20
REPORT ON THE RANGOON LUNATIC ASYLUM FOR THE YEAR 1893.
The perusal of the registers and journals of the institution affords little or
no instruction, and of oral testimony there is practically none, for so many
changes have taken place in the personnel of the Asylum establishment that of
the subordinates of a superior grade who were in office at the beginning of
the year only one remains. It will be seen then on what slender foundation any
conclusion I may draw of the prevalence of this disease must rest.
If any changes in the general management and treatment of the insane
population likely to conduce to the prevention of dysentry had been adopted
and had been followed by a decided diminution of the disease, the task before
me would be easy of performance. No change in the direction indicated has,
however, been introduced, nevertheless there is little or no dysentery in the
Asylum at the present time.
A special enquiry into the condition of the bowels among such of the Asylum
population as had lost weight and were showing indications of failing health was
recently undertaken, but the investigation did not lead to the detection of a single
case of dysentery.
The mortality from general debility does not call for any special conside-
ration. Dementia and debility are closely related, and the true cause of death in
many of these so-called cases of debility is probably insanity.
The tendency to death among cases of dementia cannot be overcome and,
in spite of all that is or can be done, early death is often inevitable.
The health of insanes will frequently fail from causes quite beyond control;
with them disease is not a necessary precursor, or associate, of death. Progres-
sive extinction of life will often occur without the presence of any definite disease.
The inmates of a lunatic asylum should be regarded as sick persons requir-
ing special care. They should be well-housed, well-clothed, well-fed, and pro-
vided with an ample staff of attendants. I do not think that sufficient attention
is paid to the wants of the lunatics in some of these matters. There are only two
small sheds in the Asylum for the accommodation throughout the day of about
220 male insanes, and overcrowding is inevitable. These sheds, consisting of
open-battened walls with shingled roofs, are well adapted for the hot weather, but in
the cold weather and in the rains they afford but poor protection to the lunatics.
The Chief Commissioner recognized the necessity for more worksheds when
he visited the Asylum in June 1892. Additional and better sheds are urgently
required.
The lunatics are not provided with clothing suited to the varying conditions
of the year, and indeed no definite and fixed scale of clothing or bedding for in-
sanes has, as far as I can discover, ever been adopted. Their destructive ten-
dencies largely interfere with the issue of more than one suit of raiment at a time,
and in the cold and rainy weather they are doubtless often insufficiently clad. In
marching to and from their cottages, which are scattered over the Asylum grounds,
at the close and opening of the day, they must occasionally become exposed to
rain and get chilled and wet.
During the cold weather, with the thermometer in the early morning often
standing at 6o° Fahrenheit, or less, exceptional precautions to obviate chill are
called for.
Seeing that the sheds used by them during the day afford but little or no
protection against the cold, the lunatics should not be taken from their relatively
warm dormitories at too early an hour, and such as are, through enfeeblement or
mental incapacity for work, condemned to idleness should be very warmly clad.
The strength of the Asylum establishment is unequal to the requirements of
the lunatics. Many of the insanes need a great deal of attention, and such as
are too infirm to work require to have facilities given them for the exercise of
their limbs.
Nearly all the warders are fully employed on strictly administrative duties,
so that the number available as attendants on the insane is inadequate. The
warder staff requires increasing.
Statement IX, showing the cash account of the Lunatic Asylum for the year
1893.—As the information which is wanting to complete this statement is not at