This completes a résumé of the chief changes made in twenty-eight years. It was an unsuccessful attempt to manage a high admission-rate, no longer considerably helped by a high death-rate, in establishments not sufficient to deal with even a quarter of the admissions. Persistent overcrowding only palliated the excessive discharge of patients, and produced great difficulties in administration. The occupation of the dining rooms and corridors by beds prevented ordinary convenience. A high accident-rate and a low recovery-rate were inevitable results of the overcrowding. We were often forced to admit over a thousand cases a year, and to discharge as many, less the number of deaths. Meanwhile these discharged cases committed crimes, and we were continually incurring criticism for our actions. Whenever an extension of accommodation was granted, it was so small, and it took so long to provide, that on its completion it was swamped at once, and the overcrowding was but little relieved. Besides managing the Hospital, one had to besiege the authorities for funds for buildings, in season and out of season, and to take every opportunity to interest them in the work, and educate them as toits importance. The lack of beds for the insane in Egypt remains grave, while in England there are 8,663 vacancies (vide Blue Book for 1922). In twenty-eight years the number of beds for the insane in Egypt has risen from 300 to 1,841. Thus there are now 14 beds to every 100,000 of population. Compare 250 in England, and 3 in India to every 100,000. It is still seldom possible in Egypt to treat curable cases until their recovery; thus 527 uncured cases were discharged in 1922, and still only the dangerous and unmanageable can claim hospital treatment.