ANNUAL REPORT ON LUNATIC ASYLUMS.
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0 f the heart 2, disease of the liver 2, asphyxia 1, and cholera 1, gangrene 1,
starvation 1, old age 1, and ancylostoma duodenale 1.
Cholera occurred in only one case. This patient, who came from Mercara
contracted the disease on his way to the asylum.
The steps taken on the
occurrence of the disease proved sufficient to prevent its spread in the asylum.
In the Calicut Asylum 7 deaths occurred against 14 in 1895. Death was due
in 3 cases to bowel complaints, in 2 to tubercle, in 1 to general paralysis of the
insane, and in 1 to hernia.
Only one death occurred in the Vizagapatam Asylum, due to general paralysis
of the insane.
(4) Epidemics and how they were dealt with.—There were no epidemics
in any of the asylums. Only one imported case of cholera was treated in the
Madras Asylum. All the asylum attendants have been ordered to be re-vaccinated
as a preventive against small-pox.
(5) htjuries received in the as//fems.-Two cases of serious injuries—both
self-inflicted—occurred in the Madras Asylum, one of which proved fatal. The
fatal case was that of a female civil insane, Madura by name, who was confined
in a single room owing to an attack of acute mania, and who in the early morn-
ing climbed up the iron door and losing her grip fell heavily on to the asphalte
floor on the back of her head. On opening the cell she was found in an uncon-
scious condition and died in a few hours without rallying. The usual inquest was
held and the post mortem disclosed an extensive fracture of the base of the skull.
A full report of the accident was duly submitted to me.
The other injury occurred in a Native civil male insane who trespassed into
another cell and on being discovered, rushed out knocking his face against the
bars and so sustained a simple fracture of the lower jaw; from this he quickly
recovered.
There were two cases of injuries during the year in the Calicut Asylum—one a
wound of the ear and the other a contusion of the face. These were caused by the
insanes assaulting each other.
There occurred only one case of injury—sprain of hand—in the Vizagapatam
Asylum, caused by two inmates fighting with each other.
(6) Hospital diets and extras.—The expenditure on extras, especially on alco-
holic stimulants, was very small in the Madras Asylum, considering the daily average
sick (57*27). A portable stove was sanctioned by me for the male hospital, it has
been found very useful.
In the Vizagapatam Asylum the only hospital diet used was * spoon' with
extras.
In the Calicut Asylum the diets and extras cost Es. 158-13-7 over the previous
year. This was due to the larger number of patients treated in the hospital during
the year and to the increased doily average sick. The Superintendent reports that
a large number of admissions had to be unavoidably placed on extras alone, owing
to the nature of their diseases.
The hospital diets are those laid down in G.O., No. 1, Public, dated 1st
January 1889.
(7) Nursing of the sick.—In Vizagapatam and Calicut the nursing was done
by the keepers and night watchmen under the supervision of the Hospital Assist-
ant. The Superintendent of the Calicut Asylum remarks that this arrangement is
very defective and considers it very desirable to have a separate establishment for
nursing. I consider it very necessary to have such special attendants who should
be trained in sick nursing.
As regards the Madras Asylum the nursing establishment consists of 1 matron,
1 head nurse and 2 nurses. One day and one night nurse were more or less in
constant attendance on the sick in the male hospital throughout the year. The
matron's and the head nurse's duties have been entirely confined to the female
section. Regarding the inadequacy of the nursing arrangements in the Madras
Asylum, I have already addressed the Government on the subject (No. T * dated
7th February 1897).
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