( 42 )
of the existing data for drawing any safe conclusion on the subject. It is invariably
most difficult, both owing to wilful or careless suppression of facts by relatives, and
to the interchangeable character of nervous diseases, to trace the indications of a
hereditary predisposition to insanity.
4. There were 43 deaths in the three asylums, and while the mortality in the
Madras and Calicut Asylums was higher than usual, that in the Waltair Asylum
was exceptionally low. In the Madras Asylum during the months of July, August
and September, the health of the patients was bad owing to an outbreak of scurvy.
The number of sick admitted into hospital under the headings Diarrhœa, Dysen-
tery and General Debility was large. The matter received the immediate personal
attention of the Surgeon-General. The great improvement in the death rate in the
Waltair Asylum was due, in a great measure, to the improved scale of diet intro-
duced during the year. The Government are glad to hear that the unsatisfactory
state of things noticed in paragraph 4 of the review on the report of the adminis-
tration for 1881-82, as to the rate of mortality in this asylum, received special
attention, and that the Superintendent is now able to report that the " health of
the inmates has been particularly good, as compared with former years." The
particulars given of the cases of the twelve patients who died in the Calicut Asy-
lum show that nine died shortly after admission, and that out of these the health
of seven was reported on admission to have been bad, and that of two indifferent.
One death occurred from small-pox.
5. There was one escape from the Madras Asylum, the patient was soon
recovered. There was one attempted suicide. The remarks of the Superintendent
are in favor of granting the patients in the asylum almost unrestricted liberty, and
the results of his system appear to have been satisfactory, " fewer escapes, and less
noise, excitement and violence." In the Waltair Asylum there were no escapes
or suicides, and the administration seems to have been good. In Calicut there was
one escape, followed by recapture. Orders have recently been issued on the defects
pointed out as existing in the buildings of this asylum.
6. The financial results of the year cannot be regarded as satisfactory. The
increase in the number of patients in the asylum entailed an increased expenditure,
while the receipts on account of private-paying patients considerably decreased.
The amount received under this heading in the year 1881-82 being Rs. 8,189-4-6,
while that received during the year under report was Rs. 4,695-5-6. An explana-
tion should be furnished for the entire absence of any receipts under this heading
in Vizagapatam, where, in the previous year, almost Rs. 4,000 were recovered from
private-paying patients, some of whom probably continued in the asylum during the
year under report. There was an increase of Rs. 3,444 in the receipts gained from
Municipalities and Local Fund Boards. The expenditure on dieting the sick in
the Madras Asylum increased ; this increase is said to have been due partly to the
increased number of patients and partly to the outbreak of sickness, which lasted
during some months of the year. Financial statements, similar to those furnished
in the report of the Superintendent of the Madras Asylum, are not furnished from
the other asylums ; they should be in future reports. The following table shows
the comparative cost of maintaining an insane patient at each asylum :—
—
Madras .. ..
Waltair .. ..
Calicut .. ..
Establish-
ment.
RS.
80
99
51
A.
0
7
15
P.
3
7
3
Diet.
RS.
92
58
84
A.
3
0
1
P.
9
11
7
Clothing.
RS.
6
4
5
A.
4
7
14
P.
10
0
6
Bazaar
Medicine.
RS.
11
0
0
A.
4
0
4
P.
1
6
6
European
Medicine.
RS.
0
1
A.
10
11
P.
2
0
...
The entries made by the Superintendent of the Madras Asylum as showing the
cost of each patient do not seem to be correct. The cost of establishment should
have been (taking the returns given in Appendix IX as correct) Rs. 78-6-0, and the