62
REPORT ON THE
evidences of mental derangement which had been progressing for some time previously.
The greater number of admissions were in the month of November.
Districts
from
whence
lunatics
were brought.
8. Table V.—Of the 16 admissions, 11 were from Cuttack district, 3 from Puri, 1 from
Singbhoom, 1 from Sumbulpore; but of the 11 admitted from Cuttack, only 7 were
residents of the district—1 was a resident of Ranchi, 1 of Ganjam, 1 of Vizianagram,
1 unknown.
Caste of those
admitted.
The population of Cuttack district is 1,500,000, of whom seven were confined as
lunatics during the year, or 4.6 in a million. Of these seven admissions, six were Hindus
and one Mahomedan; the proportion of these classes among the general population of
the district being 18 Hindus to one Mussulman. The number of males is much greater
than of females. This is doubtless in great part due to the fact that women, even though
insane, are kept more secluded and not allowed to go about and molest people; they are
probably, too, less exposed to the exciting causes of insanity.
Occupation prior to
admission.
9. Table VI.—In an agricultural country, where the greater part of the population are
cultivators, one is surprised to find only three out of the 16 admissions were from this class.
It may very likely be the case, however, that the cultivator class had more regular, steady, and
less harassing lives than other classes, and that they are less liable to mental disease. Three
of the admissions were professional beggars. There were two constables from the police
force, and a third constable was discharged from the police and sent home to his friends on
account of insanity. Priests and beggars form a large proportion of the admissions; many
of the latter, however, may be beggars because they are mad.
Age.
10. Table VII.—By far the majority of those admitted were between the ages of 20
and 30, next between 30 and 40. It is to be expected that insanity should generally develope
itself during the period of greatest mental vigour, and such is the case. Three patients under
20 were admitted: one was a girl who used to wander about the streets as a beggar; the
second, a Mahomedan of the town; the third, a beggar. In both these latter cases, ganja
was the cause.
Duration of mental
disease prior to
admission.
11. Table VIII.—Not much reliance can be placed on the reports of the duration of
the mental disease prior to admission, and in very few cases was it possible to obtain any
information from the patients' friends. In six of the cases the duration was unknown. In
one case, a criminal, the disease seems to have commenced in 1867, after the famine, when
all his family died of starvation, but he was not put under restraint till 1872. According to
the reports received, in 8 of the 16 cases the duration was less than one year.
12. Table IX.—From this it appears that the greater percentage of cures occurred
among lunatics who had been less than one year under treatment; one of the cures had been,
however, over three years under treatment.
Health
on
admission
and
discharge.
13. Table X.—Of the 16 admitted, 4 were in good, and 12 in indifferent health, on
admission.
Of the 11 discharged, all were in good health, and had gained weight while in the asylum.
The patients are well fed and cared for, and in most cases an improvement in general health
is to be expected.
Sickness.
14. Tables XI and XIV.-—There was very little bodily sickness among the lunatics
during the year. Only 45 cases were under treatment, and one died. There were 15 cases
of fever, none of them severe; seven cases of diarrhœa and dysentery, all of which yielded
to treatment. One case of a feeble emaciated old woman has had frequent attacks of chronic
rheumatic arthritis, by which nearly all her joints are thickened and deformed. She lost
one eye by sloughing of the cornea at the beginning of the year, and the other eye has had
several attacks of ulceration, threatening sloughing. She has, one may say, been kept alive
throughout the year by constant care; but in her present debilitated state a very trifling
attack of illness would prove fatal. Two other cases have remained in a state of extreme
anæmia; all the rest are in good health, and most of the lunatics have gained in weight.
Out of 51 weighed at the end of the year, 32 have gained and 19 lost weight (the latter very
slightly). Only one death occurred. A feeble old woman, who had been 19 months in the
asylum, and often sick, died of peritonitis after three days' illness. She had a fistula in
ano, which led to an enormous abscess beside the rectum, followed by peritonitis.
Mortality.
In my report of last year, I expressed my opinion that the large mortality, 25.2 per cent.
of average strength, that occurred in 1872 was an accidental circumstance; and the events of
this year support that opinion, as although there has been an equal degree of overcrowding
only one death has occurred, or 204 per cent., and this death was a female. The male-
barracks were constantly overcrowded, the female never nearly full. The outbreak of dengue
fever in the latter part of 1872 did not seem to permanently impair the health of the lunatics.
Types of insanity.
15. Table XII—Types of insanity.—The cases in the asylum were re-diagnosed at the
beginning of the year. Those in whom the symptom had materially altered, were recorded
under a new heading. One cannot, however, lay much stress upon such diagnoses, as the
prominent features of the malady, from which one makes the diagnosis, are mere symptoms
of different phases of the same mental or cerebral disease, and cannot be considered as the
disease itself. Most of the admissions are classed under acute mania, as that is their condi-
tion when the patients are first considered unfit to be at large. It is not, however, really that