31
Causes.
15. Insanity is certainly far more common among the poor than in the
case of the well-to-do. As witnessed here, ignorance,
poverty, dissipation, and vice, or, in other words, " the
forces adverse to civilization," are doubtless the most prominent agents in its
production. Testimony from first sources, or reliable information, indeed, of
any kind is, however, very rarely obtainable. Certificates are seldom other-
wise than silent, and friends, even when forthcoming, reticent, contradictory,
or ignorant. Thus conclusions have generally to be based on observation of
habits, associations, and avowed addictions, as disclosed while under treatment.
Nevertheless, a very considerable number, embracing more particularly the
admissions from amentia and dementia, must needs remain conjectural. It is,
however, unquestionable that the abuse of ganja is a fruitful factor in the
production of insanity, especially among the vagrant mendicant classes of
aboriginal blood, an addiction to the drug being seemingly a tolerably common
proclivity in vagabond life. There are at this date some 24 patients whose
condition is traceable to this cause, and it is ordinarily a notable feature in
acute cases of such origin that the hallucinations are of the wildest and most
extravagant. On no occasion has either opium, tobacco, bhang, liquor, or
venery, individually appeared as causes, but collectively they doubtless ac-
count for a number of the cases, and there are at least 13 that have no other
history. These have, accordingly, been included in Statements Nos. 3 and 14,
under the general head of debauchery. Other causes, such as religious
enthusiasm, unsuccessful litigation, commercial vicissitudes, and unhappy do-
mestic relations have also each their representative victims, as unmistakeably
betrayed by their prevailing hallucinations. Emotional influences, however,
are seldom encountered as a cause, except in the educated.
Management.
16. No change has been made under this head during the year, and as
the mode of management has been frequently detail-
ed in former reports, a brief allusion will now be suf-
ficient. Its primary aim is to diffuse, as far as practicable, a spirit of cheerful
contentment as the most rational basis of cure ; to afford the inmates at all
times the protection and assistance of humane and intelligent supervision and
care ; to keep constantly before them the example of such wholesome
influences as obedience, regularity, forbearance, mutual assistance, diligence,
and industry, in view to awakening interests and creating confidence; and,
above all, to seek to improve the physical health, and engage the attention by
exercise and employment in the open air, in regard of the intimate relations
existing between mind and body. Discipline and order are successfully
maintained under a homely system of kindness, blended with firmness,
as occasion may demand; and, as a rule, the asylum is ordinarily as quiet and
orderly as a well-regulated household. No mechanical means of restraint
have been used for many years, nor is there any padded room ; conciliation
of demeanour, with patient and forbearing attention, having generally been
found to be far more efficacious in dealing with the refractory than the em-
ployment of coercive measures. And thus temporary seclusion, with or
without the exhibition of sedatives, has been all that has been necessary even
in exceptional cases throughout the year.
Amusements.
17. The patients are, at all times, encouraged to take an interest in
the work of the garden, and engage actively in its
cultivation, alike as a healthful recreation and as as
preservative against excitement. For in-door amusements, in the intervals
of employment, games, music, and vernacular newspapers are provided. Con-
valescents, occasionally, receive some little elementary instruction, while a