No. D/1625 OF 1918.
OFFICE OF THE SURGEON GENERAL
WITH THE GOVERNMENT OF BOMBAY:
Poona, 25th June 1918.
From
THE HONOURABLE SURGEON-GENERAL R. W. S. LYONS, M.D., K.H.P., I.M.S.,
Surgeon General with the Government of Bombay ;
To
THE SECRETARY TO GOVERNMENT,
General Department, Bombay.
Sir,
I have the honour to submit, for the information of Government, the Triennial
Report on the Asylums for the treatment of Insanes in the Bombay Presidency for
the years 1915—1917. It is to be regretted that the improvements of lunatic asylums
in India has not kept pace with the improvement which has taken place in our hospitals
generally. But the fact remains that while hospitals are designed, staffed and equipped
suitably for the treatment of medical and surgical cases on the lines of western medical
science, our asylums are much behind in these respects. In England insanes are treated
in "Mental Hospitals" in which their mental diseases receive as careful individual
attention as cases of bodily illness receive in general hospitals, while in India our lunatic
asylums are little more than their name indicates, refuges for insanes, where they are
prevented from harming themselves or others and receive such care and treatment as is
possible. The designation " lunatic asylum" is a bad one and should be replaced by that
of "hospital for mental diseases" as in England. If this were done it would keep more
prominently in view the nature of these institutions and the object which they are
meant to achieve. It will be seen from the statistics of the three years under review that
there is a considerable and steady increase in the number of patients admitted. This is
due to many causes, but principally to economic stress which renders the public less
tolerant of wandering or uncared for insanes and prevents friends and relatives devoting
to them the time and attention possible when the cost of living was cheaper and the
conditions of life less exacting. It is partly due also to the fact that the public are
beginning to recognise the advantages of giving these cases the benefit of treatment
at an earlier period of the disease than formerly. They know that the sooner a case
of. bodily disease comes under hospital treatment the better, and they rightly argue
that this applies also in the case of mental diseases. Consequently patients are
sent to asylums earlier and recoveries are quicker and more frequent. The increase
which has occurred in the total population of the asylums of the Bombay
Presidency during the past three years is 22 per cent. above that of the previous
triennium and has led to over-crowding of all the asylums in the Presidency and, as
time goes on, a very much larger asylum population must be expected until the greater
portion of the insanes in the Presidency are accommodated. At present there is only
room for 1,224 insanes in our asylums while the estimated insane population of the
Presidency at the last census was 6,270. This figure must be much below the real
number, owing to the fact that the enumerators were laymen, who only entered as
insane those who were evidently " mad," the early cases of mental instability and quiet
cases passing unnoticed. It will be seen that only about one-fifth of the estimated insane
population are under treatment and that probably one-sixth would be more nearly the
correct figure. It may reasonably be anticipated that as years pass a progressively large
population of these mental cases will be admitted for treatment, and to meet the present
needs and provide for this anticipated increase, a very considerable increase in the
asylum accommodation is necessary. When the extensions of the asylums are being
built, to meet the ever-growing requirements, they should include the provision of
quarters for "voluntary boarders" who come for seclusion and rest, and provide sections
where the different classes of patients could be suitably kept in comfort and with less
prison-like surroundings than present arrangements permit. In short, they should
provide a number of wards comparable to a general hospital's wards but suitable for
mental cases. The attendants should be men and women nurses specially trained in the
care of insanes. At present our asylums are far behind our hospitals in this respect, but
it is hoped that wealthy and benevolent donors who do so much toward providing
trained nurses in our hospitals and maternities will also assist in providing attendants
trained in caring for the mentally sick.
Buildings and Repairs.
2. During the triennium under review, owing to the financial situation created by
the war, most of the works of importance, including the increased accommodation
required in the Ahmedabad, Dhárwár and Ratnágiri Asylums, sanctioned in Government
Order, General Deparement, No. 7377, dated 23rd September 1915, had to be postponed.
In consequence only the following absolutely necessary minor additions and alterations
were made.
3. At the Naupáda Asylum a room was added to the kitchen to serve as a scullery.
Expanded metal fan-lights were placed above the doors of the lunatic cells to improve
ventilation and dust-bins were provided for the servants' lines. A block for 32
non-criminal male insanes—part of the accommodation for 99 insanes, sanctioned in
Government Resolution, Public Works Department, No. C.W.—2179, dated 6th November
L 21—1