NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
ANNUAL REPORT ON LUNATIC ASYLUMS.
5
7. In Appendix No. IV will be found a table showing the occupation of the
entrants to the asylum during the year 1877-78. In 66 instances, that is in 44 per
cent., the patients either had no occupation or their occupation was unknown. In
the case of the remaining 34 per cent. all, nearly without exception, belong to the
lower and uneducated classes of society.
8.
Ages on Admission.
Statement showing the Ages of the several Patients admitted during 1877-78 with the rate per cent.
at different periods of life to Total Admissions.
Age.
Under 20 years
...
...
20 to 40 „
...
...
40 to 60
„
...
...
Upwards of 60 years
...
...
Total Admissions ...
Sex.
Males... ...
Females... ...
Males... ...
Females... ...
Males... ...
Females... ...
Males ... ...
Females ... ...
...
Admitted.
11
6
79
21
23
7
1
2
150
Rate per cent. to Total
Admissions.
11.33
66.66
20
2
...
The results of this table correspond generally with those of the preceding
year and harmonize, in all essential particulars, with the returns of Western
Asylums. The tendency to insanity is most distinctly marked in the third and
fourth decennia of life; it is less marked between the 40th and 60th years of age,
still less marked under 20 years of age, and reaches its minimum as old age
advances. The returns for 1877-78, compared with the table of Drs. Bucknill and
Tuke, show an approximate correspondence of results :—
Age.
Under 20 years of age ... ... ... ...
20 to 40 „ ... ... ... ...
40 to 60
„
...
...
... ...
Upwards of 60 years of age
...
...
...
England.
Percentage.
13.73
52.53
26.5
7.24
Madras.
Percentage.
11.33
66.66
20.0
2.0
9. Of 150 admissions 76 were cases of acute mania, 32 of chronic mania, 9 of
melancholia, 14 of acute dementia, 8 of chronic dementia, 5 of idiocy, 1 of imbecil-
ity and 2 of puerperal mania; one patient was found not to be insane and 2 were
" placed under observation."
—
Acute mania ... ... ...
Acute dementia
...
...
Chronic mania ... ... ...
Melancholia
...
...
...
Chronic dementia ... ...
Percentage
of Recoveries
to total
treated under
each head.
33.96
28.12
15.28
13.51
4.49
Of the aggregate treated in the asylums for acute mania, one-third recovered,
the recoveries from other types of insanity
being less frequent as the marginal table
shows. Acute mania is the form of insanity
most amenable to treatment, particularly when
it occurs in young persons and is early
detected. Dr. Winslow has stated that, under
favorable circumstances, the recoveries may
be as high as " 70 if not 80 per cent;" less
sanguine authors, however, estimate the pro-
bable recoveries at from 50 to 60 per cent.
In this, as in other forms of insanity, the chances of recovery lessen in the
direct ratio of the chronicity of the disease. In speaking of recoveries from attacks
of insanity and in estimating their value the tendency to relapse, which marks
most deranged conditions of the mind, should not be overlooked.
2
ANNUAL REPORT ON LUNATIC ASYLUMS.
7
The principal causes of insanity among the criminal populations of the asylum
are given as follows :—
Physical, 6 (5 men and 1 woman).
Disease of brain
...
...
...
...
...
...
Epilepsy
...
...
...
...
...
...
...
Intemperance
...
...
...
...
...
...
Narcotic drugs
...
...
...
...
...
...
Puerperal
...
...
...
...
...
...
...
Other diseases
...
...
...
...
...
...
Total ...
1 (man).
1 (do.)
1 ( do.)
1 ( do.)
1 (woman).
1 (man).
6
Moral, 1 (man).
Grief ... ... ... ... ... ... ...
Total ...
1 (man).
1
12. The subjoined table shows the more important numerical facts in connec-
tion with each of the lunatic asylums during the year under report. The Madras
Asylum presents a high death-rate and a high recovery-rate based on a high
aggregate of patients, the Vizagapatam Asylum shows a moderate death-rate
based on a small aggregate, and the Calicut Asylum shows a moderate death-rate
and a high recovery-rate based also upon a small aggregate:—
8
ANNUAL REPORT ON LUNATIC ASY
Table showing the more Important Results in each of the three Asylums.
Asylums.
Madras
...
...
Vizagapatam
...
...
Calicut
...
...
Total...
Remained
31st March 1877.
Males.
209
33
33
275
Females.
67
8
13
88
Total.
276
41
46
363
Admitted during
the Tear.
Males.
84
19
11
114
Females.
26
3
7
36
Total.
110
22
18
150
Total Treated.
Males.
293
52
44
389
Females.
93
11
20
124
Total.
386
63
64
513
Discharged.
A.
Cored.
Males.
56
4
7
67
Females.
22
2
6
30
Total.
78
6
13
97
B.
Transferred to Friends.
Improved.
Males.
11
1
...
12
Females.
1
...
...
1
Total.
12
1
...
13
Not Improved.
Males.
1
...
...
1
Females.
2
...
...
2
Total.
3
...
...
3
C.
Otherwise.
Males.
4
1
...
5
Females.
...
...
...
...
Total.
4
1
...
5
D.
Total.
Males.
72
6
7
85
Females.
25
2
6
33
Total.
97
8
13
118
Asylums.
Madras ... ...
Vizagapatam ... ...
Calicut
...
...
Total ...
Died.
Males.
51
7
5
63
Females.
15
1
1
17
Total.
66
8
6
80
Remaining
31st March
1878.
Males.
170
39
32
241
Females.
53
8
13
74
Total.
223
47
45
315
Daily Average Strength.
Males.
193.5
38.56
33.82
265.88
Females.
62
8.58
13.39
83.97
Total.
255.5
47.14
47.21
349.85
Daily Average Sick.
Males.
12.25
4.42
1.42
18.09
Females.
3.25
.71
.56
4.52
Total.
15.50
5.13
1.98
22.61
Percentage of
Cured to Daily Average
Strength.
Males.
28.94
10.37
20.69
2519
Females.
35.48
23.31
44.80
35.72
Total.
30.52
12.72
27.53
27.72
Deaths to Daily Average
Strength.
Males.
26.35
18.15
14.78
23.69
Females.
24.19
11.65
7.46
20.24
Total.
25.83
16.97
12.70
22.86
Cored to Admissions.
Males.
66.66
21.05
63.63
5.877
Females.
84.61
66.66
85.71
83.33
Total.
70.90
27.27
72.22
64.66
Deaths to Admissions.
Males.
60.71
36.84
45.45
55.26
Females.
57.69
33.33
14.28
47.22
Total.
60
36.36
33.33
53.33
12
ANNUAL REPORT ON LUNATIC ASYLUMS.
The total increase of expenditure in 1877-78 over that of 1876-77 was
Rupees 818-11-1. The increase took place chiefly in the items of pay of establish-
ment, diets including wines, perishable articles, contingencies and European
medicines. On the other hand there was a marked reduction in the expenditure
under the heads of bedding and clothing.
The following table shows the average cost of maintenance per patient in each
of the three asylums for the last two years :—
Asylums.
Madras ... ... ... ... ...
Vizagapatam ... ... ... ...
Calicut ... ... ... ... ...
1876-77.
RS.
168
128
82
A.
4
12
5
P.
7
10
9
1877-78.
R.
161
125
120
A.
15
5
4
P.
1
7
8
It will be observed that the cost has decreased slightly both in Madras and
Vizagapatam but that it has increased in Calicut. The increase in Calicut is due
to the improved diet which was rendered necessary by the physical condition of the
patients at the beginning of the year. In Table XI are given the receipts and expen-
diture on account of manufactures in 1877-78. The profits realized in Madras were
Rupees 581-9-6 as compared with the no-profit return of the previous year, and in
Calicut the excess credit amounted to Rupees 145-3-9 as compared with Rupees
138-15-0 in 1876-77. These figures take no account of much useful work done in
connection with gardens, the conservancy of the grounds, &c.
I have the honor to be,
Sir,
Your most obedient Servant,
GEORGE SMITH, M. D. ,
Surgeon- General, I.M.D.
ANNUAL REPORT ON LUNATIC ASYLUMS.
13
ANNUAL MEDICAL REPORT
OF THE
LUNATIC ASYLUM, MADRAS,
FOR THE YEAR 1877-78.
Remained ... ... ... ... ... ... ...
Admitted
...
...
...
...
...
...
...
Discharged ... ... ... ... ... ... ...
Transferred ... ... ... ... ... ... ...
Died ... ... ... ... ... ... ... ...
Remaining ... ... ... ... ... ... ...
Average daily number of sick in hospital
...
...
...
Do.
do.
of convalescent ... ... ...
Died without receiving medical treatment
...
...
...
276
110
97
...
66
228
255½
...
...
I HAVE the honor to submit the report on the Madras Lunatic Asylum for the
official year 1877-78.
2. The two cottages for superior patients have been handed over to me and
suitably furnished and are now occupied, proving most useful for the accommo-
dation of patients of a better class.
No new buildings have been erected owing to want of funds caused by the
heavy expenditure connected with the famine. Government have been pleased to
sanction an upper story to the Superintendent's quarters, which, it is hoped, will
be erected as early as possible after the commencement of the official year. This
is much needed for the protection of the family of the Superintendent, who have
at present no place of security in the event of dangerous patients escaping
from their wards. The hot season is the time when this class of patients are
usually admitted. The want of a latrine for the servants of the medical and other
subordinates is much felt, and one could be erected on open ground beyond the
dead-house, where it could be daily inspected, and in that position would not prove
a nuisance to any one and could be used by the asylum servants generally. This
is a measure that should be adopted for the better sanitary condition of that
portion of the grounds which at present are only kept in order by constant
vigilance.
Some extra godowns and a cook-room are also needed by the subordinates
and head European attendants.
The subject of the drain, gates in the cook-room, and female enclosure have
been specially brought to notice and will shortly be attended to.
The gloomy appearance of the block of 9 and 12 rooms to which I alluded
in my last annual report, caused by the walls being tarred to a considerable height,
might be obviated by removing the tar and substituting a coat of paint, which has
proved successful in the criminal enclosure. I am still of opinion, however, that
glazed tiles, as recommended by me last year, would prove more lasting, cheerful,
and cleanly. Two permanent wells have been constructed, one in the criminal
enclosure and the other near the Superintendent's quarters ; both yield a liberal
supply of good water, there being a stratum of potable water along that portion
of the grounds. The two other wells sanctioned during the water-famine were
abandoned on the setting in of the monsoon and the temporary pot-wells filled in.
4
22
ANNUAL REPORT ON LUNATIC ASYLUMS.
Messrs. Morris and Bruce, conduct the duties of their trying post in a creditable
manner. Mr. Bruce was appointed in November last in lieu of Mr. Coyne, who
resigned in order to take up the more lucrative post of Jailor at Cuddapah. He
is a steady, well-behaved man, and will, I trust, as he gains more experience, prove a
good and trustworthy attendant.
The two 1st-Class East Indian Keepers, Berryman and Muriel, work exceedingly
well. To Mr. Berryman is entrusted the care of the criminal enclosure. He was
appointed in February last vice Bruce promoted to Head European Attendant. So
far he has done well and is kind and attentive to the patients and takes great
interest in the weaving. His pay of Rupees 15 per mensem is a sum wholly inade-
quate to induce any good man to come forward; and Berryman, like Bruce, is only
holding it until something better turns up.
It is to be regretted that so important a post is only made a stepping-stone of
and taken as a temporary measure; and no fewer than three men accepted the berth
for a time and resigned owing to the nature of the work and the small salary. I
trust that Government may take the circumstances of the case into their very
favorable consideration and increase the pay of the Sergeant in charge of the
Criminal Jail from Rupees 15 to Rupees 30, considering the satisfactory manner in
which the weaving is progressing and the large saving that is now being effected by
the manufacture of excellent bedding and clothing.
The Steward's Department is working satisfactorily, and the bedding and clothing
kept in a much better condition than hitherto. The system of book-keeping in
connection with this department, introduced by the Surgeon-General, answers
admirably, and no difficulty is experienced in working it.
The night watchmen work fairly well. They require constant supervision.
The native warders are, on the whole, a very indifferent set of men. A few
work well, but I am sorry to say very little reliance can be placed in them generally.
They require constant looking after. Three of them are weavers by trade. One
is a brick-layer and several are experienced gardeners. The official visitors have
regularly inspected the asylum monthly.
Vaccination has been satisfactorily carried on.
I certify that the orders respecting the custody of poisonous drugs issued by
the Principal Inspector-General, Indian Medical Department, dated 23rd January
1863, are carefully carried out.
MADRAS,
1st April 1878.
(Signed)
L. C. NANNEY, Surgeon-Major,
Superintendent, Lunatic Asylum.
A most interesting report. Surgeon-Major Nanney evidently has all the
details of his charge well under his personal observation at all times.
MADRAS,
24th April 1878.
(Signed) W. J. VANSOMEREN, M.D.,
Deputy Surgeon- General, I.M.S.,
Presidency and Northern District.
ANNUAL REPORT ON LUNATIC ASYLUMS.
23
ANNUAL REPORT
OF THE
LUNATIC ASYLUM, WALTAIR,
FOR THE YEAR 1877-78.
Remained ... ... ... ... ... ... ... ...
Admitted ... ... ... ... ... ... ... ...
Total treated ... ... ... ... ... ... ... ...
Discharged ... ... ... ... ... ... ... ...
Transferred ... ... ... ... ... ... ... ...
Died
...
...
... ... ... ... ... ...
Remaining ...
41
22
63
7
1
8
47
THERE have been 63 cases under treatment in this asylum during the past
year. Of these 33 males and 8 females remained from the previous year, and there
were 22 admissions, viz., 19 males and 3 females. Of the 63 cases that were treated, 7
were discharged, viz., 5 males and 2 females; 1 male criminal lunatic was transferred
to the Madras Asylum; 8 died, viz., 7 males and 1 female; and there are now 47
cases under treatment.
Admissions.—Twenty-two insanes were admitted during the year under review;
of these 19 were males and 3 were females ; of the former 6 were criminal lunatics,
and the crimes of which they were guilty were as follows : mischief by fire 2,
murder 2, causing hurt with a dangerous weapon 1, and grievous hurt 1 ; the
cause of insanity attributed to these admissions was in 1 physical, 2 moral, and in 19
it was unknown (vide Form No. 7 of Annual Return). In 16 of the admissions the
disease has been of long standing; in 3 military lunatics it is said to have appeared
three months prior to the patients being sent to the asylum, in 3 other lunatics to
have been of two and three months' duration.
The criminal ward was not overcrowded during the year, but contained on
in average 8.19 inmates, and the largest number shut up on any one night during
the year was 10. The civil cottages likewise were not overcrowded.
Discharges.—Of the 7 cases discharged, 6 were cured and 1 improved and was
made over to the care of his relatives ; the percentage of cured to total admissions
27.27 and to daily average strength 12.76.
Deaths.—The death-rate has been 17.81 to daily average strength. I attribute
the high death-rate amongst the insanes to organic diseases and impaired constitu-
tions, the result, in most cases, of destitution and starvation while wandering
about prior to admission. Of the 8 deaths that occurred during the year, 7 were
males and 1 a female. Of the males 1 died from debility with atrophic wasting,
from pneumonia, 2 from valvular disease of heart, 1 from acute Bright's
disease, 1 from dysentery, and 1 from general dropsy, the result of renal disease;
one female died from fatty degeneration of the heart.
Transfers.—Criminal lunatic P. Ramudu was transferred to the lunatic
asylum at Madras under Order of Government, No. 1,583, of 4th July 1877. One
male criminal lunatic who had quite recovered was discharged from the asylum
and sent under Police escort to Masulipatam to make her defence.
ANNUAL REPORT ON LUNATIC ASYLUMS.
25
Conduct of warders and servants has been upon the whole fair with three
exceptions, a male warder, female warder, and female cooly who were dismissed
and prosecuted for striking patients. I hope these dismissals and prosecutions—in
each case a conviction was obtained—will act as a deterrent against the commission
of such offence in future.
WALTAIR,
1st April 1878.
(Signed)
J. SMITH, Surgeon,
Superintendent, Lunatic Asylum.
(Signed)
W. J. VANSOMEREN, M.D.,
Deputy Surgeon-General, I.M.S.,
Presidency and Northern District.
7
26
ANNUAL REPORT ON LUNATIC ASYLUMS.
ANNUAL REPORT
OF THE
LUNATIC ASYLUM, CALICUT,
FOR THE YEAR 1877-78.
Remained
...
...
...
...
... ... ...
Admitted during the year ... ... ... ... ... ...
Discharged cured ... ... ... ... ... ... ...
Cured and detained in the asylum ... ... ... ...
Total treated ... ... ... ... ... ... ...
Transferred to friends...
... ... ... ... ...
Died
...
...
...
...
...
...
...
...
Remaining on 31st March 1878 ... ... ... ...
Average strength for the year ... ... ... ...
Do. sick in hospital
...
... ... ... ...
Percentage of cures to average strength ... ... ...
Do.
to admission ... ... ... ...
Deaths to average strength ... ... ... ... ... ...
Do. to admission ... ... ... ... ... ... ...
46
18
13
1
64
...
6
45
47.21
1.98
27.53
72.44
12.76
33.33
THE above figures show that there is a decrease in admissions during the past
year. The deaths have been much less than the previous year. The recoveries
have been nearly double.
2. The buildings are in a fair state of repair. There have been six rooms in
the male enclosure and three in the female erected for violent patients by the
Public Works Department.
3. The water-supply is at present very deficient and always is so in the hot
weather, which causes great inconvenience ; the patients have to go about 500 yards
from the asylum to get water. It would be a great advantage if another well was
dug in the compound. The drainage of the asylum is natural.
4. The health of the inmates has been very good. The average daily sick in
hospital has been only 1.98.
Since the close of last year 35 patients have gained in weight, and 10 lost;
there was sufficient cause for those that did lose weight: all but 4 suffered from
disease.
The subjoined table shows the remained, admitted, discharged, died, &c.
(civil and criminal), during the year :—
Remained ... ... ...
Admitted
...
...
...
Discharged ... ... ...
Transferred to friends ...
Died.
...
...
...
...
Remaining ... ... ...
Civil.
Males.
24
11
6
...
3
26
Females.
10
6
6
...
...
10
Criminal.
Males.
9
1
1
...
2
7
Females.
3
...
...
...
1
2
Total.
46
18
13
...
6
45
ANNUAL REPORT ON LUNATIC ASYLUMS.
27
Admissions.—Eighteen cases were admitted during the year, 11 males and 7
females; of these there was only one criminal male.
Discharged.—Seven males and 6 females were discharged cured ; of these one
criminal male was released by the Order of Government, dated 11th July 1877,
No. 1,626.
The following table shows the ages, duration of disease prior to admission, and
residence in the asylum of the discharged cured:—
Name.
Choyee ... ...
K. Pathma ...
Kunnen ...
Andy ... ...
Kunjoothummah.
Unnerikutti ...
Parvathi ...
Sex.
M.
F.
M.
M.
P.
M.
F.
Duration of
Disease prior to
Admission.
Y.
0
M.
3
D.
0
Unknown.
Do.
Do.
Do.
Do.
Do.
Residence
in the
Asylum.
Y.
3
2
2
1
1
1
0
M.
3
10
1
4
1
0
10
D.
1
14
13
24
0
22
14
Name.
C. Parungachi ...
Lona ... ...
P. N. Moideen ...
Chayi ... ...
Durkhas ...
Kali ... ...
Sex.
F.
M.
M.
M.
F.
F.
Duration of
Disease prior to
Admission.
Y. M. D.
Unknown.
0 2 0
Unknown.
Do.
Do.
Do.
Residence
in the
Asylum.
Y.
0
0
0
0
0
0
M.
10
7
7
4
4
3
D.
21
28
16
28
15
15
5. Died.—There have been 6 deaths as compared with 31 last year; of these 2
males were admitted in a " very bad " state, and were not more than five months
in the asylum before they died from atrophy and dropsy.
The subjoined table shows the ages, the state of health on admission, the
immediate cause of death, &c :—
Name.
Navoo ... ...
Peetha ... ...
Subba ... ...
Bauppoo ... ...
Modeen Berri ...
Sadasiva Reddi ...
Age.
Y.
34
28
47
14
42
35
Sex.
F.
M.
M.
M.
M.
M.
Residence in
the Asylum.
Y.
1
0
3
0
0
1
M.
0
4
8
1
11
0
D.
21
12
19
22
20
14
State of Health on
Admission.
Fair ... ...
Very bad ...
Good ...
Very bad ...
Good ...
Indifferent ...
Disease.
Mania, acute.
Dementia, do.
Do. longa.
Do. ...
Mania longa.
Melancholia ...
Immediate Cause
of Death.
Cholera.
Atrophy.
Genl. debility.
Dropsy, heart.
Genl. dropsy.
Do. atrophy.
6. The treatment has consisted in subduing great mental excitement by large
cases of bromide of potassium, hydrate of chloral, morphia, and lately tincture
digitalis has been tried.
No further treatment has been resorted to with the exception of occupying
their minds by gardening, weaving, cotton-spinning, &c, and paying great attention
their bodily health. As soon as they are found to be failing in health, tonics,
extras, and stimulants are ordered.
Four hundred and forty-seven and a-half yards of excellent dungaree have been
repared by the inmates assisted by a warder; value Rupees 139-13-0 at 5 Annas a
rd.
Eight coir rolls have been made; value Rupees 18 at Rupees 2-4-0 per roll.
Amusements.—A Native band plays in the asylum now about once a fortnight,
and sweetmeats, fruits, betel, &c., handed round. This seems to have had a good
ect on many of the inmates; their excitement has often been subdued by a threat
at they would not be treated to the band, &c. Some of the inmates however do
seem to care anything about it.
7. The diet scale is appended. There is a change in the system of contract as
all extras and stimulants are charged for separately.