( 3 )
not due to any removable cause existing within the asylum. The
deaths fell to 30 in 1906 but rose again to 35 in 1907. The system of
flushing the cells and barracks was introduced over four years ago in
the asylum in place of the dry earth system previously in force. The
change though theoretically superior was followed by a steadily
increasing casualty roll and in June 1907 the dry earth system was
reintroduced. Colonel Sweeny reports that " the change was followed
by a decided improvement in the general health and in the year just
gone had it not been for so many cases of unexpected deaths such as
cholera, suicide, apoplexy, heart disease etc., we would have had a very
exceptionally healthy year. Out of the total of 29 deaths no fewer than
11 occurred from causes which have no reference to the sanitary
conditions of the asylum."
The death rate during 1908 was 8.58 against 10.34 in 1907 and
9.08 in 1906. The marked feature of the year 1908 was the large
number of cases of ague of which there were 113 or nearly one-third
of the population admitted to hospital as compared with 83 in 1906
and 79 in 1907. Criminal lunatic Harka committed suicide by hanging
in March 1908. In August lunatic Raghbar Mullab died by violence.
Baijnath, another lunatic, attacked him one night and beating his ribs
killed him. There was no evidence as to the motive for the murder and
the Superintendent reported that there was nothing in Baijnath's case to
indicate that he differred from the mildest of the aggressive types of
lunatics. There was no overcrowding in the asylum during 1906 and
1907. There was a very slight increase over capacity in 1908 and from
the middle of January to the middle of August the asylum was closed to
fresh admissions. It is proposed to build a barrack of about 30 cells
which will relieve the pressure as well as remove the deficiency for
segregating at night excited and otherwise objectionable lunatics.
Agra.—The number of deaths in the Agra asylum during 1903, 1904
and 1905 were 23,17 and 34 as compared with 85, 49 and 87 in 1906, 1907
and 1908. Of the 85 deaths in 1906, 20 were due to extraordinary causes
(heat stroke 18, small pox 1 and accidental rupture 1) 7 to epilepsy, 5 to
maniacal excitement, 9 to general debility, 9 to old age and 13 to dysentery.
The mortality fell to 49 in 1907 and it would have been still further
reduced to 30 if influenza, which accounted for 19 deaths, had not been
prevalent in the asylum during the last six weeks of the year. Extremely
rapid signs of pneumonia set in after a few hours malaise associated
with slight cough and fever. In many cases when the patient survived
over the third day symptoms of enteritis supervened. Of the remaining
30 deaths, dysentry accounted for 10. The year 1908 started with a great
number of patients much debilitated by the influenza epidemic. The
chief immediate causes of death were epilepsy 7, dysentery 19, old age
10, pneumonia 7, mania 7, dementia 4, anæmia 13, and Brights disease
3. The Superintendent, however, considers that malarial fever was
more or less directly responsible for 43 of these deaths although it is not
shown among the immediate causes. Malarial fever began to be prevalent
in Agra in July and the asylum shared with the country round. The daily
average number under treatment for malaria by quinine, not necessarily
shown as in hospital, were :—
July ... ...
August ... ...
September ... ...
20
56
97
October ... ...
November ... ...
December ... ...
90
50
20
The fever was of a very intractable type and in many cases hypo-
dermic medication of quinine bi-hydrochloride had to be resorted to.
Although no patient died while suffering from fever the consequent
debility was very marked, and the demented patient is unable to
convalesce rapidly. Dysentery, anæmia and pneumonia followed, carrying
off many. Weighments made in November and December showed that
the majority of the inmates had lost weight, and the general health of
the institution at the end of the year may be described as very poor, with
a daily average sick in hospital for December of 117.35. During the