NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
7
33. The following table shows the mean cost per head of the patients
in the Asylums of the Central Provinces, compared with those of other
Provinces.
TABLE VII.
Mean
of
year.
11
10
10
12
6
12
1
Asylums.
Bengal ... ...
Tezpur ... ...
Rangoon ... ...
Punjab ... ...
Bombay ... ...
Central Provinces ... ...
Do.
MEAN COST PER HEAD.
Superin-
tendence.
Rs.
21
15
12
12
23
19
11
A.
5
10
8
11
6
5
6
P.
5
1
7
9
5
4
2
Establish-
ment.
Rs.
22
25
30
30
39
16
15
A.
3
11
1
14
0
2
6
P.
4
9
3
6
4
1
6
Diet.
Rs.
41
37
54
38
67
26
28
A.
0
11
1
8
9
13
10
P.
0
2
9
11
2
2
11
Clothing
and
bedding.
Rs.
3
6
2
7
6
2
2
A.
1
0
14
0
10
5
5
P.
4
7
6
5
2
10
2
Building
and
repairs.
Rs.
1
0
A.
6
0
P.
4
2
...
0
1
0
0
1
10
6
2
9
2
3
0
Bazar
medi-
cines.
Rs.
0
0
0
0
0
A.
1
9
7
4
6
P.
4
1
8
5
1
...
...
Contin-
gent
proper.
Rs.
5
2
5
5
8
2
4
A.
15
13
2
0
14
15
13
P.
1
5
4
1
3
7
3
English
medicines.
Rs.
0
0
1
0
1
0
0
A.
9
3
14
14
15
7
5
P.
8
11
11
10
4
5
5
Total.
Rs.
95
88
107
95
149
68
63
A.
10
12
3
8
7
7
1
P.
6
2
0
8
11
8
5
34. The average annual cost per head at Nagpur was Rs. 64-5-10 against
Rs. 56-8-3 in the preceding year, or an increase of Rs. 7-13-7. At Jubbulpore
it was Rs. 61-13-0 against Rs. 60-1-1 in the preceding year. The increase
observable at Nagpur occurs under the heads diet and contingencies, and is due
to the high price of food-grains.
35. The daily average strength of lunatics employed on manufacture and
garden is shown below :—
Asylums.
Nagpur
...
...
Jubbulpore
...
...
1893 ...
1894 ...
1895 ...
1893 ...
1894 ...
1895 ...
ON
MANUFACTURE.
Male.
3.33
7.42
12.07
15.00
12.87
12.00
Female.
0.83
1.95
2.29
5.00
5.00
5.00
ON GARDEN.
Male.
10.84
22.52
34.17
40.00
38.91
42.24
Female.
...
...
1.02
...
...
...
From the above table it will be seen that at Nagpur 46.24 males and 3.31
females were employed in manufacture and garden work; and at Jubbulpore
54.24 males and 5.00 females respectively. These figures do not include those
engaged on domestic employments, such as tailoring, cooking, grinding, clean-
ing wheat, sweeping, &c., and in addition, at Nagpur, in looking after the cattle
attached to the Dairy Farm.
36. Dairy Farm.—In the month of August last, the Chief Commissioner
sanctioned the establishment of a Dairy Farm at the Nagpur Lunatic Asylum.
The land which formerly belonged to the Asylum and which had been leased to
the civil authorities in 1891 had already been restored to the Asylum, and five
cows, one buffalo, one bull, together with the necessary apparatus, had been
procured in anticipation.
The amount at first sanctioned for the purpose was Rs. 560, but an
additional sum of Rs. 300 was granted by Mr. Woodburn in November.
The objects aimed at are to afford the lunatics congenial out-door occupa-
tion, to produce milk, &c., for the Asylum, and to sell to the public sufficient to
recoup the expenditure and to possibly make a profit.
8
So far the scheme has worked most successfully. For the first half year's
working the results have been an expenditure of Rs. 593-9-4(Rs. 322-8-0 of
which went to purchase live-stock) with an income of Rs. 593-5-2.
With more dairy animals to use, further progress is confidently expected.
37. Both Asylums were inspected by me during the year. The Superin-
tendents in charge, Surgeon-Lieutenant-Colonel H. K. McKay and Surgeon-
Major G. F. A. Harris, are most efficient officers, and the Deputy Superin-
tendents, 1st Class Civil Hospital Assistant Abdul Majid Khan at Nagpur, and
1st Class Civil Hospital Assistant Mohan Lall at Jubbulpore, are both deservedly
highly praised for their excellent work.
I have the honour to be,
Sir,
Your most obedient Servant ,
J. H. NEWMAN, M. D.,
Administrative Medical Officer,
Central Provinces.
9
Report on the Nagpur Lunatic Asylum for the year 1895.
STATEMENT NO. I.
Admissions and di scharges.
There were 40 admissions into the Asylum during
the year, viz.:—
Central Provinces ...
Berars ...
Total ...
34
6
40
(28 males and 6 females)
( 6 males)
34
6
There were also 2 re-admissions during the year: —
Central Provinces ...
Berars ... ...
Total ...
1 female
1 male
2
During the year there were 19 discharges from amongst the Asylum
inmates, 14 males and 5 females:—
Cured ... ...
Improved ... ...
Not improved ... ...
Escaped ... ...
Discharged otherwise ...
Total ...
11
3
3
1
1
19
All of the discharges took place amongst the lunatics from the Central
Provinces, and the period of residence of those discharged as "cured" varied
from 5 months, 16 days to 1 year, 8 months and 28 days, and the mental diseases
for which they were admitted to the Asylum were as follows:—
Mania
...
...
Dementia ... ...
Toxic insanity ... ...
Puerperal insanity ...
Total ...
7
1
2
1
11
Three lunatics (two males and one female) were discharged and made over
to their friends as " improved," two being cases of mania, and one of melan-
cholia. Three lunatics (all males) were discharged and made over to their
friends as "not improved." One female lunatic escaped and one female luna-
tic was discharged " otherwise " being sent to stand her trial.
Mortality.
There were 12 deaths during the year, viz.:—
Central Provinces ...
Berars ... ...
Total
...
Males.
7
3
10
Females.
2
...
2
Statement VIII shows the causes of admission to hospital.
The daily average strength was 135.49 males and 35.38 females, total
170.87, against 161.20 of 1894 and 146.60 of 1893. The daily average sick was
7.36 males and 1.48 females, total 8.84, as against a total of 10.61 of 1894.
10
STATEMENT II.
Fifteen criminal lunatics, all males, were admitted during the year as
against 12 in 1894 and 14 in 1893. Of these 12 were from the Central Provinces
and 3 from the Berars.
Re-admissions and discharges.
There were 2 re-admissions into the Asylum (1 male from the Berars
and 1 female from the Central Provinces). Four
criminal lunatics (all from the Central Provinces), 2
males and 2 females, were discharged as under:—
1 female (sent for trial)
2 males (made over to their friends)
1 female (discharged as " cured ")
Classification of criminal luna-
tics.
The following particulars of the different kinds
of criminal lunatics in the Asylums at the close
of the year are given:—
(a) Those tried and acquitted on the
ground of insanity ...
(b) Those insane on admission and
found incapable of making
their defence ...
(c) Those who became insane during
imprisonment ...
Total ...
Central Provinces.
Males.
32
20
...
52
Females.
...
2
1
3
Total.
32
22
1
55
Berars.
Males.
6
4
3
13
Females.
...
1
...
1
Total.
6
5
3
14
STATEMENT III.
Of the 42 admissions and re-admissions—
16 came from the Nagpur District.
3 „ „ „
7 „ „ „
2 „ „ „
7
„
„
„
2 „ „ „
3
„
„
„
2 „ „ „
42
Bhandara „
Chanda
„
Bilaspur
„
Berars
„
Chhindwara „
Sambalpar „
Balaghat
Classifying these into castes, show—
Hindus ...
Mahomedans ...
Other castes
...
32 (27 males, 5 females)
3 ( 3 males)
7 ( 5 males, 2 females)
42
STATEMENT IV.
Status and admissions.
The largest class of admissions were from amongst the labouring classes
(8), and next from amongst the class of cultivators (6);
the begging class are also well represented (3).*
* As noticed in last year's report, it is these 3 classes that supply the largest number of lunatics to our Asylums.
A recent writer, has said : " it is the failures and vices of civilisation that bring about the great mass of insanity, and of
" these the chief is poverty, with all its attendant evils of insufficient food and wretched dwelling, and the moral evils
" of anxiety and degradation"1.— (BLANDFORD, in " Quain's Dictionary of Medicines ".)
11
STATEMENT V.
The ages of the majority of the admissions were, as in 1894, between the
ages of 20 and 40 years. One epileptic child, aged about 5—6 years, was
admitted who had been abandoned by her parents.
STATEMENT VI.
Types of insanity.
The following is a summary of the various types of insanity found to
exist amongst the new admissions:—
Mania ...
Melancholia ...
Dementia (including acquired
imbecility) ...
Idiocy ...
Epileptic insanity ...
Toxic insanity ...
Total ...
27 (23 males, 4 females)
5 ( 5, all males)
6(5 males, 1 female)
1 (
...
1 female)
2 ( 1 male, 1 female)
1 ( 1 male)
42 (35 males, 7 females)
STATEMENT VII.
Alleged cause
of
insanity.
Physical causes ...
Moral causes ...
Unknown ...
Total ...
4
0
38
42
Amongst the admissions for physical causes is one case in which the alleged
cause is said to be the abuse of ganja. In the cases of one male and one female
the direct exciting cause is said to have been epilepsy. In only one solitary
case is heredity alleged as the cause of the insanity. This is in my opinion very
much below the probable reality, e. g., it is a safe conjecture that the majority
of the 5 cases of melancholia admitted during the year had a hereditary pre-
disposition to insanity. In the one case noted above, in which the alleged cause
is said to have been the abuse of ganja, the man admits to having had a
craving during many years for smoking ganja, but he also admits that he has
at various times and places taken considerable quantities of " rasi," " dobara "
and " kapai" (country spirit of various strength); and further, that he had also
frequently eaten and smoked opium. We have therefore possibly here a triple
combination of complex causes helping to complete the overthrow of what was
probably originally a mentally weak-fibred brain.* The very large number of
cases in which no definite cause could be ascertained is noticeable.
STATEMENT VIII.
The year was a much healthier year than its immediate predecessor. The
chief cause of admission was, as in 1894, influenza. The total admissions were
126 (96 males and 30 females), and of these no fewer than 38 (31 males and
7 females) admissions were for influenza.
The following table shows the chief causes of admissions to hospital:—
Influenza
Fever
Debility
Anæmia
Epilepsy
Bronchitis and Pneumonia
Bowel complaints
Other causes
...
...
...
...
...
...
...
...
38
36
6
4
12
0
2
103
23
126
* From enquiry and observation I have reason to believe that the parents of this man are of weak intellect, so
that the fact of heredity has also to be considered in apportioning the question of causation.
12
Mortality.
There were in all 12 deaths during the year, viz:—
Influenza ...
Anæmia and debility
...
Apoplexy ...
Epilepsy ...
Pericarditis
...
Pneumonia ...
Pyo-nephrosis ...
Exhaustion ...
Total ...
1
4
1
1
1
2
1
1
12
In the case of death from pyo-nephrosis the symptoms during life led to the
suspicion of there being a stone in the bladder, which was also found to exist,
and lithotomy having been performed, the stone was extracted without difficulty.
The patient, however, died about a fortnight later, and at death the right kidney
was found converted into a bag of pus. The case of death from exhaustion
was one of very pronounced melancholia with stupor with intense depression,
and from the day of admission there was an obstinate refusal to take food of
any description. It is probable that excepting a minute quantity all the
fluid food in the shape of milk, soup, &c, which were given by the nose,
mouth and rectum, was almost immediately rejected, and the man deliberately
starved himself to death. It is very difficult to understand how he actually
continued to remain alive, practically taking a minimum quantity of food only,
for one month and sixteen days after his admission to the Asylum.
STATEMENT IX AND XI.
The total receipts from the Treasury were Rs. 10,103-4-7 against Rs. 8,073-5-5
in 1894. At the close of the year 1895 (after deducting the balance of grain
which was unexpended in 1894) there is still a balance of grain in stock of the
value of Rs. 707-3-8.
The amount received from paying patients was Rs. 2,984-13-0, which includes
a sum of Rs. 2,535 adjusted by the Comptroller, Central Provinces, for 26 Berar
lunatics at Rs. 97-8-0 per head. The actual cash receipts from paying patients
during the year amounts to Rs. 449-13-0 against Rs. 391-3-8 of 1894 and
Rs. 159-9-1 of 1893.
The following items are shown in column 4 :—
Diet supplied inter-departmentally, including
garden and farm produce ...
Value of clothing made in Asylum ...
Miscellaneous charges ...
Total ...
Rs.
459
148
7
615
A.
6
10
6
7
P.
7
0
10
5
The total given in column 5, namely, the total of book receipts has been
arrived at as follows : —
Jail clothing ... ...
European medicines ... ...
Department Public Works charges ...
Total ...
Rs.
351
72
533
956
A.
0
14
0
14
P.
0
4
0
4
The total expenditure in 1895 was Rs. 10,435-6-8 as compared with
Rs. 9,128-5-5 in 1894, or an increase of Rs. 1,307-1-3. Of this the expenditure
on the dairy (details given later) amounts to Rs. 593-9-4 and the payment of
Ambajheri water-tax Rs. 144-0-0, or a total of Rs. 737-9-4. The balance of
the excess expenditure, viz., Rs. 569-7-11 is due to the fact that the daily average
15
to increase at the ratio at which it has done during the past five years (the daily
average in 1890 was 118.27 and in 1895, 170.87), I am of opinion that he
should have the assistance of a young energetic Hospital Assistant to work
under him, and who could be trained to Asylum work, which is quite distinct
from ordinary dispensary work. In this connection, I may state that I have
this year made a commencement of utilising the educational advantages and
facilities which the Asylum affords, in arranging that all the young Hospital
Assistants, who for a longer or shorter time are attached for duty at Nagpur,
shall receive a short course of clinical and practical instruction in the care and
management of cases of mental disease, which knowledge, I hope, will occa-
sionally be of use to them in their subsequent career.
S. M. Santio, the clerk and compounder, has also carried out all his duties
to my entire satisfaction. He is punctual and regular in his habits, and the
clerical work in the office, accounts, &c., have all considerably increased of late.
The usual monthly meeting of visitors were held, and the half-yearly
meetings on the 11th January and 16 th July 1895. The Asylum was inspected
by the Chief Commissioner, Mr. Woodburn, on the 12th August and 26th
November, the second visit being specially to inspect the Dairy and Farm; and
by Mr. Lyall on the 30th December.
Surgeon-Colonel Ross, Administrative Medical Officer, paid a visit of
inspection on the 16th March, and Surgeon-Colonel Newman, Administrative
Medical Officer, on the 4th April and 3rd August.
NAGPUR :
The 20th January 1896.
G. F. A. HARRIS, M. R. C. P., LOND.,
Surgeon-Major, I. M. S.,
Superintendent, Lunatic Asylum.
17
the word " unknown", and as the man often cannot or will not talk it is rather
difficult to give a previous history or much beyond the present symptoms.
Then again, as to the probable cause of insanity, beyond what the police
or the village kotwar can say, there is little else to go on and it is only where
the lunatic has recovered sufficiently that anything can be said, and even then
it cannot be trustworthy. If asked if he has ever smoked ganja, the general
reply is " Yes ", and it is probably correct, for the majority of the lower class in
these Provinces occasionally smoke, and one is very liable for the want of any
other cause to say that ganja is the cause.
STATEMENT II.
The 33 criminal lunatics remaining on the 1st January 1895 were classified
thus:—
(a)
(b)
(c)
Tried and acquitted on the ground of
insanity ... ...
Insane and incapable of making their
defence ... ...
Became insane during imprisonment...
Total ...
Central Provinces.
Males.
8
14
3
25
Females.
1
2
0
3
Total.
9
16
3
28
Native States.
Males.
1
...
...
1
Females.
...
...
...
...
Total.
1
...
...
1
Five criminal lunatics (all males) were admitted during the year against 6 in
1894; of these, 4 came from the Central Provinces and 1 from the Rewah State.
There were 2 re-admissions (all males) from the Central Provinces during
the year. Eight criminal lunatics (7 from the Central Provinces and 1 from
the Central India Agency) were discharged as under—2 sent to stand their trial;
2 sentence-expired and transferred to the non-criminal list by order of the official
visitors and pronounced by them as still insane and unfit for discharge; 4
released and made over to their friends by order of the Chief Commissioner,
Central Provinces; 1 male died.
The following gives the particulars of the kind of criminal lunatics in the
Asylum at the close of the year :—
(a)
(b)
(c)
Those tried and acquitted on the
ground of insanity ... ...
Those insane on admission and found
incapable of making their defence ...
Those who became insane during im-
prisonment ... ...
Total ...
Total ...
Central Provinces.
Males.
9
11
3
23
Females.
1
2
0
3
Total.
10
13
3
26
Native States.
Males.
...
3
2
5
Females.
...
...
...
...
Total.
...
3
2
5
28 males, 3 females=31
The daily average being 27.85 males, 3.00 females=30 85, against 30 10
males, 3.09 females=33.19 in 1894.
STATEMENT III.
Of the 25 admissions (males 19, females 6) 6 districts sent cases and 1
Native State of the Central India Agency.
Jubbulpore ... ...
Do.
Central Jail ...
Narsinghpur ... ...
Saugor ... ...
Damoh ... ...
Nimar ... ...
Do. Jail ... ...
Hoshangabad ... ...
Rewah State ... ...
Total ...
Males.
6
1
3
3
2
1
1
1
1
19
Females.
1
...
1
1
...
1
...
1
1
6
Total.
7
1
4
4
2
2
1
2
2
25
18
Religion and sex—
Hindus
...
...
Mahomedans ... ...
Eurasian ... ...
Native Christian ... ...
Other castes ...
Total ...
Males.
13
3
1
1
1
19
Females.
6
...
...
...
...
6
Total.
19
3
1
1
1
25
A Eurasian named Robert William Young was admitted into the Asylum
on the 11th November 1895, and as there was no accommodation for Eurasian
or European lunatics he was accommodated in one of the separate rooms. The
cause of his insanity is supposed to be grief on his engagement of marriage
being suddenly broken off. He has occasional fits of violence, and his brother
states that he cannot keep at home. He is continually wandering about looking
for his wife. His friends cannot afford to support him. He was an Engine-
turner on the Bombay, Baroda and Central India Railway, and he left the service
about a year ago, since which time he has been wandering about.
The Native Christian is a Madrasee.
STATEMENT IV.
Shows the previous occupation, and does not call for any remarks. There
was one mechanic, the Eurasian described above.
STATEMENT V.
Ages—
Under 20 ... ...
Between 20 and 40 ... ...
Between 40 and 60 ... ...
Over 60 ... ...
Total ...
Males.
4
15
...
...
19
Females.
...
6
...
...
6
Total.
4
21
...
...
25
This does not call for any remark, except those under 20—3 were congenital
and epileptic and 1 was religious mania.
STATEMENT VI.
Types of insanity—
Mania ... ...
Melancholia ... ...
Dementia ... ...
Idiocy ... ...
Epileptic insanity ... ...
Toxic insanity (ganja) ...
Total ...
Males.
9
2
3
3
1
1
19
Females.
2
1
1
2
...
...
6
Total.
11
3
4
5
1
1
25
Toxic Insanity.—1 male, a re-admission. There is no doubt about this
being a case of insanity excited by the use of ganja, although the Hemp Drugs
Commission seems to think not. Dr. Franklin in his remarks on the 28th
January 1892 states that he was addicted to the use of ganja, but the Commis-
sioners commence their remarks on the 23rd February and lead one to suppose
that no mention was previously made to ganja.
The man was admitted on the 28th January 1892 as a non-criminal lunatic
and was declared quiet and rational at the beginning of February and recom-
mended to be discharged in October as he had behaved well for four or five
months. His friends were communicated with, but they did not reply, and in
July 1893, a few days before he was to be brought before the visitors to be
discharged, he made his escape. He obtained employment in the Police at
21
The usual extra table No. XII is annexed, which shows the comparative
cost of maintenance for the past 10 years:—
TABLE XII.
Heads.
Establishment
including pay
of Superinten-
dent ...
Diet ...
Clothing ...
Contingencies...
Medicines ...
Public Works
charges ...
Total ...
Per patient on
daily average
strength ...
Daily average
strength of
males and
females ...
1886.
Rs.
4.711
3,418
230
250
8
A.
10
2
15
1
8
P.
6
7
0
7
10
...
8.649
64
6
13
8
6
133.39
1887.
Rs.
4,836
3,539
189
191
8
A.
8
14
1
6
12
P.
1
4
0
1
6
...
8,7 6
64
10
9
0
1
135.75
1888.
Rs.
4,981
3,867
316
198
11
A.
3
5
11
2
2
P.
3
2
9
6
0
...
9.374
66
8
4
8
6
141.43
1889.
Rs.
5,020
4,020
298
331
15
A.
15
11
8
7
14
P.
6
2
8
11
11
...
9,686
69
15
14
6
7
138.55
1890.
Rs.
4,715
3,552
356
192
19
A.
0
8
13
7
15
P.
0
9
9
9
2
...
8,836
67
0
8
0
7
130.79
1691.
Rs.
5,052
3,888
283
255
22
A.
11
5
0
6
15
P.
2
7
1
0
3
...
J 9,502
71
6
0
1
6
133.77
1892.
Rs.
5,096
4,017
287
187
33
A.
10
10
8
11
4
P.
1
0
0
7
C
...
9,622
68
12
12
11
9
139.86
1893.
Rs.
4,273
3,970
177
581
33
A.
9
4
12
3
3
P.
1]
10
11
0
2
...
9,030
60
2
0
7
11
150.46
1894.
Rs.
3,967
4,047
291
696
23
A.
4
4
9
6
12
P.
8
6
2
9
11
...
9,016
60
6
1
0
1
150.10
1895.
Rs.
4,013
4,169
253
617
36
175
9,266
62
A.
13
14
6
6
14
3
12
15
P.
10
8
0
11
7
11
0
11
147.08
COST
PER
HEAD
PER
EACH
ITEM
PER
ANNUM.
1894.
Rs
26
26
1
4
0
A.
6
14
15
10
2
P.
11
4
1
3
6
...
...
...
...
COST
PER
HEAD
PER
EACH
ITEM
PER
ANNUM.
1895.
Rs
27
28
1
4
0
1
A.
4
5
11
3
3
3
P.
7
8
7
1
11
1
...
...
...
from which it will be seen that there is a slight increase in establishment and
medicines, which is due to the daily average number of lunatics being smaller
than last year. There has been a slight increase in the diet due to dearness
of food-grains, the average price of wheat being 14½ seers against 15½, and
dhal 12½ against 15½, and gram l7½ seers against 20¾ seers of last year.
The following table will show clearly the sums obtained from the Treasury
and Asylum on account of expenditure:—
Heads.
Diet ... ...
Raw materials for manufactures ...
Contingencies ... ...
Establishment
...
...
Clothing for establishment ...
Do.
for patients ... ...
Medicines from Government Medical Stoves.
Public Works Department charges on
account of buildings, repairs, &c. ...
Total ...
Received
from Trea-
sury.
Rs.
3,483
405
121
3,993
4
A.
0
9
11
13
0
P.
1
3
8
10
0
......
......
......
8,008 2 5
Received
from Asy-
lum.
Rs.
686
A.
14
P.
8
......
90 2 5
16
253
0
6
0
0
......
......
1,016 7 1
Received
from other
Departments.
Rs. A. P.
......
......
......
......
......
......
36
175
14
3
7
11
212 2 0
Paying patients
Miscellaneous
Total ..
REMARKS.
Grand Total.
9,266
315
376
9,958
12
6
11
13
0
6
0
6