6
ANNUAL REPORT ON LUNATIC ASYLUMS.
10. Causes of Mortality.—The proximate causes of death during the year are
indicated in the order of their frequency in the following table. They are princi-
pally diseases of debility, a class of affections to which insanes are specially liable;
for in many cases progressive decline of the bodily accompanies progressive
decadence of the mental powers. Atrophy of tissue in the case of native patients
frequently sets in and, despite tonic treatment and improved diet, the insanes
gradually sink, diarrhoea or general dropsy being in most cases the immediate
precursors of death:—
Disease.
Atrophy
...
...
...
...
...
...
Diarrhœa ...
...
...
...
...
...
Dysentery...
...
...
...
...
...
Debility ...
...
... ... ... ...
Valvular Disease of Heart
...
...
...
Epilepsy
...
...
...
...
...
...
General Dropsy
...
...
...
...
...
Males.
31
8
5
4
3
2
2
Females.
8
2
...
1
...
2
...
Total.
39
10
5
5
3
4
2
Although the insane population escaped the incidence of cholera and small-
pox during the past year, yet Dr. Nanney is of opinion that they suffered more or
less from the depressing influences of the unhealthy season.
11. Alleged Causes of Insanity.—The causes of insanity are generally grouped
under the heads Physical and Moral. The first of the following tables shows
that of 138 cases which could be traced to physical causes, 41 or 29.71 per cent.
were hereditary or congenital. Of the various causes which induce a proclivity
to insanity none are so common yet so difficult of detection as hereditary predis-
position ; next in frequency come narcotic drugs, epilepsy, intemperance and
puerperal or sexual disease ; a few cases are traceable to blows on the head, to
falls or to sunstroke. If we throw into one group such toxic agents as narcotics
and alcohol we shall find that the combined class accounts for 34 per cent, of the
cases in 1877-78 and for 37 per cent. in 1876-77. Unlike hereditary and congeni-
tal causes these causes are remediable. As drinking habits become more general
in India—and I fear that this is what we must expect as regards this Presidency
—intemperance will gradually assume a more important position than it does at
present among the physical causes of insanity. A frequent cause as well as
concomitant of insanity is epilepsy ; it is the close connection of this disease with
insanity which, in ordinary circumstances, projects so dark a shadow over the
future of the epileptic. Epilepsy is common among insane Natives. Insanity is
traced in 49 cases to moral causes. The causes indicated are primarily or second.
arily of an emotional and depressing character. In the case of criminal insanes
the physical are to the moral causes of insanity as 3 to 1.
Physical Causes.
Narcotic drugs... ... ...
Congenital
...
...
...
Hereditary
...
...
...
Epilepsy
...
...
...
...
Other diseases
...
...
...
Intemperance
...
...
...
Puerperal
...
...
...
Blow on the head
...
...
...
Fever ... ... ... ...
Disease of brain
...
...
...
Nymphomania... ... ...
Syphilis...
...
...
...
Fall
...
...
...
...
Sunstroke
...
...
...
Cranial deformity
...
...
Total ...
36
23
18
17
13
11
7
3
3
2
1
1
1
1
1
138
Moral Causes.
Grief
...
...
...
...
Domestic trouble
...
...
Misfortune
...
...
...
Religion ... ... ... ...
Fear
...
...
...
...
Anger
...
... ... ...
Desertion of husband or wife ...
Love and jealousy
...
...
Debt
...
...
...
...
Total ...
14
8
8
5
4
3
3
3
1
49