NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
report to the effect that when a tendency to insanity exists in individuals there
is little in the circumstances of the Lunatic Asylum where they are treated which
is likely to postpone its manifestation ; but the subject need not be pursued
further since it has little practical bearing upon the management of Asylums. The
same may be said of the classification of types of insanity. For some years past
there has been variation in the types enumerated by the Superintendents of the two
Asylums, Dr. Rice preferring the term " acquired idiotcy" and Dr. Brake the
term " insipientia;" and the former maintaining that cases of acute mania tended
to pass into chronic dementia. In the report for the present year Dr. Brake has
explained the reason why in this latter respect his returns have not hitherto
corresponded with those furnished by Dr. Rice. It is only since December last
that the former has made any alteration in the classification of old inhabitants of
the Asylum, whose disease has, in the meantime, changed in many cases from the
acute to the chronic form, and has even, he allows, developed into something
little removed from " acquired idiotcy."
6. Of the persons discharged as " cured," one, Mt. Sahudra, referred to
in paragraphs 4 and 6 of the Nagpur report, seems to have been erroneously
included under this head, as she is said to have shown no signs of insanity during
the six months she was in confinement in the Asylum.
7. There was a considerable amount of sickness in the Nagpur asylum, but
there were only three deaths resulting from disease, and those who died were all
three advanced in years.
8. The economical management of both the Asylums reflects great credit
on the Superintendents. Each of them shows a calculated profit on the manu-
factures of the year. Dr. Rice explains that the net profits of his manufactures
are obtained by simply deducting from the amount realized by sales (a) the value
of manufactured goods sold which had been made in previous years, and (b) the
value of the raw material used during the year. Dr. Brake has taken great pains
to purchase his supplies in the best market: and Dr. Rice was able during the
year to manufacture all the clothing required for the lunatics, in addition to
turning out blankets, dosutie and newar, for sale to the public. The cost of
management of the Jubbulpore asylum has steadily decreased during the past
three years. I am to ask you to convey the Chief Commissioner's thanks to both
these officers for the zealous way in which they have discharged their duties.
I have the honor to be,
Sir,
Your most obedient Servant,
L. K. LAURIE,
Offg. Asst. Secretary.
No. 2395/C.C.
FROM
W. WATSON, ESQUIRE, M, D.,
OFFG. DEPUTY SURGEON GENERAL,
Central Provinces,
To
THE OFFG. SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces,
Dated Nagpur, the 17th April 1883.
SIR,
I have the honor to forward the Annual Reports and Statements of
the Lunatic Asylums at Nagpur and Jubbulpore.
2. During the past year, the number of lunatics at Nagpur has fallen from
110 to 109, at Jubbulpore the number of lunatics has increased from 124 to 142.
The Jubbulpore Asylum is, however, not over-crowded, as it is capable of
holding 161 insane persons, allowing 50 superficial feet per patient.
With regard to criminal lunatics there has been an increase of 1 at Nagpur,
and of 4 at Jubbulpore.
3. From Statement III. it will be noticed that, the Zilas of Nagpur and
Jubbulpore in which the Asylums are situated, supply the largest number of
admissions. This is especially marked at Jubbulpore; and, as the Superin-
tendent states, this is only what might be expected, as, at out-stations, lunatics are
generally kept for some time under observation at the Dispensary before being
sent to the Asylum. Some of the lunatics recover at the Dispensary, and others
are, for one reason or another, made over to their friends. From some districts
there have been no admissions this year.
4. From Statement IV. it appears that, beggar lunatics predominate at
Jubbulpore. Out of a total number of 31 admissions no less than 8 were
beggars.
There was only 1 beggar lunatic at Nagpur among the 15 admissions.
At Jubbulpore there was one land owner, one Bania, and one Goldsmith,
and the Superintendent is making inquiries whether these men's relatives are able
to pay for their maintenance, either wholly or in part.
5. Statement V. shows the ages of the lunatics admitted into the Asylums.
As might be expected, the bulk of the lunatics admitted both at Nagpur and at
Jubbulpore are between 20 and 40 years of age. This is the age at which luna-
tics are likely to be dangerous to their neighbours.
6. Statement VI. gives the types of insanity. There is a considerable
variation in the 2 Asylums. 'The following table gives the classified list of
lunatics for the 31st December 1882 :—
Acute Mania ... ... ...
Chronic Mania ... ... ...
Melancholia ... ... ...
Acute Dementia ... ... ...
Chronic Dementia ... ... ...
Insipientia
...
...
...
Idiotcy ... ... ...
Homicidal Mania ... ... ...
Not insane ... ...
...
Nagpur.
8
27
11
5
49
6
0
1
2
109
Jubbulpore.
16
28
5
12
52
2
27
0
0
142
2
I think it may be assumed that different principles of classification are
adopted by the two Superintendents.
7. The Statement of the alleged causes, No. VII, is one which it is almost
impossible to analyse. The Superintendents have very properly accepted in all
obscure cases the statements sent along with the lunatics when they were first
admitted.
It is, however, difficult to believe, that there were on the 31st December
1882 in the two Asylums 16 lunatics whose lunacy was caused by grief ; 2, where
it was caused by anger ; and 15 where it was caused by religion. Of the 15 reli-
gious lunatics 14 were males.
The division in physical and moral causes appears to me to be one which
it is impossible to carry out properly.
I do not understand why secret vice should be entered as a physical cause,
and Puerperal insanity as a moral one.
The most important practical fact I can glean from Statement VII. is that
of the more common poisonous drugs. Ganga is, in the Central Provinces, much
more deleterious than either opium or spirits. The following are the numbers
as they stood on 31st December 1882 :—
Ganga ...
Spirits ...
Opium ...
Nagpur.
22
0
1
Jubbulpore.
39
1
1
I notice that in Jubbulpore there were no cases of hereditary insanity. In
Nagpur there were 5. No doubt there were at Jubbulpore some cases where
hereditary taint was a predisposing cause ; but the Superintendent has referred
these cases to the exciting cause whatever that might be.
Epilepsy and sun-stroke are included under one heading. I think this in
unfortunate. The numbers on the 31st December 1882 were :—
Males ...
Females ...
Nagpur.
7
0
7
Jubbulpore.
2
4
6
8. Table VIII. is a most important one. Each of the Superintendents has
most ably analysed it as far as it relates to his own Asylum. I will therefore
only compare the one asylum with the other.
The sickness at Nagpur was much greater than at Jubbulpore, 114 cases
against 58. The mortality was the same. In each asylum there were 4 deaths.
Taking individual diseases:—There were at Nagpur 47 cases of ague against
15 at Jubbulpore. There were 6 cases of bronchitis at Nagpur, none at Jubbul-
pore. There were 4 cases of worms at Nagpur, none at Jubbulpore.
There
were 6 cases of piles at Nagpur, none at Jubbulpore.
All these figures seem
to indicate the superior healthiness of the Jubbulpore Asylum, at all events for
the year 1882.
In 1881 the amount of sickness was more nearly equal in the 2 Asylums,
and the mortality was 9 at Jubbulpore, only 6 at Nagpur.
9. Statement IX. is the cash account. The expense at Nagpur is higher
than at Jubbulpore owing to the larger establishment.
10. Statement X. gives the sanctioned establishment.
11. Statement XI. is a very complicated one. It has been carefully and
accurately filled up in the prescribed form.
I have the honor to be,
Sir,
Your most obedient Servant,
W. WATSON, M. D.,
Offg. Deputy Surgeon General,
Central Provinces.
5
Annual Report on the Lunatic Asylum, Jubbulpore, for the year 1882.
Table I. is a Statement showing generally the admissions and results for
the past 11 years.
In 1882, as in 1881, 28 were admitted,—24 males and 4 females. 2 males
and 1 female were re-admitted.
The total population was 155 against 154 in the year preceding. The
daily average strength 131.39 against 126.18 or 5 in excess.
The number discharged " cured" and " improved" was only 7 against 14
in 1881.
Two were discharged " otherwise" against 6 in the year preceding. One of
these was a woman belonging to Poona, who was found by the Police wandering
about the Jubbulpore Railway Station. After some questioning I learned from
her that her husband kept a shop in Poona, and that she ran away from him,
because he was unkind to her. We communicated with the Collector of Poona,
and he sent her husband to take charge of her. She was made over to him in
no way improved.
The other escaped from the open ground near the cook-house, through the
latrine, and soon got lost in the city. He was an active young fellow from
Seoni ; he was never heard of since, nor likely to be until he does something
that will bring him under the cognizance of the Police.
This is the only " escape" we have had this year, which is very creditable
to the establishment, who made up for their want of numbers by extra care.
It is all the more commendable because the asylum is quite open, the
sleeping wards are surrounded with only a rough wooden palisade, over or through
which a lunatic could easily get, and once out he would very soon get lost in
the stream of people passing along the road or in the city, both of which are
close by, During the day the great majority of them are employed in the
garden, cook-room and general work of the asylum, without any thing stronger
than a light mehndi hedge to keep them in.
Only 4 died against 9 in 1881.
For all these reasons the number remaining at the end of the year has
risen from 124 in 1881 to 142 in 1882.
We have striven much to keep down the asylum population, but find it
impossible to reduce it further. We are more particular now in admitting
patients; none are received who are not dangerous to themselves or to others :
or who are capable of taking care of themselves or have relatives who can look
after them or who do not afford a prospect of cure from the special treatment to
be obtained in a Lunatic Asylum. It is obvious that when these are excepted
the cases remaining are not very hopeful, " cures" must of necessity be fewer
and the population tend to increase.
As the capacity of the asylum is for 161 patients and a number confined on
any one night did not exceed 143, there was no crowding.
Table II. deals with criminal lunatics.
During 1881 the population remained stationary, but in 1882, although
the same numbers were admitted and re-admitted as in the preceding year, only
3 were discharged against 7 in 1881, consequently the number remaining at the
end of the year rose from 26 in 1881, to 30 in 1882.
7
cases first and that I have grounds for considering the asylum the more suitable
place for them. In other districts persons thought to be insane are kept for a
longer or a shorter time under the observation of the Civil Surgeon, and doubt-
less many get better or are made over to their friends.
Besides for various reasons the neighbourhood of a large city increases the
number of lunatics, especially of wandering or homeless lunatics, who drift to
this place with the stream of travellers always tending towards it.
Table IV. shows the occupation of those admitted.
8
5
4
were habitual beggars.
„ farm labourers.
„ ordinary labourers.
In the case of 5 no information could be obtained, they were found wander-
ing about, no one could tell whence they came, or how they obtained a livelihood.
Table V. shows their ages.
25 of the 31 were between 20 and 40 years.
There are more people living between those ages, and it is about the time
when the struggle for existence commences to be made, and the cares and anxi-
eties of the life come into play.
It may be safely assumed also, that if a man is to get mad at all, it will, as
a rule, be before 40 years of age. There is little in the circumstances of those
treated in a pauper Lunatic Asylum likely to postpone an outbreak of insanity
when the tendency to it exists in the individual.
Table VI. deals with the types of insanity treated in the asylum.
In former reports I have dwelt so much on this subject, that I have nothing
new to add.
Table VII. shows the alleged causes of insanity.
I have endeavoured by reference to District officers to get hold of some
feasible cause. I regret to say that in the large proportion of 14 out of 31, not
even a guess at a 'cause' was hazarded, unless indeed it were such as " heat of
brain ", " madness ", and the like, which are not worthy of serious mention."
The District officers are all unanimous in pointing out how difficult it is
to obtain any history of those witless creatures, who are mostly strangers found
wandering in bazars, and this I am sure is no more than the fact.
Dr. Skipton, Civil Surgeon of Damoh, took a great deal of trouble in this
direction, and in two out of three of his cases was able to ascertain more than the
Police originally knew.
Under all the circumstances it is better I think to omit conjecturing a cause
which after all may be wrong and worse than useless because, misleading. Ganja
as usual holds the first place: Spirit drinking, fever, epilepsy, grief and anger
are credited with the remainder of the known causes. If I might venture to
conjecture in the case of the 14 in whom the cause of insanity is unknown it
would be to set it down to innutrition, that is semi-starvation and want of
clothing and shelter, all those who are found wandering about the bazars besides
being nameless or homeless, miserably thin, I may say emaciated, and in m any
cases in danger of death from starvation. Of course I would only call this an
"exciting" cause in people already predisposed to insanity, for many die of
starvation without going mad.
Table VIII. deals with bodily sickness and mortality.
8
10 cases remained under treatment at the close of 1881, 48 were admitted
into hospital during the year against 86 for the year preceding, or about one-
third of the total population.
This indicates a very healthy condition of the inmates, 16 were for fevers,
chiefly ordinary country ague; and 10 for bowel complaints. There were three
cases of double pneumonia, to which lunatics are much predisposed : they were
all, as may be supposed, very severe cases, and one ended fatally.
53 were discharged cured, one was made over to his friends while a patient
in hospital for paralysis. There appeared to be no chance of any further
improvement from special treatment, he was harmless and they were able and
willing to care for him.
Four died, or a little over 30 per 1,000, which is less than the death rate of
the free population. 1 from pneumonia, 2 from chronic dysentery with ulcera-
tion of the bowels, 1 died from cerebral exhaustion, simulating acute atrophy of
the brain, the result of acute mania following an attack of continued fever, probably
of a thermal nature. He was a chaprassi in the Commissioner's office and had
been ill for several days with continued fever; when the fever left him he was
found to be insane, wild, talkative, trying to break away from hisfriends. He was
in this state when brought to the asylum on the 7th October. He appeared
then worn and exhausted, his pulse was thready, he suffered from complete
insomnia. He was treated with bromide of potash, cannabis indica, hydrate of
chloral, quinine, and iron and as much nourishing food and stimulants as he
could be got to take. He sunk gradually and died 17 days after admission,
quite worn out. No post mortem was allowed.
The daily average number sick was only 2.35 against 9.47 for the year pre-
ceding ; or one 1.7 per cent of average strength against 7.5 for the previous year.
The mortality was as the rate of 30 per 1,000 per annum on the average
strength, against 71 per 1,000 for the year 1881.
Table IX. shows the expenditure from all sources incurred in maintaining
the asylum.
We had to ask for Rs. 8,130 only from the Treasury against Rs. 8,424 in
1881 and Rs. 9,170-1.4 in 1880. Although the daily strength was 5 in excess
above 1881 and 6 over 1880.
There has been a steady decrease in the cost of management during the
past three years, as will be seen from the subjoined table.
In 1881 and 1882 the clothing had to be renewed, the quality of the articles
received from the Central Jail was not good enough to resist the violent action
of lunatics!
Establishment
...
...
Diet
...
...
...
Clothing ... ... ...
Contingencies
...
...
Medicines
...
...
...
Total ...
Per patient on daily average strength ...
1882.
Rs
4,763
3,053
307
235
10
8,370
64
A.
10
4
10
13
5
11
3
P.
7
2
0
1
3
1
2
1881.
Rs.
4,832
3,108
352
261
34
8,588
69
A.
2
15
0
12
1
15
8
P.
8
3
0
6
6
11
9
1880.
Rs.
4,982
3,842
127
104
16
9,072
73
A.
0
6
10
2
12
14
2
P.
0
0
0
3
7
10
8
9
In this comparative Statement I have left out paying-patients from both
sides of the account : to include them would be a source of error. They paid
for the whole cost of their maintenance ; as they were not criminals they were
allowed by the visitors such reasonable indulgences as their friends chose to pay
for; for example one man is allowed ½ an anna worth of sweetmeats daily :
another a seer of fresh milk ; a third has a servant to cook for him ; another has
broad-cloth clothing, &c. &c.; to charge these on either side of the account
would vitiate calculations, the object of which is to show how much it costs the
State to maintain a pauper lunatic.
Statement X. shows the strength of the establishment as it stood on the
last day of the year.
It is below the sanctioned scale by 2 " Jemadars" or Head Warders, and 1
male and 2 female keepers, or 5 individuals in all, whose aggregate salary would
be Rs. 408 per annum.
I explained last year how little useful the " Head Warders" were : we did
very well without them this year.
The sanctioned scale of keepers is 1 to every 10 or portion of 10 inmates.
Table XI. deals with manufactures
As explained in former reports there is not a very large field for operations
in this direction.
Out of a total average of 131 we were able to employ 54 daily on more or
less remunerative work.
The net profits of their earnings amounted to Rs. 713-3-6. Amongst other
work we were this year able to manufacture all the clothing required for the
Lunatics. They also turned out some excellent blankets, dosutti and newar for
sale to the public.
It should not be supposed that the remaining 87 individuals were all idle.
Some 12 are employed in cooking, as many more in cleaning, sifting, and grind-
ing wheat; about 20 are employed in collecting, pounding, sifting and storing
dry earth for the latrines and wards, of which a great deal is used daily : 8 or
10 are employed in sweeping and cleaning up the premises, which are at all times
notoriously clean and neat.
Between 30 and 40 are imbeciles or too violent to do any work. The num-
ber of these is increasing year by year, whilst the best and most profitable are
lost to us of necessity by being discharged cured or made over to their friends.
To return to our manufactures.
We sold to the public articles to the value of ...
We made over to the Asylum for asylum purposes—
Manufactured goods to the value of ...
Making the total of our sales ...
To find our actual net profits we must deduct from this :—
The value of manufactured goods in hand at
the beginning of the year ...
The value of the old stock of raw material used
up—less value of the quantity remaining in
stock at the end of the year ...
Price of raw material purchased during the year
Total outlay ...
Rs. 576 12 7
„ 811
„ 1,388
14
11
6
1
„
71
„
44
„ 559
Rs. 675
8
3
12
7
0
2
5
7
Leaving Rs. 713-3.6 as our actual net profits for the year's work against
Rs. 152-3-5 for the year preceding.
The Asylum was regularly inspected by the Official visitors ; the Deputy
Surgeon General and Inspector General of Gaols, also visited it.
JUBBULPORE :
20th January 1883.
W. R. RICE, M. D.,
Supdt Govt. Lunatic Asylum.
STATEMEN
Showing the admissions, discharges, &c. &c. of Lunatics in the Asylums
1
Years.
1872 ...
1873 ...
1874 ...
1875 ...
1876 ...
1877 ...
1878 ...
1879 ...
1880 ...
1881 ...
1882 ...
2
Districts.
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur
...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore
...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
Nagpur ...
Jubbulpore ...
3
Remained on 1st January.
Male.
79
95
79
92
88
95
87
83
89
109
97
96
102
112
99
92
93
91
86
89
87
88
Female.
25
21
25
23
26
26
26
26
25
34
26
32
27
33
25
30
29
34
27
36
23
36
Total.
104
116
104
115
114
121
113
109
114
143
123
128
129
145
124
122
122
125
113
125
110
124
4
Admitted.
Male.
22
35
27
45
33
37
31
45
28
31
27
36
23
19
13
14
11
7
13
22
7
24
Female
5
8
6
16
5
12
6
16
3
5
6
6
4
4
7
8
5
4
1
6
6
4
Total
27
43
33
61
38
49
37
61
31
36
33
42
27
23
20
22
16
11
14
28
13
28
5
Re-admitted.
Male.
...
...
1
...
...
2
1
1
...
...
4
2
2
...
1
2
2
2
1
1
1
2
Female.
1
1
1
...
...
1
...
...
2
...
1
...
1
...
...
1
1
...
...
...
1
1
Total.
1
1
2
...
...
3
1
1
2
...
5
2
3
...
1
3
3
2
1
1
2
3
6
Total population.
Male.
101
130
107
137
121
134
119
129
117
140
128
134
127
131
113
108
106
100
100
112
95
114
Female.
31
30
32
39
31
39
32
42
30
39
33
38
32
37
32
39
35
38
28
42
30
41
Total.
132
160
139
176
152
173
151
171
147
179
161
172
159
168
145
147
141
138
128
154
125
155
7
Discharged.
A.
Cured.
Male.
16
15
11
23
11
29
18
10
4
12
15
12
10
19
9
7
8
...
6
10
5
2
Female.
1
2
2
9
2
5
1
1
1
6
2
5
3
6
1
1
5
...
1
...
3
2
Total.
17
17
13
32
13
34
19
11
5
18
17
17
13
25
10
8
13
...
7
10
8
4
B.
Transferred to
friends.
Improved.
Male.
...
2
...
3
3
12
3
9
6
29
4
5
7
10
2
6
5
2
2
4
2
3
Female.
...
2
...
...
1
7
2
6
1
1
2
...
2
...
1
2
...
...
1
...
...
...
Total.
...
4
...
3
4
19
5
15
7
30
6
5
9
10
3
8
5
2
3
4
2
3
Not improved.
Male.
...
2
...
1
...
...
...
...
...
...
1
1
3
...
1
...
...
...
1
...
...
...
Female.
...
...
...
...
...
...
...
...
...
...
1
...
1
...
...
...
...
...
1
1
1
...
Total.
...
2
...
1
...
...
...
...
...
...
2
1
4
...
1
...
...
...
2
1
1
...
C.
Ot he r
wi s e .
Male.
1
...
3
2
2
3
1
...
...
1
2
1
1
2
1
1
1
4
...
5
1
1
Female
...
...
...
...
...
...
2
...
...
...
...
...
...
...
...
...
...
...
...
1
...
1
Total.
1
...
3
2
2
3
3
...
...
1
2
1
1
2
1
1
1
4
...
6
1
2
D.
Total.
Male.
17
19
14
29
16
44
22
19
9
42
22
19
21
31
13
14
14
6
9
19
8
6
Female.
1
4
2
9
3
12
5
7
2
7
5
5
6
6
2
3
5
...
3
2
4
3
Total.
18
23
16
38
19
56
27
26
11
49
27
24
27
37
15
17
19
6
12
21
12
9
8
Died.
Male.
6
19
5
13
18
7
8
1
10
2
4
3
1
8
7
3
6
5
4
5
3
2
Female.
5
3
4
4
2
1
2
1
2
...
1
...
7
1
1
2
3
2
2
4
1
2
Total.
11
22
9
17
20
8
10
2
12
2
5
3
8
9
8
5
9
7
6
9
4
4
9
Remaining on 31st D
Male.
79
92
88
95
87
83
89
109
97
96
102
112
99
92
93
91
86
89
87
88
84
106
Female.
25
23
26
26
26
26
21
34
26
32
27
33
25
30
29
34
27
36
23
36
25
36
The capacity of the Asylums is at 50 superficial feet per patient
...
The maximum number of Lunatics confined on any one night was
...
Nagpur
Jubbulpore
Nagpur
Jubbulpore