ANNUAL REPORT ON LUNATIC ASYLUMS.
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the next largest entries are under anæmia and ulcer, conditions which indicate
when in large numbers, a general feebleness of health complicating the above con-
ditions and liberal treatment in the direction of food, stimulants and tonic treatment
generally. Insane patients are delicate feeders, their mental state makes them
exceedingly capricious, and if capricious, it is waste of time to attempt to reason
with insanes. They should either be given food which they like or they must be
kept on a fixed diet, but in the latter case we must be prepared to constantly see
them fed with great difficulty and slipping little by little into an anaemic state,
losing weight and at last when deteriorated in health to put them on a diet, it
would have been better to have kept them on always." " Criminal insanes have
often come in from jails where they have been for some time fed on raggi under
observation ; it is the fresh admissions whose mental state it is difficult to gauge
further than that they suffer from a certain type of mental disease, but as to how
far their bodily health is affected by their mind, and has been so, it is impossible to
say without observation for some time. These especially are the people to put on
rice diet, not on raggi though it may not at first appear to affect them."
I have informed the Superintendent that such insanes as were accustomed
to the use of raggi or cholum should be put on them on admission, that rice might
be given to such patients as require it in the opinion of the Superintendent and
that to put all on a rice diet would be a useless waste of public money. The
standing orders regarding asylums very properly leave the dieting of the patients
in the hands of the medical officer and give him ample power. If he acts on
them thoroughly and at the same time carries out the orders regarding the inspec-
tion of all insanes who have lost weight after each fortnightly weighment, there
ought to be no fear of any patient suffering from underfeeding.
9. MORTALITY AND ITS CAUSES.—Since August 1894 special casualty reports
regarding all deaths in the asylums have been submitted to me so that I have full
details of the causes of the death in each case.
There were two deaths in the asylum at Vizagapatam both of which were
unavoidable, one was from cerebral abscess following long-standing disease of
internal ear and the other from chronic pneumonic phthisis of eighteen months'
duration following influenza.
In the Calicut Asylum, there were 6 deaths (all males), as against 15 in
the previous year. The causes of death were ulceration of bowels 1, chronic
pneumonic phthisis 1, old age 1, softening of the brain 1, tubercle of lungs 1 and
cirrhosis of the liver 1.
In the Madras Asylum the mortality was 56 against 50 in 1893. These 56
deaths include one of suicide and eight deaths from cholera which occurred during
the last few days of the year 1894. Excluding these deaths from cholera, the
percentage of deaths to average strength is 9.91. The diseases which caused the
deaths were debility and anæmia 12, catarrhal inflammation of intestines 9, dysen-
tery 8, lung diseases 5, secondary syphilis 2, mania 2, and idiopathic anæmia 1,
tetanus (idiopathic) 1, hæmorrhage 1, thrombosis 1, malarial fever 1, tubercle of
lung 1, old age 1, diarrhœa 1, epilepsy 1.
A criminal insane committed suicide on the 30th December 1894 by hanging
in his cell. The fact was brought before Government in the official visitors' report
for January 1895. A magisterial inquiry was held and the Presidency Magistrate
opined that the body and clothes of the deceased were not properly searched
on the night in question. It is very probable, as was suggested by the Asylum
Superintendent, that the deceased had secreted the rope somewhere and did not
have it about his person or clothing, as the European attendant who searched him
stated at the time. The man was last seen alive at 1-45 A.M. by the patrol
attendant and found dead by another between 2 and 2-30 A.M.
After a careful enquiry, I formed the opinion that none of the attendants
could be held responsible for the accident and directed that steps should be taken
to inform all the attendants of the facts of the case in order that even greater
vigilance in examining such insanes and their cells before they were locked up for
night, should be carried out in future.
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