44
4. The ages on admission show that the largest number of persons were between
20 to 40, and between 40 and 60. The Surgeon-General is of opinion that the
tendency to insanity is most distinctly marked in the third and fourth decennia of life,
and is less between the 40th and 60th years of age.
5. The 150 admissions are classed as under:—
Actue Mania .. .. .. .. .. .. .. ..
Chronic Mania .. .. .. .. .. .. .. ..
Melancholia .. .. .. .. .. .. .. ..
Acute Dementia .. .. .. .. .. .. .. .. ..
Chronic do. .. .. .. .. .. .. .. ..
Imbecility
..
..
..
..
..
..
..
..
..
Puerperal Mania .. .. .. .. .. .. .. ..
Total ..
76
32
9
14
8
5
1
2
147
Of the remaining three, two were placed under observation and one was found not to
be insane. The percentage of recoveries to total treated was—
Actue Mania .. .. .. .. .. .. ..
Actue Dementia .. .. .. .. .. .. ..
Chronic Mania .. .. .. .. .. .. ..
Melancholia .. .. .. .. .. .. ..
Chronic Dementia .. .. .. .. .. .. ..
33.96
28.12
15.28
13.51
4.49
Acute Mania is, the Surgeon-General considers, the form of insanity most amenable to
treatment, particularly when it occurs in young persons and is early detected, and he
adds "Dr. Winslow has stated that, under favorable circumstances, the recoveries may
be as high as '70 if not 80 per cent.' Less sanguine authors however estimate the
recoveries at from 50 to 60 per cent. In this as in other forms of insanity the chances
of recovery lessen in the direct ratio of the chronicity of the disease."
6. The causes of mortality during the year were principally "Atrophy " and
"Diarrhœa." The inmates of the Asylums escaped from cholera and small-pox, but
Dr. Nanney, the Superintendent of the Madras Asylum, is of opinion that they suffered
more or less from the depressing influences of an unhealthy season.
7. The alleged causes of insanity are classified under the respective heads of
"Physical" and "Moral." "Of the various causes," writes Dr. Smith, "which induce
a proclivity to insanity none are so common yet so difficult of detection as hereditary
predisposition; next in frequency come narcotic drugs, epilepsy, intemperance, and
puerperal or sexual disease; a few cases are traceable to blows on the head, to falls, or
to sunstroke."
8. The number treated in the Hospitals of the Asylums was 197. Of these, 182
were admissions during the year. The number cured and discharged was 96, and the
number of deaths 80, leaving 21 or 6 more than last year in Hospital on the 31st
March 1878.
9. In paragraphs 14 to 16, the Surgeon-General reviews the reports of the three
Asylums. Dr. Nanney's report on the Madras Asylum is full and interesting, and shows
that the "non-restraint" system continues to work very satisfactorily. The question
of the boarding-out system will be dealt with on receipt of the opinions called for last
year from all Local Fund and Municipal Boards. The success which has attended the
introduction of occupations for the inmates of the Asylum merits approbation, and the
Government desire that every effort be made to afford similar occupations to the
inmates of the Asylums at Vizagapatam and Calicut. The sanitary condition of both
these latter Asylums has, it is observed, improved during the year. Paragraph 12
of Dr. Nanney's report will be referred to the Venerable the Archdeacon for consider-
ation.
10. The expenditure during the year amounted to Rupees 92,721-7-5 against
Rupees 91,902-12-4 in 1876-77 ; the increase of Rupees 818-11-1 is accounted for by