NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 4 )
STATEMENTS IV AND V.
19. Occupation and age of those admitted.—The largest number was, as
usual, furnished from the labouring classes, and next to these come cultivators.
The ages of the majority of persons admitted in both the Asylums were between
20 and 40 years. Surgeon-Lieutenant-Colonel McKay points out that this is the
period of life in which any inherent tendency to insanity is developed.
STATEMENT VI.
20. Types of Insanity.—This and Statement VII have been prepared on the
revised form promulgated with Home Department Resolution No. 16 Medi cal / 576-86 ,
dated 16th July, 1896. The majority of the lunatics admitted suffered from
mania and dementia, and these are the types which usually preponderate in
the Asylums in these Provinces.
Of the total of 321 inmates in both Asylums, 158 (135 males and 23
females) suffered from mania, and 97 (72 males and 25 females) from dementia.
STATEMENT VII.
21. Alleged causes of Insanity.—Of the 58 admissions during the year, 14
are ascribed to "physical causes "and 16 to " moral causes," while 28 come under
the head " causes unknown." The total of 14 under physical causes are thus
classified :—
Ganja-smoking ... ...
Use of Bhang... ...
Spirit-drinking ... ...
Fever ... ...
Epilepsy and sunstroke ...
9
1
1
1
2
22. Five cases were attributed to ganja-smoking in the previous report. The
increase of insanity due to this cause is not a favourable sign and may be in
part ascribed to the indulgence begotten of physical suffering, and the depression
due to adversity in some cases.
23. The Superintendent of the Jubbulpore Asylum alleges that the enquiry
enjoined by Book Circular XXXIV, dated 18th August, 1896, elicits as a rule
very little reliable information and that it is very difficult to get complete
histories in many cases.
STATEMENT VIII.
24. Sickness.—The total admissions into hospital in the Nagpur Asylum
was 50 (33 males and 17 females) as compared with 126 in 1895. At Jubbul-
pore there were 109 (92 males and 17 females) as compared with 103 in the
previous year. It will be noticed that there has been a great diminution in
sickness in the Nagpur Asylum due to the disappearance of influenza in an
epidemic form. There were only 2 cases of influenza as compared with 39
in 1895. Cases of fever also contributed to swell the sick list in the previous
year, and there were only 14 cases as compared with 36 in 1895. Dr. Harris
attributes the healthiness of the Asylum under his charge to the liberal supply
of milk from the dairy given to the inmates.
( 5 )
The following table shows the number of patients admitted into hospital
and the causes of admission :—
TABLE II.
Diseases.
Influenza ...
Fevers ...
Dysentery ...
Diarrhœa ...
Debility ...
Rheumatism ...
Anœmia ...
Bronchitis ...
Pneumonia ...
Abscess, Ulcer and Boil ...
Pneumonic Phthisis ...
Small-pox and Chicken-pox ...
All other causes ...
Total ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpure ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
ADMISSIONS INTO HOSPITAL.
1895.
39
1
36
55
1
6
1
1
6
3
...
...
4
...
3
5
2
4
3
5
...
...
...
2
32
21
126
103
1896.
2
4
14
41
4
4
6
5
4
6
1
1
1
1
4
5
...
4
3
8
...
...
...
...
11
30
50
109
Difference.
—37
+3
—22
—14
+3
—2
+5
+4
—2
+3
+ 1
+ 1
—3
+ 1
+ 1
—
—2
=
=
+3
—2
...
...
—21
+9
—76
+6
25. There were no cases of small-pox or cholera in either Asylum.
26. The daily average sick at Nagpur was 8.68 against 8.84, and at Jubbul-
pore 4.15 against 4.46 in 1895.
27. Mortality.—The following table shows the ratio of deaths to daily aver-
age strength and the ratio of deaths to admissions:—
TABLE III.
Asylum.
Nagpur ... ...
Jubbulpore ... ...
RATIO OF DEATHS TO
AVERAGE STRENGTH.
1894.
8.06
9.99
1895.
7.02
7.48
1896.
3.94
7.13
RATIO OF DEATHS TO
ADMISSIONS.
1894.
30.95
50.00
1893.
28.57
44.00
1896.
24.14
37.93
( 6 )
28. The various causes of death in the Asylums are specified in the follow-
ing table :—
TABLE IV.
Diseases
Influenza ... ... ... ... ...
Dysentery ... ... ... ... ...
Fevers ... ... ... ... ...
Debility ... ... ... ... ...
Old age ... ... ... ... ...
Anœmia ... ... ... ... ... ...
Pneumonia ... ... ... ... ...
Diarrhœa ... ... ... ... ...
Epilepsy ... ... ... ... ...
Phthisis ... ... ... ... ...
General paralysis of insane ... ... ...
Valvular diseases of the heart ... ... ...
Other causes ... ... ... ...
Total ...
NAGPUR.
1895.
1
...
...
3
...
1
2
...
1
...
...
...
4
12
1896.
...
1
...
1
...
2
...
...
2
...
...
...
1
7
JUBBULPORE.
1895.
...
1
1
...
3
...
1
...
1
...
...
...
4
11
1896.
...
...
1
4
2
...
...
1
1
...
...
...
2
11
29. Table V compares the causes of death in the Asylums in these
Provinces with those in the Asylums of other Provinces.
TABLE V.
Provinces.
Bengal ... ... ...
Punjab ... ... ...
Rangoon ... ... ...
Tezpur ... ... ...
Bombay ... ... ...
Central Provinces ... ...
Ditto ... ... ...
Year.
1895
1895
1895
1895
1895
1895
1896
Percentage of sick to
strength.
6.40
13.54
7.57
3.24
62.43
4.18
3.86
Percentage of death
to strength.
8.16
14.60
10.54
6.59
9.48
7.23
5.42
PERCENTAGE OF TOTAL DEATHS FROM
Fevers.
1.33
...
13.89
...
4.41
4.35
5.55
Dysentery.
14.68
9.80
5.56
14.29
17.65
4.35
5.55
Diarrhœa.
5.33
3.92
16.67
...
2.94
...
5.55
Phthisis.
24.00
17.66
19.44
...
19.12
...
...
Chest affections.
5.33
33.33
5.56
14.29
8.82
13.04
...
Anœmia.
9.33
1.96
2.78
57.13
1.47
4.35
11.11
Other causes.
40.00
33.33
36.10
14.29
45.59
73.91
72.24
The figures shew that the health of the inmates of the Asylums in these
Provinces compares favourably with that of the inmates of Asylums in other
Provinces. The percentage of deaths to average population in the Asylums of
these Provinces is lower than elsewhere.
30. Statements IX, X, XI and XII are financial Statements, and give details
of the receipts and expenditure of the two Asylums. At Nagpur Rs.10,166-3-10
were drawn from the Treasury against Rs.10,103-4-7, or Rs.62-15-3 more than
in 1895. There was a large stock in hand of unconsumed grain, the value of
which was estimated at Rs.772-4-2. At Jubbulpore Rs.8,663-0-9 were drawn
in 1896 as compared with Rs.8,008-2-5 in the previous year, an increase of
Rs.654-14-4, due to (a) the increased daily average of the Asylum population
and (b) dearness of provisions.
( 7 )
The amounts received from paying patients, maintained at the expense of
the Berar Administration or of friends or guardians, are noted as follows :—
Nagpur ... ... ...
Jubbulpore ... ... ...
Rs. 3,058
„ 2,368
8
4
8
0
31. In the figures, entered against the Nagpur Asylum, are included Rs.2,610,
adjusted inter-departmentally by the Comptroller, Central Provinces, on account
of the maintenance of 29 lunatics from Berar.
In connection with the fixed payment of Rs. 7 per mensem, by guardians of
lunatics towards their maintenance in confinement, the Superintendent of the
Jubbulpore Asylum points out that those who cannot afford to pay Rs.7, might
be required to give less, to the extent of such sum as they can afford, as under
the circumstance of not being able to pay the full amount as fixed for mainten-
ance, they should not on this account be altogether exempted from proportionate
payment. Dr. McKay also refers to the question of allowing a few luxuries to
inmates whose relations can afford to pay more than Rs. 7, the sum fixed for ac-
tual maintenance.
32. Rs.2,594-12-4 and Rs.394-5-0 were paid into the Treasury at Nagpur
and Jubbulpore respectively, under head " miscellaneous " receipts. In addition,
the value of manufactured goods, made over for the Asylum use, was
Rs.1,115-3-8 at Nagpur, and Rs.1,003-12-0 at Jubbulpore.
The large item,
Rs.2,337-11-3, entered under column 5 against Nagpur, represents disbursements
and includes an item of Rs.2,191, charged on account of works executed in the
Asylum by the Public Works Department.
33. In the following table the expenditure per inmate, per annum, under
different heads, is shewn :—
TABLE VI.
Asylum.
Nagpur ...
Jubbulpore
1895 ...
1896 ...
Difference ...
1895 ...
1896 ...
Difference ...
MEAN COST PER HEAD.
Superintendence.
Rs.
10
10
—0
12
11
0
a.
8
2
6
3
10
8
p.
7
0
7
10
11
11
Establishment.
Rs.
15
15
+0
5
14
—0
a.
12
14
2
0
5
10
p.
0
10
10
10
11
11
Diet.
Rs.
29
22
—6
28
31
+ 2
a.
0
11
4
5
1
11
p.
4
5
11
7
4
9
Clothing and bed-
ding.
Rs.
2
0
—2
1
1
—0
a.
14
7
7
11
11
0
p.
9
2
7
7
0
7
Building and re-
pairs.
Rs.
0
0
—0
a.
3
1
2
p.
11
5
6
...
...
...
Bazaar medicines.
Rs.
0
a.
0
p.
1
...
—0 0 1
...
...
...
Contingencies.
Rs.
5
13
+ 7
4
3
—0
a.
7
4
12
3
14
4
p.
3
0
9
2
7
7
English medicines.
Rs.
0
0
+ 0
0
0
+ 0
a.
6
8
2
4
6
2
p.
10
10
0
0
2
2
Total.
Rs.
64
63
—1
61
63
+1
a.
5
1
4
13
1
4
p.
10
8
2
0
11
11
( 8 )
34. The mean cost per head of the inmates of the Asylums in the Central
Provinces is compared below with the mean cost in other Provinces.
TABLE VII.
Mean of years.
11
10
10
12
6
12
1
Provinces.
Bengal ...
Tezpur ...
Rangoon ...
Punjab ...
Bombay ...
Central Provinces ...
Ditto ...
MEAN COST PER HEAD.
Superintendence.
Rs.
18
15
12
12
23
18
10
a
7
3
1
10
11
10
14
p.
1
0
1
10
10
1
5
Establishment.
Rs.
19
25
30
30
39
16
15
a.
0
14
5
5
7
1
2
p.
5
4
1
2
3
1
5
Diet.
Rs.
5
38
53
38
67
26
26
a.
9
10
14
11
7
15
14
p.
9
6
3
1
3
10
4
Clothing and bed-
ding.
Rs.
2
5
2
6
6
2
1
a.
10
12
11
15
11
4
1
p.
6
10
0
11
10
3
1
Building and re-
pairs.
Rs.
1
0
a.
2
0
p.
1
6
...
0
1
0
0
3
7
5
0
5
9
11
9
Bazaar medicines.
Rs.
0
0
0
0
0
a.
1
9
7
4
6
p.
2
0
7
3
1
...
...
Contingent proper.
Rs.
5
2
5
4
9
3
8
a.
2
13
11
14
0
2
9
p.
7
11
10
1
4
3
3
English medicines.
Rs.
0
0
3
1
2
0
0
a.
8
3
12
0
0
7
7
p.
10
6
2
10
0
4
6
Total.
Rs.
82
89
108
95
150
67
63
a
10
3
15
1
4
14
1
p.
5
7
0
7
4
9
9
The average cost per head in the Nagpur Asylum has been reduced by 20
annas, and there has been a pro tanto rise in the cost in the Jubbulpore Asylum.
The increase in the cost of diet sufficiently explains the increase in the cost of
maintenance at Jubbulpore.
35. The daily average strength of the inmates, employed-on manufactures
and in the garden, is shewn thus:—
Nagpur ... ... ... ...
Jubbulpore ... ... ...
1895
1896
1895
1896
ON MANUFACTURES.
Male.
12.07
7.41
12.00
12.03
Female.
2.29
1.19
5.00
5.01
IN GARDEN.
Male.
34.17
37.45
42.24
45.94
Female.
1.02
...
...
...
36. Dairy Farm.—The dairy farm, started at Nagpur in August, 1895,
has made progress and is a great success. Additions have been made to the farm
and the total cost of the live stock at the close of the year was noted as Rs.1,756.
The milk and butter are much in request as the quality is unexceptionable. The
Superintendent points out that with the expansion of the dairy, the question of
appointing a whole-time Supervisor will have to be considered, as the Deputy
Superintendent of the Asylum has not the leisure to enable him to efficiently
control the affairs of the dairy.
37. Inspections.—Both the Asylums were inspected by the Chief Commis-
sioner and by the Administrative Medical Officer. The Nagpur Asylum was also
inspected by the Director-General, Indian Medical Service. The official visitors
met monthly and inspected the respective institutions, and their proceedings
were regularly recorded.
38. The Asylums of these Provinces are carefully and ably managed. Doc-
tors McKay and Harris, the Superintendents, carry out their duties with zeal and
are sympathetic in their supervision, care and treatment of the inmates.
NAGPUR :
10th February, 1897.
G. HUTCHESON, M. D., SURGEON-COLONEL,
Administrative Medical Officer, C. P.
( 9 )
Report on the Nagpur Lunatic Asylum for the year 1896.
STATEMENT No. I.
Admissions and Discharges.—There were 27 admissions during the year, viz :—
Central Provinces ... ...
Berar ... ... ... ...
Total ...
Males.
20
3
23
Females.
4
...
4
There were 2 re-admissions during the year :—
Central Provinces ... ... ... ...
Berar ... ... ... ...
Total
...
1 female.
1 male.
2
Twenty-two Asylum patients were discharged during the year—18 males and
4 females.
Cured ... ... ... ...
Improved ... ... ... ...
Not improved ... ... ... ...
Discharged otherwise ... ... ...
Total ...
Males.
6
2
2
8
18
Females.
...
3
...
1
4
Of the total discharged during the year 18 were amongst lunatics sent from
the Central Provinces and 4 amongst Berar lunatics. The period of residence of
those discharged as " cured " varied from 8 months 1 day to 1 year 5 months
and 18 days. All of the six lunatics discharged during the year were admitted
for mania. Five lunatics (two males and three females) were discharged and made
over to their friends as improved ; of these, three—all females—were cases of mania,
one was a case of melancholia, and one was a case of toxic insanity. Two male
lunatics were discharged and made over to their friends as " not improved," both
being cases of mania.
Nine lunatics were discharged " otherwise." One Mussammat Subadra's
sentence expired and she was transferred from the criminal to the non-criminal
list ; one Berar criminal lunatic sent for trial, was sent back as a non-criminal.
Seven criminal lunatics have been sent to stand their trial.
Seven deaths took place amongst the Asylum inmates during the year,
all amongst lunatics from the Central Provinces.
Statement VIII shows the causes of admission to hospital.
STATEMENT No. II.
Nine criminal lunatics were admitted during the year (eight males and one
female) against fifteen in 1895 and twelve in 1894. Of these eight were from the
Central Provinces and one from Berar.
( 10 )
Twelve criminal lunatics (eleven males and one female) were discharged dur-
ing the year (nine from the Central Provinces and three from Berar) as under :—
2
8
2
12
transferred from criminal to non-criminal list (one male and one female).
males sent for trial.
males discharged and made over to their friends by orders of the Chief
Commissioner.
Classification of Criminal Lunatics.—In the subjoined table a few particulars
of the different kinds of criminal lunatics in the Asylum at the close of the year
are given.
(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
imprisonment ... ...
Total ...
CENTRAL PROVINCES.
Males.
32
16
1
49
Females.
...
2
...
2
Total.
32
18
1
51
BERAR.
Males.
5
4
2
11
Females.
...
1
...
1
Total.
5
5
2
12
STATEMENT No. III.
Of the 29 admissions and re-admissions—
5
3
1
3
6
1
4
2
4
29
Came from Nagpur District.
„ „
„ „
„ „
„ „
„ „
„ „
„ „
„ „
Balaghat „
Bhandara „
Betul
„
Bilaspur
„
Raipur
„
Sambalpur „
Wardha
„
Hyderabad Assigned Districts.
Caste and religion.
The following is the caste and religion classification of
the above :—
Hindus ... ... ...
Mahomedan ... ... ...
Other castes ... ...
25
2
2
29
(21 males, 4 females).
(both males).
(one male and one female).
( 11 )
STATEMENT No. IV.
As usual, the labouring classes furnished the largest number of admissions
(8) during 1896, the males and females being equal; 6 of those admitted came
from the cultivator class : beggars and servants giving 3 each. It will be curious
to observe whether the scarcity in some districts during the latter months of the
year just ended will produce any notable increase in the admissions during the
ensuing year into the Asylum.
STATEMENT No. V.
Ages of admission.
The ages of the majority of the admissions were, as
in the previous year, between the ages of 20 and 40
years.
STATEMENT No. VI.
Types of Insanity.
In the subjoined tabular statement the various types
of insanity found to exist amongst the new admissions is
summarised:—
Mania ... ... ...
Melancholia ...
Dementia, including acquired imbecility...
Epileptic insanity... ...
Total...
22 (19 males, 3 females).
3 (all males).
3 (1 male, 2 females).
1 (1 male).
29 (24 males, 5 females.)
STATEMENT No. VII.
Alleged causes of insanity :—
Physical causes... ... ...
Moral causes... ... ...
Unknown... ... ...
Total...
5
2
22
29
Causes of insanity.
Investigating further into the particulars of the alleged causation of the in-
sanity in those cases in which this detail has been enquired
into, we find that two non-criminal lunatics, Thakur Dass
and Bhawan Singh, were admitted from the Berars during the year, in both of
whose cases, excess of ganja smoking is alleged as the cause of insanity. Both men
belong to the class of religious mendicants; one of them, Thakur Dass, a Lohar
by caste, from Hamirpur, North-Western Provinces, has become quite sane
since his admission and willingly admits that he frequented the company of
Sadhus and used to smoke a chillum of ganja mixed with tobacco twice daily—
one pice worth of ganja—and that he had continued this custom for years. When
he became insane he was on his way to the mela at Nassik. He stated that the
ganja-smoking never made him intoxicated or excited, but only produced a con-
dition of bien être. In the second case, Bhawan Singh, it is said that at one time
"he was constantly in the company of a Sadhu with whom he used to smoke ganja
and from the time the Sadhu left him he showed symptoms of insanity." Since
his admission to the Asylum he has been continuously silent and nothing can be
ascertained about his previous habits, &c.
The first case appears more like a case of ganja intoxication or delirium and not
one of ganja mania. In the second case there appears to be some more or less per-
manent mental damage present, but whether solely attributable to ganja-smoking
or not is not very clear. In the third case, in which the abuse of ganja is alleged as
( 12 )
the cause of the insanity, there is very little evidence forthcoming to substantiate
this statement, and it is also stated that the man was an epileptic. In the case of
criminal lunatic Dhaja Ram from Sambalpur, it is noted in the statement sent with
the lunatic that " Malaria may be the cause according to his own statement" and
the duration of insanity is said to have been four months. The crime committed was
setting fire to his own house. There is absolutely nothing to confirm the suggestion
that malaria was the cause of the insanity. He had no fever whilst at Sambalpur
and he has had no fever since his admission to the Asylum. He escaped shortly
after his admission but was re-captured, and he is now practically quite sane, and
all he can say is that he had fever and does not know what he did or why he set
fire to his house. Of the two cases in which a moral cause is alleged—one was
a medical student who developed acute mania probably attributable to overwork
and depression at failure at his examinations.
In 22 cases no definite cause could be ascertained from the friends or relatives
of the lunatics, and in some no relatives could be found to furnish the necessary
particulars. In two of them at least a history of epilepsy in youth was given. In
one case the alleged cause is " excessive heat in brain" and that the insanity may
have been attributable to exposure to sun after an alcoholic debauch. In two
other cases religious excitement may have upset the mental balance (in one of
these the papers state that, " He failed in worship of his god and ran insane").
In the case of only one solitary lunatic is there a history obtainable of hereditary
tendency, the lunatic's father having been insane.
STATEMENT No. VIII.
The year was a much healthier one than its predecessor. The chief cause
of admission was fever. Influenza, which claimed such a number of patients in
1894 and 1895, I am glad to say, practically did not visit the Asylum, there being
only 2 admissions from this cause, although there were cases in the station in
the early part of the year. The total admissions for the year were 50 (33 males
and 17 females). The following table shews the chief causes of admissions to
hospital:—
Influenza ... ... ...
Fever ... ... ...
Debility... ... ...
Bronchitis... ... ...
Diarrhœa and Dysentery... ... ...
Other causes... ... ...
Total...
2
14
3
4
10
17
50
Mortality.
There were 7 deaths during the year, viz.:—
Acute Dysentery... ... ...
Debility and anœmia... ... ...
Epilepsy... ... ...
Empyœma... ... ...
Total...
1
3
2
1
7
I have no doubt of the fact that the liberal . supply of pure and separated
milk which, by the establishment of the Dairy Farm, we are now enabled to issue
during the year to the sick and convalescent has had a considerable share in
improving the health of the sick and diminishing the mortality in the Asylum.
The total Asylum mortality for the past 20 years is 211, giving an average of
nearly 11 deaths per annum. The healthiest year was 1892, with only 3 deaths,
and the most unhealthy years were 1886, 1887 and 1889, with 23, 25, and 33
deaths respectively.
( 13 )
STATEMENTS
Nos. IX AND XI.
The total amount received from the Treasury was Rs.10,166-3-10 against
Rs.10,103-4-7 drawn in 1895. The value of unconsumed grain at the close of the
year was Rs.772-4-2. The amount received from the paying patients was
Rs.3,058-8-8 ; Rs.2,610 adjusted by the Comptroller, Central Provinces, for an
average of 29 Berar lunatics at Rs.90 a head, and Rs.448-8-8 actual cash receipt
from paying patients.
The following items are shewn in column 4:—
Diet supplied inter-departmentally, including garden and
farm produce... ... ...
Value of clothing made in the Asylum ... ...
Garden and farm produce, fodder, &c. ... ...
Total...
Rs.
733
79
301
1,115
a.
11
14
10
3
p.
2
0
6
8
In column 5, viz., the total of book receipts, the following items are in-
cluded :—
P. W. D. charges... ... ...
Jail Forms... ... ...
Europe medicines... ... ...
Total...
Rs.
2,191
48
98
2,337
a.
0
6
4
11
p.
0
11
4
3
The column shewing miscellaneous receipts is made up as follows:—
Sale of Linseed, Jowari, &c, grown on the farm...
Sale of Dairy produce, &c. ... ... ...
Total...
The total receipts from all sources amounted to...
The total expenditure in 1896 was... ...
Rs.
417
2,176
2,594
19,272
16,934
a.
14
13
12
7
12
p.
7
9
4
9
6
as compared with Rs.10,435-6-8 in 1895.
The expenditure on the Dairy, the details of which are given further on,
amounted to Rs.1,805-15-10, and the payment of tax for the use of Ambajhiri
water is Rs.157-10-6.
Dairy Farm.
The progress of the Dairy Farm, which was started in August, 1895, has been
steady during the year. At the close of 1895 the live
stock on the Farm consisted of 1 breeding bull, 4 draught-bullocks, 9 cows, 1
buffalo and 24 calves, the whole valued at Rs.640.
During 1896 the following additions were made to the Farm .:—
Cows purchased... ... ...
Buffaloes „ ... ... ...
Calves
„ ... ... ...
Calves born during the year... ...
Total...
13
4
20
13
50