2
Discharges.
3. 71 lunatics were discharged this year against 58 in the preceding
year ; 32 were discharged as cured, 7 improved and
32 were discharged as otherwise against 25, 1 and 32,
respectively, in 1918. Of the 32 discharged otherwise 28 (21 males and 7 females)
were cases under observation and 4 were transferred to the list of non-criminals.
Sickness and mortality.
4. The mortality was exceptionally high giving a percentage mortality
of 13.2, the highest in the past 8 years. There were
53 deaths ; of these 27 occurred in the three months
July, August and September. In the last three months of the year there were
only 2 deaths. The high mortality in 1919 may be attributed to the following
causes :—
(a) an epidemic of cholera at the end of May,
(b) increase in the number of tubercular cases,
(c) bad state of health of a large number of cases recently admitted,
(d) unhealthy year causing high mortality among the older people,
and each of these causes may be briefly examined.
(a) 7 males and 2 females died from cholera.
(b) 5 males and 5 females died from tuberculosis of the lungs, and 9 males
and 4 females died from other tubercular diseases. Altogether 23 died from
tuberculosis.
The period of stay in the Asylum was as follows :—
Over 2 years ... ...
1 to 2 years ... ...
6 months to 1 year ... ...
Under 6 months ... ...
Total ...
Male.
4
3
2
5
14
Female.
8
...
...
1
9
Total.
12
3
2
6
23
(c) Among 101 admissions (excluding 30 observation cases) —
14 males and 3 females were from 10 to 15 lbs. under physical equivalent.
Total ...
5
2
4
25
„
„
„
„
2
3
5
13
„ „
„ „
„ „
15 to 20 „
„
20 to 25 „
„
25 lbs. and above
„
(d) The unhealthy year:—This year has been a remarkably unhealthy year.
The death rate has been higher than the birth rate throughout the whole
district, and it is difficult to assign the increase in the number of deaths
to any particular cause. It may be partly due to the general lowering of
health as a sequel of the very severe influenza epidemic; possibly the almost
continuous rain till July and August was a contributory cause. In severe weather
there is exceptional difficulty in dealing with lunatics as they are so liable to
allow their clothes to get wet ; many tear their blankets into small pieces and
while such cases may survive in favourable weather, they are very liable to catch
chills in wet weather.
It appears, therefore, that there was a combination of causes which tended to
contribute to the high mortality. First there was a small epidemic of cholera
which, although rapidly checked, caused 9 deaths. Then there was tubercular
infection, and although many cases appear to have caught the infection in the
Asylum, there is no doubt that many cases had already been affected before
admission. There was a large number of admissions of persons in a state of
inanition owing to the scarcity conditions outside, and the general unhealthy
conditions of the year also contributed to the high mortality. These conditions,
operating in a population in which there were many old persons, contributed to
the high death rate.
Out of the 53 deaths, 13 died of other tubercular diseases, 10 of tubercu-
losis of lungs, 2 of heart failure, 2 of pneumonia, 9 of cholera, 7 of old age
and general debility, 1 of exhaustion due to acute mania, 4 of epilepsy, 1 of
anæmia, 2 of acute dysentery and 2 of cirrhosis of liver.