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It is necessary to explain that the term imbecility is applied to certain forms of cerebral
weakness resulting often from intoxication, and not admitting of any more positive designations ;
from it recovery is frequent.
And of observation it is to be said, that the discovery of no sign of insanity is a frequent
issue; the patients are discharged sane, and there is no choice but to return them as recoveries.
The death-rate reckoned on total population has fallen from 18 to 13, and on the daily
average number from 33 to 23. It is satisfactory to record so large a reduction of mortality.
But a close examination of the medical records leaves no room to doubt that it is mainly due
to the fact that lunatics have reached the Asylum, as a general rule, in better physical con-
dition than heretofore. Notwithstanding that the old cases bear so much smaller a proportion
to the total number in 1867, there are still 17 deaths among inmates of more than a year
standing, in a total of 51, against 16 in 1866, i. e., a total of 66. Moreover, the deaths from
nervous exhaustion of mania fall, with one exception, on the new admissions, and being
produceable by causes independent in some degree of physical condition, point in the same
direction. In a total of 197 admissions, 28 persons arrived in bad condition, and of these
there died 15. The satisfaction which I derive from thus reporting the evidence of increased
care on the part of district officers in despatching lunatics from the interior would be greatly
enhanced, if I could point to a similar result from the many and various endeavours made from
year to year to reduce the mortality which belongs more strictly to the Asylum itself; but
this it is not yet permitted me to do. Nor am I able to add anything to that which has been
written in former years regarding the mortality of the Asylum. In my report for 1866, I
set forth fully the various changes which had been made in the life of the inmates, as suggested
from time to time, and stated the reasons which led me to anticipate their results with little
hopefulness. Some progress has at length been made towards increasing the accommodation
of the place. The southern extensions, sanctioned long ago, are nearly completed. They
will add four small rooms to the number now occupied. Compared with the requirements
of the inmates, whose number has this year increased 25 per cent., this is certainly very little,
but it is in the right direction ; and the larger northern extensions, it must be hoped, have been
brought, by the lapse of 1867, one year nearer their commencement. The number of deaths
from cachexia which has originated in the Asylum, points again, as others in former
years pointed, to some essential condition of life and health wanting at Dullunda. Every
known influence and agent has been examined in a restless search for the cause of mischief.
Change has followed upon change, until scarcely a trace remains of the Asylum as it was
eight years ago, or of the habits of its inmates. Drainage is complete. The ventilation of
existing buildings leaves nothing to desire ; the diet of the people has been improved, until it
savours of extravagance, and conservancy pursued until I have begun to charge myself with
spending public money on fancy work; but the want of breathing space at night is still in
force, if existing rules of space have any foundation. It alone remains of the known conditions
of illness, and the illness of the Asylum is of the kind most readily attributable to it;—the
kind which prevails almost universally when large numbers of men are congregated in
buildings. I wish the term " known conditions" to convey a reservation here, for the Pres-
idency Jail with its small mortality is close at hand to embarrass all reasoning, shake all
conclusions, and warn me against being too confident in urging even the measures which seem so
indispensable and full of promise. There are but a few hundred yards of distance between
the Jail and the Asylum. Setting aside the cases of illness which commence outside, the
prisoners are not more favorably conditioned than the lunatics when they are brought in.
Inside the walls they are overcrowded; their dwelling-places are no cleaner; their food, water,
and clothing no better; their employment no more healthy or more adapted to their strength ;
their faculty of fouling the earth and air surrounding them is as great; in a word, all recognized