NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
27
and thus seriously affecting their value as statistics, it is sufficient to pass
the matter with this notice. Of the aggregate, twenty were criminals.
Classes treated.
4. Classed socially 131 were paupers, and, as such, maintained solely
at the charge of Government. Native States met the
expenses in four instances, while only in 11 cases were
friends in a position to defray the costs of maintenance or contribute therete.
The disparity thus expressed might probably suggest that the well-to-do
stood aloof from the asylum. But this certainly is not the case. The true
explanation lies in the fact that insanity is less common under conditions of
competency, and is more particularly the disease of poverty and its demoraliz-
ing influences and surroundings.
5. Classed by caste,. 118 were Hindoos, 23 Mussulmans, and 1 Parsee ;
and, as far as can be known , 94 belonged to Guzerat , 23 to Upper India, the
remainder being chiefly from Marwar, the Deccan , Kattywar, the Punjab, and
Afghanistan. Of the total, 110 were British subjects.
Number admitted.
Forms of Diseases.
Amentia ... ... ...
Mania acuta ... ... ...
„
chronica ... ... ...
„
intermittens ... ...
Dementia ... ... ...
Mania acuta with epilepsy ...
„
chronica with „ ...
Amentia with epilepsy ... ...
Total ...
Males.
5
12
3
2
1
2
1
2
28
Females.
1
...
3
...
1
...
...
1
6
Total.
6
12
6
2
2
2
1
3
34
6. The admissions embraced 28 males and 6 females, as tabulated in
the margin, of whom 20 were sent by magistrates
of this district, and the rest received from Kaira, Surat,
Broach, Dohud, Baro-
da, Mahi Kanta, and
Limri.
Eleven of the
number were friend-
less strangers, utterly
unknown, and in the
few instances where
relatives
appeared,
nothing trustworthy
could be elicited to
throw any light on
habits, cause, or origin,
except that an addic-
tion to ganja was admitted in three instances. The duration of symptoms
was only mentioned in five of the number, in three of whom it was stated to be
under three months ; while the condition in the others was said to have existed
for two and three years respectively. But of the rest, saving that two were
obviously congenital idiots, nothing whatever was known of their previous
history. Of the total, there were only two re-admissions, one a male for the
second time, the other a female for the third time, and both were instances
of relapse due to premature removal from the asylum by friends before cure
was sufficiently consolidated.
Discharged cured.
Forms of Diseases.
Mania acuta
...
...
...
„
chronica ... ... ...
„
acuta with epilepsy ...
Total...
Males.
11
2
1
14
Females.
1
...
1
2
Total.
12
2
2
16
7. There were 16 discharged cured against 17 in the previous year ;
and viewed in relation to population, the proportion
of recoveries was below what it has heretofore been
in this asylum. In my
two last annual reports
this result was not only
foreseen but pointed
to as inevitable in the
large residuum
of
incurable cases neces-
sarily
accumulating
in the lapse of years.
But still the ratio of
29
Total remaining.
Forms of Diseases.
Amentia ... ... ... ... ...
Mania acuta
„
chronica
„
intermittens
Dementia
Monomania
Melancholia
Mania acuta with epilepsy
„
chronica with „
...
...
Amentia with epilepsy
Dementia with epilepsy ...
Total...
Males.
14
41
10
4
10
1
1
2
1
5
1
90
Females.
3
4
6
...
4
...
...
1
...
1
...
19
Total.
17
45
16
4
14
1
1
3
1
6
1
109
Under 6 months ... ... ...
Do.
1 year
...
...
Do,
2
do. ... ...
2 to 5
do. ... ...
5 to 10
do. ... ...
10 to 15
do. ... ...
15 to 20
do. ... ...
20 to 25
do. ... ...
25 to 30
do. ... ...
Above 30
do. ... ...
Total...
Remaining.
Males.
13
8
18
18
21
6
2
1
1
2
90
Females.
2
2
5
5
3
2
...
...
...
...
19
Total.
15
10
23
23
24
8
2
1
1
2
109
11. Of 109 at present remaining, 17 suffer from amentia, 45 are em-
braced as acute, 22 as chronic, and other forms ; demen-
tia accounts for 14, and the rest are cases complicated
with epilepsy. In
48 only is the period
under treatment less
than two years, while
47 have been over
that term and under
10 years. The re-
mainder range up to
34 years as margin-
nally shown. But
the table has less
interest than it would
otherwise possess in
the fact that nothing
trustworthy is known as to the duration of symptoms prior to admission. The
large number of chro-
nic and irremediable
cases
implied
in
these figures neces-
sarily goes on increas-
ing year by year,
and thus, in the
efflux of time, the
remaining soon come
to represent a gra-
dually growing mass
of incurables who die
out but do not reco-
ver.
Of the aggregate, 11 are slowly improving, while 8 are convalescent ;
and it is scarce needful to note that these are all comparatively recent cases.
The remaining 90 are stationary. These results are fully as favourable
as those referred to in last annual report, but they promise, as above explain-
ed, to become less hopeful in the lapse of years. The mental condition and
leading characteristics of the various cases " remaining" are succinctly
noticed in the accompanying register (No. 12), to which attention is in-
vited.
Females.
12. While the preceding remarks have applied generally to both
sexes, the women call for a separate passing notice.
Their number at the beginning of the year was 20, and
in the interval 6 have been received, making a total of 26 ; of whom 2 were
discharged cured, 2 were transferred to friends, and 3 died. There are thus
19 remaining, 1 being almost well and 3 improving, while the rest continue
mostly stationary. Prospects of treatment are, as a rule, less favourable in
the instance of females ; partly in respect of emotional influences and tem-
perament, and partly also that their cases are generally more pronounced
and, inferentially, of longer standing. In former reports repeated allusions
were made to the greater difficulty of maintaining order among them as com-
pared with the men. But since the introduction of grain-grinding as
30
an employment some eighteen months ago, they have been orderly and quiet,
exhibiting a corresponding improvement mentally, as best expressed in the
fact that the recoveries have more than doubled. This occupation, which
they engage in very readily and invariably discharge carefully, singing
blithely at their task, has proved most beneficial in averting impending pa-
roxysms of excitement ; while it has, moreover, the very great advantage of
recalling home associations and awakening feelings and influences that for
the time speak for them. The women now prepare all the grain required for
the asylum, and when thus busily employed, one has sometimes a difficulty
in realizing that they are in reality demented.
Criminal insanes.
Forms of Diseases.
Amentia ... ...
Mania acuta
...
...
„
chronica ...
„
intermittens ...
Dementia ... ...
Mania acuta with epi-
lepsy
...
...
Total...
Crimes.
Murder.
1
3
2
2
1
..
9
Attempt to
murder.
...
1
...
...
...
...
1
The ft.
...
2
1
...
...
...
3
Do. after
preparation
made for
death-hurt.
...
...
...
1
...
...
1
Grievous
hurt.
...
2
...
...
...
1
3
Mischief
and assault.
...
1
...
...
1
...
2
Intentional
insult.
...
...
1
...
...
...
1
Total.
1
9
4
3
2
1
20
13. There are 20 criminal insanes (1 being a female), or 2 more than
shown in last report, 3 having been received, and I
enlarged, the case already noticed as discharged after
nine and a half
years in the asy-
lum. Their forms
of disease and
crimes are shown
in the accompany-
ing table. With
the exception of
2, recently admit-
ted, in which some
improvement has
resulted,
they
seem to be all
cases of hopeless
character, alike
in respect of du-
ration (the majority being above five years), as in the enhanced forms of
mental disease they exhibit. Some of these, from conditions of helpless
idiocy, are utterly unfit for any work, and of the others, the risk of
employing them out of doors are sufficiently obvious to prevent that being
generally applicable. This difficulty, however, has now been met, and the
criminals, since July last, have been employed in grain-grinding—a work they
perform well and take to kindly—and they prepared all the flour required for
the use of the numerous patients in the Hutteesing Hospital. Any very
decided mental improvement in cases so pronounced is, perhaps, scarcely to
be expected ; but, so far, work has certainly proved to be in the interests of
order and good behaviour, as it has unquestionably been conducive to physi-
cal health.
Classification.
14. The construction of the asylum provides for the complete separa-
tion of the female patients in a distinct ward. Three
other compartments, communicating with the central
hall or keeper's room, arc set aside, one for criminals, another for cases of
amentia and dementia, and the third is occupied by the stationary and gene-
rally quiet class. Convalescents share the upper-floor accommodation in
common, while those that have recovered, of whom there are generally three
or four awaiting friends, occupy the keeper's room. The arrangement of the
whole is such as to admit alike of the most facile supervision with perfect
security.
33
22. Grain-grinding has been above referred to as the work of the
women, and also that of the criminal males. In respect of the latter, results
are still to be awaited in its comparatively recent introduction, as well as the
very unfavourable character of the cases. But already, as remarked, it has
certainly promoted health, order, and good behaviour, and I anticipate more.
With the women its success has been most encouraging, as evidenced by the
increasing cures, alike as in the fact that disorder and discord have now in
their case given place to tranquillity and contentment, and thus, even in the
worst, there has been a moral and material gain.
23. I would be glad to have an opportunity of further extending this
form of employment, suitable as it is for those whose sex or circumstances
disqualify them for out-door work, if that could possibly be done without
injury to other interests.
24. Brick-making was pursued up to May, when the advance of season,
as well as the then approaching completion of the new well, put an end to it;
and it has not been resumed as anticipated, owing to there being no funds
forthcoming for the extension of the out-buildings—a want urgently felt.
Rope-twisting, tailoring, and basket-making are occasional employments;
but only to meet home wants. It is very rarely that such handicraftsmen are
to be found among the patients, and others view such occupation mostly with
insuperable repugnance.
25. The number employed in work of sorts was larger than before, and
average 69.6 daily (against 51.2 in the previous year) as follows :—
Out-door
work.
In-door
work.
Employed in gardening, &c, irrigating ... ...
Do.
in levelling the ground ... ...
Do.
in brick-making ... ...
Employed in domestic service of the asylum (males)
Do.
do.
(females)
Do. in grinding-grain (males)
Do.
do.
(females)
28
21
1
— 50
4
2
7
6
— 19
26. The total realizations from labour (garden and otherwise) was
Rs. 811-1-9, and the sum was duly credited in account. The unrealized value
aggregated Rs. 1,013-0-0, made up partly of field produce grown for the
well-cattle and tobacco and vegetables for the lunatics, and partly of the value
of the labour of the patients in brick-making, levelling, and removing old
foundations, as estimated by a competent surveyor.
The details are as follows :—
Realized Amount.
From sale of garden produce ... ... ...
From grinding-grain
...
...
...
Unrealized Value.
Vegetables supplied to lunatics ... ...
Tobacco
do. do. ... ... ...
Grain for bullocks ... ... ... ...
Kurbee and grass for bullocks ... ... ...
Brick-making ... ... ... ... ...
Levelling, &c. ... ... ... ... ...
Rs.
549
261
a.
13
4
p.
5
4
95
22
21
450
25
400
0
0
0
0
0
0
0
0
0
0
0
0
Total
Rs. a. p.
811 1
9
1,013
1,824
0
1
0
9
5 L A
35
accommodation for bullocks, &c., and the concurrent risks of theft. I refer
to these facts only to add that, in the impending necessity for further
extension of the asylum buildings, the labour of the lunatics in brick-making,
&c., should be utilized in the public interests, and I am prepared to guarantee
a satisfactory and economical result.
Establishment.
30. Second Class Hospital Assistant Joseph Solomon, General No. 397,
is the only member of the 1st class establishment.
His duties are very responsible, comprising all details
of management in my absence, the issue and supervision of diet and clothing,
as well as the allotment and distribution of labour. All these he discharges
to my entire satisfaction.
1
1
9
1
2
2
Male-keeper.
Female do.
Warders.
Dhobee.
Cooks.
Sweepers.
The 2nd class establishment consists of 16 servants as per margin. The
keepers and warders, as will be seen, are in propor-
tion of 1 to 10 patients, the authorized complement
being 1 to 6; although thus much below the establish-
ed strength they are still sufficient, the arrangement
of the building affording the means alike of easy
supervision and of security. All are efficient and
well conducted.
Visitors.
31. The visitors have been regular in their half-yearly attendance, and
have duly submitted the prescribed reports of the
criminal lunatics, one of whom was discharged at
their recommendation.
36
ANNUAL ADMINISTRATION REPORT ON LUNATICS AND
LUNATIC ASYLUMS, NORTHERN DIVISION,
FOR THE YEAR 1873-74.
Introductory.
As there is but one asylum within this circle of supervision, viz.. that of
Ahmedabad, prefatory remarks are scarcely neces-
sary in the want of grounds for comparison.
2. It may be noted, however, that since its institution the patients have
been progressively increasing, the only limit to further aggregation being
want of room. Up to 1869 the original accommodation for 75 patients re-
mained untouched. From that time the results of yearly experience were as
follows :—
Years.
1-69-70 ...
1870-71...
1871-72 ...
1872-73 ...
1873-74 ...
Daily
Population.
89.6
90.9
87.3
93.9
105.9
Total
treated.
135
119
116
132
142
Dis-
charg-
ed
cured.
23
18
15
17
16
Transferred.
10
5
12
4
9
Deaths.
12
2
5
3
8
Ratio of
cures.
17.1
15.1
12.9
12.9
11.3
Ratio of
deaths.
8.8
1.6
4.3
2.3
5.6
3. The more notable features in its history for the past five years have
thus been gradual extension, as indicated by daily population and decrease
in the ratio of cures, the inevitable result of an accumulation of in curables
in the efflux of time. Touching the first, it should be mentioned that in
1871-72 it was necessary for a time to put a restriction on admissions and
keep the strength as low as possible in consequence of enlargement being
then in progress, a circumstance that explains how that year was exceptional
in fewer treated and in a larger number transferred; while, as respects the
latter point, it is to be remembered that, in the intervention of freinds, as
represented in the number of transfers, the ratio of cures is necessary less
than would otherwise be shown, since it is generally in such cases as are ad-
vanced in convalescence that relatives are most urgent for removal. There
is, however, some promise of higher results next year in the number who are
improving at this date.
4. The mortality, it will be observed, has been very moderate through-
out, giving an annual mean of 4.6, a figure less than half the ordinary ratio
of deaths among asylum inmates; and much of this is doubtless due to the
attention given to physical health, as an essential base of cure, and the rational
methods of employment in daily use, directed towards its preservation and
promotion.
5. In thus introducing the subject, I have only to add that as respects
native lunatics, it would, perhaps, be difficult to realize conditions and sur-
roundings more favourable to moral and material well-being, or, in other
words, more likely to conduce to recovery than those afforded by the asylum,
of which I am now to speak.
37
AHMEDABAD.
1. This institution, adapted for native insanes only, deservedly holds a
high place in popular estimation, alike as respects the excellency of its ar-
rangements and the marked success that has hitherto attended its manage-
ment. Occupying a well-raised and conveniently chosen site, near to the
city, the situation is cheerful, and, at the same time, sufficiently retired ;
while the surrounding grounds, extending to some 24 beegahs, mostly under
garden cultivation, afford at once a source of peaceful recreation and a
means of healthful pursuits. For the rest, the asylum has had the advantage
of having been for years under the immediate control of the officer who
originally designed it, who has thus throughout naturally identified its
interests as specially his own.
2. Built in 1862, and planned for 75 inmates, the accommodation has
since been twice extended, and is now adapted for 108. The necessity for
further enlargement has again become urgent, as expressed in the fact that
patients have latterly been refused for want of room; and I fully concur
with the Superintendent that this should take the form of a separate build-
ing for the female patients, and entirely endorse the remark made in the
opening paragraph of his accompanying report, that this matter should have
early consideration, so that timely provision may be made to meet the costs
of additional buildings.
3. The total treated was much larger than before, amounting to 142,
of whom 34 were fresh admissions. The cures numbered 16, the deaths 8,
and 9 were transferred to friends. The average daily population was 105.9.
These results, together with the phases of disease treated, are tabulated
below—
Forms of Diseases.
Amentia ... ... ...
Mania acuta ... ... ...
„
chronica ... ...
„
intermittens ... ...
Dementia ... ...
Monomania ... ...
Melancholia ... ...
Mania acuta with epilepsy ...
„
chronica with „ ...
Amentia with epilepsy ...
Dementia with „ ...
Total ..
Remained on 1st
April 1873.
13
51
14
3
14
1
1
5
2
3
1
108
Admitted during
the year.
6
12
6
2
2
...
...
...
1
3
...
34
Total.
19
63
20
5
16
1
1
7
3
6
1
142
Discharged cured.
...
12
2
...
...
...
...
2
...
...
...
16
Transferred to
friends.
1
3
1
1
1
...
...
1
1
...
...
9
Died.
1
3
1
...
1
...
...
1
1
...
...
8
Remaining.
17
45
16
4
14
1
1
3
1
6
1
109
42
LUNATICS OUT OF ASYLUMS.
29. In the civil jail, and police, hospitals and dispensaries in the North-
ern Division, 34 lunatics received treatment during the year. There were
also 2 treated at the Dorabjee Pestonjee's dispensary in the Mhow Division,
and 18 in His Highness the Rao's dispensaries at Bhooj and Mandavie.
Thus, a total of 54 insanes appears in the various returns of sick received in
this office; embracing 30 cases of mania, 8 each of dementia and melan-
cholia, 5 of imbecility, and 3 of idiocy. Of the aggregate, 24 were discharg-
ed cured, 24 absented, 4 were transferred (all to relatives), and 2 remain
under treatment at this date. It is noted of the absented, that they were
mostly accompanied by friends, and were lost sight of after brief attendance.
No further information is now obtainable, and as no special record of the
cases seems to have been kept, the causes cannot now be ascertained.
Measures, however, have been taken to secure accurate data, as far as practi-
cable, for the future.
30. Compared with the previous year the above figures show an increase
of 16 in the total as follows :—
Years.
1873-74 ...
1872-73 ...
Remained.
3
3
Admitted.
51
35
Total.
54
38
Discharged
cured.
24
13
Absented.
24
18
Transferred to
asylum.
......
2
Transferred to
friends.
2
2
Transferred
otherwise.
2
......
Remaining.
2
3
31. The only trustworthy information as to the number of lunatics out
of asylums is limited to that derivable from the Census Reports for 1872 of
the districts of Ahmedabad and Kaira. In the firstnamed collectorate, an
aggregate of 561 is shown, 321 of them returned as idiots. This is, however,
inclusive of 87 then in the asylum here. Deducting these, the corrected
numbers are 161 insanes, 313 idiots, the relative figures for the Kaira Col-
lectorate being 125 and 223, respectively, as follows :—
Census of 1872.
Ahmedabad .........
Kaira ..................
Population.
829,637
782,733
Insanes.
161
125
Idiots.
313
223
Ratio of In-
sanes to Popu-
lation per
cent.
0.029
0.016
Ratio of Idiots
to Population
per cent.
0.038
0.029
32. In what proportion those of unsound mind may be cared for by
friends, or how many are harmless and at large does not appear : nor is it
mentioned whether the term "idiots," has been restricted to congenital cases
only or applied arbitrarily. In point of fact, nothing but the bare figures, as
above, is obtainable from the census reports.
43
33. In view, however, to throwing some light on the points adverted
to, information was sought from the district medical officers as to the luna-
tics in their immediate localities, of whom they possessed distinct know-
ledge. From the replies received (16 in all) it would appear that in and
around the various dispensary towns there is an aggregate of 89 insanes, of
whom 66 are cared for by friends, 21 are harmless imbeciles, living at large
by mendicancy, 1 also friendless (at Godra) is about to be sent to an asylum,
being troublesome, and 1 said to be violent is confined in the Rajkote State
Jail. Accepting the results deducible from these figures as equally appli-
cable to both collectorates, it may thus be assumed that some 74 per cent. of
the insanes and idiots, shown in the census reports, are under the immediate
care of friends.
34. Statement No. 5, showing in detail the different institutions in
which the above insanes were treated, as compared with the previous year,
is herewith attached.
ANNUAL REMARKS, 1873-74, SIR COWASJI LUNATIC ASYLUM
HAIDARABAD.
On the 1st April 1873, there remained 96 lunatics; 79 males and 17
females, and of these 15 were criminal lunatics.
On the 1st April 1874, there remained 97 lunatics; 80 males and 17 fe-
males, and of these 13 are criminal lunatics.
The Asylum—Is calculated to accommodate 138 lunatics.
Admissions.— During the year there have been 44, of these 6 were females
and 3 were criminals.
Discharges.—Thirty-six have been discharged cured, or so much improved
as to be safely entrusted to the care of their friends; of these 6 were females
and 4 were criminals.
Mortality and Sickness.—There have been 7 deaths, last year there were
17. The deaths in 2 cases followed epileptic seizures; in the other 5 cases
death was due to bowel disorder, 1 being a case of peritonitis due to rupture
of the intestine after eating a large quantity of earth for several days. No
female or criminal died.
General Health—Has been remarkably good. A few cases have suffered
from fever, diarrhœa, and dysentery; and in January there were a few cases
of chest affection. There has been no epidemic. Dengue, in the previous
year, curiously did not attack a single lunatic, though almost all of the estab-
lishment suffered.
Buildings.—During the past year two new excellent wards have been
built by the Public Works Department, at a cost of Rs. 5,548. The asylum
can now accommodate 138 lunatics. The women's ward was exposed, being
near the road passers-by used to stop, and it became a public nuisance.
To remedy this, the ward has been enclosed by a wall 11 feet high, enclosing
a good-sized compound : a bathing-tank has been constructed inside, the com-