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no other head in this table under which they could be included. But as some of the other
returns are vitiated by this practice, I have ventured, with the concurrence of the Surgeon-
General, Punjab, to add another heading to this table, viz.," Discharged otherwise and escaped,"
which will include all cases that do not come under the heads of " Recovered," " Improved, "
or "Died."
Causes of insanity.
11. Table 7, which shows the alleged causes of insanity among the now admissions, is
defective in the same way as the proceding, and requires
the addition of the same heading to make it complete
But as far as trustworthy information goes, this table might as well be left out, for it is evident
that in almost every case the descriptive rolls of lunatics, from which information regarding
causes of insanity is chiefly derived, are left to be filled up by some ignorant subordinate,
while the officers who append their signatures to thorn, do not oven take the trouble to cast
their eye over them before doing so. This will be apparent from one or two examples of the
answers given in these papers. Under " causes of insanity " occur such answers as " dryness and
heat," "heat and drugs," "ungratified sexual desire," "took mixture of opium, bhang, rum,
poppy-heads and milk the day of his attack," " natural cause. " To the question " Is the luna-
tic subject to any form of delusion," the following answers occur : " Wishes to lead a free life;"
"no particular delusion but of troubling persons and others."
Sickness and mortality.
12. The total admissions into hospital were 521 against 478 for the previous year, and
the daily average number of sick was 19.63 against 17.82.
These figures do not indicate any very great difference in the
health of the Asylum between the two years ; but unfortunately the mortality, owing mainly to
cholera, was more than double what it was in 1880. 1880 however had by far the lowest rate
of mortality of any year as far back as the records of the Asylum go, and it is satisfactory to
find that although 1881 was a very unhealthy year, and was characterised by the severest
epidemic of cholera which has visited Lahore since 1856, still the mortality among the
lunatics was 4 per cent. less than the average mortality for the previous decade.
13. The diseases from which deaths occurred were :—remittent fever 1, cholera 13, phthisis 1,
annemia 1, general dropsy 1, epilepsy 2, acute mania 1, acute bronchitis 1, pneumonia 3, enter-
itis 1, dysentery 3, diarrhœa 4, hepatitis 1, Bright's disease 1, and debility 1,
14. When cholera was known to be in the neighbourhood every precaution was taken to
prevent its importation into the Asylum. A supply of the ordinary articles of diet is always
kept in the godown, and only this was used, Meat, however, had to be brought daily as usual
from the city. The drinking water was boiled and filtered through materials which had been
stored in the Asylum for long before. It was also thought to be a favorable opportunity for
testing the efficucy of sulphuric acid as a preventative of the disease, so much lauded by
Dr. MeCormac.
15. But all was of no avail, for on 11th July a lunatic who had been in the Asylum 4½
years was seized with severe vomiting and purging. His symptoms were not quite characteristic
of the disease, and as he recovered it was hoped that it was not a real case of cholera, although
every precaution to prevent the spread of the disease was taken as if there had been no doubt
about it. On the 22nd of July, however, an unmistakeable case occurred in a lunatic who had
been 7 years in the Asylum.
This proved fatal the following day. The next case occurred in the female ward on
3rd August, followed by a male in the dangerous ward on the 10th, and then the cases
came more rapidly, viz., 1 on the 11th, 2 on the 12th, 2 on the 13th, 2 on the 15th, 1 on the
10th, 2 on the 17th, 1 on the 22nd, 23rd and 30th, 1 on 5th September, and 2 on the 12th.
The disease thus lurked for about two months in the Asylum.
16. Owing to the difficulty and expense in moving lunatics into camp, this was delayed
as long as possible, and all that was done was to vacate the particular locality in which a
cease occurred for a certain time until it could be disinfected. On 12th September, however,
when, after a dull, the disease scemed inclined to break out again, it was at last thought
expedient to remove the harmless male lunatics. But although the disease caused from this
date, the move into camp can hardly be credited with the result, for it caused simultaneously
among the female and dangerous lunatics, 172 in number, who remained behind in the
Asylum.
17. The disease was of the most virulent kind (65 per cent. of the seizures proving fatal) ;
and, as is frequently observed, it was not the weak and unhealthy who were carried off, but
the strongest and healthiest, one of them being the most powerful man in the Asylum and
a perfect athlete,