UErORT ON THE TEZPUll LUNATIC ASYLUM.
ideatli-rate varied from 3d to 3G per cent, of average strength. In the year under review
it fell to 4"9-i per cent. This is as low as it can be eNpccted to be in such a class of
patients.
15. When the population is so small, the death-rate must be eNpccted to fluctuate
fvcry largely froth year to year, as the result of mere accident, depending on the mental con-
dition and general health of cases on admission, and other circumstances. But, quite apart
from the reduction of the death-rate, we can safely infer, from the nature and character of the
prevailing sickness among the lunatics, that there was a decided improvement in their
health last year—"dysentery and diarrhoea were less common and very mild and easily
treated, and in only one instance proved fatal." I do not think that there is much signifi-
cance in the statistics of the number of admissions to hospital and the daily average
number of sick. These numbers depend to a great extent on the idiosyncracy of the
Medical Officer in charge, one man thinking it best to treat many cases as out-patients,
[another as in-patients, but the reduction in the frequency and severity of cases of dysentery
and diarrhoea is full of meaning. As lunatics have no special tendency to suffer from these
diseases, the frequent occurrence of them in an Asylum is strongly suggestive of some
defect in the sanitary arrangements. It will be worth while to inquire to what the
decrease of these diseases in the Tezpur Asylum last year was due.
16. In my remarks on last years report I threw out the suggestion that the
prevalence of bowel-diseases among the Tezpur lunatics depended on one of three causes,
or a combination of all three, viz., (1) dampness of the floors, (2) the use of impure water,
(3) insufficient food. After a careful physical examination of the lunatics, I feel compelled
to exclude the third hypothesis altogether, for I found that their condition furnished
■ conclusive proof that they were well fed, and the stringent supervision maintained by
Dr. Garden made it quite impossible that there could have been any peculation of the food,
such as has occurred in other Asylums.
17. As regards the influence of the damp floors, I am in entire accord with
Dr. Garden, and I am quite satisfied that a large share of the decrease in the prevalence of
dysenteiy and diarrhoea, and of the general improvement in health, is due to the improve-
ments in drainage effected by that officer.
18. Dr. Garden denies altogether that the use of impure water had anything to do
with the causation of sickness in former years. The water-supply, he says, was identical
in 1877 and 1878, and therefore the improved health of the latter year canaot have been
due to any change in that particular. I think Dr. Garden is mistaken on this point, for
para. 4 of his report shows that the water was not identical in the two years. There Was,
. • m tact, a most important difference in the water-supply of the two periods. Dr. Garden
| ; says "the supply from the wells failed less, as regards quantity, so that it was less often
■ necessary to send the insanes to the Mora Bhorelli river to bathe, and on no occasion was
the drinking water obtained from any other source than the wells. The chances of the
uisanes swallowing impurities was thus far reduced,but not done away with, for, as is well
Known, it is utterly impossible to keep even sane natives from putting into their mouths
some of the water they bathe in, however foul it may be."
Now, the water of the Mora Bhorelli contains a large amount of suspended matter, and
I some four miles above the Asylum the stream receives a very foul allluent. With the
X Knowledge of the case of the Dullunda Asylum given at para. 31 of the Sanitary Report
Ilor last year, can anyone doubt that the use of such water, even for ablution purposes,
' Would lie dangerous to the health of the lunatics? The Dullunda Asylum case shows that
the supply of pure water for drinking purposes only bad no appreciable effect for the
better on the health of the inmates, so long as they were allowed access to impure tanks
tor ablution purposes; but, as soon as access to impure water for any and every purpose