NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 2425.
Extract from the Proceedings of the Chief Commissioner, Central Provinces,
in the General Department,—dated Nagpur, the 20th April 1892.
READ—Letter No. 710, dated the 15th March 1892, from the Deputy Surgeon. General,
Central Provinces, submitting, with remarks, the Annual Reports of the Nagpur and
Jubbulpore Lunatic Asylums for the year 1891.
RESOLUTION.
The statistics of admissions, discharges and deaths in the two asylums during
the year 1891 are given in the following table:—
Remained on the 1st January ... ...
Admitted and re-admitted ... ...
Total population ...
Discharged as cured or improved ...
Discharged otherwise ... ...
Died
...
...
...
Remaining on the 31st December ...
Nagpur.
125
29
154
11
4
8
Males 100
Females 31
131
Jubbulpore.
134
29
163
14
4
15
Males 104
Females 26
130
In both asylums the daily average strength was higher than in the pre-
ceding year, being 127.21 against 118.27 at Nagpur, and 133.77 against 130.79
at Jubbulpore. The number of re-admissions to the Nagpur Asylum, viz. 9, was
unusually large.
2. Owing to the absence of influenza (which was prevalent in 1890), there
was less sickness in both asylums than in the preceding year. In the Nagpur
Asylum admissions to hospital fell from 148 to 96, and the daily average
sick from 13.47 to 12.97. In the Jubbulpore Asylum, owing chiefly to an
increase of fever cases, admissions to hospital rose slightly (from 62 to 67), but
the daily average sick fell from 5.55 to 5.30.
At Nagpur the number of deaths (8) was the same as in 1890. At Jubbul-
pore the number of deaths rose from 13 to 15, but of the latter number, 7 were
due to general debility and old age, against 2 out of the former number.
There was no over-crowding at either institution.
3. The statistics relating to criminal lunatics are abstracted in the follow-
ing table: —
Remaining on the 1st January ...
Admitted and re-admitted (5 re-admitted into
the Nagpur Lunatic Asylum) ...
Total ...
Discharged, Ac. ... ...
Died ... ...
Remaining on the 31st December ...
Daily average strength ...
Nagpur.
45
10
55
7
1
Males 43
Females 4 47
46.15
Jubbulpore.
30
8
38
5
2
Males
27
Females
4 31
31.56
Nagpur continues to have a larger population of criminal lunatics than
Jubbulpore.
2
4. The most common types of insanity among the lunatics treated during
the year were mania and dementia, of which there were 246 cases, out of a total of
317. In a large number of these 317 cases, viz. 172, the immediate cause of
insanity was not traceable.
5. From the table given in paragraph 27 of the Report, it appears that
the average cost of each patient fell in the Nagpur Asylum from Rs. 77-14-5
to Rs. 71-14-2, and rose in the Jubbulpore Asylum from Rs. 67-9-1 to Rs. 71-0-6.
The cost of Superintendence is higher in the Jubbulpore than in the Nagpur
Asylum Rs. 3,000 against Rs. 1,800), while Establishment charges are somewhat
higher in the latter than the former. The cost of dieting was about the same
in both institutions. Deducting receipts from paying patients and the net profits
in the year of each asylum, each patient cost Rs. 52-14-2 at Nagpur, and
Rs. 56-4-11 at Jubbulpore. The net profits were greater in both asylums than
in the previous year.
6. Various structural improvements have been carried out or are in
progress in the Nagpur Asylum. The chief of these is the construction of an
enclosing wall and railing to the premises. The improvement of the water-supply
has also received special attention. At Jubbulpore quarters were constructed
for the Native Establishment.
7. As stated in paragraph 3 of the Report, it has been arranged, under the
orders of the Government of India (Home Department No. 20, dated the 14th
January 1892), that lunatics from Central India shall be admitted in future
to the Jubbulpore Asylum. The Deputy Surgeon-General is mistaken in
supposing that these orders extend to the reception of lunatics from Rai-
putana.
8. The thanks of the Chief Commissioner are due to Dr. Franklin and
Dr. Harris for their efficient management of the institutions under their charge.
ORDER.—Ordered, that a copy of this Resolution (with the usual number
of spare copies) be submitted to the Government of India in the Home Depart-
ment, and that a copy be forwarded to the Deputy Surgeon-General, Central
Provinces, for information and guidance; also that it be published in the Sup-
plement to the Central Provinces Gazette, and that copies, bound with the
Report, be distributed as usual.
[True Extract.]
F. C. ANDERSON,
Secretary.
Secretariat Press, Nagpur:—21-4-92—170
No. 710.
FROM
SURGEON-COLONEL J. G. PILCHER, F. R. C. S.,
DEPUTY SURGEON-GENERAL,
Central Provinces,
TO
THE SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Nagpur, the 15th March 1892.
SIR,
I have the honour to forward, for submission to the Chief Commissioner,
the annual Report and Statements of the Lunatic Asylums in the Central Pro-
vinces for the year 1891.
2. The charge of the asylum at Nagpur was held by Surgeon-Major
Harris, and Surgeon-Lieutenant-Colonel Franklin was the Superintendent of the
asylum at Jubbulpore. Each held charge throughout the year.
3. These two asylums, in addition to providing accommodation for the
insane of these Provinces, receive, in the case of Nagpur, the lunatics of the
Berars, and the asylum at Jubbulpore will in future, under recent orders, admit
cases sent to it from Rajputana and Central India.
Additions and alterations.
4. At Nagpur extensive improvements have been and are in course of
being carried out.
Servants' quarters have been completed, the roofs of the male and female
cells have been boarded over, and a window for ventilation added to each
female cell. The foundations of the boundary wall—consisting of brick masonry
pillars and iron gratings on a raised plinth—were laid, and the work is in pro-
gress. Plans and estimates were prepared for a scheme of water-supply, by
which, in addition to the water required for personal use, the vegetables and
fruit required for the Institution may be cultivated within the boundary wall.
5. At Jubbulpore a piece of Nazul land was added to the frontage of the
asylum, with the view to increase the privacy of the Institution, and afford a
site for quarters for the Native Establishment.
These quarters were built in the year, and they will materially add to the
efficiency of the management in many respects.
An iron grating was put up at the entrance to the premises of the asylum,
and the usual repairs were done to all buildings by the Department of Public
Works.
2
STATEMENT I.
6. Nagpur.—The asylum here had a total population of 154 insanes, of
whom 35 were females.
Twelve males and 3 females were admitted from the Central Provinces, and
4 males and 1 female from the Berars; and the re-admissions were 8 males and 1
female, two of which came from the Berars. The admissions of 1891 are fewer
than in either of the previous 7 years, except in 1888 when they were equal.
Five patients were discharged as "cured," 3 males and 2 females, including
a female lunatic from the Berars; and 4 under the heading "discharged other-
wise," including 3 sent for trial and 1 to complete his sentence in jail.
7. At the Jubbulpore Institution the total population was 163, of whom 31
were females. There had been 27 "admissions," of which 4 were females; and
the "re-admissions" numbered 2 only—1 male and 1 female. Of the total
population, 12 males were discharged as "cured," 2(1 male and 1 female) as
improved, 4 (3 males and 1 female) were discharged "otherwise," and 15
(12 males and 3 females) died, leaving 130 (104 males and 26 females) under
treatment at the close of the year.
Both the re-admissions to this asylum were prisoner lunatics who were
transferred from the criminal to the non-criminal list.
8. In both Institutions the daily average strength, the admissions and
re-admissions were slightly greater than in the previous year.
9. The percentage of "cured "to the daily average strength was greater
in the Jubbulpore and less in the Nagpur Institution than in 1890.
10. The percentage of deaths to daily average strength was more favour-
able in the Nagpur Asylum than it had been in the five previous years.
In the Jubbulpore Asylum it was less favourable, having been 11.21 as
compared with 9.94 in 1890.
11. The percentage of cured to daily average strength in the two asylums
is shown below:—
Nagpur
1890 ...
„
1891 ...
Jubbulpore 1890 ...
„
1891
...
6.76
3.3
5.35
8.97
The percentage of " cured" to admissions shows better results for the past
as compared with the year 1890.
12. There was no over-crowding at either Institution. The capacity of
the Nagpur and Jubbulpore Asylums, at 54 superficial feet per patient, is 162
and 163; and the maximum number of patients in confinement on any one
night was 135 and 139 respectively in each.
13. An interesting comparison is made in Table I of the vital statistics
of the two Central Provinces asylums with the asylums of other Provinces.
3
TABLE I.
Provinces.
Bengal ...
Punjab ...
Rangoon ...
Tezpur ...
Bombay ...
Central Provinces ...
Do. ...
Year.
1890
1890
1890
1890
1890
1890
1891
Total popula-
tion during
the year.
1,240
419
354
142
1,006
308
317
Daily average
strength.
1007.30
327.21
259.46
110.65
706.1
249.06
260.98
Cured during
the year.
86
54
28
6
114
15
17
Percentage of
cured to total
population.
6.9
12.9
7.9
4.2
11.3
4.8
5.4
Percentage of
cured to daily
average
strength.
8.5
16.5
10.8
5.4
16.1
6.0
6.5
STATEMENT II.
14. Of criminal lunatics remaining under treatment in January 1891,
there were 45 at Nagpur and 30 at Jubbulpore. The admissions (5) were fewer
at Nagpur than they had been for the four previous years, but greater (8) at
Jubbulpore than in the ten years ending with 1891.
Of the re-admissions of criminal lunatics, there were 5 at Nagpur and
none at Jubbulpore, and there is little material difference in the daily average
strength of this class between the years 1890 and 1891.
15. Statements III to V—relating to the religion, sex, occupation and age
of patients—do not call for any special observations.
16. No. VI is the Statement showing the types of insanity; and the figures
of the two asylums show that the classification of the various forms of mental
disease is fairly uniform.
17. Statement VII gives the causes of insanity, as far as they can be ascer-
tained from the very meagre history with which patients first come under the
observations of Civil Surgeons.
Moreover heredity, which is an important factor in the majority of cases
of insanity, will always present difficulties in investigation.
It is not surprising therefore that the cause of insanity should be returned
as " unknown" in so large a percentage of the patients treated in these and
other asylums in India.
It is interesting to note that of the 73 patients remaining in both asylums
on the 31st December last whose mental disorder is attributed to physical
causes, only 5 of them are females.
STATEMENT VIII.
18. The health of the patients in both asylums may be said to have been
fairly good.
4
19. Table II shows the principal causes of admission to hospital:—
TABLE II.
Diseases.
Influenza
...
Fevers
...
Dysentery
...
Diarrhœa
...
Debility
...
Rheumatism
...
Anœmia ...
Bronchitis
....
Pneumonia
...
Abscess, Ulcer and Boil
...
Cholera
...
Jaundice
...
All other causes
...
Total
...
Nagpur ...
Jubbulpore
...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Admissions into Hospital.
1890.
29
27
62
10
6
2
2
...
13
1
2
2
2
2
4
...
...
1
8
...
...
...
...
...
20
17
148
62
1891.
...
...
51
23
1
2
...
4
4
5
...
1
1
4
10
1
...
2
4
5
1
...
...
...
24
20
96
67
Differences.
—29
—27
—11
+ 13
— 5
=
— 2
+ 4
— 9
+ 4
— 2
— 1
— 1
+ 2
+ 6
+ 1
...
+ 1
— 4
+ 5
+ 1
...
...
...
+ 4
+ 3
—52
+ 5
20. The admissions to Hospital in the Nagpur Asylum fell from 148 in
1890 to 96 in 1891, and the percentage of deaths to strength from 6.76 in 1890
to 6.29.
5
There was a marked absence of bowel complaint in this asylum during
1890, as compared with previous years.
In the Jubbulpore Asylum the sickness and mortality were somewhat
greater than in the previous year ; the admissions being as 67 to 62, and the
percentage of deaths to strength as 11.21 to 9.94.
The daily average sick at both asylums was :—
At Nagpur ...
At Jubbulpore ...
1890.
13.47
5.55
1891.
12.97
5.30
21. A comparison is made in the following table of the ratio of deaths to
the daily average strength, and of the deaths to admission.
TABLE III.
Asylums.
Nagpur
...
Jubbulpore ...
Ratio of deaths to daily average
strength.
1889.
25.47
15.16
1890.
6.76
9.94
1891.
6.29
11.21
Ratio of deaths to admission.
1889.
91.66
123.53
1890.
25.00
56.52
1891.
27.59
51.72
22. The various causes of death are shown in Table IV.
TABLE IV.
Diseases.
Influenza
...
...
Cholera ... ...
Dysentery ... ...
Fever
...
...
General debility ... ...
Old age ... ...
Anœmia ... ...
Epilepsy ... ...
Acute mania ... ...
General paralysis of the insane ...
Heart disease ... ...
Bronchitis ... ...
Pneumonia ... ...
Other causes ... ...
Total ...
Nagpur.
1890.
1
...
...
2
2
...
1
...
...
...
...
1
...
1
8
1891.
...
1
...
2
1
...
...
...
...
1
...
3
...
...
8
Jubbulpore.
1890.
5
...
1
...
1
1
1
...
2
...
...
...
...
2
13
1891.
...
...
1
...
4
3
1
1
...
...
1
...
1
3
15
Of the eight deaths in the Nagpur Asylum, 3 were caused by bronchitis,
2 by fever, and 1 each by cholera (a solitary case), general debility and gene-
ral paralysis of the insane. At Jubbulpore 7 of the deaths are returned as
due to general debility and old age, and 1 each to dysentery, anœmia
6
epilepsy, fatty degeneration of the heart, and pneumonia. There were 3
deaths from other causes, one of which was suffocation, from food blocking
the windpipe.
23. Table V compares the death causes in the asylums of the Central
Provinces with those in the asylums of other Provinces.
TABLE V.
Provinces.
Bengal ...
Punjab ...
Rangoon ...
Tezpur ...
Bombay ...
Central Provinces ...
Do. ...
Year.
1890 ...
1890 ...
1890 ...
1890 ...
1890 ...
1890 ...
1891 ...
Percent-
age of
sick to
strength.
5.77
8.26
8.13
7.04
9.54
7.64
7.00
Percent-
age of
deaths to
strength.
6.94
10.39
15.41
8.20
11.04
8.43
8.81
Percentage of total deaths from
Fevers.
2.86
11.76
...
...
6.41
9.52
13.04
Dysen-
tery.
20.00
26.47
7.50
22.22
11.54
4.76
4.35
Diar-
rhœa.
...
11.76
15.00
11.11
23.07
...
...
Phthisis.
1.43
2.94
...
...
1.28
...
...
Chest
affec-
tions.
4.28
14.71
5.00
...
3.85
4.76
17.39
Anœmia.
7.14
...
...
11.11
...
9.52
4.35
Other
diseases.
64.29
32.36
72.50
55.56
53.85
71.44
60.87
24. Statement No. IX gives the details of receipts and expenditure of
the two asylums.
There was a decrease of Rs. 239-13-1 in the amount drawn from the Trea-
sury for the Nagpur Asylum in 1891, as compared with 1890, due to the saving
in Establishment and Fines.
In the Jubbulpore Asylum Rs. 680 were drawn in excess of last year's
totals, accounted for by—
(1) Rs. 300 being drawn in full for Superintendent's charge allowance;
(2) Rs. 108 spent over and above the amount of last year for Warders'
uniform;
(3) the greater cost of rations by Rs. 336 ; and
(4) Rs. 63 in larger requirements for contingencies.
25. The sums paid into the Treasury by the Superintendents of the two
Asylums are here stated, and compared with the previous years :—
Nagpur ...
Jubbulpore
1890
1891
1890
1891
On account of paying
patients.
Rs.
132
98
916
899
a.
0
2
7
5
p.
7
7
4
6
On account of sales.
Rs.
759
1,726
324
541
a.
4
14
14
10
p.
10
2
0
3
The receipts from paying patients is seen to be again less in both asylums,
the reason for which is explained in the Reports of the Superintendent.
7
26. The average actual cost per patient in the two asylums is very nearly
the same, being Rs. 71-14-2 in Nagpur, and Rs. 71-0-6 in Jubbulpore. Exclud-
ing the item Allowance of Superintendent, which is twice as great at Jubbulpore
as at Nagpur, the expenditure under all other heads was greater at Nagpur,
except a very small excess for diet at Jubbulpore.
27. In Table No. VI is seen at a glance the expenditure of the two
Institutions under the various headings.
TABLE VI.
Mean cost per head.
Asylums.
Nag-
pur.
1890.
1891.
Difference ...
Jub-
bul-
pore.
1890.
1891.
Difference ...
Superinten-
dence.
Rs.
18
14
-4
20
22
+ 1
a.
5
2
2
10
6
12
p.
1
5
8
3
10
7
Establish-
ment.
Rs.
22
19
-3
15
15
-0
a.
7
4
3
6
5
1
p.
6
6
0
7
6
1
Diet.
Rs.
25
28
+ 3
27
29
+1
a.
5
15
10
2
1
14
p.
2
8
6
7
1
6
Clothing
and
bedding.
Rs.
5
5
+ 0
2
2
-0
a.
13
15
1
11
1
9
p.
4
1
9
8
10
10
Building
and
repair.
Rs.
0
0
-0
a.
3
1
1
p.
10
11
11
...
...
...
Bazar
medi-
cines.
a. p.
...
0
+ 0
1
1
...
...
...
Contingen-
cies.
Rs.
4
2
-2
1
1
+ 0
a.
13
12
0
7
14
6
p.
2
9
5
7
6
11
English
medicines.
Rs.
0
0
-0
0
0
+ 0
a.
14
9
4
2
2
0
p.
4
9
7
5
9
4
Total.
Rs.
77
71
- 6
67
71
+ 3
a.
14
14
0
9
0
7
p.
5
2
3
1
6
5
28. Statement X is a detail of the sanctioned establishment.
29. Statement XI gives details of the receipts and expenditure in manu-
factures.
In both asylums efforts are made to supply all that is used in the asylums
themselves, and a small amount is realized by sales to the public in addition.
30. Statement XII is an abstract of the Cash Account, and gives for ten
years—ending with 1891—the total cost, and the cost of each lunatic calcu-
lated on the average strength.
31. The total net profits were greater at both asylums in 1891 than they
were in 1890 by Rs. 1,172-11-3 at Nagpur, and Rs. 198-6-3 at Jubbulpore.
The net gain per head is also larger at both asylums, being Rs. 10-11 2 at
Nagpur, and Rs. 2-8-2 at Jubbulpore better than in 1890.
The total cost per inmate is as under: —
Nagpur ... ...
Jubbulpore ... ...
Rs.
71
71
a.
14
0
p.
2
6
or, after deducting the receipts from paying patients and the net profits of the
year in each asylum, Nagpur patients cost Rs. 52-14-2 and Jubbulpore Rs. 56-4-11.
32. The establishment of both asylums was for the first time supplied
with uniform free of cost.
8
33. It is instructive to compare the mean cost per head of the patients in
the asylums of the Central Provinces with those of other Provinces, and to
show this the following Table VII has been prepared:—
TABLE VII.
Mean of
Years.
7
6
6
8
2
8
1
Provinces.
Bengal ...
Tezpur ...
Rangoon ...
Punjab ...
Bombay ...
Central Provinces ...
Central
Provinces
1891 ...
Mean cost per head.
Superin-
tendence.
Rs.
19
19
13
12
25
21
18
a.
11
14
3
14
0
9
6
p.
10
6
2
8
2
7
3
Estab-
lishment
Rs.
20
25
29
32
38
16
17
a.
13
8
13
14
11
3
4
p.
0
4
0
2
10
11
2
Diet.
Rs.
34
34
46
38
66
26
29
a.
15
15
5
8
6
0
0
p.
0
10
5
0
5
8
5
Clothing
and
bedding.
Rs.
2
4
2
6
6
2
3
a.
11
8
5
12
13
8
15
p.
9
8
9
4
10
6
8
Building
and
repair.
Rs.
1
0
a.
7
0
p.
9
3
...
...
3
0
0
8
9
0
0
3
11
Bazar
medi-
cines.
Rs.
0
0
0
0
0
a.
1
9
7
3
5
p.
1
6
1
8
2
...
...
Contin-
gencies
proper.
Rs.
4
2
3
5
8
3
2
a.
11
2
12
14
3
5
5
p.
8
0
3
4
5
1
6
English
medi-
cines.
Rs.
0
0
2
0
2
0
0
a.
7
7
3
13
0
7
6
p.
4
5
6
7
5
6
9
Total.
Rs.
84
88
98
98
151
70
71
a.
15
2
2
0
1
12
7
p.
5
6
2
9
3
6
8
34. I visited these asylums more than once during the year, and consider
the Superintendents of both Institutions are well deserving of the thanks of
Government for the excellent order and efficiency maintained in them.
I have the honour to be,
Sir,
Your most obedient Servant,
J. G. PILCHER, F. R. C. S., SURGEON-COLONEL,
Deputy Surgeon-General,
Central Provinces.
3
materially affected the quality of the vegetables grown during the months of July, August, Sep-
tember and October, and diminished the quantity of some ingredient normally present in those
vegetables (possibly vegetable salts?). In the case of the lunatics the worst effects noted
were tumefaction and sponginess of the gums, anœmia, and a loss of weight, and the extensive
indurations of the fleshy parts of the extremities ; but exhausting dysentery, which formed so
common a feature of this scorbutic condition amongst the outside population, was not seen
amongst the lunatics.
The causes of death were :—
Cholera ...
Remittent fever ...
Debility ...
General paralysis ...
Bronchitis ...
1 (ptomaine poisoning ?)
2
1
1
3
8
STATEMENTS Nos. IX AND XI.
The total receipts from the Treasury were Rs. 239-13-1 less than in the previous year,
owing to savings in Establishment and Fines. The amount received from paying patients was
Rs. 98-2-7, compared with Rs. 132-0-7 in 1890. There is only one paying patient in the
asylum, and the monthly amount paid for her subsistence has been recently reduced from
Rs. 7 to Rs. 3-8 by order of the Board of Visitors. The remainder is made up by subsistence
allowance received from the Deputy Commissioner an account of patients sent for observation
as to their mental condition.
The amount in column 4 is made up as follows :—
Garden and Farm ... ...
Europe Medicines ... ...
Clothing and Bedding ... ...
Jail Miscellaneous ... ...
Public Works Department charges ...
Total ...
Rs.
612
77
681
15
2,756
4,142
a.
9
11
10
0
0
15
p.
2
6
6
0
0
2
The total expenditure is Rs. 12,003-13-10 as compared with Rs. 10,395-15-1 of 1890, or an
excess expenditure in 1891 of Rs. 1,607-14-9. It will be noted, however, that there is an excess
of Public Works Department charges in 1891 of Rs. 1,707-0-0, as compared with the same
charges in 1890. Dieting in 1891 cost Rs. 490-1-8 more than in 1890, but there were
more lunatics to be fed in 1891 than in the former year, and the daily average strength, as
shown in Statement No. I, was 127.21, as compared with a daily average of 118.27 in 1890.
During the months of October, November and December the price of food grains also
increased.
The amount paid into the Treasury was Rs. 1,726-14-2, as compared with Rs. 759-4-10
in 1890. It having been decided to abolish the Asylum Farm, this was done, and the stock
realised Rs. 794. The sale of farm produce of the previous season makes up the balance.
The net profit on the year's transaction was Rs. 2,318-10-10, as compared with
Rs. 1,145-15-7 of the previous year, which was then noted as the highest since the opening of
the asylum.
The following Table gives the average cost per lunatic under the various heads during
the past 6 years. The total per head is Rs. 5-8-5 less than the previous year, the chief items
of expenditure which are less being cost of Establishment, Contingencies and Medicines. The
cost of diet is identical with the cost in 1890; and the clothing is Re. 0-1-9 per head higher
than in 1890, this is owing to higher rates charged in the jail for blankets. New uniforms have
been supplied to the asylum warders, keepers, and female keepers.