13
Types of Insanity.
10. Out of a total of 457 treated, 232, or 50 per cent., were suffering
from mania—189 being males and 43 females ; of
these 175 were acute, and 57 chronic cases. There
were 134 cases of dementia—114 males and 20 females, of whom 75 were
acute and 59 chronic. Melancholia occurred in 43 males and 10 females.
Eighteen males and 2 females were confirmed epileptics, and 15 males and 3
females were idiots or imbeciles born with imperfect mental and bodily
organization.
Sickness and Mortality.
11. Fever has been remarkably prevalent among the patients during the
year, causing 317 on the " sick return;" 40 patients
suffered from bronchitis, and about the usual
amount of dysentery and diarrhœa prevailed. Fever and bowel diseases
were chiefly confined to the occupants of the ground-floors of the old build-
ing. The floor of this part of the asylum consists of badly-adjusted boards
which have been there for years ; filth and water sinking between the inter-
stices of these saturate the earth beneath, and the deleterious emanations
from this affect injuriously the health of the lunatics who live in the rooms ;
these, in addition, are badly ventilated during the monsoon months, thus in-
creasing the evil. I may mention also that there are two grave-yards in the
vicinity, and that the drains open to the windward of the asylum. It
is impossible to say, so long as other insanitary conditions exist, how far over-
crowding influenced the rate of sickness ; but I make no doubt it had a share.
The tinea tonsurans or ring-worm, which formerly caused a large number
of admissions, has, I am happy to say, been nearly eradicated. The daily
average number of sick was 42.8, and the death-rate to treated was in the
proportion of 2.4 per cent. ; last year the death-rate to treated was 7.1 per
cent. One patient, I regret to say, committed suicide by cutting his throat
with a knife while employed with other patients in the workshop.
Dietary.
12. The food is good and sufficient. A few extras are allowed to the
sick and debilitated, and also to a few working
patients as encouragement. The system of supply
by contract, under the immediate control of the Medical Department, has
been in force since the 1st April last, and gives satisfaction ; the provisions
are generally superior to those previously supplied by the Commissariat
Department.
Occupation.
13. Of the 84 Europeans who were admitted, 67 were soldiers and
3 wives of soldiers, 4 were sailors, 4 tradesmen,
2 engineers, 1 officer's wife, 1 missionary, 1 cotton
inspector, and 1 school boy. The natives were mainly composed of persons
belonging to the poorer classes. Paupers 31, petty dealers 17, tradesmen 17,
domestic servants 8, native soldiers 7, school-master 1, cultivators 6,
kallasee 1, native medical practitioner 1, and the occupation of 5 was
" unknown."
Treatment.
14. Insanity being essentially a disease of debility, the general princi-
ples of treatment were directed chiefly towards im-
proving the general health of the patients by a
generous diet, by engaging their attention, as far as possible, in suitable em-
ployment, and in tranquillizing the excited by removing from them any
sources of irritation ; with this view seclusion has been, except in fresh