LUNATIC ASYLUMS IN BENGAL.
9
22. Anæmia and debility gave a considerable decrease in Dullunda;
a slight increase in Dacca, Patna, and Berhampore ; remaining stationary at
Cuttack. Diarrhœa increased in Dacca. One case only was admitted throughout
the year in Cuttack. In 1884 the disease was absent altogether in this
asylum. It decreased elsewhere. Dysentery increased very slightly in
Dacca (1), Patna (2), Cuttack (3), but Berhampore, which had been
entirely free from the disease in 1884, gave three cases. In none of the
asylums could the disease be said to have been epidemic. On the contrary,
the total admissions were small, being 11, 9, 7, 5, and 3 for each
institution respectively. Pneumonia occurred in Dullunda, two cases only
being recorded. The almost entire absence of this disease from the returns
this year is a most healthful sign, and points to a very satisfactory sanitary
condition of the asylums. The very large decrease in phthisical cases also
is a most gratifying feature in the present returns. The total treated
under this head in 1884 was 34. In 1885 they totalled 16 only. There
were no deaths from cholera registered in the year. Only two cases
of the disease were treated. They occurred at Berhampore. In 1884 there
were two fatal cases at Dacca. All the other asylums remained entirely free
from the disease in 1884 and 1885. The following figures shew the prevalence
of cholera in the jails adjacent to the asylums:—
Presidency Jail ... ... ...
Alipore
„
...
...
...
Dacca
„ ... ... ...
Patna
„
...
...
...
Cuttack „ ... ... ...
Berhampore „ ... ... ...
Total
treated.
1
90
12
3
...
7
Died.
1
39
8
2
...
5
Thus, save in Cuttack, the disease was present in each jail in 1885, and in
some of them in an epidemic form. That the asylums should have been so
free from cholera, considering its prevalence in their immediate vicinity, is
very satisfactory. The immunity, it may almost be said, which these institu-
tions enjoyed from this most fatal disease reflects the greatest credit on the
responsible officers, and speaks volumes as to the admirable sanitary condition
of their respective charges. Small-pox made its appearance in the Dacca
Asylum. Three cases were admitted under treatment of which two died.
Both these cases bore marks of inoculation. Chicken-pox was also a visitant
in this asylum during the year. Three cases are recorded. Two cases
of the same disease were also admitted into the Patna Asylum. In neither
of these institutions, however, did the disease spread. It was confined to
these solitary instances. Dropsy following on malarial fevers shews a
decrease. Fevers rose considerably in Patna and Berhampore, while the
falling of in Dacca is remarkable. I have no doubt the late floods in
that part of the province tided over the miasmatic period of the year to a
very sensible extent. The amount of fevers in the Dullunda Asylum fell to a
solitary admission in 1885, but the return of the fever cases treated as out-
patients in that institution shews that they amounted to 117. Dr. Murray
explains this as follows :—" The prevailing type of fever among the lunatics
in this asylum is a mild remittent, and it has always been customary to
treat the cases as out-patients. Consequently without sending in a return of
out-patients, the actual fever prevalence cannot be estimated. It was only in
the event of a case becoming serious that he was admitted as an in-patient.
So that his admission was determined by the severity rather than by the duration
of his fever. There was only one such bad case in 1885, and he is shewn as
usual in return No. 8. I consider this mode of classifying fever patients to be
open to objection, but as it has been in vogue for so many years, I did not
care to alter it without due consideration. The line of action proposed for
adoption in paragraph 25 of your annual report for 1884 would have been
followed during the year under review, but it was received too late in the year
to make a change in our system desirable. During the current year all fever
cases are admitted as in-patients as soon as a diagnosis is made." The diversity
of practice which exists among the several Superintendents with regard to the