14
ANNUAL REPORT ON LUNATIC ASYLUMS.
3. The general condition of the asylum and its inmates is satisfactory,
although from the high death-rate it might not appear so. This, however, must be
referred to causes which I will detail fully under the heading of mortality. On
the other hand, the very large percentage of cures, which exceeds by nearly one-
half the highest on record, may be looked upon as fully compensating for the
apparently high death-rate; and out of these, 2 were Europeans of a better class
whose cases on admission gave very little grounds for hope. No epidemic of any
kind has visited the asylum, although small-pox, cholera, typhoid and fevers of a
low type generally have been prevalent in the Town of Madras. Here there has not
been a single case of any of the above. No accidents of a serious nature have
occurred, no suicides or homicides have taken place. The criminals have been
quiet and well behaved, which I attribute to the constant and interesting employ-
ments provided for them in weaving, spinning, and gardening operations. There
have been four escapes, of whom one only was recaptured; all were harmless, quiet
lunatics, and therefore evaded the vigilance of the warders, whose attention is
more specially directed to the troublesome and dangerous patients. No criminals
effected their escape. To obviate the wandering away of the inmates, the aloe
fence surrounding the asylum is being repaired and the trench deepened, as the cost
of a wall, which would alone effectually prevent escapes, is found too heavy.
4. The number of patients remaining under treatment on the 31st March
1878 was 223, the numbers on the same dates in 1877, 1876, and 1875 having
been respectively, 276, 244, and 243. It is observable that the population which
steadily increased from year to year has this season shown a decided diminution
owing in part probably to the large number of poor creatures swept away by famine
and disease, amongst whom those bereft of reason would be likely to succumb
early, and also to the large mortality amongst chronic cases, by which the resident
population is mainly increased, 42 of the deaths having occurred amongst cases of
over one year residence in the asylum. The admissions also have been less
numerous, doubtless owing to the first-mentioned cause.
5. The number of new admissions amounts to 110, of which only one was a
re-admission. Of these—
Military ...
...
...
...
...
...
...
...
Criminal ...
...
..
...
...
...
...
...
Paupers maintained by Municipalities and Local Fund Boards.
Do.
by Government
Better class patients, &c. ... ... ... ... ...
Patients partially maintained by relatives
... ... ...
Total ...
11
16
29
49
2
3
110
Of the admissions 84 were males and 26 females. This number shows a
decrease of 19 already accounted for in paragraph 4.
6. In Form 7 are detailed the causes to which the various cases of insanity
have been ascribed. These are divided into physical and moral, the latter being
in very small proportion as compared with the former, but those in which the
cause is unknown largely exceeding both. It must not however be supposed that
these are more than the proximate or exciting causes, except in certain physical
ones, such as a blow or actual injury to the brain. In the majority of cases the
insane neurosis exists long previously to any visible symptom of insanity traceable
in many instances by those accustomed to note the incipient sign of madness, but
unremarked by the ordinary observer until some occurrence, such as any of the
so-called moral causes, disturbs the unstable equilibrium of the mind and insanity
becomes manifest. The hereditary character of the insane diathesis is the most
difficult to trace, as it appears from recent investigation that the forms of nervous
diseases are interchangeable. What is in one generation hysteria, epilepsy or
neuralgia appearing in another in some form of mental disorder; and thus the
taint may lurk through generations of moral perversity and hysterical and nervous