16
REPORT ON THE RANGOON LUNATIC ASYLUM FOR THE YEAR 1894.
The following table shows the results of the periodical examinations:—
Date of examina-
tion.
24th October ...
4th November ...
11th November ...
18th November ...
25th November ...
2nd December ...
9th December ...
Number previously attacked.
30
104
160
174
209
211
214
FRESH CASES DIS-
COVERED SINCE
LAST EXAMINATION.
Marked œdema.
4
20
5
15
1
2
1
Slight œdema.
70
36
9
20
1
1
...
Total.
74
56
14
35
2
3
1
STATE OF ASYLUM POPULATION ON
DATES OF EXAMINATION.
Marked œdema.
32
50
53
68
69
71
71
Slight œdema.
70
58
44
71
13
4
5
Total with œde-
ma.
102
108
97
139
82
75
76
No œdema.
151
142
154
112
176
187
185
Total* popula-
tion.
253
250
251
251
258
262
261
Remarks.
* Including those in
camp at Moulmein
and Toungoo.
Note.—The
figure
showing the state of
the asylum popula-
tion is only approxi-
mately correct.
82. It will be seen from the foregoing remarks and tabular statement that
the outbreak began on the 4th October and remained epidemic until the 25th
November, when admissions almost completely ceased, and that between the
dates given no less than 211 lunatics, representing approximately 80 per cent. of
the asylum population, suffered from it more or less.
83. Six of those attacked died before the close of the year, four in the
asylum and two at Moulmein. In the return of mortality which is submitted
with this report beriberi is shown to have caused 7 deaths, but one of the
deceased, of whom further mention will hereafter be made, acquired the disease
prior to his admission into the asylum. Although the disease ceased to spread
some weeks in advance of the end of the year, it by no means follows that the
mortality list is complete, for many of the patients attacked are yet far from well,
while two or three are still suffering severely.
84. The lunatics who were the first to exhibit marked symptoms of the
disease came from the criminal enclosure, wherein each lunatic is provided
with a separate cell; but at a later date patients were admitted from all parts
of the asylum. Insanes engaged in gardening operations, however, appeared
to suffer to a slighter extent than those confined between the sectional walls of
the asylum.
85. The disease was pretty evenly distributed among the various races
found in the asylum, and, in respect of sex, no distinction was shown.
86. Symptoms of the disease.—Whereas the investigation of subjective
symptoms occurring among insanes is a hopeless task, the physical signs of disease
in them are almost as easily observed as in other classes of patients. In beri-
beri there are two easily recognizable symptoms on which, when they co-exist,
considerable reliance can be placed in arriving at a diagnosis, even when the
disease is in an early stage—one is œdema of the legs and the other loss of
knee-jerk. As has already been pointed out, the diagnostic sign accepted in the
asylum was œdema. It was found, however, that whenever pronounced œdema
was present, knee-jerk was generally absent. Exceptions were met with even in
cases of marked œdema where the knee-jerk was normal or exaggerated.
87. The fact that writers on beriberi have described a dry variety of the
disease in which no œdema takes place is not overlooked, but that type of the
malady was not met with in the asylum.
Dry or atropic beriberi may be occasionally seen in the Civil Hospital
in chronic cases, in succession to dropsical beriberi, but examples of beri-