2
to 314 last year. The admissions to hospital decreased from 407 to 295 last
year. These figures would be satisfactory, were it not that the mortality has
been unusually high last year, as I shall notice further on; but this apart,
the above figures show that the general health of this Asylum has been more
favorable than in 1888.
9. Intermittent fever, ulcers, acute bronchitis, diarrhœa and dysentery
were the most common causes of admissions. Unfortunately, too, cholera made
its appearance during the epidemic which prevailed in Lahore towards the end
of the summer. Nine cases of this disease occurred among the inmates, 7 of
which proved fatal. The Superintendent took every precaution against the
importation of cholera into his Asylum. The first case occurred on the 27th
August among female lunatics, and up to the 9th September the disease appears
to have been sporadic, 5 cases occurring up to this date, when 3 fresh
cases occurred and the inmates of the affected section were moved into camp,
after which there was only 1 case.
10. The number of deaths in the Lahore Asylum during 1889 was very
high, 37 against 13 in the previous year. It will be noticed that in 1887, also,
there were 37 deaths in this Asylum. Seven of the deaths last year were from
cholera, 6 from dysentery, 6 from remittent fever, 1 from secondary syphilis,
1 from apoplexy, 2 from debility, 1 from old age and debility, 3 from epilepsy,
2 from acute mania and 1 each from fatty degeneration of the heart, chronic
bronchitis, pneumonia, diarrhœa, ascites, rupture of the spleen due to a fall,
impaction of food in the throat, and hanging (suicide). The deaths were at the
rate of 146.9 per 1,000 of average strength. If the deaths from cholera be sub-
tracted, it will still leave the high rates of 119 per mille of strength, compared
with 50 6 per mille in 1888, or more than double. The Superintendent's ex-
planation of the high mortality is not altogether satisfactory. He states that it is
due to cholera, and to the fact that many weakly patients suffering from organic
disease succumbed to a very unhealthy season ; but, excluding the mortality from
cholera, the death-rate is more than double that of 1888, while the record of
admissions to hospital and daily average sick are more favorable last year than
were the same figures for 1888. It is presumed also that most of the lunatics
who died last year were inmates of the Asylum in 1888. Apart from this high
mortality, the records of sickness for 1889 do not show it to be a more unhealthy
year than 1888. The causes of death, so far as can be judged from the diseases,
show that only about one-third died from what may be termed chronic disease,
which still leaves the mortality of last year much higher than that of 1888.
The deaths from dysentery, 6, are more than one-third of the admissions
from this complaint, 17. In 1888 there were 20 cases of dysentery and no
deaths, and none were under treatment for it at the close of that year. I shall
make further enquiries into this matter.
11. The health of the Delhi Asylum was fairly good. There were 90
admissions into hospital compared with 98 in 1888, and the daily average sick
was 5.01 against 4.62 the previous year.. The admissions to hospital were
935 per 1,000, which compares favorably with the rate of 1,053 in 1888 and
the rate of 1,171 at Lahore last year.
12. Diarrhœa, intermittent fever, debility, pneumonia and abscess were
the most common causes of admissions. Over 22 per cent. of the admissions
were for diarrhœa, a far higher rate than that of last year, which was 13 per
cent.; pneumonia was also prevalent, though in a less degree than in 1888, when
there were 12 cases against 7 recorded last year.
13. There were six deaths at Delhi last year, 3 from pneumonia
and 3 from general debility. This gives a death-rate of 6.2 on the daily
average population, and is happily much lower than the rate of 15 per cent.
in 1888, when there were 14 deaths.
14. In comparing the general health of the two Asylums, I find that at
Lahore the daily sick rate per cent. of strength was 7 against 5.2 at Delhi.
The admissions to hospital per 1,000 of strength were at Lahore 1,171, and
at Delhi 935.