( 3 )
but the smaller number of such cases in the total of acute mania reduces the
recoveries under that head from 26 per cent. in 1878 to 18. The same influence
has also affected the percentage of cure under other heads.
9. The causes of insanity were unknown in exactly half the cases
admitted and re-admitted taken together (98 out of 196). In 81 cases physical
causes were assigned, and in 17 moral causes; 43 ordinary and 18 criminal
cases were ascribed to the use of ganga, bhang, or churrus; 5 ordinary and
1 criminal case to ardent spirits; 1 ordinary and 1 criminal case to opium.
In by far the greater number of known cases, therefore, the use of drugs is
believed to have been the procuring cause of insanity.
10. The health of the asylums during the year was by no means satis-
factory. Although the total number of admissions to hospital was only 510
as against 739 in 1878 and 818 in 1877, cases of fatal sickness were more
numerous. There are no returns of the admissions to hospital at Hazaribagh
for the three months during which that asylum was open; and this fact serves
to reduce the apparent total of admissions in 1879. If Hazaribagh be excluded
altogether, the number of admissions was nearly the same as in 1878, and less
by 86 than in 1877. But, as the Surgeon-General remarks, the inmates of
Hazaribagh were only transferred to the other asylums, and helped to raise the
totals of their sick lists for the remainder of the year.The totals of the year
may therefore not unfairly be compared with those of 1878. The following
table gives an analysis of the figures for each asylum:—
Admissions into hospital
...
...
...
...
...
Ditto per cent. of mean strength
...
...
...
Daily average sick
...
...
...
...
...
...
Ditto
in 1878
...
...
...
...
...
Ditto
per cent. of mean strength ... ...
Ditto
ditto
in 1878
...
...
Dullunda.
69
31.31
6.63
3.15
3.05
1.54
Dacca.
120
61.19
8.70
16.07
4.43
8.17
Patna.
170
74.45
14.75
11.81
6.46
5.83
Cuttack.
35
68.22
1.20
1.84
2.33
3.84
Berhampore.
116
58.85
7.38
5.74
3.74
2.97
Total.
510
57.30
38.66
38.61
4.34
4.57
It is not possible to compare accurately the rates of sickness in the different
asylums because, as the Surgeon-General points out, differences of practice
exist with regard to the entry of patients in the hospital returns. Thus, in
Dullunda the admissions to hospital are fewer than in other asylums because
trivial cases are treated as out-patients and kept on a separate list. The Lieu-
tenant-Governor thinks that there should be a uniform rule of practice for all
asylums, and that all cases receiving medical treatment during the year should
appear in the sick returns. He would be glad if the Surgeon-General would
issue orders on the point. It is open to him to make such distinction as he
thinks necessary between in-patients and out-patients of the asylum hospitals;
but both classes should be taken into account in any estimate of the compara-
tive healthiness of the asylums.
11. The death-rate in all the large asylums was, as already noticed, very
high, there being 131 deaths (not 122, as stated in paragraph 17) against 100 in
1878 and 73 in 1877. The Lieutenant-Governor is aware that the mortality
in jails during 1879 has also been very high. The increased mortality in the
asylums was not due to any increase in zymotic or preventible disease ; fever
and cholera having caused fewer deaths than usual; dysentery and diarrhœa
about the same. The chief increase is, as the Surgeon-General points out, " in
pulmonary diseases, which have been fatal in 32 cases against 20 in 1878; and
the increase (in such deaths) is confined to the Dullunda Asylum." The follow-
ing statement compares the mortality of 1878 and 1879 in each asylum :—
Dullunda
...
...
...
...
...
Dacca... ... ... ... ...
Patna
...
...
...
...
...
Berhampore
...
...
...
...
...
Cuttack
...
...
...
...
...
Hazaribagh
...
...
...
...
...
1879.
Mean strength.
1
217.16
196.10
228.32
197.08
51.30
......
Total deaths.
2
42
20
35
22
3
9*
Percentage of
column 2 to
column 1.
3
19.34
10.19
15.33
11.16
5.85
......
Deaths from
pulmonary dis-
ease.
4
20
7
4
1
......
......
Percentage of
column 4 to
column 2.
5
47.62
35.00
11.42
4.54
......
......
1878.
Mean strength.
1
204.31
196.58
202.26
193.19
47.85
207.1
Total deaths.
2
15
8
13
16
5
43
Percentage of
column 2 to
column 1.
3
7.34
4.06
6.43
8.28
10.44
20.76
Deaths from
pulmonary dis-
ease.
4
7
1
2
2
1
7
Percentage of
column 4 to
column 2.
5
46.66
12.50
15.38
12.50
20.00
16.28
* In first quarter of year.