( 9 )
The causes are classified under the two heads " predisposing " and " exciting."
Great difficulty attaches in practice to the determination of the causes of
insanity, and with the exciting causes in particular early symptoms of the disorder
may very rapidly be confounded. Hence the results which have been arrived at,
though very carefully scrutinized, are only to be regarded as approximations to
truth.
The causes are further divided into the physical and moral, the moral pre-
dominating to a great extent.
In three cases ganja is reported to have been the exciting cause. Two of these
patients were well-to-do Hindus, clerks in the employ of a man who is known to
be a ganja-smoker. In these particular cases it is very doubtful whether the
practice of smoking which had preceded the attack of insanity could really be
regarded as its cause ; in both cases the amount of smoking was so small as justly
to lead to doubt in this respect. It may be said that these are the only cases of
insanity said to have had their origin in ganja-smoking which have been admitted
into the asylum for years past.
Statement VIII shows the hospital statistics during the year. There were 96
admissions into the hospital and 2 remained from last year, so the total under
treatment was 98, out of which number 79 were discharged and 7 remained at the
close of the period under review.
I have to report the enjoyment of excellent general health throughout the
year, there having been no sickness of importance except what was presented by
the patients who eventually died, and the causes of whose deaths will bear a satis-
factory inspection.
The deaths recorded were 12, being 7 under the total of last year, or, in pro-
portion to admissions, 21.43 per cent.
It appears the mean mortality of the establishment for the last ten years has
been about 9.4 per cent. In the year 1881 it amounted to 13.7, in 1882 10.7,
and in the past year 6.3. Fluctuations of this kind will necessarily occur in all
establishments; and in the experience of this asylum a year of excessive mortality
has usually been compensated by a succeeding year in which the deaths have
been few.
The mortality was due to the following causes :—
Diarrhæa ... ... ... ... ...
General debility ... ... ... ... ...
Dysentery ... ... ... ... ...
Fever ... ... ... ... ...
Paralysis ... ... ... ... ...
Ulcer ... ... ... ... ...
Dyspepsia ... ... ... ... ...
Splenitis ... ... ... ... ...
Prolapsus ani ... ... ... ... ...
Total ...
Cases.
1
1
3
1
2
1
1
1
1
12
Statement IX, Finances.—During the year Rs. 237 were received from paying
patients as compared with Rs. 125 in 1882.
The expenditure in establishment amounted to Rs. 8,922, which was more
by Rs. 175-7-9 than the expenditure for 1882: the increase is owing to the over-
seer having drawn throughout the year the enhanced pay sanctioned in 1882.
The expenditure on account of diet was Rs. 7,529-11-6 against Rs. 6,809-13-5,
being an increase of Rs. 719-14-1: this increase is owing to the daily average of
treated being more than last year. Rs. 337-4-0 were spent on clothing and
bedding against Rs. 363 of last year, being a decrease of Rs. 25-12-0.
Bazar medicines cost Rs. 129-1-0 as compared with Rs. 45-10-3 in 1882.
Contingencies amounted to Rs. 681-11-6 as against Rs. 696-3-0 in 1882.
The total cost of each lunatic in 1883 was therefore Rs. 103-6-6 as compared
with Rs. 134-0-4 of 1882, or Rs. 30-9-10 less than in the previous year: this
decrease is due to there having been no expenditure on account of public works.
Statement X contains the sanctioned establishment at the close of the year,
from which it will be seen that the percentage of jemadars to males is 1.68, to
3