6
REPORT ON THE LUNATIC ASYLUMS OF BURMA FOR THE TRIENNIUM 1918-20.
Statement
VI.
18. The types of insanity do not seem to have varied much of late years.
Heading III—" Result of Infection, toxic and other general conditions" has
increased from 24 in 1918 to 45 in 1919 and 36 in 1920, and seems to point in
the same direction as the figures in statement VII, i.e. increasing use of drugs.
Statement
VII.
19. Statement VII deals with the supposed causes of insanity dividing
them into " Predisposing " and " Exciting."
In the return for 1920, no entries appear under the head of "exciting
causes," while many such entries are given in the last triennial report, and in
the returns for 1918 and 1919. The Superintendent gives the following explana-
tion of this procedure: " It was brought to my notice that the Yeravda Asylum
under the charge of Major W. S. J. Shaw. I.M.S., in its report for the year 1919
published in 1920 left the column for entries under exciting cause blank and this
procedure was therefore adopted as it appears probable that the great number of
common conditions previously entered as exciting causes, and which are common
to vastly greater number of persons who never develop insanity, were far more
likely to be correctly assessed as only predisposing factors whether found singly
or multiply in any case, the exact exciting cause that brought insanity out, in
one among millions of drunkards, of ganja consumers, of disappointed lovers, of
bankrupts, or of puerperal females, being presumed to be some pathological
condition or group of conditions as yet unelucidated. It will be noted that in
conformity with the above view all the 'common causes' previously scattered
promiscuously about to give figures in both the predisposing and exciting columns
are recorded in the 'predisposing column.' "
I do not agree with the above, but it is a question for alienists to decide. In
the latest returns at my disposal from Lunatic Asylums in India, this method has
not been adopted.
In 1917, 106 admissions were shown under the head of " no cause assign-
able" this fell to 6 in 1918, 16 in 1919 and 1 in 1920. The value of such
statistics for the purposes of comparison is nil.
One fact however stands out clearly, the great increase in the number of
cases of insanity attributed to drugs. In the previous triennium, 48 cases were
shown as due to one or other of the following drugs, alcohol, opium, including
morphia, cocaine and ganja. During 1918-20, this figure has risen to 87.
There exists a general impression that addiction to drugs is on the increase
in Burma, and these figures lend support to the belief.
Statement
VIII.
20. Finance, Rangoon.—The cost of upkeep amounted to Rs. 2,15,288 as com-
pared with Rs. 2,26,858 in 1919 and Rs 1,72,887 in 1918. The higher cost in
1919 was due to expenditure by the Public Works Department amounting to
Rs. 42,363 in 1919 as compared with Rs. 8,327 in 1920. Apart from this item,
there has been a very general increase in most forms of expenditure owing to high
prices. The cost of diet was 50 per cent. more in 1920 than in 1918, bedding
and clothing 75 per cent. and bazaar medicines 81 per cent. Only a small portion
of these increases was due to increase in the population.
The average cost per head in Rangoon was Rs 215 in 1920, Rs. 193 in
1919 and Rs. 164 in 1918. The corresponding figures in Minbu were Rs. 150,
Rs. 131 and Rs. 115.
Statement
IX.
21. Staff.—Civil Assistant Surgeon C. S. Krishnasawmi Iyer was in charge of
the Rangoon Asylum from the 1st January 1918 to the 5th April 1920 when he was
relieved by Military Assistant Surgeon F. H. O'Leary, who in turn was relieved
on the 13th December 1920 by Captain H. H. Robson, I. M.S., belonging to the
alienist department. The latter officer is proceeding on leave to Europe and,
while there, proposes to make a study of Modern Asylum Construction. On his
return, his experience should be most valuable in supervising the building of the
Male Section of the New Asylum at Kokine which has not yet been begun.
Dr. O'Leary deserves great credit for his management of the Asylum
during the greater part of 1920. Discipline improved and friction diminished
under his regime, while the health of the inmates, as evidenced by the fall in the
death rate, in the daily average of sick inmates, and in the percentage of patients
who lost weight, distinctly improved.