No. 983, JUDICIAL, 8TH JUNE 1896.
The rise in the daily average sick-rate in the three asylums is explained by the
Surgeon-General to have been due, in Madras, to the prolonged retention in hospital
of a considerable number of patients suffering only from mental disease ; in Vizaga-
patam to the treatment of certain chronic cases ; and in Calicut to the admission into
hospital of all weakly inmates. The year was also in some respects unhealthy. At
Calicut the deaths numbered fourteen against six in 189J, but they do not appear
to have arisen from preventible causes. The great increase in the mortality at the
Madras asylum was due to the occurrence of 37 deaths from cholera in the epidemic
to which allusion was made in the last annual review. Excluding these, however, the
percentage of deaths in the three asylums taken together was higher than in 1893 or
1&94, being 12" 1 against 11'69 and 10*30, respectively. A slight epidemic of small-
pox occurred in the Madras asylum. The Surgeon-General will be requested to state
if it has been possible to trace the manner in which the disease was conveyed into the
institution. Eighteen patients were admitted to hospital in the same asylum for
tubercle of the lung, of whom thirteen died. No cases of this disease occurred in
1894, and the Surgeon General will be good enough to report whether any explanation
of the increase is forthcoming and whether it is merely owing to changes in the
nomenclature of diseases or was in his opinion due to the effects of dampness or
insufficient clothing or bedding. Ten deaths occurred in Madras from starvation and
anaemia (they appear to have been classified indifferently under either head) as against
twelve in 1894. Some particulars of these would have been of interest.
It is observed that there were four cases in which insanes were injured by their
fellow-patients. The Government trusts that these occurrences are not traceable to
insufficient care on the part of the attendants.
4. Finance.—The subjoined table shows the total cost of, and the cost per head
of average strength in, each of the three asylums as compared with 1894 :—
Madras.
Vizagapatam.
Calicut.
__
_»
Total.
Year.
Total
cost.
Cost
per head
of aveiage
strength.
Total
cost.
Cost
per head
of average
strength.
Total
cost.
Cost
per head
of average
strength.
Total
cost.
Cost
per head
of average
strength.
1894
1895
fi8.
73,649
68,648
BS. A. r.
155 6 0
155 15 2
us.
4,262
4,432
as. A. r.
86 9 11
74 10 0
RS.
12,308
12,o93
as. A. i'.
125 7 11
121 13 6
as.
90,218
85,673
as. A. v.
122 7 11
117 7 6
The cost per head in Vizagapatam was the lowest on record and the administration
of the Superintendent does much credit to him. The figures given in paragraph 18 of
the Surgeon-General's report show that there were on the whole considerable decreases
hi the expenditure under establishment and diet, but the causes of these are left unex-
plained. In both cases they occurred almost entirely in Madras. The fall in the cost
of diet is probably due to the reduction in the price of food-grains which took place
during the year. The Surgeon-General will be requested to report whether efforts were
made to purchase stocks of grain when the market was favourable. It seems from
a passage in the Superintendent's report that this was effected in Vizagapatam, but
it does not appear that attention was paid to the matter at the other two asylums.
The expenditure under contingencies and medicines is obscured by the fact that
in Madras, for reasons which have not been explained, the payments for medicines and
municipal taxes were allowed to fall into arrears and charges properly belonging to
1894 woro paid in 1895. The cost under clothing and bedding was increased by
unusual purchases at the same asylum. These exceptional charges resulted in an
increase in the expenditure per head of average strength in Madras, which would
otherwise have fallen somewhat. The expenditure in the other two asylums showed
a decline, and this was again particularly noticeable in Vizagapatam. The Govern-
ment continues in the opinion that the expenditure upon diets in Madras and Calicut
is oapable of further reduction. The presence of Europeans in the former asylum
u o doubt tends to raise the average cost per head, but it does not appear to afford a