3
parts, of which the first is to be filled in by the police in the course of their local
inquiry into the case of the lunatic and the second by the medical officer, the ultimate
responsibility resting with the committing officer. As these modifications were made
in June 1911, no remarks can be passed until the result has been watched for a suffi-
cient length of time.
VITAL.
4. The total number of admissions to hospitals was 315 in 1909, 300 in 1910 and
310 in 1911. In 1909 it was higher in the Dacca than in the Tezpur Asylum. The
daily average sick was 33.96, 33.77 and 27.78 in 1909, 1910 and 1911, respectively. At
Dacca it fell from 22.93 in 1909 to 19.21 in 1910 and to 13.51 in 1911, while at
Tezpur there was a slight increase in sickness in the last two years of the triennium.
During the triennium malarial fever was prevalent in the Tezpur Asylum and
dysentery in both. There were 56 deaths in 1911, 62 in 1910 and 69 in 1909. The
number of deaths in the Dacca Asylum was 33, 42 and 51 and in the Tezpur Asylum
23, 20 and 18, respectively. The causes of mortality in the first two years of the trien-
nium was fully explained in my notes on the statistical returns of Lunatic Asylums
for those years.
In 1911 the chief causes of deaths in the Dacca Asylum were cholera (14),
tuberculosis (5), dysentery (3) and malarial fever (2). The death rate in this asylum
would have been low, i.e., 6.37 instead of 11.06, but for the 14 deaths from cholera
which broke out in an epidemic form from the 22nd January. The first case was a
male insane sent from Sylhet who must have contracted the disease on the way. The
epidemic lasted throughout February and first few days of March. In all, there were
26 attacks with 14 deaths. Major MacLeod, I.M.S., who took charge of the asylum on
the 1st March took prompt measures to stop the epidemic and no fresh case occurred
from the 1st March except 2 doubtful cases. There was comparatively less fever
amongst the inmates of this asylum during 1911 and this was probably due to the
prophylactic treatment with quinine which was commenced on the 19th January,
twenty-five thousand five-grain tabloids having been distributed during the year. The
Superintendent, Major E. C. MacLeod, I.M.S., is of opinion that quinine regularly
administered is not only prophylactic to malaria but also to some extent to intestinal
parasites and in addition acts as a general tonic. The number of deaths from diarrhœa
and dysentery fell from 14 in 1910 to 4 in 1911 and from exhaustion from mania from
8 to nil. Hypodermic injections of hyoscin and morphia were freely used in these cases
with excellent results. The chief causes of deaths at Tezpur during 1911 were
tubercle of lungs (10), anæmia (4), dysentery (2), fever (2), pneumonia (2), and acute
mania (2). One lunatic committed suicide by jumping into the asylum well which
will soon be protected by a safety elevator. Tubercle is gradually spreading amongst
the inmates of this asylum, there being 10 deaths from this cause in 1909, 12 in 1910,
and 10 in 1911, i e., a total of 32 against 9 in the previous triennium. There is no
accommodation for segregating this class of patients, and moreover the asylum wards
are overcrowded, which is an important factor in the propagation of this disease. A
small temporary tubercle ward has been sanctioned, but the work of construction has
not yet been commenced for want of materials. It is however expected it will be
erected shortly. In 1910 I drew up a set of rules as to the precautions to be taken to
lessen the incidence of tubercle, copies of which were forwarded to the Superintendents
of the Asylums for their guidance.
In 1911 at Dacca there were 3 cases of injuries and accidents, one case of simple
fracture of the clavicle due to a fall and 2 cases of wounds. None of these proved
fatal. The cases of injuries and accidents occurring in this asylum in 1909 and 1910
were noticed in my notes on the Statistical Returns of Lunatic Asylums for those
years. There were a few cases of accidents and self inflicted wounds in the Tezpur
Asylum, but they led to no serious results except one case in 1909 in which a lunatic
suddenly became violent, struck another lunatic on the head and fractured the base
of the skull. Though the case was a serious one the injured lunatic fortunately reco-
vered under prompt and careful treatment.
For 1911 the Dacca Asylum mortality was 111 per mille, that of the Dacca
Central jail 25, and that of the Dacca Municipality 25, that of the Tezpur Asylum 98,
that of the Tezpur Jail 57, and that of the Tezpur Municipality 25.