28
cures, calculated on mean daily population, was equal to 15.1, a figure
that compares favourably with kindred institutions , being nearly double
that of the Hanwell Asylum. Excepting the instance of a criminal whohad
been 9½ years an inmate (but perfectly sane since 1867), the cures were all
effected in cases that had been less than two years under treatment. The
longest period was one year and nine months, the least two months, the
majority being under one year. In every instance convalescence was gradual,
and, in general, slow, sometimes not without partial relapse; the interval from
the first indications of dawning improvement to the full restoration of reason
ranging from 7 weeks to 15 months. It was noticeable, as before, that cure
was most rapidly accomplished in cases traceable to the abuse of ganja.
Number transferred.
8. The intervention of friends is necessarily a disturbing element in
estimating success. During the year nine patients were
thus removed (as authorized by Sections IV. and X. of Act
XXXVI. of 1858), the reasons assigned being generally of a domestic nature.
The number was about the ordinary average entered under this head, although
double that of the previous year. In four of these cases treatment had extended
from 1 to 4½ years without appreciable benefit ; they are thus doubtless to be
estimated in the category of incurables. But in three treated, for periods: of
4, 5, and 15 months, the condition had so greatly improved, that eventual
recovery was merely a question of a few weeks at most; while in the remaining
two instances, the patients had been too short a time in the asylum to admit of
a judgment being formed respecting them.
Deaths.
9. There were eight deaths during the year, giving a ratio of 7.5 per cent. to
daily population, and, therefore, a proportion considerably
below the average, both here and elsewhere. Two of
these happened from Bright's disease in patients who had been, respectively, two
and seven years in the asylum; and in the former, the condition was recognized
on admission. One occurred from diarrhœa and concurrent exhaustion on the
fifth day from reception, in the instance of an aged female of 70, sinking from
the outset. Phthisis proved fatal in a young man 28 days under treatment,
he being hopelessly circumstanced when received. The fifth death was due
to anæmia, and the sixth to uncontrollable ulceration of the rectum in connec-
tion with cirrhosis. Both these patients, who had been inmates for upwards
of six years, were idiotic throughout, and had long been declining in health.
The seventh was the case of an old man of 80, afflicted with dementia.
He was suffering from valvular cardiac disease, with dysponœa and ædema,
from admission, and sunk by sudden syncope after 5 weeks. Of the eight,
only two, those affected with Bright's disease, were over lucid while under treat-
ment. The last casualty was in the instance of an inmate received in 1869, and
then suffering from asthma in connection with enlargement of heart. He con-
tinued subject to recurring attacks throughout, and sunk by syncope on the
10th ultimo after a severe asthmatic seizure.
10. The ratio of mortality in the case of the insane is a very varying
quantity, being more dependent on the state of physical health obtaining on
admission than influenced by existing mental conditions, or subsequently
acquired ailment. Thus, for the previous ten years, it has ranged from a
minimum of 1.8 per cent. of mean strength up to 22, the latter excessive figure,
however, being due in part to cholera ; while the average for the decennium is
shown to be 95