8
disease of the heart and one died from bronchitis. It will thus be seen that
general debility is credited with about half the mortality of the year, deaths from
cholera excluded : these cases of anœmia or general debility are the most hopeless
and unsatisfactory that are met with in the asylum ; the ages of four ranged from
65 to 71 years. I gave details of a number of such cases in the Report for 1887,
and the Chief Commissioner in reviewing the report expressed his conviction
that no one death could be ascribed to any cause connected with the conditions
of the asylum or the treatment of its inmates; and stated that in most of the
cases the patients were kept alive in spite of themselves. Again in 1889 the
same causes were in operation, viz., an unhealthy year generally and a feeble set
of patients. I should probably be considered wearisome were I to give details
of these fatal cases as I gave them in 1887; I confine myself, therefore, to three
only, taken at random, they will serve for all fairly well. I have tried every
thing that seemed suitable for these cases, but some go steadily downwards du-
ring sickly years, never improving at all. As in 1887, mortality from fever was
heavy, many of these cases (9) succumbed more from the effects of fever than
from the disease itself; the patients refuse food, get puffy faces, swollen legs,
and run down.
General Debility.— No. 8—Shaik Enayet, admitted November 1875, aged
48 years, weight 115 lbs., suffering from chronic mania. Angry, excited, refuses
to work, subject to various delusions, removes all clothing when within enclo-
sure, suffered from remittent fever in April and May which reduced him greatly ;
became anœmic and peevish, refused all food, got œdema of feet and sank in
July : illness lasted 3 months and 4 days. Residence in asylum 13 years and 8
months. Superintended working parties.
No. 20—Kurson, admitted March 1888, aged 54 years, suffering from chronic
mania, weight 110 lbs. Very incoherent, at times violent, never assaults,
only threatens, collects rubbish, eats badly, sleeps well. Had severe small-pox
in April, recovered from this, health began to fail in August, fed with difficulty.
got œdema of feet and died in August: illness lasted 4 months and 7 days.
Residence in asylum 21 years and 5 months.
Fever.—No. 31—Ramaswamy, admitted October 1878, weight 127 lbs, aged
40 years, chronic mania. Very noisy and talkative, jumps about, snatches chap-
patties from others, attacked with fever on 1st November which continued till the
15th when he was very anœmic, got œdema of feet, refused all food and died on
the 1st of December: illness lasted 30 days. Residence in asylum 11 years, 1
month: did a little work, carrying water.
Admissions to hospital numbered 121 against 57 in 1888 and 124 in 1887;
they thus just touched the number recorded in one of the most unhealthy years
on record, and were more than double the number for the previous year.
The asylum had been free from cholera since 1883, when one case took place:
eleven cases, eight being fatal, occurred in 1889. Cholera was reported in the
eastern part of the district early in February: on the 16th of April some cases
occurred in the city and on the 23rd a serious outbreak occurred in the Sadar