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observed in previous years. The patients belong chiefly to the poorer classes of
society, being cultivators, domestic servants, beggars, coolies, or shop-keepers.
They are principally drawn from the large towns where the asylums are situated,
or from their immediate neighbourhood. Cachar and Sylhet, however, continue
to send to our asylums an exceptionally large number of insanes. The age of
the insanes when brought to the asylums continues to range generally from 20
to 40 years.
4. In remarking on the increased mortality of the asylums, the Surgeon-
General observes that while there was an excess over the average of five years
previous of 28.8 per cent. in the absolute number of deaths, the death-rates yet
remained nearly the same. The Lieutenant-Governor observes that the ratio of
deaths to daily average strength was 13.3, or precisely the same as the average
of five years previously: while the ratio to the total number of patients treated
was slightly increased, having been 9.3 against 8.9. Contrasting the ratio
borne by deaths to average strength in Bengal with the corresponding figures
for asylums in other presidencies, we have the following table:—
PROVINCES.
Bengal
...
...
...
...
...
...
...
North-Western Provinces
...
...
...
...
Central Provinces ... ... ... ... ...
Oudh
...
...
...
...
...
...
Punjab ...
...
...
...
...
British Burmah ... ... ... ... ... ... ...
Daily average
strength.
1050.86
567.26
238.07
139.46
307.5
140
Deaths.
140
67
28
28
34
10
Percentage
of deaths to
strength.
13.32
11.8
11.76
20.07
11
7.14
Excepting the asylums in Oudh, these figures are not favorable to Bengal;
but it has, however, to be observed that Bengal has a number of insanes under
treatment far in excess of any of the other provinces named.
5. In reviewing the causes of the mortality in the Bengal asylums, the
Surgeon-General remarks that the chief peculiarities of 1874 were an excess
of dysentery and of lung diseases. The proportion of the total number
of deaths due to the former disease was, it appears, 25 per cent., against an
average for ten years of 17.46. Of deaths due to lung diseases, the proportion
similarly was, it appears, 10.7 per cent., against 5.7. Although no certain con-
clusion can be drawn as to the causes to which the increase in bowel complaints
were due, it appears that the mortality from these diseases was lower in the
asylums than that which usually occurs in provincial hospitals and jail hospitals
in Bengal. As regards these cases, the Surgeon-General is inclined to think that
they merely show the modes of death among a class of worn and wasted human
beings in whom little life is left. It is important, however, to ascertain what
proportion of patients died from these and other diseases soon after their admis-
sion into the asylums, and the Lieutenant-Governor hopes that the Surgeon-
General will be able to furnish this information in future reports. With
respect to lung diseases, the Surgeon-General observes that these are due for
the most part to exciting causes capable of prevention, and that cold and con-
taminated air are the most frequent causes. In noting that the great majority
of cases were confined to the Dacca asylum, the Surgeon-General states that,
assuming that the lunatics were sufficiently clad, and that their wards were
p roperly warmed, it is reasonable to attribute the excessive number of
deaths which occurred there to the overcrowding which prevailed throughout
the year. But it appears to the Lieutenant-Governor that if proper advantage
had been taken of the instructions issued to transfer the harmless lunatics from
the Dacca asylum building to the Lallbagh barracks, and for the boarding out
of others, no hurtful overcrowding should have been allowed to occur in the
asylum. The report, however, does not show what the actual population
retained throughout the year in the asylum proper really was, and though it
appears that advantage was taken of the orders issued to transfer some of the