REPORT ON THE RANGOON LUNATIC ASYLUM FOR THE YEAR 1893.
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in last year's figures, I had them examined and compared with the Register of
admissions. The figures given in the first line of the statement for this year are
now in correspondence with the Asylum Registers as they stood on the 31st
December 1892 with two exceptions. One of the changes made consists in
transferring from column 7 to column 8 an Austrian prostitute who was removed
to the Asylum from the General Hospital, where she was under my treatment
for syphilitic disease of the brain ; and the other in taking a patient from column 4,
a criminal male insane who recovered his reason shortly after his admission to
the Asylum. This man was on the one hand said to be suffering from a type of
incurable insanity, while on the other he was declared and reported to be sane by the
Asylum visitors. For a man to be suffering from the incurable mental malady " Im-
becility acquired," which is the diagnosis in the case book, and yet to be in full pos-
session of his senses was indeed a surprising anomaly. He has been placed in
Column II, Mania, and the necessary corrections both in his case and in that of the
Austrian prostitute have been made in the Register of admissions. It is to be
hoped further mistakes will not occur, since correcting them entails a considerable
amount of labour. In considering the errors noted here and elsewhere, some of
which are of long standing, it must not be forgotten that the returns' of this
Asylum have hitherto been compiled by an industrious but untutored Jemadar.
Although the types of disease shown in the return are now in agreement
with the entries given in the registers, I have not, excepting for the cases quite
recently admitted, any share in the responsibility of diagnosing these types.
Notwithstanding that the accurate diagnosis of mental derangements often
abounds in difficulties, no special skill is required for the recognition of general
paralysis of the insane, a physical as well as a mental malady, characterized by
pathognomonic symptoms which are to be easily observed.
I should not have referred to this subject were it not that, although general
paralysis of the insane is unknown to occur among Natives of India domiciled
throughout their lives at home, no less than three cases of this disease are re-
corded in the return under consideration. One of the subjects is a Eurasian male
who presents typical symptoms of the malady. But in respect of the other two,
a Chinaman and a Burmese female, errors have obviously been made in diagnosis,
for neither of these persons has any of the symptoms of general paralysis of the
insane. The Chinaman suffers from some gross lesion of the brain, of which the
most prominent symptom is hemiplegia, while the Burmese female is afflicted
with ataxy of an obscure kind in association with insanity.
Whereas in general paralysis death, as a rule, takes place within three years
from the onset of the disease, both the patients whose cases are cited have al-
ready been inmates of the Asylum for close on four years.
From the circumstances related it may, I think, be concluded that Burmans
born and brought up on their native soil are, similarly with Natives of India, as
yet exempt from general paralysis of the insane.
The absence of correspondence between the causes of insanity shown in
Statement VII and the types of insanity resulting from these causes shown in
Statement VI invites remark; but I am not able to enter into a consideration of
this interesting question.
Spirit-drinking which is stated (vide admissions in Statement VII) to have
caused insanity in 11 instances has contributed the following figures to State-
ment VI,—Melancholia 3, Mania 4, Dementia 1, Spirit-drinking 3 ; total 11 : and
in one case of epileptic insanity the agent credited with its production is fear.
Statement VII, showing the alleged causes of insanity among the lunatics
in the Asylum at Rangoon during the year 1893.—Although the historical state-
ments sent with lunatics admitted into the Asylum have begun to show some
improvement, nevertheless, seeing that in more than half the cases received during
the year no cause for the production of madness has been assigned, it is obvious
there is room for further reform.
The changes made in the first line of this statement were necessitated for
reasons similar to those given for altering the first line of Statement VI.
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