NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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expenditure as calculated per patient, but especially to a decrease in the cost
of clothing and contingencies. On account of diets the net expenditure was
somewhat greater than in the previous year, but the expenditure per patient
was less than in 1875.
Cost per Patient.
20. The average cost per patient was Rs. 145-2-8, or less by Rs. 22-0-5
than in 1875. A great diminution will be observed,
on referring to Form 9, in the cost per head under
each item of expenditure during the past year. Owing to the increase in the
number of patients, the cost of establishment per patient shows a very marked
decrease.
Numbers employed.
21. The average number of lunatics employed during the year was 48—
35 males and 13 females, being a slight increase over
the previous year's number, viz., 45—37 males and
8 females. The receipts on account of the cultiva-
tion of the garden and other labour are also greater by Rs. 234-8-5 than in
the previous year.
General Remarks on em-
ployment.
22. The garden, being small, does not afford sufficient scope for the
constant employment of the large number of males
suited for out-door work ; but rather than allow these
men to be idle, and thus deprived of the beneficial
influences on body and mind accruing from healthy labour, many of them are
employed from time to time, under proper care and supervision, on garden
work in the compound of the Collector's Kutcherry and the Sassoon Hos-
pital. Only two years have elapsed since a beginning was made to cultivate
the asylum compound ; now every corner of it is utilized, and besides its
cultivation being profitable to Government, the work afforded to the patients
has proved a most valuable agent in the treatment of their diseases. The
female patients are employed in their own quarters, chiefly in grinding grain
supplied by dealers in the city.
Escape.
23. One lunatic escaped through the ventilator in the roof of his small
room three days after his admission into the asylum,
and has not yet been captured. Having no dis-
tinctive bodily marks, and his insanity being of a quiet and undemonstrative
character, it is probable that he will be able for a considerable time to evade
the search which is being made for him.
24. The official visitors in varying numbers have met at the asylum
every month during the currency of the year under report, and carefully
performed the duties devolving on them in their official capacity.
DHARWAR ASYLUM.
Superintendent—SURGEON-MAJOR C. J. SYLVESTER, M.D.
Building.
1. These were fully described in Dr. Bell's report for the year 1875, and
no alterations or additions have been made during
the year under review. I quite endorse Dr. Bell's
opinion that the accommodation is insufficient for the wants of the district,
and additional day-rooms are urgently required for classification and the
19
separation of patients who are partially recovered from others who are filthy
in their habits, or noisy and obscene. This want will probably be supplied
on the removal of the Civil Hospital to the Fort, which measure is in con-
templation, and will enable the present Civil Hospital to be utilized for the
above purpose.
Capacity.
2. The asylum is capable of accommodating 18 patients, if strict regard
were paid to the number of sleeping cells only; but
by making use of the day-wards as sleeping quarters
for a few of the quieter patients, as many as 24 have been under treatment at
one time.
Inmates.
3. The number of lunatics remaining on the 31st December 1875 was
21, and 4 have been admitted during the year. One
patient was discharged from the asylum in the
month of June and placed in charge of his friends with the sanction of the
Asylum Committee. The actual number under treatment during the past
year has been 25, and the number remaining on the 31st December 1876 was
24. Of these 14 were cases of mania, 9 of dementia, and 2 of imbecility.
Causes of Insanity.
4. In 19 patients the cause of insanity is unknown : of the remainder the
cause of insanity was as follows :—2 from ganja, 3
from grief, and 1 from fever.
Criminal Lunatics.
5. No criminal lunatics have been received into
the asylum during the year.
General Health.
6. The health of the lunatics has been very good, and no death has
occurred during the year. The only cases of sickness
have been 3 from diarrhœa, 1 from scurvy, and 2 from
debility. In one of the latter patients (a deaf mute) the prostration was so
extreme that he was unable to take food of any description, and for nearly
two months was fed by nutritive enematœ ; the patient eventually recovered,
and is now in his usual state of health.
Average Cost of each
Patient.
7. The expenditure for each patient for the year has been Rs. 179-11-1
being Rs. 1-13-8 in excess of the average cost during
the year 1875. This difference has arisen from the
cost of clothing and enhanced price of provisions in
this district during the latter end of the year owing to deficiency of rainfall
and consequent scarcity.
Employment of Luna-
tics.
8. The only employment available for the lunatics has been out-door
work in the asylum garden. The average number
of patients able to employ themselves in this way
has been 6 ; the working hours being from 6-30 or
7 A.M. until 10 A.M. This employment has been conducive to health and re-
covery of the patients, and at the same time useful in cultivating vegetables
for daily consumption in the asylum and for sale. The mental condition of
the remaining lunatics has rendered them unfit for any employment whatever.
Paying Patients.
9. The number of paying patients during the year
has been one only.
Profit of Garden.
10. The produce of the garden has been sufficient for the wants of the
asylum. Vegetables to the amount of Rs. 46-14-4
have been sold to the public during the year, this sum
being slightly in excess of the sales in 1875 ; in addition to which Rs. 109-6-0
20
have been saved by economy in the management of the garden, making a
total of Rs. 156-4-4 paid into the Treasury to the credit of Government,
against Rs. 121-15-0 paid in on a similar account during the previous year.
The demand for English vegetables by the public has been only slightly
greater than formerly, the majority of the European residents having gar-
dens of their own, and the native inhabitants being able to procure country
vegetables at a cheaper rate in the bazaar.
Recommendations.
11. The enlargement of the present asylum by the addition of extra
day-wards on the removal of the Civil Hospital to the
Fort. The substitution of earth for stone in the
flooring of the 9 sleeping cells which are now paved with the latter material,
the former being found more cleanly and more conducive to the health of
the patients.
AHMEDABAD ASYLUM.
Superintendent.—SURGEON-MAJOR C. G. WIEHE, M.D.
Buildings.
1. The asylum buildings have undergone no
alterations during the year, nor have there been any
new constructions.
Ventilation, Water-sup-
ply, Conservancy,
and
Drainage.
2. These remain in every respect the same as last reported. The
remarks made in the Annual Report for 1875 are
equally applicable to the period
now under
review.
Details of Treated.
3. On the 1st January 1876 there remained 91 males and 17 females
in the asylum, giving a total of 108 patients. The
admissions during the year amounted to 12—8 males
and 4 females ; there were also 2 re-admissions, both of male lunatics. The
total population was 122—101 males and 21 females. Of this number 10 were
discharged, including 1 escaped ; 3 were cured, 2 males and 1 female; 6 were
transferred to friends on application, 1 of these was " improved, " and 5 " not
improved."
Mortality.
4. There were 4 deaths during the year, against 12 in 1875—an ex-
ceptional year; 1 died from diarrhœa, after a duration
of 9 days only ; 1 from epilepsy, suddenly, during the
fit; an old female, who had never completely recovered from an attack of
cholera some months before, from debility; and 1 male also from the same
cause.
Decrease in Admissions.
5. Compared with the numbers admitted during 1875 there has been
a decrease of 8 in the past year in the admissions,
and of 10 in the total population; the re-admissions
in both years were equal. I attribute this falling off in some measure to the
orders of Government in paragraph 12 of Resolution, General Department,
No. 2856, dated the 18th September 1875, in which it is directed that
" Magistrates should not, therefore, send any patients to asylums unless con-
vinced of their danger to society, or because their condition or treatment by
relations is such that humanity positively calls on the State to intervene
or their protection ;" and also to those in Resolution No. 2660, dated the
21
26th August 1877, in which the " police authorities " are " warned that there
is at present great scarcity of accommodation, and desired to be more
careful in sending lunatics to the asylums."
Daily Average Strength.
6. The daily average strength was 105.6, against 109.6 during 1875,
Of the former 87.8 represents the average strength
of males, and 17.8 of females.
Daily Sick.
7. The daily average sick was 1.1 males and 0.8 females—total 1.9,
against 2.6 during the previous year, when a good
deal of sickness was due to exceptional and unavoid-
able causes.
Percentages.
8. The percentages on the daily average
strength were—of
Cured ...
Died
...
Males ...
Females ...
Males ...
Females ...
2.3
5.6
3.4
5.6
Total ...
Total ...
2.8
3.8
The percentages to admissions were—of
Cured ...
Died
...
Males ...
Females ...
Males ...
Females ...
20.0
25.0
30.0
25.0
Total ...
Total ...
21.4
28.6
Criminal Lunatics.
9. On the 1st January 1876 there remained 20 criminal lunatics, 19
males and 1 female, and 1 was admitted during the
year—giving a total of 21. Of these 1 was transferred
on expiry of sentence, to the non-criminal class, thus leaving the numbers
at the close of the year as they were at the commencement, viz., 19 males
and 1 female. The daily average strength was 19.6.
Crimes of Criminal Luna-
tics.
10. Of the 21 criminal lunatics confined during the year, 9 were com-
mitted for murder, 1 for attempt at murder, 3 for
theft, 1 for culpable homicide, 2 for grievous hurt,
2 for mischief and assault, 1 for intentional insult,
1 for inability to furnish security for good conduct, and 1 for attempt at
house-breaking. There was but one female lunatic in confinement; her
crime was murder; she remains in the same weak condition of mind as on
admission. None of this class has shown propensities to violence of any kind.
Employment of Criminal
Lunatics.
11. The actual number employed was 18, and the daily average 15
males and 1.0 females; the latter, together with an
average of 7.97 males, were employed in grinding
grain for the use of the asylum and Hutteesing
Hospital, and the former, in the average of 6 and 2, respectively, were occupied
in out-door labour and in domestic duties.
Religion, Sex, and Resi-
dence.
12. Of the 14 admissions, inclusive of re-admissions, there were 11
Hindus and 3 Mahomedans ; of the former 4 were
females. Of the total population remaining on the
31st December 1876, there were 82 Hindus, 24
Mahomedans, and 2 Parsis, of whom 89 were males and 19 females.
22
The districts of Ahmedabad furnished 5, of Surat and Kaira 4 each, and
of Broach 1 of the admissions. In the previous year patients were received
from Kattywar, Mahi Kánta, Konkan, Hindustan, Malwa, Marwar, &c.; but
during the period under report they have been entirely restricted to the four
districts abovenamed,—no doubt, in a great measure, owing to the orders of
Government already quoted.
Previous Employment.
13. Among the 14 admissions, 1 was a beggar, 1 a tailor, of 3 the
occupation was unknown, 2 were agents, 3 labourers,
2 traders, and 2 cultivators. With the exception of
7, these lunatics were in circumstances akin to starvation.
Ages.
14. As far as could be ascertained by their appearance there were 6
males between 20 and 40 years of age, and 4 between
40 and 60. Of the females 3 were between 20 and
40 and 1 between 40 and 60.
Types of Insanity.
15. At the close of 1875 there remained 22 cases of acute mania, 59 of
chronic mania, 3 of melancholia, 3 of acute demen-
tia, 11 of chronic dementia, 4 of idiotcy, and 6 of
imbecility. Of the admissions, 8 were acute mania, 2 chronic mania, 1 chronic
dementia, and 3 idiotcy. The total treated amounted to 122. Of these, 30
cases were of acute mania; 1 recovered. Of chronic mania there were 61 cases ;
2 recovered, and 3 died. Melancholia and acute dementia give 6 cases, 1 of
which was transferred to friends improved. There were 12 cases of chronic
dementia, 7 of idiotcy, and 6 of imbecility. In none of these was there any
change except in the former, 1 of which proved fatal.
Causes of Insanity.
16. Out of a total population of 122 there were 71 patients in whom
the causes of insanity are said to have been known,
and 51 in whose behalf information on this head is
entirely wanting.
Of the former there were 29 said to have become
insane from the abuse of ganja, 7 from spirit-drinking and debauchery,
3 from fever, 10 from epilepsy, and in 11 the insanity was hereditary and
congenital: these comprise the physical causes. Among the moral reasons
religion accounts for 6 cases, and grief for 5.
Sick in Hospital.
17. There were 34 admissions during the year. Of these 24 were
discharged cured, 4 died, and 6 remain under treat-
ment. Ague supplies 14 cases. It may be explained
that the case of scurvy was admitted in that condition; the disease is not
known in the asylum. The case of malposition of the fœtus was that of
a patient received from Kaira advanced in pregnancy.
Percentages of Sickness
and Mortality.
18 The daily average number of sick was 1.9,
and the death-rate to treated was in proportion to
11.8 per cent. against 27.3 during 1875.
Cash Accounts.
19. The receipts from the Treasury amount to Rs. 11,742-7-11; the
money recovered from paying patients to Rs.
849-10-7; and the value of garden produce and
labour to Rs. 573-15-3—the total being Rs. 13,166-1-9. These are cash
receipts.
Expenditure—Decrease.
20. With regard to expenditure, as per Statement 9, there is a de-
crease of Rs. 2,440-14-3 on account of " Establish-
ment "; this is due to the expenditure in 1875 under
24
married males had shown no improvement. One single male escaped. This
patient had recovered, and would have been discharged at the next meeting
of visitors. No attempt was, therefore, made to apprehend him. Of the 4
patients who died 2 were single males, and the condition of the remaining
2—a male and female—was unknown.
28. Out of the 122 who represent the total population of the year, 44
were single—42 males and 2 females; 45 were married—38 males and 7
females; 13 were widowed—5 males and 8 females ; and of the remaining 20—
16 males and 4 females—the condition was not known.
29. With reference to caste, there were 95 Hindus, 25 Mahomedans,
and 2 Parsis. Of these 44 were single—42 males and 2 females; 45 married
—38 males and 7 females ; 13 were widowed—5 males and 8 females ; and the
condition of 20—16 males and 4 females—was unknown.
Garden.
30. The asylum grounds comprise 24 bighas, about 12 of which are
under careful cultivation, and the vegetables pro-
duced are almost equal to those grown in Europe; the
remaining 12 bighas are sown with jowári in the monsoon, the outturn of
which very much depends upon the amount of rain, as this portion of ground
is not susceptible of irrigation ; but, as a rule, the crops thus obtained almost
suffice for the feed of the six bullocks during the year.
Vaccination.
31. There were 34 patients vaccinated during the year. Of these 3 failed
and 31 were successful. All the inmates are now
protected.
Restraint.
32. There has been no occasion to resort to
restraint of any kind during the year.
Clothing.
33. The clothing is supplied by the jail. The
quality is more durable, and the price is rather below
that of the bazaar.
Food.
34. The food is supplied by contract as heretofore; though not of
the first quality, it is good and thoroughly wholesome.
The diet scale in use is that prescribed in the asy-
lum rules. No alteration is required.
Visitors.
35. The visitors have held their monthly and
half-yearly meetings punctually during the year.
Establishment.
36. The establishment has been efficient. The gardener was placed on
the permanent establishment with the sanction of
Government. I would again commend the Resident
Assistant, Mr. Joseph Solomon, to favourable notice for the very satisfactory
way in which he continues to perform his duties.
General Remarks.
37. The financial and sanitary results of the year's administration have
been favourable. The profits have increased, and
there has been a saving of Rs. 20-7-10 per head in
the net cost. A fair amount of work has been done with very imperfect
means. The health has been good, and the mortality small.
25
SIR COWASJI JEHANGIER LUNATIC
ASYLUM, HYDERABAD.
Superintendent.—SURGEON HOLMESTED.
1. Insanes from all parts of Sind are sent to this asylum. During the
past year twenty lunatics were received from the Kurrachee Collectorate ;
nineteen from Hyderabad ; one from Shikárpur ; three from Jacobabad; and
two from Thar and Párkar.
Site.
2. The site on which the asylum is built is
good; the bunder road alongside it is the one dis-
advantage.
Garden.
3. The garden has been less productive during the past year, owing to
deficiency of rain chiefly ; the grape and mango crops
were scanty; most of the trees have been recently
manured by digging a hole six feet deep and four feet in diameter on one
side, at a little distance from each tree, and filling in with the sweepings, &c.,
from the adjoining village; another cause was fewer men having been
employed on the garden.
Buildings.
4. The asylum buildings remain unaltered : the usual repairs were exe-
cuted by the Public Works Department. The lunatics
have made a wall round part of the asylum ; also they
have made a wall round six sleeping wards, and have constructed four small
latrines. All the materials have been procured on the ground, with the excep-
tion of iron pans for the latrines, tar for dammering the floors of the latrines,
and a little roofing ; limestones were brought and burnt, from which chunam
was made; bricks were made ; and grass was collected and chopped up for
making plaster. I do not think the Public Works Department could have done
the same amount of work for less than Rs. 1,200. The Executive Engineer con-
curred with the way the work was carried out, and agreed to the plans, and will
shortly make an estimate of the value of the work executed; the ground
around these six wards was levelled also. All this was just completed to
show the Viceroy, and he much disappointed us, as the Commissioner in Sind
had arranged to show him the asylum.
Water-supply.
5. The water-supply has been good throughout
the year; the drainage is good ; the rainfall was
8 inches 45 cents.
Clothing.
6. The clothing has been good and sufficient;
it was all procured from the jail factory.
Food.
7. Food has been good and sufficient. When the famine in the Deccan
began, prices rose rapidly ; but, notwithstanding, I
have had no fault to find with the contractor, who
must have suffered some loss.
B 864—d
26
Accommodation,
8. The accommodation has been more than
sufficient. No alterations are needed.
Conservancy.
9. The conservancy is good and effective.
Admissions.
10. During the year there were 45 new admissions—10 females and
35 males; of the latter 3 were criminals. Of these
28 were Mahomedans, 14 were Hindus, 2 were
Native Christians, and 1 was a Parsee. Twenty-nine were discharged—24
males and 5 females. Of the males 6 were criminals.
Sickness.
11. There has been a considerable amount of sickness at various times
during the year, chiefly fever with abdominal com-
plications, as dysentery, diarrhœa; 18 casualties
occurred, 1 in excess of the preceding year. Of these 4 were females,
and 2 were criminal lunatics; 2 cases were admitted paralyzed, and several
cases were admitted excessively weak, 1 in the last stage of exhaustion
from starvation; this man for many days previously had refused all food.
Remaining.
12. There are now remaining in the asylum 17 females and 89 males.
Of the latter 15 are criminals. There has only been
one re-admission.
Vaccination.
13. Those admitted during the past year have been vaccinated: though
1,400 cases of small-pox have occurred in the town
not a single case has occurred in the asylum.
Escapes.
14. During the past year there has been no
escape.
Causes of Insanity.
15. The causes of insanity in the new admissions have chiefly been
due to intoxicating drinks, and to grief, and loss of
money. During the past year there have been many
fakirs and sepoys admitted.
Restraint.
16. Restraint has been rarely needed; a few times only during the year
it has been necessary to confine a violent lunatic on
a large ward by himself for a couple of days. No
lunatic has done any injury to any other lunatic or warder during the year.
Treatment.
17. The treatment is the same as in previous years. A woman with
secondary syphilis derived much benefit from sub-
cutaneous injections of perchloride of mercury: bath-
ing is resorted to, and frictions with oil all down the spine. One man attacked
with hemiplegia after several severe epileptic fits, was treated first with iodide
and bromide of potassium and afterwards with strychnine injections ; this man
is now nearly well mentally as well as bodily. A female with a child at her
breast became suddenly very violent, threatening to destroy her child, which
had to be taken away from her for some days; the mother's milk here made
the child very ill.
Re-admission.
18. There-admission was a native of Hindustan upwards of a thou-
sand miles from the asylum. He had been discharged
in the early part of the year, his brother having come
to take him home ; he had money of his own. After some months, not being
happy, he left without telling any of his friends, with only a few rupees in
his pockets, and came back to the asylum, asking to be re-admitted.
27
Employment and Amuse-
ment.
19. All are encouraged to work, and often a little extra is allowed
them as milk or curd, especially to the weak; the best
prognosis we have is their willingness to work. We
also try to amuse them and let them play a few drums
and other instruments. Sir Cowasji has promised me a musical box, which
will also be a diversion.
Cost.
20. The total cost of the asylum has been Rs. 10,920-4-2, and the cost
per patient Rs. 98-8-8, somewhat more than during
the previous year, chiefly owing to the Superintend-
ent's salary being more for the past nine months. Rs. 55 were paid into the
treasury on account of paying patients, and Rs. 223 from sale of garden pro-
duce ; this is less than was realized during the previous year. In addition
is the value of the work, as detailed above, executed by the lunatics, and
which would have cost a large sum had it been left to the Public Works
Department; their estimate for a part of the work was Rs. 2,000.
Daily Average Inmates.
21. The daily average has been 108 ; and the establishment, all told,
number 28 persons. Mr. Mendes, the Hospital
Assistant, and the 21 warders generally have all
worked well.