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The admissions to hospitals were more numerous in 1900 than in the
previous year, owing to the greater unhealthiness of some of the towns in which
the asylums are situated and to the fact that a larger number of trifling cases were
treated in hospital for shorter periods. In 1901 the lunatics enjoyed excellent
health, a circumstance which was generally in keeping with the health results
of these towns and the neighbouring jails. In 1902 although the asylum popu-
lation was much larger than in the previous year, the admissions to hospitals
were greater by 28 only, while the daily average sick showed a large reduction,
viz., 65.66, against 77.15 in 1901. At Dullunda and Bhawanipur, the increase
in admissions was trifling; but in the former the daily average sick showed a
marked diminution—13.44, against 24.52. At Dacca the admissions were
fewer by 18, and at Cuttack by 9. At Berhampore fevers were more common,
and in this respect there was an agreement between the asylum figures and the
local public health, which was bad. The total admissions were, however, fewer
by 16 than in the previous year, there having been fewer cases of general bad
health. At Patna the admissions increased by 68, although the health of the
general population of the town and of the prisoners in the jail was better. The
increase at Patna is attributed to lung affections and diarrhœa, which was most
prevalent in July. The asylum itself is of the worst type as regards buildings
and is alone sufficient to account for the increase.
Bowel-complaints (dysentery and diarrhœa) furnished 287 cases in 1900, 102
in 1901, and 117 in 1902. In 1900 Dullunda had the largest number of cases,
and the prevalence was chiefly connected with the deficient supply of filtered
water. As stated above diarrhœa was more common at Patna in 1902, but the
Superintendent could trace no local cause. Fevers gave 232 cases in 1900, 139
in 1901, and 187 in 1902. Most of the increase in 1902 occurred at Berhampore,
Phthisis was responsible for 31 cases in 1900, 24 in 1901, and 47 in 1902.
There was a large increase of this affection at Dacca in 1900, in 1901 there was
1 more case than in the previous year, but in 1902 there were 29 cases, against
13 in 1901. The patients were isolated as much as possible under existing
arrangements, but to do this thoroughly and effectually I suggested during my
last inspection of this asylum that a special ward should be set apart for such
cases and the Superintendent has been asked to submit plans and estimate of
cost for building it. Of the 29 cases at Dacca five were in an advanced stage
of the disease, and admitted direct into the hospital. There were 12 cases of
cholera in 1900, one in 1901, and two in 1902. The two in 1902 occurred at
Berhampore where the infection was carried by the coolies of the Public Works
Department, who were working in the asylum. The disease was also more
prevalent in the town in 1902. One female and 17 male lunatics suffered from
chicken-pox in 1902 at Dullunda. Pneumonia was the cause of admission
of 8 cases in 1900, 6 in 1901, and 18 in 1902. The increase in 1902
chiefly took place at Dullunda and Patna, although the Superintendents of
these asylums report that the sick and weakly patients were supplied with
sufficient warm clothing.
The total death-rate was 10.67 per cent. in 1900, 6.18 in 1901, an ex-
ceptionally low figure, which was followed by a higher rate in 1902, viz., 9.35.
The percentage for 1902 was greater than those which obtained in that year in
the United Provinces of Agra and Oudh (6.39), and the Punjab (7.94) but was
nearly the same as in Bombay (9.), though much less than in Burmah (10.57).
In 1902 Dacca and Patna showed a large increase in mortality. In the former
asylum there were 27 deaths against 12 in 1901. The majority of the lunatics
who died in 1902 were criminals, most of whom were old chronic cases, and had
been residents in the asylum for years. Of the 27, six occurred among patients
who were brought straight into the hospital. Eighteen deaths resulted from
phthisis, two from apoplexy, one each from rupture of an artery, peritonitis,
and obstruction of the bowels. The causes of death of the remaining cases do
not call for notice. At Patna there were 15 more deaths than in 1901, 28
against 13. Of the 28 deaths 11 occurred among criminal and 17 among non-
criminal lunatics, against 5 and 8, respectively, in 1901. There was heavy
mortality from lung affections in 1902, viz., 14 against 3 in 1901. Of the 14,
7 were due to pneumonia against 1 and 5 from phthisis against 2 in 1901.
Four deaths resulted from tuberculosis, three from epilepsy, one from con-
cussion of the brain, a case of accident referred to later on, and one from