24
APPENDIX TO ANNUAL REPORT ON LUNATIC ASYLUMS.
(g) Drainage.—In the criminal enclosure, where the greatest number of cases arose, there
is the best drainage with good masonry gutters, far superior to the rest of the asylum in which
the drainage is defective. The method of removing the excreta at present in use is by allowing
the excrement to run into pails which are removed by hand by the toties; the flushing of the
blocks also runs into these pails or cisterns.
5. Meteorological phenomena.—I have noticed that such cold as we have had they have—cold
mornings with dew and a sprinkling of rain once or twice affects these insanes considerably ; they
shiver, and though having blankets often won't use them, and even when put on, they often
throw them off. One of the greatest difficulties with these people is their delicacy, making
them susceptible to slight indispositions which are due to their mental state which reduces
them to a condition of childish helplessness and extreme sensitiveness.
6. I think that, considering the whole course of the epidemic, the disease came from
outside and was imported by means of clothes or by an attendant, though this is by no means
proved. If Mr. Downey's case was the starting point, from him there is no difficulty in tracing
the course to the criminal enclosure as he informed Surgeon-Captain Robertson at the General
Hospital that he had passed motions in the criminal enclosure latrine on the 22nd December;
but this would not account for the case in the female enclosure, which commenced at the same
time as those in the criminal section, and I consider that, with more than one probability, there
is still nothing proved; I leave the matter as it often is in the history of epidemics, a field for
probable surmises.
7. The return of the number of epidemics that have occurred during the last ten years is
attached (appendix B).
8. By order of the Surgeon-Greneral all the patients were transferred to the isolation blocks
and tents (when the increased number of cases required the latter to be pitched) ; all doubtful
cases were retained in the ordinary hospital enclosure until the diagnosis was certain (this being
necessary from the fact of their being insanes, the importance of their security was not to be lost
sight of); after that- they were removed to the isolation cottages and tents. Their cotton clothing
was destroyed and their blankets washed in perchloride of mercury solution and fumigated.
On their return to their sections after recovery fresh clothing was given them. All cholera
excreta were buried in an open part of the asylum grounds at first, and at a later period the
excreta were burnt. In the hospital enclosure half the blocks were emptied of patients at one time
for purposes of cleaning and fumigation with sulphur; on the completion of this, the remaining
blocks were cleaned and fumigated in the same way. A similar method was adopted in cleaning
and fumigating the single cells. Mr. Downey's quarters were also cleaned and fumigated.
9. The blocks in the asylum were partially re-limewashed and tarred, and the greatest care
was taken to have them thoroughly cleaned.
10. Visitors were precluded from visiting the asylum.
11. A temporary staff of one hospital assistant, six native attendants and three toties was
entertained for the cholera cases.
MADRAS LUNATIC ASYLUM,
16th January
1895.
MADRAS LUNATIC ASYLUM,
19th March 1895.
Revised copy signed by
C. H. LEE PALK, M.D., Surgeon-Captain,
Superintendent, Government Lunatic Asylum.
From the Government Analyst, North-West Provinces and Oudh, to Surgeon-Major D. ELCUM,
Superintendent, Lunatic Asylum, Madras, dated
No. 27.
I have the honour to acknowledge the receipt of the undermentioned articles:—
A. Specimon of water from a cistern near a well,
B. Earth taken from a spot four yards from the latrine,
C. Dust and fluff scraped up in the corner of a room near above,
D. Earth from ground further off from the latrine ;
the despatch of which for analysis was intimated in your No. D.O., dated 22nd January 1895,
and to report the result of the analysis, that a mierobe indistinguishable from that of cholera
was detected in the sample marked A, but not in the other specimens.