3
nution of mental power and by a muscular paralysis which gradually increases and
invades the whole muscular system, while the mental derangement is generally
marked by an exaggerated feeling of personal power and importance. It is
usually, though not always, rapidly fatal, most cases running their course in about
two years. The case in point is one of simple chronic mania in an old man who
was admitted ten years ago, and who has been for the last three years crippled in
his lower extremities by rheumatism. During the last month of the year all cases
have been carefully examined and re-diagnosed, and the resulting changes will be
shown in the report of the following year.
The two cases returned as "not insane" are criminals acquitted on the ground of insa-
nity but considered to be sane when replaced in the asylum. The majority of
recoveries were as usual from acute mania."
Statement No. 7.
Assigned causes of insanity.
11. As usual, the cause assigned for every particular case of insanity must
be accepted as open to much question, and this statement
can only be said to show approximately the real figures
under the different heads. What Dr. Beatson says as to
difficulty in filling up this statement has doubtless much weight:—
"This return is not put forward nor to be accepted as absolutely correct. It is very pro-
bably correct so far as physical causation is concerned, less reliable on the subject
of moral causes, and at least honest when it declares the causes to be unknown.
"To ascertain the cause of insanity is a difficulty to the most expert, inasmuch as men-
tal aberration does not in general depend on any one cause, but is the outcome
of many concurrent causes.
"The grouping of causes in a seemingly strange manner, such as so many cases being
shown as due to grief and so many due to loss of money and relations, is due to
the exigencies of the form, which gives separate columns for grief and fear, and
only allows two blanks in which all other moral causes must be recorded."
Statement No. 8.
Diseases.
12. There is not much to note on in this statement. The year generally
was a most healthy one, and the diseases are none of
them of an unusual type. One point only I would remark
on, and that is with regard to paragraph 18 of my last year's report, wherein the
absence of ague at Nagpur and of "continued fever" in the Jubbulpore asylum was
commented on. In this year's statements none of the latter disease is shown at
Nagpur, whilst 13 cases of ague are said to have occurred. This strengthens the
argument that the classification of disease would appear to be to a great extent
arbitrary.
Statement No. 9.
Cash account.
Establishment.
13. This statement shows the cost of each institution during the past year.
There has been a decrease under the head of establish-
ment, both at Nagpur and at Jubbulpore, caused at
Nagpur by the substitution of a 2nd Class Hospital As-
sistant for a 1st Class man as Deputy Superintendent ;
and at Jubbulpore in consequence of the house rent allowed in previous years for
the Deputy Superintendent being no longer required, the lunatics having in 1876
constructed excellent quarters at the asylum for the Deputy Superintendent.
Diet.
Diet is somewhat more, in consequence of the increase of patients and also
in prices of all articles of food and drink.
Clothing.
Clothing has increased in cost as compared with 1876, but this, as shown by
the Superintendents in their reports, was unavoidable,
as the supply of the former year had been insufficient,
and had to a great extent to be entirely renewed.
The fact is as regards clothing that no safe comparison can be made be-
tween any two consecutive years, because it may not be till the close of the year
that the necessity for renewal may become apparent.
The expenditure on account of such renewal would not be a recurring charge
for possibly 18 months or more, and thus there would in the year following be