DACCA ASYLUM.
37
these peculiarities, I am unable to say. Six out of 50 cases of dysentery admitted into
hospital, or 12 per cent., died. This disease is extremely fatal amongst natives in Dacca.
Dr. Wise found from the returns of the Mitford hospital, from the year 1854 to the year 1868
inclusive, that of 868 admissions into that hospital from dysentery and diarrhœa, no less than
462, or 53.22 per cent., had died. " Distinguishing the pauper cases sent in by the police
from those seeking admission voluntarily, the enormous mortality of 78.8 was reached; viz.
80.6 per cent. from dysentery and 73 from diarrhœa." The lunatics who this year died of
dysentery, suffered from it in a chronic form. They long remained in an anæmic, feeble and
emaciated condition, and sank from exhaustion. Evidence of disease of old date was abun-
dantly manifested along the whole tract of the colon, and sometimes of more recent date,
about the termination of the ileum. Eighty-two cases of diarrhœa were treated during the
year. The death-rate rose to be highest, as is usual in this asylum, during the cold months
of December and January, in which two months 31.46 per cent. of all the deaths for the year
occurred. Table No. 13 shews the number of deaths that occurred in each month for the five
years 1866-70 inclusive, and appears to me to go far to support the belief that cold may be
regarded as one of the causes which much affect the death-rate in the Dacca lunatic asylum.
Last year I suggested that one of the wards should, as an experiment, be artificially heated
during the cold weather. The Inspector-General of Hospitals, however, thought that any
injurious effects of cold could be prevented by giving the lunatics extra blankets. This has
been done; but it has appeared to me that those who suffer most from cold, are the demented
creatures, who are too apathetic to keep themselves constantly clothed. If the experiment of
heating one ward were tried, of course a careful selection of cases to fill it would be made.
From table No. 12 it will be seen that each lunatic now has 720.13 cubical feet of space, and
44.96 square feet of superficial area, in the wards of the asylum. A copy of the dietary is
given in the table No. 14. I have seen nothing to induce me to think that the scale of diet
is otherwise than liberal. The lunatics drink the water of the river after it has been filtered
in the common ghurrah filters constructed with sand and charcoal. I two years ago recom-
mended that proper filters should be constructed for the jail, and I am of opinion that the
most efficient filters possible should be provided for the lunatic asylum. The explanation of
the chief causes of the high rate of mortality in this asylum may, I think, be found in what
I have said in paragraph 2 in endeavouring to describe the peculiar features of the population
of the asylum, which is chiefly made up of cases of the more violent forms of acute mania,
amongst which the ratio of mortality is every where high, or of the chronic cases of insanity,
in which the intellectual powers have become too feeble to insure the safe protection of the
individuals whose physical states are usually debilitated and anæmic, and whose constitutions
have, in many instances, been irretrievably damaged prior to admission into the asylum. I do
not think that these or any other of the lunatics suffer from any injurious occupation. On
the contrary, I believe that so far as the nature or amount of work which they perform is
concerned, it is rather beneficial than otherwise to them. I do, however, think that the
peculiarities of the population, and specially the great number of cases of dementia, advanced
to the stage of apathy, point distinctly to the urgent requirement of close watching and
intelligent supervision in the asylum, with a view to the earliest possible detection of drooping
powers or existing disease, and to the absolute necessity of systematic nursing and thoughtful
care of the patients when in hospital. The prevalence of bowel affections in the asylum is
a further indication of the necessity of constant and intelligent watchfulness on the part of
the attendants. I think the defects in the asylum are more obvious in this direction than in
any other to which I can point. I shall again refer to this subject when reporting on the
establishment.
Two cases of suicide occurred in the asylum during the year. The first was that of a
criminal lunatic named Brojo Mohun Dey, who was admitted from Tipperah into the Dacca
lunatic asylum at 9 A.M. on the 3rd June 1870, suffering from melancholia. He was looked
up in a solitary cell at 6 P.M., and at 4-30 A.M., on the 4th, his body was found hanging by
K