( 2 )
3. The first point to be noticed concerning the mortality of 1879 is, that
there has been great increase in the death-rates of all the asylums, Cuttack from
the smallness of its numbers being left unconsidered. There was no epidemic
disease. The public health of the year, so far as it is yet known, was generally
better than 1878. If, therefore, the mortality of the asylums have a common
cause, it will probably be in great part a cause special to themselves. Such a
cause existed in the distribution, between the affected asylums, of the lunatics
from Chota Nagpore. These people had been dying in large numbers at Hazaree-
bagh up to the time when the asylum was closed. The state of health in which
they reached Calcutta and Berhampore was very bad, and it was probably not
much better at Patna. Of 60 persons sent to Dullunda eight died; of 54 sent
sent to Patna six died; of 32 sent to Berhampore ten died, and of 17 sent to
Dacca one died. Of the total number distributed, viz. 163, there died in the
several places 25 persons, in nine months. At Hazareebagh, in 1878, of a total
of 229 persons there had died 43; and during the first two-and-a-half months
of 1879 the deaths were nine in 175, or nearly 27 per cent. of the total per
annum, a rate much higher than the highest recorded elsewhere. Thus, though
the transfers added largely to the death lists of the other asylums, the
transferred people gained by a reduced death-rate among themselves.
4. Having regard to the great influence on mortality of the condition in
which persons newly admitted reach an asylum, it would be more correct to
reckon death-rates on total numbers treated, as is done in hospitals, than on
the average population, as is done in jails. I append a statement showing the
numerical relation between admissions and deaths in 1879, the former including
transfers from Hazareebagh as well as re-admissions.
Dullunda ... ... ...
Patna ... ... ...
Dacca ... ... ...
Berhampore ... ...
Total treated.
335
296
247
229
Deaths.
42
35
20
22
Admissions.
134
97
59
49
Here the indication is very pointed. It is disturbed only by the case of
Berhampore, where the death-rate among the transferred persons was very high.
If the transfers be separated, the order will be unbroken, viz.—
Dullunda ... ... ...
Patna
...
...
...
Dacca ... ... ...
Berhampore ... ... ...
Total.
275
242
230
197
Deaths.
34
29
19
12
Local admissions.
74
43
42
17
5. Of the 134 persons admitted into Dullunda asylum, 40 only reached
the asylum in good condition, and there were 14 deaths in the total number.
At Patna, of 97 persons admitted, 57 were in bad or indifferent health. The
actual number of deaths among these was 13; of the 35 persons who died,
only five were in good health on admission, and 17 were actually sick or in
bad health. At Dacca nothing is said of the condition of lunatics received, in
the aggregate. The register gives only four deaths among the admissions
of the year; and of the 20 persons who died, nine are recorded as in good
health on admission. One of them had come from Hazareebagh. Dr. Shircore
at Berhampore, speaks of the wretched condition of the lunatics from Hazaree-
bagh, but says nothing of the local admissions of the year. Among the
latter there were no deaths in 1879 ; among the former there were ten. Of the
entire number of fatal cases, four only are said to have reached the asylum
in good health.
6. It is necessary next to consider the influence of sickly admissions on the
increase of mortality in 1879, that is, the difference between the deaths among
new admissions in 1878 and 1879. So far as I can yet learn, there has been
less public sickness in the latter year throughout the Province, except at
Patna, where 1879 is reported to have been more unhealthy than any year
since 1874. Lunatics at large share, in very full measure, the influence of
season.
At Dullunda there were five deaths among new admissions in 1878, and
14 in 1879 ; at Patna three in 1878, and 13 in 1879 ; at Dacca four in
1878, and four in 1879 ; at Berhampore two in 1878, and 10 in 1879. The