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women are sent into the asylum for treatment: the Burmese, apparently, dislike to
send their women insane here.
Statement No. VI.—The types of insanity are shown herein. Of those treated,
namely 254, 108 were suffering from acute mania, six from chronic mania, 68
from melancholia, 37 from acute dementia, two from chronic dementia, one from
paralysis of the insane, seven from idiotcy, 14 from imbecility, and 11 not insane.
It was remarked last year that the admissions under the heads of acute mania
and melancholia showed a large increase on the former year ; this year the increase
in this respect is even more marked, there being 32 admissions of acute mania
against 25 of the former year, and 35 melancholia against 23 of last year.
The relative proportion of cases of mania and melancholia was pretty nearly
the same for the two sexes. Melancholia was 2.0 per cent. more frequent in
males and mania 5.2 more frequent in males. In consequence, however, of the
changes which mental disorders undergo during their progress, the above esti-
mate does not represent the exact proportions of the different forms of disorder
treated in the institution. Even in the earlier stages, and in the more acute
cases, a state of mental excitement is often followed by one of depression ; and,
on the contrary, melancholia often passes into mania before complete recovery
takes place. When the disorder has become chronic, and especially if it have
assumed a recurrent form, these alternations perhaps still more frequently occur.
In cases likewise of incurable insanity, the violence of the original disorder for
the most part gradually abates and leaves in general a weakened condition of
the memory, judgment, and other mental powers, with a consequent state of
imbecility or incoherence. These are the first stages of dementia, which not un-
frequently terminate in a completely fatuous condition, or in confirmed dementia
which, except by attention to the history, can scarcely be distinguished from
original idiotcy. In my experience I find that melancholia and monomania,
when they become incurable, appear to have less tendency than mania to pass
into a demented condition.
Medical treatment.—I have written fully under this head in former reports.
The asylum containing persons physically as well as mentally debilitated has been
regarded as a hospital for the insane, and the general management has been con-
ducted on the principles of ordinary hospital practice. The varying phases of
disease and the different modes of diagnosis have, therefore, been clinically studied
and that treatment adopted which appeared the most important auxiliary for the
control of intercurrent or individual diseases.
Statement No. VII.—No remarks.
Statement No. VIII shows the hospital statistics during the year. There
were 12 cases left from 1884 with a total of 122 admissions, making a grand total
of 134. Of these 113 were discharged cured, 12 died, and nine remained at the
close of the year.
The diseases in order of frequency treated during the year were intermit-
tent fever, general debility, dysentery, diarrhœa, asthma, abscesses, epilepsy,
wounds, &c. The return is remarkable from the absence of cases of rheumatism
and lung diseases.
In my last report it was stated that the year 1884 was the most unhealthy
of the series. The year under review, I am happy to be able to state, has been
an unusually healthy one.
The number of deaths during the year was 12 and the mortality to average
strength per cent. 6.3, the latter being 6.4 less than that of the previous year.
Three deaths were due to general debility; two of these were admitted in
a moribund condition, dying in a few days, or a short period after admission, and
should really not have been sent at all; two to intermittent fever,—it is somewhat
remarkable that deaths from fever seldom or ever happen here, and this is due not
to excellence of treatment, but to the fact that no case sufficiently severe to prove
dangerous to life frequently come under treatment;—three to epilepsy; two to dy-
sentery; one to paralysis; and one to diarrhœa. I need not point out that diseases
are much more fatal in the case of many lunatics than when they affect the sane,
inasmuch as the former are frequently in a weak and anœmic condition before
they are attacked, and after they are attacked they often obstinately refuse food,
2