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remembered that there are cases in which resort to intoxicants is only
one of the first symptoms of mental unsoundness, and, though symptoms
may be immediately produced by the drug or the alcohol used, the true cause
of insanity is antecedent, and the disease genuine."
6. There were 32 patients in hospital at the beginning of the year,
and during it there were 385 admissions, the total number treated being
417. There has been a gradual and satisfactory improvement in the health
of the lunatics during the last four years. The number treated in 1878 was
784, and it fell to 543 and 516 in 1879 and 1880 respectively. The daily
average number of patients in hospital was 34.93 as compared with 40.6 in the
preceding year. The average number of out-patients also fell from 79.02 to
61.06. There was a great decrease in the number of cases of anæmia and debility,
the number having fallen from 60 in 1879 and 47 in 1880 to 25 during the
past year. In the Patna Asylum the number fell from 24 to 9. In his report
for 1880, Dr. Payne remarked "it is probable that under the regular practice
of post-mortem examinations, the vague names of debility and anæmia will appear
less frequently in asylum returns." The results as shown in the returns for the past
year have been in accordance with the Surgeon-General's anticipations. During
1880 there were 12 cases of cholera in the asylums, 9 of the cases having
occurred in the Berhampore Asylum and the other 3 in the Patna Asylum.
During the past year there was not a single case of cholera. There were also,
during 1880, 36 cases of diarrhœa in the Patna Asylum, and 20 cases in the
Berhampore Asylum: the numbers during the past year have been reduced to 13
and 5 respectively. In his preceding report, the Surgeon-General observed that
the water used in the Patna and Berhampore Asylums was open to suspicion,
and during 1881 the water at both these places was tested. It having been
condemned in each instance, it was decided to erect filters similar to those in
use in various jails. The filter at Patna has been erected, though it was not
completed till after the close of the year. .The filter for the Berhampore Asylum
has not yet been constructed; the Superintendent has, however, effected
an improvement in the water-supply, to which Dr. Payne attributed the decrease
in the number of cases of diarrhoea in that institution. There were only 82
cases of dysentery during 1881 as compared with 107 in 1880. Fever, on the
other hand, rose from 123 to 136 cases, the principal increase being in the Dacca
and the Patna Asylums. The number of cases of phthisis was 37 against 34 in
1880, and pneumonia increased from 5 to 9 cases.
7. The decrease in the mortality during the past two years has been very
marked. In 1879 there were 131 deaths, in 1880 there were 109, and during the
past year the number was only 84. With the exception of 1877, the number of
deaths has not been so low in any year since 1871 as it has been in 1881.
The death-rate reckoned on the mean daily strength fell to 9.6 in the past year,
from 12.3 in the year which preceded it. The largest number of deaths from
any particular disease was 28; these deaths were all due to phthisis. There were
13 deaths from dysentery, 7 from diarrhœa, and 5 from anæmia.
The
largest number of deaths from phthisis occurred in the Patna Asylum. It is,
however, reported that not one of the patients who died from this disease in
that institution was in a good state of health when he was admitted. The
number of deaths was, as in 1880 and 1879, higher in the Patna and Dullunda
Asylums than in any of the others. This depends, as the Surgeon-General
points out, on the number of annual admissions and the condition in which the
patients are received. The condition in which the patients were received into
the Dullunda and Patna Asylums during the past year was apparently worse
than that of those received into the Dacca, for the deaths amongst persons who
had been less than one year in the asylum amounted to 11 in the Dullunda
Asylum and to 10 in the Dacca Asylum. There were only two deaths amongst
patients of the same standing in the Dacca Asylum, though the admissions into
the Dullunda Asylum during the past two years were 82 and 80, and into the
Patna Asylum 65 and 52, while those into the Dacca Asylum amounted to 47
and 46 during the same years respectively. The excess of deaths in these two
institutions is also in part to be attributed to the larger proportion of maniacs to
the total number of patients in them. This form of insanity is more fatal
than any other, and the results in the different asylums are in accordance
with this fact. Thus in the Dullunda Asylum, with 277 inmates and 165