NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Report on the Lunatic Asylum at Nagpur for 1887.
ADDITIONS AND ALTERATIONS.
These were few and unimportant; worn out wood bars gave place to new iron
ones in the west bungalow, greater security has thus been secured. The bars of
barracks one and two were strengthened. A room has been added to the cook
house for storing purposes and a new iron sun-shade was fixed over the doors
of the female cells for protection from sun and rain, Lunatics continue to
improve the environs; indeed the general appearance of the place has been
quite changed during the past few years.
STATEMENT NO. I.
2. Admissions exceeded those for the previous year by four but were fewer
than those for 1885 by thirteen ; they exceeded the average annual number of
admissions for the previous ten years (Berar admissions in 1884 excluded) by
nine. Of the eight re-admitted four were relapses after intervals of from two
to seven years. Of the remaining four two were merely transfers from the
criminal to the non-criminal list on expiry of sentence, two were discharged for
trial and readmitted.
3. Thirty-seven left the asylum under these conditions ; 21 were cured, the
highest number on record; of these 9 suffered from acute mania and recovered
after intervals varying from two and half years to two months, the average
residence being just under one year. One case of chronic mania was discharged
after one year and six months' residence: 7 acute dementia cases were dis-
charged after residence varying from two years and five months to four months
the average residence being seven months. One very mild case of chronic
dementia and 3 cases considered not insane on admission to the asylum were
discharged after short residence.
4. Of the 7 shown as improved, two acute mania cases were made over
to friends after a residence of nearly six and four months respectively: a case
of chronic mania was similarly made over after twenty months residence : and a
case of melancholia was similarly disposed of after four months, whilst three
cases of chronic dementia were discharged after residence respectively of
twelve years and two months.
5. Of the 9 discharged otherwise. two criminal lunatics having recovered
were sent to the Central Prison for security, four were sent for trial, one
escaped and two were transferred to the non-criminal list on expiry of sentence.
6. Although the daily average number sick was lower than during the
previous year, 11.79 as against 14.87, the number of admissions being nearly
similar, there has again been heavy mortality; twenty-five died, or 18 per cent
of the average strength, the highest on record. Various causes have been sug-
gested to account for the heavy mortality here of late, as for instance the man-
ner in which the food is cooked, the position of the asylum, farm operations,
and so on. I am of opinion that the sickness and mortality that has occurred
during the past two years is not owing to any of these causes, but rather to con-
ditions inseparable from mental disease, to some of the causes set forth in para-
9
November 1886, fed and physiced with great difficulty; died February 1887
Residence in asylum 11 years and 8 months. Did no work.
DIAREHŒA.
No. 3, admitted Berar, October 1881, aged 35./Nagpur July 1884; weight 80 lbs. ;melacholia, large depres¬
sions in frontal bone, caused by bites of a tiger, never ceases crying, quite help-
less, filthy in habits, refuses food, fed forcibly, became perfectly imbecile
towards close of 1886, got diarrhœa in October, which continued till April
1887, when he died. Residence in asylum 5 years and 6 months. Did no
work.
ANŒMIA 5.
No.4, admitted Berar,February 1878,aged40./ Nagpur,July 1884,weight 104 lbs,: chronic dementia, very
filthy in his habits, goes naked, got fever in September 1886, which continued
for three months off and on : very anœmic, refused food in January, fed forci-
bly, died in February. Residence in asylum 8 years and 11 months. Did no
work.
No. 5, admitted November 1875, aged 30, weight 113 lbs., melancholia:
silent, shameless, refused food, forced to eat, had three attacks of fever and two
of dysentery between August and December 1886, recovered, but very anœmic,
began to run down early in the year and died in March. Residence in asylum
11 years and 5 months. Did no work.
No. 6, admitted May 1885, aged 22 years, weight 86 lbs., acute mania;
very violent, destructive, noisy, assaults, goes naked, fever and pneumonia in
October and November 1866. Very anœmic afterwards, refused food in July
1887. Persistent vomiting set in, and he died in August, Residence in asylum
2 years and 3 months. Did no work.
No. 7, admitted September 1882, aged 40 years, weight 116 lbs., chronic
dementia. Health began to fail in January 1887, no particular disease till
August when being anœmic he got dysentery, recovered from this but sank in
September from anœmia. Residence in asylum 5 years. Worked a little about
the cook house.
No. 8, female, admitted May 1882, aged 18 years, weight 72 lbs., acute
dementia. Perfectly shameless, goes naked, filthy in habits, coerced to eat,
health began to fail at the close of 1886, got œdema of feet, and legs. fed with
great difficulty, got fever in September 1887, recovered from this, died from
anœmia in October. Residence in asylum 5 years and 5 months. Did no
work.
GENERAL DEBILITY 5.
No. 9, admitted September 1885, aged 32, weight 111 lbs., acute dementia ;
silent, filthy, refuses food, general health bad, improved a little in 1886, but
got worse in every respect in 1887, refused all food, took to crying, got œdema of
feet and sank in August. Residence in asylum 1 year and 11 months. Did no
work.
10
No. 10, admitted Berar, August 1878, aged 34, / Nagpur, July 1884,weight 103 lbs, chronic mania.Very
violent, goes naked, very filthy, assaults every one near him, refuses food, fed
with great difficulty, masturbates to excess, began to run down in Septem-
ber 1886, and died in March 1887 worn out. Residence in asylum 8 years and
6 months. Did no work.
No. 11, admitted December 1835, aged about 35, acute dementia ; much
emaciated, speechless, helpless, passes motions and urine involuntarily, gapes
and stares in an extraordinary manner, twists his head from shoulder to shoul-
der, fed with the greatest difficulty, improved in 1886, was able to speak at its
close when he weighed 97 lbs. again relapsed in March into the same condition
as described on admission, feeding became almost impossible and he died worn
out in June 1887. Residence in asylum 1 year and 5 months, did no work.
No. 12, admitted June 1884, aged 55, weight 106 lbs, acute mania. An
extremely violent case on admission, improved and escaped from the asylum
in February 1887, readmitted in June violent, unmanageable, filthy, covered
with sores, left eye in a disorganised state, emaciated, lost 32 lbs. whilst at
large; improved in all respects after readmission, gained 17 lbs, health began
to decline in August and he rapidly ran down, died in November. Residence
in asylum 3 Jears and 5 months. Did a little cleaning up about the asylum.
No. 13, female, admitted July 1837, aged 40, acute mania. Very violent,
very filthy, destructive, throws food and clothes away, in very bad health,
fed with great difficulty, got worse, refused all food, and died very emaciated
in November. Residence in asylum 4 months. Did no work.
FEVER 7.
No. 14, admitted October 1876, aged 30, chronic mania. Suffered from
constant attacks of maniacal excitement which usually left him very depressed,
got remittent fever in May which continued till June when he was very
anœmic; subsequently he suffered from recurring attacks and died on 25th
June, illness lasted 42 days. Residence in asylum 10 years and 7 months.
Did a little sweeping.
No. 15, admitted Berar;May 1877,aged 32/Nagpur July 1884,weight 112lbs., chronic dementia. Very
filthy, coerced to eat, moved about with difficulty, had dysentery in 1885,
became anœmic with swollen feet, got fever in June and died after 66 days
illness. Residence in asylum 10 years and 2 months. Did no work.
No. 16, admitted June 15th, aged 40, acute mania, received emaciated
and in very bad health, violent, destructive, refuses food altogether, goes naked,
got fever in September and soon died. Residence in asylum 3 months. Did
no work.
No. 17, admitted November 1886, aged 60, weight 76 lbs, acute mania.
An emaciated anœmic old man in very bad health, very destructive and
violent, fed with great difficulty ; got fever in August and died October worn
out. Residence in asylum 11 months. Did no work.
No. 18, a Gond, admitted November 1867, aged 35, weight 140 lbs, chronic
dementia. Began to lose flesh in March without any apparent disease, ran
down rapidly notwithstanding great care and nursing, fed with difficulty
11
from August, got fever in September and died in October. Residence in
asylum 19 years and 11 months. Did farm work from his admission to asylum
till he began to fail.
No. 19, female, admitted November 1868, aged 30, weight 80 lbs, chronic
dementia. A thin woman, latterly fed with difficulty, anaemic, got fever
in April, recovered in June, again attacked in September and died in October:
illness 1 month and 25 days. Residence in asylum 19 years and one month.
Did no work.
No. 20, female, admitted December 1880, aged 15, weight 80 lbs, disease
imbecility. Extremely filthy, shameless, fed with the greatest difficulty,
got fever in October and died in November; ill 45 days. Residence in asylum
7 years. Did no work.
DROPSY.
No. 21, admitted May 1873, aged 24, weight 98 lbs, melancholia. Had
not spoken for four years after admission. In 1877 and subsequently spoke
a few syllables occasionally, got jaundice in 1883, dropsy set in in 1884, kept
alive by great care and nursing, got worse gradually, and died in July 1887.
Residence in asylum 14 years and 1 month. Did a little sweeping occa-
sionally.
PARALYSIS.
No.22,admitted Berar August 1874, aged 20 years/ Nagpur July 1884,weight 106 lbs. ,acute mania. Filthy,
abusive, assaults and bites inmates, flings his food about, has some paralysis
of legs, a most troublesome patient. Paralysis increased, his general health
gave way and he died in February 1887. Residence in asylum 12 years and
5 months. Did no work.
ASTHMA.
No. 23, female, admitted June 1887, aged 50, weight 71 lbs, acute mania.
An emaciated woman suffering from acute mania complicated with severe
asthma, fed with the greatest difficulty, she sank in November. Residence
in asylum 4 months. Did no work.
PHTHISIS.
No. 24, admitted May 1884, aged 20, weight 110 lbs, chronic dementia.
An epileptic and phthisical patient and very filthy in his habits, got bronchitis
and diarrhoea, rapidly ran down and died from Hœmoptysis in March.
Residence in asylum 2 years and 10 months. Did no work.
ACUTE MANIA.
No. 25, admitted August 1887, aged 35, a furious patient, biting himself
screaming, jumping, in fact nothing could exceed his violence ; died worn
out after 13 days residence, during which time he took no food or medicines
of any kind although strenuous efforts were made to give both. Residence
in asylum 13 days.
8. This abstract gives but a faint idea of the condition of some of these
unfortunates; all that could be done by watching, nursing, feeding and clothing
was patiently and persistently carried out by the Deputy Superintendent; and
12
athough it used to be the custom formerly to visit the asylum twice or three
times a week only, I considered that the state of things rendered a daily
visit and frequently two visits a day necessary. The first and last of the
histories are fairly typical cases. The former was a man of long residence
during the whole of which it was necessary to feed him forcibly. It cannot
be supposed that during these eleven years of forcible feeding he swallowed
sufficient food at each meal, indeed his under-fed appearance showed that
he did not: the day of reckoning came when he got dysentery, his want
of stamina was soon apparent; recovering from the disease under the usual
treatment he become anœmic and this meant for him the beginning of the
end; he failed to assimilate the food forcibly passed into his stomach and he
ran down. Such a history might apply mutatis mutandis in such cases as
Nos. 2, 3, 4, 5, 6, 8, 9, 15, 19, and 22. Again the last in the series, 25, was a
lunatic of extreme violence who ate nothing during the thirteen days of his
confinement, indeed he never once 1 eft the cells enclosure and only on a few
occasions was it found feasible to let him out of his cell, he died worn out. It
seemed to me marvellous how some of these creatures held out; it is difficult
to select the worst of the cases where nearly all were alike bad: Nos. 3, 5, 6,
8, 9, 11 are perhaps extreme cases and to these may be added 19, 21, 22 and
23. It will be seen that only four were able to do a little work (the Betul
Gond excepted) and this of the simplest kind as picking up weeds or sweeping;
they sat about in a listless manner unfit to do anything and at length suc-
cumbed.
STATEMENT No. II.
9. The two re-admitted were men sent for trial and subsequently sent
back to the asylum: and of the eleven discharged transferred, three were
released under orders of the Local Government : four were sent for trial: two
were transferred to the non-criminal list on completion of sentence, and two
were transferred to the Central Jail for security, being then sane.
Nos. III., IV. and V.
10. There is nothing in these statements calling for special remark.
Nos. VI. and VII.
11. It was not found necessary to change the type of disease in any
of those remaining from previous years : acute dementia admissions approxi-
mated the number received in 1885, but exceeded greatly the admissions for
1886, the other types differed but slightly in numbers.
The physical causes of insanity as reported by transmitting officers were
very similar to those registered in previous years, the abuse of ganja being
the principal cause; moral causes reached four as against two in the previous
two years. The number of cases in which the causes of insanity cannot be
traced exceeds that in which these are said to be known similarly as during
previous years.
No. VIII.
12. This statement has been already nearly disposed of in the remarks
under Statement No. 1, it only remains to say that whilst bowel diseases
13
caused the bulk of the admissions and deaths in 1886, fevers and anœmia
with general debility were the chief causes of mortality in 1887 or 17 out of
a total of 25, those shown as discharged otherwise represent patients whose
disease was changed, those made over to friends and one escape. The remaining
sick at the close of the year stood at 14 against 22 in the previous year, whilst
the character of the sickness was much lighter : thus the opening of the year
1888 was brighter than that of the year under report.
STATEMENT No. IX.
Receipts from the treasury were less than those of the previous two
years ; fewer patients, eleven months pay of establishment instead of twelve
and the purchase of grain in bulk in a distant market caused this. The value
of articles received from Manufacture Department is made up thus :—
Garden and Farm produce ...
Jail clothing
...
Europe medicine
...
Rams for the sheep farm ...
D. P. W. charges ...
Printing ...
Total Rs.
Rs.
657
599
394
40
1,989
27
3,708
a.
3
0
10
0
9
12
3
p.
10
0
4
0
9
0
11
The first of the above is less than the amount realized during the previous
year, owing to poor crops. Jail clothing was charged for at higher rates than
during the previous year,—a matter beyond my control.
The actual cost of English medicines was Rs. 97 only, the excess nearly
Rs. 300 is in accordance with orders regarding division of the cost of drugs
required for the Civil station, Lunatic Asylum and Police ordered by Govern¬
ment, as intimated to me by the Comptroller. The anomaly so far as it affects
this asylum was noticed in my report for the previous year, when it was
stated that " perhaps the matter would bear looking into and reconsideration."
I have as yet however received no orders on the subject.
The following Statement shows the average cost per lunatic under various
headings during the past five years:—
Establishment ...
Diet ...
Clothing ...
Contingencies
...
Medicines ...
Cost per Lunatic ...
1883.
Rs.
21
26
2
4
0
54
a.
0
7
5
1
5
4
p.
0
10
11
6
2
5
1884.
Rs.
18
26
2
7
0
55
a.
5
5
15
10
3
7
p.
4
0
11
6
0
9
1885.
Rs.
16
24
2
5
0
48
a.
0
8
10
5
5
14
p.
7
11
3
2
11
10
1886.
Rs.
16
26
3
6
1
53
a.
8
13
1
0
1
10
p.
7
8
4
11
9
3
1887.
Rs
16
26
4
4
2
56
a.
15
15
5
14
13
0
p.
8
10
0
1
5
0
NAGPUR :
9th February 1888.
J. F. BARTER, Brigade-Surgeon,
Superintendent Lunatic Asylum
14
Anuual Report on the Lunatic Asylum, Jubbulpore, for the year 1887.
The buildings in the asylum have been kept in repair by the Public
Works Department, with the exception of the barrack outside the main enclo-
sure, they are all in good order and suitable to the requirements of the
inmates. The barrack outside the enclosure will require partial re-roofing before
next rainy season, as the bamboo framework on which the tiles are laid is
insect eaten and falling to pieces. The old shed in the women's enclosure,
used for grinding grain in, has been partially re-built with a new roof, and
flagged floor added.
The godown in the North-eastern corner of the same enclosure has been
re-built, and a verandah added. As it is now much too good for a godown,
I have converted it into a hospital for sick females, and it answers this purpose
very well.
These buildings have cost Rs. 968-4-9.
STATEMENT I.
There was but little change in the strength of the asylum during the
past year, the number remaining on the 1st January was 134 (105 males, 29
females). The average remaining for the past ten years was 131.7, so there
has been very little variation. There were 15 admissions (10 males, 5 females)
making a total of 149 (115 males, 34 females). Of these 8 (7 males, 1 female)
were discharged cured, and 9 (7 males, 2 females) died, leaving 132 (101
males, 31 females) under treatment at the close of the year. There were no
re-admissions. Of the 15 admissions 3 (2 males, 1 female) were criminal
lunatics. Of the 8 discharged cured, five were cases of acute mania, one
chronic mania, one melancholia and one acute dementia; their residence in
the asylum varying from 3 months to 3 years.
The greatest number confined on any one night was 140 (109 males, 31
females) the capacity of the asylum being for 174, so there was no over-
crowding. The daily average strength was 135.75 compared with 133.39 in
the preceding year. This was an increase of 2.36. As has been stated before
there is no separation of criminal from non-criminal lunatics, they are divided
according to their mental condition and tendencies such as dangerous, harmless,
and dirty. Those who are dangerous are locked up in separate compartment,
only being allowed outside when under the immediate care of an attendant.
I see no reason for departing from this rule.
There were no escapes.
Nine patients died, being one less than last year, and two more than the
average of the last ten years. There are in the asylum a great many patients
whose mental condition is hopeless, and who are advanced in years, so that
there must eventually be a considerable mortality. Of the deaths this year
one was from senile decay, the deceased had been an inmate for nearly eleven
years.
15
STATEMENT II.
At the beginning of the year there were 28 criminal lunatics (22 males,
6 females) in the asylum. 3 (2 males, 1 female) were admitted, making a
total treated of 31 (24 males, 7 females). Of these one died of small-pox and
one was discharged cured, being declared by the visitors as capable of making
his defence. Of the admissions two were cases of acute mania, the use of
ganja being the cause in both cases; the third, a female, was melancholia—cause
unknown.
The number remaining at the end of the year was 29, the average for
last ten years being 26.6.
STATEMENT III.
There is little calling for remark under this statement. Jubbulpore,
including the Central Jail, furnished 8 out of the 16 admissions. There is no
reason to suppose that insanity is more prevalent in this than in the neighbour-
ing districts, but these cases wander towards large cities and being found with-
out friends are sent to the asylum.
One admission came from Sehore in Central India.
STATEMENTS IV. & V.
Do not call for any remark.
STATEMENT VI.
Some changes in the classification of the old patients were made during
the year, this is noted in the return. Of those admitted acute mania was the
form of insanity in 11 out of a total of 15, chronic mania and melancholia
giving two each.
STATEMENT VII.
This statement deals with the causes of insanity, this is only known in
the cases of 6 out of 15 admitted. Ganja was the cause in 2, hereditary
influence and jealousy 1. anger 1, grief 1, and loss of money 1.
STATEMENT VIII.
This statement shows the sickness and mortality. There were 78 admis-
sions and 9 deaths as compared with 59 admissions and 10 deaths in the pre.
ceeding year. As might be expected " Fever" gave most admissions, viz., 28.
then dyspepsia 8, ulcers 5, anæmia and general debility 4 each, respiratory
affections 4, diarrhœa 2, dysentery 1.
The daily average number of sick was 3.65 ; although this is higher than
last year it is so very trifling that it does not call for any comment. The free-
dom from bowel complaints, the asylum continuesto enjoy, is some what remark-
able, considering the prevalence of these diseases in the neighbouring Jail. The
only explanation I can offer is that in the asylum the wheat is more carefully
selected, and the bread better baked than is the case in the Jail, The lunatics
are also perhaps better protected from cold, their blankets being warmer. In
the asylum labour is of course optional; if the inmates do not feel inclined to