12
LUNATIC ASYLUMS IN BENGAL.
33. Mortality.—The total deaths in 1884 rose to 87 from 52 in 1883, or
a return to what it stood at in 1882. It is not a high mortality; and could we
but eliminate those deaths which rightfully belong to 1883, the rate would be
an average one. The healthy year 1883, possibly prolonged the lives of the
phthisical, the debilitated, and senile, lives which depend in a great degree,
some altogether, upon meteorological conditions. Thus, in 1883 two deaths
were placed to debility, two to old age and thirteen to phthisis—the correspond-
ing numbers for 1884 being seven, four, and twenty-six. Dr. French, in his
annual report for 1883, wrote: " There were four deaths from this disease
(phthisis) out of 10 cases, but the six (remaining) will very probably die this
year." In the present report he adds.—" This actually occurred, and besides
nine new cases of the disease also died, bringing up the total number of deaths
from this disease alone to 15." He continues,—"A good many of our new
admissions are found on examination to be suffering more or less from phthisis,
and after admission into the asylum simply go on from bad to worse."
Phthisis is a well recognized accompaniment of some forms of insanity, if
it is not one of its true causes. Anæmia and debility, conjointly or separately
again, are so frequently concomitants of mental disease—especially in malarious
situations—that the chances of recovery are greatly diminished in such cases,
34. Exhaustion from " mania" caused two deaths, apoplexy two, hydro-
cephalus 1, meningitis 1, general paralysis 1, and shaking palsy I, or 8 fatal
cases in all, which were directly or indirectly attributable to the cerebral condi-
tions, on account of which the patients were confined. The principal increase of
mortality in 1884, over that of 1883, was occasioned by diarrhœa,
dysentery, debility and phthisis, and the increase was confined to Dullunda,
Dacca and Patna. There were three fatal cases of bowel-complaints in
Dullunda during 1884, viz., one from diarrhœa and two from dysentery.
In 1883 the asylum was reported free from deaths from these diseases. Patna
furnished two deaths from diarrhoea, Cuttack one from dysentery, while in
Berhampore the deaths from these complaints were absent altogether. Cholera
shewed itself in Dacca, causing two deaths. There was no cholera in the other
asylums. One case of small-pox was admitted into the Patna Hospital, which
proved fatal. The remaining deaths are not above the average.
Insanes confined in asylums are subjected to the same influences which the
period of the year exercises on the sane, and, as a rule, the general mortality
rises and falls with that among the inhabitants in the neighbourhood. That so
few cases of the types of zymotic diseases were present throughout the year, and
the deaths so small,—when we remember that small-pox and cholera were both
extensively epidemic in the several districts of this Province,—speaks highly
to the protected state of the inmates, and reflects infinite credit on those
responsible for the sanitary condition of the institutions.
35. The mortality among insanes is undoubtedly greater than among the
sane. The following table exhibits the death-rate recorded in the cities
and towns in which our lunatic asylums are situated—
TABLE No. 13.
Statement of deaths in 1883 and 1884.
NAMES OF
LOCALITIES.
Calcutta* ...
Dacca ...
Patna ...
Cuttack ...
Berhampore ...
Population.
433,219
80,161
160,237
43,239
23,605
Fever.
1883.
3,442
664
2,082
181
303
1884.
3,577
847
675
163
335
Bowel-
complaints.
1883.
1,307
220
1,140
174
10
1884.
1,187
275
334
111
34
Cholera.
1883.
2,037
48
538
61
23
1884.
2,139
231
76
162
49
Total deaths from
all causes.
1883.
12,325
1,916
5,254
579
438
1884.
12,944
2,568
1,943
786
469
Ratio per 1,000
of population.
1883.
28.45
23.9
32.78
13.39
18.55
1884.
32.22 32.03 12.12 18.17 19.86
* Exclusive of Fort and Port.
36. General and concluding remarks.—I have to note with much satisfaction
a considerable increase in examinations.—Post mortem. An autopsy should be
held after every death in an asylum, provided no objections are raised
by relatives or friends of the deceased.