3
Five males and 1 female were admitted suffering from acute mania. Two
females from chronic mania extending over 4 years or more. One male and 2
females suffered from melancholia, the first apparently from brooding over his
confinement in jail, and one of the females was attacked after child-bearing.
The case of acute dementia is that of a man with strong hereditary predis-
position suddenly becoming incoherent and unable to control his thoughts. Of
those chronically demented one comes without history, and another is an epilep-
tic with softening of the brain, and the third is hopelessly insane from excesses and
ganja smoking.
The idiots are a man and a girl picked up by the police in out-districts and
sent in for treatment. They probably have been encouraged to wander from their
homes on account of the cost and trouble to their relations, at present unknown ;
but I have requested the district officers to have the wanderings of the man and
girl traced back, in order that their friends may be found, for beyond some improve-
ment in their habits little can be hoped for from treatment in the asylum.
The man returned as "not insane" is the criminal Khushal recovered so as to
be able to stand his trial, at which he was acquitted on the ground of insanity.
11. Statement 7.—Gives the causes of insanity as far as they can be ascer-
tained. The one criminal entered under the column "fever" is the man Khushal
who murdered his child when suffering, in all probability, from what is popularly
known as brain fever. He was cured under treatment, and received back after
trial " not insane."
Of the ganja smokers one was confined twice during the year and remains in
the asylum.
12. Statement 8.—The number of sick under treatment was not great, but
the diseases in some instances very severe.
There has been more than the usual difficulty in getting some of the patients
to swallow medicines or even food ; or it may be that the present Deputy
Superintendent is less successful in persuading the patients than his predecessors.
Two patients at least have been kept alive by feeding through a tube introduced
into the stomach, or by injection of soup and stimulants into the rectum. In others
life was prolonged somewhat by the same means.
Nine died during the year, being one more than in 1879, and in eight cases
there were post mortem examinations to verify the diagnosis, &c. One man who
died from pneumonia was taken away by his friends.
13. Full details of the examinations are recorded, but being strictly medical
are only briefly given below; but they tend to confirm my opinion that in a large
proportion of cases in which the causes of insanity are returned as " unknown"
the patients must at some time have suffered from inflammatory disease of the
brain or its membranes, brought on by injury, over-stimulation, exposure to sun, or
febrile diseases.
Luchman, an old man, aged about 60 years, who died from epilepsy, had been
in the asylum since its establishment in 1864, having been transferred from the old
Nagpur Jail. The bones of his skull were much thickened, membranes thickened,
and brain atrophied, besides which he had a fatty and enlarged heart with
roughened valve.
Bhowani, an old man, had been in the asylum since 1865, ultimately dying
from anæmia. He was an inveterate mud-eater, and at last refused to take food
or medicine. In him the membranes of the brain were found thickened, the heart
fatty and enlarged with thickening and irregularity from deposit on the mitral
valve.
Mismee, an old woman, aged about 60 years, had been in the asylum since
1867, and died from old age, debility, and long standing heart disease. The brain
was atrophied, membranes thickened and dura mater firmly adhered to skull, heart
and liver fatty and enlarged.
Sukaram in the asylum since 1868, bed ridden for years, remained in hospi-
tal from the end of 1879, and died in November from peritonitis. His knees were
contracted but there was no other sign of rheumatism. Heart small and pale,
but free from adhesion or disease. Brain soft, pale and anæmic, membranes
anæmic and not adherent.