NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
2
Health of the inmates of
the Asylum.
In the Jubbulpore Asylum the daily average strength was about the same
in both years.
In both Asylums there was accommodation enough and to spare for the
patients under treatment throughout the year.
3. The daily average of sick patients during the
past four years is given below :—
1882 ...
1883 ...
1884 ...
1885 ...
Nagpur.
10.41 ...
9.45 ...
6.63 ...
11.19 ...
Jubbulpore.
2.35
1.53
1.43
1.74
The difference between the figures for the two Asylums is far beyond any-
thing that could be accounted for by the difference in daily average strength,
and calls for explanation. It is possibly due to some difference in the system of
recording admissions to hospital or to medical treatment.
In both Asylums there was more sickness than usual, and in both the death-
rate was higher than in the preceding year. The Superintendent of the Nagpur
Asylum observes that the patients under his charge were a " sickly, weakly lot
" in poor health," and that there was nothing special in the conditions either of
the season or of the Asylum to cause an increase in the sick and death-rates.
The Superintendent of the Jubbulpore Asylum writes that although he had more
sickness than usual to deal with, yet "none the less the Asylum was very
" healthy, and the illness generally very trivial." The Nagpur Asylum, it may
be mentioned, stands on a healthy, open site, and its situation would appear to
have nothing to say to the prevalence of sickness among the inmates.
Results of treatment.
4. The number of cases wholly or partially cured and the percentages of
complete cures effected to daily average strength and
to admissions during the year are shown for two years
below :—
Nagpur ...
Jubbulpore ...
1884
1885
1884
1885
Number
cured and
discharged.
5
12
8
6
Number
improved
and dis-
charged.
2
10
...
1
Percentage of cured
To daily
average
strength.
3.77
7.42
5.97
4.51
To admis-
sions dur-
ing the year.
8.77
25.53
57.14
40.00
The success obtained at Nagpur has been greater than in the previous year
—that obtained at Jubbulpore less. The results will of course vary to a great
extent with the nature of the new cases that come in for treatment from time to
time. There may have been more new cases than usual in the Nagpur Asylum,
which yielded with comparative readiness to treatment.
In the table given in paragraph 5 of your letter you bring together the statis-
tics of other Provinces relating to cures for the purpose of comparing them with
4
provinces which shows that differences in classification are as striking elsewhere
as here, owing no doubt to differences in the views of the various types of
insanity taken by the officers in charge of different Asylums.
There appears to be little advantage in attempting to compare the percentage
of cures of the various types of cases treated in the different provinces, as is done
in Table III. in paragraph 13 of your Report, if dissimilarities in classifi-
cation make it uncertain whether similar things are being compared or not.
General management.
6. There has been a considerable increase of expenditure in the Nagpur
Asylum, due, the Superintendent states, to the increase
in the number of inmates. The ordinary expenditure on
establishment, diet, &c., in the Jubbulpore Asylum is about the same as in the
previous year. In the former institution there was a noticeable decrease in the
sum received for paying patients, in the latter there was an increase. The
Officiating Chief Commissioner observes that you have not compared the cost
per head in the two institutions with that of the previous year, and with that
in similar institutions in other provinces. I am to request that in future you
will take the opportunity of examining the details of expenditure more
closely.
7. In conclusion, I am to request that you will convey the Officiating
Chief Commissioner's thanks to both Dr. Rice and Dr. Barter for their good
services as Superintendents of the Jubbulpore and Nagpur Asylums.
I have the honour to be,
Sir,
Your most obedient Servant,
F. C. ANDERSON,
Offg. Secretary.
No. 1674-542 L. A.
FROM
JAMES H. LOCH, ESQ., M. D.,
DEPUTY SURGEON-GENERAL,
Central Provinces.
To
THE SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Nagpur, the 18th August 1886.
SIR,
I have the honour to forward for submission to the Chief Commissioner
the Annual Reports and Statements of the Nagpur and Jubbulpore Lunatic
Asylums for the year 1885.
2. The improvements in the buildings and in the grounds of the Nagpur
Asylum were continued and are described in the Superintendent's report.
3. The number of admissions and discharges at the Nagpur Asylum can-
not be satisfactorily compared with those of previous years, for prior to 1884
the Asylum contained only lunatics from the Central Provinces, but in that
year all the Asylum population of the Berars was transferred to it, and it now
receives the lunatics from both Provinces.
At Jubbulpore the number of admissions and discharges (including deaths)
and the daily average strength are almost the same for the two years.
4. There was not any overcrowding in either the men's or women's wards
in either of the Asylums.
5. At Nagpur the percentage cured was twice as high as it was in 1884,
while at Jubbulpore it was rather lower, the ratio being considerably lower at
Jubbulpore than at Nagpur.
The following figures show, as did those submitted in the report for 1884,
that the ratio of cured to admissions is very much smaller in the Central Pro-
vinces than in other Provinces.
2
TABLE I.
Province.
Bengal ... ...
Madras ... ...
Bombay ... ...
Central Provinces ...
Punjab ... ...
Burmah
...
...
Assam
...
...
Central Provinces ...
Year.
1,879
to
1,884
1879 to 1883
1882 and 1884
1880 to 1884
1,885
Total ad-
mitted.
6,661
3,508
5,456
1,751
2,245
494
394
348
Total cured.
530
456
488
101
258
51
51
18
Percentage
of cured to
admitted.
7.9
13.0
8.9
5.7
11.5
10.3
12.9
5.1
6. The number discharged as " improved" from the Nagpur Asylum was
far above the average of previous years.
7. The death ratio was considerably higher in 1885 than in 1884, at both
the Asylums.
8. There was only one re-admission at Nagpur and none at Jubbulpore.
STATEMENT II.
9. Does not call for any special remarks.
STATEMENT III.
10. Of the admissions nearly half were from the Head-quarters districts :
this corresponds with the experience of most former years.
STATEMENT IV.
11. Does not call for any remarks.
STATEMENT V.
12. The age of the majority of the patients admitted is as usual between
20 and 40.
STATEMENT VI.
13. Acute mania and acute dementia were the types of insanity under
which by far the greater number of the lunatics admitted to the Nagpur Asy-
lum were suffering, and nearly all those admitted to the Jubbulpore Asylum
were entered as cases of acute mania.
The following figures show that the differences in classification are as great
in the Asylums of other Provinces as in those of the Central Provinces.
3
TABLE II.
Table showing the percentage (on total admissions) of cases of Mania and
Dementia admitted to various Asylums.
Bengal
...
Madras
...
Bombay
...
Punjab ...
Rangoon ...
Assam ...
Central Provin-
ces.
Central Provin-
ces.
Dullunda ...
Dacca ...
Patna ...
Cuttack ...
Berhampore ...
Total ...
Madras ...
Vizagapatam ...
Calicut ...
Total ...
Colaba ...
Poona ...
Dharwar ...
Ahmedabad ...
Hyderabad ...
Total ...
Delhi ...
Rangoon ...
Tezpur ...
Nagpur ...
Jubbulpore ...
Total ...
Nagpur ...
Jubbulpore ...
Total ...
Year.
1884.
...
1884-85.
...
1885.
...
1883 ...
1885 ...
1885 ...
1884
...
1885
...
Acute
Mania.
Percentage on total
admitted.
48.18
30.77
58.70
78.26
28.57
49.14
22.75
45.45
65.31
33.64
35.43
65.00
16.67
54.84
90.57
52.32
49.21
44.44
56.52
28.07
42.86
30.99
53.19
80.00
59.68
Chronic
Mania.
Percentage on total
admitted.
42.73
43.59
8.70
8.70
57.14
33.62
35.06
27.27
14.29
29.91
8.66
10.00
33.33
6.45
7.55
8.86
12.70
...
13.04
19.30
7.14
16.90
6.38
...
4.84
Acute
Demen-
tia.
Percentage on total
admitted.
...
2.56
17.39
...
...
3.88
1.30
18.18
12.24
4.67
1.57
...
...
38.71
...
5.91
3.17
2.77
...
15.79
7.14
14.08
25.53
...
19.35
Chronic
Dementia.
Percentage on total
admitted.
1.80
7.69
10.87
8.70
...
5.17
5.19
...
6.12
5.14
18.11
10.00
50.00
...
1.89
12.24
6.35
...
4.35
28.07
21.43
26.76
12.77
...
9.68
4
As Dr. Rice points out, acute mania will of necessity in consequence of the
orders of Government for the admission of patients now in force, be the type
of insanity exhibited by the majority of patients on their admission.
The following figures give the percentage of recoveries from the more com-
mon types of insanity in the Asylums of other Provinces as well as in those of
the Central Provinces.
TABLE III.
Bengal ...
Madras ...
Bombay ...
Central Provinces ...
Punjab ...
Burmah ...
Assam ...
Central Provinces ...
Year.
1879 to 1884.
1879 to 1883.
1882 & 1884
1880 to 1884.
1885.
Percentage of cured to admitted in
Acute mania.
16.89
23.62
18.64
17.14
10.18
10.10
18.75
13.70
Chronic mania.
5.37
10.72
6.08
2.74
7.09
11.11
...
3.75
Melancholia.
3.70
11.67
6.25
5.88
6.52
14.81
9.52
7.14
Acute dementia.
4.35
13.51
5.34
11.71
5.26
2.63
9.09
13.33
Chronic dementia.
2.51
4.48
1.64
3.92
5.88
...
...
...
The figures show that in Bengal, Bombay, the Punjab and Assam the per-
centage of recoveries is very much larger in acute mania than in any other form
of insanity. In Madras and the Central Provinces the percentage of re-
coveries in acute dementia is also large.
STATEMENT VII.
14. As in former years in the case of a large number of the patients
admitted, the cause was unknown : of those in which it was known ganja was
by far the most common cause in the case of the patients admitted to the
Nagpur Asylum, but not of those sent to Jubbulpore.
The following figures show the percentage of admissions and of recoveries
under each of the most commonly alleged causes of insanity for the Central and
other Provinces.
5
TABLE IV.
Province.
Bengal ...
Madras ...
Bombay
...
Central Provinces ...
Punjab ...
Burmah ...
Assam ...
Central Provinces ...
Year.
1879 to 1884.
1879 to 1883.
1882 and 1884.
1880 to 1884.
1885.
Percentage of admissions and recoveries under—
Ganja and
bhang.
Admitted.
25.22
5.47
14.92
25.98
18.26
7.28
20.26
21.26
Recovered.
27.11
12.50
15.44
9.21
13.42
11.11
18.75
9.46
Spirit.
Admitted.
4.32
1.91
4.84
0.63
2.45
4.05
6.30
0.86
Recovered.
10.42
18.18
11.36
...
9.09
30.00
20.00
...
Opium.
Admitted.
0.75
...
1.19
0.91
2.67
4.45
7.56
1.44
Recovered.
...
...
9.09
...
8.33
...
...
...
Fever.
Admitted.
2.25
0.38
3.11
3.65
3.77
2.42
...
4.02
Recovered.
8.00
25.00
21.43
9.01
17.64
16.66
...
7.14
Epilepsy.
Admitted.
1.72
3.31
3.13
5.48
4.24
2.02
3.78
5.75
Recovered.
...
10.53
3.57
6.25
...
20.00
...
15.00
Grief.
Admitted.
6.15
2.59
5.96
5.65
8.92
8.10
6.30
2.59
Recovered.
5.88
13.33
9.26
6.25
15.00
5.00
20.00
...
Religion.
Admitted.
0.61
0.97
1.03
5.31
...
1.21
...
4.60
Recovered.
...
16.66
11.11
6.25
...
33.33
...
12.50
Hereditary
Admitted.
3.26
2.62
3.35
1.43
1.10
2.42
...
2.01
Recovered.
2.78
13.33
6.45
...
...
...
...
...
Unkonwn
causes.
Admitted.
49.98
66.53
50.95
43.69
47.22
37.25
50.63
47.70
Recovered.
5.88
13.62
7.34
3.94
10.85
9.78
10.00
9.04
6
STATEMENT VIII.
15. The daily average sick at both the Asylums is higher than it was in
1884, the ratio per cent to strength being—
Nagpur ... ...
Jubbulpore ... ...
1884,
4.2
0.7
1885.
6.9
1.3
The proportion of cases of fever treated at Nagpur was as usual much larger
than at Jubbulpore. The percentage of death to daily average strength was also
higher at both Asylums than in 1884.
The increase of mortality in the Nagpur Asylum is not attributed by the
Superintendent to any special cause in the asylum or season. At each asylum
3 of the deaths are due to causes outside the asylum.
TABLE V.
Province.
Bengal ...
Madras ...
Bombay ...
Central Pro-
vinces ...
Punjab ...
Burmah ...
Assam ...
Central Pro-
vinces ...
Year.
1879
to
1884
1879 to 1883
1882 & 1884
1880 to 1884
1885
Percentage of sick
to strength.
4.22
3.61
7.23
4.57
6.97
3.12
4.15
4.39
Percentage of deaths
to strength.
10.17
6.86
9.45
4.86
12.3
10.78
13.91
5.43
Percentage of total deaths from
Fevers.
4.44
...
6.90
...
7.32
9.52
...
6.25
Dysentery.
14.44
9.52
6.90
25.00
4.88
14.3
6.25
Diarrhœa.
8.89
7.14
17.24
8.33
12.19
14. 3
...
...
Phthisis.
18.89
11.90
3.45
8.33
4.88
...
12.5
6.25
Chest affec-
tions.
12.22
4.76
6.90
16.67
24.39
...
12.5
6.25
Anosmia.
3.33
...
1.72
...
...
9.52
...
12.50
Other diseases
37.78
64.28
55.17
41.67
46.34
52.38
75.00
62.50
The above figures show that the ratio of sickness in the asylums of the
Central Provinces compares favourably with that in the asylums of other Pro-
vinces, and that the ratio of death is lower than that in any other Province.
The percentage of deaths from bowel affections in the asylums of the Cen-
tral Provinces is very low this year and compares most favourably with the
average of former years.
STATEMENT IX., X., XI.
16. Details regarding the items of receipts and expenditure are given by
the Superintendents in their reports.
7
At Nagpur the inmates of the asylum besides doing a large amount of most
useful work in the way of levelling, road making, &c., for which no payment is
made, raised Farm garden produce to the value of Rs. 1,070-6-5; at Jubbulpore
the patients turned out manufactured articles to the value of Rs. 1,560.
These figures show clearly that the Superintendents have, as in former years,
realized and utilized the value of employment not only as a part of the treat-
ment of their patients, but as a means of reducing the cost of the institutions
under their charge.
I have been much pleased with all that I have seen in their management.
on my visits to the asylums.
I have the honour to be,
Sir,
Your most obedient Servant,
JAMES H. LOCH, M. D.,
Deputy Surgeon General,
Central Provinces.
9
Report on the Nagpur Lunatic Asylum for the year 1885.
The manner in which the Asylum buildings had been remodelled in 1884,
and the alterations still in progress, were described in the report for that year ;
all were put out of hand in 1885. In addition two good separate cells for women
built on old secure foundations, and a reconstructed latrine for women were put
out of hand; whilst a dreary looking ward [Female No. 3 in previous year's
report] was remodelled; these works were executed by the Public Works
Department.
2. The lunatics have done much around the asylum to make it look trim
and neat: this work is still in progress, and although there is still some untidy-
ness about the environs, those only who knew the place formerly can estimate
the nature of the work done ; whilst the appearance of the wards is altogether
changed. The old male cells were simply dismantled and pulled to pieces by
violent lunatics during the year. New brick and lime cells have been sanctioned
and work has commenced ; the old foundations are good and will be built on ;
keepers' quarters, remodelling the Deputy Superintendent's house, and a new
male latrine are still required.
STATEMENT No. I.
3. With the exception of the previous year when Berar lunatics were admitted
in a body, no year since the asylum was opened showed so many admissions as
1885,—forty-six, with one re-admission, total 47; the total population being 200.
The number discharged, 25, has been higher than during any year since 1878;
of these, 12 were cured, 10 were improved, and 3 were discharged otherwise.
4. Of the 12 discharged cured, six laboured under acute mania; one of these
had been sixteen months under treatment; one thirteen months ; two had each
been eight and half months ; one seven and a half; and one five months. Two
labouring under chronic mania were cured, one of them in twenty-six months and
one in twenty-five. Three suffering from acute dementia recovered, one in seven
months, one in four and a half months, and one in six weeks ; and lastly one
received from the Berar Asylum and who was improving on admission from
melancholia was released after twelve months' residence, cured.
5. Of the ten discharged improved, three suffered from acute mania, one was
discharged in six weeks, one in nineteen, and one in fifteen days. Two laboured
under chronic mania, one of these was discharged after four years and nine
months' residence, and one after two years. Four suffered from acute dementia,
two for 9 months each and two for seven, and one labouring under chronic
dementia was discharged in four months.
6. Three were discharged otherwise thus : one escaped. One a woman of
over 80 received from the jail under a long sentence, so much of it as was in
default of fine being remitted by the Chief Commissioner; she was a garrulous
old woman and might have been on the border-land of insanity. One was
retransferred to the Jail ; he showed but few symptoms of insanity and insti-
gated the lunatics to escape.
10
7. Ten died ; one was an old woman who had been 12 months in the asy-
lum. She was very violent, in bad health, and having got remittent fever, she
rapidly sank. One admitted in 1876 died of phthisis. One admitted scorbutic
from Berar and continued in bad health until he sank. One died from anæmia;
his was a most aggravated case of secret vice, in public and private, by night and
by day he practised it; nothing checked it but blisters on the organ, but to this
treatment there was of course a limit, he died worn out. An idiot boy nine
years in the asylum died from epilepsy; one from dysentery, who had been
eleven years in the asylum. One died from peritonitis, one from pure debility
after six years' residence. One was received moribund and died on the third day,
and one died from dropsy after 11 years' residence.
8. The asylum was at no time overcrowded, and with the exception of
loss of the male cells, the capacity continued as during the previous year.
STATEMENTS NOS. 2, 3, 4 AND 5.
9. The first of these calls for no remarks, and all that can be said of State-
ment No. 3 is that, as hitherto, Nagpur and Kamptee furnished a large number of
the lunatics admitted.
STATEMENT No. 6.
10. A large number of persons suffering from acute mania was admitted,
some were very violent requiring separation in cells ; these they demolished ;
they tore down the roof, pulled out the doors, dug up the floors, broke down the
walls, necessitating rebuilding of the entire range. Clothing them was out of the
question and feeding them was a laborious task. One man when let loose by the
policemen who brought him to the asylum, went for the first man he met, a
keeper, catching him on the stomach with his head and promptly upsetting him ;
another was a very short time in a cell when he got through the roof on to the
ridge and there danced about at the risk of his own life and to the terror of
those below at whom he pelted tiles. The keepers and establishment had a busy
time with them ; yet these men soon calmed down. A glance at this statement
will show that Magistrates have been careful in sending to the asylum only
those cases which demanded admission.
11. I have not found it necessary to alter the types of diseases of those in
the asylum of previous years ; there was of course some difference in the
demeanour and symptoms in regard to some, but on the whole not sufficient to
render a change in type necessary. The remaining figures, recoveries, &c., in this
statement have been already commented on.
STATEMENT No. 7.
12. The causes of insanity have been commented on in previous reports.
They are in most cases only guessed at and in 28 out of 47 admissions are
absolutely unknown.
STATEMENT No. 8.
13. The sick list was a full one and the death rate heavy. There was
nothing in the season or in the asylum special to cause this,—a sickly weakly lot
in poor health succumbed. I have alluded to them already in detail.
11
STATEMENT No. 9.
14. Receipts from the Treasury are in excess of those for 1884, owing to an
increase in the number of lunatics. The population in 1884 was 174 and in 1885
it reached 200. The value of articles received from the Manufactory depart-
ment is rather more, due to higher Public Works Department charges, which it
is usual to exhibit here ; and the item Rs. 6,087-15-11 is thus made up:—
Garden Farm produce ... ...
Jail clothing ... ...
Miscellaneous ... ...
Medicines ... ...
Work done by D. P. W. ...
Rs.
804
427
1
60
4,794
6,087
a.
9
14
8
0
0
15
p.
11
0
0
0
0
11
The farm supplied less than during the previous year, owing to poor crops;
Jail clothing more.
15. Establishment proper cost more ; the pay of extra warders employed
to guard Berar lunatics appears in the accounts. Diet cost more, the number
of lunatics being higher. There is in fact an increase in expenditure all round,
owing to an increase in the number of inmates.
STATEMENT No. 10.
16. The sanctioned Establishment and the actual expenditure thereon
rarely tally, owing to deductions on account of fines, absentees, &c.
STATEMENT No. 11.
17. The net profits were less than in 1884, mainly owing to poor crops.
J. BARTER,
Surgeon Major,
Superintendent, Lunatic Asylum,
Nagpur.
12
Annual Report on the Lunatic Asylum, Jubbulpore, for the year 1885.
STATEMETN I.—133 Males 102/Females 31remained at the beginning of the year.
15 Males 13/Females 2 new patients were admitted, making the total number treated
148 Males 115/Females 33. 6 Males 5/Females 1 were discharged cured: and one a male,
was made over to his friends much improved under Section 10 Act XXXVI. of
1858. One a male escaped and 6 Males 5/Females 1 died, leaving in the asylum at the
end of the year 134 Males 103/Females 31.
The man made over to his friends became insane some six years ago on the
death of his brother, a seller of brass pots in the city of Jubbulpore. On his
recovery he worked steadily in his shop and was a good man of business. In
August last he became again insane and was a good deal of a nuisance to all sorts
of people; proclaiming his grievances in a loud voice to any and every person he
could get hold of, he frequented places of public resort and visited me regularly
at the main dispensary. At last he found his way into the Church and began
pulling the punkhas, and in other ways disturbing people.
After a few weeks' residence in the asylum it was found that he was not
dangerous, and was made over to his friends a good deal improved.
The man who escaped got away from the latrine across the nullah into the
city; he was not missed in time to re-capture him, so he made good his escape;
the latrine is very open, and the locality unprotected by a fence; none the less the
warder in charge was grossly careless and dismissed in consequence.
The Deputy Superintendent also incurred blame in the matter and was
seriously warned.
The daily average strength was 133.03 Males 102.97/Females 30.03 and the greatest
number of lunatics confined on any one night was 135 Males 104/Females 31. The capa-
city of the Asylum is for males 132, and females 42, so that there was no
crowding.
STATEMENT II.
Deals with those of the foregoing known as "Criminal Lunatics."
25 Males 20/Females 5 remained at the beginning of the year. 2 males were since
admitted, 1 a male, was found to be sane in all respects; he was discharged by
order of the Chief Commissioner. 2 Males 1/Females 1 died during the year, and
24 Males 20/Females 4 are now remaining.
Of the 2 admitted, one is a man named Ranjit Kalar, a prisoner from the
Bilaspur district, confined in the Central Jail under sentence of transportation
for life for killing his wife, but sent back from Alipore on account of being
physically unfit to be sent to the Andamans. About 3½ years ago he was tried.
The evidence in the record shows that during the preceding six years he had