( 6 )
this year 37. With one other exception—namely, ague, giving 25 admissions—other diseases
were less than during the previous year.
At the close of the previous year, 3 sick were in hospital, 107 were admitted during
the year, 82 were discharged, 23 died, and 5 remained at the close of the year.
The following are the diseases causing death :—
Dysentery .. .. .. .. .. .. .. ..
Diarrhœa .. .. .. .. .. .. .. ..
Epilepsy .. .. .. .. .. .. .. ..
General debility .. .. .. .. .. .. .. ..
Anæmia .. .. .. .. .. .. .. ..
Fracture of ribs and rupture of liver .. .. .. .. ..
Total ..
5
4
3
9
1
1
23
In the five cases of dysentery, the post-mortem revealed sloughing of the colon and per-
foration in three cases, and abscess of the liver in two cases.
In the cases of diarrhœa and general debility, there was generally extensive disease of
the nervous centres, such as adhesions and old signs of inflammation about the mem-
branes of the brain, extensive serious effusions between the membranes and the brain and
into the ventricles, and softening of the brain substance. In one case of epilepsy there were
signs of an injury to the head,—a scar disease of the inner table of the calvarum—and soften-
ing of the brain ; in another, there was a small tumour near the corpus striatum. The
greater number of the cases of general debility were finally cut off by diarrhœa or dysentery.
There are still many who are at present in a state of great debility, and many more of them
will sooner or later succumb to disease. The chief medical treatment in the Asylum has
been directed to the various forms of bodily disease. No empirical treatment has been
given to the lunatics: only such medicines as were requisite for bodily disease, and such
as were requisite to raise the general health. Hypnotics have been frequently used, the
most common being hydrate of chloral, bromide of potassium, opium, coinum, &c.
Mechanical restraint has been seldom used,—only occasionally when some of the dan-
gerous had violent fits ; but they were always released as soon as possible. Kindness, with
soothing and healthy occupation of the mind, diminishes the tendency to violence.
Statement No. 9 shews the annual expenditure of the year, viz., Rs. 17,307-15-7, or
Rs. 1,925-3-9 in excess of the amount drawn in the previous year. This is due to the fol-
lowing causes :—1st, increased number of lunatics, 2nd, two additional night-watchmen who
were throughout the whole of this year, and only for three months last year ; 3rd, the high
rate of paddy. The contractor threw up his contract, and we were obliged to buy the
paddy at the market rates.
The cost of each patient per head was Rs. 89-10-9, or Rs. 5-10-1 more than last year.
The sum of Rs. 476-4-0 was received from the friends of patients in payment of main-
tenance, or Rs. 290-1-3 more than last year. This is an improvement, but not so much as
it ought to be.
I do not think that sufficient attention is paid to enquire into the circumstances of
patients by the officers committing the lunatics to the Asylum. The money we have
obtained this year is chiefly due to the energy of Mr. Robinson, displayed in finding out
the circumstances of the relatives of those coming from the Rangoon district and town.
The amount to be received for maintenance depends chiefly on the district officers who
send them for admission into the Asylum.
If, from the gross expenditure, Rs. 2,798-13-8 on account of the net profit on insane
labour, and Rs. 476-4-0, received from friends, be deducted, the average cost per patient
will be Rs. 72-11-2, being Rs. 4-10-5 more than last year.
Statement No. 10 exhibits the sanctioned establishment as it was at the close of the
year. Few changes have occurred in the staff during the year.
The Superintendent in charge at the beginning of the year was Dr. Griffith, who left
on furlough ; then Dr. Dundas had it for a short time ; and on 23rd May I took over charge.
One or two recently engaged have been discharged, but most of the attendants have
been connected with the Asylum for a long period, and all have worked well. The pro-
portion of jemadars to males is 1.13 ; to females, 1.17 ; male-keepers to males is 4.54; and
female-keepers to females is 5.88.
Statement No. 11 shews the amount of profit derived from the industrial labour of
the insanes. The amount realized during the year was Rs. 2,798-13-8, or Rs. 69-1-2 more
than was remitted during the previous year.
General Remarks.—The subordinate establishment have, as a rule, conducted them -
selves well during the year. Mr. Robinson, the Overseer, has kept the place in excellent order
during the year, and has always paid every attention to the lunatics, and treated them
with kindness and gentleness.
The majority of the attendants have also worked well and continuously, and have
afforded valuable assistance in the treatment of the lunatics.
The chief requirements of the Asylum now are—more accommodation in the way of
additional cells for criminals, and also observation and strong rooms for civil insanes ;
and I hope that no delay may take place in affording more accommodation. One more
building is required which I have not mentioned, and that is a dead-house : at present there
is no such place connected with the Asylum.