( 5 )
Statement V shows the age of those admitted. As usual the majority are
aged between 20 and 40 years, but in the absence of any history in most cases it
is impossible to say at what age insanity was developed.
Statement VI shows the types of insanity.
Of a total of 335 treated 128 suffered from acute or chronic mania, but it
must be noted that this number refers to the description of insanity under which
these patients were admitted and many of the 128 are now suffering from sim-
ple dementia, next comes melancholia 112, then dementia 44, toxic 26, (includ-
ing ganja-smoking 12, spirit-drinking 8, opium-smoking 5, opium-eating 1) epi-
leptic 10, and idiocy one.
Of insanity due to morbid changes in the brain there are 5 cases, " Other
forms" 4, and not diagnosed 5.
The admissions during the year follow much the same order of frequency.
Mania 41, melancholia 26, ganja-smoking 5, spirit-drinking 5, dementia 4,
epileptic, opium-smoking, and other causes, 1 each. There is very little to
guide one in the histories of those sent from other stations than Rangoon, and,
even in the cases from Rangoon, we can glean little or no information regarding
antecedents. The majority of those admitted every year are those who wander
about friendless or whose friends, in finding the lunatic a burden to them, send
him to the asylum and take no further notice of him. The number of violent
cases is few in comparison to the admissions. No accident has occurred during
the year.
The chief difficulty in each case is to determine whether it is a " first attack "
or otherwise, as the prognosis as to the chances of recovery rests on this ; most
recoveries occur among the first and recent attacks.
It certainly seems that the greater proportion of cases is incurable.
Recoveries in order of the type of insanity during the year under review were
mania 15, melancholia 7, toxic 7 (including ganja-smoking 3, spirit-drinking 3,
opium-smoking 1,) dementia 2 and other varieties 1.
Statement VII shows the causes of insanity of those admitted during
the year.
Of the total number of admissions 84, 15 come under the heading physical
causes, 28 under moral causes, and unknown 41. Under physical causes are included
ganja-smoking, spirit-drinking, and opium, with one case from fever, and one
from epilepsy. Among the moral causes, grief comes first, then loss of property,
fright, poverty, and disappointment in love. From the result of this table no
certain conclusion can be drawn as doubt exists as to the accuracy of the infor-
mation given. It is odd, seeing what a powerful factor in the production of insanity
heredity is in Europe, that no case was admitted in which any history of here-
dity could be traced.
Statement VIII is the return of the sick from other diseases than insanity
treated in the Asylum Hospital. From this it will be seen that the general
health of the lunatics was good during the year, the admissions being much
fewer than last year—75 against 136.
The number of deaths was very much less, being 22 against 40 of last year.
The greatest number of admissions was for general debility, but fewer such
cases were admitted than last year, 16 instead of 39; the number of deaths
from this cause was five. Of the 5 deaths from general debility in 2 cases
tubercular deposits were found in the lungs post mortem. Intermittent fever
gave 10 admissions and 1 death, diarrhœa 7 admissions and 4 deaths, dysentery
4 admissions and 2 deaths, phthisis 2 admissions and 2 deaths, and cancers 2
admissions and 2 deaths. Of the new cases admitted into the Asylum during
the year 4 died. Of the casualties 2 only are specially noteworthy. In one of
these, rupture of a vessel on the abdomen was the cause of death, and in the
other cerebral hæmorrhage.
There were no cases of violence amongst the lunatics during the year.
Treatment.—The improvement and maintenance of the general health of the
lunatics have been the primary objects of treatment, and every endeavour has
been used to provide healthy occupation of mind and body and so promote sleep
and improve appetite.
2