10
LUNATIC ASYLUMS IN BENGAL.
30. Mortality.—The total number of deaths in Bengal asylums fell from
131 in 1879 to 109 in 1880, and the ratio per cent. on daily population from
14.7 to 12.3, the proportionate fall among males being somewhat larger than
among females. The average of the previous decade was 11.5 per cent. These
figures as they stand would probably not attract much attention, for the rise in
1880 over the average is well within the range of ordinary fluctuations; but
inasmuch as mortality in 1877 and 1878 had fallen very low, and as the events
of two asylums only have prevented the totals from being low in 1880, it is
advisable that the circumstances be examined as minutely as they were last
year.
31. At the Presidency the number of deaths fell from 42 to 38, at Dacca
from 20 to 10, at Berhampore from 22 to 15, at Patna the number rose from
35 to 42, and at Cuttack from 3 to 4.
32. In my last report I showed the effect on mortality in other asylums,
of the transfer of lunatics from Hazaribagh, where they had been dying in
large numbers. Of these lunatics, the Presidency Asylum had received 60,
Patna 54, Berhampore 32, and Dacca 17. In the nine months of 1879 follow-
ing the transfer, 8 of these persons had died at the Presidency, 6 at Patna,
10 at Berhampore, and 1 at Dacca. The influence did not end with 1879.
In 1880 there died of persons received from Hazaribagh at the Presidency
10, at Patna 8, at Dacca 3, and at Berhampore 1. Of the entire number who
died, it can be said of only one that he was in good health on admission.
Many were received at once into hospital, and all, with that single exception,
were invalids. The death lists therefore at the Presidency and at Patna were
considerably lengthened by invalids from Hazaribagh. At Dacca also the
effect of transfer must not be ignored ; for, though the cases were much less
numerous, the deaths bore high proportion both to the transferred number and
to the total of deaths.
33. Of the 38 persons who died at the Presidency, 26 were ill from their
admission, whereof 9 came from Hazaribagh and 17 from other places. Of
the total number, 6 only were received into the asylum in good health, though
many lived with recurring illness for considerable periods.
34. At Patna, of the 42 persons who died, 4 only are noted as received
in good health, of 4 there is no record, and the rest are described as weak or
actually ill. Of the 10 persons at Dacca, 1 only is noted as in good, and 3 were
in fair, health on admission. Of 15 at Berhampore, 2 were in very good, and
3 in fair, health. Of 4 at Cuttack, 1 only was in good health on admission.
35. I would again draw attention to the deceptiveness of the figured
statement which purports to show the duration of illness in fatal cases under
headings of particular periods. The entries record only the duration of the
last sojourn in hospital, and as many chronic invalids are treated for long
periods out of hospital, the table has no value as a measure of the effect of
asylum residence on illness, nor is it even a true index of the duration of
illness.
36. The relation of death to recent admission was as follows. At the
Presidency 14 persons of less than one year's residence died in 1879 and 13
in 1880: in 1878 the number was 5. At Patna the numbers were 3 in 1878,
13 in 1879, and 14 in 1880. At Dacca 5 persons were of less than one year's
residence, at Berhampore 4, and at Cuttack 1 only. A rough estimate of the
bearing of recent admission on mortality yields the following proportions.
At the Presidency old residents died in 1880 at the rate of 12 per cent. and
new-comers at the rate of 21 per cent. At Patna old residents showed 12 per
cent. and new-comers 23. At Dacca old residents 2½ per cent. and new-
comers 14. At Berhampore and Cuttack the numbers admitted were too
small to support a ratio. At Berhampore 4 persons died out of 7 admitted
within a year. It is clear from this that, broadly speaking, the asylum whose
annual admissions bear the largest proportion to its old residents will have the
largest mortality, and the bearing of this on the Presidency and Patna Asylums
is seen in the tables. It is clear also that the increase of mortality in these
two asylums in 1879 and 1880 owes much to the condition in which people
were admitted.