entirely in accordance with modern progress. While it would be most beneficial under the present circumstances of the Lunacy Law, in the event of legislation being considered on the lines suggested by the recent Report of the Royal Commission in Lunacy for England, this addition to the hospital would easily make the hospital an ideal clinique for the whole of the County of Lanark.

The medical care of the patients continues to be characterised by a conscientious endeavour to do all that is possible to restore the patients to health or to ameliorate their condition, and in carrying out this work the medical staff is ably assisted by a competent and well-trained nursing staff.

It was gratifying to observe the kindly relationship existing between the nurses and their patients.

Favourable reference is made to the large number of post-mortem examinations which it has been found possible to conduct.

All parts of the institution were found in good order. The sittingrooms were bright with plants and flowers, comfortably heated and well furnished. In the dormitories the beds and bedding are kept in good order and thorough repair.

The dietary is highly satisfactory and the food supplied was tasted The milk at both visits. It was well cooked, good in quality, sufficient in quantity and served in an appetising, efficient and orderly manner. supply to the Asylum is entirely from the Asylum farm; it is tuberclefree and in regard to quality is of a high grade.

The general health of the patients is good and suitable attention is paid to out-door exercise and employment. At the first visit no less than 169 male patients were employed as garden workers or farm servants.

On the Sunday previous to the first visit 452 patients attended Divine Service and 376 patients were capable of taking part in associated

amusements.

Midlothian and Peebles District Asylum.

Inspected 1st April and 20th December, 1926.

(Average number of patients resident during year, 347.5.)

All parts of this institution were found in good order, clean and tidy. At the second visit, however, it was observed that the heating system was not being used owing to the expense of coal, but an assurance was given that the heating of the institution would be resumed at once. The beds and bedding in the dormitories are of a modern description. and the bed-clothing is sufficient and suitable.

Much repainting and redecoration of the wards still require to be done and should be undertaken as soon as possible, as bright and cheerful surroundings are of much importance in the care and treatment of mental patients.

The alterations in the bathroom and lavatory accommodation in No. 1 Ward of both male and female sides and the erection of Nurses' quarters have been under consideration for a long time and it is most desirable that these alterations and improvements should now be begun.

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The dietary of the patients is satisfactory and the food seen was suitable in quality and each patient had an adequate supply.

The patients generally were found in good health, and their medical and nursing care is reported as being carried out in a skilful and kindly

manner.

Satisfaction is expressed with the large number of post-mortem examinations which it has been found possible to conduct.

The management of the Asylum is represented as being carried on in a thoughtful and kindly manner.

Morayshire District Asylum.

Inspected 7th April and 15th September, 1926.

(Average number of patients resident during year, 156-0.)

It is proposed to improve the conditions of the general bathing by the erection either of a new bathroom for the whole institution or of a bathroom attached to each side of the institution. If these bathrooms are erected, and it is necessary to have baths and bathing accommodation of a more modern description, the District Board might consider the question of building bathrooms which will not only meet the needs of bathing but can also be used for hydro-therapy, which is very advantageous in mental and nervous troubles, and of associating with the bathroom a

sun room.

The electric lighting system has now been installed and its advantages are manifest in every department in the institution.

All parts of the institution were found in excellent order, clean, well ventilated, suitably heated and comfortably furnished.

The patients are well fed and suitably and tidily clothed. The clothing of the women was neat and attractive.

Favourable mention is made of the medical and nursing care. It is believed to be both efficient and kindly.

Such patients as were able to be occupied were engaged in varied employments with obvious benefit to their physical and mental health. The management is reported to be efficient and painstaking.

Paisley District Asylum.

Inspected 19th March and 20th October, 1926.

(Average number of patients resident during year, 243-0.)

Approbation is again expressed of the high recovery rate which continues to be maintained in this institution. For the period under review it is 53 per cent. calculated on the number of admissions. This in itself represents the skill and attention given to the patients from a medical point of view, though there were other evidences of efficiency in the care and treatment of the patients in the hospitals and generally throughout the institution.

The medical administration is ably supported by a competent and conscientious nursing staff.

Mention is made of the department for Occupational Therapy. It is carried on with marked enthusiasm and progressive thought, while its advantages for certain types of patients are now beyond question.

The conditions at Hawkhead House have been much improved by the redecoration of the dormitories and other rooms which were not formerly in use.

It has been proposed to substitute one of these large rooms for the present sitting-room which has been condemned in previous reports, but a more desirable arrangement would be the conversion of two rooms on the ground floor into sitting-rooms and a third room, which could be easily entered from the outside, into a boot room and lavatory for the convenience of the patients.

Arrangements are being made at the farm steading for the better housing of the cattle. This is an important matter as it involves the question of the cleanliness and satisfactory state of the milk supply which can only be obtained by keeping the cows in modern hygienic conditions. Several of the institutions throughout Scotland have tubercle-free herds of cattle and this should be the aim of the Authorities of an institution where, unless careful precautions are taken, tuberculosis is apt to be relatively frequent compared with general hospitals.

The management of the institution continues to deserve the favourable comments that have been embodied in previous reports regarding its efficiency and concern for the best interests of the patients.

Perth District Asylum.

Inspected 29th April and 15th October, 1926.

(Average number of patients resident during year, 384-0.)

All the patients were seen individually and in general were found to be enjoying good health. They are sufficiently exercised in the extensive and beautiful grounds of the institution and all who are capable of benefiting from varied employments are occupied in these works.

The hospitals were found in good order. The nursing is capable and efficient and the medical care is of a most capable description and fully abreast of all modern requirements and methods.

A pleasing feature of the institution is the bright and tasteful manner in which all parts of it are decorated, and though this may appear to be a small matter the influence of bright and cheerful surroundings on the patients suffering from mental disorder has a remarkably beneficial effect and indeed forms part of the treatment.

The dietary of the patients is satisfactory. The food was tasted and found to be well cooked, appetising and suitable in every respect. They receive an ample supply of food and the meals are served in an orderly and efficient manner.

The material comforts of the patients as to clothing and hygiene are most adequately secured.

The management of the institution continues to be of the most kindly and conscientious description and is most efficient.

Renfrew District Asylum.

Inspected 17th March and 13th August, 1926.

(Average number of patients resident during year, 379-0.)

Amongst many noteworthy features of a thoughtful and successful administration it is observed that the villa system is fully utilised in a careful classification of the inmates and that the patients in the observation villas were remarkably quiet and contented. The latter result is largely due to the careful attention paid to active employment. The record of patients employed is very commendable.

The institution of itself is perhaps too small to incur the expense of the introduction of light treatment and various other forms of electrical and therapeutic treatment, but it may be possible to enter into an arrangement with the Authorities at Paisley Hospital to give such treatment when the Medical Superintendent considers it desirable that it should be given.

The number of post-mortem examinations which it has been found possible to conduct receives favourable notice.

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The Reception Hospital is at present occupied on the female side by one patient who contracted typhoid fever and one carrier." As the number of patients continues steadily to increase, it will be necessary to utilise the accommodation in this block for general use and it is hoped that some other means of isolating the carrier will be adopted as soon as possible.

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It is desirable to introduce into some part of the hospital all the apparatus necessary for a Visiting Dentist to make a thorough examination of the teeth of the individual patients throughout the institution and remedy any defects in this respect.

Almost all the institutions in Scotland have each a special dental room and the services of a Visiting Dentist. The effects of this are beginning to be noticed in the improved general health of the patients, and the very marked benefit which some individuals have acquired from the removal of the toxic conditions of the mouth, which in some cases cause mental trouble and in many aggravate it.

The hospital arrangements in this institution both as regards nursing and medical care are of an excellent description, and the general arrangements for the care and treatment of the patients are strikingly complete and modern. While, however, the entire nursing service throughout the Asylum is under the direction of the Matron, there are no female nurses on the male side. The work of the male nurses in the hospital is uncommonly well done, and the care of the restless and excited patients is characterised by great tact, patience and kindliness. It is doubtful, however, looking to the experience of other Asylums if there can be any adequate reason for withholding from the sick and infirm on the male side of an Asylum those nursing services which a properly selected female staff can provide.

All parts of the institution were found in good order. The day-rooms were bright with plants and flowers; the beds were all of a modern description and so placed as to give ample room to the individual patients. The bedding was clean, ample and well attended to.

The dietary is quite satisfactory and the material comforts of the patients are adequately secured.

Roxburgh District Asylum.

Inspected 27th May and 7th October, 1926.

(Average number of patients resident during year, 360-0.)

The two verandahs, which have been erected in connection with the hospitals of this Asylum, were found to be in occupation, and the open-air treatment of patients, especially those newly admitted, is being taken full advantage of with obvious benefit to the patients concerned.

The new mess-room, which has been completed, has been found to be most useful and appreciated by the staff.

All parts of the institution were found hygienic, clean, comfortably furnished and the patients satisfactorily provided for in every material respect.

The medical care of the patients is kindly, capable and conscientious and the nursing is highly efficient.

It is recommended that the District Board should consider the question of appointing a visiting dentist to the Asylum.

The general health of the patients is reported as good and the food provided as excellent in every respect. It was noticeable that a very commendable attention was paid to the needs and even idiosyncrasies of individual patients, and the amount and variety of extra and invalid diet was one of many evidences of a kindly and thoughtful management. The evening meal is supplemented by such additions as gingerbread, jam and cheese, special attention being given to the patients' preference. The condition of the Asylum was found to be very satisfactory. The day-rooms are bright and hygienic, the dormitories clean and comfortably equipped.

An alarm of fire was given from the laundry block. The reply of the Asylum fire brigade was commendably prompt and the drill very satisfactory.

The management of the institution is very painstaking and kindly.

Stirling District Asylum.

Inspected 27th May and 16th December, 1926.

(Average number of patients resident during year, 875.5.)

The whole of the new Reception Hospital in this Asylum is now in occupation and its condition is such as to be worthy of commendation. The latest forms of medical treatment, namely, ultra-violet therapy and electrical baths have been introduced and are already proving of benefit. There is an excellent X-ray installation and a fully equipped operating theatre.

Advantage has been taken of the opening of the new Hospital temporarily to vacate the old Hospital which is being overhauled and redecorated throughout.

The dental room has been well planned and contains all the necessary apparatus. A visiting dentist comes one day weekly.

In connection with the care and treatment of the patients, it is noteworthy that not only is there no record of restraint or seclusion, but there is no such record since 1899. Considering the large number of patients and the admission rate, approaching an average of 250 per annum, this fact alone testifies to the excellent and humane manner in which the patients are cared for.