Note on the Report of the Punjab Lunatic Asylum, Lahore, for the
triennium 1918-1920.
THE report forwarded herewith is for the triennial period 1918—1920. It
has been written by Major H. W. V. Cox, I.M.D., who has been in charge of
the Asylum since the 9th February 1921, owing to the sudden and serious
illness of Major J. F. Fleming, I.M.D., who held charge throughout the
triennium.
Population.
New admissions during the three years under review numbered 449
(376 males and 73 females), 297 (249 males and 48
females and 340 (276 males and 64 females); and
readmissions accounted for 22 (15 males and 7 females), 48 (37 males and 11
females) and 51 (36 males and 15 females). The continued high percentage of
cases cured is worthy of note ; as also the fall in the number of new admis-
sions during the two latter years of the triennium accounted for by the reduc-
tion in the supply of military insanes.
Accommodation.
2. Owing to the progressive increase of the population of the Asylum,
the question of accommodation has become
acute, and will only be settled when the pro-
posed criminal lunatic asylum is provided. The site proposed was selected,
inter alia, for convenience of administration. As a new site on the south
side is now suggested by the Superintendent as preferable the matter will
be reconsidered on the spot in the light of reasons adduced for the change.
By the completion of the tubercular section segregation of patients suffering
from this disease will now be much facilitated.
Attendant Staff.
3. The difficulty in connection with enlisting and retaining a suitable
Attendant Staff, which has been the subject of
comment in previous reports, still exists, notwith-
standing a substantial increase of pay during the year 1919. The disagreeable
as well as responsible duties associated with the care of insanes is likely at all
times to act as a deterrent to recruitment of men physically and mentally
equipped for this exacting work.
Escapes.
4. Notwithstanding the increased population the number of escapes,
aggregating five, was less by four than in the
preceding triennium. Two of the escaped patients
have not been recovered, the one having been at large since 1918, the other
since last year. The attendants at fault in each case have been suitably dealt
with.
Deaths from violence.
5. Two deaths were caused by onslaughts on patients by quiet and
tractable insanes suddently seized with homi-
cidal frenzy.
Suicides.
6. There were three cases of suicide during the period under report ,
which compared with only one during the three
years 1915—17.
Sickness.
7. In the latter part of 1918, there was a severe epidemic of influenza,
complicated in many cases with pneumonia, con-
fined entirely to the male asylum with an inci-
dence of 135 cases and 31 deaths. In 1919 the disease reappeared in the male
section accounting for 3 deaths: while in the end of 1920 the female asylum
suffered from a visitation which accounted for 64 cases with 13 deaths: the
male asylum was not affected.
As usual the largest number of patients were treated for diarrhoea Of
324 cases treated 92 died. Admissions for and deaths from tubercle after
undergoing a considerable reduction in 1919, as compared with 1918 rose con-
siderably in 1920 over the previous two years.
Major J. F. Fleming, I.M.D., acted as Superintendent continuously from
January 1916. He discharged the onerous and multifarious duties single-handed,
without either a Deputy Superintendent, or an Assistant Deputy Superintendent
in a manner which has elicited the highest praise each year. The strain on him
without assistance was severe: and it is greatly to be regretted that he suddenly
broke down and became seriously ill on the 9th February 1921, necessitating
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