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the Medical authorities, desirable that relief should be given by any increase
in the accommodation at Dullunda itself, where the asylum has already reached
the limits which cannot be exceeded consistently with efficient management.
The pulmonary disease which prevailed during the year is pointed to as the
direct result of overcrowding. It is observable, however, that it prevailed least
in the female ward, where the overcrowding was greatest. The daily average
of sick was slightly in excess of that in 1872, but greatly less than in any of
the four preceding years. The death-rate was only 10.8 per cent., against 12.4
in 1872, and an average of 14.4 for the five years, 1868-72. The most fatal
disease was dysentery. Considering that more than half those who died were,
on admission to the asylum, in a bad or indifferent state of health, the results
may be looked on as not altogether unfavorable.
14. The extent to which resort was had in asylums to the use of
mechanical means to restrain refractory patients in 1872, formed the subject of
unfavorable comment last year. The Lieutenant-Governor is glad to observe
that in 1873 the practice has been kept within reasonable limits. He has
sufficient confidence in Dr. Payne to accept the opinion expressed by that officer,
that a certain amount of discretion must be left to the Medical Superintendent
in the matter. Without insisting on an absolute abandonment of mechanical
restraint, the Lieutenant-Governor hopes that it may be adopted sparingly.
15. The importance of providing insanes with industrial employment
both as a preservative of health and as an effective aid in maintaining disci-
pline is not lost sight of in this institution. On an average, all the patients
present, except 48 including the sick, were engaged in some useful occupation.
The total cash outlay in manufactures amounted to Rs. 21,826. The cash sales
outside the asylum amounted to Rs. 11,339 only; but including the value of
articles made over for asylum use, of those in store, and of the labor employed
in repairs and petty constructions, the year closed with a balance of profit of
Rs. 5,783. Deducting this from Rs. 49,879, the total expenditure on the
asylum, the net cost of each patient is said to have been Rs. 117 only, against
Rs. 123 in 1872. The results are satisfactory.
16. Dacca.—This asylum has been visited by the Lieutenant-Governor
and found to be in good condition. There were 127 admissions and re-admissions
to it against 118 discharges and deaths. The increase in the average
daily strength of the patients from 218 in 1872 to 244 in the past year, reduced
the superficial space available for the accommodation of each patient. The
result is said to be apparent in the excessive number of admissions to
hospital of patients suffering from pneumonia. This disease was very fatal,
47 per cent. of those attacked with it having died. There was also a sharp
outbreak of cholera, which proved fatal in 11 out of 16 cases. On this
occasion 50 harmless lunatics were removed to the Lalbagh barracks, where
they must remain for the present. The daily average of sick was 24. The
number of patients discharged cured compares favorably with the previous
year, but is still much below the standard prevailing at Dullunda. The
reason assigned is that Calcutta furnishes a larger proportion of acute and
therefore curable cases than Dacca. The actual cash profit derived from
manufactures was Rs. 2,163, but the estimated value of the patients' labor
was no less than Rs. 6,833. The total expenditure of the asylum was
Rs. 22,892, and the net cost of each patient a little over Rs. 91.
17. The experiment of boarding out harmless lunatics has been tried on
a small scale in this asylum. The great obstacle to success is said to be a
fear of the consequences in case the lunatics should escape or die. The
system, if successful, would effect a considerable saving to Government, and
might afford the best solution for the difficulty presented by the increase of
lunatics in confinement. The Lieutenant-Governor hopes that some of the
more influential inhabitants of Dacca may be induced to give their assistance
in selecting fit persons for the charge of the lunatics and in prevailing on them
to accept it.
18. Patna.—There were 126 patients admitted or re-admitted to this
asylum, against 105 who died or were discharged. Of those who died, 15 are
said to have been in a very bad or indifferent state of health on arrival, and
there is some reason to fear that due care was not taken in removing them to