LUNATIC ASYLUMS IN BENGAL.
11
The condition of 1881 was ordinary. The increase of bowel disorders and the
very great increase of cholera were not represented in the asylum.
At Dacca fevers were more fatal in the town, but there was only one death
in the asylum. Bowel complaints were more fatal in the town, but did not vary
in the asylum. Cholera increased also in the town, but was absent from the
asylum.
At Patna fevers were very fatal in the town, and in the asylum 3 deaths
took place. Bowel complaints were more fatal in town and less in the asylum.
Cholera caused more deaths than before in the town, and none in the asylum.
At Cuttack the town shewed no important variations. There was some
increase of cholera.
24. Regarding the death-rates of particular asylums, it will be observed
that in this, as in former years, the mortality, both absolute and proportional,
has been much higher at the Presidency and Patna. The general causes of
this were fully set forth last year, viz., the number of annual admissions and the
condition in which lunatics are received. The effect of the last point is not
measured by the numbers of those who die shortly after admission. It deter-
mines largely the condition of the inmates as a whole and the general death-
rates. Thus, at Dullunda there were 80 admissions in the year and 33 deaths. Of
these, 11 were among recent admissions, and all of these 11 brought to the asylum
the illness that was fatal. In all, 16 of the fatal cases dated from admission,
though in some ill health took a longer and a fluctuating course. Of the cases of
fatal phthisis, all but one were ill from admission. Of the entire number admitted
in 1881, only 48 were noted as in good physical health at the time.
At Patna there were, in all, 52 admissions and 30 deaths. Of the 52
persons admitted, 12 only were received in good health. Of the 30 persons
who died, it is recorded of only two that they were in good health on admission.
Of the 16 deaths from phthisis, it is said that not one was that of a person
received in good health. Four, however, had lived more than 29 years in the
place, one eight, and one six years. It seems clear, concerning six others,
that they brought the disease with them to the asylum and died after short
periods. All that need be said of this disease has already been said in
discussing the number of cases; for this, and not the number of deaths, is the point
for enquiry. With phthisis death is, in the aggregate, a mere question of time.
At Dacca there were 46 admissions and re-admissions and 10 deaths; of 42
primary admissions the health on admission of 26 was noted as good, of 15 as
indifferent, and of one as bad. Of the 10 persons who died, four were said to
have been in good, and 2 in fair, health on admission. Two only of the 10 died
within a year of admission, one of them within a few days, being ill throughout.
At Cuttack there were 16 admissions in all, among which 7 persons are said
to have been in good health, 6 were feeble, and 3 were ill. Of the six who died, the
health on admission is reported as good in two cases, and indifferent in the rest.
At Berhampore there were 19 admissions and re-admissions, and 13 are
noted as having been in good health on arrival. Of the five persons who died two
are noted as in fair health on admission.
25. The relation of death to recent admission appears as follows:—At the
Presidency, 11 persons of less than one year's residence died; at Dacca the
number was 2 ; at Patna 10; at Cuttack 2 ; and at Berhampore 1. It is clear,
therefore, that the joint influence of the number and condition of persons
annually admitted was very strong in determining the comparative mortality of
the several asylums in 1881.
26. The 6th and 7th tables of the appendix contain some figures which
call for notice as illustrating the effect of mental condition on life. It is well
known that maniacal affections are more fatal than other forms of insanity, not
only by direct nervous exhaustion, but as causing or favouring development of
physical disease and preventing recovery from it. The asylum therefore which
harbours the largest number of maniacs should cœteris paribus have the largest
number of deaths. Results in Bengal are in close accordance with existing
knowledge on this point. In the Presidency Asylum in 1881, there were
treated in all 277 persons (excluding those returned as "not insane"), and
among them were 165 maniacs. At Dacca there was a total of 226 with
only 88 maniacs. At Patna 280 with 161 maniacs. The relation of these
figures to the death number is very marked.