7
ventricles ; no abnormal growth of any kind could be seen. Other organs normal.
The patient who died of debility was admitted into the asylum on 15th August
1896 for dementia by order of the First Class Magistrate, Dhulia. He was then in
an impaired state of health and in a weak and excitable condition and difficult to
manage. He soon became liable to recurrent attacks of fever which necessi-
tated his being placed on the sick list on 10th June 1897. He gradually sank and
died on 24th September 1897. The post-mortem examination showed that the
surface and membranes of the brain were congested and soft with a little serous
fluid in the ventricles and cavity of the arachnoid. No morbid growth of any
sort was detected; the brain weighed 2 lbs. and 6 ounces. The fatal case of apo-
plexy was admitted on 18th January 1880 for chronic mania associated with in-
somnia. On admission he was fairly robust, but liable to frequent and violent
outbursts of passion, and very dirty in habits. During his long residence in the
asylum he was not placed on sick list until 19th June 1897, when he was sudden-
ly attacked with hemiplegia of the left side from which he never recovered, and
died on the fifth day after the attack. The post-mortem examination declared
as follows:—" Brain congested, the veins containing an abnormal quantity of
dark venous fluid. There were a large number of dark clots in the superior
longitudinal sinus, some serous fluid in the cavity of the arachnoid and also in the
ventricles. No abnormal growth. Brain weighed 40 ounces." The third case of
albuminuria was in an indifferent state of health, when admitted into the asylum
on 18th November 1896, due to albuminuria associated with chronic diarrhœa.
For the next six months he gradually improved in health, but towards the
beginning of June 1897 albumen increased, necessitating his permanent transfer
to the sick list on 20th idem. From this time he gradually got weaker and
more emaciated and died on 12th August 1897. The post-mortem examination
showed as follows:—"There was nothing remarkable in the membranes of the
brain. The brain was rather anæmic and soft with some clear serous fluid in
the ventricles.
The choroid plexuses were anæmic. The brain weighed
2 lbs and 6 ounces, and there was no abnormal growth. The heart somewhat
fatty. Lungs normal. Both kidneys fatty." The fourth case was, on admis-
sion into the asylum on 26th February 1891, returned as in good health and
remained comparatively well until 10th July 1897, when symptoms of albuminuria
gradually supervened and necessitated his being placed on the sick list. From
this time his health became steadily impaired and the quantity of albumen in-
creased. On the night of 16th October 1897 he suddenly became delirious and
shortly afterwards passed into a comatose condition which lasted until death at
4 A. M. next morning. The post-mortem examination showed that the brain
weighed 48 ounces; membranes were anæmic ; no fluid in the cavity of the
arachnoid. The vessels on surface of brain shrunken ; substance of brain very
anæmic and the cut surface had a white appearance. No fluid in the ventricles,
nor abnormal growth of any sort detected. The heart and other organs presented
a very pale appearance.
The Dhárwár Asylum shows an increase of 2 deaths over the previous year,
viz. 6 against 4, giving a ratio of 85.7 per mille of the total population as com-
pared with 71.4 in 1896. The casualty in two cases resulted from choleraic
diarrhœa and in 1 each from pneumonia, epilepsy, scurvy following starvation
and general debility. The 2 choleraic diarrhœa cases were probably due to out-
side causes—one died two days after attack from exhaustion and the other (an
old man) owing to failure of heart's action. The fatal case of scurvy had been
refusing his food at times since November 1896 and had to be fed artificially ; he
became gradually emaciated and at last succumbed in January 1897 from ex-
haustion. The patient who died of pneumonia was first admitted with symptoms
of bronchitis, subsequently developing pneumonia.
The case of death from
epilepsy was that of a blind and debilitated old man. He died from suffocation
caused by a morsel of food during an attack of epilepsy whilst taking his food.
The fatal case of general debility was that of an insane who was suffering for a
long time from gradual weakness. General dropsy supervened and he died after
nearly a year's illness.
At Ahmedabad the number of deaths was 2, or 3 less than in 1896. The
ratio of deaths per mille of the total population was 16.7 as compared with 42.7
of the preceding year. Of the two deaths, one was that of a female insane who