8
LUNATIC ASYLUMS IN BENGAL,
a palpable error; one to cholera—an equally ludicrous piece of guess-work ;
93 to grief ; 10 to fear; 13 to jealousy ; 1 to litigation; 2 to love; 7 to religion ;
1 to a dream; and 6 to anger ; or finally 582 are placed to " known " causes
and 557 to " unknown," for which no possible reason could be made out.
22. Gunja, undoubtedly, as in the case of opium, possesses aphrodisiac
properties in the first instance. That it may be indulged in for this purpose
is possible. The subject is not alluded to in any one of the annual reports-
The fact, however, that women very rarely either smoke the drug, or drink an
infusion of it, is significant. In the statement one woman is set down as
having suffered from the effects of bhang (Dullunda), while opium is alleged
to have caused mental disease in another (Patna). Yet opium is said to be
extensively consumed by both sexes in some districts. Spirits as a cause, of
insanity is largely represented. No mention, notwithstanding this, is made
of " alcoholism " or "delirium tremens," in any of the returns. From this fact,
I am inclined to doubt the correctness of assigning so many cases to excessive
drink.
The alleged causes entered in statement VII, bears the stamp of mere
guess-work.
TABLE No. 9.
Admissions into hospitals
...
...
...
...
...
Ditto
per cent. of mean strength
...
...
...
Daily average sick
...
...
...
...
...
Ditto
in 1883
...
...
...
...
...
Ditto
per cent. of mean strength
...
...
Ditto
ditto
in 1883
...
...
Daily average number of out-patients
...
...
...
Dullunda.
93
40.93
13.38
6.18
5.88
3.09
19.75
Dacca.
136
59.77
11.88
10.17
5.22
4.58
4.18
Patna.
84
36.23
13.3
10.06
5.73
4.94
5.41
Cuttack.
16
27.25
2.95
3.42
5.02
6.41
13.96
Berhampore.
36
20.48
3.19
4.48
1.81
2.49
6.18
Total.
365
39.63
44.7
34.31
4.85
3.9
49.48
23. Sickness.—Generally the health of the asylums, with the exception
of Patna, Dullunda, and Dacca, where the rise in the admissions into hospital
from fevers, diarrhœa, and phthisis is noticeable throughout the year under
report, may be said to have been fairly good. When comparing the results of
1884 with 1883, it must not be lost sight of, that the latter year was, in regard
to the sickness in the asylums, an exceptionally healthy one.
24. The daily average sick rose in Dullunda, Dacca, and Patna, and fell
in Cuttack and Berhampore. The admissions into hospital in the three former
asylums were 93, 136, and 84 in 1884, against 36, 51, and 77 in 1883
respectively.
25. In the analysis of the figures presented in Statement VIII, much
depends on factors unseen, such as, the general health conditions—physical
health on reception into the asylums—of the persons confined, the season of
the year, epidemics among the free population, and atmospheric influences, in
the elucidation of anything of real value from them. Besides, the system of
treating " mild " cases as " out-door patients," and discharging sick to the care
of friends, nullifies the average ratios. A daily average number of out-door
patients treated is given in the return, it is true, and the figures, so far, are
corroborative of what I have said ; but the whole truth is not available for
accurate comparison. Some medical officers carry the practice of treating their
patients on the " out-door" list to a greater length than others, and all treated
in this way are not registered. It is impossible, I am aware, to lay down hard-
and-fast rules suitable to all cases. Medical officers should undoubtedly be free
to exercise their own discretion in deciding when or not a patient ought to be
admitted into hospital. Still, I think, if a patient, with a specific illness,
is required to attend hospital over 24 hours—I am speaking now of mild cases,
for of course all serious cases are admitted at once—his or her name should
be registered, either as an " out " or " in door patient." The tendency to keep
down the sick list is sufficiently apparent, where practised, on calculating the
percentage of"recoveries" and "deaths "to" total treated." Dr. Murray
partly accounts for the increase of sickness in the Dullunda Asylum, in 1884,
"to the practice adopted during the year of admitting many cases into
hospital, which in former years would have been treated as out-patients."
26. This " diversity of practice," noticed in paragraph 15 of the annual report
for 1879, could not be better illustrated than in the following table, which I