( 3 )
Statement IV.—No comments seem necessary in respect of this statement
beyond the remark that the information is not very reliable as the means of
ascertaining trustworthy particulars of their antecedents are not always available
in the case of insanes.
Statement V.—The bulk of the admissions during the year were of persons
between the ages of 20 to 40, but there were 10 admitted who were under 20
years of age and 16 over 40 years. In this connection it may be useful to note
that 33 were admitted in good health, 46 in fair, and 23 in bad and indifferent
health.
Statement VI—Exhibits the various types of insanity. The following
table transposes the figures of the statement and shows in a more convenient
form the result of the treatment:—
Mania ... ... ... ...
Melancholia ... ... ... ...
Dementia including acquired imbecility ...
Idiocy ... ... ... ...
Epileptic insanity ... ... ...
Ganja-smoking ... ... ...
Opium-smoking ... ... ...
Opium-eating ... ... ... ...
Spirit-drinking ... ... ...
Other intoxicants ... ... ...
Insanity associated with morbid change or changes
in the brain.
Other types ... ... ... ...
Total ...
Remained.
90
89
38
1
7
9
4
1
5
...
2
8
254
Admitted.
39
32
16
2
...
2
...
...
10
1
...
...
102
Total.
129
121
54
3
7
11
4
1
15
1
2
8
356
Recovered.
13
8
...
...
...
3
...
...
3
1
...
...
28
Improved.
14
8
4
...
3
2
1
...
4
...
...
...
36
Died.
8
10
5
...
1
2
...
...
1
...
...
...
27
Mania and melancholia contributed more than two-thirds of the admissions,
and dementia and acquired imbecility about a sixth, and spirit-drinking about
a tenth. The cases under the first three headings were often most troublesome,
and the want of padded rooms and the means of restraining the more violent
was much felt. Cures and improvements were effected most frequently in the
case of patients suffering from mania and melancholia, but these forms of
insanity contributed the largest number of deaths.
The Superintendent describes the treatment adopted as follows :—
"The treatment adopted was medicinal and hygienic. The former consisted of sedatives,
such as bromides, chloral, sulphonal, chloralamide, Indian hemp, &c., internally; and
counter-irritants and sometimes even vesicants, such as croton oil, tartar emetic-ointment,
&c, on the head externally. Of all these the bromides seemed to give better results than
any.
" The hygienic part of the treatment consisted of proper attention to diet, regular
weighments of the patients every week, and giving them extras in case of their losing in
weight, regular exercise and some amount of manual physical work every day, cleanliness
of body by regular baths, &c. Means for giving all the inmates some amount of work
requiring manual physical labour are very scanty as mentioned above; and as long as no
steps are taken for providing big worksheds and lots of enclosed land for cultivation,
improvement to any great extent in the condition of the patients is scarcely to be expected."
The information given under this head is too general to be of any practical
value. No definite record is given of experience gained regarding the value of
the many forms of treatment adopted, such as change of surroundings, baths,
discipline, employment, forms of restraint, &c., nor are any opinions expressed
as to the efficacy of some of the drugs employed. It would have been interesting
to know what measure of success had attended the use of sulphonal and chlora-
lamide drugs ; regarding the value of which,—in the treatment of different forms
of insomnia of the insane,—opinions are still very much divided.
Statement VII.—Out of a total number of 356 treated the exciting cause in
the case of no less than 199 is unknown. Of the remaining 157 seventy-six cases
of insanity are attributed to physical and 81 to moral causes. The most fertile