10
ANNUAL REPORT ON LUNATIC ASYLUMS.
17. Sickness in the Asylums.—During the year under review there were 191
admissions into hospital, and including remained, 212 treated. Of these 129 were
discharged cured, 5 were discharged otherwise, 69 died and 9 remained in hospital
at the close of the year. Full details as to general sickness appear in Table VIII of
Appendix.
18. Madras Asylum.—The report of Surgeon-Major Nanney is appended, and is
as usual, interesting. The results show that the asylum was satisfactorily worked
by the Superintendent, and that he has a thorough knowledge of, and takes a lively
interest in his duties. As the report itself is so full it will be unnecessary here to
do more than notice some of its more important points. The strong cottages for
dangerous Europeans, sanctioned two years ago, have not been erected, but some
minor improvements under the head of Buildings were carried out. The year
opened with 223 under treatment, and closed with 227 remaining in the asylum.
The number of admissions was 136, and therefore the highest on record, and there
were 85 discharges and 47 deaths. The 85 discharges include 5 escapes.
19. The reduction in the numbers remaining at the close of 1877-78 and
1878-79 as compared with the results of preceding years is remarkable and was due,
chiefly to the heavy mortality occurring amongst patients of the poorer classes, or
who had suffered from famine pressure prior to admission.
20. The recovery rate in the year under review was less favorable than in
1877-78, but still exceptionally large. The ratio of recoveries to admissions in the
former year was 41.17 per cent. and 70.90 per cent. in the latter. Regarding this
decrease Dr. Nanney says, "it is impossible that so high a percentage as 70.09 on
admissions could be kept up, and the number of recoveries is always liable to
fluctuate with the nature of the cases admitted, and the various considerations of
age, duration of disease, &c." The large number of admissions would also neces-
sarily reduce the ratio of recoveries to admissions.
21. The recoveries were most numerous in acute mania, having been over one-
fourth of the total treated, whereas in chronic mania only about 6 per cent., and in
melancholia about 9 cases out of 41 recovered. The mortality in 1878-79 was at
the rate of 20.36 per cent. to daily average strength, while in the preceding year it
was in the ratio of 25.83 per cent. This shows considerable improvement, but
still in this, as in the two other Madras asylums, the mortality continues high.
Dr. Nanney in explanation notices that 11 of the patients admitted during the
year died, and that the health state of 16 was very bad and of 4 bad on admission.
22. The non-restraint system is the rule of the institution, but at the same
time discipline is maintained. Great attention is also given to clothing, diet, exer-
cise, suitable occupation and recreation. The patients are employed in gardening,
weaving, needle-work, carrying water and other domestic occupations, assisted by
warders, and the Superintendent states that this scene of busy industry "more nearly
approaches the spirit of the Gheel community in many respects, and has few points
of resemblance to the prison-like and crowded asylums we too frequently see."
In selecting occupation care is taken to make it practical and cheerful, and weaving
has been found to be particularly adapted for the insane.
23. The band of the 10th Regiment, which used to perform once a fortnight,
could only be procured but rarely in 1878-79, owing to want of funds to provide
carriage for the bandsmen. The usual Christmas treat was given, and much enjoyed
both by the patients and the visitors on the occasion.
24. The weekly religious services have again been resumed by the Chaplain of
Vepery, and were it possible to introduce instrumental music into these it would
render them more attractive and pleasing.
25. The sanitary condition of the buildings and grounds receives every
attention, and the whole place presents a most creditable appearance.
26. The gross cost of the working of the institution in 1878-79 was in excess
of that in 1877-78 by Rupees 189. The increase was mainly due to the rise in
the Superintendent's pay on promotion and the increased cost of dieting patients.
A considerable saving was effected under the head of Clothing and Bedding, due to