( 6 )
occupied by a clot of blood, which also infiltrated the surrounding cerebral sub-
stance.
(13) General debility.—Nga Aung Gyi, age 35, received into the asylum in
an indifferent state of health on the 13th December 1884. At the time of his death
he had been in the asylum 1 year and 18 days. Post-mortem.—Great emaci-
ation ; fluid in the areolar tissue and the cavities generally.
(14) General debility.—Nga Pan Paw, age 54, received into the asylum in in-
different health on the 9th December 1885. At the time of his death he had been
in the asylum 8 months and 24 days. Post-mortem.—Great emaciation ; tissues
pale and anæmic ; fluid in the ventricles and base of brain ; the different organs
were found free from disease.
(15) Ah Kain, age 30, received into the asylum in bad health on the 19th
January 1886. At the time of his death he had only been 9 months in the asy-
lum. Post-mortem.—Great emaciation ; the lungs, were in a state of congestion ;
serum seen in the ventricles and base, and also in the chest and abdomen.
(16) Paralysis.—Mutusamy, age 30, admitted into the asylum with hemiplegia
and bad health generally on the 28th August 1886, and at the time of his death he
had been detained 2 months and 14 days only. Post-mortem.—A large quantity
of serum in the ventricles and base of brain.
(17) General debility.—Nga Aung Myat, age 28, a leper, was received into the
asylum in bad health on the 3rd June 1886 and at the time of his death he had
been detained only 6 months and 10 days. Post-mortem.—Great emaciation ; tissues
pale and anæmic ; serum in the areolar tissue, ventricles, and base of the brain.
(18) One man, Nga Te, a criminal lunatic, received into the asylum on the
8th February 1886 from Rangoon, committed suicide in his cell on the night of the
1st July 1886. At the time of his death he had been altogether detained 3
months and 8 days, during which period he betrayed no symptoms of a suicidal
tendency. It appears from the report made to the Magistrate who held the en-
quiry at the asylum that the patient was placed in his sleeping room at the usual
hour, and on the attendant opening the door next morning he found the luna-
tic suspended by a strip of his gunny covering to the bars of the door of his cell.
The night attendant had made his rounds with regularity and he reported that
nothing had occurred during his visits to excite his suspicion. Unhappily the
patient's attempt was too well made to cause any noise or struggling, or the fatal
result might have been prevented.
It will be seen from the above summary that out of the 17 deaths from natu-
ral causes 11 were in very bad or indifferent health when admitted and the
majority had been under a year in the asylum; on the other hand all those
admitted in good health had been in the asylum from four to 14 years, and only
one had been detained under a year; one was 81 when he died and had been an
inmate for over 10 years ; one was 70 years, three were 60 years, one was 54,
four were upwards of 40, four were between 30 and 40, one was 25, one was 28,
and one 29 years of age when they died.
As to what in reality is the essential character of the alteration of the brain
in insanity I am as much in the dark as I was when I first took charge of the
asylum, but one cannot fail to observe certain changes, and changes of great
similarity, which are seen in a great number of the post-mortems made.
The facts most frequently noticed are serous effusions into the serous cavi-
ties of the brain and hardness of its substance, with well-marked appearances of
deficient and degraded nutrition. Out of the 140 autopsies, extending over a
period of nearly 16 years, in 90 effusion had taken place into the ventricles ; in
60 the pia mater was infiltrated ; in 40 turgidities of the brain and membranes
were observed; in 35 the arachnoid had become thickened and opaque; in 15 the
colour of the brain appeared to have changed; in 14 bloody points were observed
on the cut medullary surfaces, whilst in eight blood was effused, sometimes to a
considerable amount, within the cranium.
Statement No. IX.—Finances.—During the year Rs. 544-12-10 were received
from paying patients as compared with Rs. 454-8-0 in 1885.
The expenditure on account of establishment was Rs. 9,634, almost exactly
what it was last year.