( 13 )
are imported into the class many persons from the Mofussil with their greater liability to death,
I shall of necessity fall short of the truth in representing the comparative healthiness of the
whole group as that of Calcutta men. Nor is there any begging of the question here, for
the greater liability of Mofussilites to death is a fact susceptible of independent proof.
Again, to make the record scientifically accurate, those cases should be removed from it which
cannot reasonably be connected with any avoidable cause. Nervous exhaustion must be ac-
cepted as a condition to which any debilitating influence greatly conduces; but apart from this,
there are—a case of pneumonia from Nuddea, of pulmonary abscess from Calcutta, of epilepsy
from Calcutta, of phthisis from Jessore, and of Bright's disease from Moorshedabad. Five
in all, and only one from Moorshedabad.
To exclude these would obviously strengthen my argument, and I have not cared to do it.
First, of the general death-rate of the several classes. Here, even if Calcutta be included, the
disproportion of deaths from distant places is very great. Such figures as 11.7, 12.5, and 20.4
percent., after due criticism of the method by which they are obtained, call for little comment.
Second. Of the separation of deaths which occur early from those which are deferred.
The general figures are 34 and 17 respectively, and of the first no less than 30 occurred within
four months. The deferred death from Moydapore should indeed be treated as belonging to
the former class, when considered with reference to the effect of travelling, for the man never
convalesced from the illness which he brought with him. Of the effect of travelling, the
figures appear to me to give no uncertain evidence. I will estimate it only by the numbers
of persons who began their journey in health, and ended it in sickness and exhaustion. Here
there is an independent cause operating on people from Calcutta, as I have already said. The
Asylum is to them as a special pauper hospital, a refuge from the exhaustion of climate or
vice, when its symptom is delirium; and to compare them with men certified to be able-bodied
when they leave their districts would be deliberately wrong. Thirteen per cent. of them
reached the Asylum ill. From the second class of districts there came 37 persons, and 3 of
these, or 8.3 per cent., were sick. These were, in all respects but that of distance, similarly
situated with the third class. This third class contributed a total of 32 ; and 8 of them, or 25
per cent., were sick. The evidence of good health at starting is open to no doubt in these, for
the people from Moorshedabad all bring with their papers the Civil Surgeon's certificate of
fitness to travel. However apparent the effects of long journeys may have been in the figures
submitted last year, it is clear that, as Dr. Green pointed out, it was only indicated, not proved
by the deaths. For proof it is necessary to regard the whole number admitted, and the condition
in which they arrived. This having been done, it will, I think, be allowed, that inference has
given place to demonstration. The fact which the deaths really prove is, that in the Asylum
neither care nor money availed to save their lives.
Of the 30 fatal cases from Calcutta and its environs, 18 took place within a year,
and 12 beyond it; of those from a moderate distance 6 died speedily, and 4 outlived a
year; of the other class there were 10 early deaths; 1 alone survived the year; and in that
one his illness came with him to the Asylum.
It may perhaps be objected that this method of grouping cases from districts equi-distant
from Calcutta, gives rise to error, as all do not contribute in equal degree to the results ; that
the transmission of lunatics from some remote districts is carried on without mischief, which
districts, being coupled with others, are made to appear as if they shared their characters ; whereas
they ought really to be: used as countervailing data against the ill success of the others, and
therefore in disproof of the general evil of travelling. But if the table be inspected closely, it
will be seen that there is no single district whose figures give any counter-indication to that
afforded by the worst of them. Either the total of admissions is too small for useful reckoning,
E