ANNUAL REPORT ON LUNATIC ASYLUMS.
15
disorders. Even where intemperance is the proximate cause, it is in many cases a
atal inheritance where it assumes the form of dipsomania ; " this disease being
nearly every case inherited from some insane progenitor, possibly so remote that
he has been forgotten "—(Wynter).
Such intimate acquaintance with the history of cases is rarely, if ever, obtain-
able in a large asylum where patients are sent from all parts of the country, and
the information furnished is brief and but little to the purpose. It is to be
regretted that fuller details are not furnished, and it is evident that the causes of
insanity even where given are but partially guessed at. Reviewing the original
causes, we observe that the largest proportion are from indulgence in narcotic
drugs, and of these one-third have recovered. Next in number are those classed
is hereditary ; although were true histories of cases known this number would be
very largely increased. Of these six have recovered and two improved, in all half,
but it is doubtful in these cases whether the cure may be permanent, frequent
elapses forming a feature of hereditary insanity. Next come those from intem-
erance, in which the proportion of cures is smaller—little more than one-fourth.
he degenerating influence of intemperance appears to make a permanent impress on
the system and may be regarded as " the most prolific cause of insanity" and other
lied nervous diseases, and there are those who go so far as to attribute the large
increase of insanity among the upper classes to the intemperate habits which were
lerated two generations back. Before leaving this subject it may be observed
that insanity is more frequently the result of depraved bodily condition than of
verstrained mind, as Dr. Duncan observes—" a large section of the human race
ies more or less insane from prolonged stupidity."
Instances occur of a mind of high order failing from too great mental exertion ;
it the majority of cases are instances of degeneration of race which nature thus
xtinguishes.
7. The percentage of cures for the present year is unusually high, being 70.909
in admissions and 30.52 on average population. The number of recoveries this
ear is the highest on record and more than compensates for the high mortality.
may be regarded as a most satisfactory sign of the effective working of the
asylum as the number of admissions is smaller than usual, and it is in these cases
and not in chronic cases that the larger number of recoveries usually take place,
being considered that the chances of recovery are greatest under six months.
The percentage of cures in the Madras Asylum compares most favorably with
the Bengal Asylums, in which, referring to the report for 1876, I find the percentage
admissions to be 35.51 and on total population 8.59.
The Madras Asylum will also contrast favorably with the best English Asylums
the percentage of cures, the average for the ten years 1865—74 given by the
ancet Commission of Lunatic Asylums being on admissions 30.51 per cent. and to
cases treated 22.95 in Hanwell, Wandsworth, Colney Hatch, Stone, and Brookwood
asylums.
Amongst the recoveries this year two especially occurred in Europeans of a
tter class, whose cases on first admission appeared almost hopeless. With regard to
e type of the disease, we observe in Form 6 that the largest number of recoveries
e from acute mania, being 77.77 per cent. on the admissions. The greater number
admissions also are from this form of the disease, whilst the largest number of
mained cases are of chronic mania, and the number of recoveries comparatively
small. In acute and chronic dementia the cures are few, this form of disease
indicating a stage of mental decrepitude which is almost hopeless.
8. The number of deaths during the year has been 66, being a percentage of—
25.83
17.12
60
to average population,
to total treated, and
to admissions.
An analysis of the list of deaths appended shows that of the total number :—