( 7 )
The total admissions during the year have been much fewer than in the year
1878. The total treated in 1879 was 84, against 110 of 1878 and 216 of 1877.
The chief causes of admissions were ague, diarrhœa, and general debility ; but
the admissions from these causes were much fewer than in 1878, with the excep-
tion of general debility. Admissions from ague were 14, against 25 in 1878;
dysentery three, against 12 during last year; 17 diarrhœa, against 31. General
debility gave 16, against nine in 1878.
At the close of the year 1878 there were five remaining in hospital. Seventy-
nine were admitted during the year, 58 were discharged, 25 died, and one
remained.
The following are the causes of deaths:—
General debility .. .. .. ..
Diarrhœa .. .. .. ..
Phthisis .. .. .. ..
Ulcer
..
..
..
..
..
Anæmia .. .. .. ..
Anasarca .. .. .. ..
Peritonitis .. .. .. ..
Dysentery .. .. .. ..
Inflammation and softening of brain .. ..
Total ..
9
8
2
1
1
1
1
1
1
25
(leper.)
Out of these 25 deaths, seven were old lunatics who have been in the asylum
since it was opened, and who have been falling off year by year. Other three
had been only a short time in the asylum—one about 14 days and two about
1½ months—all three being in a wretched state of health on admission. Post
mortems were performed in all cases.
Among those dying of diarrhœa, three had tubercular deposits in the lungs
and mesentery, two nutmeg liver and disease of kidney, and one cirrhosis of the
liver. One had ulceration of the intestines, which were packed full of lumbrici.
Among those dying under the head of general debility, one had cancer of
right lung, in another the right kidney looked like a cancerous mass, another the
left kidney was a mere shell filled with pus ; two others had tubercular deposits
in the lungs, with the liver studded over with small tubercular-looking masses ;
the rest seemed to succumb more to extensive disease of the brain and its mem-
branes. The two cases of phthisis succumbed to pneumonia supervening on
lungs infiltrated with tubercle, the lungs in both cases being one disorganized
mass.
In the case of anasarca, the liver was extensively diseased, being filled with
pyæmic-looking abcesses.
The case of peritonitis presented the usual signs, and the intestines were
filled with worms. There were no signs that this case resulted in any way from
violence. In all the cases there was always evidence of organic nervous disease,
chiefly adhesions and thickening of the membranes, effusions of serum into the
arachnoid and ventricles, and softening of the brain substance.
In most of the cases of diarrhœa and general debility the spleen was very
much atropied : in seven cases it did not weigh over two ounces.
During the present year there have been more lunatics suffering from worms
than I noticed last year. In very few cases of post mortems were they absent.
The fact was so much brought to my notice that I at once picked out all those
who seemed in bad health among the lunatics and put them under treatment
for lumbrici, and had them all watched; and out of 20 so picked out all had
worms in their evacuations more or less, and in a few the number was marvellous :
these were looked after and watched for some time ; all improved in health very
much afterwards: these cases are not entered into the hospital statistics, because
they were not admitted into hospital. Whether worms existed to such an extent
before I am unable to say, as no remarks have been made in previous reports ;
and certainly during last year, though a few cases came to my notice, it was not
brought so prominently to my notice as this year, although this might in part be
due to the fact that they were not so well watched, and therefore escaped detec-
tion. As regards the cause, one would think of the quality of the water : this
has always been taken from the same wells, and there is no evident sign of con-