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racked with pains in his loins. He ultimately became dropsical. He survived about three months, and after death both kidneys were found studded with masses of white cancerous deposit.

Fractures.—There were three fatal fractures during the year. First, P. C. aged 50 years, brought to hospital in a state of insensibility, having fallen from a loft on his head against the pavement. Died same day. Base of the skull was found to have been extensively fractured. An inquest was held next day. Second, D. B., aged 56 years, similar in most respects to the last, except that the subject fell into the hold of a ship. Third, J. D., aged 17 years, admitted November 5th, from Kaipara, with a compound and comminuted fracture of right leg. It being too late to amputate, an attempt was made to save the limb; matters seemed to go on favourably for some days, but vomiting supervened, and death took place somewhat unexpectedly. Much more extensive injury than was at first apprehended was found after death, even the knee joint being filled with blood.

CARIES.—W. W., aged 58 years, admitted May 12th, for caries of the left thigh bone of many years standing. An operation of partial excision and gouging was performed, but without permanent benefit. The whole of the bone was found diseased after death.

PARTURITION.—M. McM., aged 35. This was a case of difficult labour sent down to hospital from Papakura. Delivery had been too long delayed, and the woman was in an exhausted state on admission. Gangrene of the parts concerned ensued. Prodigious tympanites took place long before death.

GENERAL DEBILITY.—First, J. A., aged 76 years, admitted immediately on her arrival from Melbourne, in a state of utter prostration. Second, R. A., aged 98 years, had been in hospital 18 months. Third, T. P., aged 58 years, admitted primarily for general debility, the effect of intemperate habits; subsequently he became epileptic, and died comatose: evidence of serous apoplexy was found after death. Fourth, S. V., aged 65 years, had long suffered from chronic bronchitis and urinary complaints. The diagnosis was fully verified on dissection. Fifth, M. K., aged 58 years, admitted originally for ascites, for which she was tapped eleven times, with the result of a complete cure. A few days before her death she was attacked with pleuro pneumonia of the left side: lung found hepatized, and the liver in a shrunken state. Sixth, M. M. M., aged 74, moribund on admission. Seventh, J. B., aged 63 years, in hospital three weeks: gradually sank.

There is urgent need of increased accommodation for female patients, who are at present crowded together into two small wards and a garret. According to present arrangements we are unable to classify these patients, many of whom are of the most degraded sort. Association of the young and virtuous with such must be contaminating, and yet it cannot be entirely avoided. Part of the old asylum might be appropriated with a view to remedy this evil. In fact, it would be best to remove all the females thither, and devote the whole of the hospital to the males. Thus the present most objectionable practice of making beds on the dining-room floor would be obviated. If this cannot be done, to prevent the meeting of male and female patients in the hospital passages, the corridor might be partitioned off and a separate entrance made for each sex. It is also recommended that the rear of the hospital be enclosed with a wooden fence, which would have the effect of rendering the wards more comfortable, and excluding the public gaze. At the present low price of timber and wages, the changes above mentioned might easily be introduced.

A coal-shed is also greatly needed. Since the last report a very great desideratum has been obtained, in laying down water-pipes from the reservoir to the asylum, so that we have now a constant supply of water at all seasons. The work of carrying the water from the asylum to the hospital is performed by the convalescent patients.

VISITATION.

The hospital visitation for the year has been as follows:

Visits.

• Ladies of Church of England ... 101
• Clergymen ... 250
  • Church of England ... 82
  • Presbyterian Ministers ... 11
  • Baptist ... 48
  • Independent ... 8
  • Wesleyan ... 15
• Members of Provincial Council ... 15
• Commissioner for Sick, &c. ... 18
• Medical Gentlemen ... 178
• General Public ... 43

Total ... 764

T. M. PHILSON, M.D.
Provincial Surgeon.

March 14th, 1867