28
LUNATIC ASYLUMS IN BENGAL.
Cholera appeared on the 3rd July, when a very suspicious case occurred among the
women, whose compound and ward are cut off from the rest of the asylum by a high
wall. The native doctor, Annoda Pershad Dey, thought it a case of worms; but although
a round worm was expelled by vomiting, yet I adhered to the diagnosis of cholera, the
case was treated as such, and recovered. On the 10th July the second jemadar was taken
ill at the asylum after a burra khana in the bazar, where cholera was. The next case
among the patients, also a woman, occurred on the 4th July and proved fatal. On the
14th a careful post-mortem examination was made. The first case among the men happened
on the 18th July, and proved fatal; and the other cases (two) on the 20th, (two) 22nd, (one)
23rd, (one) 30th of July, (one) 2nd, and (one) 5th of August, respectively. The female
cases were isolated as far as possible, being treated in the workshed (there is no female
hospital), and the males likewise in the isolation ward in the garden. The medicines used
were chiefly simple astringents for vomiting and purging, effervescent drinks, tincture of
cantharides, and nitrate and acetate of potash for suppression of urine. A trial was made
here as in the Penitentiary with Amyl Nitrite, followed by Belladonna; but no definite
advantage was noticed from the use of these two medicines.
Diarrhœa caused 42 cases and 12 deaths, and dysentery 31 cases and seven deaths.
These diseases were thus very prevalent. I cannot but think that, although the season was
a very unhealthy one generally, had an arrangement for lattice-work bathing-platforms
been carried out, much of this kind of sickness would have been prevented.
The arrangements at present allow of patients drinking the water they have washed
in, and the occurrence of intestinal worms, as well as these diseases, is clearly shown to be
frequently closely related to the state of the drinking water. At the day latrine the
stop-cock arrangement would have prevented the use of dirty water; but they were not
working. Both at the wells and at the tank were the male lunatics bathed. Dirty water
was undoubtedly habitually drunk. All the wells were cleaned out last year in the hot
weather. The incidence of cases among the females was, in July, cholera two, diarrhœa two;
August, dysentery one, and September, dysentery one; total, excluding cholera, four; and
among the males, in January, diarrhœa two; February, dysentery one; March, diarrhœa
two; April, diarrhœa 13, dysentery two; May, diarrhœa three,. dysentery two; June,
diarrhœa nine, dysentery four; July, diarrhœa two, dysentery seven; August, diarrhœa
three, dysentery five; September, diarrhœa five; October, diarrhœa two, dysentery three;
November, diarrhœa three, dysentery four; and December, diarrhœa two and dysentery
two; total 76.
The habits of the patients as to promiscuous defæcation and earth-eating is doubtless
a fertile source of these diseases. The freedom with which lunatics part with their clothes,
and the consequent difficulty in keeping them covered, especially at night, is another likely
source of this class of disease. The quality of the food was carefully looked to and
was good. The wards, frequently and minutely inspected, were clean and dry, but
perhaps a little too freely ventilated for the colder months, which fault in the cases of the
hospital ward was rectified by having most of the small round holes in the shutters plugged
up. As to diseases of the respiratory organs there was one case of pneumonia remaining ; in
January, pneumonia one; February, pneumonia one ; April, pneumonia one; July, pneumonia
two ; August, bronchitis one; November, bronchitis one, pneumonia two, pleurisy one; and
December, pleurisy one ; total (pneumonia eight, pleurisy two, bronchitis two) 12. The deaths
occurred in January two, May one, July one, August one, and November one ; total six.
Almost all of the fatal cases were complicated.
There were 33 cases of ague falling chiefly in February three, March four, May five,
June five, and September four; and two deaths in April and one in July. Of the 12 anæmia
cases, three remained and others came in: in February one, July two, August
two, November two, and December one, and one female- also in December.
There were
three deaths, viz. September one, October one, and December one. Dysentery and diarrhœa
occurred in all these.
The fatal case under " lumbago " died of dysentery.
8. Income and expenditure.—The total manufacture credits of the asylum for
1878 amounted to Rs. 3,192-4-8, and those for 1877 to Rs. 1,953-3, showing an
increase of Rs. 1,239-1-0. The expenditure for 1878 was Rs. 2,419-5-8 and for 1877
Rs. 1,286-5-6, the increase being Rs. 1,133-0-2. The excess of credits or profits during
1878 was Rs. 772-15, in 1877 it was Rs. 666-14-2. The outstanding bills, amounting to
Rs 23-4-1, consisted of amounts from about Rs. 9 downwards, which were not collected
before the end of the year, e.g. value of oil-cake sold Rs. 8-13-7, of mats sold Rs. 7-6,
and of tea-baskets sold Rs. 7-0-6.
As to the heads of expenditure, the cost of establishment was Rs. 8,613-2-1 against
Rs. 8,342-11-5 in 1877. The increase amounts to Rs. 270-6-8, and is due partly to short-
drawings in January 1877 on account of pay for December 1876 issued in December 1878,
and chiefly to the entertainment for 12 months in 1878 against four months in 1877.
The expenditure during the year for vegetables has been Rs. 120-15-10, most having
been furnished by the asylum garden under the able superintendence of Mr. Maunder, the
Overseer. More land than in 1877 was under cultivation immediately around the asylum,
and rice, dâls, wheat, mustard, and sirguja were grown, and turned out good crops, particu-
larly the dâls rahur, burai, and chunna. The diet cost in cash Rs. 6,084-14-1 against
Rs. 6,283 in 1877. More articles by Rs. 2,164-0-1 against Rs. 1,497-13 were supplied