8
ANNUAL EEPORT ON LUNATIC ASYLUMS.
In the Vizagapatam Asylum there were 50 admissions, 20 of whom were cases
of simple continued fever and probably due to chills. The daily average sick was
3*11 against 4*63 in the previous year.
In the Calicut Asylum there were 159 admissions with a daily avernge sick of
26*36 as compared with 141 admissions, and a daily average sick of 24'82 in the
previous year; dysentery, intermittent fever, and anaemia contributed the largest
number of admissions.
(2) Forcible feeding and methods in use.—In the Madras Asylum 27 cases
required forcible feeding by the naso-pharyngeal tube, and 1 case was fed per
rectum. In Vizagapatam, 5 patients were fed by hand and 1 by nasal tube. In
Calicut, 6 insanes had to be fed forcibly by the hand, and 3 others were fed by naso-
pharyngeal tube during all their periods of excitement.
(3) Mortality and its causes.—37 deaths occurred in the Madras Asylum
against 38 in the previous year. Death was due to the following causes :—Mania
and other mental states 13, general paralysis of the insane 8, epilepsy 2, tubercle
2, cancer 2, starvation 2, chronic interstitial inflammation of the lungs 2, enteritis 2,
and one each of dysentery, secondary syphilis, anchylostomosis, anaemia, paraplegia,
pneumonia, catarrhal inflammation of the stomach, ulceration of the intestine and
injury to the chest.
Only one death occurred in the Vizagapatam Asylum, due to " exhaustion of
mania."
In the Calicut Asylum 21 deaths occurred against 7 in 1896. The causes of
death were—cholera 8. idiopathic anaemia 4, dysentery 3, and one each of rheuma-
tism, valvular disease of the heart, gangrene of the lung, chronic phthisis, catarrhal
inflammation of the intestines and Bright's disease.
(4) Epidemics and how they were dealt with.—No epidemics occurred in the
Madras or Vizagapatam Asylums. In Calicut some cases of cholera occurred in
July during the epidemic in the neighbourhood. The patients were segregated,
and a separate extra establishment was appointed. The wells were re-Hankenized
and all water for drinking purposes was boiled before use. Phenyl was freely used.
Evacuations were carefully collected in a vessel containing saw-dust and burnt with
kerosine-oil. Old cumblies and clothing were burnt, and good ones were boiled
in a solution of perchloride of mercury. The inmates were given water acidulated
with sulphuric acid, and a diminished quantity of salt for food. After the epi-
demic was over, the wails and floors were scraped, cleaned, disinfected and white-
washed :
(5) Injuries received in the asylums.—Tn Madras Asylum there was one case of
serious injury during the year. A native female criminal died within a few hours
of her admission on the 17th April 1897, as the result of extensive abdominal
injury, but how it was brought about, the magisterial enquiry that followed failed
to elicit. As a departmental punishment, the head nurse was reduced to second-
grade nurse, and an ayah was dismissed.
Two cases of fracture of the forearm occurred in Calicut Asylum ; in both cases
the injuries took place in a fall while fighting, and before the keepers could
separate the combatants.
A scalp wound (not serious) was the only injury reported from Vizagapatam
Asylum.
(6) Hospital diet and extras.—The hospital diets are those laid down in CO.,
Wo. 1, Public, dated 1st January 1889. The scale was found both ample and well
suited to the requirements of the sick. In the Madras Asylum the hospital extras
being included with the extras of the non-hospital diets, the Superintendent could
not furnish the amount spent on hospital diets with extras for the year 1897. He
has been directed to take steps to correct this in future. In Vizagapatam the total
cost amounted to Rs. 41-0-10, and the daily average sick to 3*11. In Calicut the
cost of hospital diet and extras, including the dieting of paying patients, amounted
to Rs. 1,950-14-7, and the average daily sick was 26*36.
(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 Assistant,