REPORT ON THE TEZrUR LUNATIC ASYLUM.
Dr. Garden states the death-rate of 1876 at only 25"8 per cent., but his calculation is
based on the results of nine months only, whereas, in order to make the results of the two
years fairly comparable, 1 have, in accordance with established statistical principles, calcula-
ted the death-rate of 1876 on three-fourths of the average strength, the Asylum havim?
been opened for only nine months of that year. The average death-rate of the Bengal
Asylums for five years ending in 1876 was only 12*28 per cent, of average strength.
This is the only useful standard of comparison available.
The population of the Tezpur Asylum is so small that the death-rates by themselves
cannot be held sufficient to discredit the sanitary state of the institution, but, taken in
connection with the table given at para. 41, showing the diseases that chiefly caused ad-
missions, they make it almost certain that there must have been some radical defects in the
sanitary arrangements. Eleven cases of dysentery and diarrhoea attended with five deaths
in so small a population is an enormous proportion of that class of diseases. The damp-
ness of the floors would probably account for a large share of it, but the prevalence of
bowel affections is so commonly associated with two other conditions that it is not
improbable they may have contributed to the effect.
8. I refer to diet and water-supply. The food allowance of lunatics is very apt to
become the subject of peculation on the part of subordinates. In 1876 this was found to
have been the case in the Dacca Asylum to a great extent, with the natural result, that
dysentery and diarrhoea caused 42 per cent, of the total mortality among the males,
and 27 per cent, of that among the females. Lunatics are unable to protect themselves
against this form of peculation; the greatest watchfulness is therefore necessary on the
part of the superior authority to prevent it.
9. Bad water-supply, too, is a very common cause of dysentery and diarrhoea, and
from the description given of the Asylum supply it is evidently open to suspicion. The
wells go dry in the dry weather. The inference from this fact is that the water is merely
surface drainage, more or less filtered. It is probable that most of the drainage passes
down between the steining of the well and the surrounding soil, without undergoing any*
efficient filtration at all. But there is another source of pollution: the wells are, I believe,
provided with covers, on which the people stand when drawing water, and the effect of this
arrangement is that the drippings and washing of the feet and legs of the drawers must fall
into the well, and thus, when the wells are nearly dry, the water must be a very foul
poisonous compound. These defects have only to be explained in order to suggest the
method of preventing them.
10. Dr. Garden's remarks on the need of more complete information being recorded
on the forms of inquiry brought with lunatics on first presentation at the Asylum deserve
attention. I fear it will be impossible to get much reliable information regarding the
previous medical history of the lunatics; but on one point of considerable importance
strict inquiry should always be made, and that is, whether the relations have or have not
the means of contributing to the support of the lunatics.
11. I abstain from offering any remarks on the forms of insanity exhibited by the
patients, and the age and sex of those affected. The facts recorded are as yet too few, and
too unreliable, to admit of any safe conclusions being drawn from them.
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