Note on the Report of the Punjab Lunatic Asylum, Lahore,
for the triennium 1906-1908.
This report is for the triennium 1906—1908. It has been written by
Major G. F. W. Ewens, I.M.S., who is an officer of wide experience as an alienist
in, this country, having been in charge of the Punjab Lunatic Asylum since 27th
February, 1900, except when he has been absent on leave.
2. In accordance with the orders of the Local Government, the Inspector-
General of Civil Hospitals must, in forwarding the report, confine his remarks
to important points noticed therein. The different paragraphs of the report will
be taken in their order.
Population.
3. There has been a progressive but not a very marked increase in the
total population from 770 in 1906, to
790 in 1907, and 827 last year. The
daily average strength shows a corresponding advance, the figures for the three
years being, respectively, 604.75, 608.18 and 627.34. These numbers are too
small to afford an indication of the actual condition of the community as regards
mental unsoundness. The opening up of the country, the gradual advance of
civilization and wider diffusion of the knowledge that provision is made by the
Government for the care and treatment of the mentally afflicted are sufficient to
account for the larger number of persons coming under observation. It is also
likely that the improvement in the arrangements, coincident with the opening
of the present institution, induces persons to have recourse to the asylum when
circumstances render some measure of restraint necessary. The daily average
number of female patients has steadily declined from 131.42 in 1906, to 127.55
in 1907 and 124.17 in 1908. There has been a certain amount of overcrowd-
ing in the male section, but provision has been made in verandahs and tents for
the accommodation of the number in excess of the capacity of the barracks.
Results of treatment.
4. The percentage cured, calculated on the daily average strength, was
14.19 last year against 8.89 in 1907, and
11.24 in 1906 ; the poor results in 1907
are ascribable to the heavy mortality that occurred in that year. The per-
centage cured to admissions, also, was much lower in 1907, than in 1906 and in
1908. Re-admissions have risen from 16 in 1906, to 17 in 1907, and 24 in 1908;
but these figures, compared with the number discharged from year to year,
indicate that the benefit conferred by the asylum treatment is permanent in the
great majority of cases. The steady increase in the number of criminal lunatics
and in the daily average strength is almost certainly attributable to more careful
discrimination by the courts of the mental condition of persons sent for trial, and
a growing solicitude on the part of jail officers for the welfare of the prisoners
in their charge.
Causes of insanlty.
5. There is nothing fresh to be said on the subject of causation. State-
ment No. VII shows that the use of
Indian hemp, in some shape, and epilepsy
account for 251 of the 371 cases having a physical origin, and that in as many
as 389 cases no cause could be assigned. Difficult in the most favourable cir-
cumstances, it must be well-nigh impossible to determine the factors disturbing
the mental balance in persons whose mentality is only partially understood and
whose antecedents are very imperfectly communicated. A new system of cause-
classification has been introduced in lunatic asylums at home, which is more in
conformity with modern scientific opinion, and it may be thought necessary to
make a similar change in the form of Statement No. VII.
Employment.
6. Only a small proportion of the inmates is fit for employment of any
kind and it is mainly composed of the
criminal element. The vast majority
are hopelessly and permanently insane, work requiring even the smallest amount
of intelligence being quite beyond them. In the circumstances comparatively
little can be done, though the advantages of healthy occupation, as an adjunct
to other treatment, are fully appreciated.