2
DULLUNDA ASYLUM.
attendant physical debility. On the whole it has appeared to me that the sanitary condition
of the asylum has improved much of late, and this improvement is measured by the decrease
and more tractable character of this cachexia. How far this is to be ascribed to internal
changes, I cannot satisfactorily ascertain. Improved condition on admission is of prime
importance in inquiring into the cause, and doubtless affects this year's figures in common
with those of 1868.
It will be in your recollection that in the month of August you made an inspection of
the inmates with especial regard to their physical condition. You found in the blueness of
the gums which was perceptible in many of them what you considered to be evidence of a
scorbutic taint, the result of insufficient diet; and you sanctioned a reformed dietary scale for
future use. An exceedingly liberal diet was supplied from that time, including a daily issue
of meat or ghee to each person. Arrangements had been previously completed for the pre-
paration of atta chuppatties in lieu of a portion of the rice in daily use, and the scale now
adopted is, I believe, more ample, and in quality more complete, than in any other institution,
and contains every thing that can be thought useful. Several of the lunatics are unable to
consume the rations allowed to them.
The events of the ensuing year will shew the effect of this change on the mortality of
the asylum. It would be premature now to offer an opinion on the subject. During the
short time that has elapsed since the change took place, there has been no decrease of death.
It is not to be expected under the circumstances that there should be such. Even if the
men then in a cachectic state, and doomed to die before the year was ended, had owed
their condition solely to defective diet, and crowding were in no way concerned in producing
it, it would be scarcely reasonable to expect their restoration. It is not to them, nor to the
cases of serious illness on admission, that regard must be had in estimating the value of the
food; but to the class which having once had fair health in the asylum, have lapsed into
debility of this particular kind; and diminution of these cases can only be made clear by
prolonged observation. Meanwhile, though not myself sanguine in expecting any material
improvement, because, as you are aware, I ascribed much of the sickly condition to insufficient
space, and did not consider the former dietary defective, I cannot blind myself to the fact
that the healthier men have gained in flesh and general appearance—all that was to be
expected from the additional food.
Causes of insanity.—The table No. 4 sets forth the same fact which has been exemplified
in former years, viz., the great preponderance of intoxication in producing the cases that fill
the asylum. Tables 5, 6, and 7 call for no special remark, while the noteworthy facts in
table 8 have been already treated in my remarks on mortality.
Expenditure.—In table No. 9 the expenditure of the year is stated. The establish-
ment is on a fixed scale sanctioned in the preceding year. In my last report I shewed
the manner in which the change from a fluctuating to a fixed staff of servants had with
increasing numbers proved to be a measure of money saving as well as improved efficiency.
The maintenance of high numbers of inmates renders the same observations applicable to the
year under report.
The charge for diet is larger than before, from the increased daily numbers, the high
price of provisions, and the greater cost of the liberal scale sanctioned in August. This
last item, however, has not contributed to swell the amount so much as would appear from a
direct comparison of the daily cost per man with that which preceded it. At the time of
its adoption an increase in the contract rate for the former diet was inevitable, and as very
great care was exercised in ascertaining the true cost of the new supplies, the contractor
was kept in check and a very small additional expense incurred. This also is pecuniarily
advantageous in another way. The full diet is not supplied to men in hospital, but instead