NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
4
ANNUAL REPORT ON LUNATIC ASYLUMS.
4. Criminal Lunatics.—Thirty-three admissions of this class occurred during
the year, and, including those already in asylums, the numbers were 92, of whom 84
were males and 8 females. Twenty were either discharged or by expiry of sentence
transferred to the class of civil lunatics, and nine died, leaving the strength at the
end of the year at 63 (males 56 and females 7). Amongst this class there are
detained in the Madras Asylum several persons who have never been pronounced
insane by professional experts, and, as recent experience has shown, their super-
vision and custody is attended by grave risks and embarrassment.
Criminal Lunatics.
Years.
1878-79
...
...
1879-80
...
...
1880-81
...
...
Admitted.
Males.
37
26
32
Females.
5
1
1
Total.
42
27
33
Total Treated.
Males.
93
83
84
Females.
13
12
8
Total.
106
95
92
Discharged.
Males.
16
19
19
Females.
2
3
1
Total.
18
22
20
Died.
Males.
20
12
9
Females.
...
2
...
Total.
20
14
9
Remaining.
Males.
57
52
56
Females.
11
7
7
Total.
68
59
63
5. The following abstract shows the particulars of criminal lunatics in each
asylum. There were four more in custody at the end of the year than in the
beginning, the increase being in the Calicut and Waltair Asylums :—
Asylums.
Madras ...
Waltair ...
Calicut ...
Total ...
Remained.
Males.
37
9
6
52
Females.
6
...
1
7
Total.
43
9
7
59
Admitted.
Males.
22
4
6
32
Females.
...
1
...
1
Total.
22
5
6
33
Total Treated.
Males.
59
13
12
84
Females.
6
1
1
8
Total.
65
14
13
92
Discharged.
Males.
16
2
1
19
Females.
1
...
...
1
Total.
17
2
1
20
Died.
Males.
6
2
1
9
Females.
...
...
...
...
Total.
6
2
1
9
Remaining.
Males.
37
9
10
56
Females.
5
1
1
7
Total.
42
10
11
63
6. Civil Insanes.—The number of admissions of insane persons of the civil
population was 182, or 10 in excess of the number of the previous year. Of these
137 were males and 45 females. The numbers of each class of the population are
shown in the following table. European and East Indian insanes bear a large
proportion to the population of those classes, for the reason that it is not customary
with them to keep insane members of their families in their homes, whereas with
natives of India this custom very largely prevails :—
Caste.
Europeans and East Indians ...
Hindus
...
...
...
...
Mahomedans ... ... ...
Native Christians ... ... ...
Other Castes
...
...
...
Total ...
Males.
23
82
23
5
4
137
Females.
11
25
5
4
...
45
Total.
34
107
28
9
4
182
7. Previous Occupation of Insane.—A list of previous occupations is given in
Statement IV. They are very various. The army sends the largest number
apparently of any occupation, but this is due to the fact that mental aberration is
at once discovered and brought to notice in the army. Cultivators and laborers
are numerous, but the greatest proportion of the insane admissions had "no occupa-
tion," or it was "unknown."
ANNUAL REPORT ON LUNATIC ASYLUMS.
5
8. Ages of the Patients.—The following abstract bears out the conclusion come
to in former reports, that insanity is a disease which shows itself most commonly
in the prime of life, between the ages of 20 and 40. Of the total admissions, 69.23
per cent. were between those ages :—
Age.
Under 20 years
...
...
20 to 40 do. ... ...
40 to
60
do. ... ...
Upwards of 60 years
...
Sex.
Males ... ...
Females ... ...
Males ... ...
Females ... ...
Males ... ...
Females ... ...
Males ... ...
Females ... ...
Total Admissions ...
Admitted.
4
4
98
28
32
10
3
3
182
Rate per
Cent. to Total
Admissions.
4.39
69.23
23.07
3.29
...
9. Forms of Insanity.—The
particulars are given in Statement VI. Of acute
mania 121 cases were treated, of chronic mania 205, of melancholia 42, of acute
dementia 34, of chronic dementia 67, paralysis of the insane 2, idiotcy 20, im-
beciles 5, puerperal mania 4. These numbers indicate pretty well the relative
proportions of the various forms of mental unsoundness coming under observation
in asylums.
The recoveries, as a matter of course, are always in the highest proportion in
the acute forms of insanity, and the results of the last year are given below. They
indicate that prompt treatment and seclusion in an asylum are often efficacious in
restoring to health those recently attacked :—
Puerperal mania ... ... ... ... ... ...
Acute mania ... ... ... ... ... ...
Do. dementia ... ... ... ... ... ...
Melancholia ... ... ... ... ... ...
Chronic mania ... ... ... ... ... ...
Do. dementia ... ... ... ... ... ...
Percentage of
Recoveries to
Total Treated
under each Head.
50.00
31.40
11.70
11.90
10.73
4.47
10. Proximate Causes of Insanity.—I am afraid that the alleged causes of
insanity, as given in the official returns, are not very reliable. They are classified
as physical or moral, and the former causes in this country greatly preponderate
over the latter. 135 cases were said to owe their origin to physical, and 53 to
moral, causes. Of the physical causes of insanity, the abuse of narcotic drugs,
intemperance, epilepsy and hereditary seem to be the most common. Of the moral
causes grief, misfortune, and anxiety :—
Physical Causes.
Narcotic drugs ... ... ...
Epilepsy ... ... ... ...
Other diseases
...
...
...
Congenital
...
...
...
...
Intemperance
...
...
...
Hereditary
...
...
...
...
Puerperal
...
...
...
...
Starvation
...
...
...
...
Blow on the head
...
...
...
Fever
...
...
...
...
...
Syphilitic
...
...
...
...
Disease of brain
...
...
...
Nymphomania ... ... ...
Total ...
26
21
19
17
15
13
8
8
2
2
2
1
1
135
Moral Causes.
Grief ...
...
...
...
...
Misfortune
...
...
...
...
Fear
...
...
...
...
...
Religion
...
...
...
...
Family quarrel
...
...
...
Love and jealousy
...
...
...
Desertion of husband or wife ...
Infidelity
...
...
...
...
Anger
...
...
...
...
Domestic trouble
...
...
...
Total ...
15
9
8
6
5
4
2
2
1
1
53
2
6
ANNUAL REPORT ON LUNATIC ASYLUMS.
11. Causes of Mortality.—The asylums in the Madras Presidency have been
exempt from epidemic diseases during the year. The insane seems to be particularly
liable to phthisis, atrophy, and bowel-diseases.
Regarding the latter the remarks of Dr. Leapingwell show that the tendency
to bowel-diseases is probably much enhanced by the habits of the people of eating
or drinking from any dirty source. Dr. Leapingwell surmises that diarrhœa and
dysentery may be often induced by the patients drinking water from a foul source,
and the practical point to be borne in mind is that foul water, or dirty food, should
not be permitted within the range of lunatics.
Some years ago in the Native Asylum of Calcutta it was found that the
inmates suffered much from worms, and the disease was traced to the mode of
supplying water to the latrines. With a change in the washing arrangements, so
that the lunatics could not drink fouled water, the disease ceased.
In the Madras Asylum arrangements are being made to close the tanks contain-
ing surface water. The ordinary supply from wells is pure and good.
12. There were in all 29 deaths in the Lunatic Asylums; the heaviest ratio of
mortality occurred at Waltair, where most of the cases are of a chronic nature.
The following table shows the causes of death:—
Phthisis pulmonalis ... ... ...
Atrophy of the muscles ... ... ...
Debility ... ... ... ... ...
Dysentery ... ... ... ... ...
Diarrhœa ... ... ... ... ...
Apoplexy ... ... ... ... ...
Valvular disease of heart ... ... ...
Males.
5
5
4
3
2
2
2
Females.
1
...
1
3
1
...
...
Total.
6
5
5
6
3
2
2
GENERAL RESULTS IN EACH ASYLUM.
13. The annexed table shows the more important results in each asylum in
one view. The ratio of recoveries to daily strength was highest in Vizagapatam,
and in this asylum also the mortality was the highest, but taking the admissions,
instead of daily strength, the percentage of recoveries was lowest in Vizagapatam.
The death-rate to daily strength was lowest in Madras, where only 8.82 per cent,
died. In Vizagapatam the mortality to daily strength was 39.2 and in Calicut 13.3.
The Madras death-rate was much below, and that of Vizagapatam above, the average.
In the latter asylum a nurse and patient were apparently both bitten at night by a
venomous snake in one of the rooms, and both were found dead next morning.
ANNUAL REPORT ON LUNATIC ASYLUMS.
7
Table showing the more Important Results in each of the three Asylums.
Asylums.
Madras ... ... ...
Vizagapatam ... ...
Calicut ... ... ...
Total ...
Asylums.
Madras ... ...
Vizagapatam ...
Calicut ... ...
Total ...
Died.
Males.
16
13
6
35
Females.
7
2
1
10
Total.
23
15
7
45
Remained
31st March 1880.
Males.
179
31
34
244
Females.
67
6
13
86
Remaining
31st March
1881.
Males.
195
34
37
266
Females.
72
7
18
97
Total.
267
41
55
363
Total.
246
37
47
330
Admitted during
the Year.
Males.
92
28
17
137
Females.
30
3
12
45
Daily Average Strength.
Males.
192.50
32.41
36.07
260.98
Females.
68
5.84
16.31
90.15
Total.
260.50
38.25
52.38
351.13
Total.
122
31
29
182
Total Treated.
Males.
271
59
51
381
Females.
97
9
25
131
Daily Average Sick.
Males.
17.50
4.29
.61
22.40
Females.
10
0.14
.28
10.42
Total.
27.50
4.43
.89
32.82
Total.
368
68
76
512
Discharged.
A.
Cured.
Males.
37
12
8
57
Females.
12
...
6
18
Total.
49
12
14
75
B.
Transferred to Friends.
Improved.
Males.
13
...
...
13
Females.
6
...
...
6
Total.
19
...
...
19
Not Improved.
Males.
...
...
...
...
Females.
...
...
...
...
Total.
...
...
...
...
C.
Otherwise.
Males.
10
...
...
10
Females.
...
...
...
...
Total.
10
...
...
10
D.
Total.
Males.
60
12
8
80
Females.
18
...
6
24
Total.
78
12
14
104
Percentage of
Cured to Daily Average
Strength.
Males.
19.22
37.02
22.17
21.84
Females.
17.64
...
36.78
19.96
Total.
18.80
31.37
26.72
21.35
Deaths to Daily Average
Strength.
Males.
8.31
40.11
16.63
13.41
Females.
10.29
34.24
6.13
11.09
Total.
8.82
39.21
13.36
12.81
Cured to Admissions.
Males.
40.21
48.25
47.05
41.60
Females.
40.00
...
50.00
40.00
Total.
40.16
38.71
48.27
41.20
Deaths to Admissions.
Males.
17.39
46.42
35.29
25.54
Females.
23.33
66.66
8.33
22.22
Total.
18.85
48.38
24.13
24.72
ANNUAL REPORT ON LUNATIC ASYLUMS.
11
32. Diets and supplies for all the asylums are provided by contractors. The
food in all cases has been good and plentiful, and the best evidence of its sufficiency
is that all the patients whose mental condition improve gain in weight during their
residence in an asylum.
33. The recoveries for dieting patients have been larger than in any previous
year, as have been also the proceeds from manufactures in asylums, as the following
particulars will show. I hope the gardening operations in Madras, where labor is
plentiful, will soon show a considerable advantage to the asylum :—
—
Madras ... ... ... ... ...
Vizagapatam ... ... ... ...
Calicut ... ... ... ... ...
Total ...
Paying Patients,
Municipalities,
Local Boards,
and Hospital
Stoppages.
RS.
9,726
4,884
604
15,215
A.
3
13
2
3
P.
2
6
8
4
Manufacture.
RS.
1,049
143
446
1,640
A.
11
10
13
3
P.
1
5
6
0
34. On the whole I have to record my opinion that the asylums in Madras
have been efficiently and economically managed. It may be that the results of
labor are less evident in the balance sheet than in some other institutions of the
kind which, from local causes, can employ the energies of the patients in profitable
labor. In the Madras Asylum all the clothing is woven and made on the premises,
but we could not introduce stone-breaking or oil-pressing to make a profit, and
the great bulk of the labor in the grounds and garden show no profit.
I have the honor to be,
Sir,
Your most obedient servant,
W. R. CORNISH, Surgn.-Genl.,F.R.C.S., C.I.E.,
Surgeon-General with the Govt. of Madras.
12
ANNUAL REPORT ON LUNATIC ASYLUMS.
ANNUAL MEDICAL REPORT
OF THE
LUNATIC ASYLUM, MADRAS,
FOR THE YEAR 1880-81.
Remained 1st April 1880 ... ... ... ... ... ... ...
Admitted … … … … … …
Readmitted … … … … … …
Discharged recovered … … … … … …
Relieved and handed over to relations … … … … … …
Handed over to police … … … … … …
Transferred to England … … … … … …
Absconded … … … … … …
Died … … … … … …
Remaining 31st March 1881 … … … … … …
246
120
2
49
19
2
6
2
23
267
I HAVE the honor to submit the report of the Madras Lunatic Asylum for the
year 1880-81.
Buildings.—During the past year an upper story has been added to the Super-
intendent's quarters, the roofs of all buildings have been repaired, the Duff's
cooking ranges have been refitted and in part renewed, and the eight single rooms in
the criminal enclosure have been repainted. The buildings are now generally in
good order, but the asphalte floors of some of the cottages require repair.
Population.—On 31st March 1880 there remained 179 males, 67 females, or
together 246 insanes.
—
Europeans ... ... ...
Natives ... ... ...
Total ...
Males.
43
136
179
Females.
26
41
67
Total.
69
177
246
During the year 122 patients have been admitted, 76 discharged, 23 died, and
2 escaped. The total number treated was 368, viz., Europeans 103, Natives 265.
The greatest number in the asylum on any one day was 271 ; the average
daily number was 260½. The number remaining on 31st March of this year was
267—males 195, females 72.
—
Europeans ... ... ...
Natives ... ... ...
Total ...
Males.
51
144
195
Females.
27
45
72
Total.
78
189
267
13
ANNUAL REPORT ON LUNATIC ASYLUMS.
Admissions.— There were 122 admissions—34 Europeans, 88 Natives ; of these
two were readmissions, that is to say, they were discharged and readmitted within
the official year. Twelve others, or 10 per cent. of the whole, had been under treat-
ment in this asylum on some former occasion.
The admissions consist of—
Military
...
...
...
...
...
...
...
...
Criminal ... ... ... ... ... ... ... ...
Patients maintained by Government ... ... ... ...
Do. do. by Local Fund Boards and Municipalities.
Do. partially maintained by relatives ... ... ...
Do. wholly maintained by relatives ... ... ...
Total ...
17
22
47
24
9
3
122
Of the 17 military, 7 were Europeans and 10 Natives; of the 22 criminals, 2
were Europeans and 20 Natives—all males. No female criminals were admitted
during the year. The three patients maintained by relatives were Europeans. Of
the 9 patients partially maintained by relatives, 5 were Natives and 4 were
Europeans.
The admissions were less by 14 than in either of the two previous years,
and the number might have been still further reduced if greater care had been
shown in signing medical certificates and in giving orders for admission. Cases
of chronic dementia should only exceptionally be admitted into a Lunatic Asylum,
as they are incurable and cannot be said to require the restraints of a Lunatic
Asylum.
The new cases admitted were—
Acute mania ... ...
Chronic do. ... ...
Melancholia ... ...
Acute dementia ...
Chronic do. ... ...
Puerperal mania ...
General paralysis ...
Observatio ... ...
Total ...
Military.
7
4
4
1
...
...
1
...
17
Civil.
27
40
5
5
5
1
...
...
83
Criminal.
7
9
4
...
...
...
...
2
22
Types of
Insanity.
Acute mania ...
...
...
Chronic do.
...
...
Melancholia
...
...
Acute dementia ... ...
Chronic do. ... ...
Puerperal mania
...
...
General paralysis of the in-
sane
...
...
...
Observatio
...
...
...
Total ...
41
53
13
6
5
1
1
2
122
Thirty-three per cent. of the admissions were for acute mania against 28 per
cent. last year.
Forty-three per cent. were chronic mania against 42 per cent. last year.
There was one case of general paralysis of the insane.
The patient, an European soldier, a fine powerfully-built man, 33 years of age,
was passed by a Medical Committee as suffering from mania. On admission all the
symptoms of general paralysis in its first stage were well marked, and the disease
progressed rapidly during his stay. I can find no records of any other case having
been under treatment in this asylum. The disease is invariably fatal, and is the
cause of more than 25 per cent. of the whole mortality of Home Asylums. It is
said to be known in natives of India.
The two patients returned as under observation are criminals, who are thought
to be feigning insanity.
Assigned Causes.—The information on this point is very unsatisfactory and
untrustworthy. Of the 122 admissions, 47 are attributed to physical causes, 10 to
moral causes, and in 65 nothing is known.
4
14
ANNUAL REPORT ON LUNATIC ASYLUMS.
Physical.
Intemperance ... ...
Hereditary ... ...
Epilepsy ... ... ...
Narcotic drugs ... ...
Masturbation ... ...
Child-birth
...
...
Other causes ... ...
Total ...
Military.
2
1
...
1
...
...
3
...
Civil.
8
5
5
3
2
3
9
...
Criminal.
...
1
1
1
2
...
...
...
Total.
10
7
6
5
4
3
12
47
Moral.
Civil ... ... ...
Military ... ... ...
Criminal ... ...
6
1
3
Unknown.
Civil
...
...
...
Military ... ...
Criminal ... ...
42
9
14
Moral.—The ten cases assigned to moral cases may all be included under one
heading "grief." Probably one reason why so many cases
are returned as " unknown " is that the insanes have wandered
away from their villages and have no one to give any informa-
tion regarding them, and in others the relatives are too igno-
rant to suggest a possible cause, and often attribute the
disorder to witchcraft. Even in the case of Europeans the
information obtained from relatives is very misleading. This
is in great part owing to their inability to appreciate early symptoms of impor-
tance, and to the common error of dating an attack from the first outbreak of
violence.
To give an instance. A European woman came to see me regarding her son,
who, she said, had been "out of his mind for a week. " On questioning her she
at once admitted that he had been "peculiar for four years," had kept to himself,
and refused to take his meals with the other members of the family, but she still
persisted in saying that he had only been " mad " for a week.
The following shows how little reliance can be placed on the information
contained in the Forms A and C received with patients. A European suffering
from chronic mania was admitted, and in his papers it was stated that the cause of
his insanity was " loss of Government employment," and that there was " no here-
ditary history." I subsequently ascertained that there was a direct hereditary
taint, and that two near relatives had been in this asylum. He had lost his
employment through his extraordinary conduct, and refusal to obey orders, though
no one appears to have suspected insanity at the time.
Age.
7 patients were under 20 years of age ...
79 do. were between 20 and 40 years of age.
31 do.
do.
40 and 60
do. ...
5
do. were above 60 years ... ...
Military.
1
15
1
...
Civil.
5
45
28
5
Criminal.
1
19
2
...
122
The youngest patient admitted was a European child 9 years of age, whose
mental disorder is due to epilepsy. The oldest patient was an East Indian woman
aged 75. Her age and feeble state rendered her unfit subject for an asylum. I
represented this to her friends, and she was removed within a few days of her
admission.
16
ANNUAL REPORT ON LUNATIC ASYLUMS.
Since I have been in charge of this asylum I have found the hospital accom-
modation provided for the males to be quite inadequate for the purpose, and have
been obliged to take over the general cottage nearest to the hospital for the
treatment of a portion of the sick, reserving the former hospital for the more
severe cases. I have also placed Second-class Warder Appavoo in charge of the
hospital. This man, an old sepoy, was one of the two warders mentioned by my
predecessor in his last report as trustworthy, and, as I found him employed as a
peon for carrying letters, I considered his services might be turned to better account
in hospital, and I am glad to say that the nursing and feeding of the sick, which
at one time gave me much cause for dissatisfaction, has under his supervision
greatly improved.
There have been 23 deaths, giving a percentage of 8.82 to average daily
strength and 6.25 to total treated. This is lower than in any year since 1872.
Percentage of Deaths to Average Daily Strength for the last Four Years.
Strength ... ... ...
Deaths ... ... ...
1877-78.
255½
25.83
1878-79.
231¾
20.28
1879-80.
246½
12.98
1880-81.
260½
8.82
The death-rates of the different classes differ much ; those of Europeans and
Native males (civil) are low ; those of Native females and of Native males (criminal)
are high.
Death-rate per cent. to Average Strength.
Europeans
...
...
...
...
...
...
...
Native males (civil)
...
...
...
...
...
...
...
Do.
(criminal) ... ... ... ... ... ... ...
Native females ...
...
...
...
...
...
...
4.3
7.28
16.32
13.52
I will endeavor to explain the high death-rate of the two last when describing
the causes of death.
Causes of Death.
Phthisis pulmonalis ...
Dysentery ... ... ...
Pleurisy ... ... ...
Pneumonia ... ... ...
Apoplexy ... ... ...
Epilepsy ... ... ...
Valvular disease of heart ...
Diarrhœa ... ... ...
General debility ... ...
Atrophy ... ... ...
Exhaustion of mania ...
Drowning ... ... ...
Compound fracture of skull.
Total ...
Number.
6
4
1
1
2
1
1
1
2
1
1
1
1
23
Civil.
5
3
1
1
1
1
...
1
2
1
...
1
...
17
Military.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Criminal.
1
1
...
...
1
...
1
...
...
...
1
...
1
6
There were only 3 deaths this year from general debility and atrophy, as
compared with 9 last year and 20 the year before. Phthisis pulmonalis caused 6
deaths. One patient was suffering from the disease when admitted, and the other
5 had all been more than two years in the asylum, one of them over 10 years.
Dysentery caused 4 deaths. I made post mortem examination in every case and
found extensive ulceration, but nothing to lead me to suppose that it was other than
dysenteric. I mention this as I find that many deaths in former years have been
returned as from " ulceration of bowels."
20
ANNUAL REPORT ON LUNATIC ASYLUMS.
is under the heading " Diets." This is owing to the lower contract rates and to a
very greatly diminished issue of " extras." Contingencies show a decrease of
Rs. 1,800 and odd, and wines and spirits a decrease of Rs. 240.
Financial Condition.
—
Medical Officer's salary
...
...
Medical Subordinate's salary ...
Servants' wages ... ... ...
Europe medicines ... ... ...
Clothing and bedding ... ... ...
Dieting sick ... ... ... ...
Wines and spirits ... ... ... ...
Perishable articles and contingencies...
Total ...
1879-80.
RS.
8,731
3,794
9,999
508
181
30,721
1,333
4,704
59,976
A.
4
14
9
2
12
14
12
14
3
P.
5
0
7
0
8
0
2
8
6
1880-81.
RS.
7,963
3,398
10,075
233
131
19,641
787
2,875
45,105
A.
3
8
11
10
3
3
4
1
13
P.
6
0
5
8
0½
2
0
5½
3
Increase.
RS. A.
P.
...
...
76 1 10
...
...
...
...
...
76 1 10
Decrease.
RS.
768
396
A.
0
6
P.
11
0
...
274
50
11,080
546
1,829
14,946
7
9
10
8
13
8
4
7½
10
2
2½
1
The average monthly cost (excluding the Superintendent's pay) has been—
European
...
...
...
...
...
...
Native
...
...
...
...
...
...
...
RS.
18
9
A.
6
8
P.
9
3
Average Monthly Cost (excluding pay of the Superintendent) for the last Three Years.
1878-79
...
...
...
...
1879-80 ... ... ... ...
1880-81
...
...
...
...
Europeans.
RS.
28
26
18
A.
14
0
6
P.
6
6
9
Natives.
RS.
16
14
9
A.
7
13
8
P.
5
11
3
Total Annual Cost of an Insane (European and Native) under the various headings for the last
Two Years.
—
Establishment ... ... ...
Diets ... ... ...
Clothing and bedding ... ...
Bazaar medicines and contingencies.
Europe medicines ... ... ...
Total ...
1879-80.
RS.
91
130
3
19
2
245
A.
6
0
0
7
1
15
P.
1
8
0
11
0
8
1880-81.
RS.
82
78
4
11
0
177
A.
4
6
9
0
14
3
P.
8
8
3
7
4
6
—
Expenditure ... ... ... ...
Receipts from Local Fund Boards
and Municipalities, from paying
patients, and from hospital stop-
pages ... ... ... ...
1879-80.
RS.
59,976
A.
3
P.
6
9,986 1 0
1880-81.
RS.
45,105
A.
13
P.
3
9,726 3 2
The expenditure last year as compared with receipts was in the proportion of
6 to 1 ; the expenditure this year as compared with receipts is rather less than
5 to 1.