8
graph 8 of my Report for 1886 and to sickly seasons: thus admissions from fevers
numbered 24, 50 and 72 in the three years 1885, 1886 and 1887 respectively,
the average strength being 161, 160 and 138. A large increase in fevers treated
at the various dispensaries in the Nagpur district has also been registered in
1887, viz. 28 per cent with reference to the previous year, the increase in total
treated being 5 per cent only. The cooking arrangements are precisely similar
to those in the Central Jails; they are supervised with care, and the fact that
only eight cases of bowel disease occurred in 1887 without a fatal result would
seem to be opposed to the theory of inferior cooking to which it was suggested
the heavy bowel disease of 1886 might be due, 25 admissions and 14 deaths,
the cooking arrangements of both years being the same, nor is it possible to
feed men forcibly with chappaties, the food to which exception has been taken:
food forcibly administered was for the most part fluid or soft, as soup, milk,
rice, dal, vegetables, and so on. As regards the position of the asylum I am of
opinion that it is one of the best in Nagpur, and with respect to farm labour,
which has been suggested as a possible cause, we have the high authority of
the late Sanitary Commissioner with the Government of India Surgeon-General
Cunningham, and the opinions of Surgeons-General Beatson and Townsend,
former Superintendents of this asylum, to the effect that this form of employ-
ment was most suitable for lunatics: also the fact that only one man who was
so employed died during the year under report. This man (No. 18 in the detail
of cases here given) a Betul Gond, had been over nineteen years in the asylum,
during which period he was employed exclusively on farm work.
7. In paragraph 8 of my Report for 1886 I gave some of the causes of
mortality which were in operation during that year. It was considered, however,
(Deputy Surgeon-General's covering letter, paragraph 15) that the causes of
sickness producing this mortality might have also been explained : although
the causes of sickness and of mortality may for practical purposes be said to be
synonymous. I give here in short detail the histories of those who died; the
cause of sickness may be plainly read in this record, whilst the causes of mor-
tality are obvious : there is nothing I think in this short record to show that
either the cooking, the site or the labour is at fault. Of the 22 who remained
at the close of the year 1886 under treatment 9 died, thus :—Bowel disease three,
anœmia and general debility four, and one each from general paralysis and
dropsy : and of the 124 admitted to hospital during the year sixteen died,
thus:—Anœmia and general debility six ; phthisis, asthma and acute mania one
each, and fevers seven. The following are summaries of the histories of fatal
cases:—
DYSENTERY.
No. 1, admitted June 1875, aged 35, weight 100 lbs., disease chronic
dementia.
History.—Hides at meal time, throws his food about, refuses to eat, has
to be forcibly fed Began to run down in September 1886, ulcers formed on
parts pressed on, got dysentery in October, this disappeared, leaving him very
anœmic, diarrhœa then set in, from which he sank in January 1887. Resi-
dence in asylum 11 years and 7 months. Did no work.
DIARRHÆA.
No. 2, admitted June 1875, aged 35, weight 103 lbs., chronic dementia,
goes naked, refuses all food, constantly eating rubbish and mud, got diarrhœa