NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
xxvi
STATEMENT No. IX
SHOWING THE SANCTIONED ESTABLISHMENT OF THE
PUNJAB LUNATIC, ASYLUM, LAHORE, AS IT STOOD
ON THE 31ST DECEMBER 1922.
1
Establishment.
Superintendent
...
...
Deputy Superintendent ... ...
Assistant Deputy Superintendent ...
Head Clerk ... ... ...
Second Clerk ... ... ...
Moharrir ... ... ...
Sub-Assistant Surgeons ...
...
European Warder ... ...
Matron ... ... ...
Assistant Matrons ... ...
Superior Warders ... ...
Head-Attendant ... ...
Deputy Head Attendants ... ...
Attendants ... ... ...
Gate-Keeper ... ... ...
Sanitary Keeper ... ...
Dhobi
...
...
...
Chaprasi ... ... ...
Probationers ... ... ...
Male Attendants
...
„.
Female Attendant
...
...
Cook
...
...
...
Malis
...
...
...
Head Sweeper ... ... ...
Sweepers ... ... ...
2
Number.
1
1
1
1
1
1
2
1
1
3
2
1
2
90
1
1
1
1
16
2
1
1
2
1
27
3
Monthly wages.
Rs.
1,300
425
450
115
42
50
324
190
200
395
112
49
76
2,343
20
16
25
16
400
50
19
21
42
14
351
Daily average number of males including observation
cases
...
...
Daily average number of females
ditto
...
...
...
A.
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
P.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
683.39
184.30
Proportion of ...
Jamadars to males
...
Jemadarnis to females
...
Male keepers to males
...
Female keepers to females
...
136.68
184.30
7.05
23.04
STATEMENT No. X
SHOWING RECEIPTS AND EXPENDITURE ON ACCOUNT
OF MANUFACTURES IN THE PUNJAB LUNATIC
ASYLUM LAHORE, DURING THE YEAR 1922
AND TWO PREVIOUS YEARS.
xxviii
STATEMENT
SHOWING RECEIPTS AND EXPENDITURE ON ACCOUN
LAHORE, DURING THE YEAR 192
YEAR.
1
1920 ...
1921 ...
1922 ...
MEAN POPULATION.
Males.
2
703.83
705.55
683.39
Females.
3
158.99
161.92
184.30
Total.
4
862.82
867.47
867.69
C
Cash paid into Treasury for
articles sold.
5
Rs.
2,226
1,240
875
A.
11
7
10
P.
8
3
3
Value of manufactured goods
made over to Asylum for
Asylum purpose.
6
Rs.
22,587
22,636
23,971
A.
4
12
13
P.
2
YEAR.
1
1920 ...
1921 ...
1922 ...
DEBITS—concld.
Value of plant and machinery
in store on 1st Janu-
ary.
13
Rs.
651
651
651
A.
12
12
12
P.
0
0
0
Raw material
purchased.
14
Rs.
11,733
11,301
6,973
A.
8
0
11
P.
6
6
7
Contingencies
of
Manufacture.
15
Rs.
105
251
415
A.
14
3
1
P.
0
7
10
All other
charges.
16
Rs. A. P.
...
...
...
Total Debits.
17
Rs.
13,141
13,087
8,611
A.
2
1
4
P.
NOTE (1).—The average number of inmates employed during the year
(2).––The " value'' of materials, sta
xxix
No.X
OF MANUFACTURES IN THE PUNJAB LUNATIC ASYLUM,
AND TWO PREVIOUS YEARS.
DITS.
Value of raw material in store
at the end of the
year.
7
Rs.
8 3
5 0
9 5
A.
1
11
6
P.
0
0
6
Value of manufactured goods
in store at the end of the
year.
8
Rs. A. P.
...
...
...
Value of plant and machinery
in store at the end of
the year.
9
Rs.
651
651
651
A.
12
12
12
P.
0
0
0
Total credits.
10
Rs.
26,348
25,099
26,414
A.
12
10
10
P.
10
6
1
DEBITS.
Value of manufactured goods
in store on 1st January.
11
Rs. A. P.
...
...
...
Value of raw material in
store on 1st January
12
Rs.
649
833
570
A.
15
1
11
P.
7
0
0
RESULTS.
Excess of credits
or profits.
18
Rs.
13,207
12,012
17,803
A.
10
9
5
P.
9
5
8
Excess of debits
or less.
19
Rs. A. P.
...
...
...
REMARKS.
Average number of lunatics employed on
manufactures.
20
Males.
152.91
165.85
163.33
Females.
20.00
10.16
10.00
Total.
172.91
176.01
173.33
man factures may be stated in the column for Remarks or in a footnote.
ye ,must be entered at market rates.
PRINTED BY THE
SUPERINTENDENT, GOVERNMENT PRINTING, PUNJAB.
109 IGCH—261—1-5-23—SGPP Lahore.
TRIENNIAL REPORT
ON THE WORKING OF THE
PUNJAB LUNATIC ASYLUM
For the years, 1921, 1922 and 1923.
Lahore:
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRINTING, PUNJAB,
1924.
Price: Re. 0-14-0 or 1s. 2d.
Punjab Lunatic Asylum Report for the
Triennium 1921—1923.
Revised List of Agents for the sale of Punjab Government Publications.
IN THE UNITED KINGDOM.
CONSTABLE & Co., 10, Orange Street,
Leicester Square, London, W. C.
KEGAN PAUL,TRENCH, TRÜBNER & Co.,
Limited, 68.74, Carter Lane, E. C., and
39, New Oxford Street, London, W. C.
BERNARD QUARITCH, 11, Grafton Street,
New Bond Street, London, W.
T. FISHER UNWIN, Limited, No. 1, Adelphi
Terrace, London, W. C.
P. S. KING & SON, 2 & 4, Great Smith
Street, Westminster, London, S. W.
GRINDLAY & Co., 54, Parliament Street,
London, S. W.
W. THACKER & Co., 2, Creed Lane,
London, E. C.
LUZAC & Co., 46, Great Russell Street,
London, W. C.
B. H. BLACKWELL, 50 and 51, Broad
Street, Oxford.
DEIGHTON BELL & Co., Limited, Cam-
bridge.
OLIVER & BOYD, Tweeddale Court, Edin-
burgh.
E. PONSONBY, Limited, 116, Grafton
Street, Dublin.
Messrs. WHELDON & WESLEY, Limited.
2, 3 & 4, Arthur Street, New Oxford
Street, London, W. C. 2.
Messrs. East & West, Limited, 8, Vic-
toria Street, London, S. W, I.
ON THE CONTINENT.
ERNEST LEROUX, 28, Rue Bonaparte,
Paris, France,
MARTINUS
NIJHOFF,
The Hague,
Holland.
OTTO HARRASSOWITZ, Leipzig.
FRIEDLANDER & SOHAN, Berlin.
IN INDIA.
THE MANAGER, Imperial Book Depôt
Delhi.
GULAB SINGH & SONS, Mufid-i-'Am Press,
Lahore.
MANAGER, Punjab Law Book Depôt,
Anarkali Bazar, Lahore.
RAMA KRISHNA & SONS, Book-sellers and
News Agents, Anarkali Street, Lahore.
HONORARY SECRETARY, Punjab Religious
Book Society, Anarkali, Lahore.
M. ABDUL AZIZ, Manager, The
Vakil
and Roze Bazar Electric Press, Am -
ritsar.
L. LABHU RAM, Book-seller, Ludhiana.
N. B. MATHUR, Superintendent and Pro-
prietor, Nazir Kanun Hind Press,
Allahabad.
D. B. TARAPOREVALA , SONS & Co.,
Bombay.
THACKER, SPINK & Co., Calcutta and
Simla.
NEWMAN & Co., Calcutta.
R. CAMBRAY & Co., Calcutta.
THACKER & Co., Bombay.
HIGGINBOTHAMS , Limited, Madras.
T. FISHER UNWIN, Calcutta.
V. KALYANARAM IYER & Co., 189, Espla-
nade Row, Madras.
G. A. NATESAN & Co., Madras.
SUPERINTENDENT , American Baptist Mis-
sion Press, Rangoon.
THE MANEGER, "Hitavada." Nagpur
Central Provinces.
TRIENNIAL REPORT
ON THE WORKING OF THE
PUNJAB LUNATIC ASYLUM
For the years, 1921, 1922 and 1923.
Lahore :
PRINTED BY THE SUPERINTENDENT , GOVERNMENT
PRINTING,
PUNJAB,
1924.
Proceedings of the Punjab Government (Ministry of Education)
in the Home [Medical and Sanitary) Department , No.
14178 , dated 16th May 1924.
READ.—A letter No. 3926-G., dated 15th April 1924, from the Inspector-
General of Civil Hospitals, Punjab, forwarding the Punjab Lunatíc
Asylum Report for the Triennium 1921—23 together with his own note
thereon.
Remarks.—The report relates to the years 1921, 1922 and
1923. The total population of the Asylum at present shows
little change from year to year, but the average daily strength
is increasing steadily, and stood during 1923 at close upon 900.
It is satisfactory, therefore, that during the period under review
improvements have been made or undertaken in the accommo-
dation available for patients and in the sanitation of the Asylum.
The extension of the Tubercular section was completed in 1921;
the new criminal section, which will do much to relieve over-
crowding, will be ready for occupation very shortly ; improve-
ments in the water supply have been undertaken ; and a drain-
age scheme has been taken in hand.
2. During the period under review the physical health of
the patients was on the whole good. The average number of
sick treated daily rose from 36 13 in 1921 to 51.83 in 1923. The
increase is due to the special efforts made by the Superintendent
to combat tuberculosis, which have resulted in a substantial in-
crease in the number of patients examined and treated for this
disease. There were no epidemics during the period under re-
view, and the death-rate was comparatively low. In 1922 the
number of deaths fell to 58, but stood at over 90 in 1921 and
1923. The average death-rate for the three years was 9.38 per
cent. of the average daily strength, as against 12.66 per cent.
for the preceding triennium.
3. The remarks of the Superintendent as to the diagnosis
and treatment of mental cases are of considerable interest, and it
is to be hoped that the greater liberty allowed to patients, and
the free use of the system of occupational Therapy will have
good results. The Superintendent expresses the opinion that
the patients are already more contented and amenable than they
were formerly, and there are certainly no signs that the increase
in the liberty allowed them has resulted in any escapes or exhi-
bitions of violence. There were ten escapes during the period
under review, six of which occurred in 1921. There were also
three suicides in 1922, but no other instances of violence what-
ever.
2
4. The profits of manufactures carried on in the Asylum
show a creditable increase. They stood at Rs. 12,000 in 1921,
Rs. 17,800 in 1922, and Rs. 18,800 in 1923. The possibilities
of increasing these profits are, of course, limited, but in view of
the heavy cost of the Asylum to Government it is desirable that
they should be as large as possible and the Punjab Government
(Ministry of Education) are glad to note that the manufactures
are being conducted on business lines.
5. This Government desire to place upon record their ap-
preciation of the good work done by the late Major J. F. Flem-
ing, I.M.D., of whom mention was made in the review on the
last triennial report; Major H.W.V. Cox, I.M.D., and Captain
C. J. Lodge-Patch, I.M.S., who successively held charge of the
Asylum during the period under review. The services of Mr.
Thomas, the Deputy Superintendent of the Asylum and the un-
selfish devotion of the Revd. Mother Superior and the Fran-
ciscan sisters are also worthy of mention.
ORDER.— Ordered that a copy of the report and of the
foregoing remarks be forwarded to the Government of India,
Home Department, for information, also that the review be
published in the Punjab Gazette.
Ordered also that a copy of the foregoing remarks be
forwarded to the Inspector General of Civil Hospitals, Punjab,
for information.
By order of the Government (Ministry of Education).
FAZL-I-HUSAIN,
A. LATIFI,
Minister for Education. Secretary to Government, Punjab,
Transferred Departments.
Note on the Report of the Punjab Lunatic Asylum, Lahore,
for triennium 1921—1923.
THE report forwarded, herewith, is for the triennial period
1921 1923. It has been written by Captain C. J. Lodge-
Patch, I. M S., who has been in charge of the Asylum since the-
14th November 1922. The late Major J. F. Fleming, I. M. D.,
was in charge of the institution from 1st January to 8th Feb-
ruary 1921, and Major H. W. V. Cox, I. M. D., from the 9th
February 1921 to 13th November 1922
Population.
There has been no marked variation in the total population
of the Asylum, the figures for the three years
under review being 1,204, 1,168 and 1,197. The
daily average strength, however, shows a steady increase from
864.58 in 1921 to 867.17 in 1922 and 829.53 in 1923. New
admissions numbered 285 in 1921, 260 in 1922 and 279 in 1923
while re-admissions accounted for 69, 62 and 38.
Accommodation.
2. It is gratifying to note that the new Criminal Asylum,
which has cost over three lacs, will be ready
for occupation in a few months. The question
of accommodation which had, owing to the progressive
increase of the population of the Asylum, become very
acute, will now be settled satisfactorily. The extension of
the tubercular section, which was completed in 1921, has supplied
a long felt want.
Attendant Staff.
3. In consequence of the considerable increase in the pay of
attendants during the triennium, it is possible
to recruit more reliable and trustworthy atten-
dants than before.
Escapes.
4. There were only two escapes in 1923 as compared with
6 in 1921 and 2 in 1922 and both were recap-
tured.
Suicides.
5. There were no cases of suicide in 1921 and 1923 while 3
deaths were reported in 1922 and in the preced-
ing triennium.
Sickness.
6. There were no epidemics of disease during the triennium.
The number of cases under treatment in hospital
was 36.13 in 1921,40.61 in 1922 and 51.83 in
1923, while the percentage of deaths to daily average strength
was 11.22, 6.69 and 10.23.
2
Acknowledgments.
7. Captain C. J. Lodge-Patch, I. M. S., who is a highly-
trained and experienced Alienist, has discharged
his onerous and responsible duties with marked
zeal and ability. My acknowledgments are due to him and Mr.
Thomas, Deputy Superintendent, who ably assisted him in the
efficient administration of the Asylum.
The Franciscan Sisters in charge of the female Asylum
continue to devote themselves to their trying and arduous duties
with their usual zeal.
LAHORE:
E. L. WARD, LIEUT.-COLONEL, I.M.S.,
Offg.
Inspector-General of Civil
The 2nd April 1924.
Hospitals, Punjab.
TRIENNIAL REPORT ON THE WORKING OF THE
PUNJAB LUNATIC ASYLUM, FOR THE YEARS
1921, 1922 AND 1923.
1. —POPULATION.
The mean population of the Asylum for the three years
reported on was 867.47, 867.69 and 901.03, so that in the last
year there has been an increase of 33 in the average number
of patients treated. The largest number of patients under
treatment at any one time was on 14th September 1923, when
there were 930 in the Asylum.
The number of admissions and re-admissions during the
three years are 354, 322 and 317.
Among the discharges, those cured amount to 138, 113 and
123 ; those improved were 88, 94 and 79 ; those not-improved
and " discharged otherwise " were 35, 23 and 32 ; so the total
number of patients discharged were 261, 230 and 234.
The number of patients who died in these three years were
97, 58 and 92. The death rate for 1922 was gratifyingly low
for an institution of this size.
The number of criminal patients for the triennium shows
a reduction from 168.13 in 1921 to 160.11 in 1922, and a still fur-
ther drop to 158.25 in 1923.
2.—ACCOMMODATION, NEW WORKS, ETC.
Much has been written in former reports regarding the
overcrowding in the various sections of the Asylum ; but it is ex-
pected that the congestion will shortly be relieved on the male
side by the new Criminal Section, which has now been practi-
cally completed, and which will be ready for occupation in a
few months. There is still a shortage of accommodation for
the staff and personnel. And when the new Criminal Section
is occupied and the number of attendants is increased, this short-
age will be even more acute than it is at present.
For many years past the water-supply has been inadequate ;
but steps have been taken to increase this. Motors have been
fitted to a third well in the Hospital Section.
The sanitation of the Asylum seems always to have been
unsatisfactory ; but a new drainage scheme has been taken in
hand by the Sanitary Department of the Public Works Depart-
ment, and this should effect a considerable improvement in cer-
2
tain sections of the Asylum. One advantage of the new scheme
is that, at a later date, the other sections and the Female Asylum
can be drained into the new Jhallar.
The extension to the Tubercular Section was completed in
1921.
The electric lighting of the whole Asylum has been thorough
ly overhauled, and certain additions and alterations have been
made.
There have never been any fire precautions in the Asylum
till 1923, when Government sanction was obtained for this pur-
pose. Minimax Fire Extinguishers have been installed, and
a portable Fire Pump has been purchased. A monthly fire drill
is being instituted, so that in the event of an outbreak of fire,
there will be no confusion on the part of the attendants and
others engaged in putting it out.
3.—THE FEMALE ASYLUM.
The Female Asylum continues to be looked after by the
Franciscan nuns, who have devoted their lives to this task.
Their staff has been increased by an extra sister, who came out
from France in December 1922. Up to now Government sanc-
tion has not been accorded for her to be placed on the same scale
of pay as the other Assistant Matrons.
There is a pressing need for some extension to be made to
the Female Asylum. I have put forward a recommendation
that its grounds should extend on to Jail Road, and that it
should occupy some waste land which lies between its present
north boundary wall and the Central Jail.
4.—DIET AND TREATMENT.
The diet scale in this institution is a very liberal one. It
is necessary for mental patients to be well fed ; and with this
end in view, every endeavour has been made to keep the various
articles of food-stuff up to a standard quality. At the same
time, all unnecessary wastage has been stopped by the introduc-
tion of new methods for checking the expenditure. Milk forms
one of the most expensive items of the diet; and it is believed that
further economy could be effected, if the Asylum were to start
a Dairy Farm of its own.
The Asylum has been brought into line, as far as possible,
with modern mental hospitals, in regard to the treatment of
the insane. With very few exceptions, patients are allowed
complete liberty within the precincts of their sections ; whereas
3
all were formerly kept locked in their cells and barracks for
two or three hours during the heat of the day, while their attend-
ants were off duty, and violent cases were hardly ever allowed
out of their cells. The supervision of the patients by attendants
and the nursing staff has been generally smartened up. The
rates of pay for attendants has been considerably increased
during the last three years, so it is now possible to get more re-
liable and trustworthy attendants than before.
Formerly, suicidal patients were kept locked in their cells
at night, where they had every facility for taking their own
lives ; but now, all cases of acute melancholia and all patients
who exhibit definite suicidal tendencies are kept in an open
Hospital Ward, with trained attendants on duty day and night.
It is recognised that this cannot absolutely prevent suicides ;
but it should go far towards avoiding the most serious calamity
that is apt to occur in an Asylum.
Epileptics have all been collected in the Hospital Section,
so that they can be satisfactorily nursed. They have special
food cooked for them ; salt is left out of their diets, and its
place is taken by Potassium Bromide, on the lines suggested
by Richet and Toulouse.
Every effort has been made to diagnose and treat cases of
Tuberculosis at the earliest opportunity. This has increased the
number of patients on the Hospital books ; so that the average
number of daily sick is now 51.83, whereas in 1921 and 1922, it
was 36.13 and 40.61, respectively. Tubercular patients are treat-
ed with routine injections of Sodium Morrhuate. This drug has
the advantage of being extremely cheap, and appears to be
fairly effective. It is too soon to say very much as to the re-
sults of treatment, but there have been a certain number of
apparent cures. No patient is discharged from the Tubercular
Section till the clinical signs of the disease have disappeared,
and the sputum is negative to the tubercle bacillus.
Occupational Therapy is largely employed, and as many;
patients as possible are engaged in gardening and other out-
door occupations. But there are so many advanced and hope-
less dements in the Asylum that the percentage of working
patients is not so high as it might be.
In consequence of the greater liberty that the patients now
enjoy and the other measures for their comfort and well-being,
they appear to be far more contented than they were formerly,
and there have been practically no exhibitions of acute violence
or extreme depression within the last twelve months.
4
5.—ESCAPES, SUICIDES, AND DEATHS FROM
VIOLENCE.
There were six escapes in 1921, two in 1922, and two in
1923. One of the latter was a harmless old dement, who walked
away from his squad while he was working in the garden ;
he has since been brought back. The other was a criminal and
a most determined jail-breaker. He has since been re-captured
by the police, but not before he had succeeded in murdering a
relative.
There were no suicides in 1921 or 1923 ; but in 1922, no
less than three suicides occurred within a few weeks (two were
on consecutive days). There have been no deaths from vio-
lence.
6.—DIAGNOSIS AND TYPES OF INSANITY.
The diagnosis of all the patients have had to be carefully
revised. Many patients are wrongly diagnosed in the first in-
stance, owing to their not having been kept under observation for
a sufficiently long period for an accurate diagnosis to have been
made. Also, the general rule in most types of insanity is for
a patient to pass into a state of secondary dementia, which ne-
cessitates an alteration in the original diagnosis. Such altera-
tions should be shown year by year in the annual returns by
discharging a patient " otherwise," and readmitting him under
the revised diagnosis. But this has never been done, and since
the inception of the Asylum, it has been the practice to carry
forward the remainders on the 31st December of one year to
the 1st January of the following year with mathematical pre-
cision, so that the errors in the diagnosis of the patients in this
institution have been cumulative over a period of more than
twenty years. I do not feel that I can reasonably show several
hundred patients " discharged otherwise," and " readmitted ;"
so I have indicated the revised diagnosis as remaining on De-
cember 31st, 1922.
In consequence of the above-mentioned revision, it will now
be seen that 40 per cent. of the insanes are secondary dements.
The diseases which follow in order of frequency are mania,
dementia precox, insanity due to Indian hemp or its derivatives,
manic-depressive insanity (included under alternating insanity),
and melancholia.
7.—CASH ACCOUNTS.
The total amount of money expended on the Asylum has
been greater in 1923 than in any previous year. The cash tran-
sactions have amounted to Rs. 640,992-15-3, but of this sum
5
Rs. 382,977 is on account of work done by the Public Works
Department. The new Criminal Section has cost over three
lakhs, and more than half a lakh was paid in 1923 as compen-
sation for the 48 acres of land acquired in 1921.
The amounts received from the Treasury in 1921, 1922 and
1923, respectively, are Rs. 2,30,911, Rs. 2,30,011 and
Rs. 2,27,874. The latter figure indicates a considerable re-
duction in the cost of upkeep of the Asylum, particularly when
it is remembered that the average number of patients in the
institution was 33 more in 1923 than in the two previous years,
and that the amount paid as salaries of the medical staff and
personnel has been doubled in the last four years.
In the triennial report for the years 1918—20, it was point-
ed out that the actual cost of the maintenance of each patient
was Rs. 18-10-8. Since then the cost of food has fallen
slightly, but on the other hand the wages of the staff have been
greatly increased. The establishment and superintendence in
1918—20 averaged Rs. 49,644-13-0, whereas in 1923 it amount-
ed to Rs. 94,735-7-0. Government sanction has been obtained
to increase the maintenance charges from Rs. 16 to Rs. 20 per
month with effect from 1st January 1924.
The total debits of the Asylum are lower in 1923 than they
have been since 1912.
The total profits, however, are higher for 1923 than they
have ever been, amounting to Rs. 18,874-13-4.
These profits have been obtained by buying the raw material
for manufactures at the cheapest rates compatible with good
quality thus eliminating the middleman's profit, by reducing
the out-turn of those manufactured goods which are not profit-
able, and increasing that of the more profitable manufactures.
For instance, " Ban " (for the manufacture of Munj mats) is
now obtained from the Central Jail for a little more than half
the price at which it was formerly bought in the open market.
The manufacture of blankets has been reduced, partly because
of the excessive price of the woollen yarn, and partly because
it has been found that ready made blankets are only a very little
more expensive than those manufactured in the Asylum.
8. SICKNESS AND MORTALITY.
The death rates for 1921, 1922 and 1923, as compared with
the total population of the Asylum for these years were 11.22,
6.69 and 10.23, which gives an average of 9.38, as compared with
an average of 12.66 for the three preceding years.