NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
15
REPORT ON THE POONA LUNATIC ASYLUM FOR
THE YEAR 1873-74.
To endeavour to meet the requirements of the Surgeon-General's cir-
cular of the 8th instant, No. 1397, of 1874, I have had the set of forms
received with it filled in, which I now forward.
2. I cannot, from personal observation, speak to most of the events of
the last year, having been in charge of the asylum only for a few months at
the end of it; but from information derived from the records, added to my
previous acquaintance with the institution, I am enabled to offer the follow-
ing remarks.
3. The establishment of a lunatic asylum at Poona appears to have
taken place about fifty years ago, and a sketch of the history of the institu-
tion from that time (1823) until its separation from the civil hospital, on
incorporation of the latter with the Sassoon Hospital in 1867, will be found
in my report on the subject, No. 330, dated 16th November 1867.
4. A later special report, to which I would request more particular
attention, was forwarded on the 15th February 1869, describing the accom-
modation afforded by the asylum, and detailing measures considered necessary
for its improvement and enlargement, most of which are still applicable to
existing circumstances, though a few unimportant modifications might be
required to suit changes that have taken place in the last five years.
5. The resolution of Government on the medical administration of the
presidency in 1872-73, declares the working of the institution to have been
unsatisfactory; and thus throws the onus of improving it on the Medical
Department, which in return may fairly expect that reasonable assistance
and means towards effecting the object will be afforded, that a new asylum
will be either realized or abandoned, and if the latter, that the old one will be
remodelled and so constructed as to afford the commonest and most evident
requirements of a medical institution for treatment of the different classes of
mental diseases, which, at present, it is utterly devoid of.
General results of practice.
6. The general results of practice in the
asylum for the year, taken from the returns
forwarded, may be thus stated :—
Remained at commencement ... ... ...
Admitted throughout the year ... ... ...
Total treated ...
61
11
72
Of whom were
Discharged cured
Removed not cured
Died
Remained, 31st March
Males.
60
7
...
6
47
Females.
12
1
1
...
10
Total.
72
8
1
6
57
Ratio of mortality.
7. The ratio of mortality among all male patients was 10 per cent.,
females nil. On the total treated the ratio
would be 8.47 per cent. The casualties occur-
red entirely among Hindoos, raising the ratio in males of that class to 13 per
cent. The total average for males of all castes being 10 per cent. to total
treated, or 12.6 to the daily average strength of that sex.
Of cures.
8. The percentage of cured to treated
was in males 11.7, females 8.3, and to total
treated of both sexes 11.1.
18
Criminal lunatics.
19. As it has been decided by Government that the criminal lunatics
now at Poona shall be transferred to Kolaba,
and as their crimes have been specified as
directed in the tabular form forwarded, and separate special reports on the
present state of each furnished, when required in the Judicial Department,
it does not seem necessary to enter into further details regarding them in
this report.
Lunatics out of asylums.
20. Regarding lunatics out of asylums, district magistrates, civil
surgeons, and village authorities, or dispensary
subordinates, might be requested to report.
In the asylum, only cases sent for observation could be so returned, and
with this view an accurate register of such cases has been kept from the
commencement of the current year.
Former Superintendent's state-
ment.
21. In compliance with the regulations of the Service (Rule 67, Section
IV.) a copy of portion of the statement left by
the last superintendent is here transcribed, the
earlier part being omitted, as it refers only to
numbers treated and results which have now been embodied in the returns
rendered for the whole year. Dr. Beatty states—
" Since the last annual report was made, a covered shed with stand and
large chatty pots for holding drinking-water has been erected, and
a requisition made for a better bathing arrangement than at present
exists.
During the period under notice a decrease has been made in the pay of
the conservancy establishment from Rs. 22-8 to Rs. 15.
A still further reduction is now being made in the cost of dieting the
lunatics.
Arrangements are now being entered into, and tenders called for, for
supplying the patients by contract instead of by the more expen
sive method of the Commissariat Department, and a considerable
saving will, it is believed, be effected thereby."
Alterations, &c., since effected in
the asylum.
22. When I resumed charge, a partition wall, 9 feet high, was being
built to divide the larger male ward into two,
and a door made into the portion thus cut off,
by which the space of three beds was taken up.
Subsequently, I had two bed places made in the end of the outer ward next
the cells, which brings our accommodation up to 47 beds for males, one less
than the asylum formerly held. Considering the great want of accommo-
dation, especially for male patients, which frequently compels us to refuse
admission even for urgent cases, I submitted a proposal for taking in, at a
very trifling expense, one of the wards of the old civil hospital, and making
Proposed convalescent ward.
it a ward for progressing and convalescent
lunatic cases, by which we could increase the
number of beds in the asylum to 74, or about one-fourth, the present
number being 59, males and females. This proposition the visitors approved
of, and desired to be submitted to Government, which was done; but under
existing circumstances further consideration has probably been deferred.
19
Latrine accommodation for
servants.
23. The absence of any latrine accommodation for the servants of the
asylum and of the Sassoon Hospital, residing
on the premises, and their families, in all about
78 persons, and the consequent filthy and
unwholesome state of the compound were reported, and the sanction of Govern-
ment obtained for the outlay required for opening doors into and making
available for use one of the old hospital latrines, which has since been done.
Bathing-place for females.
24. The bathing-place adjoining the covered shed, alluded to in Dr.
Beatty's report,has been completed in the female
part of the asylum, but something of the
same kind, but larger, for the males is very much needed.
Proposal for procuring diets by
contract negatived.
25. The probable result of the proposal for dieting the lunatic patients
by contract, instead of through the Commis-
sariat Department, was fully reported on in
my letter of 19th December 1873, No. 108, and
Government, in their resolution on the subject, have decided that Dr. Beatty
must have written under misapprehension.
Water-suply desired.
Saving proposed.
26. The desirability of supplying the asylum with Kuruckwasla water
from a stand-pipe on the premises, from which
the patients could obtain and distribute water
for their own use, and so save fifteen rupees a month, now paid to a bheesty,
has been laid before the visitors, and submitted
through the Irrigation Department to Govern-
ment for approval and sanction.
Question of improving old
asylum.
27. In conclusion, I may beg to offer as a suggestion worth consideration
the query: Whether the present asylum and
grounds, if somewhat altered and added to, pro-
perly enclosed and provided with an abundant
supply of good water, might not for an outlay, which would be a fraction of
what an entirely new site and buildings will cost, be made to afford accommo-
dation with seclusion, separation, and occupation for 100 native patients?
which, as the site is not inimical to the health of such inmates as the insti-
tution ordinarily receives, are about all the chief requisites for a local or
district asylum for natives of Poona and the adjoining collectorates.
20
ANNUAL MEDICAL REPORT OF THE LUNATIC ASYLUM,
DHARWAR, FOR THE YEAR CLOSING MARCH 31ST, 1874.
During the past year there have been admitted 6 patients : 4 dementia
and 2 mania ; the deaths amounting to 4, divisible into : 1 from fever, 2
diarrhœa, and 1 debility ; 3 were of the males and 1 (debility) female.
In all these cases the diseases ran a slow but persistent course, and the
difficulty of medicinally treating the poor creatures render their chances of
recovery much less than they would otherwise be.
Two patients, partly recovered, were, at the request of their friends and
sanctioned by the visitors, taken to their own houses.
Of the 24 lunatics now in the asylum, 20 are males and 4 females, and
an average of 7 males go out working daily in the garden under charge of
the warder, the others are not trustworthy, but all day are allowed the use
of the large day-room. Of the 18 cells or night-rooms, 1 is occupied by
a female and the other 17 by males, an average or balance of three males using
the day-room at night. Two of the cells are now padded for the use of any
very uproarious or dangerous patients. The garden supplies a fair quantity
of vegetable daily to the insanes, and is as a remedial or palliative agent
most beneficial to the lunatics.
The crowded state of the asylum and its proximity to the civil and
police hospital is a great evil, only to be remedied some years hence by
the removal of the civil hospital to the town.
21
REPORT BY DEPUTY SURGEON-GENERAL MAITLAND ON
THE LUNATIC ASYLUMS OF POONA AND DHARWAR.
The aggregate number of patients remaining in the Poona and Dhar-
war Asylums at the commencement of the official year was 85, fresh ad-
missions 17; making a total of 102 insanes treated during the year. Of
these, 8 were discharged cured, re-admitted none, transferred 3, died 10;
leaving under treatment, on the 31st March, 67 males and 14 females.
To each report submitted by superintendents of asylums is attached
14 tabular statements, which, when collated and compared with statements
from other asylums, will no doubt afford valuable information. At present
some of the forms appear complicated, and, I think, attempt to show too
much from too great sub-division of small numbers. The results obtained
from forms 8 and 10, showing the age, caste, and condition of life of lunatics,
would be useful, had the statements been based on reliable data, which can
hardly be expected when we consider how little really is known of each in-
dividual's case. For it has been long a subject of complaint, that lunatics,
as a rule, are sent to asylums with blank history sheets ; and instances are
even recorded in which their names were unknown. In support of this state-
ment, I need only allude to the fact that, out of a total of 105 patients treated
during the year, 94, or 92 per cent., are labouring under forms of insanity, the
causes of which the medical officers are ignorant of.
As, however, Government have issued stringent orders on this subject
and expect that hereafter no lunatic will be forwarded to an asylum,
without, as far as practicable, every information regarding his previous his-
tory and present state being ascertained and made known to the superin-
tendent, the mass of information these statements are intended to supply
will in time be full and complete.
The above remarks, of course, do not apply to criminal lunatics, whose
antecedents are generally only too well known ; but, unfortunately, not until
they appear at the bar of justice, accused of perpetrating some grievous
assault or cruel murder.
POONA ASYLUM.
Since last report the alterations and additions therein recommended have
been carried out. The long south ward has been divided into two, and a small
adjoining building converted into two safe and comfortable padded rooms for
refractory patients. A bathing-shed has also been put up for the use of
the females ; which last convenience, I think, might also be erected on a larger
scale in the male compound.
Additional accommodation in the asylum is still urgently needed for
male lunatics, especially for progressing and convalescent patients, and it is
with this object that the superintendent has submitted to Government,
through the visitors of the asylum, a proposal to convert one of the wards of
the old civil hospital, now used as an office by the assistant collector, into
a convalescent ward, and in this way raise the number of sick to 74.
As Government see no probability, at present, of a general lunatic
asylum being built at Poona, I strongly recommend that Dr. Lord's sugges-
tions be carried out, so soon as office-room can be found for the collector.
23
by superintendents, should the suggestion meet with the approval of the
Surgeon-General.
At my visits to the asylum I have had every reason to be satisfied that,
as far as practicable, and the present arrangements of the ward will admit of,
everything is done to ensure order and cleanliness, and to provide for the
comfort and well-being of the insanes; and no medical officer, I feel sure, is
more keenly alive to the disadvantage under which the duties of the asylum
are carried on, or more zealous and anxious to ameliorate the condition of its
inmates, than is Dr. Lord, its present superintendent.
DHARWAR LUNATIC ASYLUM.
As the prospect of any enlargement being made to this asylum is
dependent on the removal of the civil hospital to a position nearer the town,
some few years must yet be allowed to pass over before the institution is
able to meet the pressing calls made upon it.
In this asylum, 30 lunatics have been treated during the year: 6 of
these were fresh admissions, 4 have died, or 13.3 of deaths to strength, 2
transferred to their friends, leaving 24 patients under treatment.
There is no room available in which the sick insanes can be treated, as
obtains at Poona, nor is a hospital required at present for the few sick, who
can be very properly attended to in the night-room, or separate cells, on
which principle this asylum is built.
At present there is only one criminal lunatic in the asylum, and he
will shortly, I trust, be sent to Bombay, together with those at Poona; for no
proper accommodation exists for that class of insanes in either of the
asylums in this division.
The superintendent states that the only alterations to this asylum, since
the former report, is the conversion of two cells into padded rooms for
refractory patients.
The garden in which the insanes are employed, the superintendent like-
wise states, is productive, and supplies a fair quantity of vegetables daily to
the prisoners; and he considers that this kind of employment is, as a
remedial or palliative agent, most beneficial to the lunatics.
The crowded state of the asylum, to which Dr. Mackenzie alludes, I am
afraid cannot be remedied until the civil hospital is removed elsewhere.
On my inspection in January last, I was favourably impressed with the
cleanliness, order, and good arrangement, for the comfort of the insanes,
which everywhere existed in this asylum, and which reflects credit on the
superintendent.
24
REPORT ON LUNATICS TREATED IN CIVIL, POLICE , AND
JAIL HOSPITALS DURING THE YEAR 1873-74
There remained in the civil hospitals at the close of the year 1873-74
21 lunatic patients, since admitted 72, making a total of 95 insanes;
25 of these were discharged cured, 16 transferred to Kolaba Asylum,
27 to friends, and 4 have died, leaving 21 still under treatment in the
hospitals.
At the asylum attached to the civil hospital at Kolhapur, the largest
number of patients have been treated, and still remain under treatment.
The asylum is built after the plan of the one at Dharwar, at the
expense of the Kolhapur State, and has already proved a most necessary and
valuable addition to the civil hospital.
The accommodation assigned to the lunatic patients at the Dhulia
Civil Hospital answers well enough, but an additional force is required to
assist in keeping in order the excitable and more refractory insanes. Eight
lunatics still remain under treatment.
At Satara nothing has been done to provide proper accommodation for
insanes. They are still kept in two side rooms belonging to the female
hospital, which is a separate building and surrounded by a wall, an ar-
rangement which certainly ensures the safe custody of the lunatics, but
one which is very detrimental to the comfort and welfare of the female
patients. In view to remedy this evil, it is now proposed to convert a small
detached building, situated at the western entrance of the compound, and
at present used as a storeroom, into small lunatic wards, capable of hold-
ing four patients; and I have directed the civil surgeon to obtain from the
executive engineer a plan and estimate of the alterations and additions
required.
The Civil Hospital at Nasik is a very large old building, and quite
capable of affording room for the insanes sent to it for treatment. Seven
patients have passed through the hospital during the year ; 3 were discharged
cured, 1 transferred to Colaba, and 3 to friends.
The Sholapur Civil Hospital affords no accommodation whatever for
lunatics. During the year only 5 insanes have been admitted, and were
treated in the civil ward with other patients. Of these, 1 was discharged
cured, 3 were transferred to Kolaba, 1 remained. A separate ward is here
also much needed in which this class of patients might be properly cared
for and treated.
Lunatics when admitted to the Civil Hospital, Dharwar, are either
transferred to the local or to the parent asylum at Kolaba; but in slight cases
they are kept under observation and treatment in the civil hospital, and,
when cured, discharged.
25
The table annexed to this report will show the number of lunatics
treated in each hospital, and the manner in which each patient has been
disposed of.
POLICE HOSPITAL.
Only two cases of insanity have been admitted to police hospitals during
the year.
One occurred at Dharwar, and the man, after remaining in hospital for a
short time, was discharged cured; the other at the Sassoon Hospital. He
likewise was discharged cured.
Insanes treated at civil and charitable dispensaries have been as
follows :—
At Civil Dispensaries ... ... ...
At Charitable do. ... ... ...
6
33
39
The insanes who are brought by friends to dispensaries for treatment are,
it is presumed, either harmless lunatics or idiots, otherwise they would
have been handed over to the Magistrate to be dealt in accordance with Sec-
tion 4 of Act XXXVI. of 1858.
4 L A
26
ANNUAL REPORT OF THE AHMEDABAD LUNATIC
ASYLUM FOR THE YEAR 1873-74.
Introductory.
The asylum was constructed in 1862, and originally designed to accom-
modate an aggregate of 70 inmates, the highest daily
number of insanes up to that time being only 45. In
1869, however, it was necessary to enlarge it to meet pressing wants ; and a
further addition was made in 1872. Thus extended, it is equal to the recep-
tion of 108 patients, a number now exceeded; and hence it has again become
necessary for some months past to decline fresh admissions. This fact has a
significancy that should now be recognized, inasmuch as it cannot be supposed
that the present pressure on space is merely temporary. On the contrary,
the history of the asylum, as expressed by its development within the past
ten years, sufficiently indicates that the want of accommodation, now noticed,
promises soon to be urgently felt as a permanent requirement. It therefore
appears expedient that this matter should have early consideration, so that
timely provision may be made to meet the cost of additional buildings.
Number treated.
2. The number of insanes under treatment for the year was much
larger than before, amounting to an aggregate of 142, of
whom 108 were remaining at the date of last report,
and 34 were fresh admissions. Of the total, 16 were discharged cured, 9
were transferred to friends, 8 died, and 109 now remain. Compared with
the previous year, these figures show an increase of 10 in the total, of 12 in
the daily strength, of 5 in the deaths, and of 1 in the remaining; while
there is a decrease of 1 in the cures as below exhibited :—
Years.
1872-73 ..
1873-74 ..
Daily
Popu-
lation.
93.9
105.9
Total
treated.
132
142
Dischar-
ged
cured.
17
16
Transfer-
red.
4
9
Deaths.
3
8
Ratio of
cures.
12.9
11.3
Ratio of
deaths.
2.3
5.6
Out of the total, 116 were males against 26 females. Of the former, 72
belonged to the industrious classes, chiefly agriculturists, handicraftsmen,
labourers, clerks, sepoys, and traders. The remainder comprised fukeers,
gossaies, and other vagrant mendicants of no settled homes or pursuits.
Forms of Diseases.
Amentia ... ... ...
Mania acuta ... ... ...
„
chronica
...
...
...
„
intermittens
...
...
...
Dementia
...
...
...
Monomania ... ... ...
Melancholia
...
...
...
Mania acuta with epilepsy ...
„
chronica with „ ...
Amentia with epilepsy ... ...
Dementia with
„ ... ...
Total ...
Males.
15
57
13
5
11
1
1
4
3
5
1
116
Females.
4
6
7
...
5
...
...
3
...
1
...
26
Total.
19
63
20
5
16
1
1
7
3
6
1
142
3. The number treated under the different phases of insanity, as
exhibited on admis-
sion, is marginally
given for both sexes.
But the large prepon-
derance
of
acute
mania, as thus shown,
is scarcely a fact at
this date, as in the
lapse of years many
of these cases would
necessarily be more
correctly included in
the chronic category,
As such adjustment,
however, could not be
made without obviously disturbing the numbers"admitted" and "discharged,"