NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 44 )
remitted to the treasury on account of patients confined in the asylum, which should
not have been calculated as a portion of the real expenditure on the asylums; deduct-
ing this sum Rs. 85,576-14-3 remains as the net expenditure on the different institu-
tions compared with Rs. 80,313-2-0, the expenditure calculated in the same way in
the previous year. It is noted that while in the previous year only Rs. 1,747-0-2
were spent on account of work done by the Public Works department in the year under
report Rs. 4,104-12-11 were spent under this head. The increase in the receipts
from municipalities and local Boards on account of patients in the asylums is satis-
factory. The maintenance of these three asylums saves local bodies from the
necessity of maintaining similar institutions of their own, the care of lunatics being
one of the duties imposed upon mofussil municipalities and local Boards by law. It is
therefore only just that each local body should, as is the case now, be called upon to
support the civil lunatic patients of its own district maintained in the Provincial
asylums. The total annual cost of an insane in the asylums was as follows:—
Madras
..
..
..
..
..
.. .. ..
Walter .. .. .. .. .. .. .. ..
Calicut .. .. .. .. .. .. .. ..
RS.
178
144
132
A.
12
13
8
P.
8
8
7
The excessive cost in the Madras Asylum is explained by the existence in that asylum
of a considerable number of European and Eurasian patients.
7. Generally the state of the asylums is satisfactory, and the Surgeon-General is
again able to express his acknowledgments to the officers in charge for the manner in
which they have performed their duties. In view of the necessity which must shortly
arise of extending the accommodation for lunatics it is well that the lands held in
connection with the asylums will afford a means of extending the buildings without
any danger of overcrowding.
(True Extract.)
E. F. WEBSTER,
Chief Secretary.
ANNUAL REPORT
ON
THE LUNATIC ASYLUMS
IN THE
MADRAS PRESIDENCY
DURING THE YEAR
1884-85.
MADRAS:
PRINTED BY E. KEYS, AT THE GOVERNMENT PRESS.
1885.
OFFICE OF SURGEON-GENERAL
WITH THE GOVERNMENT OF MADRAS,
FORT ST. GEORGE, 7th July 1885.
No. 279.
From
M. C. FURNELL, ESQ., M.D., F.R.C.S.,
Surgeon-General with the Government of Madras,
To
THE HONORABLE E. F. WEBSTER,
Chief Secretary to Government,
Judicial Department.
SIR,
I HAVE the honor to submit, for the information of the Right Honorable the
Governor in Council, the reports on the Lunatic Asylums in the Madras Presidency
for the official year ending 31st March 1885.
2. ACCOMMODATION. —I have only to repeat what has been stated in the past
year's report, that demand for asylum accommodation is steadily on the increase.
Applications for admission had to be refused in many instances for want of accom-
modation. Although Government have, in their order No. 2876, P. W., of 18th
November 1884, sanctioned an enlargement of the accommodation at Calicut, the
work has not as yet been commenced by the Public Works Department.
3. GENERAL RESULTS.—There were 493 lunatics of all classes remaining in
the three asylums on 31st March 1884; 214 were admitted during the year under
review, and the total number of all classes treated was 707. Out of these, 91
were discharged cured, 33 were transferred to the care of friends, 8 were dis-
charged otherwise, and 35 died, leaving 544 under treatment at the end of the
year, or 51 more than the number remaining in the previous year.
4. The civil and criminal classes of lunatics have both shown a tendency to
increase. The three asylums accommodate nearly 600 patients. As stated in
paragraph 2, additional accommodation has been sanctioned by Government for
the Calicut asylum. A ward for 12 patients and 6 single rooms have also been
sanctioned for the asylum at Madras.
5. The daily average of lunatics present in the asylums during the year under
report was 521 against 475 in the preceding year.
6. There has been a slight fall in the proportion of recoveries to admissions
as compared with the results of the past year, with a corresponding increase in the
rate of mortality; but taking into consideration the proportions of former years,
the results of the year under review may still be said to be very satisfactory.
4
ANNUAL REPORT ON LUNATIC ASYLUMS.
The following table shows the proportion of recoveries to admissions and of
deaths to average daily strength for a series of years :—
Years.
1877-78 ... ... ... ... ...
1878-79 ... ... ... ... ...
1879-80 ... ... ... ... ...
1880-81 ... ... ... ... ...
1881-82 ... ... ... ... ...
1882-83 ... ... ... ... ...
1883-84 ... ... ... ... ...
1884-85 ... ... ... ... ...
Percentage of
recoveries to
admissions.
64.66
46.02
41.86
41.20
37.71
30.00
44.95
42.52
Percentage
of deaths to
daily average
strength.
22.86
21.73
13.45
12.81
9.02
10.14
5.05
6.71
7. Criminal Lunatics.—The number of criminal lunatics received during the
year under review was 30, viz., 29 males and 1 female; 16 were discharged (15 males
and 1 female) and 6 (males) died, leaving 109 at the end of the year, of whom 97
were males and 12 females.
The following table shows the steady increase, in number of those under
treatment, of criminal lunatics during the last three years :—
Years.
1880-81 ... ...
1881-82 ... ...
1882-83 ... ...
1883-84 ... ...
1884-85 ... ...
Admitted.
Males.
32
25
38
33
29
Females.
1
3
5
3
1
Total.
33
28
43
36
30
Total treated.
Males.
84
81
101
106
118
Females.
8
10
15
17
14
Total.
92
91
116
123
132
Discharged.
Males.
19
14
24
15
15
Females.
1
...
1
4
1
Total.
20
14
25
19
16
Died.
Males.
9
4
4
2
6
Females.
...
...
...
...
...
Total.
9
4
4
2
6
Remaining.
Males.
56
63
73
89
97
Females.
7
10
14
13
12
Total.
63
73
87
102
109
8. The distribution of the criminal lunatics in the three asylums is shown in
the following abstract :—
Asylums.
Madras ... ...
Waltair ... ...
Calicut ... ...
Total ...
Remained.
Males.
58
15
16
89
Femles.
10
...
3
13
Total.
68
15
19
102
Admitted.
Males.
19
1
9
29
Females.
1
...
...
1
Total.
20
1
9
30
Total treated.
Males.
77
16
25
118
Females.
11
...
3
14
Total.
88
16
28
132
Discharged.
Males.
10
...
5
15
Females.
1
...
...
1
Total.
11
...
5
16
Died.
Males.
4
1
1
6
Females.
...
...
...
...
Total.
4
1
1
6
Remaining.
Males.
63
15
19
97
Females.
9
...
3
12
Total.
72
15
22
109
9. The admissions from the civil population may be said to be nearly equal to
those of the former year, i.e., 214, against 218 in 1883-84. These included 161
males and 53 females.
The following table shows the number of civil lunatics from the several classes
of the population :—
Caste.
Europeans and East Indians ...
Hindus ... ... ... ...
Muhammadans ... ... ...
Native Christians ... ... ...
Other castes ... ... ...
Total ...
Males.
20
104
26
9
2
161
Females.
5
37
9
2
...
53
Total.
25
141
35
11
2
214
ANNUAL REPORT ON LUNATIC ASYLUMS.
5
10. The following table classifies the ages of lunatics on admission :—
Age.
Under 20 years
...
...
20 to 40 years
...
...
40 to 60 years
...
...
Upwards of 60 years
...
Sex.
Males ... ...
Females ... ...
Males
...
...
Females ... ...
Males ... ...
Females ... ...
Males
...
...
Females ... ...
Total Admissions ...
Admitted.
4
5
119
34
37
14
1
...
214
Ratio per cent.
to total
admissions.
4.20
71.49
23.83
0.47
...
11. The following table shows the proportion of recoveries to total treated for
the various forms of insanity :—
Acute mania
...
...
...
...
...
...
Chronic mania ... ... ... ... ... ...
Acute dementia
...
...
...
...
...
...
Chronic dementia ... ... ... ... ... ...
Melancnolia
...
...
...
...
...
...
Per cent.
19.25
18.24
9.52
6.15
11.11
12. In the following table are recorded the alleged causes of insanity. As
stated in the previous report, it is difficult to ascertain its proximate causes in this
country.
Physical causes.
Narcotic drugs ... ... ... ...
Blow on the head ... ... ...
Congenital ... ... ... ...
Concussion of brain ... ... ...
Epilepsy ... ... ... ...
Fever
...
...
...
...
...
Intemperance ... ... ... ...
Hereditary ... ... ... ...
Starvation ... ... ... ...
Puerperal mania ... ... ...
Syphilitic ... ... ... ...
Sunstroke ... ... ... ...
Privation ... ... ... ...
Over study ... ... ... ...
Other causes ... ... ... ...
Total ...
42
2
18
1
23
3
6
21
14
6
1
1
4
1
8
151
Moral causes.
Disappointment
...
...
...
False belief ... ... ... ...
Anxiety ... ... ... ... ...
Grief
...
...
...
...
...
Loss of property ... ... ...
Family quarrel ... ... ... ...
Misfortune ... ... ... ...
Religion ... ... ... ...
Infidelity ... ... ... ...
Fear
...
...
...
...
...
Love and jealousy ... ... ...
Confinement ... ... ... ...
Disgrace ... ... ... ...
Vicious habit
...
...
...
...
Total ...
2
2
5
15
5
7
7
8
2
4
7
1
2
1
71
13. Mortality.—The rate of mortality in the asylums has been a little higher
than in the previous year. No epidemic diseases, however, appeared in any of
them. The following table shows the causes of death:—
Causes.
Phthisis pulmonalis ... ... ...
Apoplexy ... ... ... ... ...
Dysentery ... ... ... ... ...
Diarrhœa ... ... ... ... ...
General debility ... ... ... ...
Paralysis insanorum ... ... ...
Males.
4
2
2
5
1
2
Females.
2
2
4
4
2
...
Total.
6
4
6
9
3
2
14. In the subjoined table will be found separately the general results for
each asylum:—
2
6
ANNUAL REPORT ON LUNATIC ASYLUMS.
Asylums.
Madras ...
Vizagapatam ...
Calicut ...
Total ...
Asylums.
Madras ...
Vizagapatam ...
Calicut ...
Total ...
Remained 31st March 1884.
Males.
250
45
74
369
Females.
89
9
26
124
Died.
Males.
13
4
4
21
Females.
12
1
1
14
Total.
25
5
5
35
Total.
339
54
100
493
Remaining
31st March 1885.
Males.
279
41
83
403
Females.
101
8
31
140
Total.
380
49
114
543
Admitted during the year.
Males.
116
8
37
161
Females.
38
3
12
53
Total.
154
11
49
214
Daily average strength.
Males.
261.50
43.55
78.27
383.32
Females.
98.50
8.88
30.33
137.71
Total.
360.00
52.43
108.60
521.03
Total treated.
Males.
366
53
111
530
Females.
127
12
38
177
Daily average sick.
Males.
7.52
2.75
2.80
13.07
Females.
4.25
0.11
0.73
5.09
Total.
11.77
2.86
3.53
18.16
Total.
493
65
149
707
Discharged.
A.
Cured.
Males.
46
8
21
75
Females.
8
3
5
16
Total.
54
11
26
91
B.
Transferred to friends
Improved.
Males.
23
...
...
23
Females.
6
...
...
6
Total.
29
...
...
29
Not improved.
Males.
...
...
3
3
Females.
...
...
1
1
Total.
...
...
4
4
C.
Otherwise.
Males.
5
...
...
5
Females.
...
...
...
...
Total.
5
...
...
5
D.
Total.
Males.
74
8
24
106
Females.
14
3
6
23
Total.
88
11
30
129
Percentage of
Cured to daily
average strength.
Males.
17.59
18.36
26.83
19.56
Females.
8.12
33.78
16.48
11.61
Total.
15.00
20.98
23.94
17.46
Deaths to daily
average strength.
Males.
4.79
9.18
5.11
5.47
Females.
12.18
11.25
3.29
10.66
Total.
6.94
9.53
4.60
6.71
Cured to admissions.
Males.
39.65
100.00
56.76
46.57
Females.
21.05
100.00
41.66
30.19
Total.
35.06
100.00
53.06
42.52
Deaths to admissions.
Males.
11.20
50.00
10.81
13.04
Females.
31.57
33.33
8.33
26.41
Total.
16.23
45.45
10.20
16.35
8
ANNUAL REPORT ON LUNATIC ASYLUMS.
tendency on the part of the local authorities in some districts to dispute their
liability for the maintenance of lunatics from Local or Municipal funds.
30. Great improvements have been made in the manufacturing department
of the Madras asylum. Printing, washing, carpet making, carpentry and black-
smith's work have been added to the asylum industries, which were only confined
to weaving and making up of clothing and bedding, &c., during the previous years.
In the Calicut asylum, weaving, coir-rope making, fibre spinning, tailoring, &c., are
carried on.
31. On the whole the administration of the several asylums has been carried
on efficiently during the year.
I have the honor to be,
Sir,
Your most obedient servant,
M. C. FURNELL, M.D., F.R.C.S.,
Surgeon-General with the Government of Madras.
ANNUAL REPORT ON LUNATIC ASYLUMS.
9
ANNUAL MEDICAL REPORT
OF THE
GOVERNMENT LUNATIC ASYLUM, MADRAS,
FOR THE YEAR 1884-85.
I HAVE the honor to submit the report on the Government Lunatic Asylum, Madras,
for the year 1884-85.
I.—BUILDINGS.
The whole asylum has been under repair. Quarters for the Assistant Matron
and two second-class European attendants have been sanctioned. A ward for 12
patients and 6 single rooms have been sanctioned to relieve the overcrowding in the
jail.
Part of the wall of the female enclosure fell down during the cyclone of last
November and has been rebuilt; the remainder of the old wall is to be put in order.
Owing to the increased number of patients, two day sheds were converted into
temporary sleeping wards.
A shower-bath is greatly needed in the female enclosure and could be built
in one of the bath rooms at a small cost.
II.—FINANCIAL.
(a.) The average monthly cost, excluding the Superintendent's pay, for each
patient has been as follows for the three last years:—
Years.
1882-83 ... ... ... ...
1883-84
...
...
...
...
1884-85
...
...
...
...
Europeans and
East Indians.
Rs.
19
19
15
A.
14
6
12
P.
10
2
8
Natives.
Rs.
11
11
10
A.
10
3
2
P.
7
5
5
(b.) Total annual cost of an insane under the various headings :—
—
Establishment
...
...
...
...
...
Diet
...
...
...
......
...
Clothing
...
...
...
...
...
Bazaar medicines ... ... ... ...
Contingencies ... ... ... ... ...
Hospital miscellanies ... ... ... ...
European
medicines...
...
...
...
Total ...
1883-84.
Rs.
71
87
6
5
2
5
0
178
A.
12
5
1
2
4
11
6
12
P.
1
9
0
10
6
7
11
8
1884-85.
Rs.
75
74
4
4
*4
2
0
165
A.
0
1
5
10
9
9
10
15
P.
3
7
7
2
6
9
2
0
Remarks.
* Increase is due to the
purchase of washing
machines and one tell-
tale clock.
3
10
ANNUAL REOPRT ON LUNATIC ASYLUMS.
(c.) Expenditure and receipts—
—
Expenditure ... ... ...
Receipts ... ... ... ...
1883-84.
Rs.
58,595
15,936
A.
7
3
P.
0
2
1884-85.
Rs.
59,743
14,144
A.
2
12
P.
3
0
(d.) Financial statement—
—
Medical Officer's salary ...
Medical
Subordinate's
salary ... ... ...
Servants' wages ... ...
European medicines ...
Clothing and bedding ...
Dieting sick
...
...
Wines and spirits ...
Perishable articles and
contingencies ... ...
Total ...
1883-84.
Rs.
6,978
3,223
13,370
142
780
27,722
975
5,543
58,738
A.
11
8
9
11
0
13
15
12
2
P.
5
0
7
11
6
6
4
8
11
1884-85.
Rs.
9,553
3,428
14,025
229
960
26,423
253
4,869
59,743
A.
1
10
2
11
3
8
1
12
2
P.
4
6
4
1
0
2
4
6
3
Increase.
Rs.
2,574
205
654
86
180
A.
5
2
8
15
2
P.
11
6
9
2
6
...
...
...
3,701 2 10
Decrease.
Rs. A. P.
...
...
...
...
...
1,299
722
674
2,696
5
14
0
3
4
0
2
6
Remarks.
Drew Surgeon-Major's pay.
Drawing asylum allowance
of Rs. 60 per mensem.
Increase of patients.
Do.
do.
Do.
do.
(e.) The asylum makes up its own bedding and clothing. This year its value
was Rs. 737-5-9.
(f.) No payment is received from the Madras Municipality.
The number of patients for whom no maintenance is paid has increased.
The following table shows how maintenance charges have been met during the
year:—
Military ... ... ... ... ... ... ... ...
Criminal
...
...
...
...
...
...
...
...
Madras patients paid for by Government ... ... ...
Other patients maintained by Government ... ... ...
Patients maintained by Local Fund Boards and Municipalities
Patients maintained by friends ... ... ... ... ...
Patients partially maintained by friends ... ... ...
Total ...
23
88
178
66
109
10
19
493
Of the 66 "other patients maintained by Government" 12 are criminals whose
sentences have expired ; 5 are military patients transferred to civil, as they have
been two years in the asylum; 38 are pilgrims and others with no known abode;
2 are old cases from Rangoon ; 3 are transferred from Trichinopoly asylum, 5 are
cases under reference to Magistrates and Presidents of Local Fund Boards and
Municipalities; and the remaining 1 is Mr. Bacon, who has been in the asylum
for 35 years.
Since G.O., No. 667, dated 13th March 1884 was issued, the number of
patients to be maintained by Government has increased, as Municipalities and
Local Fund Boards are no longer responsible for the maintenance of wandering
lunatics.
III.—STAFF AND ESTABLISHMENT.
Senior Apothecary—J. J. Watts.
Civil Apothecary—E. T. Jones.
First-class European Attendant—H. McColeman.
Do.
do.
—R. T. Lawrence.
Steward—K. Annu Chetty.
Assistant Steward—A. C. McKenzie.
Writer—S. Audinarayaniah.
Second-class European Attendant—R. Leason.
Do.
do.
—D. A. Bruce.
Matron—Mrs. L. Hennon.
Assistant Matron—Mrs. M. Wakefield.
These are adequate. Honesty,
energy and kindness are the qualities
required of the staff, upon whom depends
the economical working of the institu-
tion and the welfare of the patients, and
these qualities are fairly well repre-
sented.
The Steward is a hard-working man
and of great assistance in reducing expenditure. The proportion of attendants to
ANNUAL REPORT ON LUNATIC ASYLUMS.
11
patients is double that allowed in England. This allows of more freedom, and the
open-door system can thus be more easily carried out in its entirety.
Three native attendants have been dismissed for ill-treatment, and many have
been punished for using unnecessary force.
My predecessor encouraged the employment of pensioners as attendants, and
the practice has been continued.
Dent's portable tell-tale clocks, introduced in 1883, have worked so success-
fully that they are now in use all over the asylum.
The dhobies received small pay and washed badly. In December washing
machines were started and are now worked by patients, the services of the dhobies
having been dispensed with in January. This new system has worked well and
affords daily employment for a number of patients.
IV.—THE PATIENTS.
(a.) Remained on the 31st March 1884—
—
Males ... ... ... ...
Females ... ... ...
Total ...
Grand Total ...
Europeans and
Eurasians.
45
27
72
Natives.
205
62
267
339
During the year the following were—
Admitted.
154
Discharged.
85
Died.
25
Escaped.
1
Total treated.—Europeans and Eurasians 96, natives 397. The maximum
reached on any one day was 382 and the average daily strength was 360.
—
Males ... ... ... ...
Females ... ... ...
Total ...
Grand Total ...
Remained 31st March 1885.
Europeans and
Eurasians.
52
29
81
Natives.
227
72
299
380
(b.) Admissions.—Europeans and Eurasians 24, natives 130.
Re-admissions.—Four were re-admitted within the year and 7 had been under
treatment here before.
The admissions were—
European males—
Military
...
...
...
...
...
...
...
...
Civil ... ... ... ... ... ... ... ...
Criminal (Military) ... ... ... ... ... ...
European females ... ... ... ... ... ... ...
4
1
...
...
12
ANNUAL REPORT ON LUNATIC ASYLUMS.
Eurasian males —
Military
...
...
...
...
...
...
...
...
Civil ... ... ... ... ... ... ... ... ...
Criminal
...
...
...
...
...
...
...
...
Eurasian females ... ... ... ... ... ... ...
Native males—
Military
...
...
...
...
...
...
...
...
Civil ... ... ... ... ... ... ... ...
Criminal ... ... ... ... ... ... ... ...
Native females—
Civil ... ... ... ... ... ... ... ...
Criminal
...
...
...
...
...
...
...
...
Total ...
2
11
1
5
9
70
18
32
1
154
The admissions exceed by 4 those of the previous year.
There were only 4 admissions of European military insanes, one of whom was
an officer. A marked increase occurred in the number of Eurasian male and female
patients, 14 of the former and 5 of the latter having been received against 8 males
and 3 females in 1883-84.
—
European males ... ...
Do.
females ... ...
Eurasian males ... ...
Do. females ... ...
Native males ... ...
Do. females ... ...
Total admitted ...
1883-84.
6
1
8
3
98
34
150
1884.85.
5
...
14
5
97
33
154
Increase in
1884-85.
...
...
6
2
...
...
...
Decrease in
1884-85.
1
1
...
...
1
1
...
The diseases of the European patients were as follows :—
Diseases.
Acute mania ... ...
Chronic mania
...
...
Melancholia
...
...
European males.
Military.
2
1
1
Civil.
...
...
1
Criminal.
...
...
...
European females.
Military.
...
...
...
Civil.
...
...
...
Criminal.
...
...
...
Two criminals (murderers) have been again reported on as showing no signs of
insanity, and the release of one has been strongly recommended to Government.
(c.) Types of insanity—
Acute mania (of whom 1 was an epileptic)
...
...
...
Chronic mania (of whom 4 were epileptics)
...
...
...
Melancholia
...
...
...
...
...
...
...
Acute dementia
...
...
...
...
...
...
...
Chronic do.
...
...
...
...
...
...
...
General paralysis
...
...
...
...
...
...
...
Idiotcy, congenital
...
...
...
...
...
...
Imbecility (of whom 1 was an epileptic)
...
...
...
Puerperal mania
...
...
...
...
...
...
...
Observation (of whom none were epileptics)
...
...
...
Total ...
35
54
46
2
8
1
1
2
2
3
154
ANNUAL REPORT ON LUNATIC ASYLUMS.
13
(d.) Causes.—The following list, which may be relied on, shows the cause in a
few cases only :—
Causes.
Physical.
Congenital ... ...
Epilepsy ...
...
...
Hereditary ... ...
Narcotic drugs
...
...
Over study
...
...
Puerperal
...
...
Moral.
Misfortune ... ...
Religion ... ... ...
Love ... ...
Infidelity ... ... ...
Family quarrel
...
...
Total ...
Europeans.
...
...
2
...
1
...
1
...
...
...
...
4
Eurasians.
2
...
3
...
...
2
1
1
2
...
...
11
Natives.
1
5
2
6
...
...
3
...
...
1
3
21
Total.
3
5
7
6
1
2
5
1
2
1
3
36
Of the remaining 118 nothing is known.
(e.) Age—
8 patients were under 20 years of age.
107 patients were between 20 and 40 years.
38 patients were between 40 and 60 years.
1 patient was above 60 years.
(f.) Caste—
Europeans and Eurasians ... ... ... ... ...
Hindus ... ... ... ... ... ... ... ...
Muhammadans ... ... ... ... ... ... ...
Brahmins ... ... ... ... ... ... ...
Native Christians
...
...
...
...
...
...
...
Other castes
...
...
...
...
...
...
...
24
106
19
3
1
1
(g.) Recoveries—
Disease.
Acute mania ... ... ...
Chronic mania ... ... ...
Melancholia
...
...
...
Observation ... ... ...
Number.
9
30
9
6
Percentage to
Admissions.
25.71
55.55
19.56
200.00
Total treated.
17.64
11.45
10.71
26.08
Years.
1883-84
...
...
...
1884-85
...
...
...
Number.
66
54
Percentage
to total treated.
14.50
10.95
(h.) Escapes.—One man escaped: the usual measures were taken for his re-
capture, but without success.
(i.) Suicides.—None.
(j.) Births.—None.
(k.) Sickness and Mortality.—Considering the very emaciated state in which
most of the patients are received there has not been an undue amount of sickness
among them nor have any epidemics occurred.
Of the 154 admissions only 45 were received in good health.
4