4
as the chief, and perhaps the only means, of saving a large number of those
exhaustion cases from a life long ai ment which eventually ends in Dementia,
is by liberal feeding, and the majority of such who are brought here are
famished and starving ; their illness being due to exposure and want of
food.
Sickness and mortality.
There has been nothing out of the ordinary to note about the ailments
occurring Malaria as before accounts
for the largest number of admissions
into hospital though it occurs with less frequency among the lunatics than
the attendant staff living outside the walls. Bowel complaints as usual occur
frequently, and this, considering the extremely filthy habits of a great
number who eat any rubbish they may pick up, is no matter of surprise, and
is responsible for a large proportion of the deaths.
The benefits of the new hospital accommodation are becoming more
evident in the reduction of the number suffering from Anæmia and Anchy-
lostomyasis. All mud eaters have now been completely segregated in rooms
of an upper storey with tiled dadoes and pucca floors and their excreta is
separately dessicated ; yet with all these precautions it is extraordinary to
what an extent some will go to satisfy their craving for earth. Bricks are
frequently pulled down from the walls above the glazed dado and the mud
mortar voraciously eaten. Unfortunately, during 1912, and again in 1913,
there were outbreaks of cholera. In neither of these did the attack assume
serious proportion. The number of deaths being 4 and 2 respectively. It is
difficult to account for the introduction of the disease in 1912 ; but in 1913 it
may be assumed that the complaint was brought in from outside, as cholera
was prevalent in the immediate vicinity of the asylum. The energetic and
prompt measures taken on the appearance of the disease prevented its further
spread.
The mortality on the daily average strength of 10.40, 11.42 and 10.73
for the 3 years calls for no special comment and compares favourably with
that registered in other asylums.
Escapes.
Of these there were five—3 in 1913 and 2 in 1914 less as compared
with the previous triennium when there
were 8. Two however were of a very
serious nature being criminal lunatics who escaped from a barrack during the
night, having burst open a door, the frame work of which, was white-ant
eaten so that the hinges easily gave way on pressure. They then scaled both
inner and outer enclosure walls, the former a matter of no difficulty and even-
tually succeeded in getting across the border to their own country. The other 3
escapes were of non-criminals, two from gangs working outside in the garden
and the third succeeded in getting over the low wall of the tractable enclosure a
very easy achievement. The inner walls of both the criminal and tractable
enclosures have since been raised sufficiently, and now form a serious barrier to
escape. The escapes in all cases were due to the carelessness of the attendants
on duty, and the men concerned were severely punished.
Deaths from violence.
Five men died from the result of assaults made by fellow lunatics.
There was little or no provocation to
cause any. In July 1912 a katatonic
for no reason, fractured the skull of an inoffensive old man with a broom
handle, in one of the hospital wards
The second death was caused by an
epileptic in the furor of mania following a fit smashing to pulp with a brick the
head of a harmless dement. The aggressor in this instance was a Pathan of good
character and habits and most easily manageable in the intervals of his fits.
There was absolutely no provocation. In 1913 there were two deaths from phy-
sical violence both in garrulous old maniacs and there was a strong suspicion
that their garrulity was a source of irritation to the assailants. Death in one
instance being due to several ribs being fractured and in the other to a ruptur-
ed spleen. The last case of assault was perpetrated by a chronic maniac with
rare epileptic seizures who had been in the asylum for years; a most peaceful