NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
STATEMENT No. XI.
Showing Receipts and Expenditure on account of Manufactures of the Nagpur and Jubbulpore Lunatic Asylums during the year 1886.
1
Name of Asylum.
Nagpur ...
Jubbulpore ...
2
Mean population.
M
127.08
102.26
F
33.21
31.13
Total
160.29
133.39
3
Average number
employed.
M
108.40
43.00
F
25.98
12.00
Total
134.38
55.00
4
5
6
7
8
9
Credits.
Cash paid into Treasury during the
year for articles sold.
Rs
381
500
a
13
12
p.
10
2
Value of manufactured goods made
over to Asylum for Asylum purposes.
Rs
867
882
a
5
9
p.
5
9
Value
of raw materials in the store at
the end of the year 1886.
Rs
3
a
0
p
0
......
Value of manufactured goods in store
at the end of the year 1886.
Rs
15
...
Value of plant and machinery in store
at the end of the year 1886.
Rs
1,193
24
a
11
8
p.
6
0
Total Credits.
Rs
2,460
1,407
a.
14
p.
9
13 11
10
11
12
13
14
15
16
Debits.
Value of manufactured
goods in store
on
1st January 1886
Rs
...
...
Value of raw materials in store on
1st January 1886.
Rs
7
a
0
p
0
......
Value of plant
and machinery in store
on 1st January 1886.
Rs
1,016
24
a
5
8
p
9
0
Raw materials purchased and all
other charges.
Rs
571
535
a
5
12
p
6
0
Contingencies
of manufactures, viz.,
indulgences to Lunatics as rewards
for work &c.
Rs
...
...
Charges for work
done by Public
Works Department.
Rs
...
...
Tot al Debi s .
Rs
1,594
560
a
11
4
p
3
0
17
Excess
of credits or profit.
Rs
866
847
a
3
9
p
6
11
18
Excess of debits or loss.
Rs
...
...
19
Net
profit as per
memorandum at foot.
Rs
677
847
a
13
9
p.
9
11
MEMO. OF ACTUAL PROFITS.
Profits as per above table, Column 17
...
...
...
Difference of raw materials in store
...
...
...
Total
...
Difference of manufactured goods in
store
...
...
...
Total ...
Difference of plant and machinery in store
...
...
...
Total Net Profit ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore
...
Nagpur ...
Jubbulpore
...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Rs.
866
847
+ 4
a
3
9
0
p
6
11
0
.......
870
847
—15
3
9
0
6
11
0
......
855
847
-177
3
9
5
6
11
9
......
677
847
13
9
9
11
REPORT
ON THE
LUNATIC
ASYLUMS
IN THE
CENTRAL PROVINCES
FOR
THE YEAR 1887.
NAGPUR:
PRINTED AT THE CHIEF COMMISSIONER'S OFFICE PRESS.
1888.
[ PRICE EIGHT ANNAS. ]
No.3367 A./130
Extract from the Proceedings of the Chief Commissioner, Central Provinces,
in the General Department, dated 14th June 1888.
READ.—-Letter No. 640, dated 1st May 1888, from the Deputy Surgeon-General, Central
Provinces, submitting the Annual Reports and Statements of the Nagpur and
Jubbulpore Lunatic Asylums for the year 1887.
READ ALSO.—The Reports and Statements of the Superintendents of the Asylums.
RESOLUTION.
On the 1st January 1887 the total number of inmates in the Nagpur
Asylum was 151 (123males and 28 females). The number of patients admitted
during the year was 33 (26 males and 7 females) and the number re-admitted 8
(5 males and 3 females). Of these last, 4 were cases of relapses, 2 were crim-
inal lunatics detained after expiry of their sentences, and 2 were re-admitted
after being sent to stand their trial. An escaped lunatic who was re-captured
has not apparently been included among the re-admissions.
In the Jubbulpore Asylum the total number of inmates on 1st January
1887 was 134 (105 males and 29 females). The number of admissions was 15
(10 males and 5 females). There were no re-admissions. In both asylums
the number of admissions varied but slightly from the number in the previous
year.
2. The number of patients discharged during the year from the Nagpur
Asylum was exceptionally large. The total was 37 (31 males and 6 females).
Of these, 21 were cured, the highest number on record ; 7 were made over to
their friends as improved; and 9 were discharged " otherwise." Of the latter,
2 were criminal lunatics, who on recovery were transferred to the Central
Jail; 2, as above noted, were re-admitted as non-criminals after expiry of
sentence; 4 were sent for trial, of whom 2 appear to have been re-admitted
and 2 sent to the Central Jail ; and one escaped but was subsequently
re-admitted.
From the Jubbulpore Asylum there were 8 lunatics discharged (7 males
and 1 female) all of whom were cured. There were no escapes.
3. In the Nagpur Asylum there were 25 deaths (20 males and 5 females),
and in the Jubbulpore Asylum 9 deaths (7 males and 2 females). Thus the
total number of inmates at the close of the year was in Nagpur 130 (103
males and 27 females); and in Jubbulpore 132 (101 males and 31 females).
4. As last year, the classification of the types of insanity varied consider-
ably in the two asylums. None of the admissions to the Jubbulpore Asylum
are classed as dementia. Some changes* in the classification at Jubbulpore
were made during the year.
*NOTE.—The total of cases remaining on 1st January 1887 at Jubbulpore according to the former classification
as shewn in Statement VI. appears to be 132, not 134. There is some mistake in the figures.
2
5. The marked difference in the comparative healthiness of the two
asylums still continues, though in respect of admissions to hospital, Nagpur
showed an improvement and Jubbulpore a falling off as compared with the
previous year, the percentage of sick to average daily strength being :—
Nagpur ...
Jubbulpore ...
9.2
1.8
8
2.7
The percentage of deaths to daily average strength was 18.00 in the
Nagpur and 6.63 in the Jubbulpore Asylum, compared with 14.35 and 7.49 in
the preceding year. In Nagpur fever was the chief cause of mortality and in
Jubbulpore general debility.
The Government of India, in Home Department letter No. 417, date d
30th July 1887, commenting on the difference between the vital statistics of
the two asylums, especially in respect of bowel complaints, suggested an
assimilation of the diet scales as far as practicable. This had already been
adopted, but the Deputy Surgeon-General is of opinion that the new scale has
not been long enough in force at Nagpur to admit of a judgment being passed
on the effect of its introduction. Nor does the difference between the two
asylums in respect of vital statistics seem to be attributable to the forms of
labour on which the patients are employed or to other conditions of manage¬
ment. The Superintendent of the Nagpur Asylum has given details of the
histories of all the patients who died during the year. These descriptions
show clearly that in no one case can death be ascribed to any cause connected
with the treatment or conditions of the asylum, and in most of these cases the
patients had been kept alive by force in spite of themselves. The sickness
and mortality in the Nagpur Asylum can apparently be only attributed to
the characteristics of the insanity of the inmates; and possibly the fact that
the Jubbulpore Asylum has, as noted last year, more idiots and comparatively
fewer demented and maniacs, may affect the ratio of the vital statistics. There
may also be something in the fact that so many of the Nagpur cases are those
of ganja smokers.
6. The average cost of each lunatic at the two asylums as compared with
the previous year was :—
Nagpur ...
Jubbulpore ...
1886.
Rs.
72
64
a.
2
14
p.
7
9
1887.
RS.
76
64
8.
11
9
p.
4
1
The increased cost per head at Nagpur is due to the decrease in the num-
ber of patients; in fact the total expenditure fell from Rs. 16,012-15-6 in
1886 to Rs. 13,196-8-3 in 1887. The possibility of reducing the expenditure
on clothing and establishment in the Nagpur Asylum, which largely exceeds
that at Jubbulpore, is reported to be under consideration. The question raised
by the Superintendent of the Nagpur Asylum, regarding the classification
of charges for Europe medicines at Nagpur, should be re-considered: it is
anomalous that the institution should be debited for Rs. 395 worth of drugs
3
when it only received Rs. 97 worth. The Deputy Surgeon-General should
refer the matter for orders. The profits of the patients labour as compared
with last year were:—
Nagpur ...
Jubbulpore ...
1886.
Rs.
677
847
a.
13
9
p.
9
11
1887.
Rs.
510
774
a.
15
1
p.
10
2
Both institutions are, the Chief Commissioner believes, carefully man-
aged.
ORDER.—Ordered that a copy of this Resolution be forwarded to the
Deputy Surgeon-General, and that copies, bound with the Report, be distributed
as usual.
[True Extract.]
A. L. SAUNDERS,
Under-Secretary.
No. 640.
FROM
JAMES H. LOCH, ESQ., M. D.,
DEPUTY SURGEON-GENERAL,
Central Provinces,
TO
THE SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Nagpur, the 1st May 1888.
SIR,
I have the honour to forward for submission to the Chief Com-
missioner, the Annual Reports and Statements of the Nagpur and Jubhulpore
Lunatic Asylums for the year 1887.
2. At neither of the asylums were any new buildings erected, but at Jub-
-ulpore some improvements were effected; among others a godown was altered
so that it is fitted for and is now used as a hospital for the female patients.
3. The admissions to both asylums were in excess of those in 1886, but
at neither was the excess large.
The number of patients discharged was largely in excess of that in 1886,
that at the Nagpur Asylum being the highest of any in the past 10 years and
that at Jubbulpore being double what it was the previous year ; out of the
37 patients discharged from the Nagpur Asylum, 28 were actually sent away
from the institution.
The daily average strength was somewhat lower at Nagpur and very
slightly higher at Jubbulpore than in 1886.
4. There was not any approach to overcrowding at any time in either
of the asylums,
5. The percentage of cured to daily strength at Nagpur is not only
double that of last year but is the highest returned in any of the past 10 years :
it is nearly three times higher than that of Jubbulpore where it is about the
average of past years.
The percentage of cured to admissions is also high at Nagpur, but not so
markedly so as is that of cured to daily strength.
Among the cured are included 3 patients who showed no signs of in-
sanity during their stay in the asylum.
2
This large number of cures at Nagpur has caused the ratio of such for
the Central Provinces to approximate more closely to that of other provinces
than in former years: the latest figures available to me being as under :—
TABLE I.
Provinces.
Bengal ...
Bombay ...
Punjab ...
Rangoon
...
Tejpur ...
Central Provinces ...
Ditto
...
Year.
1886
„
„
„
„
„
1887
Total popula-
tion during
the year
1886.
1,173
887
505
281
95
342
341
Daily average
strength.
963.90
653.20
383.30
216.51
67.54
293.68
274.62
Cured during
the year
1886.
87
60
58
24
10
15
29
Percentage of
cured to
total popu-
lation.
7.4
6.8
11.5
8.5
10.5
4.4
8.5
Percentage of
cured to
daily average
strength
9.0
9.4
15.1
11.1
14.8
5.1
10.5
6. The number of patients discharged improved was at Nagpur again
as in 1885 high, but at Jubbulpore, as in the previous year, no patient was
discharged " improved.''
It will be instructive, as well as necessary, to watch whether any number
of the many patients discharged partially cured in 1885 and 1887, are re-
admitted as relapses in future years. In 1887, 4 relapsed patients were re¬
ceived in the Nagpur Asylum, of these two had been discharged cured and
two improved : in the case of the two latter, 2 and 7 years respectively had
elapsed since their discharge.
7. The number of patients discharged " otherwise " is also large, but of
the 9 so discharged only 5 really left the asylum; 4 were transferred to the
Central Jail and one escaped.
8. The death ratio at Nagpur was again very high, being the highest
on record for this asylum.
At Jubbulpore the ratio is slightly below that of 1886 and about the
average of the previous 10 years.
STATEMENT II.
9. While the number of criminal lunatics admitted to the Nagpur
Asylum is larger than that for either of the two previous years and than the
general average of the previous 10 years, the number admitted at Jubbulpore
was only half of that in 1886.
The two criminal patients said to have been re-admitted at Nagpur were
really never discharged, having been sent to stand their trial. The daily
average strength of the criminal class was about the average of previous
years at both asylums.
3
STATEMENT III.
10. As usual the districts (if we accept the statements in the patients
papers) which supplied the largest number of lunatics, are Nagpur and Jub-
bulpore.
STATEMENT IV.
11. Does not call for any special remark.
STATEMENT V.
12. There is not anything unusual as to the ages of the patients
admitted.
STATEMENT VI.
13. At both the asylums mania was the type of insanity in more than
half the patients admitted, but as in former years, while Dr. Barter considered
a considerable number of those admitted to be suffering from Dementia, the
Superintendent of the Jubbulpore Asylum does not return a case of this type
of insanity among the admissions, and enters by far the greater part as labour-
ing under acute mania.
STATEMENT VII.
14. Of the causes assigned as having brought on the attack of insanity,
Ganja is very markedly the most common in the case of the patients admitted
to the Nagpur Asylum: but in the case of those admitted at Jubbulpore
no one cause is said to have been markedly more common than another.
STATEMENT VIII.
15. The average daily sick at Nagpur, though less than in 1886, is higher
than in any previous year, except l885 and 1886, and at Jubbulpore it is in
excess of that of any of the previous 5 years ; the percentage of sick to daily
strength for the two asylums is—
Nagpur
...
...
Jubbulpore ... ...
8
2.7
At Nagpur fever caused 72 or 58 per cent. of all admissions to hospital, the
other diseases which were treated in any numbers being Anœmia and Bronchitis
(each 7 cases) Ophthalmia, Dysentery and General debility (each 6 cases).
At Jubbulpore, fever caused 28 or 36 per cent of all admissions, and the
only other diseases for which any considerable number of patients were
admitted are Dyspepsia (8 cases) and ulcer (5 cases).
At Jubbulpore 90 per cent and at Nagpur 83 per cent of the fever cases
were suffering from ordinary ague. On going over the Nagpur Asylum
figures for the past 12 years 1 find that the mean admission rate from fever
is 30 per cent of strength, but that in 4 of these years it was upwards of 10
per cent, that in 1881 it was 49 and in 1883, 51 per cent.
I find that during the year 1887,48 per cent of the average daily strength
of prisoners in the Central Jail at Nagpur were admitted to hospital for
fever.
The admissions to hospital, for dysentery and for diarrhœa at Nagpur were
only 6 and 2 respectively, or 1/3 and less than 1/3 of what they were in 1886.
4
At Jubbulpore the admissions from bowel-complaints, though more than
in 1886 which was quite exceptional, are lower than in any other of the previ-
ous 13 years.
A comparison of the Nagpur Asylum figures for the past 13 years shows,
that the percentage of admission for dysentery in 1887 is slightly "below the
average, but that if those for last year in which the disease prevailed to an
unusual degree be excluded, then the ratio for 1887 is about the average. The
ratio of admission for diarrhœa at Nagpur is the lowest but two of any recorded
during the previous 13 years.
The Government of India, in their review of the Central Provinces
Asylums Report for 1886, suggested that the difference in the diet scales of the
two asylums might account for the higher sickness and mortality from bowel-
complaints at Nagpur.
Previous to the receipt of this letter, the Nagpur scale had, by the Chief
Commissioner's orders, been made to correspond with that of Jubbulpore
Asylum as far as seemed advisable, taking into consideration the difference in
the diet used at their own homes by the patients in the two asylums.
The period during which this reduced scale has been in force, 5 months is
I think too short for the drawing of any conclusion.
The ratio of died to daily strength for the Nagpur Asylum is very much
higher than that for any of the previous ten years : the chief causes of death
were Remittent fever (7), Anæmia (5), General Debility (5), Diarrhœa (2) :
two of the deaths were due to mental affections, with which residence in the
asylum could not have had any connection.
Dysentery caused only 1 and diarrhœa only 2 deaths at Nagpur.
Fever was thus, even if we take only those deaths directly ascribed to it'
the chief cause of mortality in the Nagpur Asylum.
At Jubbulpore the death rate is higher than the average of previous years
but lower than in 1886. Two of the 9 deaths were due to Epilepsy, 1 to small-
pox and one to old age, causes which had no connection with residence in the
asylum, and if we exclude these the only disease which caused more than one
death was General Debility, from which 3 paients died.
I have gone carefully into the question of the effect of different kinds of
employments on the health of the lunatics, as judged by the admissions to
Hospital in 1886 and 1887, and find that as regards sickness in general, bowel¬
complaints and fevers, the figures do not warrant any statement beyond this, viz.
that in 1887 of the Nagpur lunatics employed on various kinds of labour
55 per cent of those working at in-door occupations were admitted for fevers
while of those working out-of-doors, the proportion was only 30 per cent.
The figures for 1887 in the table inserted below show, as regards the
asylums of this Province, that the percentage of sick to strength may be con-
sidered satisfactory, that the percentage of death is decidedly high, that the
5
proportion of death due to fever is excessive, but that those from Dysentery
and Diarrhœa are both low :—
TABLE II.
Provinces.
Bengal ...
Bombay ...
Punjab ...
Rangoon ...
Tezpur ...
Central Provinces. ...
Central Provinces. ...
Year.
1886.
1887.
Percent
age of¬
sick to
strength.
4.25
10.53
9.50
3.71
5.53
5.95
5.62
Percent-
age of
death to
strength.
8.82
7.96
8.35
8.31
14.80
11.23
12.38
Percentage of total deaths front
Fever.
3.53
5.77
9.37
22.22
...
6.06
20.59
Dysen-
tery.
18.82
9.62
9.37
...
...
33.33
5.88
Diar-
rhœa.
5.88
17.31
15.63
...
10.00
9.09
5.88
Phthi-
sis.
8.24
3.85
6.25
...
10.00
...
2.94
Chest
affec-
tions.
10.59
1.92
9.37
...
30.00
9.09
2.94
Anœ¬
mia.
4.71
1.2
...
...
...
6.06
17.65
Other
diseases.
48.23
59.61
50.00
77.78
50.00
36.6
44.12
STATEMENTS IX., X. AND XI.
16. A comparison of the expenditure. under its different heads, shows
that at Nagpur each patient cost Rs. 6-11-0 more than in 1886, the increase
having taken place in every item except contingencies. The largest increase
is in Superintendence, which cost nearly Rs. 3 per head more, and the next
largest is in the cost of Europe medicines, but the cost per patient of the former
of these charges is entirely dependent on the average strength of the Asylum
population and the amount entered under the latter is not the actual cost under
that head.
Besides these two heads, there was a large increase in the cost of clothing
and establishment, and a smaller increase in that of diet and repairs.
At Jubbulpore, each patient cost Rs. 0-5-8 less htan in 1886 : the largest
increase was in the cost of Establishment, but this was due entirely to the Deputy
Superintendents having drawn a higher rate of pay on promotion to the
1st class of Hospital Assistant, the strength of the Establishment was (one) less
than in 1886. There was a small increase in the cost of diet and repairs, and
a decrease in that of Superintendence, clothing and contingencies.
The average annual cost of each lunatic in 1887 was according to the accounts
Rs. 14-4-6 more at Nagpur than at Jubbulpore, or Rs. 12-2-3. if we calculate
the cost of Europe medicine in the same way for both asylums. The only
head under which the cost at Nagpur was less than at Jubbulpore was Super-
intendence, and the largest difference occurred under Establishment, clothing
and contingencies.
The excess cost of diet and repairs at Nagpur is small.
The clothing at Nagpur is supplied from the Central Jail, while at Jubbul
pore it is made up in the asylum. The difference in the cost of clothing at the
two asylums appears due chiefly to a more liberal supply at Nagpur.
6
During the last five months of the year, the full scale of diet of the Nagpur
Asylum has been the same as that in use at Jubbulpore, except that at the
former 9 chhattacks of atta and 3 of rice are given, in place of 12 chhattacks of
atta, which is the scale at Jubbulpore, and in future any difference in the cost
of diet will be due chiefly to a difference in the rates at which the articles
are purchased.
The following table exhibits the comparative cost of each patient in the
asylums of different Provinces, and shows that not only as regards the total cost,
but that under each head of expenditure, the institutions of the Central Pro-
vinces compare favourably with the others :—
TABLE III.
Years.
3
3
2
2
5
5
1
Provinces.
Bengal ...
Bombay ...
Tezpur ...
Rangoon ...
Punjab ...
Central Provincess ...
Do.
Do. 1887.
Mean cost per head of.
Superin-
tendent.
Rs
19
29
28
14
12
22
21
a.
10
3
8
12
14
10
13
p.
8
11
0
4
8
1
7
Establish¬
ment.
Rs.
21
37
31
32
33
16
15
a.
4
8
15
9
0
1
7
p.
1
4
8
10
3
10
6
Diet.
Rs.
34
85
40
40
41
25
26
a.
11
13
15
14
3
3
8
p.
11
11
8
11
11
1
4
Cloth-
ing.
Rs.
2
9
5
1
7
2
2
a.
14
11
0
15
5
3
13
p.
11
6
1
4
8
5
7
Building
and
repairs.
Rs.
2
2
0
0
0
0
0
a.
2
0
0
0
0
6
11
p.
3
3
2
0
0
9
0
Bazar
medicine.
Rs.
0
0
1
0
0
0
0
a.
0
2
0
6
2
0
0
p.
10
9
3
0
11
0
0
Contin-
gent
proper.
Rs.
4
10
2
4
6
3
2
a.
13
0
4
8
2
2
14
p.
7
11
11
1
0
2
0
English
medicine.
Rs.
0
1
0
2
0
0
1
a.
15
3
9
10
15
4
7
p.
4
4
5
5
2
11
2
Total.
Rs.
86
175
110
97
101
70
71
a.
9
12
6
13
12
0
11
p.
7
10
2
2
7
3
3
The possibility of reducing the expenditure on clothing and establishment
in the Nagpur Asylum is under consideration.
The total net profits were at Nagpur Rs. 166-13-11 and at Jubbulpore
Rs. 73-8.9 less than in 1886, and the net profit per head was at Nagpur
Rs. 0-13-6 and at Jubbulpore Rs. 1-1-3 less than in 1886. The cost per head,
debiting the cost of only the Europe medicines actually expended is —
Nagpur ...
Jubbulpore ...
Rs.
76
64
a.
11
9
p.
4
1
or after deducting the amount received from paying patients and that of net
profits
Nagpur ...
Jubbulpore ...
Rs.
71
55
a.
12
5
p.
4
3
I have the honour to be,
Sir,
Your most obedient Servant,
JAMES H. LOCH, M.D.,
Deputy Surgeon-General,
Central Provinces.