4
GENERAL REMARKS.
The general health of the inmates of all the asyluns been favourably
reported on.
The complaint of want of information regarding new patients is made
by all the medical superintendents. Dr. Niven calls particular attention
to this, and since this report was commenced, I have received a letter from
him, in which he points out that, out of 18 criminal lunatics, in 10 no infor-
mation was given, while in the remainder it was as scanty as could be.
It is to be regretted patients are sent to asylums, either with very im-
perfect information regarding them, or, as too frequently happens, without
any history of their previous state. I would suggest that Government
be pleased to direct that no insane be received into an asylum without
some history of the case being furnished at the time, unless it be stated
that none such could be obtained. So little inquiry has been made in some
cases, that Deputy Surgeon General Maitland mentions as a subject of
complaint that lunatics, as a rule, are sent to asylums with blank history
sheets, instances being recorded in which their names were unknown. In
support of this, he gives the large number, 92 per cent., of insanes in which
the causes of the disease were unknown to the medical officers.
A consequence of this want of information regarding most of the
inmates is that not much confidence can be placed in the table of assigned
causes, though the chief are said to be the excessive use of ganja and other
deleterious drugs.
It is not always easy to define, with anything like accuracy, the factorship
of mental disease, and, therefore, statistics must not be relied on as being
free from error. The etiology of insanity is beset with difficulties and
complications. For instance, intemperance is put down as the most frequent
cause of insanity, but in how many of the cases could they be traced to the
earliest symptoms of the mental alienation, would it be found to be only a result.
This taste for drink is often hereditarily transmitted, and the origin of the
malady found to be due to the habitual intoxication of the parents. In this
country, where the sale of intoxicating liquors, and liquors apparently of so
deleterious a character, is so unrestricted, and the use and abuse of them
amongst the poorer classes seemingly on the increase, would it not be a wise
precautionary measure on the part of the Government, and possibly prevent
an increase in the number of insanes which may otherwise be looked for, were
the sale of these in some measure restricted, and their adulteration better
looked after and punished ?
All the medical officers agree that debauchery is the most fruitful
source of insanity. Dr. Wyllie does not consider the abuse of opium
alone a cause, though the combined use of this with other drugs is, in his
opinion, a most efficient one. While Dr. Beatty attributes the greater preva-
lence of mental disease amongst males to this, Dr. Lord does not think
the proportion between the sexes holds good in this more than in ordinary
diseases, as exemplified at the Poona Civil Hospital, but is rather disposed to
believe it duo to the females being kept at home by their friends, unless in
eases of poverty,or of those who are troublesome. Tobacco, when indulged in to
excess and in some cases even its moderate use, may considerably affect the
functions of the entire nervous system. Although there seem to be no facta