ANNUAL REPORT ON LUNATIC ASYLUMS.
15
should be sustained without damage, and in various trials steadfastness and trust
still preserved."
It is most difficult, however, to trace the indications of hereditary predisposi-
tion, owing—
Firstly, to the insufficient data furnished with each case, of which, indeed,
the larger proportion are simply recorded as " unknown."
Secondly, to wilful suppression of facts by relatives, in whom a morbid
sensitiveness on the subject is most common.
Thirdly, as has been previously pointed out, to the interchangeable character
of nervous diseases, such as hysteria, epilepsy, or neuralgia.
An analysis of Form 7 yields the following results:—
Moral ... ... ... ... ... ...
Physical
...
...
...
...
...
...
Unknown
...
...
...
...
...
...
25
102
232
It is evident, therefore, that no conclusions can be arrived at with any degree
of precision, the large number of cases which remain wrapped in mystery rendering
figures unreliable. It may, however, be observed that, of the known cases, the
larger number are congenital, viz., 18, none of whom are criminals. In these cases
recovery is rare; indeed, it is, in most instances, that last stage of degeneration,
which happily ends in extinction of the race. Next in number are those cases
caused by indulgence in narcotic drugs, 16, in which the proportion of cures is
one-fourth.
Intemperance comes next, 15, of which one-third recovered. In these two
classes it frequently occurs that the obscuration of reason is due only to the
exciting cause which, when removed by the restraint of an asylum, the effect
ceases.
To all, however, who are acquainted with the inveterate nature of intemperate
habits, it will be evident that many of these will resume them on being exposed to
temptation, especially where the failing is inherited, and each attack will bring
nearer the fatal end, until the sufferer sinks into hopeless imbecility.
Of 12 epileptics, 4 have recovered, but the permanency of the cure may, in
some cases, be doubted.
Under hereditary 9 cases are recorded, but no reliance can be placed on this
number, as could the true histories be known, many not only of those at present
classed as " unknown," but also of those placed under other headings would be
assigned to this cause.
Of moral causes, family quarrels appear to have been most effectual in
overthrowing the balance of the weak and disordered mind, for only so can it be
regarded as (again to quote the words of the accomplished Dr. Conolly), " the
infirmly sensitive mind bending under the weight of unexpected and sudden trial."
7. The percentage of cures for the present year is 41.102 on admissions and
24.26 on average population.
This falls short of last year, which was the highest on record. It is, however,
impossible that so high a percentage as 70.09 on admissions could be kept up,
and the number of cures is always liable to fluctuate with the nature of the cases
admitted, and various considerations of age, duration of disease, &c.
The present numbers can bear comparison with those of English asylums,
and also the number of cures has only twice been exceeded in the Madras Asylum
during the past ten years. It may, therefore, be regarded as favorable, more
especially as the death-rate is lower. It may also be observed that in English
asylums a large number of those discharged as cured are readmitted. A recent
writer in the 19th century estimating the number readmitted as .26 per cent.,
whilst in the present year we have only one readmission, and during the past
ten years only in all 22 readmissions. It may, therefore, be presumed that after
deducting readmissions our percentage of cures would contrast most favorably
with English asylums.
Of the various types of insanity, the cures are most numerous in acute mania,
being over one-fourth of the total treated, whereas in chronic mania only about