34
REPORT
ON THE
Low vital stami-
na of lunatics.
fracture of the ribs. The latter was, as far as known, accidently produced. The physical con-
dition of the patients is noted as good, fair, or indifferent; but while many of them are fat and
look well fed, in reality the nervous force of almost all, if not all native insanes is below par. It
is owing to this that they bear sickness badly, and that disease amongst them rarely appears
in the acute form.
Wasting.
Bowel com-
plaints.
Many of the inmates keep wasting day by day without apparent cause. They may
eat and sleep well, but yet they grow thin. This wasting sometimes depends on what is
known as inward fever or marked ague, and is checked by giving diffusible stimuli and qui-
nine. Dysentery and diarrhœa among insanes advance very insidiously, and unless the
greatest care is exercised, may have obtained thorough dominion over the patient before they
are discovered. Patients are uncomplaining, because they are less sensible to pain and dis-
comfort than sane persons, or because they are more abstracted. This, combined with the
insidious nature of the complaints, renders extra care and watchfulness necessary. In this
asylum all the mehters and mehtranees are strictly enjoined to report at once the slightest
traces of diarrhœa or dysentery in the stools of the lunatics.
Mortality and re-
covery according
to duration of re-
sidence.
Table No. 9 (see general Statement No. 7) shows that the period of greatest mortality
was from 4 to 5 months, and of the lowest mortality from 4 to 5 years. The percentages of
deaths on the totals of these periods being respectively 52.63 and 3.28. The period which
claims the greatest number of cures was 2 to 3 months, with a percentage of 88.6 ; while
the smallest number of cures was achieved in the period of 4 to 5 years, with a percentage of
3.28 on the totals. The lowest mortality, and the least number of cures amongst the average
daily living, belong to the same period. Taking actual numbers, the highest mortality
belongs to the period 1 to 2 years, and the greatest number of cures to the same. Taking
groups of periods, it is clear that the greatest number of cures occur amongst those under
one year's residence, and the greatest mortality amongst those under three months' residence.
The same table shows that, as the length of the period of residence increases, the death-rate
(calculated on the totals of each period) declines. Thus, the death-rate of the period under
three months is 23.05, of under six months 21.0, and of under one year 20 per cent., and so on.
It is noteworthy that the average residence of each man living in the asylum, and the average
residence of each of those who died, belong to the period of two to three years. The
average period of residence of those who were discharged cured, fell to the period of
nine to twelve months.
Deaths accord-
ing to season.
In the cold months, viz., January, February, November, and December, 13 inmates
died. In the hot season, from March to June, 16 died; and in the rains, from July to
October, 15. The mortality was, therefore, pretty equally distributed throughout the year.
Sickness.
5. Sickness.—Those seriously sick are admitted as in-patients, and managed as in an
ordinary hospital. Those suffering from slight ailments, and those discharged from hospital,
are treated as out-patients. When sufficiently recovered, the out-patients are placed in the
convalescent ward, where they are watched in case of relapse, and fed with extra food.
From this they are discharged to work, when they have sufficiently recovered their strength.
Table 14 refers to the in-patients only.
Bodily health.
6. Condition on admission.—Of the 219 insanes admitted in the year, 132 at the
time of admission were in good, 35 in indifferent, and 52 in bad, condition. Condition on
admission does not, however, appear to have any direct relation to the mortality list, as of the
44 who died, 29 were admitted in a good state of health. Of the 123 discharged otherwise
than by death, 111 were in good health.
Varieties of men-
tal disease.
7. Types of Insanity.—The inmates of the asylum are all classified under four types,
viz., mania acute, mania chronic, melancholia and dementia chronic; the columns in Form