ANNUAL REPORT ON LUNATIC ASYLUMS.
5
Out of 220 instances, in which causes were assigned, 155 were of a physical and 65
of a moral nature. The comparative infrequency of moral causes is probably to
some extent due to the incompetency of the reporters to discern and appreciate
such influences. Of all known physical causes the abuse of narcotic drugs was the
most common, and next to that hereditary tendency and epilepsy. In 16 instances
the attacks are ascribed to starvation or privation, and in 5 to intemperance. Of
moral causes the most frequent were grief, family quarrels, religion (possibly
"false belief" should come under this head), fear and loss of property. If the
probable causes of insanity were more commonly reported in this country they
would afford scope for interesting comparison and discussion; but like many other
incidents connected with domestic native life we only come to learn them, in most
cases, as it were by accident.
8. SICKNESS.—The general sickness amongst the insanes was of the usual varied
character, and the most prevalent diseases were bowel-complaints, diarrhœa and
dysentery. Diseases of the nervous system, as secondary complaints, were by no
means frequent. Affections of the respiratory system, including 10 cases of phthisis,
were much more common. Of heart disease but 2 cases are recorded. Amongst
constitutional diseases, secondary syphilis and chancre appear, and 1 case of leprosy
found its way into the Madras Asylum. Fortunately the whole of the institutions
were free from epidemic disease.
9. MORTALITY.—The deaths numbered 27, and, of those who died, 22 were
males and 5 females, giving ratios of 5.0 and 3.4 per cent. respectively on the daily
average population of each sex. These results are in accordance with the experi-
ence of English asylums, in which the mortality is much greater amongst males
than females. The death-rate of the two sexes combined, per 100 of daily average
strength, was 4.64, which is moderate as compared with recent local rates.
10. The main causes of death were phthisis pulmonalis (5), sanguineous
apoplexy (4), dysentery (3), meningitis, atrophy, fatty heart, and diarrhœa
(2 each).
The following statement shows in detail the several causes of death :—
Causes.
Phthisis pulmonalis ... ... ...
Meningitis
... ... ... ...
Apoplexy sanguineous ... ... ...
Atrophy ...
...
...
...
...
Epilepsy ...
...
...
...
...
Paralysis insanorum ... ... ...
Fatty degeneration of heart ... ...
Syncope ... ...
...
...
...
Pneumonia (with pleurisy) ... ...
Dysentery ... ... ... ... ...
Diarrhœa ...
...
...
...
...
Ascites
...
...
...
...
...
Chronic Bright's disease ... ...
General debility ... ... ... ...
Males.
5
2
3
2
1
1
1
1
1
3
...
...
1
1
Females.
...
...
1
...
...
...
1
...
...
...
2
1
...
...
Total.
5
2
4
2
1
1
2
1
1
3
2
1
1
1
11. FORMS OF INSANITY.—The several types of insanity, and the number of
cases of each under treatment are given in the following abstract:—
Epilepsy (epileptic insanity) ... ... ... ... ... ...
Acute mania
...
...
...
...
...
...
...
...
Chronic do.
...
...
...
...
...
...
...
...
Melancholia
...
...
...
...
...
...
...
Acute dementia
...
...
...
...
...
...
Chronic do. ...
...
...
...
...
...
...
...
Paralysis of the insane ... ... ... ... ... ...
Idiotcy, congenital
...
...
...
...
...
...
...
Imbecility ... ... ... ... ... ...
Puerperal mania ... ... ... ... ... ...
2
No. of cases.
1
162
274
108
46
81
2
17
6
2