( 6 )
Loss of appetite, distaste for, and finally refusal of food is a frequently
occurring chain of events in cases of melancholia. In such cases nourishment
has to be supplied by means of the stomach pump or nutrient enemata are used.
To combat sleeplessness it is desirable, in the first place at any rate, to use
hygenic measures in preference to the use of soporifics, which too frequently
interfere with digestion. In acute cases if sleep can be induced the hope of
cure is greater than in cases of developed insanity unattended by insomnia. Of
drugs for the treament of sleeplessness, sulphonal is preferable for several reasons.
It is odourless and tasteless and, so far as experience goes, its use is not followed
by any undesirable symptoms. Moreover, if its continued use is necessary, the
dose need not be increased but may be diminished.
A dose of from 15 to 20 grains is sufficient to procure about eight hours'
sleep. Chloralamide has also been used, but sufficient experience has not yet
been gained to warrant an expression of opinion as to its usefulness. Chloral
and bromide potassium are useful in many cases. In melancholia and the
insomnia of the aged Cannabis Indica has been found most useful, especially
in cases of melancholia attended by great depression. Other medicinal treat-
ment has been chiefly in the way of tonics, such as codliver oil, maltine, and the
hypophosphates.
Statement IX. Cash Account.—This shows the expenditure and receipts for
the year.
Under the column "Received from paying patients" the sum is Rs. 11,471-4-4.
This amount is composed of Rs. 11,222-4-4 received from the various munici-
palities and townships and Rs. 249 from friends of the lunatics. The amount
given by friends was less than last year ; Rs. 249 as against Rs. 590-1-0. This
is owing to the death of some and discharge of others of the paying patients.
The amount received from municipalities is greater, namely Rs. 11,222-4-4 as
against Rs. 8,293-4-4. This increase is due to the Moulmein Municipality pay-
ing debts of the previous year.
The expenditure on account of establishment was Rs. 9,969 as against
Rs. 10,033. This decrease is due to deduction of pay for fines imposed on
certain of the peons.
The expenditure on account of diet was Rs. 15,167-12-11 as against
Rs. 14,140-10-4 of last year, showing an increase of Rs. 1,027-2-7. This increase
is due to the purchase of white rice and paddy at increased rates, the price of
the latter having risen from Rs. 90 to Rs. 110 per 100 baskets.
On clothing and bedding the expenditure was Rs. 692-2-11 as against
Rs. 729-3-0 of last year.
Both bazaar and European medicines cost a little less than last year, namely,
Rs. 343-10-6 as against Rs. 363-13-6.
The following statement shows the daily average number of lunatics for
1891, the total yearly expenditure, average cost of each insane, and average
cost of each item of outgoings per individual during the year :—
(1)
(2)
Average daily number of inmates ...
Average daily number employed ...
(3)
(4)
(5)
(6)
(7)
(8)
Total expenditure throughout the year ...
Total income from lunatic labour and other
sources ... ... ... ...
Payment by friends of lunatics ... ...
Received from Municipalities
...
...
Average cost of each lunatic, column 3 ...
Cost of each lunatic after deducting items
from columns 5 and 6 ... ...
248.62
219
Rs.
28,341
5,809
249
11,222
114
67
A.
15
10
0
4
0
13
P.
7
5
0
4
0
9
Average expenditure of each patient in relation to—
(9)
(10)
(11)
(12)
(13)
(14)
(15)
Establishment ... ... ...
Diet ... ... ... ...
Bazaar and Europe medicines ... ...
Clothing and bedding ... ... ...
Contingencies proper* ... ...
Contingencies of manufacture ... ...
Cost of printing forms... ... ...
40
61
1
2
4
3
0
1
0
6
12
10
11
6
6
2
1
7
1
0
5
* Excluding Rs. 50 from Manufacture Department.