APPENDIX TO ANNUAL REPORT ON LUNATIC ASYLUMS.
25
REMARKS BY THE SURGEON-GENERAL WITH THE GOVERNMENT OF MADRAS.
1. The Superintendent of the Lunatic Asylum, Madras, reported to me on the 30th
Pecember 1894, that five insanes had been attacked on the previous day with cholera and died
within a few hours of their admission, also that other patients, who had been admitted during
the night of the 29th, were in a more or less precarious state. All the men who had been
attacked were from the criminal enclosure though from different blocks.
2. I visited the asylum on the 31st December and gave orders that the cases should be
treated in the isolation wards, and suggested certain precautions which he carried out.
3. This report clearly shows that Mr. Downey, the European attendant, passed his evacuations
on the 22nd December in the general latrine of the criminal enclosure and that no precautions
were taken about these as cholera was not suspected, also that the evacuations passed by him on
the night of the 23rd and the morning of the 24th December were collected in a chatty and put
with other filth into the buckets at the general latrine (Block No. 112, Government plan) outside
the criminal enclosure, that no dry earth or disinfectant of any kind was used when removing
these. It appears that his servant was in the habit of daily going to the Smithfield market and
had been to his own house near Chintadripet on the 19th December. As far as can be ascertained
neither he nor his master was in immediate contact with persons suffering from cholera, although
outbreaks of this disease existed in Madras following on the dispersion of the crowds from
the great festival at Trinnomalle. Konkichettivadu, who was taken ill on the 27th December, was
sent to hospital from Block 7, Section IV (Government plan). The first case attacked in the
female enclosure was Kulliamal, who was grinding grain on the 27th December and came in
contact with men who brought the grain bags from the criminal to the female enclosure.
4. A copy of the site plan is attached to the report to show the buildings from which the
cases were admitted in the order of their admissions :—
Number.
1
2
3
4
5
6
7
8
9
Government plan,
Block No.
Block No. 6 .. ..
Do. No. 13 .. ..
Do. No. 11 .. ..
Do. No. 10 .. ..
Do. No. 2 .. ..
Do. No. 8 .. ..
Do. No. 5 .. ..
Do. No. 14 .. ..
Do. No. 12 .. ..
Place where patient was placed.
25th cell
..
..
..
No. 6, General cottage .. .. ..
No. 3
Do.
..
..
..
No.
5
Do. .. .. ..
Filthy cottage .. .. .. ..
Second row of single rooms .. .. ..
Six rooms
..
..
..
..
No. 4, General cottage .. .. ..
No
1
Do.
..
..
..
Date of attack.
27th December 1894.
29th December 1894.
Do.
Do.
Do.
1st January 1895.
Do.
Do.
3rd January 1895.
5. The Superintendent has reported that the evacuations of the patients while in the hospital
enclosure were treated in a similar manner to those of all other hospital sick, i.e., with McDougall's
powder in the wards and dry earth in the latrine and were carried away in the conservancy carts.
From and after the 31st December, when the cases were removed to the isolation blocks, the
evacuations were collected, thoroughly disinfected and buried. After the 21st January, the
discharges were burned in the incinerator.
While the patients were in the hospital, the clothing and bedding were washed with carbolic
lotion, soap and water and then dried. After their transfer to the isolation blocks, the articles
of bedding and clothing already used by the patients were burned ; and those in use at the time
and afterwards were burned in the incinerator, the blankets only being preserved. The proper
boiling and disinfection of blankets were commenced on the 10th January.
6. The Acting Sanitary Commissioner of Madras, at my request, visited the asylum with
me on the 4th January, and suggested that specimens of the water from the well and earth from
the places which were first polluted should be sent to Professor Hankin and that he should be
asked to carry out a bacteriological examination of them, as he had kindly told Surgeon-Lieutenant-
Colonel King, that he would be happy to do so at any time if be were asked. In reply to a
letter of mine, the Acting Sanitary Commissioner remarked on the 29th January that the failure
to diagnose the first cases has led to difficulties as to complete segregation of the cholera poison
and ottered the following suggestions :—
(1) That the well and cistern in the jail compound should at once be closed till the end
of the epidemic and be disinfected before use by chlorinated lime and sodium sulphite in certain
proportions to the amount of the water in the well;
(2) That sewage farming in the asylum compound should cease till the epidemic was
over and that the patients should neither use the vegetables grown on it, nor handle its soil
in any way ;
(3) That the floors of each ward should be carefully washed with perchloride of mercury
lotion 1 in 1,000 ;
(4) That all destructible eating and drinking vessels should be destroyed and the non-
destructible ones should be plunged in boiling water, and in subsequent use be washed with
Red Hills water at a site not hitherto employed ;
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