5
It will be seen from the above table that excepting Poona and Hyderabad,
the death-rate was higher in all the asylums during the year under review.
At Colába there were 51 deaths (3 Europeans and 48 natives), or 16 more than
in the previous year, making a death rate of 118.1 per mille of the total popu-
lation as compared with 83.9 in 1895. Among the Europeans the number of
deaths was 3, or the same as in the previous year, and the ratio of deaths per
mille to the total population 41.1 as compared with 44.8 in 1895. The three
European patients who died during the year were cases of chronic pneumonic
phthisis, dysentery and enteric fever. The cases of phthisis and dysentery were
long residents of the asylum and had been suffering for many years from
chronic dementia. They were much enervated by the long confinement neces-
sarily entailed, and they succumbed to the bodily ailments which subsequently
supervened. The case of enteric fever was in a British soldier who was ailing
from malarial fever prior to his admission into the asylum. Indications of
typhoid fever were observed in his case soon after admission and unfavourable
symptoms having rapidly set in, the case terminated fatally within 12 days.
The mortality among the natives was at the rate of 133.7 per mille of the total
population against 91.4 in 1895, being chiefly under dysentery, chronic pneumonic
phthisis, epilepsy and Bright's disease. Thirteen of these cases were brought
in by the Police and they were found on admission to be suffering from
exhaustion by privations and ailing from an advanced stage of the diseases,
chiefly from dysentery and chronic pneumonic phthisis. Others were more or less
old residents of the asylum who had been suffering from anæmia and debility
for some time; all such cases have succumbed to the prevailing diseases. The
rains, which commenced exceptionally heavy in the beginning of the monsoon
of the year under report, have also contributed to the cause for the increased
sickness and mortality, and most of the cases attacked by dysentery then have
proved fatal within a shorter period than in the ordinary times.
At Ratnágiri there were 4 deaths as compared with 3 in the preceding year,
giving a ratio of 36.0 per mille of the total population against 27.8 in 1895.
The causes of death were debility, hemiplegia, tubercle of lungs and anæmia.
The case of debility was an old man, aged 61, who had been under treatment
as an insane for 30 years, having been transferred from the Colába Lunatic
Asylum in 1886. During his residence he had been thrice in hospital for fever
and was last admitted for debility associated with fever on 17th November 1895,
and being an old man, he succumbed on 9th January 1896. The female who
died of hemiplegia had been bed-ridden for nearly five years. She was aged 55
and was dirty and uncontrollable. Diarrhœa supervened and she died on 16th
May 1896. The case reported as having died of tubercle of lungs was a male
aged 34, and a dirt-eater. He had been five times in hospital in his four years'
residence in the asylum for fever and asthma and, pulmonary tuberculosis
developing, he died on 12th June 1896. The health of the fourth case was
good on admission on 21st May 1890, but frequent masturbation aggravated
his mental condition, and anæmia developed. He refused to take any food, and
diarrhœa developing, he died on 6th August 1896.
At Poona the number of deaths was considerably smaller, viz. 9, as com-
pared with 18 of the previous year, giving a death-rate of 62.1 per mille of the
total population against 128.6 in 1895. The mortality was due to anæmia 3
and remittent fever, old age, general paralysis, chronic bronchitis, diarrhœa
and chronic albuminuria 1 each. The case of chronic bronchitis was that of a
female who, when admitted into the asylum on 29th March 1894, was about
six weeks pregnant and in a fair state of health. She continued in much the
same condition until about six months after her confinement on the 14th
November following, when she suffered from an attack of bronchitis which
impaired her general health and left her liable to recurrent attacks of this
disease. Though this patient was not actually placed on the sick list until 9th
October 1895, she had occasionally been treated with expectorants and local
applications to chest. On the latter date she was seized by a severe attack of
bronchitis, having temperature 102.6°, which on the following day rose to 103.4°.
It gradually fell to about 99.0 with occasional exascerbations, until death,
which took place on 7th January 1896, it may be said that the temperature
was never once normal. The one who died of remittent fever was, on admission
B 2521—2