( 21 )
believed to be explainable by variations in the proportion of first class and
second class patients.
Meat
...
...
...
...
...
Bread
...
...
...
...
...
Vegetables
...
...
...
...
...
Rice
...
...
...
...
...
Sugar
...
...
...
...
...
Onions
...
...
...
...
...
Butter
...
...
...
...
...
Flour
...
...
...
...
...
Barley
...
...
...
...
...
Tea
...
...
...
...
...
Spices
...
...
...
...
...
Fruit.
Lemonade.
Milk, one measure.
1 lb.
1 „
1 „
4 oz.
1 „
1 „
1 „
½ „
½ „
½ „
¾ „
Average.
1856
1857
1858
1859
1860
1861
1862
1863
1864
1865
1866
1867
1868
1869
1870
1871
1872
1873
1874
1875
1876
1877
1878
Strength.
...
...
...
...
59
56
46
36
26
27
23
25
26
27
25
30
38
27
25
26
26
29
28
No. of
deaths.
9
4
8
3
5
5
5
3
1
2
6
7
3
2
2
3
1
4
3
3
4
0
5
Per cent. of
deaths.
......
......
......
......
8.13
8.93
10.87
8.33
3.85
7.40
26.08
28.00
11.54
7.40
8.00
10.00
2.63
14.80
12.00
11.54
15.38
0.0
17.86
There can be little doubt that up to 1862 the quantity of food supplied
was excessive, for although there were
no diet scales, that noted in the margin
was considered "a bare standard full diet "
for the pauper patients, subject to daily
alterations and additions such as "poultry,
pastry, wine, beer, coffee, ice, &c." The
first class patients, had for breakfast
" Eggs, fish, steaks, chops, cold meat, rice,
fruit, preserves, tea, coffee," and for dinner,
"soup, joints, or poultry, side-dishes,
vegetables, pastry, fruit, preserves, sherry, port, beer, lemonade of lemons or
bael, iced when desired," and tea and toast morning and evening. The
quantities appear to have been unlimited. The second class " bare standard "
scale, prescribes 56 ounces of food exclusive of fruit, condiments, and milk, or
nearly double the quantity which one of the latest authorities on food states to be
sufficient for Europeans working in a cold climate, where more food is necessary
than in India, and far more than most actively employed Europeans consume
in India. Considering that the lunatics do no work, Dr. Payne reduced the
quantities considerably in 1862 without in any way affecting the health of the
patients. They have always been singularly healthy, a fact repeatedly men-
tioned in the reports. The death-rate of so small a community is extremely
misleading. One or two deaths more or less will make an enormous difference
in the rates as is shown in the margin.
A considerable number of these deaths
took place shortly after admission, the
patients being hopelessly ill when received
into the asylum; and the amount of sick-
ness has always been small. The death-
rates prior to 1860 cannot be calculated,
as the average strength was unknown, but
the actual number of deaths vary greatly
as in subsequent years. One man who
died this year (1879) had been 48 years
in the asylum. Of the five deaths last
year, one occurred in a man aged about
70; one case was admitted moribund;
and another with the fatal illness already
developed; none of the five could be
attributed to the influence of the asylum.
Sickness seldom arises in the asylum. The dietaries and the death-rates have
had no apparent connection. At present the average consumption of food is about
36 ounces per patient daily. It is of excellent quality. The great saving
in 1878 has been due to a diminution in the number of first class patients,
and of pure Europeans who eat more than Eurasians. The average cost
of diets has varied from 7 annas 6 pies in 1863 to 13 annas 6 pies
in 1877; but, as already pointed out by Dr. Payne, this is a mere arith-
metical mean, and does not correctly represent the expenditure on either
class of patients. The first class patients have cost much more, and the
pauper patients much less than the average. The variations have depended
on the proportions of different classes of patients and of Europeans and
Eurasians. Since 1876 there have been four classes of patients, the first three
paying Rs. 150, Rs. 80, and Rs. 45 respectively, the fourth paying nothing. Up
to 1877 no attempt was made to distribute the cost of dieting the different
classes, but this is now done as far as practicable. It is found that first class
patients cost about Rs. 32 per mensem, second class Rs. 17, third class from
Rs. 10 to Rs. 12, and fourth class from Rs. 8 to Rs. 10 ; the amount varying with
the season of the year. The daily expenditure on fourth class patients varies
from about 3 annas 2 pies to 5 annas 2 pies according to season, the average
being about 4 annas 1 pie. This, however, does not represent with absolute
exactness, the true value, since waste is not permitted, and any food