REPORT ON THE LUNATIC ASYLUMS.
capable of accommodating comfortably about 200 to 250 patients, has enabled the
authorities to introduce various changes in the way of concerts and variety enter-
tainments for the amusement of the patients. Several hundred books of light
and solid reading for the library at Madras were purchased direct from home
through the Superintendent of Stationery. On festival occasions treats were pro-
vided—the usual periodical ones being held in Madras. Sri Maharani, Lady
Gajapathy Rao Garu and M.K.Ry. D. Bangaru Raju contributed towards these at
Vizagapatatn, and Haji Currim Haji Mahomed Sait at Calicut. There is a gramo-
phone in each of the asylums, which helps to provide music, and occasionally local
bands are engaged.
24. Statistics of health and treatment of the nick—Sickness and its Vauses.—The
average daily sick was 67*80', 53*57, and bi*64 in th« three asylums together in
the three years 1909, 1910 and 1U11 respectively. The mean for the triennium
was 62*02—greater by 9 than the last which was 53*06. This increase is due to
the health of many new admissions being bad necessitating their immediate admis-
sion into the hospital, and to all acute cases of insanity requiring careful nursing
and dieting being also admitted. The principal diseases from which the inmates
suffered were in order of frequency :—diseases of the digestive system, including
dysentery and diarrhoea; of the nervous system, including mania, melancholia, etc.,
anaemia and debility, tubercular diseases and malarial fever. Coincidental with the
increase of dysentery and diarrhoea among the population of the town there were a
great many admissions of these diseases among the criminal population at Madras.
25. Forcible feeding and methods in use.—Very seldom resorted to at Vizaga-
patam and Calicut, but at Madras it is found a necessity. The annual mean
number of feedings for the triennium was j.,392. No bad results have accrued and
the method has been found suitable and satisfactory. Nasal feeding is adopted by
means of a Jacques catheter and syphon tubing.
26. Mortality and its causes.—The total number of deaths was 48, 79 and 69
in the three years or an average of 65*53 per annum (the large number in 1910
includes 12 from cholera in the Madras Abylum). The average for the previous
triennium being 77 67. The chief causes of mortality were (a) tubercle which, as
usual, heads the list, 14, 18 and 16 for the three years under report of a total of 39,
64 and 5b respectively in the Madras Asylum (Vizagapatam contributing 0, 1 and 1
of a total of 3, 6 and 6 deaths respectively and Calicut, 0, 1 and 3 of a total of 6, 9
and 7 deaths respectively) : (6) diseases of the nervous system and (c) dysentery and
catarrhal inflammation of the bowels. The percentage mortality calculated on the
daily average strength yields 7*09, ll*0b* and 9*lii as compared with 11-67, 16*30
and 9*11 respectively for the previous three years.
27. Epidemics and how they were dealt with.—The Vizagapatam and Calicut
asvlums were free from epidemics during the three years, and Madras Asylum in
1M09 and 1911, but in October 1910 a fairly severe outbreak of cholera occurred.
There were 22 cases with 12 deaths, a case mortality of 54*55 per cent.—the lowest
on record in the Institution. I quote in extenso from the report of the Super-
intendent :—"Every possible means was taken to check the disease and all eases
" were treated in the contagious disease sheds and a special staff of servants were
" entertained for the purpose. The method of treatment was that advocated by
u Major Leonard Rogers, O.I.E., I M.S. The cause of the outbreak could not be
44 definitely traced but two factors were believed to have played some important part—
u one was the fact that the water of the kitchen well was found to be highly conta-
u minated and contained vibrios in great numbers, and it was possible that the water
" had been consumed by some of the patients who suffered from cholera—the other
44 was that, when the outbreak occurred, several hundred coolies were employed in
44 the asylum by various Public Works Department contractors and it was possible
"that one of them might have conveyed the disease by some means or other, but
44 no sickness could be traced amongst these coolies or their families." In the
previous trieunium (October 1907) there were 1' attacks and 14 deaths, and in the
one euding 31st December 1905, 19 attacks with 12 deaths, with a case mortality of
82*35 and 63 16 per cent, respectively. In the former of these the cause was attri-
buted to the conveyance of infection by flies which swarmed considerably at the time