( 3 )
dementia. There were no recoveries from idiocy or amentia. The proportion
of complete cures was 10.61 per cent. of average strength, 8.58 per cent. of
cases treated, and 35.51 per cent of admissions. The proportion of recoveries,
partial and total, was 17.14 per cent of average strength, 13.86 per cent. of the
total treated, and 57.36 per cent. of admissions. These results are much less
favourable than those of the previous year, which gave 28.23, 21.31, and 76.07
per cent. respectively, and were also considerably below the average of
the preceding quinqueninal period. The various fluctuations will be noticed
in the special remarks on the different asylums. No general explanation
of the decrease is offered, but it is doubtless in some degree attributable
to the more careful selection of lunatics for admission during a part of the
year; and from this point of view it may be expected that the results of the
current year will also appear less successful than those of 1875 and the
year immediately preceding it. Dr. Beatson points out that even last
year's results compare favourably with the statistics of the public asylums
of Middlesex and Surrey for the ten years ending in 1874. It appears that in
these institutions the average proportion of cures was 7.56 per cent. of average
strength, 22.95 per cent. of cases treated, and 30.51 per cent. of admissions.
The comparison is interesting, but it does not appear to be of any practical
value. The mass of the population of England, and especially of the metro-
politan districts, is exposed to very different mental conditions from those
which are produced by the every-day life of the native of Bengal. The
stimulus to mental activity is greater and more sustained, and the strain on the
faculties is more severe. It is only natural, therefore, that in the former case
lunacy would assume more complex and less tractable forms than in the latter.
The only useful basis of comparison is to be found in the results of different
asylums in Bengal, and in the results of the same asylums in different years.
Viewed according to these tests, the results of the year exhibit a wide and
imperfectly explained divergence in the degree of success attained.
6. There were 1,152 admissions into hospital, or 94 per cent. of average
daily strength, against a proportion of 102.4 per cent in 1875. The average
daily number of sick was 8.02 per cent. of mean strength, against 7.48 in the
previous year. The admissions into hospital were exceptionally numerous in
Dacca and Moydapore, where they numbered 250 and 230 per cent. of males
and 103 and 235 per cent. of females respectively. In Dacca the daily average
proportion of sick to mean strength was 17.49 per cent. of males and 12.54 per
cent. of females; in Patna it was 9.42 and 7.46 respectively; and in Hazaree-
bagh, where only males were conf1ned, it was 10.83. In Dullunda and
Berhampore the rates were, for males 53.6 and 55.48 admissions and
3.49 and 2.47 daily average sick per cent. of mean strength, and for females
49.6 and 3.3 and 65.9 and 1.9 respectively. It is clear therefore, after
every allowance is made for the mental and inferior physical condition
of insane patients, that there must be some special conditions affecting
the health of the lunatics in Dacca, Moydapore, and Hazareebagh. This
point will be adverted to further on. It seems highly probable that the great
frequency of diarrhœa and dysentery in all the asylums may be to a consider-
able extent due to a practice amongst the lunatics, discovered both at Dullunda
and Hazareebagh, of drinking exceedingly impure water; but measures have
now been adopted to exclude them from access to this impure supply at those
two asylums, and similar precautions should be taken in other asylums. The
average mortality in the asylums during the year was 9.7 per cent. of mean
strength. This death-rate is lower than was attained in any one of the
previous ten years, and it is no less than 5 per cent. below the average
mortality of that period. Cuttack heads the list with 18.11 per cent., chiefly
caused by diarrhœa and dysentery; Dacca and Dullunda come next with 13
and 11.3 respectively; Hazareebagh and Moydapore, in which, as has been
remarked, the number of sick was large, the mortality was, curiously enough,
below the average. Berhampore and Patna are the only asylums which
preserve a fairly low rate both of sickness and of mortality.