( 3 )
1907 and 101.31 in 1908. These variations occurred chiefly in the Berhampore
Asylum. Last year the reduction in hospital cases in this Asylum was credited to
sanitary improvements The large increase in 1908, however, (the figures being
605 against 363 in 1907) might seem to negative this conclusion, but it does not,
as the excess was mostly confined to cases of indifferent health and trifling
ailments which were accorded regular treatment in the hospital instead of in
their quarters. There was only one case of cholera in the triennium under review.
The patient recovered. Cases of fevers decreased from 267 in 1906 to 185
in 1907 and 149 in 1908. In the last of these years all the Asylums showed
a decrease of fever and not a single death, against one each in 1907 and 1906.
These results may be connected with the use of prophylactics during un-
healthy seasons of the year in all the Asylums. Of zymotic diseases, small-
pox broke out only at Patna, there being throe attacks in 1906 and one each in
1907 and 1908. There was no death. Bowel complaints (dysentery and
diarrhoea) gave 123 admissions in 1906, 81 in 1907 and 48 in 1908. The
deaths from these affections also steadily decreased, the numbers being 20, 7
and 5, respectively. It is interesting to notice that at Patna where these
disorders were prevalent in 1907, the number of cases in 1908 showed a de-
crease from 43 to 11, a result which is due to improvement in the drinking
water-supply which I suggested in July 1907. The Superintendent at Ber-
hampore urges the construction of a separate building for dysenteric cases.
A temporary building is being constructed which will meet present require-
ments. Anti-dysenteric vaccine from the Central Institute at Kasauli was
obtained, but met with little success. Phthisis was largely present at
Berhampore during each of the past three years and gave 28 admissions
in 1906, 24 in 1907 and 29 in 1908, but there was a much lessened
mortality in 1908, viz., 14 against 22 in 1907 and 21 in 1906. It is
stated that some of the lunatics were admitted in the asylum in 1908 suffering
from the disease. Patna had a clean return as regards this affection in 1906
and 1907, but in 1908 there were 4 cases with 3 deaths. Two of the lunatics
who died from this cause were admitted during that year in bad health.
Suitable arrangements have been made at Berhampore for the separate treat-
ment and segregation of tubercular patients. The open air method of treat
ment so essentially necessary in such cases was also adopted during the last
3 months of 1908 by treating selected cases in tents pitched in the grounds of
the Asylum. This resulted in great benefit to the patients. The excreta of
dysentery cases and sputum of tubercular cases were burnt daily in this Asylum.
All soiled blankets were also boiled every day. Pneumonia was responsible for
a total of 7 admissions in 1906 and 5 deaths, 9 and 7, respectively, in 1907 and
5 and 1 in 1908. At Patna there was one case only in 1908 which died,
against 6 in 1907, all fatal. At Berhampore seven lunatics were also treated
for leprosy in 1908. Two died. These patients are at present housed in the
cholera shed, but the Superintendent does not consider it desirable to retain
them in the Asylum grounds. The question of the proper housing of these
sufferers is now engaging my attention.
9. The total death-rate on daily average strength was 10.27 in 1906,
8.94 in 1907 and 7.63 in 1908, an average of 8.94 against 10.29 in the
previous three years. The rate of mortality in 1908 was less than in Madras
(9.11), in the same year, Punjab (11.64), United Provinces (12.62), Bombay
(8.9), and Eastern Bengal and Assam (8.54), and it was much less than that
recorded for County and Borough Asylums in England where it was 10.12
per cent. in 1907.
10. For the past two years Berhampore has shown a decreasing mortality,
viz., 46 against 55 in 1907 and 64 in 1906. It is remarkable that female
lunatics did not so largely share in this result. The portion of the old
Asylum which they occupy is not readily susceptible of improvement. Of
the 46 lunatics who died in 1908 one was resident in the Asylum for 42 years,
and two from 19 to 20 years. One lunatic came to the Asylum in an advanced
stage of tuberculosis and died after 11 days from the date of admission.
Another was received in such poor health that he succumbed to secondary
syphilis after 22 days. In this Asylum there were two deaths in 1908 from
severe injuries which will be referred to in a later paragraph of this report.
11. If these two casualties are excluded from the total mortality in
Bengal in 1908, the death-rate per cent. will stand at 7.40 for that year instead
of 7.63. There are no other special features in mortality statistics of the
Asylums which call for detailed criticism in this report.