DACCA LUNATIC ASYLUM.
67
Moral causes of
insanity.
42. Moral causes of insanity occasion 28 per cent. of the cases to which a cause is
assigned.
Grief for the loss of children or parents, and anxiety of mind, are the most frequent
exciting moral causes of insanity among natives. Sixteen out of 46 women admitted are
said to have been driven mad by domestic losses; while only 33 among 214 males were
affected in a like manner.
Debauchery.
Debauchery is still returned as a moral cause of insanity, but few at the present day
who lead dissolute lives, abstain entirely from spirit-drinking, or from the use of intoxicating
drugs; as with persons habituated to gangah-smoking, insanity is the result of a combination,
of causes. The wild, reckless, and irregular life, and the feeling of self-degradation, have
probably more to do with the production of insanity than the sensuality and depravity of
their lives.
Sickness.
43. In 14 is the annual return of sick patients treated in the asylum during the year.
Dengue.
The first point of note is the appearance of dengue fever among the inmates. If it is
as infectious as it is generally represented to be, it is strange that only 37 of the lunatics were
attacked, and that in no instance did the fever spread to patients lying in adjoining beds.
Although dengue fever was followed in several instances by insanity, sometimes in the
form of acute mania, among the outside population, yet it did not appear to aggravate the
mental disease of the lunatic patients. The disease was always mild in the asylum,
and delirium was rare. During the height of the fever the patients lay in a torpid state,
unconscious of the racking pains, and heedless of everything around them.
Only four cases were admitted in June, when the epidemic was as its height in the city ;
thirteen in July, none in August, three in September, fifteen in October, and two in Novem-
ber. The first case occurred on the 20th June, the last on the 2nd November.
Inflammation of
the lungs.
44. Pneumonia has been one of the most common and fatal diseases in the asylum this
year. It is always a complication to be looked for in protracted fevers, or after any disease
causing poverty and deficiency of healthy blood. It is more frequent in Dacca than in any
other station known to me. In former years it was attributed to cold, and it was hoped that with
warmer clothing and artificially-heated wards the disease would be less frequently met with.
Such has not proved to be the case. The lunatics were this year much more warmly clad than
any other body of people ; yet the admissions from pneumonia exceeded those of former years.
In 1871 only 1.3 per cent. of the admissions into hospital were from this disease. In 1872
the ratio was 6.3 per cent.
Cause of excess
of chest diseases.
45. In attempting to explain the greater prevalence of inflammation of the lungs during
the past year, it is necessary to remark that if the influence of a chill was the direct exciting
cause of the disease, we would have the majority of the admissions during those months when
the weather is coldest, or when there are the most sudden alternations of temperature. Yet,
on analyzing the register, it is found that from January to April and from November to the
end of December 12 cases were admitted, while during the warm months 10 cases occurred.
Probably due to
overcrowding.
The true explanation, it is probable, lies in the fact that the wards were all dangerously
crowded during the year, and that the lunatics suffered physically, and were for that reason
predisposed to catch the disease. It is a well-known remark that pneumonia often becomes
epidemic when measles is general. It would be interesting to ascertain if pneumonia has in
other stations been as common this year among all classes as it has been in Dacca, and whether
this prevalence attended or followed the epidemic of dengue.
Bowel complaints.
46. Although affections of the lungs were unusually common, diseases of the bowels,
which, in the reports of former years, caused a large percentage of the sickness and mortality,
were less common during 1872.