ANNUAL REPORT ON LUNATIC ASYLUMS.
5
It will be seen that in Madras there was an appreciable decrease in the death-
rate, while in Waltair and Calicut there was a large increase. In the case of
Calicut the increased death-rate is explained by the Superintendent as being
chiefly due to an outbreak of cholera which caused 9 deaths, 3, however, died
from other bowel-complaints. At Waltair the death-rate (20.98) represents,
however, only 9 deaths, of which 2 died of bowel-complaints. The remaining
deaths in both the asylums were of the usual type common among insanes.
9. The daily average sick increased in all the asylums. In Madras it was
38.73 against 16.41. This increase was due to the weakly condition of the insanes
on admission and to the efforts made to stay the sickness and mortality by largely
increasing the number of patients in hospital and in the convalescent gang. The
truth of this explanation will be seen from the fact that, in 1891, there were 37
admissions for debility and 2 for anæmia, while, in 1892, the figures were 76 and
20 respectively, evidently showing the Superintendent's anxiety to exercise great
supervision over the obviously weakly cases. On the other hand, the admissions
for bowel-complaints showed a large decrease, the figures being for 1891 dysentery
60 and diarrhœa 116 and for 1892, 56 and 47 respectively. These latter are usually
classed among the preventable diseases, and the sick-rate for bowel-complaints is,
ceteris paribus, a fairly reliable criterion of the care bestowed on the insanes and
the influence of the asylum on their general health. Again, from the table
appended it will be seen that the actual percentage of sick to total treated
diminished considerably, showing that though the sick treated spent a large
time on the sick list for the reasons given above, yet the actual number reporting
sick decreased.
Table showing percentage of sick to total population in Madras Lunatic Asylum.
—
Madras ... ... ...
1888.
37.78
1889.
45.23
1890.
48.19
1891.
73.73
1892.
63.19
10. In Waltair the sick-rate increased to 6.17 from 2.19 in the preceding
year. There was, however, only a very slight increase in admissions under bowel¬
complaints, the increase therefore is chiefly due to diseases of a more general
nature. In Calicut although the number of admissions is larger, the average daily
sick showed but a slight increase ; this is accounted for by the fact that the admis-
sion for bowel-complaints showed a considerable increase and cholera carried off 9
cases. The Superintendent further reports that there was an unusually heavy
monsoon, which prejudicially affected the health of the old and weakly inmates.
11. As observed above, cholera attacked both the Madras and Calicut Asy-
lums. In the former there were 9 cases with 8 deaths, 6 of which occurred in
September, at a time when mortality from other causes was least. In Calicut
there were 13 cases, of which 9 ended fatally. Active measures, however, were
adopted, including isolation of those attacked, and the spread of the disease was
combated successfully.
12. The annexed statement gives the percentage of deaths to average strength
arranged according to sexes for the last five years.
Percentage of Deaths according to sex, to daily average strength during the five years ending 1892.
—
Madras ... ... ...
1888.
Males.
5.75
Females.
10.69
1889.
Males.
7.61
Females.
15.24
1890.
Males.
17.90
Females.
21.26
1891.
Males.
23.87
Females.
20.64
1892.
Males.
17.37
Females.
17.26
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