5
He was anæmic. In 1895 he suffered from dysentery and in 1897 from fever.
He was admitted into hospital on 17th October 1898 for remittent fever, and
died exhausted on 22nd of the same month. The patient who died of old age on
16th December 1898 was transferred from the Colába to this asylum in 1886,
having been in confinement since 1865. On 12th October 1898, he was placed
on the sick list for debility resulting from old age. Before admission into
hospital he had gradually lost his eye-sight from senile cataract. The patient
who died from diarrhœa on the 21st February was in the asylum for nearly 5
years. His weight on admission was 106 lbs., which became reduced to 90 lbs.
The woman reported as having died of concussion of the brain is reported to
have been weak, excitable and dirty on her admission into the asylum. She
often tried to strike her head against a wall. On 14th February 1898, while
running towards a privy, she is said to have fallen on rough ground and to have
become insensible. She sustained a contused wound of the head, and died
within an hour of the accident. A post-mortem examination was held, but no
injury to the internal parts was found, except that there was extravasation of
blood beneath the scalp on the back of her head. The inquest attached no blame
to any one, and death was attributed to shock.
The Poona Asylum shows a decrease of 2 deaths. The ratio of
deaths per mille of the total population was 70.4 against 85.1 in 1897. The
mortality was due to anæmia 4, and epilepsy, debility, diarrhoea, phthisis
pulmonalis, empyema and albuminuria 1 each. The female who died of
anæmia was, on admission into the asylum for acute dementia on 2nd
December 1896, in a "fair" state of health, though anæmic and rather
weak and emaciated. There was a slight improvement in her general
condition for a short time, but this soon ceased and she had recurrent attacks of
fever which necessitated her permanent transfer to the sick list on 15th October
1897. She steadily got worse and died on 3rd January 1898. On examination
the body was found emaciated. The brain weighed 2 lbs. 5 ozs.; its substance
was soft and a large quantity of serous fluid was present in the cavity of the
arachnoid. The cerebral veins were congested. No abnormal growth of any kind
could be detected. Heart was normal in appearance. Liver weighed 2 lbs. and
2 ozs., spleen 5 ozs. The second case of anaemia was that of a male who was
admitted into the asylum for acute mania on 25th January 1898, and being
very weak and emaciated was at once put on the sick list. He continued in this
state until death, which took place on 16th February 1898 from exhaustion.
At the request of his relation, no post-mortem examination was made. The
third fatal case of anæmia was that of an old man who had to be placed on the
sick list when admitted to the asylum for dementia on 14th January 1898, being
so weak and emaciated as to be unable to walk or assist himself in any way.
His general condition did not improve, and he died from exhaustion on 26th
February 1898. There was some opaque fluid beneath the membranes, on the
surface, and also in the ventricles of the brain, the tissue of which was somewhat
softened. No abnormal growth in the brain could be seen. The heart and
spleen were normal, lungs congested. The liver weighed 2 lbs. The fourth
fatal case of anæmia was that of a woman, admitted into the asylum for acute
mania on 21st December 1895, who was liable to attacks of great excitement
and was difficult to manage. She was taken into the hospital on 1st March
1898 for fever and diarrhœa, which steadily increased the anæmia and debility.
She died on 31st July 1898. The body was thin and anæmic. The membranes
and substance of the brain were pale; some serous fluid was seen in the cavity of
the arachnoid and ventricles. The choroid plexuses were atrophied and anæmic.
The heart was pale, so also were the lungs. The liver fatty; the spleen of normal
size. The intestines presented a reddened appearance in their lower part. The
patient who died of debility was admitted into the asylum on 5th August 1888 in a
starving condition, anæmic and emaciated. He continued in much the same
condition, but dyspepsia supervened, and he gradually sank until he died on 13th
July 1898. The body was emaciated; the brain weighed 45 ounces, and was
soft and anæmic; the cavity of the arachnoid and the ventricles contained about
4 ozs. of thin fluid. No abnormal growth was seen. The heart, lungs and
abdominal organs were anæmic. The fatal case of diarrhœa was that of a
female who, when admitted for chronic mania, was in a fair state of health. She
had recurrent attacks of diarrhœa for which she was placed on special diet and
B 54—2