REPORT ON THE LUNATIC ASYLUMS OF BURMA FOR THE TRIENNIUM 1918-20.
5
The three chief causes of death in Lunatic Asylums, Tuberculosis, Pneumonia,
and Dysentery totalled 39 in 1918, 47 in 1919 and 32 in 1920. For the whole
triennium the number of deaths from these causes was 118 as compared with 73
in the preceding triennium. Even allowing for increased population it is evident
that these diseases have exacted a heavier toll than formerly, and that over-
crowding has been followed by its inevitable result
The number of deaths from tuberculosis alone fell from 26 in 1919 to 18 in 1920,
and the deaths amongst females was reduced from 18 to 12. The daily average
sick has fallen from 172 in 1918 to 156 in 1920, in spite of the increase in population.
All inmates were inoculated against plague in January and against influenza
in July 1920. No cases of the former disease occurred and only 96 of the latter
of whom one died. Anchylostomiasis is not mentioned as a cause of ill-health,
but I feel sure it plays a considerable share in its production.
Minbu.—The health of the inmates was good throughout the year ; there were
two deaths, one from cancer and one from tuberculosis. As only selected
inmates are sent here, the conditions differ radically from those in Rangoon and
no comparison is possible.
The death rate in Indian Lunatic Asylums in 1919 calculated on daily average
strength varied from 5.21 in Assam to 15 in Bombay. The corresponding rate in
Burma was 9.6. In 1920 the Burman death rate was 6.7 which will probably be
found below that of most Indian Provinces.
Statement
II.
14. There has been an increase of 17 per cent. in the average criminal popula-
tion as compared with the previous triennium. This is less than the increase in
civil lunatics, which reached over 25 percent. In both cases the increase has
been almost entirely confined to males.
This increase of criminal lunatics is much greater than can be accounted for
by the normal increase in the population, but whether it represents an actual
increase in insanity amongst criminals or is merely a reflection of the increasing
belief that the criminal is a mental degenerate, and should be treated as such, is
a difficult question to answer. I incline, however, to the belief that many criminals
who would formerly have gone to Jail, now come to the Asylum.
Statement
III.
15. The number of admissions during 1920 was 209 as compared with 212
and 235 in 1919 and 1918 and in all three years about one-half of the total admis-
sions came from Rangoon Town. The reports for the three years of the trien-
nium throw no light on the causes of this state of affairs. It is certainly not
altogether due to the strain of town life, none of the other large towns in Burma
show any increase over rural districts except Mandalay, and even there the
number of admissions in 1920 was 15 only. Nor can the increase be due to the
immigration of large numbers of Indians, for the indigenous population in propor-
tion to its number supplies almost as large a percentage of the admissions as
Indians. The question can only be settled by a careful enquiry into the
antecedents of every lunatic admitted from Rangoon Town. It is certainly
curious that about one-fortieth of the population of Burma should be responsible
for one-half of the admissions into the Asylums, and I rather lean to the belief
that there is something wrong with the statistics.
Statement
IV
16. Statement IV contains details of the various occupations followed by
lunatics previous to their admission into the Asylum, but no reliance can be placed
on these figures or any deductions drawn from them. For instance in 1918, 48
labourers were admitted, whereas in 1919 and 1920 there were none. In 1920,
15 patients were admitted who had no occupation—a heading which does not
appear in 1918 or in 1919. Twenty-five admissions in 1920 are shown as" unknown"
against 18 in 1919 and 4 in 1918. Forty-seven cultivators were admitted in 1920,
39 in 1919 and only 3 in 1918. These differences are evidently due to vagaries
of classification and not to any real alteration in the occupations from which
patients were drawn, but they make any comparison of the statistics valueless.
I hope the future will show a more systematic and reliable classification.
Statement
V.
17. Statement V shows that 74 per cent. of the patients admitted, were
between 20 and 40 years of age, which I believe is in accordance with experience
elsewhere, the most active period of life, when the physical and mental strain is
greatest, is the age that supplies the largest number of inmates.