( 4 )
It will be seen that the great increase in mortality, viewed as a whole,
is a feature common to Dullunda, Dacca, and Patna, and that although the
absolute number of deaths from pulmonary disease in Dullunda is large, the
proportionate number of deaths in that asylum from. diseases of that class is
but little higher than in 1878.
12. Taking the asylums separately, the returns for Dullunda for 1878
showed 34 admissions to hospital during the year, and two remaining from the
preceding year, or a total of 36 under treatment. Of these, 15 were cured, 15 died,
and 6 were left in hospital at the close of the year. There was only 1 case of
fever, one of diarrhœa, none of dysentery or cholera, 7 of anæmia, 4 of pneumonia
and 5 of phthisis. Of the deaths, 7 were due to pulmonary diseases. In the year
1879 there were 69 admissions to hospital and 75 altogether under treatment,
of whom 25 were cured, 1 was discharged, and 42 died. The principal
diseases prevalent were anæmia, giving 6 cases; diarrhœa, 5 cases; dysentery,
10 cases; fevers, 2 cases; pneumonia, 3 cases; phthisis, 16 cases. The deaths
were due, 3 to anæmia, 1 to asthma, 3 to cirrhosis of the liver, 1 to debility, 1 to
diarrhœa, 5 to dysentery, 1 to emphysema, 1 to enteritis, 1 to epilepsy, 3 to
exhaustion of mania, 1 to hepatitis, 1 to leprosy, 1 to meninggitis, 1 to old age,
1 to pleurisy, 16 to phthisis, and 1 to pulmonary apoplexy. Pulmonary affec-
tions thus caused 20 of the 42 deaths. Dr. Payne remarks that this class of
diseases has long been prevalent in this asylum, but never before attained the
development of the past year; and it appears that the servants of the asylum
suffered as well as the patients, though it is not stated whether there were
any fatal cases among the former. On the other hand it is stated that
simple acute diseases of the lungs are seldom fatal at Dullunda. Of the
six persons who died from diarrhœa and dysentery, four brought their illness
with them to the asylum, and in another case old age contributed to the fatal
result. Generally it is reported that in five cases of death old age was an
important factor, and it is said that in 18 cases the disease was brought to
the asylum with the patient. It would at the same time appear from the state-
ment (11) given in paragraph 23 of the report that in the great majority of
fatal cases of phthisis the patients had been more than six months in the
asylum.
13. The Lieutenant-Governor would wish to have more full and detailed
report upon the exceptional mortality of the year both in Dullunda and in the
other asylums. It should be investigated specially with reference to the health
and mortuary statistic of the year among the neighbouring jail and civil
populations. The causes are evidently of a general character, as there was
nothing in the working of the asylums during the year to account for the
mortality. The changes of diet introduced in Dullunda led to the patients
gaining flesh, and no changes were made in the buildings or in the clothing of
the lunatics. It should, however, be reported whether there is any ground for
suspecting that the character of the buildings at Dullunda has anything to say
to the prevalence of pulmonary diseases in that asylum ; and, if so, it should be
considered whether any improvements, such as asphalting the floors, &c., are
desirable.
14. In the Dacca Asylum there were, in 1878, 189 admissions and 14
cases remaining from the previous year, or a total of 203 under treatment. Of
these the great majority were cases of febrile affections, dysentery, and diarrhœa.
There were only six cases of pulmonary disease, and the deaths were only
8 in all—2 of these being from diarrhœa, 1 from dysentery, 1 from cholera,
and 1 from pulmonary disease. In 1879 there were only 120 admissions and
136 under treatment; but there were 20 deaths—7 from diarrhœa, 2 from
dysentery, and 7 from pulmonary diseases. Half the total number of deaths
are said to have occurred within a month of admission, by which is meant
apparently admission into hospital. As already remarked, Statement No. 11
does not show that these pulmonary diseases were most fatal among new
admissions to the asylums. As regards zymotic or preventible diseases, the
health of this asylum has greatly improved of late years, as the following
statement proves:—
Fevers
...
...
Diarrhœa ... ...
Dysentery ... ...
Admissions to hospital.
1875.
128
64
47
1876.
113
67
40
1877.
53
44
37
1878.
49
40
15
1879.
30
14
8