four male patienta occupying beds. All of them are proper hospital cases. The female ward is empty, but was recently tenanted by two patients. As many as eight beds have been simultaneously occupied since my former visit. I found everything in good order and scrupulously clean. A considerable change for the better was everywhere apparent. Various improvements have been effected; and the Committee are now engaged about others, which will be paid for out of the small Government grant of money recently made for that purpose. The kitchen has now been lined with matchboarding and made much more comfortable. Various small matters have improved the appearance of the wards; which, however, require some comfortable chairs and better furniture as soon as funds are available. A portion of the female ward still serves —very inconveniently —as a dispensary. I had the pleasure of an interview with the Committee, and took the opportunity of pointing out some improvements which might be effected at a trifling cost. The bath-room, being a detached building behind the hospital, is of very little service. It could readily be removed to the back of the female ward, and would make a good dispensary. A good bath-room can be made of the old dispensary, which has long been in disuse on account of its awkward situation. This room is readily accessible to the wards, and is only separated by a partition from a copper, which is used, for heating the bath. It is intended to paint, paper, and varnish the interior of the hospital, and to repair the verandah and the drain. These and other matters will absorb nearly the whole of the grant. The Medical Officer's house badly requires to be rebuilt (as regards the older portion). The expense will not be great, and it is to be hoped that means of carrying out this necessary work will be provided next year. Dr. Collins has held the office of Medical Attendant for the past nine months. It is very evident that he gives the hospital his best attention, and that the Committee take a good deal of interest in this institution, which serves not merely for the township, but for a large extent of country farther south. 3rd April, 1884.

BOTOEUA. I have been engaged for the past few days in an examination of the portion of the new township set apart as a sanatorium. Since my former visit in April, 1883, a great deal has been done in remodelling the bathing arrangements, and in planning and erecting buildings for the accommodation of patients and attendants. It is, however, a matter for regret that so much delay has taken place in these matters that the present season will be practically lost. ' The refectory now in course of erection will contain a dining-hall, with kitchen and offices, as well as a dispensary and consulting-room. It is proposed to provide lodging for twelve patients in two adjacent cottages. Plans for these have been prepared, but no commencement has yet been made with their building. An excellent four-roomed cottage has been provided for the bath-attendanta; and another, now occupied by workmen, can subsequently be adapted for patients' use. The bathing-pavilion has

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been re-erected in a much more suitable position, than formerly ; and precautions taken to obviate the rapid destruction of its component materials, which was found, on removal, to have taken place. The internal arrangements have been remodelled, and will shortly be completed. They include two double bath-rooms for ladies, and two single bath-rooms for each sex, with consultingroom, waiting-rooms, and other conveniences. In enclosed courts at the rear are four fine air baths, formed of cement concrete, and measuring some 16ft. by 13ft. These will be provided with awnings of canvas and with suitable dressing-boxes, and supplied from the so-called " Madame Eachel " and " Priest's " "Springs. At the present time the only one in use is the "Priest's" bath. -This was formerly lined with planks, but has now concrete walls, with an open rubble bottom, through which the spring rises in considerable volume, constantly causing a rapid change of the bath-water. The " Madame Eachel" Spring is now being conducted to the pavilion through glazed earthenware pipes, the laying of which will shortly bo completed. A portion of the supply is diverted en route into a cooling-tank, 30ft. square by 2ft. 3in. deep. This will enable a large number of baths to be brought down to the desired temperature without any dilution of their chemical constituents. The whole of the internal small baths will be supplied by this spring. They have- been likewise constructed of cement concrete, and appear to bo very suitable for their purpose. The waste water will be conveyed from them in carefully-constructed concrete channels. On account of the corrosive properties of the water some difficulty has occurred in devising suitable stopcocks. I would recommend for this purpose short lengths of india-rubber hose, which can be compressed externally by a weighted lever or a screw-clamp. The small iron building lately occupied by the bath-attendant is now in use as a laundry, for which it is much more suitable._ It will be well to provide here a supply of hot water from the " Madame Eachel" Spring, to facilitate the washing of towels and to counteract the destructive effects upon them of the "Priest's " water. Some small but useful additions have been made to the temporary residence of the Medical Officer. A considerable area of garden-ground is under cultivation, and the young trees and plants have made surprising progress since I last say/ them. I had ocular demonstration that all kinds of vegetables, as well as flowers and fruit, can be grown here to perfection. The sulphurous emanations certainly have no injurious effect upon them. The soil is shallow and of a peaty character; it is poor in quality, but only needs manure to make it very productive. Ornamental grounds and extensive planting ought to be put in hand without delay, and will soon give a very attractive appearance to the place. It is also highly desirable to bring under cultivation at least twenty acres of adjoining land, so that a good paddock may be in readiness for the cows and horses which it will hereafter be found necessary to keep. The bath-keeper's cottage might with advantage have an enclosed garden, in which good results would, I am certain, shortly be seen. I have conferred fully with Dr. Lewis regarding the regulations for admission of patients to the benefits of the hospital, and also as to the staff of officials which will become necessary. A number of suggestions on these matters will shortly bo submitted for approval. Meanwhile I may remark that strict precautions must be taken to prevent any accumulation here of " chronic incurable " or "indigent" cases; also that it will be necessary to provide hospital accommodation for cases of illness arising in the district, or of infectious disease, developing itself perchance, at the sanatorium after infection elsewhere. This accommodation should be inexpensive, and attached to the cottage of one of the permanent staff of the sanatorium. I learn, on inquiry, that repeated requests are made by patients to be lodged and boarded somewhere near the baths ; and have not the least doubt that the cottages about to be erected will very shortly prove to the demand for accommodation. The alterations in progress have materially interfered, with the number of baths given. I see by the visitors' book that (up to 11 a.m.) on the 26th January fifteen persons bathed. The number in one day has been as high as twenty-six during the present month. A large increase may be expected when the arrangements are more complete. Mr. and Mrs. Hall, the bath-attendants, are giving great satisfaction, both to the visitors and to the Eesident Medical Officer. I have had an opportunity of conversing with a number of the visitors, all of whom express themselves as more or less benefited by their stay here. They appear to come from all parts of the world. 28th January, 1884.

THAMES. On the morning of the 12th December, 1883, my periodical visit of inspection was made to this hospital. I found nineteen patients residing, all of them being of the male sex, and proper subjects for treatment in a hospital. Indeed, several were suffering from very severe injuries, received either in the mines or in the bush. Since my last visit the largest number resident in one day has been twenty-six. On this occasion the dining-room was used to contain beds. There is accommodation at present for about thirty males and seven females, but a larger and more airy ward is required for the treatment of male surgical cases. lam glad to report that a very great improvement is apparent in the condition of the establishment, and that it pervades the whole of its details. The wards have been well and neatly painted, as also have the dining-room and those occupied by the Steward. The boards and white paint, which obstructed and obscured the lower portions of the windows, have given place to dwarf muslin blinds. Holland roller-blinds have been fixed, bedside-lockers provided, and grates for burning coal fixed in the fireplaces. Some new bed-clothing has been purchased, as well as a fair supply of excellent horsehair mattresses ; and a number of capital pictures in-frames are hung upon the walls. These latter are gifts; the Medical Officer, Dr. Payne, subscribing handsomely towards their framing. The bath-room, with which I formerly found so much fault, has undergone a complete transformation, and is now as neat and orderly as it was formerly dirty and untidy. A new cupboard has been constructed here to contain utensils, linseed meal, and surgical dressings and appliances. A large bin contains the soiled, linen (for short periods only), and the 3—H. 7a.

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whole room, with the adjoining lobby and passage, has been lined with match-boarding and varnished. The kitchen has been improved by throwing into it the store-room, and constructing a new one to replace it. The locally-made range continues to prove both satisfactory and economical in its working. A very good mortuary has recently been built, and fitted with suitable appliances. The old mortuary has been converted into a very good linen store, where I saw some good new blankets, and a small, but sufficient, stock of bed-linen. In process of construction are four well-arranged pail-closets, situated near the back of the hospital. The old linen-room forms a good and quiet bedroom for the Night Wardsman. The female wards were empty. Two of the small rooms here should be thrown into one. Some of the counterpanes here are much stained with lotions, and one was very greasy, but otherwise all was in good order. The kitchen-garden is well kept and well stocked. The surgery and dispensary are in very good order. About six patients attend here daily as out-patients. It would be well to keep their prescriptions in a book, and not on the loose papers now in use. _ A better form of register for in-patients is also very desirable. The supply of stores and rations is carefully checked, and a diet-scale has recently been adopted and posted up in each ward. The amount of alcoholic liquors consumed is not large, when the severity of the cases under treatment is taken into account. Throughout the establishment I found cleanliness, and evidences of good order and comfort. The patients themselves (without exception) spoke well of their surroundings. I would draw attention to the unsafe condition of a large portion of the verandahfloor, which is very rotten; and I would recommend that linoleum floor-cloth be laid over a portion of the floor of the surgical ward, where dressings of a greasy nature are constantly in use. Some effort should also be made to increase the small and old stock of books for reading. Of the painstaking services of Dr. Payne I had ocular demonstration during my visit. That the Steward is an able officer, and diligent in the performance of his duties, lam satisfied. The general condition of the hospital, and the improvements recently effected, reflect great credit upon the Committee of Management. 12th December, 1883.

TIM ABU. My inspection of this hospital was made this morning. At present only sixteen beds are occupied by patients, of whom thirteen are males and three females. Some of these are of the chronic or refuge class. Advantage has been taken of the emptiness of the wards to give them a thorough cleaning. The largo male ward is at present being painted throughout in a very tasteful manner, and the floor will be planed and re-varnished. The whole establishment is in excellent order and beautifully clean. The bedding is good and well attended to. None of the patients made any complaint to me, though I gave them all an opportunity of doing so. Dinner was served while I was present: it consisted of boiled mutton, beef tea, potatoes, carrots, and rice pudding. All were well cooked and sufficient in quantity. The vegetables are procured from the kitchen-garden which is well kept and cropped. The grounds generally show that much time and trouble are expended upon them. They have a very ornamental and pleasing appearance. I noticed that a thatched summerhouse had been added since my last visit. The buildings seem to be in good repair. No alteration has been made except the division of the old female ward into a bedroom and a workroom, as formerly recommended by me. The bedroom provided for the Medical Officer is very unsuitable : it might be materially improved by the insertion of some glass in the verandah roof outside the window, and by removing the partition which separates it from the Steward's office. This latter is a mere cupboard, in which gas has constantly to be used. A more suitable room should be built at the back of the corridor, adjoining the kitchen, for the Steward's use. The dispensary, which is used as an operating-room also, should be furnished with a glass lantern in the roof. The present lighting is very insufficient. Another want to which I will draw attention is a proper mortuary. The present wooden building is destitute of water-supply and any fittings whatever. _ It is moreover badly placed, and is too low down for drainage. A better site exists on the west side of the grounds, near the public road; and, if erected here, the new mortuary might without inconvenience serve also for the town. I examined the books and found them well kept. The consumption of stimulants has not been large of late, and colonial draught ale takes the place of bottled ale and stout. A great error has been in the magnitude of this hospital, which can make up in all seventy-three beds. For some time past the largest number of in-patients has not exceeded twenty-six; and the trouble and expense of keeping it throughout in its present very creditable state must be very great. Mr. and Mrs. Jowsey, the Steward and Matron, are indefatigable in the discharge of their duties, and quite capable of dealing with a much larger number of patients. Dr. Drew has held the appointment Medical Officer since May last. Hβ appears to be much interested in his work, which he regrets is at present so limited. I may state that the average number of out-patients is thirty per month. 23rd October, 1883.

I have inspected to-day every part of this hospital, which I find in most creditable order, and scrupulously clean throughout. The grounds have a very attractive appearance, being beautifully kept, and well stocked with flowers. The kitchen-garden also appears to be very productive, and to be made very valuable to the establishment. There are at present sixteen patients only under treatment; of whom eleven are males and five females. Three, at least, of this number belong to the chronic class. I satisfied myself, by observation and individual inquiry, that all are very kindly and carefully treated. There is a want of a dining-room for convalescent patients of the male sex : this might be furnished by throwing into one two small wards which could be spared for this use. The mortuary remains unaltered. A new one should be erected-on a convenient site, where it would also serve for the purpose of the town, having an approach from the neighbouring high road.

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I notice that some alteration is required, before winter sets in, in some of the ward fireplaces: these would be inspected by an officer from the Public Works Department. The hospital is far too large for its purpose ; and the recent diminution in the number of patients would seem to show that it was formerly used by those who could obtain medical attendance at their own homes. 16th April, 1884.

WAIMATE. My inspection of this hospital was made on the 22nd October, 1883, when I examined the whole of the buildings and premises, and conversed separately with each of the patients. Of these, there are at present ten occupying beds, and there are also two female relatives in attendance upon two of them who are children. The whole may fairly be considered as fit subjects for hospital treatment, and the reason of the number being so large is to be found in the good reputation which the hospital enjoys. All the patients I found to be satisfied with their treatment and surroundings. The wards have a homely and comfortable appearance. The bedding is good, and scrupulously clean. Books and papers are liberally provided; and, in addition to the other furniture, I noticed that some good bedside tables had been procured since my last visit was made. The large male ward badly requires colouring and painting, the walls having become very shabby and dirty. Adjoining this ward a room is now being built for a nurse or wardsman, who will be able to exercise control over the patients and render them assistance when needed. This will supply a defect which has sometimes caused inconvenience. The kitchen likewise requires cleaning and colouring. The rest of the establishment is in excellent order. The fever-hospital has been in use for four cases of typhoid and one of erysipelas since my last inspection. It is now empty of patients ; but all the beds are made up with beautifully clean linen, and are ready for immediate use when required. The wards in this small building are very cheerful and well arranged : they contain nine beds. I find that a good many out-patients attend at the hospital, their prescriptions being fully entered in a book kept for that purpose. Of the collection of maintenance-money, the book-keeping, and the procuring of supplies, I have nothing to add to what was stated in my former report. A kitchen-garden has recently been fenced in and planted: this will prove a valuable addition. Mr. and Mrs. Petit, the Steward and Matron, continue to devote their best energies to the welfare of the establishment, the condition of which reflects much credit upon them. Dr. Hassell is now the Medical Officer, and appears to visit with great regularity. 22nd October, 1883.

WAIPUKUEAU. This hospital was inspected on the 19th January, 1884. After finding so few patients, at this busy season of the year, in some of the other hospitals, I was surprised to see here ten beds occupied. All the patients were of the male sex, and, with one exception, fair subjects for hospital treatment. Some of them had sustained severe injuries. As many as sixteen beds had been occupied at one time since my last visit, which is good evidence that this establishment supplies a pressing want. The fever-ward (detached) is now completed, and furnished for its special use, but no necessity has as yet arisen for its occupation. This building is well planned and well constructed. The large and lofty ward is intended to accommodate five patients, but at present two bedsteads only are provided. The ventilation is good, and the walls are plastered in a good cement. Two chairs, a table, and a metal washstand complete the list of furniture. A fixed bath is provided, to which water is not laid on at present. An excellent earth-closet, with hopper and distributing apparatus, occupies a projecting room. The nurse's room has an enamelled-iron sink, with supply of rainwater. A linencloset is provided in the lobby. Of the main portion of the hospital I have very little to add to my former report. Some additional chairs have been procured, and others made more comfortable. An American organ, for use at Divine service, has kindly been lent by Mr. Wilding. Every portion of the establishment, with its furniture and bedding, I found in the best possible order and condition. The patients expressed themselves as thoroughly satisfied. The Steward and Matron, Mr. and Mrs. Putnam, are admirably suited for the position they occupy. I had the opportunity of conversing with Mr. Smith, M.H.E., and Mr. Wilding, two members of the Committee, who take a very active interest in the welfare of this well-managed hospital. 19th January, 1884.

WANGANUI. On the 18th December, 1883, I paid a visit of inspection to this hospital. I found in residence sixteen male and two female patients : one or two were chronic cases. The largest number treated as in-patients on any one day has been twenty-six. Out-patients are very few in number. No fevercases have required admission. I found that a very material alteration had been effected as regards the internal condition of this hospital. New and wider entrance-doors to the female fever-ward; a new water-closet and lavatory, well arranged : a pair of baize-covered doors, dividing the male from the female division; a good kitchen-range, with high-pressure boiler; a fixed bath, with hot- and cold-water supply, were all noticed with satisfaction. Outside the building a suitable mortuary has been provided in what was formerly a mere shed; the old mortuary forms a coal-store ; two additional detached water-closets have been erected, a hydrant, with proper hose, provided, and the yard near the kitchen enclosed with a good fence, and concreted near the building. The fever-wards are warmed in cold weather by central stoves, which are removed during the summer : they appear to have given satisfaction. A number of nicely-framed pictures have been hung on the walls of the wards, where I also saw a profusion of cut flowers. The whole interior has been cleaned and coloured or painted. The kitchen roof has been lined with match-board, and this room made much mora

H,—7a

comfortable than was formerly the case. The entrance-hall has been laid with cocoanut-fibre matting, and furnished with a filter and a clock. A number of surgical instruments have been ordered from England. I saw dinner served, and it appeared to be in all respects a satisfactory meal. The whole of the patients had an opportunity of conversing with me alone, and made no single complaint. I can report very favourably of the good order and perfect cleanliness which everywhere prevailed, and which reflect much credit upon the Steward and Matron. From inquiries made I find that the refuse is now collected in a large box, and frequently removed. The old well is still used for offensive matters, but these are well covered with earth, and the space is now almost entirely filled up. The Committee have evidently given the hospital much thought and attention of late. Some better bedsteads and mattresses should next engage their attention, and might be provided by degrees. 20th December, 1883.

WELLINGTON. I have been engaged during the 30th and 31st July in an inspection of this hospital, of which I have seen every portion. I have also examined the books and records, and conversed separately with all the patients. There are at present occupying beds 36 males and 12 females—total, 48; but several of these persons are not proper inmates of a hospital: in fact, the usefulness and the discipline of the establishment are seriously embarrassed by their presence. The fever-ward is tenanted by three women of this class, for whom it would be difficult to find accommodation elsewhere. Since my last report was written a complete and radical change has been made in the management. Dr. Hammond has been appointed Medical Officer, and Mrs. Moore Lady Superintendent. The nurses have been supplanted by probationers drawn from a higher order of society, a new steward and dispenser and a man cook having also taken office. No one who was conversant with the condition of the hospital six months ago can fail to be struck with the improvements which have resulted from the new regime. I ana glad, moreover, to be able to state that this good result goes beneath the mere surface, and extends to every little detail. Cleanliness and comfort prevail everywhere, and discipline is strictly adhered to. It would not have been difficult to foresee that such a system could not please every one. There will always be those who prefer to be slovenly ; and others, who have hitherto been permitted to do exactly as they pleased, naturally fret at any restraint, however wholesome. The patients, without exception, spoke well of their surroundings; the only complaint which I heard was from a man who said he was not permitted to go beyond the hospital grounds, though he admitted to me that he had never asked to be allowed to do so. Additions have been made to the furniture and fittings of the wards : presses for linen, cupboards for medicines and appliances; baskets containing instruments, &c, for emergencies ; workbaskets, ornaments with cut flowers, pictures, bedside lockers (which also form convenient tables for meals); and, in the ward-kitchens, dressers for crockery and other articles. Warm woollen rugs are provided for each patient; also flannel dressing-gowns and other wraps, neat in colour and design. All these additions have been planned, and many of them manufactured, at the hospital. Report-books lie upon the tables, in which entries of the condition of every patient, night and day, are made by the probationers, who also take their temperature daily with the thermometer. I.took the opportunity of visiting every room while dinner was served. Everything is now well cooked, and the mode of serving the meal leaves nothing to be desired. The kitchen and its offices are very clean and orderly, though somewhat bare of fittings at present: a great change for the better lias taken place in this department, as also in the store-rooms, which the Steward has succeeded in getting into good order. The large front corridor of the hospital has had the iloor stained and varnished at the sides. A number of growing plants have been introduced, and ornamental boards fixed showing the names of the visiting staff for the time being, and also the names of the various wards. In the back corridor presses of a simple kind are in course of construction by the carpenter for containing the clothing worn by patients when admitted. Opening into this corridor are the passages leading to the baths, lavatories, closets, and urinals. Although these are carefully attended to, they are by no means free from offensive odour, which the defective planning of this portion of the hospital permits to enter the wards at times. So-called earth-closets are in use, and are provided with a mixture of spent gas-lime and earth. Wator-closets would be far preferable here, and, in fact, everywhere else, if a good water-supply and system of drainage be available. The floors of the urinals are of an absorbent concrete, and contribute to the offensive smell. I have made some suggestions to Dr. Hammond with the view of modifying or removing this evil. The supply of hot water is as unsatisfactory as ever : a large quantity of fuel is used, and a prodigious quantity of water wasted, under the present plan. One of the two furnaces is falling to pieces, and it would be well to remove both and replace them by a single good boiler in a central position. The advantages which the hospital now offers' in the way of treatment during illness are so great that, when better known, a demand for more accommodation must arise on the part of those who are able to pay for the same. At present there is onlj one private room available, and this may at any moment be needed for the isolation of a troublesome or noisy patient. The other private rooms are occupied by the Lady Superintendent, and by the Steward and Dispenser. It would be found practicable to make the latter a non-resident officer; while the former should, have apartments in such a position that, while within call, she would at times be free from the noises, bad smells, and Other concomitants of a residence close to the door of a large ward. The very successful introduction of the probationer system will also necessitate some structural addition of inexpensive character. These nurses take the greatest possible interest in their calling, which they have chosen from other than pecuniary motives only ; and I have no hesitation in stating that a foundation is here being laid for a considerable permanent benefit to the colony. The system, however, caunot much longer be continued unless a few small bedrooms, a large sitting-room, and bath, lavatory,

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and other accommodation be provided for their use. In connection with this subject it may be well to mention that the salary of a probationer is only £25 a year, whereas an ordinary nurse would cost twice that amount. Some provision should be made elsewhere for the refuge-patients ; and, if the fever-hospital is to be used for the two sexes simultaneously, common' decency demands the erection of another ward. My visit has given me much pleasure, and I have seen abundant evidence of the administrative ability of Dr. Hammond, and of the undoubted good qualifications of the Lady Superintendent for the responsible position she now occupies. Ist August, 1883.

WESTPOKT. Theeb are at present in this hospital six patients, all of whom are of the male sex. Three of these are of the chronic or refuge class. The total number of beds is twelve ; but fourteen patients have been treated simultaneously since my last visit. Altogether there have been sixty-six inpatients since the last inspection, three of whom have died. The register is properly kept, as also is a book containing sums due by patients for treatment and maintenance. These amounts are collected, whenever practicable, by the Secretary. An inventory of all hospital properties has now been taken. : The condition of the hospital, as regards order and cleanliness, is very creditable ; and I noticed many improvements which have been carried out. The piles supporting the building have been renewed, and the window-sashes repaired. Paths have been formed in the garden, grass-seed sown, and flowers planted ; the kitchen-garden is very well cultivated and cropped. A commodious shed has been erected behind the kitchen, serving for a coal and wood store, and for other uses. The kitchen has been cleaned, the doors painted, and a cupboard added. In the wards I noticed some additional unframed pictures, and a new commode (on wheels). There is much, however, still needed. The large ward is very draughty and cold at times, and has a bare and povertystricken look. Some of the bedsteads require replacing by new ones, or, failing this, new iron laths should be fitted where necessary. Several of the straw-mattresses are quite worn out, and, though very clean, are full of holes. Some additional counterpanes are also needed, and a few comfortable chairs. It would be well to replace the kitchen-range, which is small and much worn, by an American stove of good construction. The storage for rainwater is not larger than is absolutely necessary, and one of the iron tanks is completely worn out. Some commencement should be made in procuring a stock of surgical instruments and appliances. No proper accommodation exists for convalescent patients : a room in which they could sit, read, and take their meals, away from other offensive cases, would be a great boon. There can be no doubt whatever that this hospital supplies a want and does good work ; it is also evident that the imperfect appliances existing are made the best possible use of. The patients receive very careful medical attention, and are otherwise well cared for. The dinner to-day consisted of good broth, boiled beef, parsnips, and potatoes. I could hear no complaints whatever. 3rd November, 1883.

Table I.—Showing Receipts on account of Hospitals during the Year 1883.

Hospitals. Subscriptions and Donations. Received -p o ~- i * „_,„ Received Received From Rents from 7?,w™ ( n „? from Borough from County and other Patients. uovernment. Council. Council. Revenuo. Total. £ s. d. £ s. d. 54 19 0 70 19 6 158 4 3 323 7 9 107 11 8 19 10 0 357 15 6 £ s. d. 318 17 10 244 6 6 436 5 3 5,747 0 9 353 2 11 129 2 1 4,707 1 8 301 6 0 266 9 8 G,775 18 0 535 2 9 594 18 6 1,837 13 4 80 1 6 2,455 19 0 1,062 11 1 492 0 0 974 11 3 225 2 7 3,451 5 5 215 11 1 1,727 0 0 728 3 3 771 2 9 £ s. d. £, a. d. £ s. d. £ s. d. 373 16. 10 896 14 9 1,264 9 6 6,276 2 8 460 14 7 259 12 8 5,064 17 2 503 1 4 754 14 2 7,210 0 9 1,187 12 10 1,454 5 1 3,320 13 10 247 7 6 3,093 19 2 2,087 19 3 837 5 6 1,628 0 8 ■448 17 2 5,082 4 6 701 17 7 1,915 5 6 927 12 2 1,615 16 6 Akaroa Arrowtown Ashburton Auckland Blenheim Charleston Chrisfcchureh Coromandel Cromwell Dunodin Dunstan Gisborne ' 381 ' 8 9 193 10 8 91 9 7 70 0 0 600"0 0 200 0 0 12*3 C 19 11 0 176 15 4 367 17 2 77 9 4 424 7 9 134 8 3 100 5 8 577 11 0 67 1 0 83 5 0 93 9 0 5 5 0 133 19 8 9 10 0 143 13 6 94 12 7 162 18 6 198 8 11 26 11 0 2o"o 0 25 0 0 1718 0 9 15 0 Groymouth Greytown Hokitika Invercargill Kumara Lawrence Masterton Napier .. Naseby Nelson New Plymouth .. Oa.mara Patea* .. Picton .. Queeiistown Eeefton Riverton !ftoss Thames Timaru .. Waimatie Waipawa Wangarrai Wellington Wosfcport 493 1 10 63d- 0 11 849 6 0 85 7 G 493 2 2 771 5 10 230 0 6 434 17 3 214 4 7 1,131 0 5 336 13 11 25 0 0 7 5 0 25 0 0 50 0 0 ioo"o o 6 3 6 7 12 6 61 13 0 60 13 4 50 0 0 10 10 0 40 0 0 .34"2 0 290 0 0 25 0 0 66 5 2 1 0 0 489 17 9 2d"7 0 328 5 0 0 8 0 288 10 11 562 3 6 213 16 6 123 7 0 132 4 G 42 9 9 l>5 2 1 193 1G 11 79 15 3 10 10 0 37 5 0 6 15 0 111 1 G 109 15 6 41 0 6 4 0 0 66 3 10 180 10 1 111 17 9 64 10 3 0 18 0 212 1 9 120 6 6 156 3 7 2 835 2 4 432 12 9 23:) 14 6 311 7 0 1,992 1 1 2,099 3 4 881 4 3 951 10 ' 4 863 10 10 5,916 16 11 1,092 8 6 10 10 0 15 0 449 19 1 370 9 I, 89 19 0 165 5 2 1,195 3 10 1,484 1 3 694 10 6 638 14 0 2,521 15 8 2,322 3 2 1,063 7 6 1,459 17 6 1,658 18 10 6,139 8 8 1,250 0 0 25 0 0 200 0 0 50 0 0 331 19 10 5"3 5 315 10- 3 250 0 0 397 14 0 1 10 6 Totals 9,209 9 7 4,454 4 G 49,833 2 2 703 5 3 1,888 4 0 2,058 15 10 68,206 7 9 * No return re* :eived.

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Table II.—Showing the Expenditure on Account of Hospitals during the Year 1883.

Hospitals. Provisions. Wine, Ale, Drugs and Instruments. Fuel and Light. Bedding and Clothing. Furniture, Crockery, &o. Washing. Salaries and Wages. Water Supply. Funerals. Repairs. Printing and Advertising. For Interest. For Insurance. For Commission. Other Expenses. Total. £ s. d. 110 9 6 128 3 0 368 15 0 1,976 15 3 261 15 9 63 3 4 1,415 2 5 63 8 4 199 3 2 2,011 5 10 136 17 1 201 10 0 730 9 11 100 0 0 937 6 4 347 5 3 203 16 0 436 4 8 81 3 5 880 18 5 120 14 1 389 10 11 199 12 0 167 15 9 £ s. d. 3 16 10 0 0 42 2 0 367 12 8 48 6 0 8 0 6 370 3 0 £ s. d. 41 11 7 31 7 10 111 4 7 559 3 3 73 0 2 £ s. a. £ s. a. £ s. a. £ s. a. £ s. d. 201 13 4 360 18 4 355 0 0 1,479 10 3: 314 15 0 238 0 0 1,492 18 4 228 15 4 350 0 0 2,094 13 6 409 0 0 276 14 0 971 9 8 170 0 0 1,178 0 0 659 16 10 396 1 6 585 17 4 223 5 0 1,031 6 10 304 5 0 697 7 6 392 0 0 365 13 6 £ s. a. £ a. a. £ s. a. £ s. d. £ s. a. £. s. d. £ s. a. £ s. d. 17 0 11 74 0 0 16 18 10 104 9 4 4 10 0 11 2 3 137 14 2 86 0 0 53 11 7 45 0 0 332 6 4 104 4 4 86 9 4 0 9 8 132 15 3 22 18 8 30 6 6 78 16 2 2 2 0 156 15 8 £ s. a. 373 16 10 .711 4 3 1,140 12 1 6,276 2 8 854 18 8 372 5 0 5,064 17 2 486 2 3 798 8 9 6,775 18 0 1,183 11 5 1,078 7 7 2,183 11 7 389 9 3 3,093 19 2 1,702 19 9 1,045 3 0 1,751 13 3 440 10 4 3,451 5 5 595 8 10 1,863 13 4 927 12 2 1,606 13 5 Akaroa Arrowtown .. Ashburton .. Auckland Blenheim Charleston .. Christchuech Coromandel.. Cromwell Dunedin Dunstan Gisborne Groymouth .. Greytown Hokitika Invercargill .. Kumara Lawrence Masterton .. Hapier Naseby Nelson New Plymouth Oamaru Patea* Picton Queenstown.. Eeefton Kiverton Ross Thame3 Timaru Waimats Waipawa Whanganui.. Wellington .. Westport* .. 11 13 0 267 12 11 26 9 6 120 0 0 10 0 110 8 1 25 10 0 22 13 0 61 5 2 3 16 0 247 5 7 8 10 51 9 0 50 8 0 31 18 8 415 8 11 24 7 0 32 19 6 707 3 71 30 13 1 201 12 0; 27 1 5 44 17 7 212 16 4 110 14 11 49 7 0 170 18 2 22 1 4 415 5 11 60 19 3 162 12 3 91 12 5 38 9 1 22 5 6 65 13 6 280 5 3 56 9 3 19 10 0 515 15 9 29 9 9 382 3 9 36 11 6 86 5 11 13 0 9 142 9 5 152 12 1 41 11 0 145 8 4 18 0 4 96 12 2 34 11 0 135 9 1 29 16 0 101 9 4 20 19 5 T 3 9 42S O 4 33 13 11 19 9 227 18 3 20 1 9 100 13 5 33 12 0 67 18 7 12 5 6 65 5 0 43 16 1 31 5 0 98 5 10 2 6 0 200 0 0 6 10 0 29 13 10 12 18 0 62 5 8 9 0 0 57 4 9 434 4 8 33 5 4 0 17 8 35 0 0 17 8 5 342 17 11 94 16 8 6 3 1 60 12 2 6 0 3 52 2 6 24 14 0 40 16 7 23 6 5 80 5 10 11 5 0 71 8 10 20 5 0 50 1 2 17 5 0 334 19 10 3 18 0 7 "l 9 5 10 0 "8 4 82 18 0 2 3 6 •■ !l62 "6 8] 20 10 0 13 9 0 111 0 0 5 0 0 4 0 0 35 11 0 11 0 0 40 10 0 5 12 6 23 5 0 15 8 0 9 0 0 30 14 0 22 2 6 5 0 0 3 15 0 15 0 0 32 10 3 1 18 0 58 2 4 18 5 6 8 14 0 432 11 9 22 11 2 49 11 7 741 4 7 130 0 0 40 0 0 9 12 8 118 11 9 206 18 8 242 15 0 9 19 1 248 6 0 23 14 5 147 10 2 4 17 3 11 14 2 9 17 6 15 8 6 18 5 6 18 15 5 9 6 6 21 13 7 12 12 1 12 15 0 42 12 6 48 7 3 38 7 6 64 4 6 6 16 6 65 4 6 39 10 9 22 8 0 27 1 6 14 12 8 56 18 9 5 6 7 7 10 42 10 8 1 14 10 5 V 10 0 3 0 4 "l 1 .. I 2 8 0 9 6 0 7 0 0 16 11 6 0 18 3 10 10 0 4 "0 0 2 "5 6 5 5 0 12 19 6 10 5 9 9 10 0 39 0 0 3 15 0 7 12 6 5 0 0 5 5 0 40*' 0 0 9 3 9 4 17 6 10 ' 0 157 5 9 49 1 6 644 2 8 41 12 0 7 15 0 "o o 13 15 0 19 10 0 17 10 0 30 "0 6 0 16 C 11 8 79 10 3 136 8 3 251 7 6 275 18 10 195 4 7 132 8 8 662 13 0 562 0 10 160 6 6 432 6 10 280 3 7 2,174 2 8 19 13 8 9 5 6 13 12 6 15 10 6 7 10 73 9 7 106 6 0 18 2 0 21 8 11 99 0 11 288 10 0 25 18 8 70 0 0 42 10 4 22 11 9 39 3 6 340 10 3 227 12 8 33 15 4 269 19 9 129 2 3 323 1 8 26 10 4 101 2 3 74 3 2 25 13 4 22 17 0 104 14 10 16 10 2 35 5 9 7 13 0 7 16 5 138 17 2 18 18 10 27 19 6 9 16 8 47 18 6 1 12 0 21 1 8 107 18 0 32 9 5 17 6 6 151 8 11 131 6 9 321 8 0 15 "5 8 235 10 0 397 12 3 490 0 0 361 16 0 352 8 0 960 8 9 838 4 3 527 17 6 395 10 0 357 4 0 1,385 4 7 1 12 0 6 0 0 4 0 0 6 10 6 2 10 0 77 3 9 130 0 0 150 19 3 3 2 0 78 19 0 407 0 8 191 1" 10 21 15 0 367 0 0 84 12 4 43 1 6 7 10 13 5 1 84 6 0 5 14 9 33 17 6 32 5 10 30 3 6 31 7 6 128 17 6 40 14 2 11 6 5 11 16 0 391 6 9 77 4 2 47 11 3 77 14 0 344 19 7 255 18 1 715 5 2 1,131 16 11 1,284 7 0 697 8 4 725 11 3 3,196 4 3 2,322 3 .2 920 0 7 1,777 10 2 1,602 4 7 6,139 8 8 1,250 0 0 4 16 0 - 12 0 0 10 0 C 6 2 6 17 5 0 5 12 0 34 14 0 12 0 0 3 0 0 ; 5 0 0 2 2 6 6 19 0 4 10 0 11 9 6 13 10 0 25 11 0 - 51 10 0 7 16 9 209 9 0 39 19 6 9 19 9 78 0 11 738 19 0 5 5 0 30 2 1 241 5 10 16 13 8 3 5 0 13 10 0 '47 9 11 1333 11 4 12 17 6 0 16 0 8 15 0 36 16 0 9 0 3 5 16 3 8 16 0 - -. .. • • •■ •• •• ■• .. •• • • • • I 'I I 947 0 6 21,198 14 9 )230 8 8 S516 15 9 4,111 13 816 7 7 193 19 5 177 5 5 176 16 9 3,766 17 2 63,840 4 Totals .. 16,894 5 11 2,570 16 2 5,158 13 4 3,724 13 11 2,112 1 2 2,292 2 2 * No return sent in.

H_—7a

[Compiled in the Registrar-General's Office.] Table III.—Showing the Accommodation and Amount of Relief afforded in the various Hospitals in the Colony of New Zealand during the Year 1883.

Accommodation. Patients (Indoor) in 18S3. Relief. Where situated. Remaining on 1st Jan., 1883, from previous Year. Aggregate Number of Cubic Feet Number of Beds. Admitted during Year. Discharged during Year. Died during Year. Remaining 31st December, 1883. Number of Inmates who received Relief in 1883. Number relievedi Outdoor.. in Sleeping Wards. M. F. M. F. M. J K For Males. For Females Total. Total. M. F. M. F. M. F. M. F. Total. I I Auckland Thames Coromandel .. Gisborne New Plymouth Patea f Napier Waipukurau .. Wellington Wanganui Masterton Greytown Picton Blenheim Nelson Westport Charleston Reefton Greymouth Kumara Hokitika Ross Christchurch .. Akaroa Ashburton Timaru Waimate Oamaru Dunedin Dunstan Cromwell Arrowtown Wakatipu Naseby Lawrence Invercargill .. Riverton * . . 7 io 3 3 5 4 4 4 7 4 4 4 6 1 1 3 4 3 4 3 5 2 12 9 5 9 12 '■ 3 3 3 ■ 3 i 5 5 ■ 8 4 I 111,788 23,803 8,279 21,308 21,056 15,504 38,760 15,608 184,520 23,443 24,648 6,602 19,000 21,866 96,800 19,440 9.989 13.550 38,000 13,141 69,921 17,280 168,945 6,000 35,728 121,294 33.347 31.384 208,348 12,100 10,000 10,000 26,400 12,000 36,842 21,932 10,315 68 20 5 12 19 10 22 10 58 18 7 6 14 14 42 12 8 12 3 1 9 44 12 7 2 21 10 4 4 2 II 5 48 8 2 3 10 2 26 2 2 6 3 13 3 36 4 10 15 9 5 52 89 3° 5 16 23 12 33 15 106 26 9 9 24 16 68 14 8 14 37 12 57 15 108 8 82 18 I 2 6 9 19 5 46 13 2 1 8 8 5 1 3 17 2 17 2 '*8 16 2 1 1 7 1 3 i x 499 28 67 126 16 218 266 90 25 26 II 57 49 63 16 70 71 37 209 27 444 20 93 155 60 68 523 35 4 1 37 56 37 124 219 36 135 42 24 15 25 116 22 2 2 I 3 28 7 1 17 58 145 5 7 36 14 353 11 10 13 18 5 22 42 13 442 141 28 62 116 23 199 57 243 73 21 21 7 50 37 53 15 65 61 28 *97 J 24 400 19 85 151 54 60 459 32 35 35 52 37 114 199 31 3.726 117 39 ■■ 24 ■■ 79 25 109 21 3 I 1 16 46 2 123 3 7 29 17 14 327 10 10 13 12 6 22 36 13 1.183 69 11 I 6 5 1 17 27 13 6 3 1 5 7 5 1 3 9 6 9 3 44 10 2 8 57 2 21 3 I •• 1 II 10 1 ! 4 70 17 1 11 1 21 42 3 8 10 13 10 28 55 4 6 16 6 6 81 14 2 7 13 2 1 2 1 3 58l 169 29 69 132 25 237 69 312 103 27 27 16 65 57 68 17 73 88 39 234 3° 499 24 101. I 177 62 74 597 38 I 43 ] 39 : 61 J 152 44 24 15 97 25 132 24 3 2 1 4 35 7 2 20 3 59 2 157 5 8 38 19 14 389 11 11 733 213 29 93 147 334 94 444 127 30 29 17 69 92 75 17 75 108 42 293 32 656 29 log 215 81 88 986 135 j 68 36 J 6 124 18" 15 266 84 262 187 50 I 6 •• •- 4 •.. 8 .. 14 231 39 75 8 324 280 203" 42 -." 14a . 15 35°* 449 56 * ■■ 45 1427a 604 11' •• 9 25 3 55 4 8 22 2 6 74 3 2 2 5 6 13 4 1 4 12 19 1 15 1 1 5 1 1,182 879 j 2,06>I 4 20 58 16 12 116 18 6 15 8 26 18 15 •• .. .. i ■■■ 30 73 25 17 168 •• I 1 167 123 75 j 9° 41 16 1,236 1,552 38 19 4 I 17 12 30 10 290 165 57 2,788 57 29 40& 36 2 4 1 '38 4 3 3 5 5 7 10 22 10 9 20 •■ 4 4 2 6 49 54 52 80 1 4 2 1 1 1 2 1 1 3 2 2 5 13 19 6 13 33 28 19 11 4 12 2 5 1 43 137 232 4° 4.634 ! 24 43 X 4 49 161 275 54 6,056 ,. I 97 11 4 13 4 2 20 5 "6 "5 1 I Totals us 4.134 I 1 1 181 1,558,941 864 357 1,221 500 386 in 522 128 •• ■• •• 1,304 1,422 * From 12th September to end of year. t No patients were admitted from the 20th June to the 31st December, figures represent the number of applications, not the actual number of persons relieved. J And 68 children. jj One fever ward. § Approximately. 11 These

H.-7a

[Compiled in the Registrar-General's Office.] Table IV.—Showing the Number of Cases of Disease and of Deaths from each Cause in the various Hospitals throughout the Colony of New Zealand during the Year 1883.

6 Orders, Diseases, &c. -3 < 5 & d £-3 5 c 6a 5 OJD to J= in rt 2 6 I Cβ 2 5 o 'd s to ■I' i '3 rt o 6 a O '-■ ■j 8 a a o o ft, l<3 a o . 5 c E o « LS i O j B 1 I I a o-g O C II (3 a 111 j<3 a| 1 i 1 6 & c c in £ p o < a. w rt L " c ttJ c rt o; 1 I "ctfQ o d d Q d o D % a rt a 5; CC tn d rt I « u| a O d a 1/1 6 a o J2 1 o d a o rt rt a p Order i.— Mias Diseases. Small-pox Measles Scarlet Fever an d Scarlatina Diphtheria, Cynanche Maligna Quinsy Croup Whooping Cough Typhus Fever ... Enteric or Typhoid Fever... Simple Continued Fever ... Erysipelas, Blister Puerperal Fever (Metria) ... Carbuncle, Boil, &c. Influenza, Catarrh, &c. ... Dysentery Diarrhoea Cholera Ague Remittent Fever Rheumatism, &c. Others 54 12 3 7 3 1 I 1 I I 1C ... ■■; 1 3 1 2 ... 4 i| ... 2 1 6 ... •■"I ...I 2 7 I 4 "1 7 1 ... ... ... ... ■ ... ... ... 2 1 I ... 1 I 2 ! ... ... ... "1 I 1 1 ... 2 4 1 ... * 1 3 H "i 3 1 4 1 1 [ ... 13 ... 2 ! ' ■I ' 6 ... 2 ■> 20 ... 2| 4 2 4 j ... 2 ... ... 1 9 3 2 ... I 14 4 179 5° 22 31 "3 - ■* \ 3 \ ... .. < . j ... 2 1 .0 8 i 2 1 1 I '" 5 ... ... 3 i 1 ... ... 2 ... 2 i ! 2! 1 1 "■ 1 "'? I ... 3 6 ■ 181 2 •• ■■■ ... ... I 1 2 3 4 1 1 ■ 3 8 "■ ... = ... 35 36 32 43 5 8 1 1 2 I ■■; 2 1 ... 1 ... I 1 '" ... I "1! 4 6 3 1 I 1 "I » ; -,! 2 -. ... ... ■1 I I 1 ... 2 1 ■ » ! « 5 I I j ... 5 ... ... ... ...I ... ... 1 i ... ... ... 4 ... 2 ... 3 ! , "■ ..J 2 ... .. I 10 c 34 ,5 I 2 •■■I 8 ... 22 - » 3 1 2 ... ■,6 "i 2 4 4 7 ... 5 2 7 3 i'e 10 4 3' , : ! 49 13 !" 6 1 3 1 4 1 60 7 1 ii 2 i'o ,20 3 410 7 i 1 "' 2 ... • 1 " ... ... Total Order i ... ! I I I 11 1 I ! I _ 62 - — 1 ' ! 6 - 6 H i_ __ - _ I I I — _ ■ 8 ! 1 i - - — 1 — I ! h I 116 I I __ I — I I H ■ 2 23 , 1 , 22 3 1 • H 87 H 2 2 4 \'"\ 14 a 2Oi H f 55 2 ! .1 * M 23 - H 4 .. 1 l 7 ! 2 22 23! i >3 u 2 5 958 I 44 II 1 ! I I _ _ I I I . I ■__■ I 1 I ! i_ - _ ! I _ 1 _! _ Order z. — Euthetic Diseases. Syphilis Ulcer of Groin ... Gonorrhoea Stricture of Urethra Others 24 2 < - I 3 : 4, 3 10 3 1 '"I -I 1 ... ... ■■ 11 loj 6 9 3 3 5 ... ' 1 38 38 I 1 1 I j ; _ - • • 1 4 ■ I ... 1. 129 21 79 63 2 2 6 ... 4 14 9 ... ... 2 ... ...! 2 . 4 1 ! ... 'i I ! 1 1 5 1 ; .. ... 4 4 1 2 5 ... 2 1 3 ■ ... ... ... •1 ... ■■■ ... ... ... - Total Order 2 ... — ■ I ~l __ __ — 1 : _ I I - 46 — I 1 — — I I t I I 1 1 1 1 i 1 - I 6 _ - I ! I — " i I I i I 1 1 H 1 6 1 — 3.4 I 5 I '7 1 \l 7 1 3 I I , 21 ' " 20 ] So h 6 2 2 6 3 I 292 S - ... - - — — - - I __ — _ 1 _ _i _. I i _ ' — ; I •1 Order 3.— Dietic Diseases. Privation Want of Breast Milk Purpura and Scurvy Alcohol- f"-Delirium Tre- ■ < mens (. b. Intemperance I — - — I - — — 1 1 I I 6 ... 1 9 1 1 ... ... ■ S .. I . 2 1 ■•• 9 1 1 9 .6! 2 3 1 6 6 126 16 " 6 ... •- ... ■ ... 1 ... ... >3 3 7 2 5 I 1 I I 4 ' 1 2 ! . ... - ■■■ I.. H 2 I ■ I i> 2 2 3 'I — ~l I M !— H — - - — — I I 1 1 1 - .... Total Order 3 ... - I — 6 _ H _ — II I H .— - 6 t 16 J * 1 I 9 4 22 1 i 2 1 i I j 1 1 2 1 18 7 I 77 -1 2 5 J 2 1 ~"S 11 • — ... ... ... — — I 1 — I — — — — - — I 1 — — ~ 1 — _i — —, w - l_l I I 1 :- : ■1 — u I — 1 ; - —

H.—7a.

4—H. 7a.

Ord. 4.— Parasitic Diseases. Worms, &c. Hydatids Scabies ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... - ... ... - !■■■: ... ... I •- "1 ... ... ... ... ... ... ... ... - 1 "1 ... ... ... ... 3 ... ... ... ... ... ... ... ... ... .... 1 i- 1 i— I H - — I _ I — i 11 11 — I — — — 1 u — _ ■■~ _j I — Total Order 4 ... 1 - ... ; 1 3 1,468 — ... ... ... ••• ... ... ;■■■: — ... ... ... — ■•: — ... " ': - — - — h _ ; — i - — _ - — — H - — _ H _ — ! — - — - — h — h 67 - - — — B !- : I — — h - 1 — -: '- ! — i 1 I _ h H Total Class I. ... '75 :: \» 4 7 '9 1 1 A u 3 78 2 28 •S6 ; 6 33 2 1 I 2 3 \ 4 20 t; " 27 20 I , ; 8 I i. 2 5 '44 5 I 4 ' 2 4; : 2 . 8 2 73 J 33 33 : 1 2 S 1 3 9 60 ;••• — _ — ! — _! — _ — - — _ I- — — - — — - : _ - ; 1 — — '—: 1 — LJ _ — 5 z o o I Ord. i. — Diathetic Diseases. Gout Dropsy Cancer Tumour, &c. Cancrum Oris (Noma) ... Mortification Others 1 4 30 2 6 ... ; 2 4 2 i ... 4 ... ... ... 1 3 7 1 4 2 ... 2 1 ... 1 1 1 ... 3 - ■ ... 4 ... I ... 2 1 ... 2 3 1 ... 3 ... ... "A ... ... ... 1 ••• ... 12 -7I 1 3 2 1 2 1 2 1 I ... 1 I 4 2 46 ... 1 ,6 2 ... 1 1 1 ... 3 1 ... 1 2 i • 3 ... ... ■I 1 11 20| I2 7 ! "I 1 10 4 ... ... I !■• " 1 ... ... 2 I 5 1 ... ... "J 3 1 1 9 1 - 1 - ... ... ... ... i = ... 14 2 ... ... ... ... ... ... Total Order 1 ... — — — — i_ II ! I I i 1 l_ _i 1 i_ H 1 ! H i_ 1 1 l_ I H I _J I — - I — — H - ~ H I 67 - LJ - " I _ H 1 29 10 2 j 1 I " 4 1 '3 j 1 11 5 7 3 1 1 1 3 1 5 1 ! 2 1 5 1 3 4 1 13 7 6 3 4 i 1 I I '7 2 1 1 1 J 1 7 1 ; 1 209 ... ... ... ... ... ... '— — - — - : - - — — — — - _i - — - - — — — — -! — — — J — - — — - Order 2.— Tubercular Diseases. Scrofula Tabes Mcsenterica Phthisis Hydrocephalus... Others 4 49 I? 2 5 1 ... 1 ! I ... 7 ... 4 4 ... ... ■7 ... ... 5 11 1 1 1 ... ... 2 1 ... ... ... 3 2 ... 4 3 ... ... ... ' 1 ... 3 3 ... ... 9 ... 2 2 " 46 26 3 ... 9 11 4 , 5 10 2 ... 2 2 ... ... 12 29 I 1 3 2 1 3 1 8 5 9 ! 2 2 2 ... 78 215 1 So ... ... ... ... ... ... ... ... 6 ... 2 1 1 1 "1 ... ... 10 ... ... ... ... ... ... Total Order 2 ... - _ 1 I I — — I I h I — h - H l_ _ — I I — H — — — — h h h _ — 1 - S3 ■7 9 1 1 I 1 10 4 4 1 '7 5 12 2 I ! I ... 6 3 4 [3 ... 1 1 1 3 8 3 ... ... 10 H 2 72 12 5 I 21 3 1 : 2 i ... 42 '4 3 2 I 4 I i 8 s 6 11 3 4 3°4 Total Class II. ... - — - I — — h - - H H h h h H _ _ - 1 - 1 . - _ - _ h — — H - — I — - - h 82 27 1 1 I 2 '5 1 23 4 S 1 4 ° ! 9 • : i I I 1 1 - I 3 9 4 H ■ 1 1 1 4 3 •4 2, ! 3 '9 11 4 25 4 H H I 1; IO9 3' 5 2 5 : 2 2 1 1 18 3 5 I 5'3 14: — ... ... — - — — _ LJ 1 — - — !__! II I :__i — - — l_ — - — — - 1 - — - — — - — - 3 Order i.— Diseases of the Nervovs System. Cephalitis Apoplexy Paralysis Insanity, &c. ... ... Chorea Epilepsy, Hysteria, &c. ... Convulsions Brain Disease, Eye Disease, Sec. Others 3 3 9 ... 3 1 1 4 5 ... ... 1 ... .1 >l ... 2 ... ... ... I 4 1 1 ... I ... 1 ■ • 1 4 2 i *■ 3 10 2 1 ... ;- 4 ... 2 1 ... 3 ...1 I ... 2 1 ... ••• 1 3 1 3 ...I I 1 1 1 1 ... 2 9 1 3 7 ... 1 1 2 1 2 3 1 4 ... ... I 3 1 ... ... 4 1 ... 1 2 1 1 ... ... 2 2 1 1 ■ • 3 5 1 1 9 1 1 '9 1 1 106 37 '7 1 \2 i 7 I I 1 1 . 10 ■■ 2; ... ... I ij ... ... 1 ... 2 ... ... 2 , 1 1 ... ... 4 1 I 1 ... ... ... ... - ... ... ... ... ...! ... ... ... ... ...I I ... 23 2 1 6 - ... j 5 1 20 ! ... '7 ... - ... - " I"' ; - 3 ... 2 - ... - 16 1 ■ M 3 ■ - ? ; ... ... ... ... ... 6 1 2 i ... ... 5 2 180 14 1 I < 3 ... ... " ... ... ... ... ... ... i - ... ... •■• ... : ... ... Total Order 1. ... 1 8 ~ — - - H — [ - — - H H H 1 16 I I I I 8 H h - M 8 — H — — - - - H I- _ - H 1 47 •7 7 1 s ! ?■ 28 ! ' 6 37 4 15 2 1 ... 1 3 1 I 5 3 I 3 1 28 2 2 49 8 1 24 ■ 2 2 40 A A 10 I 1 3 5 I 1 J7 : 1 I 4 443 38 ... ... - ... — — — !— - : — — 1 - - LJ — — - — I _ I — — 1 — — 1 I I Order 2.— Diseases of the Organs of Circulation. Pericarditis Aneurism Heart Disease, &c. 1 2 2 I ' 6 22 172 I 2 7 54 ... 1 ... - ... i ... ... ... - - 'I ... ... - - ... - ... ... - ... ... ... ... ... - ••■ ... ... 6 8 ... ... ... ... 5 - 1 ... : 1 1 28 7 3 2 ... I 1 4 7 I 2] 2 7 *6 1 1 6 5 3 1 1 ■i 1 ... 6 3 ' 3 5 3 16 2 ... 2 ■7 1 5 1 2 1 2 1 2 I 1 1 2 1 1 5 ... - 4 ... ... 1 - - 6 H u 6 I— -4 '< H - \i H H H — 16 - _ - j -J — _ Total Order 2 ... 29 8 3 2 1 2 ... 1 •3 i 4 1 2 7 ... 1 . ... s 3 ! 5 1 2 4 I 51 ! 3 ... 2 2 I 2 3 .0 1 2 2 ... 3 2\ 3° • 1 2 1 . . 1 M 1 - 200 63 ...

H.—7a

Table IV.—Showing the Number of Cases of Disease and of Deaths from each Cause in the various Hospitals throughout the Colony of New Zealand during the Year 1883— continued.

u Orders, Diseases, &c. < if I w rt o u> rt ' 6 a\ 01 rt Q u C c 1!. a o o I I p J 5 z I C « ■a OB u Q i O 2 S c ! - •3 Q II I » Q S < O 9 E 5 D i O 1 ! u a U 3| d a u a rt rt & 1 u n u a Q H U j= ■n c< rt 5 Q rt - S S I I CO «J u a IS U u a I I c3 I u a U .r: Order 3.— Diseases of the Respiratory System. Laryngitis Bronchitis Pleurisy Pneumonia Asthma Lung Disease, &c. 3 20 6 16 1 5 2 ... 4 9 7 } 1 3 i 1 "I » 1 ■a 2 1 3 - i i 6 9 2 ] i j " 1 I 3 1 1 1 - 3 1 ... ... -I 2\ 3 - 6' I ... 1 5 2 ... 1 7 3 1 4 1 1 29 4 24 2 4 1 2 9 s 1 4 2 i 3 3' 1 i 2 ... 2 ... 15 ; 4 ... 9 2 1 "i 18 206 49 170 49 1 ~l 3 16 3 39 1 ... 5 4 4 2 i ' I I: 3 ! ... I I"' 1 *" ... 7 2 ■ ] "6 1 ; 3 ! 1 1 7 7 . 1 1 ... -I I2 1 2 1 1 ... 4 1 1 - 3 2 18 3 3 4 1 1 ... ... ! I I"" ij 1 ; __ ... 12 1 1 2 ... ... ... ... ,1 1 I I ... ... '"I 3 9 66 1 ... ... .. 2 Total Order 3 ... 1 1 1 - H _! ! - 1 1 1 i 1 1 h i ! - - h 6J - - - _ II I — - — I I ... - H 16 - I i 1 H I — - - ... 47 - H — _ - 6 : 64 10 20 2 1 '3 9 2 ■ 21 i h 2 3' ; 2 1 4 4 5 J 5 8 ! 18 ■ 3! 18 1 1 7 IO 3 2 9 •■ 2 , \J1 ! 7 7 21 8 1 '7 2 J 33 4 I -d ... ... 1 1 I _ — I I i — — - — ! 1 — 1 i 1 — — _ i_i __ f Tj~S 3 o Order 4.— Diseases of the Digestive Organs. Gastritis Enteritis Peritonitis Ascites Ulceration of Intestines ... Hernia Ileus, Obstruction of Bowels Intussusception Stricture of Intestines Fistula Stomach Disease, &c. Pancreas Disease, &c. Hepatitis Jaundice, Gallstone Liver Disease ... Spleen Disease... Others s 2 5 ... 3 "3 ...i • 1 2 1 2 I I ... ... 1 ..., ... 1 1 ... 1 • - 1 1 I I 1 a "1 ... 1 1 ■ 1 ... - 1 1 1 I . I ... ... 3';i| 1 -A — 1 — ... ... 1 2 - ... 1 I I 2 4 1 5 1 — I 3 I , >3 1 1 1 ... ... 1 — ... ... 27 2 2 2 ■ J I 1 - i ; 1 4 1 — ... — 1 2 I 2 11 2 4 — 1 ... '"I 1 I 8.1 '4 12 3 16 6 2' 8 1 6 4 6 2 2 2 ... ... .1 4 6 1 1 I... ... 1 2 ... I ! 1 I ■ 3 3 ••■ I ... 3 10 2 ■ 1 '7 "7 2: '" 1 "6 4 21 1 39 1 ;• I 1 1 ■ »s 1 1 ;. ... 1... ......... ... 1 ... E - '"I < I 5 2 ... "1 ... 1 •• 1 2 2 ■ «|- * 1 » 1 ... 1 2 I 1 : 1 ••■ I ... "s ... ... 1... I ... ... ,2 I 2 1 2' 37 8 46 3 I ... I ... 1 1 i 4 1 ... ...1 ... ... 2 I ... 1 ...... ■■ 2 |". ! ...... ... ... 3 • H *!"i ... I 3 3 j 3 ... 2 ' ...... ... . -I 3 i"'l ... 'I ... I ...I 3 i 6 1 «.s ... "I 3 ... ■ 1 ... I 1 ... ... ....... 1 I... ... I- ■•■! ... ... ...... ... 1 ... 1 ... 3 —1 ... Total Order 4 ... Order 5.— Diseases of the Urinary Organs. Nephritis Ischuria Bright's Disease (Nephria) Diabetes Calculus Cystitis Kidney Disease, &c. .J... : 2' 2 I 3 ■ • ■ ... 1 — 8 - 1 2 1 1 1 t 1 |- — hi i 5 1 I 1 — 1 g i 1 1 1 ! t 1 « II ... ! 1 _i i_ — ! ■ 1 48 M 2 — r" \'"\ 13 1 2 II M — ' i I I I ! 1 1 ... 1 12 ... - 1 1 - "1 3] 1 ! I ' l_ 1 I 3 l_ _l ■• _i ""l s "■ I 2 II 5 2 1 I h _ 4 1 ... ... 1 ... 1 1 1 i — "• ... 1 .... ... H 1 11 1 " i_ 1 ... L_ 34 ■ J i 1 — ... 1 1 1 1 1 1 I ... I I I I I "I 33 ~ « II ... I 7 I 1 I ... — 18 I ... ... 1 1 1 1 1 1 1 I H 1 1 1 . I 3 ... 2 " 3 I - (y - ... I \ 2 I I ... "2! "T 4 j_ .0 I !_ j 12 ! •i 1 ' - ... — 24 1 j 1 1 2 — - 8 - _j ... 8 3 10 6 9 33 I 391 I 49 2 "6 1 ...j r> ... 2 I ... ... ... 2 ... •- ~ ... ..J ... ... 1 ... ... 1 ... 2 1 ... ••• I 1 1 • .. ... ... ... 2 1 1 1 I I I M — • ... 11 ■■■ 11 ,1 ' 6 11. 2 ... 3 1 ;--i 3 ... *"| ... ". 1 ... ... 3 ... ... ! . 10 I- ... I 1 ... ... - ... I... ! 2 "■ ... 2 - ... i: 2 4 Total Order 5 ... 4 2 1 3 1 3 I 3 . -' '— 4 H 3 — ~ I I 1 — 2 1 1 _5 H — 1 1 — 1 1 1 1 1 1 I — _ 1 ... ... ... - -, ... ... ! ... 14 2 1 ■ * 1 1 o ■ 2I ■ 94 I ' 4 ... ... ... ... 1 - I - I 1. — 1 1 —i l_ I — — I U _ 1 ... 1 1 1 1 1 ■ '— — ! J \-4 — — 1

H.—7a.

Order 6.— Diseases of the Organs of Generation. Ovarian Dropsy Others 1 ....... i ' 1 1 ... 1... 4 18 3 8 ... ... ... "« ... 3 [ I ... 7 1 1 ... 3 10 ... 1 ... - ... ... ... ... ... 1 ... 1 • ■• 1 "- ... - ... 23 1 1 I - 6 ... .., ... ... ... 2 20 1 ... 7 - 2 ... 1 4 -3 ... 3 ... 13 141 4 2 en o S ... ... ... 1 1 I I** , !■■•: — Total Order 6 ... I 22 j_ 3 8 __ i i 6 :_! 3 H 1 7 1 1 i__ 13 - J 1 1 I I — — i_j _ I 1 I I 1 \__ ■_ -J — 8 I I — _ — 23 1 I w 6 .. 1 5: I I 7 — " 2 - 5 - j>1 [ ... h 3 I L» 6 ... 22 ! ... - ... ... ... ... ... ... ... ... ... ... ■■ i1 1 i ] I - — - - - — — '-i !_J — - — — - M — ~ — — .1 1 1 i_i — — — — — - ! — I ! ! I i !_ i_ I Order 7.— Diseases of the Locomotive System. Synovitis, Ostitis, Periostitis Joint Disease, &c. 3 ... 1 1 3 1 1 \ i, ... I I - I - .... 6 10 ... 1 ;« 1 ... 1 10 " - ... ... ... - ... 4 ... 1 "■ 1 1 4 I ... ! 2 i 3 1 » ... ("" 1 ... ... 1 ... J - 1 - 3 1 12 73 ... 1 - 2 ... 2 "I i 4 ... "■I ... ... i 1 "■ 3 ... 46 I?? 3 ... ... Total Order 7 ... — 1 I ! 1 1 ■ — ~ 1 I 1 16 l_l I I 1 H - — — — H - [ : H >- — - h I — :-! - - I — -4 H :_ _ 35 i ! J H — ' 1 1 2 1 1 4 . S| 5 ! 2 » ■ 1 3 1 3 I ... 85 3--2 ... \ 4 ... 9; - 4 ... I 223 3 — ... - ... ... - ['" ... ... ... - ... 1 1 1 1 1 — - — i_ — — - _ - _ I 1 1 - — - I I — — 11 — — - -i — — — — — — - — — — — — — I ' Order 8.— Diseases of the Integumentary System. rh'.IJ.TOT. Whitlow, &c... Ulcer Skin Disease, &c. 24 .1 5 4 I "I I3| 2 3 1 1 1 I 1'" 1 2... 3 3| 1 3 1 4 6 4 44 16 5 4 2 10 ... 81 1 ... 1...1 T I — i ... - i ... j ... I "I ... ... 3! ... I ■ 6 ..... 3 is I I" ! ... "I ... ... ... I ,-- 7 2 '"I 5 1 1 ... - ••: ... "I - ... '6 1 8 ... 3 1 20 H 1 2 4 16 ... 1 4 3 1 209 130 1 1 1 .6 1 ...I -I ... 1 1 1... r ...I ... 13 ... ... ... ... ... ... ... ... 6 _ — — h H I I I I i — H _ I 1 - — — — - h 1 1 _ - - _ I — — — 1 I ! I H - - — - 64" - — — H - 6 — _ - Total Order 8 ... 1 12 H 13 3° • r 8 3° '4 5 ... M M 4 I _9 7 ! 2 H _9 45 6 9 31 ! 1 i 1 — 4 7 i 4 ... 420 1 ... ... — ... ... — — ... — — ... — I ... ... ... Total Class III. ... I 1 H - H - _ — I I 1 H - H - h - 1 |_I H I - - 1 1 I H - — H I — - — 1 1 — - I _ 8 — 280' ' f J3 c ; 8 £1 45 2 9 1 [69 K \ 3 2 -! '45 = 4 42 4 11 2 4 3' I 2 I W '28 4 37 I 2 '60 4 18 4 144 A 1 3 2;3 34 5 74 1 3 +° 46 5 345 36 35 i 70 4 J 5 I 5' 4 139 32 2,442 240 ... — I ' 1 1 - I_J I — — — — I _ ! ■ II 1 : j 1 1 — _i — EC V! ■A 5 OrdeE I.— Developmental Diseases of Children. Premature Birth Cyanosis Spina Bifida Other Malformations Teething Others ... ... " ... ... ... ... ... ... ... ... ... "T" I ... ... ... .... — ... ... ... ... ... - ... ... ... ... -I ... -1 1 ■1 ... ...i ... 2 ... ... 2 "1 ! ... ... ... ... I '"I i ■" 2 ... ... 4 ... 1 ... ... ... 3 ... ... ... ... i ... ... ... ... 2 1 9 ' 2 I ... ... • J I- ... — I I - — _ J I 1 — — i I _J 1 1 __ : — — _ I I I " 1 - 1 I l 1 — 1 — _L _ ! i 1 I 1 i — — ! t - — H — Total Order 1 ... 1 ... 2 2J ... I 4 ... ... — 3 ... I ... ... ... 15 ... ... — ... ••• ... ... — ... ... — I 1 L_l 1 1 i_ — _ — — 1 — I — — - — — — — - — - — - — [ — - - — ! _ - — — — — — I — 1 - _ ! — I ! o > 1—1 Order 2.—Developmental Diseases of Adults. Paramenia Childbirth (see Metria) ,.. Others 1 ... - ... ... - ■ ■•1 ... 1 84 20 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... ... I »l ... ' 2 1 1 1 7 1 I I ... ... |...| I -I • ... ... I— 10 J i I -I -I I... " I--I ... ... ... _ t 1 1 M _ I 1 1 Total Order 2 ... r""i II — : 1 1 1 1 __ i 1 1 I 1 _ 1 — — :—! 1 1 I I I _ ! I— 16 _ H — - ; i I II " 1 2 I a 74 2 ! i I ! ...j ! i i°5 3 ... ... ... ... ... ... — . . ' '" "* ... ... ... - - ! I i — — — ■ 1 LJ I I i — — _ — — __; - II II — — 1 i — 1 1 — 1 I — i_i 1 _ I ! — — Order 3.— Developmental Diseases of Old People. Old Age 2 ! 1 i ' 3 2 . - ' 1 1 4 ... ... 2 15 2 ... ... ... ... I - ... I'" ... 1- ... ... - _ ! - — — _ : ._' 1 1 - - ■ — - I I 1 1 1 _ _ — 1 I — — 1 - ! \ - - 1 i_ I 1 1 1 :_ — '"l — I I — I i 1 - I — - Order 4.— Diseases of Nutrition. Atrophy and Debility Total Class IV.... 14 — 4 H 3 1 . .. — - — — *■! ... — ... 4 2 , 11 I 3 1 26 — ... " s ... ... _i - ... J) 1" ' 1 I ... _ _ 3 ... - 1 1 1 1 ... — ... — — .0 ... 4 ! l 1 8 — ... !— ... — ... ... 3' 107 - 2 ... _l 1 ... ... 9 9 I II , " S | 26| i 8 13 '5 4 11 4 » 8 | 2 8 ! . ... 2 2 4, 4 . 1 3° - 5 • "5 ... Jl ... ... ... ...

H.—7a.

Table IV.—Showing the Number of Cases of Disease and of Deaths from each Cause in the various Hospitals throughout the Colony of New Zealand during the Year 1883— continued.

By Authority: Geobge Didsbust, Government Printer, Wellington.— 1884.

u Orders, Diseases, &c. O — O "a r el ri 7; a 1 1 l|l O 5 i o I o I 31 c a. I 2 si i ll 1 5 S Hi w ri 3 s -s 31a Is I 131 O 3 1 I en rt v. rt i m rt J U Q U Q j U Q a> i rt 1 03 c! ' « 1 rt j 1 rt in s (4 (J O U a II || 1 rt U s rt s II U Q s u o rt 1 u rt i '■j s ! g -S u c ! a Order 1.— Accident or Negligence. Fractures, Contusions, &c. Gunshot Wounds Cut, Stab, &c. ... Burns and Scalds Poison Drowning Suffocation Others 149 1 2 4 67 7 2 * 14 ... ... [O 1 ... 2 9 ■■ ... 1 ... 3' 16 7 1 i 19 : 62 1 ... f i" 'I 1 ! I I 2 2 6 4 2 3 ... 12 1 1 21 I ... !.? 9 "9 ... ... ... !J t 1 1 47 'i ■s 93 22 4 5 I '' .0 > 29 ... 9 5 ! 1 '7 3 ,3 ...I 2 86 ■ 20 9 ' I 24 2 18 1 lc i 1 1 I 2$ H 1 5 2 2 7 I : 8 982 '53 63 2 2 28 1 2 4 - ... 1... ... ■•■: ... ... ...I ... ... 1 ... ... ... 1 I - ... ... 4 3 1... ... .. • ' 2 2 .. - ! : 1 2 ... 1... 26 ... 1 47 1,262 ... "■ ... — •■■ ...I I ... ... ■56 H 76 h i _ — I II — I H !— L I 1 _ _ 6 _ - I H ' 1 1 H :— I I I — _ 26| 1 1 i L.6 ' 6 ~ — 1 I 1 68 H 67 — Total Order 1 ... 4 3 '4 ■i H Jl j « M _z IL ,6 1 6 ,0 •-; . " 2 2 I 9 - ! 65 M 124 5 H « 3 i 3, 28| I 2O| !I : i 1 H 35 ... ... ■■■■ ... 1 i ~ i " I - — ~ II — — ! I I I— _ __ — i 1 — i 1 - — I i— - 11 — Order z.—Batllt ... ... ... ... — ... ... ... ... — ■• ... 2 > Order 3.— Homicide. Murder and Manslaughter Order 4.— Suicide. Gunshot Wounds Cut, Stab, &c. ... Poison Drowning Hanging Others ... I ! l_l ... l_ _ i_ I — _ !— —I ... i_ ... _[ ' 1 11 |...i ! I •■■1 I i - I i !- !__i 1 __ — :-; — — - I — ... __ ... — I — - — ... — ! ■ — 1 — — — I _ 1 1 1 — 1 — — — - _ — ... — ... — — 1 I L_ — — — I 1 __ l_ \r-\ 1 ... I ...... ... ... ... ... ■ ... * ... ... ... ... - ... '• ... ... ... ... ... ... ... !■•• ... ... 1 ... ... ... ... - 2 I .... ... ... 1 1 ... I... I 1 ... ij 1 ... ... ! "1 2 ... ... I ... ..-. ... ... ... ... ... I •■■ ... ! ... - I I i ' I I I I "■'! ... ... ... I »• ,.,.; ... I ... ... I ...I 1 1 .... 1 .... ..., .. ... I ... I ... i_i 1 1 1 1 .... :■■■! ... ... ... ... — I— [-! ! j 1 1 __| I I I I I "I !—! !-! I I i i H 1 1 I I I i ' _ I I — _l h _ — i 1 I 1 1 - — H _ __ — 8 ■ Total Ordef 4. ... ! ■!•■! -I 1 » 1 I • i I 1 ...I ) 1 1 I I 3 — - ... ... ... ... :••• .... — — H _ _ ! I i_ _ — 1 I 60 _ 63 h 28 h 6 — 1 16 6 ■ ! i~~ u I - _ - 66 — — - _ H 26 1 1 116 6 — H 68 - _ . Total Class V. ... !f 7 i 4 ?s <4 ... b 44 ... '3 A 2C 1 4 1 ... - 10 f-> 13 I 1 22 ... 22 ... '9 •A •A 124 5 21 •• 43 3 ... 3' ... 29 2 20 .. 1 1 _6? ! 8 1,270 83 3S _ — — I — - I- — — — — — — _ :— - II I i -J I 1 t — Causes undefined 24... I 16 1 I I 1 2 I ; Jl 1 1 ... ... 3 ... ... ... ... ... — ... ... ... — ... ... — ... - ... — ... ... ... ... ... — — j" i i_i — _ — !_ II ! -! - - — - - ;- ! 1 i — 11 — — — I I — 1 1 1 I 1 - Abscess undefined ...... i 733 H 1 ..J 2 7 ... '7 1 ... ...... ... ... ... ... - " — — ... ''I ... ... ... ... - '"I fl - I \~\ I I I _! H _ — I I — H H 6 I - - '; - H H H H — h io8 h - — 1 - 656 - - — H - _ H 986 - 8 H _ l_ 161 - — _ H General Totals ... ! "3 14 *9 6 '47 -:; : J334! ,8 94 J 444; 37 M '4 3° •9 3 H ! ■ 5 H 75 s 92 \A I 42 6 |293 13 3* 3 w 138 u W M 8, ! 3| SS 8 ! '03 •37 • .. P7S '5 54 497 I i

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HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS., Appendix to the Journals of the House of Representatives, 1884 Session I, H-07a

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HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS. Appendix to the Journals of the House of Representatives, 1884 Session I, H-07a

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HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS. Appendix to the Journals of the House of Representatives, 1884 Session I, H-07a

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Bibliographic details

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HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS. Appendix to the Journals of the House of Representatives, 1884 Session I, H-07a

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No known copyright (New Zealand)

HOSPITALS IN NEW ZEALAND (REPORT ON), BY INSPECTOR OF HOSPITALS. Appendix to the Journals of the House of Representatives, 1884 Session I, H-07a

Using This Item

No known copyright (New Zealand)