( 92 )
Sickness and Mortality.—Four deaths have to be recorded; two of phthisis, one of dysentery,
and one of asthenia. No cholera or small-pox occurred. Vaccination has been uniformly practised.
The intimate relation that exists between phthisical disease and insanity is remarkable. The
two fatal cases above recorded were both lads of 22 and 26 years respectively with very imper-
fect physical development; their lungs were extensively diseased. There was no trace of
family history of the complaint. The insidious nature of this malady and its liability to occur in
lunatics whose defective innervation is likely to lead to malnutrition and so predispose to the
tubercular state (particularly when they bolt their food without sufficiently salivating it for
proper assimilation) has led me to apply for a weighing machine to prepare a monthly record
of the weights of lunatics. When ill they so seldom complain that, though otherwise carefully
watched, it is very desirable to add to our observation the changes which from time to time
they undergo in weight. As a rule, our hopeful cases show early signs of physical improve-
ment ; mind and body re-act upon one another, preserving a mutual relation in the progress of
the case.
No necessity at present exists for a separate building as an hospital; the occasional cases
of illness that occur are treated in some of the spare wards.
During the year the daily averages of employed and unemployed have been as follows :—
Sick and physically unfit to work ... ... ... ...
Intractables or laboring under delusions ... ...
Working regularly ... ... ... ... ... ...
5.30
7.45
21.14
The casualties that occurred have been among those who have never been able to work.
A few there are who abstain on account of monomaniacal delusions, and do not see why they
should engage in labor as do others; these move about the grounds, watching everything going
on, and enjoy average good health. The worst cases are those of imbecility approaching idiocy,
who do not move about in the least, but sit quite gloomy and absent till stirred to some
recollection of themselves.
Annual Expenditure.—The total amount drawn was Rs. 4,576 (including cost of
maintenance of a. European, which has since been refunded into the Treasury) ; the daily average
throughout the year was 33.89; this gives an average annual expenditure of Rs. 113 for
each patient, or Rs. 11-8 per month, which is exactly the same as in the past year.
The grant of a famine allowance to all servants of the institution, and the prevailing high
prices are exceptional circumstances to be remembered in connection with the expenditure
of the year under report.
Statement No. 10 shows the amount of profits by the employment of the lunatics in
gunny-weaving, twine, and thread-spinning, gardening, soorkee and gravel-pounding, &c. Our
small number prevents the setting up of any manufacture on a large scale, at the same time
those able to work are encouraged to employ their time as usefully as possible, each in that
direction which particularly suits him; nothing like compulsion to work is permitted. If
kindness and the force of example do not succeed, the patient is left to engage himself as best
it suits him, so long as he does not harm himself or others. The construction of earthen beds
has been commenced and worked by the insanes. Already one cell with five beds has been
neatly laid out and occupied by those who took most interest in the work.