From Surgeon-Colonel D. SINCLAIR, M.B., C.M., Inspector-General of Jails, with Civil Medical Adminis-
tration, Burma, to the Secretary to the Chief Commissioner, Burma,—No. 1130-103M., dated the 9th
February 1897.
I HAVE the honour to submit, with the prescribed statements, the report on
the Rangoon Lunatic Asylum for the year 1896. The Committee of Visitors to
whom the report was circulated for perusal and review offer no remarks.*
2. During the year quarters for 24 keepers (12 married and 12 single)
have been completed ; and including 28 cells and 6 strong-rooms, also finished
during the year, there is accommodation now for 384 insanes of all classes and
both sexes. With the completion of the new hospital providing for 30 sick, the
construction of which is already far advanced, there will be room for 414 insanes.
In paragraph 15 of his report the Superintendent calculates that two years hence
the accommodation for criminal lunatics will need to be extended.
3. As was remarked when forwarding the report for 1895, insanity is far
more generally prevalent in Burma than elsewhere in India. I was not satisfied,
however, that the excess population in the asylum compared with the population
in the asylums of other provinces was altogether accounted for by the circum-
stance, and the effect of the instructions contained in paragraph 2 of the resolu-
tion on the report just cited confirms the suspicion that renewed attention to the
orders of the Govenment of India in this connection were very necessary. Great-
er care has been taken to thoroughly investigate the cases and to take early ac-
tion with a view to the prompt discharge of all those already admitted as well as
to prevent as far as possible the admission of harmless vagrant insanes and such
other non-dangerous lunatics as had friends to look after them. Evidence of
this is to be found in the larger number discharged and in the smaller number of
admissions and re-admissions—93 and 92 respectively, against averages of 55 and
98 during the previous decennium, vide columns 6 and 3 and 4, Statement I.
Further information in this connection is given in paragraphs 1, 15, 17 and 18
of the report now submitted. Another matter for congratulation is the reduction
in the number of escapes from eight, nine and seven in 1893, 1894 and 1895 to
four in the year under review. All four were civil insanes and, with one excep-
tion, were re-captured and returned to the asylum within a few days.
4. Details of sick and death causes are given in Statement VIII. Of the
104 admissions to hospital 13 were due to debility, to tubercle 11, to diarrhœa
8, to dysentery 9, to rheumatism and bronchitis 8 each, and to epilepsy 6.
There were 30 deaths with a death-rate of 9 per cent. of the daily average
strength, compared with 36 deaths and a death-rate of 10.54 during the previous
year, the death-rate during the previous decennium being 10.96. Ten deaths are
attributed to tubercle, five to mania, three to dysentery, two each to diarrhœa
and epilepsy, and the remaining eight each to a different cause. No deaths oc-
curred amongst the 27 criminal lunatics transferred to the Rangoon Jail on the
10th June and therein detained until the 25th November when they, with 16
others, were returned to the asylum. Amongst a daily average of 144 criminal
lunatics detained in the asylum there were nine deaths or a percentage of 6.3,
the death-rate for the previous decennium averaging 8.8. In paragraph 24 the
higher mortality amongst civil insanes, as compared with that amongst criminal
insanes, especially in the case of recent admissions, is again emphasized.
The Superintendent seems disposed to attribute the excessive mortality amongst
the former to their " wretched state of health on admission " and is of opinion
that several of those who died early were cases which should have been taken to a
hospital. Whether an asylum or hospital is the best place for the treatment of
incipient, unconfirmed mental disorders due to toxæmia, puerperal causes or
exhaustion is a problem which is now engaging much attention in England ; but
in the present state of matters in this province I am inclined to think that it does
not much signify whether the patient is taken to the one or the other. Early
treatment is in all such cases the paramount need.
* Remarks by visitors have been added since this letter was written.