ANNUAL REPORT ON THETEZPUR LUNATIC ASSYLUM, 1884.
No. 227C, dated Shillotig, the 24th February 1885.
From—DR. A. ETESON, Deputy-Surgeon-General, Eastern Frontier District,
To—The Secretary to the Chief Commissioner of Assam.
I HAVE the honour to forward the Tezpur Lunatic Asylum Report for 1884, prepared
by the Superintendent, Surgeon R. Neil Campbell, M.H.
2. 'Hie Report and Tables were received in this office on the 27th January, but on
examination the details were in several instances found incomplete. It was returned
for correction, and received back and accepted on the 21st current.
3. There has been little change made in the internal economy of the institution
during the year; the average number of inmates has decreased from 63 to 59, the admis-
sions having been 6 less and the discharged 13 more in 1884. The mortality has decreased
from 14 to 8.
4. The medical history of the Asylum, although not so favourable ns formerly,
shows an improvement on the figures of 1883. It will be remembered that there was a
sustained epidemic of cholera resulting in 9 deaths in the latter year. The disease re-
appeared on the 24th June, and 5 cases occurred up to the 26th, when the attacks ceased.
Of these 5 sick persons 2 died and 3 recovered. The first case is reported to have been a
chaukidar, who spent the day in his village three and a half miles off, where cholera was
prevalent. Dr. Campbell infers that the chaukidar contracted cholera in his village, and
that it was "imported" through him into the Asylum. But the evidence is meagre and
inconclusive; Dr. Campbell should study the recent publication by the Sanitary Commis-
sioner withthe Government of India on the facts of cholera in India as opposed to inferences.
It was in accordance with precedent that cholera should re-appear in a locality where the
disease had been epidemic the year before, and had been allowed to take its course
unchecked by removal of the affected population. The return of vital statistics for June
1884 shows four deaths in Tezpur town, and 173 deaths in the thana from cholera.
5. I cannot say the preventive measures adopted altogether commend themselves
to my judgment either to obviate future risk, or to give those attacked a better chance
of recovery, or to check the spread of the disease at the time. If the removal of the sick
chaukidar was a benefit, as claimed, why w r ere not all the cholera inmates transferred to a
temporary hospital outside the Asylum precincts? The treatment of these patients within
the Asylum is contrary to sanitary principles; and, if continued year after year, the in-
stitution may become a permanently-infected locality, and may have to be abandoned. A
temporary shed should be put together within convenient distance outside the Asylum and
afterwards burnt. No more difficulty should be experienced in doing this for an Asylum
than for a jail. Burning sulphur, except in closed rooms, can have no appreciable effect ;
and under all circumstances its benefit is doubtful. No intimation of this cholera epidemic
of 1884 was made to me. I only heard of it when I visited the Asylum in December.
6. Besides cholera, there were also 7 deaths from general disease, viz., phthisis
3, general debility and dysentery 4, which bring the total mortality to 135
per mille of population, and to 380 per mille of admissions into hospital. These are grave
records. Much is to be urged in respect of the bad health in which so many inmates
are received, and also that with so limited a population fluctuation of rates will often
he extreme; but the total of 66 deaths on 243 admissions, since the Asylum was opened
eight years ago, gives the high figure of 271 per thousand. Dr. Campbell has added notes
on the physical condition of many of the insanes to show that they had on admission
already contracted fatal disease from want and exposure in their previous forlorn state.
7. The statistics of daily sickness in the Asylum certainly bear out the contentions
that the extraordinary mortality is not caused by want of proper care, food, clothing, &c,
Within the precincts. An admission rate of 1,486 per thousand and a daily average
■ s ick of 22 per thousand cannot be considered excessive among a population who may be
considered primarily diseased as a body; and the type of ailment from which the lunatics
suffer is only that of the ordinary population.