26
LUNATIC ASYLUMS IN BENGAL.
such insanes as are unmanageable outside, or dangerous or uncertain in their behaviour.
So also the friends and relatives of insanes able to provide for them endeavour to get them
out of the asylum, for so long as they are confined they lose position in caste. Fathers
are anxious to have their sons out to provide against the improper performance of funeral rites,
and for other family reasons.”
Difficulty in
distinguishing
non-dangerous
lunatics.
8. Dr. Stewart records his opinion as to the difficulty in distinguishing those lunatics
who may be considered harmless as follows:—“It is no easy matter to demarcate the broad
line ‘ not absolutely dangerous’ in lunatics, and thus separate those who should be excluded
from asylums, specially in subjects whose insanity is connected with ganja and other
physical exciting causes. Such may in a maniacal fit commit the most unexpected
excesses.”
Daily average sick.
9. The daily average number of sick in hospital was (males 3.50, females .35) 3.85, or
at the rate of (males 6.51, females 5.00) 6.3 per cent. of mean strength, and was considerably
higher than it had been in any year since 1867, with the exception of 1872, when it was
(males 3.81, females 1.03) 4.84.
Rate of admissions.
Rate of mortality.
10. During the year there were (males 40, females 4) 44 insane patients admitted
into hospital for treatment on account of disease, or at the rate of (males 74.44, females
57.14) 72.45 per cent. of mean strength. Of these (males 9, females 2) 11 died, and the
death-rate (males 16.75, females 28.57), 18.11 per cent. of mean strength, was higher than
that of any year of the preceding decennial period with the exception of 1866 and 1872,
when it was shown as (males 21.94, females 13.51) 19.87 and (males 25.16, females
25.66) 25.27 respectively. The following table shows those diseases which caused the
most marked amount of sickness and mortality among the male and female patients
respectively.
DISEASES.
Diarrhœa
...
...
Dysentery
...
...
Fevers
...
....
Of nervous system ...
Other diseases
...
...
MALES.
Admitted.
15
8
10
1
6
Per cent. of total
admissions.
37.5
20.0
25.0
2.5
15.0
Deaths.
5
...
...
1
3
Deaths per cent. of
total mortality.
55.6
......
......
11.1
33.3
Deaths per cent. of
treated.
33.3
......
......
100
50
DISEASES.
Diarrhœa
...
...
Dysentery
...
...
Fevers
...
...
Of nervous system ...
Other diseases ... ...
FEMALES.
Admitted.
1
2
...
...
1
Per cent. of total
admissions.
25
50
......
.
25
Deaths.
1
1
...
...
...
Deaths per cent. of
total mortality.
50
50
......
.
......
Deaths per cent. of
treated.
100
50
......
......
......
Causes of increased
sickness and
mortality.
11. From the foregoing statement it will be gathered that bowel complaints were
answerable for the greatest proportion of sickness and mortality in this asylum during the past
year; and judging from the high admission and sick rate of the male lunatics, there can be
little doubt but that the overcrowding mentioned in paragraph 5 of this summary exerted
a prejudicial influence on them. Regarding the increased sickness and mortality of the year,
Dr. Stewart offers the following explanation :—“ The average daily sick has been slightly in
excess, being 3.85. In 1875 it was 1.65 ; 1874, 2.42 ; and in 1872 it was 4.84. There has
also been greater mortality this year than in past years. This is partly due to overcrowding,
and partly to the weakly and aged condition of some of the chronic insanes, whose decline
was inevitable under any circumstances. There have been 11 deaths out of a daily average
strength of 60.73, or 18.11 per cent. The deaths during the three previous years were 2,
3, and 1 respectively. In 1872 there were 13. These figures show that the excessive mortality
of one year as compared with another is often due to accidental circumstances, as was noticed
in previous reports. The confirmed chronic insane declines in health, and becomes weaker
and weaker year by year. Bodily health suffers simultaneously or very soon after mental
health begins to fail. The cachexia which follows is evidenced by the wasted body, languid
functions of all organs, and a visible subsidence of life, which nourishment and careful nurs-
ing are powerless to prevent. Such cases go on for a few years and then suddenly drop off.
Nearly all the deaths this year were chronic cases, some of whom were from three to eleven
years resident in the asylum.”
No hospital for the
reception of the
sick.
12. It appears that in this asylum there is no separate hospital in which lunatics, when
sick, can be placed for treatment, nor is there any way of isolating special cases. Dr. Stewart
reports that “ considerable inconvenience is also experienced in treating cases of sickness owing
to no separate hospital ward existing. Patients are with difficulty kept separate from other
insanes, and isolation is impossible.”
Criminal lunatics.
13. At the commencement of the year 12 criminal lunatics (males) were in the asylum,
and 4 were admitted. Of these 3 died, or at the rate of 24.07 per cent. of mean strength,
which was 12.46. The four criminal lunatics admitted were chiefly from the hill states of
Orissa, on account of unprovoked murderous assaults. A few of this class in the asylum are