( 3 )
A careful digest of these morbid appearances might form an interesting chapter
in future asylum reports as well as a valuable contribution to the pathology of
insanity.
9. STATEMENT IX shows the cash account of the establishment for the year.
The increased cost of bazar medicines and contingencies of manufactures alone
remain unexplained in the Superintendent's report. The amount received from
paying patients, Rs. 237, is Rs. 112 more than was received in 1882 ; but such
a contribution is altogether disproportionate to the regard displayed (vide above)
by friends and relatives to the mortal remains of their deceased connections. If in
a position before complying with their request, they might fairly be required to
give additional help to the funds of the institution.
10. STATEMENT X details the pay of the sanctioned establishment. The
Overseer's pay is sufficient to command the services of an apothecary, and in my
opinion a Medical Officer with better qualifications than a Hospital Assistant
should be resident at the asylum. The Superintendent is also Civil Surgeon and
has numerous other equally important duties with those connected with the
insane to attend to and may not in an emergency (unavoidable contingencies
in all institutions of the sort) be at hand. The inmates of an asylum should be
constantly under the eye of a skilled observer. Diseases to which in the sane
attention would be at once directed may go on to the end undetected in the
insane. Intercurrent bodily ailments are exceedingly insidious with them and
their characteristics are often obscured by the inertia which attends morbid states
of the nervous system. Under these circumstances, and in view of the economy
of the arrangement, as the services of the Hospital Assistant may then be dis-
pensed with, I would advocate that the next permanent incumbent of the Over-
seership or Deputy Superintendency be an apothecary. Mr. Robinson has fallen
ill and is not likely ever to return to duty. His officiating successor is a quiet
and sober man but, like his predecessor, is insufficiently educated to give intelli-
gent supervision, or to understand, much less to keep, accounts or registers.
Much of this work has consequently to be done by the jemadar, who of the sub-
ordinate establishment is the most intelligent and best informed in all matters
connected with the asylum. From a conversation with Dr. Griffith on this sub-
ject, I learn he is himself in favour of the appointment of a Medical Deputy Super-
intendent, if a suitable man can be found, about which I anticipate no difficulty.
Annual Report on the Rangoon Lunatic Asylum for the year 1883.
1. Situation and buildings.—With the exception of the construction of asphalted
floors to some of the cottages, there has been no change made in the asylum
buildings during the year. Additional accommodation is required for the steadily
increasing population on the criminal side, and the Chief Commissioner has sanc-
tioned a sufficient sum of money to erect an upper storey to the criminal cells, which
is now under construction. The space was much too limited for the number of
criminal lunatics under treatment. To separate the noisy and quarrelsome from
the quietly-disposed and recovering is an essential element in treatment, which
I was unable to carry out under arrangements prevailing in the last part of the
year.
The pressure from overcrowding and the danger of keeping violent insanes
so near to one another were such that permission was sought and obtained to
transfer some to the Rangoon Central Jail.
Although a wall around the recreation-ground of the house is not an essen-
tial necessity, the asylum cannot be said to be complete for all purposes without
it, and I here enter the remarks made last year on the subject:—
" The asylum recreation-ground is at present enclosed with a bamboo hedge, which
is not sufficiently resisting to prevent intruders. I am of opinion that it is desirable that
the pleasure-grounds should be securely enclosed to protect the patients from the gaze
and impertinent curiosity of visitors and from excitement occasioned by their presence on
the grounds. This enclosure should be of a permanent character, about 10 feet high.
Although the first cost of the wall will be about double that of a fence of the proper kind,
still its durability and greater efficiency in every respect will make it cheaper in the end.