NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
7
the present time, I doubt if we have laid hold of insanity as it really
exists among the many millions of people.
The conduct of the subordinates and servants generally has been very
satisfactory.
With these general observations I proceed to remark on, 1st, Europeans
in the Kolaba Asylum.
92 Europeans (86 males and 6 females came under treatment during
the year, an excess of 37 over 1872-73, when 55 were treated, (53 males and
2 females). Of the 92 insanes 6 remained at the beginning of the year and
86 were admitted during the year.
The occupations of the 86 insanes admitted were as follows, as far as
could be ascertained:—
1 military officer, 74 soldiers, 2 sailors, 1 surveyor, 1 fitter, 1 railway
guard, 1 shipwright, 1 no occupation, 3 wives of soldiers, 1 wife of
merchant.
The causes of insanity in the total treated were as follows:—
In the men 63 per cent. of the causes are said to be known, the princi-
pal being 15 liquor, 6 exposure to the sun, 10 blows on the head, 3 syphilis, 3
congenital, 4 hereditary; in 31 the causes are unknown. In the women,
a cause is assigned in every case of insanity, 2 are ascribed to poverty, 1 to
fever, 2 to child-birth, and 1 to family troubles.
Results of treatment.—In this country 4 were cured and discharged, 2
were improved and made over to friends, whilst 77 (74 males and 3 females)
were sent to Europe. There were no deaths during the year, nor in
1872-73.
The history of Europeans in the asylum is mainly one of the reception
and quick discharge during the trooping season.
Of the admissions, the
greatest number occurred in three months of the year ; 29 in November, 19 in
February, 18 in March. The discharges took place principally in 4 months ;
24 in November, 14 in December, 19 in February, and 20 in March.
The number of Europeans unconnected with the military is too small to
pursue their history through a series of statistics.
Eurasians.—Of mixed race, 13 persons (7 males and 6 females) were
treated during the year as compared with 15 (10 males and 5 females) in
1872-73.
One male insane died, 2 females were cured.
The numbers are
too small to call for or admit of much remark, and there is no information
that I am aware of, at present, available as to the number of the class in the
presidency.
Natives in Asylums.—During the year 705 native insanes (583 males, 122
females) have come under treatment, 33 more than in 1872-73 when the
number was 672, viz., 557 males, 115 females.
8
TABLE NO. VI.
Remained...
Admitted ...
Re -admitted
1872-73
M.
384
161
12
557
F.
79
34
2
115
Total
463
195
14
672
1873-74.
M.
416
162
5
583
F.
87
32
3
122
Total
503
194
8
705
TABLE NO. VII.—Discharges.
Cured.. ... ...
Improved .....
Not improved
Escaped.... ...
Died............
M.
67
21
7
2
44
141
1872-73
F.
17
0
2
0
9
28
Total
84
21
9
2
53
169
1873-74
M.
78
30
12
2
46
168
F.
14
3
4
0
11
32
Total
92
33
16
2
57
200
Arranged in another way as per margin, these figures give an insight
into one side of asylum life, the still side if
I may so term it, as represented by the very
large number of the remained. It may be
said that the active life of asylums has re-
lation to the admissions and discharges, and
that, stated generally, the balance of one or
of the other goes to build up or to decrease
the remained,
which class represents
mainly the incurable side of insanity.
Examining the figures in this light, it is found the admissions, together with
the re-admissions, were 209 in 1872-73, and
202 in 1873.74, whilst from Table No. VII.
of the discharged, it will be found the num-
bers are 169 and 200, respectively; so that,
last year 2, and in the preceding year 40,
may be said to have been added to the fixed
class of insanes. During the past year the
percentage of cured and improved to the
total treated was 17.7, and to admissions
64.4, and for 1872-73 15 6 and 53.8, respec-
tively. The death rate to total treated for
the same periods was 8.0 and 7.8 per cent.,
results which may be considered as most satisfactory.
TABLE NO. VIII.
Presidency and
Year.
Bengal
1872......
Bombay 1873-74...
Total
Treated.
1,352
705
Admis-
sions.
467
191
Cured
and
Improved
243
125
Died.
116
57
Cured and Improved
To total
Treated.
17.9
17.7
To Admis-
sions.
52.0
64.4
Deaths per
cent. to Total
Treated.
8.5
8 0
It is always interesting to compare what has been done in one presi-
dency with similar work in another, and the above table shows that, in all
the important points noted, the results obtained hero closely approximate
with those recorded in Bengal, having regard to the larger numbers of the
more populous presidency.
I gather, too, that the conditions as to the want of accommodation are
the same ; here, as in Bengal, there is a continual and increasing demand for
more room. This over-crowding, of which all the superintendents complain,
and the great and increasing pressure upon them, must somewhere find a
limit.
Having thus oxamined the general results which have been taken from
Form No. I., I proceed to notice the particulars regarding native insanes,
which are to be gathered from each of the remaining Forms in consecutive
order.
10
It is remarkable that these intoxicants are so rare as causes of insanity
in Poona and Dharwar ; indeed, there appears to be a singular absence of any
knowledge of causes in these two asylums.
I have no facts to guide me regarding the frequency in this country
of marriages of consanguinity, and therefore can only allude to their fatal
influence in the production of this and other evils of which there are many
examples in the transformation of nervous affections through hereditary
influences.
The remaining causes of insanity, physical, moral, and predisposing
may be accepted, and require no special comment.
Of the whole known causes—
Physical formed
...
...
...
..
per cent.
Moral ... ... ... ... ... ... ...
Predisposing, which includes hereditary & congenital...
1872-73
M.
34.2
8.1
4.2
F.
32.8
14.8
4.1
1873-74
M.
40.5
8.6
5.6
F.
37.3
14.9
4.4
Table No. 4—Bodily diseases.
Besides the mental disease, insanes also subject to various bodily
ailments, the result of many causes, some
of which pertain to themselves, others to the
condition in which they are placed, these
conditions being more favorable to bodily health in some asylums than in
others. 53.2 per cent, of the total number of native insanes were treated
for bodily diseases in 1872-73, and 59*1 per cent. during the past year.
Kolaba is the largest asylum, and had the largest number of sick during
1873-74. Of 321 native insanes, 301 were treated for bodily diseases, 46
of them being for ailments, associated with old age and debility.
Ahmedabad, with 142 insanes, had 84 treated; Haidarabad, with 140,
had 23 ; Poona, with 72, had 9 ; and Dharwar, with 30, had no sick with bodily
ailments. These figures show what, indeed, is well known without them
that the asylum at Kolaba is the most unhealthy of all our asylums. There
are two grave defects in its sanitary condition: 1st, the annually recurring
deficiency of water supply; 2nd, the want of garden and out-door employ-
ment of a kind to interest the patients. The general want of employment is
especially injurious in the monsoon, which is noticed by the superintendent
as the period when the largest number of deaths occur.
The principal bodily ailments at Kolaba during the past year have been
continued and malarial fevers, diseases of the lungs, diarrhoea and dysentery.
At Ahmedabad, cholera, scorbutic alfections, diseases of the lungs
diarrhoea, and dysentery ; there has boon an entire absence of fever.
At Haidarabad, an asylum on a new site, there has been a considerable
improvement on the previous year, the bodily diseases comprised a few cases
of malarial fever and diarrhoea, with only 1 case of dysentery, of which there
were 17 in 1872-73.
At Poona the principal ailment given is old age.
At Dharwar it has been already mentioned there were no cases.
The question of bodily disease is of importance with relation especially
to sanitary and other defects. Much fever, diarrhoea, and dysentery, and lung
a flections, pointing to the necessity of hygienic and sanitary precautions,
with close attention to diet and employment.
11
Kolaba cannot, as it ought to do, obtain any relief from its always over-
crowded state, by sending suitable eases to other asylums for change, as
these are almost always full. So far from being able to do this, this asylum
is the one to which all cases are sent when other asylums have no accommo-
dation.
The want of additional asylum space is much to be regretted, as it must
have a very serious effect on the health of the insaues at Kolaba, many of
whom would be better in the Deccan, where also the cost of them would bo
less.
Table No. 5.—Diseases causing mor-
tality.
The mortality amongst native insaues was
7.8 and 8.08 per cent. of total treated in
1872-73 and 1873-74, respectively.
Two of the causes of mortality, which may be expected to be well
marked in this class, are age and debility, and diseases of the nervous system,
which together gave 21 and 24 fatal cases in the last two years, or 39.6 and
42.1 per cent. of the whole mortality.
Diarrhoea and dysentery are the diseases next in order of magnitude
causing mortality ; there were 18 cases in each of the past two years, or, res-
pectively, 34 and 31.5 per cent. of the total deaths.
During the past year there was but one death from diseases of the lungs,
there having been 5 in the previous year. The remaining diseases causing
mortality require no special remark.
There can be no doubt that all the diseases noticed are greatly influenced
by excellent hygienic and sanitary arrangements, or the contrary, and until
a central asylum shall be built, I can see no prospect of any great improve
ment in the decidedly unfavorable condition in which a large number of
native insanes are now living in the Kolaba asylum.
Table No. 6.—Comparative statement.
This table gives the whole number of
insanes treated in asylums during the past
ten years.
The smallest number (including all races) was 548 in 1866-67, the
largest 982 in 1870-71, the average for the whole period being 681 per
annum. The average of the last four years of the decade was 789, whilst that
of the antecedent six years was 609, a difference of 180 in favor of the la-tor
period. This points to an actual increase in the number of insanes, received
into asylums during the past few years, as to which there can bo no reason-
able doubt, although there may have been no increase in the amount of
insanity in the country.
Examining the numbers of each class of natives separately, an increase
is found in each in the later years as compared with the earlier.
Native Christians : lowest number in any year 26, highest 78. Average
of the decade 39 ; of the last half 46 ; of the first 30.
Hindoos: lowest 255, highest 426. Average 326. Average of the last
five years 363 ; of the first 288.
la Mussulmans : lowest 180, highest 284. Average 210. Average of the
st five years 225 ; of the first 194.
Parsis ; lowest 18, highest 49. Average 29. Average of the last five
years 35 ; of the first 23.
12
Jews are not numerous enough to form a basis of calculation.
Other castes : lowest 3, highest 22. Average 11. Average of last five
years 13, of first 8.
The increase is well marked in the Kolaba, Ahmedabad, and Sindh
asylums, whilst in those of Poona and Dharwar, in which the accommodation
is of a limited and fixed character, there is no increase.
Table No. 7.—Age and Caste.
This table shows that the ages of native insanes form an ascending and
descending series : beginning with youth to
35 years of age the scale ascends ; in the
next period, 35 to 40, the descent com-
mences very gradually, and goes on until 60 is attained, when the numbers
become small as the periods reach to extreme old age.
During the past year there were—
From
„
„
„
„
„
„
„
„
„
„
„
„
„
„
„
5 to 15
15 „ 20
20 „ 25
25 „ 30
30 „ 35
35 „ 40
40 „ 45
45 „ 50
50 „ 55
55 „ 60
60 „ 65
65 „ 70
70 „ 75
75 „ 80
80 „ 85
85 „ 90
years,
„
„
„
„
„
„
„
„
„
„
„
„
„
„
„
5
19
99
121
129
119
84
52
31
27
9
3
2
3
1
1
cases.
„
„
„
„
„
„
„
„
„
„
„
„
„
„
„
The oldest insane is a native Christian, a female, period 85 to 90 ; the
next between 80 and 85 is a male Hindoo ; in the next period from 75 to 80
there are two Mahomedans. One Parsi has attained the period of 70 to 75 ;
so that, as a matter of fact, it may be said the representatives of all native
races may, and do attain, extreme old age in our asylums.
The large majority of insanes are found to be in the periods between
20 to 25 and 45 to 50, including in this remark all races and both sexes.
Caste does not seem to influence the age at which insanity is most
prevalent, which from the table would appear to be the same in every class.
There is this to be said, however, that the table only gives the age and
caste of the inmates of asylums during the past two years. It is easily con-
ceivable, and indeed even probable that, of say, 24 insanes, under 20 years
of age, not all would be cured, but some would remain in the asylum, and
by passage of time contribute to succeeding periods of age ; so that it can
only be said, not that insanity is most prevalent in the middle period of life
—the table affords no proof of that—but that the greatest number of insanes
of all classes and of both sexes under treatment in asylums are of the middle
age ; and that this result, to some extent at least, is brought about by the
simple process of progressive accumulation.
13
Table No. 8.—Length of residence.
This table gives the period of residence in asylums of all insanes " dis-
charged," whether cured, not cured, or died.
The length of residence of the " remaining "
has not been given, owing to an oversight in the framing of the table. One
hundred and sixty-eight native insanes were discharged in 1872-73, and 200
in 1873-74.
The largest number were discharged after a residence of from 3 to 6
months, viz., 43 in 1872-73 and 32 in 1873-74. In the first year of resi-
dence 104 were discharged in 1872-73, or 61.9 per cent, of the total; in
1873-74, 106 were discharged, or 53 per cent, of the whole number
After the first year's residence the number steadily decreases with each
year. Two Mahomedans, however, reached a period of residence of between
24 and 25 years.
During the past year 39 were discharged after a residence of from 1 to
2 years; 16 from 2 to 3 years; 8 from 3 to 4 years; and 6 from 4 to 5 years.
Within the period of five years' residence, 175 were discharged, or 87.5 per
cent. of the total. Had the table been amplified, so as to contain the length
of residence of all lunatics treated, there is no doubt that the same general
facts would have been brought out, viz., that the great body of insanes are
under five years' residence; that length of residence beyond five years is
marked by an annually decreasing number of insanes until ten years have
been reached, and that beyond this period the residents are few, are generally
incurably insane, but occasionally capable of living for many years.
Table No. 9.—Conditions as to
marriage.
During the year, 296 natives are said to have been " single," or 42
per cent. of the total treated ; 245 were
" married," or 34.7 per cent. of the whole ;
34 men had lost their wives, or 5.8 per
cent.. 34 women had lost their husbands, or 27 per cent.; whilst of
96 or 13.6 per cent. of the treated, the condition as to marriage is said to be
" unknown.''
In Europe, importance is attached to the many-sided influences of
marriage with relation to insanity, but in this country, 1 am not aware
that the subject has received any particular attention. As regards one
interesting part of it, viz., the influence marriages of consanguinity have
in the production of insanity ; so little is really known of the personal and
family history of the insanes in this part of India, that I am unable to recall
to mind a single report or statement in which the condition has been noti-
ced. During 1873-74 there were 376 insanes" single;" of these 26 died
or 6.9 per cent. : 267 were "married;" of these 6 died, or 2.2 per cent.: 34
widowers with 5 deaths, or 14.7 per cent : 36 widows, of whom 7 died, or 19.4
per cent. Of the 97 " unknown, " 14 died, or 14.7 per cent.
From these figures it would appear that the " married" have the lightest
death rate, and next the "single," whilst widowers, widows and unknown
have a high death rate.
The " married" have also the largest proportion of " cured," 26.5 of the
strength ; the " single " have 6.6 per cent., whilst the lowest, the widowed,
have only 2.2 per cent. of cures.
15
I must, however, add in justice to the Superintendent that he has to
contend with great difficulties, and that to introduce work of the various
kinds indicated would necessitate a larger expenditure than Government
are probably at present able to grant. At the same time, it is highly neces-
sary that a move should be made in the matter.
Table No. 11.— Register of insanes.
Requires no remark.
Table No. 12.— Criminal Lunatics
During the past year there were 76 criminal lunatics in charge (74
males and 2 females), and the same number in
1872-73, viz., 73 males, and 3 females, arranged
as shown in table.
Table No. IX.
Eurasians ... ...
Hindoos ... ...
Mussulmans ...
Parsis ... ...
Other castes ...
Total ... ...
1872-73.
M.
1
37
35
F.
0
3
0
Total.
1
40
35
......
......
73 3 76
1873-74.
M. F. Total.
......
40
32
1
1
74
2
0
0
0
2
42
32
1
1
76
The proportion of Hindoo criminal lunatics to total natives treated was
6 per cent. in 1872-73, and 5.9 per
per cent. during the past year, and
of Mussulmans for the same period
5.2 and 4.5 per cent., respectively.
There were only 3 Hindoo females
in 1872-73 amongst this class, and
2 during the past year ; whilst the
Mussulman criminal lunatics were
all males. It is noticeable that of
the 18 criminal lunatics in Sindh, I only is a Hindoo, whilst 17 are
Mussulmans.
Very little is said by the Superintendents about this class of lunatics,
and no statistics are available to show the connection of the use of intoxi-
cants with crime.
During the past year, the average daily strength was 62.9 males and
2.0 females, 30 being the average daily number employed.
Table No. X.
Remained ... ...
Admitted ... ...
Readmitted ...
1872-73
M.
56
16
1
73
F.
2
1
0
3
Total
58
17
1
76
1873-74
M.
60
14
F.
2
0
Total
62
14
......
74 2 76
The " remained" formed the larger
portion of the class as with other
lunatics. 18 were admitted, includ-
ing one re-admission in 1872-73,
and 14 during the past year.
The discharges, as will be seen on comparison, are very dissimilar
to those of ordinary lunatics.
Table No. XI.
Cured ...
...
Escaped ... ...
Remanded to Jail
Died ... ...
On expiration of
sentence ...
Remaining ...
Total .....
M.
7
F.
1
Total
8
......
2
2
2
60
73
0
0
0
2
3
2
2
2
62
76
M.
7
1
F.
0
0
Total
7
1
......
3 0 3
......
63
74
2
2
65
76
The percentage of " cured " to
total treated of this class was, for
1872-73 10.5, and for the past year
9.2, and the death rate for the same,
respectively, 2.6 and 4.0 per cent.
The general death-rate for the same
periods being 8.0 and 7.8, would seem
to show that the health of this class
is superior to that of the general
body of the lunatics, for if criminal
16
lunatics had been excluded, instead of being included, in the general calcula-
tions, the death-rate of the whole body of lunatics would have been raised
to a higher degree.
Table No. XII.
CRIME.
Theft ... ... ...
Murder ... ... ...
Culpable homicide ...
Loitering ... ...
Receiving stolen goods...
Suicide ... ... ...
Mischief ... ... ...
Causing grievous hurt ...
Mischief by fire ... ...
Trespass ... ... ...
Kidnapping ... ...
House-breaking ... ...
Theft after
prepara-
tion for death-hurt....
Mischief and assault ...
Intentional insult ...
Destroying image ...
Piracy and assault ...
Total ...
1872-73.
M.
13
36
7
2
1
2
1
6
F.
1
2
0
0
0
0
0
0
Total
14
38
7
2
1
2
1
6
......
......
1
2
0
0
1
2
......
2 0 2
......
......
......
73 3 76
1873-74.
M.
14
32
7
F.
0
2
0
Total
14
34
7
......
......
3
1
6
1
1
1
2
1
2
1
1
1
74
0
0
0
0
0
0
0
0
0
0
0
0
2
3
1
6
1
1
1
2
1
2
1
1
1
76
It only remains for me to notice
the forms of crime which have
been tabulated for easy reference.
From the table it will be seen
that the main forms of crime were
murder 38, homicide not amounting
to murder 7, and grievous hurt 6,
together 51 in 1872-73 and 47 in
1873-74; being 67.1 and 61.8 per
cent., respectively, of the whole
number of cases. Murder alone
furnished 50 per cent. of the total
in 1872-73, and 44.7 per cent. in
1873-74.
Theft is a common crime, giving
18.4 per cent. of the total.
Crime with violence and theft together furnish 85.5 and 80.2 per cent.,
respectively, of the whole number of cases tabulated during the past too years.
The remaining crimes, under twelve different denominations, are not
of importance numerically ; their variety only is noticeable.
Table No. XIII.— Causes
with the results of treatment.
Table No. 3 dealt with the causes of insanity amongst natives only. This
table includes the total treated of all races,
the causes being simply enumerated; the results
of treatment are set forth under each heading,
and first to notice the physical causes of insanity
Intoxicants occupy the most prominent place, and the most important
of these is Indian hemp, the various preparations of which are used
solely by natives.
There were during the past year 140 cases, 3 only being amongst persons
sufficiently well off to pay for their maintenance; the rest, 137 in number,
being paupers.
The results of treatment were as follows:— 22, or 15.7 per cent. of
strength, were cured ; 10, or 7.1 per cent., cured and improved, together being
22.8 per cent. of the number of cases, whilst 9 or 6.4 per cent. died.
Opium also would appear from the table to have been used only by natives.
There were 8 cases : 1 was cured and 1 improved. There was no death.
Liquor and Debauchery.—Europeans and natives share in this cause of
insanity. There were 57 cases—44 males and 13 females: 13 were cured,
or 22.8 per cent.; 5 improved, or 8.7per cent.; 1 died, or 1.7 per cent.