NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. S.B./74 OF 1878.
FROM
THE SURGEON-GENERAL,
Indian Medical Department,
To
THE SECRETARY TO GOVERNMENT,
General Department.
Bombay, 21st February 1878.
SIR,
I have the honour to submit, for the information of His Excellency the
Governor in Council, the Annual Report on the Lunatic Asylums of this
Presidency and Sind for the year 1877.
Number and comparative
size of the asylums.
2. The asylums under the control of this department are five in
number, viz., Colaba, Poona, Dharwar, Ahmedabad,
and Hyderabad. The first is in charge of a Super-
intendent specially appointed, and of the others the
respective Civil Surgeons at the stations are the Superintendents. Colaba, the
largest and most important of these institutions, had, during the past year,
an average daily strength of 288.0 inmates; Hyderabad comes next with a
strength of 115.0, then follow Ahmedabad with 108.1, Poona with 66.8, and
Dharwar with 21.0. From these figures an idea of their comparative sizes
may be gathered. The separate reports of the Superintendents, which are
printed in full, give in detail all necessary information connected with the
management of each asylum. I shall offer merely a few general remarks,
and, as on former occasions, shall preface them with a short review of each
series of statistical statements.
Population.
Admissions and re-admis-
sions.
Discharged.
3. Statements No. 1 furnish various particulars regarding admissions
and discharges; it shows that the total asylum po-
pulation was, for the past year, 869, as compared with
846 in the previous year. The total was composed of 717 males and 152
females. There remained, on the 1st January 1877, 469 males and 113 females,
a total of 582 ; the new admissions during the year
numbered 240 males and 34 females, and 8 males and
5 females were re-admitted. The total number of
discharges from the asylums were 205 males and 35 females. Of these 81
males and 18 females were cured ; of 117 males and
16 females transferred to friends 82 of the former and
11 of the latter had undergone improvement to some extent, while 35 males
and 5 females were thus transferred without having made any advance towards
recovery. Many were, indeed, hopeless incurables. Of 8 insanes returned
as discharged "otherwise," 6 males and 1 female were transferred to other
B 672—1
2
Mortality.
asylums, and the eighth was an escape from Ahmedabad. The mortality has
been greater. There were 56 deaths during 1877 as
compared with 36 in the preceding year ; 44 of these
were males and 12 females. On the 31st of December last, the total number
remaining in the asylums was 573.
Daily average strength
and daily average sick.
4. The daily average strength shows a further increase ; it has risen
from 584.7 in 1876 to 598.9 for the year under
review. The average daily sick was 61.7, nearly
the same as last year.
Percentages of cures and
deaths.
5. The percentages of cures and deaths to the
daily average strength were—
Cured ...
Died ...
Mal es
...
...
...
...
...
Females
...
...
...
...
...
Males...
...
...
...
...
Females
...
...
...
...
...
16.7
15.9
9.1
10.6
Total 16.5
Total 9.3
The percentages to admissions were—
Cured ...
Died ...
Males...
...
...
...
...
Females
...
...
...
...
...
Males
...
...
...
...
...
Females
...
...
...
...
...
32.6
46.1
17.7
30.8
Total 34.5
Total 19.5
Criminal lunatics.
6. The details regarding criminal insanes are shown in Statements No. 2.
At the beginning of 1877, 80 males and 4 females
remained, while 20 males and 2 females were ad-
mitted during the year, making the total treated of the criminal class 100
males and 6 females. Out of these, 8 males and 2 females were discharged
cured; 2 males who were improved and 2 others not improved were
removed by their friends ; 2 males ceased to be criminal, their periods of
sentence having expired, and were accordingly transferred to the non-crimi-
nal list ; 2 males and 1 female died. At the end of the year 84 males
and 3 females remained in the asylums. The daily average strength was
87.0 as compared with 83.5 for the preceding year.
Religion, sex, and resi-
dence.
7. Statements No. 3 furnish information relating to the residence, sex,
and religion of the patients admitted during the
twelve months. The Christians included 93 Euro-
peans, 9 Eurasians, and 6 Native Christians, and of
the total 96 were males and 12 females—the majority of the Europeans
were soldiers, sent here from all parts of India. Ninety-eight Hindus 82
males and 16 females—were admitted. The Mahomedans numbered 62
males and 8 females, the Parsis 7 males and 2 females, and "other castes"
1 of each sex. The total admissions for all castes and classes was 287.
Previous occupations.
8. In Statements No. 4 the previous occupations of the new admissions
are shown. There were 78 European soldiers, 5
Native soldiers, and 3 European sailors. Amongst the
others, 68 are classed as paupers and mendicants ; there are 27 tradesmen of
various denominations, 22 cultivators, 16 labourers, and 5 domestic servants.
The remainder include, besides a few professional men and police sepoys, no
less than 27 whose occupations are unknown.
5
Net cost per head.
duce, asylum manufactures, &c., Rs. 2,316-8-11; this is an increase on both
tems of Rs. 611-3-8 and Rs. 127-8-9 respectively. The net cost per head
in each asylum for the past two years, together with
the average net cost and average daily strength, is
thus shown :—
Colaba ... ...
Poona ...
Dharwar ...
Ahmedabad ...
Hyderabad ...
Average cost ...
Average daily strength ...
1876.
Rs.
... „
... „
...
„
...
„
... Rs.
... „
176
139
171
97
95
143
7
2
12
11
15
5
11
3
8
4
5
0
584.7
1877.
177
133
216
108
100
146
4
8
10
4
10
9
7
1
2
0
11
10
598.9
Establishments.
14. Statements No. 10 deal with the sanctioned establishments of the
asylums. Their total monthly cost was Rs. 3,455,
exceeding that of last year by Rs. 6-8-0. The increase
is due to a small rise in the salary of the steward at Colaba and to the en-
tertainment of an extra sweeper for the same asylum.
Manufactures.
Number of insanes em-
ployed.
15. The receipts and expenditure on account of manufactures are detailed
in Statement No. 11. A total credit of Rs. 4,430-10-7
is shown ; this is less by Rs. 72-14-6 than the total
credit shown for the previous year. The excess profit amounts to Rs. 2,396-3-2
as compared with one of Rs. 2,161-0-2 for 1876. In the table below a com-
parison of the daily average number of insanes em-
ployed during the two past years is given for each
asylum. It will be seen that the figures are almost
alike for both years :—
Colaba ...
...
Poona ...
...
Dharwar ... ...
Ahmedabad ... ...
Sir C. Jehangier's ...
Total ...
1876 ...
1877 ...
1876 ...
1877 ...
1876 ...
1877 ...
1876 ...
1877 ...
1876 ...
1877 ...
1876 ...
1877 ...
Average Strength.
Males.
230.9
232.2
46.0
49.5
16.9
15.5
87.8
90.4
90.0
98.0
471.6
485.6
Females
56.3
55.8
15.0
17.3
6.0
5.5
17.8
17.7
18.0
17.0
113.1
113.3
Total.
287.2
288.0
61.0
66.8
22.9
21.0
105.6
108.1
108.0
115.0
584.7
598.9
Employed.
Males.
98.2
94.2
35.0
38.0
6.0
6.3
64.0
70.0
61.0
58.0
264.2
266.5
Females
21.0
20.2
13.0
15.0
...
...
13.2
12.0
14.0
13.0
61.2
60.2
Total.
119.2
114.4
48.0
53.0
6.0
6.3
77.2
82.0
75.0
71.0
325.4
326.7
6
Condition as regards mar-
riage and caste.
16. Statements No. 12 set forth the conditions of the asylum population
as to marriage and caste. No. I of the accompany-
ing tables gives the percentage which mortality and
cures bear to the total treated for each sex and for each
condition. In No. II are shown the conditions as regards marriage for the
lunatics belonging to the principal Native communities :—
No. I.
Single ..
Married..
Widowed ..
Unknown..
1876 ..
1877 ..
1876 ..
1877 ..
1876 ..
1877 ..
1876 ..
1877 ..
Total Number.
Treated.
M.
346
379
207
204
54
46
90
88
F.
27
23
59
72
39
33
24
24
T.
373
402
266
276
93
79
114
112
Cured.
M.
38
39
27
31
8
8
2
3
F.
1
1
5
11
8
4
1
2
T.
39
40
32
42
16
12
3
5
Died.
M.
14
22
5
16
5
1
4
5
F.
2
3
1
4
4
..
1
5
T.
16
25
6
20
9
1
5
10
Percentages of
Cures to Treated.
M.
10.9
10.2
13.0
15.1
14.8
17.4
2.2
3.4
F.
3.7
4.3
8.4
15.2
20.5
12.1
4.1
8.3
T.
10.5
9.9
12.0
15.2
17.2
15.1
2.6
4.4
Deaths to Treated.
M.
4.0
5.7
2.4
7.8
9.2
2.1
4.4
5.7
F.
7.4
13.0
1.6
5.5
10.2
..
4.1
20.8
T.
4.2
6.2
2.2
7.2
9.6
1.2
4.3
8.9
No. II.
Single ...
Married ...
Widowed...
Unknown .
Hindus ...
Mussulmans ...
Parsis ...
Hindus ...
Mussulmans ...
Parsis ...
Hindus ...
Mussulmans ...
Parsis ...
Hindus ...
Mussulmans ...
Parsis ...
Number.
1876.
151
120
8
140
55
30
47
17
4
72
29
2
1877.
157
130
9
145
65
27
37
19
3
70
29
2
Percentages to Total
Treated.
1876.
40.5
32.2
2.1
52.6
20.6
11.2
50.5
18.3
4.3
63.1
25.4
1.7
1877.
39.0
32.3
2.2
52.5
23.5
9.7
46.8
24.1
3.8
62.5
25.9
1.8
Number of criminal lu-
natics and their crimes.
17. Statements No. 13 furnish certain additional information regarding
criminal lunatics. The average daily number employ-
ed was 55.1 males and 3.4 females, that for the
previous year having been 58.9 and 4.0 respectively.
8
Treatment.
23. As a mode of treatment, suitable employment still appears to be
the one from which the greatest amount of benefit
has been derived, the experience of each year showing
more and more conclusively its value as an agent in the amelioration of the
mental condition of the patients. I cannot speak too strongly of the evil
influence exercised on treatment by the associating together of criminals and
non-criminals, and would ask the earnest attention of Government to the
remarks made by my predecessor on this matter in para. 25 of last year's
report. The latter part of Dr. Murphy's 15th para.—detailing how certain
criminals, who have recovered and are still detained in the asylum, are a
constant source of anxiety and responsibility and an evil example to the
other inmates—is also worthy the particular attention of Government. The
presence of such people as these amongst the patients of a large asylum cannot
but prove prejudicial to all afforts in the direction of treatment.
Employment.
24. The asylum population have, as far as practicable, been induced to
engage in healthful labour, with advantage, not only
to themselves bodily and mentally, but to the State
financially. The total average number employed scarcely differs from that
of last year.
Vaccination.
25. Vaccination has been carefully attended to wherever considered
necessary. All unprotected new admissions are at
once vaccinated. No cases of small-pox have occurred
during the year.
Establishment.
26. Favourable reports have been received of
the several establishments. All appear to have per-
formed their work conscientiously.
Inspection by visitors and
Deputy Surgeon-Generals.
27. The official visitors of the asylums have
attended regularly, and separate inspections have been
made by the Deputy Surgeon-Generals.
Commendations.
28. I have much pleasure in testifying to the very satisfactory manner
in which the Superintendents have carried out their
important duties.
I have the honour to be,
Sir,
Your most obedient Servant,
W. G. HUNTER, M.D.,
Surgeon General.
9
COLABA ASYLUM.
Superintendent.—SURGEON P. MURPHY, M.D.
Improvements and altera-
tions in the Buildings.
A great improvement has been effected in the ground-floor of the
old buildings by the substitution of asphalte for the
old board flooring, which I described in my report
of last year as being in a bad state; hitherto it
was scarcely possible to keep this portion of the building, notwithstanding
constant washings and the free use of deodorants, free from smells; these
no longer exist, and apart from the benefit which will accrue to the health
of the lunatics by the change, less water will also be required for cleans-
ing, a consideration where the supply is so limited. Several of the rooms
were also altered and improved, having been built on the old principle of
excluding light as a remedy for subduing excitement; they were provided
with pigeon holes for windows which only afforded shelter for rats and accu-
mulations of dirt, and prevented their being properly cleaned and ventilated.
A door which opened directly from one of the epileptic rooms into a latrine
was closed up as it rendered the greater portion of the room quite useless,
and another door with a railed passage was made on the outside. A partition
wall which cut off a portion of an associated room for the purpose of a store-
room was removed, as the store-room was no longer required. These alter-
ations and improvements will give accommodation to 15 additional lunatics.
Under the present arrangement the asylum is equal to the reception of 300
persons.
Water-supply.
2. The water-supply has been very limited, the supply from the Vehar
pipes which was never sufficient, ceased for the
first time altogether this year, so that the asylum
was dependent for its supply of water on what could be brought in bullock
carts daily. The two local wells also furnished a very limited supply for
washing and cleansing purposes on account of the irregular rainfall.
Conservancy and drainage.
3. Seven additional trap-doors were placed in the three main drains
which convey the liquid matters and waste water
from the asylum, in order to facilitate their cleansing
and to render them less liable to become choked. This work was done at a
very trifling expenditure by the mason and carpenter employed on the
premises, assisted by lunatics; the drainage remains unaltered.
Details of treated.
4. During the year 367 males and 79 females, total 446, were treated;
of these 227 males and 54 females, total 281, remained
from last year; 135 males and 20 females,total 155,
were admitted; and 5 males and 5 females re-admitted The total dis-
charges and deaths amounted to 174, of whom 149 were males and 25
females ; 35 males and 10 females, total 45, were discharged cured; 65 males
and 7 females, total 72, improved and were transferred to friends ; 33 males
and 5 females, total 38, left "not improved ;" 16 males and 3 females died;
and there remain 218 males and 54 females, total 272.
B 672—2
10
Comparison between the
present and previous year.
5. The number remaining on the 1st January 1877 shows an increase
of 4, as compared with the number on the same date
of the previous year, the admissions fell short by 15,
the re-admissions are the same. Amongst these were
a male and female who were discharged and re-admitted three times in the
course of the year. There is a decrease of 11 in the total treated, though
the daily average strength has slightly increased. The discharges show 45
recoveries against 53 last year, and the deaths amount to 19, 6 over the
previous year.
Daily average strength.
6. The daily average strength was 232.2 males
and 55.8 females, total 2880. The percentage on the
daily average were—of
Percentage to admission
were
Cured ...
Died ...
Cured ...
Died ...
Males
Females
Males
Females
Males
Females
Males
Females
15.1
17.9
6.8
5.4
25.0
40.0
11.4
12.0
Total
Total
Total
Total
15.6
6.6
27.2
11.5
Types of Insanity.
7. Of acute mania 12 cases remained from the previous year and 62
were admitted, total 74; of these 16 recovered, 19
improved, and 2 died. For chronic mania 8 were
admitted and 57 remained, total 65 ; of these 5 recovered, 5 improved, and 3
died. Of melancholia 19 remained and 28 were admitted, of whom 25 were
European, 1 recovered, 15 improved. Of acute dementia 20 remained and
46 were admitted, total 66 ; of these 10 recovered, 24 improved, and 2 died.
For chronic dementia 150 remained and 11 were admitted, of these 11
recovered, 4 improved, and 10 died. All the patients were re-diagnosed at
the commencement of the year, and hence there is a considerable dispropor-
tion between the number of cases treated for mania and dementia as
compared with the number of those forms of insanity in previous returns.
Hitherto it has been the custom to return patients under the form of insanity
from which they happened to be suffering on admission; this was obviously
incorrect, for all maniacal cases, which do not recover or sink from exhaus-
tion in the course of time, pass into dementia.
Religion, sex, and resi-
dence.
8. Ninety-two, or 31.9 of the daily average, were Europeans, 86 being
males and 6 females; 21 males and 9 females were
Hindoos; 18 males and 1 female Mahomedans; 6 males
and 2 females Parsees; 8 males and 6 females
Eurasians and Native Christians; and 1 male and 1 female were Jews.
Previous occupation.
9. Of the 92 Europeans admitted, 78 were European soldiers, and 3
wives of soldiers, there were 8 sailors, 1 clerk, 1 bank
manager, 1 chemist, 1 painter, 1 overseer in the
Public Works Department, 1 engineer's wife, and 2 females unknown. Of
the natives there were 24 paupers, 1 i tradesmen, 7 clerks, 6 cultivators,
5 native soldiers, 3 scholars, 2 domestic servants, 1 barrister, 1 apothecary,
and 1 school mistress ; the occupations of 8 were unknown.
Ages of the insane.
10. Of the 165 admitted, 127 males and 22 females were between the
ages of 20 to 40, from 40 to 60 there were 10 males
and 2 females, and under 20, 3 males and 1 female.
12
1 " not improved" was sent to England, and 1 died. The daily average
strength was 47.8 males and 2.2 females ; of these 53.1 per cent of males and
89.68 of females were daily employed. Their crimes were murder, 30 males
and 2 females ; voluntarily causing grievous hurt, 7 males, 5 mischief, 2
house-breaking, 1 piracy and assault; 10 males and 1 female theft, 1 culpable
homicide not amounting to murder, and 1 rape.
I wish to call particular attention to the fact that there are at present
certain criminals who have quite recovered and are now perfectly sane and
do not require any further treatment in an asylum These cases are a con-
stant source of anxiety and responsibility. They are constantly plotting and
endeavouring to escape, and, as they have to be treated as lunatics, they seldom
or never can be got to work, thus setting a bad example not only in this res-
pect, but also by inciting the lunatic patients to give trouble and not to work.
General management.
16. The treatment of the inmates has been conducted on the same
principles as described in previous reports. Re-
straint has never been employed, and only in very
rare instances has there been occasion to resort to seclusion, and then only
for a short time. The attention of the lunatics was engaged as far as means
would permit in some occupation, as nothing tends so much to subdue
excitement and to diminish the necessity for seclusion as well ordered
employment. The daily average number of insanes employed was 942
males and 20.2 females. The men were chiefly employed at cane-work,
tailoring and gardening, and a few were engaged at the washing machine
and in assisting the servants in the general domestic work of the insti-
tution.
Working account.
17. The following are the details of the work-
ing account :—
Reailized from work-shop and paid into the Treasury ...
Expended in the purchase of materials
...
...
Unrealized.
Value of garden vegetables ... ... ...
„ of 966 yards of cloth W. and made into C. ...
„ of cane-baskets, chairs, and repairs ... ...
„ of labour of lunatics in grinding corn ... ...
„ of do at 1 anna per day ... ... ...
Rs.
865
664
30
705
39
51
2,559
a.
5
5
0
0
0
11
15
p.
11
3
0
0
6
9
3
Receipts and expenditure.
18. The sum drawn from the Treasury was Rs. 57,632-1-9, the sum
paid into the Treasury was Rs. 6,572-13-11, which
consists of the money received from paying patients,
of the amount realized from the work-shop, and of the stoppages from the
pay of European soldiers by the Military Pay Master for their maintenance.
The net expenditure was, therefore, Rs. 51,059-3-10, showing an increase of
Rs. 369-10-4 over last year ; this is partly due to an increase in the cost of
diets, partly to an increase in the cost for water ; but chiefly to an increase in
the pay of the establishment on account of grain compensation.
The actual cost of each patient was Rs. 177-4-7 ; the cost of each patient,
in relation to establishment, was Rs. 86-3-2, to diets 84-8 6, and to clothing
Rs. 1-2-9.
Visitors.
19. The visitors wore invariably regular in
their attendance at the monthly meetings.
14
Remained on the 1st
January 1877.
6. On this date there were 63 patients in the asylum, of whom 46
were males and 17 females. During the past year
there have been 38 male admissions (of whom 1
was a re-admission) and 3 females, showing a total
of 84 males and 20 females—in all 104 treated.
Daily average strength.
7. The daily average strength was 49.5 for
males and 17.3 for females—total 66.8.
Percentages.
8. The percentages on the daily average
strength were
Percentages to admis-
sions.
Cured ...
Died ...
Cured ...
Died
...
Males ...
Females ...
Males ...
Females ...
Males ...
Females ...
Males ...
Females ...
34.3
17.3
10.1
5.7
44.7
100.0
13.1
33.3
Total
Total
Total
Total
29.9
8.9
48.7
14.6
Types of insanity in
admissions.
9. The majority of admissions were from
mania—in all 31, or a total of 75.6 per cent.
Type of disease.
Mania ...
Dementia ...
Melancholia ...
Total...
Treated.
76
19
7
92
Recovered.
15
2
3
20
Died.
4
1
1
6
Criminal lunatics.
10. Neither the arrangements nor the establishment being such as to
admit of the care of criminal lunatics in this asylum,
in 1874 all criminals were transfered to Colaba.
Owing to some mistake a female criminal lunatic was sent here last April,
being cured, she was remanded to the Dhulia jail the following July.
Religion, sex, and resi-
dence of lunatics.
11. This asylum, though adapted to the wants of the Poona Districts,
has lately admitted patients from Mhow, Tanna and
Bombay, owing to the over-crowded state of the
Colaba Asylum. Of the 38 males, 26 were Hindus, 11 Mahomedans and
1 Parsee. Of the 3 females 2 were Hindus and 1 Mahomedan, Table 3
shows the residence of those admitted during the year.
Occupation previous to
admission.
12. Table No. 4 gives the nature of the occupation of all patients ad-
mitted in 1877, but the previous history of such
patients is necessarily but scantily supplied ; 14 are
shown as beggars, and of 13 nothing was known ; the next largest number—
4—were sepoys.
Paying patients.
13. From the class of patients for whom admission is sought paying
patients can scarcely be expected. One well-to-do
Brahmin was maintained by his relatives, and from
a Ponsioned Hospital Assistant the regulation sum was recovered.