( 6 )
reached, two being under 20, one being upwards of 60. The largest number of
admissions occurred between the ages of 20 and 40, being altogether 22. I think
greater care might be exercised by district officers in estimating the real necessity
which may exist for sending to the asylum persons merely displaying the signs of
decay and derangement of mind in the close of life. A just discrimination would
seem proper between the violent and troublesome conduct, with dirty habits, of such
and those of younger persons in whom such symptoms are truly characteristic of
disease demanding special treatment for the common safety and its own cure.
I find that five persons in their second childhood died within nine months of
their admission, whilst probably a little more patience at home, guided by a per-
ception of the real nature and prospect of the cases, would have shown the
removal to be needless in some of these. It appears that not less than 37 persons
suffering this sort of violent insanity, engrafted on imbecility, or arising out of the
decay of nature, were received since the opening of the asylum. The asylum is
growing so filled that it has become important to occupy no space in a light way
or needlessly.
12. Statement No. VI shows the types of insanity. Of the total treated, 225,
100 were suffering from acute mania, 20 from chronic mania, 28 melancholia, 28
acute dementia, 4 chronic dementia, 4 paralysis of the insane, 8 idiotcy, 32 imbeci-
lity, and 1 not insane. A marked increase is observed, both in the instances of
repeated attack and of re-admission into the asylum. This was to be expected.
It is not the modern practice to detain patients in asylums because, having been
once insane, they lie under a great risk of becoming so again ; but when the cur-
rent attack may be fairly said to have come to an end, and one period of observa-
tion has been superadded to the confinement already borne as security against
premature relapse, the patient is discharged as cured. This practice should lead
us to look for more re-admissions, but not (or apparently only) for more
repetitions of the attack. I do not know that it has as yet been shown that
insanity once suffered is more prone to re-appear than certain other diseases not
affecting the mind, but of a constitutional or hereditary character.
13. Statement No. VII shows the causes of insanity in those admitted during
the year and also the total under treatment. Out of 36 admissions, only in eight
cases was any alleged cause given. Among the alleged physical causes, fever was
the only one. Loss of property, disappointment in love, and domestic troubles
were the chief moral causes.
14. Statement No. VIII shows the hospital statistics during the year.
There were fewer admissions into hospital than the previous year, with less mor-
tality. Out of 36 admissions, 12 were in good health, 21 in indifferent health, and
3 in bad health.
Great numbers of patients are admitted in a bad state of health, emaciated
in body as well as incurably diseased in mind, and often in a condition of inde-
scribable squalor and filth. These unhappy creatures come to the asylum literally
to die, requiring to be carried or assisted to the bed from which they never rise.
The total treated in 1880 was 57, against 84 in 1879, 110 in 1878,
and 216 in 1877. The chief causes of admissions were fever, diarrhœa, general
debility, and dysentery.
At the close of the year 1879 there remained in hospital 1. Fifty-six were
admitted during the year, 36 were discharged, 19 died, and 2 remained.
The following disorders cause the deaths : —
Fever ... ... ... ... ...
Hæmoptysis ... ... ... ...
Diarrhœa ... ... ... ...
Bronchitis ... ... ... ...
General debility ... ...
...
...
Pneumonia ... ... ... ...
Paralysis ... ... ... ...
Ulcers ... ... ... ... ...
Heart disease ... ... ... ...
Anæmia ... ... ... ... ...
Dysentery ... ... ... ...
Total ...
2
1
1
1
5
2
1
1
1
1
3
19