( 3 )
The number at Bareilly was the same for both periods, a slight variation took
place at Benares while the Agra incidence decreased by 77.
Bareilly.— Of the 76 deaths at Bareilly pneumonia accounted for 13, phthisis
for 18, epilepsy for 5, Bright's disease for 4, dysentery and diarrhœa for 15. Of
the 13 deaths from pneumonia 9 occurred in 1909 and 3 in 1910. There was only
one death from this cause in 1911. It was a case of acute mania, the patient being
constantly excited. He was very destructive, tearing up and throwing out of his
cell the whole of his clothing and bedding. He contracted pneumonia from
exposure, and being in a very run-down condition soon succumbed to the disease.
The deaths from phthisis decreased from 10 in 1908 to 6 in 1909. The number
rose to 7 in 1910 but fell to 5 in 1911. The construction of an isolation ward for
tuberculous cases in 1909 will, no doubt, tend to still further reduce the mortality
from this disease.
In 1911 one death was due to heart failure following on old age. The
patient had been 37 years in confinement and was 60 years old when he died. Two
died from exhaustion and anæmia due to round worms. Both were admitted in
bad health and one had been in confinement for almost 16 years and her age was 50
at the time of death. Both were confirmed earth eaters. At my inspection in
July last I informed the Superintendent that it would be worth while investigating
such cases for anchylostomia which is often harboured at the same time, and is a
more frequent cause of pernicious anæmia.
In one case death was due to
aneurysm of the Aorta in an old man, 63 years of age, who had been in confinement
for nearly 16 years. A female patient died of acute yellow atrophy of the liver, and
a case of plague proved fatal.
As started in the last triennial report the large number of deaths in 1908,
(35) was due to the health of the inmates being seriously affected by malaria which
undermined the health of the old and feeble. Although the daily average strength
during 1909 was about the same as in the previous year (290.98 against 300.25)
the death rate decreased from 11.66 to 10.65, and in 1910, with a higher daily
average of 299.10, it fell to 5.34. This is, I consider, satisfactory. The death
rate rose in 1911 to 9.10, but the daily average strength also rose to 318.60. The
following table shows the condition of health on admission of the patients who
died, the ages at which death occurred and the length of confinement of those
who died :—
Year.
1909 ...
1910 ...
1911 ...
Condition of health.
Good.
8
3
4
Fair.
10
5
9
Indifferent.
2
1
4
Bad.
11
6
9
Very bad.
...
1
3
Total.
31
16
29
Age at time of death.
Under 20.
1
...
...
Between 20
and 40.
9
7
12
Between 40
and 60.
16
8
10
Over 60.
5
1
7
Total.
31
16
29
Length of confinement of those who died.
Under three
months.
2
2
1
Under
one
year.
4
3
5
Under two
years.
2
2
2
Under
five
years.
2
2
4
Under
ten
years.
5
4
7
Under fifteen
years.
5
...
2
Under twenty
years.
6
...
2
Under twenty
five years.
1
...
2
Under thirty
years.
2
1
3
Under forty
years.
2
2
1
Total.
31
16
29
Benares.—The death rate (5.81) in 1909 was the lowest during the last six
years. It rose to 7.23 in 1910, which is lower than the rate recorded during each
of the three years of the previous triennium. The death rate of 13.50 in 1911 is,
however, the highest recorded during the last six years. There were in all 45
deaths against 25 in 1910, and 20 in 1909. This is the more noticeable as the daily
average strength was 333.35 against 346.00 and 344.00 during the two preceding
years. Of the 45 deaths dysentery accounted for 19. Lieutenant-Colonel Crawford
remarks " I think it is a question how many of these deaths are really attributable
to true dysentery. The inmates of the Asylum are so infested with worms (Ascaris
lumbricaides) that it is probable that the initial lesion in the bowel is caused by these
parasites, the resulting ulcer forming a suitable 'nidus' for the dysentery bacillus
to settle in. Two deaths were returned under the heading Ascaris lumbricaides,
both very anæmic individuals, one of whom had 15 full grown round worms in his
intestines after death, the other vomited one and passed 43 while in hospital.
The parasites are probably acquired through mud eating and other dirty habits