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for diet and payment of outstanding bills of the previous year for bedding and
clothing. An amount of Rs. 1,403-9-0 was spent to purchase movable iron
latrine seats (Durbar Pattern) to replace the bamboo baskets formerly in use
for the purpose, thus improving the general sanitation of the hospital. The
average annual cost per head excluding the Public Works Department charges
was Rs. 259-13-7 against Rs. 211-11-7 in 1923. The Public Works Depart-
ment charges per head in 1924 was Rs. 5-2-7 against Rs. 2-4-10 in 1923.
Staff.—The work done by the subordinate keeper staff was, with a few
exceptions, not altogether satisfactory. Owing to their ignorance, laziness
and generally unsympathetic attitude they failed to realize that this place was
a hospital and the unfortunate inmates were patients to be nursed and looked
after and not convicts under jail warders. When the present Deputy Super-
intendent Dr. J. Roy tried to inculcate the principle to be followed in the
treatment of patients and insisted on the observance of rules laid down in the
Bihar and Orissa Lunatic Asylums Manual, there was a general strike
amongst the keeper staff. Dr. Roy managed the situation tactfully and
brought round most of the keepers, but 13 remained obdurate. Both from
consideration of discipline and of common humanity it was not possible to
retain in the service men who refused to carry out orders given with a view
to secure proper attention to the primary needs of the sick inmates of the
mental hospital, and so I dismissed these 13 men from Government service.
This step undoubtedly produced some salutary effect, but still much remains
to be attained. If the institution is to be looked upon as a hospital then the
proper nursing and supervision of the patients should be secured by the employ-
ment of an adequate number of nurses—male and female—recruited from
fairly educated classes who can make intelligent observation about the conduct
of the patients and also constantly supervise the work of these ignorant and
illiterate keepers. I would therefore suggest that this point may be carefully
considered while making appointments for the new hospital at Kanke.
General.—It has always been extremely difficult to get correct and detailed
information about the family and previous history of the patients. The
descriptive-roll which is to accompany each patient, is required to be filled up
by a police officer, and more often than not these are either most haphazardly
filled up or valuable informations are withheld by the relatives of the patient
through their ignorance or suspicion of a police officer. Whatever may be the
reason the informations thus collected are, from the scientific and therapeutic
point of view, quite valueless.
In some cases medical certificates granted have been very unsatisfactory.
Establishment.—Lieut-Col. H. R. Dutton, M.R.C.P. (Lond.), P.T.M. & H.
(Camb.), I.M.S., was the Superintendent of the Hospital from 1st January
to 16th July 1924 and again from 17th November to 31st December 1924,
and Major A. W. Duncan, I.M.S. held charge from 17th July to 16th November
1924, when Lt.-Col. H. R. Dutton was on leave.
Dr. Ashutosh Brahmachari, M.B., was the Deputy Superintendent from 1st
January to 25th January 1924. He was succeeded by Dr. Jyotirmay Roy,
M.B., D.P.M. (Eng)., who remained in the post to the end of the year. Owing to
Dr. Roy's special training in England and his sound knowledge of mental
diseases, the general treatment and welfare of all the patients have been very
considerably improved. Proof of this is reflected in the number of cures and the
low death-rate. Sub-Assistant Surgeon Jogesh Chandra Guha was on duty
throughout the year and performed his duties very satisfactorily.
H. R. DUTTON, M.R.C.P. (Lond.),
D.T.M. & H. (Camb.),
LT.-COL., I.M.S.,
Superintendent, Patna Mental Hospital.