ANNUAL REPORT ON THE CUTTACK LUNATIC ASYLUM
For the year 1873.
By Surgeon-Major H. CAYLEY, Superintendent.
Overcrowding.
2. Statement No. 1 shows that the asylum has again been overcrowded, and the
transfer of lunatics from the Central Provinces had to be almost stopped, and only those
from Cuttack and adjoining districts of Orissa could be admitted.
The overcrowding has been confined to the male-wards, in which there is accommodation
for 31 males. The daily average male population has been 40.5, and there were 44 males
remaining at the end of the year.
The female side accommodates 13, and the daily average number has been only 8.7.
There is a tendency to a yearly increase in the number of patients, and the present asylum is
too small to meet the requirements of the population. A project for building a new asylum
for from 80 to 100 lunatics has, I believe, received the sanction of Government.
New asylum.
A site has been selected between the new general hospital and Jobra irrigation work-
shops, at a considerable distance from the town, and the plan of the new asylum, with arrange-
ment of ground and buildings, are now under consideration. The site selected, though good
in most respects, has one serious objection,—that it is in great part a barren, sandy plain,
and the difficulty and expense of getting up a garden will be very great, gardening being
the most suitable, and often the only practicable, employment for a majority of lunatics.
Admissions.
3. The number of admissions during the year was 16 = 13 males and 3 females.
No deduction can, I think, be made from these numbers as to increased prevalence or other-
wise of insanity in the general population. In the five years 1869 to 1873 the admissions
were 16, 20, 37,13, and 16 respectively. In 1872, however, the despatch of lunatics from the
Central Provinces to Cuttack had to be stopped, and during 1873 only two were admitted from
places other than Orissa, viz. one male from Singbhoom and one female from Sumbulpore.
There is no doubt that the number of admissions depends often on the vigilance of the police
or district authorities, who sometimes arrest all obvious lunatics found wandering about, and
at other times leave them at large unless they are public nuisances.
Re-admissions.
4. There were no re-admissions during the year, which speaks well for the permanency
of the cures or improvement of those discharged in previous years.
Discharges.
5. The number remaining at the end of 1872 was 49; the number admitted in 1873,
16, making a total population of 67. Of these 11 were cured. The number discharged
cured during the last 10 years varies so greatly, and seems to bear so little relation to either
the number of admissions or the total population, that no safe conclusion can be drawn from
these figures. Of the 11 recoveries, three had been not over seven months under treatment,
two had been about a year, three between one and two years, and three above two years.
In seven of the recovered the disease was attributed to ganja as its cause, in one
to grief, in one said to be hereditary, and in two the cause was unknown. Only one death
occurred, a female patient. The daily average sick has been 2.39.
Criminals.
6. Statement III.—The criminal lunatics have undergone little change since the
previous year; 13 remained, one was admitted, one died, and none discharged. They constitute
24 per cent. of the asylum inmates. Of the criminals, two or three have never shown any
symptom of mental derangement, and are to all intents and purposes sane, and perhaps never
were really insane, though they committed most grievous crimes. Such cases, which are
probably common in all asylums, require, I think, exceptional treatment and strict, perhaps
penal, discipline. There is in this asylum no greater proportion of dangerous or violent
cases among the criminal than among the other lunatics : in fact, at present the only
really violent or dangerous lunatics are non-criminal; and I think that lunatics of common
type, though they should happen to have committed some crime, may just as well be
treated in an ordinary asylum as transferred to a special criminal asylum. I think, however,
that it would be very desirable to remove from small asylums the constantly violent and
dangerous lunatics, whether criminal or no, as they greatly interfere with the treatment of
the rest.
7. Table IV.—The numbers are too small to be able to draw any conclusions as to
the influence of different seasons on the admissions. The date of admission of a lunatic
into the asylum is little or no guide to the time when the attack first appeared, as lunatics
are very seldom put under restraint until they become violent or in some way troublesome;
and it is well known that acute mania is very seldom the first symptom of insanity, and
only in very exceptional cases; but it nearly always follows some less strongly marked