BENGAL LUNATIC ASYLUMS. One of the most
interesting
of tlie numerous
reports,
the
which
Medical
annually compiled Bengal by Department, is that which concerns the Lunatic Asylums of the province of Bengal, and the report for the year 187& is particularly interesting, initsmuch as it contains, in addition and submitted
are
to
the reports and statistics of the year,
of the
previous
decade
for natives in
18G3?1872.
statistical review are
5 Lunatic
province of Bengal, situated at Dullundah (Calcutta), Dacca, Batna, Cuttack and Moydapore (Berhampore), and one Asylum for Europeans, situated at Asylums
the
a
There
April
BENGAL LUNATIC ASYLUMS.
1, 1875.]
Bhowanipore properly not
The latter is very
in the suburbs of Caloutta.
included in the statistical summaries.
It
con-
very different class of patients from the others,? different in race, conditions of admission and discharge, and tains
a
almost
and their inclusion in any
every circumstance of life,
scheme of statistical tables with native
patients would render ihem utterly valueless. Some few patients do lire out their lunacy in the Bhowanipore Asylum ; but for the majority, whether Military or Oivil^ it is a mere resting house where they are lodged until acute symptoms subside or arrangements can be made for transporting them to England. Under these circumstances, the statistics of this institution lums
cannot
give
be of much scientific value.
more
valuable
of tho lunatics live out
statistical their
rate remain in them until
The native asy-
data.
lunacy become
The
majority
in
them, or harmless and
at
any
they can be They are no index of the amount of lunacy existing in the province; but they furnish some interesting facts regarding the nature, causation and issue of mental disease. The proportion of lunatics to population in Bengal is not known. The residents of the asylums of the province only constitute ?001-4 per cent, of the population, while in England the proportion of lunatics under the surveillance of the commissioners of lunacy is *24 per cent, of population. When the census of Bengal was taken in 1872, note was made of the number of insanes and idiots in the province. The following is the result: entrusted to friends.
Actual number.
Males. Insaues Idiots
Total
Females.
Percent, of
Males.
Total
population. Total
Females.
10,323
3,193
13.516
0321
?0099
?0210
4,739
1,143
6,182
?0147
?0045
?0096
15,062
4,636
19,698
We fear that these results
are
more
curious than
among the sexes casts
true.
The
strong suspicion lunacy remarkable a upon tho figures. As they stand, they present contrast to the English results above quoted. On the 1st of January 1873 there was 972 lunatics under detention in the native asylums of Bengal?766 males and 206 females.
disparity
of
a
On the 31st of December the numbers had increased to 1,003? 782 males and 221 females.
Tho mean
777 6 mules and 213 8 females.
population
was
991*4?
Tho manifest increase
of
tho year is an indication of a progressive the of increase population of these asylums which has been since they were established. Thus, taking the
numbers
during
taking place previous decade, the numbers under detention and 93 females, in January 1863 wero 416 males
on
the 1st of
all 509, and
number of inmates for that year was 526 7 j that is to say, tho population of Bengal asylums has very nearly doubled in 10 years, or, as the Surgeon-General's report puts it, the
in
1873, 26'4 per cent, of the whole number ; from 1 to 2 years, 19 3 ; 2 to 3, 95; 3 to 4, 7 2 ; and 4 to 5, 5-4; taking was,
quinquennial periods, the percentages of residents were :?1st, 2nd, 18 8; 3rd, 5 9; 4th, 4"5 ; and taking decennial periods :?1st, 86 6 ; 2nd, 10 3 ; and 3rd, 3 0 ; no asylum con67'9 ;
tained any resident of above 30
the
In an interestpatients are not allowed to linger in asylums. of asylum inmates, reside"00 of duration tho table showing ing it appears " that tho percentage of residents under one year
years' asylum age."
The same-
conclusion is deducible from the percentage of admissions and discharges to mean population. They were, in 1873,? 51-8 and 48 7; the difference of 3*1 is the rate of increase for the The corresponding rates for English county and borough asylums are 28 "1, 25 3 and 2 8. It is clear that the population of Bengal asylums is much more rapidly changed than in England, and that the chronic residents are more numerous
jear.
in the latter
case
than in the former.
confirmed by the fact that the
This inference is further
period of residence of considerably higher than in Bengal It is clear, however, from the SurgeonGeneral's statistics that the Bengal asylums are gradually accumulating a larger residual population ; but it is very doubtful whether this will ever approach the English standard. There must in every country be a different composition of asylum populations depending on the circumstances and conditions of admission, the ratios of recoveries and deaths, and the general longevity of the population and special longevity of lunatics, and it is very necessary to study the composition of asylum populations, more especially as regards relative number of long and short-termed residents, before making any comparison of the statistics of the asylums of different countries. Tables such as we have quoted from above are of great value The relation which mean population bears for this purpose mean
is
each lunatic in
England (287 days against 246).
to the number of admissions in any year or series of years is test of the comparative number of old residents a rough
Bengal this relation is, in 5 years, 1 to 3, showing that, quite apart from differEngland ences depending on race, climate, &c., &c., the composition of the asylum populations is not the same, and that the asylum statistics are not comparable without very many qualifications. and recent
cases.
In
1 to 1-5,
and in
One very remarkable feature in which the statistics of Indian differ from English is the large proportion of criminal
Asylums
lunatics which they contain.
1873,
21*4
England
of the
percent, proportion
the
Criminal
population
is about 1*3
difference cannot be due to
constituted, in Bengal asylums. In percent. This amazing
of crime committed under
excess
an
lunatics
of
the influence of madness in this
country or of a greater proneness in criminals to become insane during their confinement in jails. The truth is that asylums are not used by the general public or for the general public to the same extent as in England} and that they are used by the state for the detention of lunatics falling more immediately under the notice and protection of Government. This conclusion is rendered more
mean
the daily average 9 population has increased 90 per cent., and readtnissions 101*1 strength 71'3 per cent., the admissions cent." 6 And 75 per treated yet per cent., and the total "
107
greater
number of lunatics is
they are situated known, where, moreover,
districts in which ence
is best
than from
probable by
sent to
more
distant districts.
the fact that
asylums
from
the
and in which their existaccess to
This is very
thein is easier,
clearly brought
figures of the years 1863?1872. by Whereas, for example, 814, 358, and 286 lunatics were admitted during these ten years from the districts of 24-Pergunnahs (including Calcutta), Patna, aud Dacca, only 48, 46, out
the
the INDIAN MEDICAL GAZETTE.
108
adjoining districts of Jessore districts, such as ChittaBackergunge. gong, Chumparun and Goalpara only sent 7, 6, and 4. It also appears that the number of criminal lunatics is undergoing a steady increase. In the decade in question their mean has risen from 86 to 194'8. These lunatics do not strength pass so rapidly through asylums as non-criminal lunatics, and have a greater tendency to accumulate in them. Wliile in 1873 tlie admission and discharge rates of non-criminal lunatics were
and 19 were received from the
Remote
Tirhoot and
56'6 and 406, those of criminal lunatics is also
mortality strength. It proportion of
were
221.
Their
less?11*2
against 15-3 reckoned on mean is not surprising therefore to find that the criminal lunatics in asylums shows a tendency to
increase, and that their numbers grow faster than those of the
general asylum population. It naturally follows from the increased number of lunatics coming yearly under detention that the asylum accommodation is becoming too limited for the wants of the proThe asylums are, in fact, becoming vince. overcrowded notwithstanding appeal's from
a
frequent table in
additions
to their
capacity.
the report of 1873 that
It
while the
hold at 50 superficial feet per inmate are fit to 640 persons, the number in confinement on the 31st of December 1872 was 972, or 52 per cent, in excess of the existing ac-
asylums
The consequence of this is an increase of mortaespecially of mortality from chest diseases and bowel
commodation.
lity,
more
Drs. Payne and Wise, in their reports for 1873, forcibly upon the overcrowded state of the Dullundah and Dacca Asylums, and point to the unnecessarily large mortality as a positive and palpable effect of it. The necessity of providing additional accommodation for the rapidly increasing lunatics of Bengal has, in short, become so apparent within
complaints. dwell
recent years that Government lias been the Surgeon-General to build
repeatedly and strongly new asylums. Looking urged by to the relatively greater increase of criminal lunatics, the greater tendency of this class to accumulate in asylums and some peculiarities of discipline and treatment to which it is necessary to subject some of them, the Surgeon-General lias for some years advocated the erection of a separate asylum for them. Sir George Campbell did not approve of this measure, and thought that what was wanted was a special asylum for the unruly and dangerous insane classes. I he massing together of noisy and violent lunatics is, however, opposed to the most advanced views of asylum management, and we trust that this principle will We are glad to observe that Governnot be carried into effect. ment has acknowledged the need of increased asylum accommodation, but the steps hitherto taken are utterly insufficient to remedy the present difficulty. Hiere can be no manner of doubt that the overcrowding which now obtains causes a positive sacrifice of life, and justice and humanity alike demand that immediate measures be adopted to relieve existing institutions of their
We shall
return to this
issue.
surplus population. interesting report in our next
probably
Tolerance of Bee Stings.?The Philadelphia Reporter, oil the statement by an English journal devoted to that after one has received about twenty stings from bees, within about a month, a tolerance is established to such a decree that no subsequent swelling and hardly anv pain is caused by the sting, says that a similar inoculation unquestionably follows mosquito' bites.? Medical Press and Circular.
remarking apiculture
[April 1,
1875.
interesting
of tlie numerous
reports,
the
which
Medical
annually compiled Bengal by Department, is that which concerns the Lunatic Asylums of the province of Bengal, and the report for the year 187& is particularly interesting, initsmuch as it contains, in addition and submitted
are
to
the reports and statistics of the year,
of the
previous
decade
for natives in
18G3?1872.
statistical review are
5 Lunatic
province of Bengal, situated at Dullundah (Calcutta), Dacca, Batna, Cuttack and Moydapore (Berhampore), and one Asylum for Europeans, situated at Asylums
the
a
There
April
BENGAL LUNATIC ASYLUMS.
1, 1875.]
Bhowanipore properly not
The latter is very
in the suburbs of Caloutta.
included in the statistical summaries.
It
con-
very different class of patients from the others,? different in race, conditions of admission and discharge, and tains
a
almost
and their inclusion in any
every circumstance of life,
scheme of statistical tables with native
patients would render ihem utterly valueless. Some few patients do lire out their lunacy in the Bhowanipore Asylum ; but for the majority, whether Military or Oivil^ it is a mere resting house where they are lodged until acute symptoms subside or arrangements can be made for transporting them to England. Under these circumstances, the statistics of this institution lums
cannot
give
be of much scientific value.
more
valuable
of tho lunatics live out
statistical their
rate remain in them until
The native asy-
data.
lunacy become
The
majority
in
them, or harmless and
at
any
they can be They are no index of the amount of lunacy existing in the province; but they furnish some interesting facts regarding the nature, causation and issue of mental disease. The proportion of lunatics to population in Bengal is not known. The residents of the asylums of the province only constitute ?001-4 per cent, of the population, while in England the proportion of lunatics under the surveillance of the commissioners of lunacy is *24 per cent, of population. When the census of Bengal was taken in 1872, note was made of the number of insanes and idiots in the province. The following is the result: entrusted to friends.
Actual number.
Males. Insaues Idiots
Total
Females.
Percent, of
Males.
Total
population. Total
Females.
10,323
3,193
13.516
0321
?0099
?0210
4,739
1,143
6,182
?0147
?0045
?0096
15,062
4,636
19,698
We fear that these results
are
more
curious than
among the sexes casts
true.
The
strong suspicion lunacy remarkable a upon tho figures. As they stand, they present contrast to the English results above quoted. On the 1st of January 1873 there was 972 lunatics under detention in the native asylums of Bengal?766 males and 206 females.
disparity
of
a
On the 31st of December the numbers had increased to 1,003? 782 males and 221 females.
Tho mean
777 6 mules and 213 8 females.
population
was
991*4?
Tho manifest increase
of
tho year is an indication of a progressive the of increase population of these asylums which has been since they were established. Thus, taking the
numbers
during
taking place previous decade, the numbers under detention and 93 females, in January 1863 wero 416 males
on
the 1st of
all 509, and
number of inmates for that year was 526 7 j that is to say, tho population of Bengal asylums has very nearly doubled in 10 years, or, as the Surgeon-General's report puts it, the
in
1873, 26'4 per cent, of the whole number ; from 1 to 2 years, 19 3 ; 2 to 3, 95; 3 to 4, 7 2 ; and 4 to 5, 5-4; taking was,
quinquennial periods, the percentages of residents were :?1st, 2nd, 18 8; 3rd, 5 9; 4th, 4"5 ; and taking decennial periods :?1st, 86 6 ; 2nd, 10 3 ; and 3rd, 3 0 ; no asylum con67'9 ;
tained any resident of above 30
the
In an interestpatients are not allowed to linger in asylums. of asylum inmates, reside"00 of duration tho table showing ing it appears " that tho percentage of residents under one year
years' asylum age."
The same-
conclusion is deducible from the percentage of admissions and discharges to mean population. They were, in 1873,? 51-8 and 48 7; the difference of 3*1 is the rate of increase for the The corresponding rates for English county and borough asylums are 28 "1, 25 3 and 2 8. It is clear that the population of Bengal asylums is much more rapidly changed than in England, and that the chronic residents are more numerous
jear.
in the latter
case
than in the former.
confirmed by the fact that the
This inference is further
period of residence of considerably higher than in Bengal It is clear, however, from the SurgeonGeneral's statistics that the Bengal asylums are gradually accumulating a larger residual population ; but it is very doubtful whether this will ever approach the English standard. There must in every country be a different composition of asylum populations depending on the circumstances and conditions of admission, the ratios of recoveries and deaths, and the general longevity of the population and special longevity of lunatics, and it is very necessary to study the composition of asylum populations, more especially as regards relative number of long and short-termed residents, before making any comparison of the statistics of the asylums of different countries. Tables such as we have quoted from above are of great value The relation which mean population bears for this purpose mean
is
each lunatic in
England (287 days against 246).
to the number of admissions in any year or series of years is test of the comparative number of old residents a rough
Bengal this relation is, in 5 years, 1 to 3, showing that, quite apart from differEngland ences depending on race, climate, &c., &c., the composition of the asylum populations is not the same, and that the asylum statistics are not comparable without very many qualifications. and recent
cases.
In
1 to 1-5,
and in
One very remarkable feature in which the statistics of Indian differ from English is the large proportion of criminal
Asylums
lunatics which they contain.
1873,
21*4
England
of the
percent, proportion
the
Criminal
population
is about 1*3
difference cannot be due to
constituted, in Bengal asylums. In percent. This amazing
of crime committed under
excess
an
lunatics
of
the influence of madness in this
country or of a greater proneness in criminals to become insane during their confinement in jails. The truth is that asylums are not used by the general public or for the general public to the same extent as in England} and that they are used by the state for the detention of lunatics falling more immediately under the notice and protection of Government. This conclusion is rendered more
mean
the daily average 9 population has increased 90 per cent., and readtnissions 101*1 strength 71'3 per cent., the admissions cent." 6 And 75 per treated yet per cent., and the total "
107
greater
number of lunatics is
they are situated known, where, moreover,
districts in which ence
is best
than from
probable by
sent to
more
distant districts.
the fact that
asylums
from
the
and in which their existaccess to
This is very
thein is easier,
clearly brought
figures of the years 1863?1872. by Whereas, for example, 814, 358, and 286 lunatics were admitted during these ten years from the districts of 24-Pergunnahs (including Calcutta), Patna, aud Dacca, only 48, 46, out
the
the INDIAN MEDICAL GAZETTE.
108
adjoining districts of Jessore districts, such as ChittaBackergunge. gong, Chumparun and Goalpara only sent 7, 6, and 4. It also appears that the number of criminal lunatics is undergoing a steady increase. In the decade in question their mean has risen from 86 to 194'8. These lunatics do not strength pass so rapidly through asylums as non-criminal lunatics, and have a greater tendency to accumulate in them. Wliile in 1873 tlie admission and discharge rates of non-criminal lunatics were
and 19 were received from the
Remote
Tirhoot and
56'6 and 406, those of criminal lunatics is also
mortality strength. It proportion of
were
221.
Their
less?11*2
against 15-3 reckoned on mean is not surprising therefore to find that the criminal lunatics in asylums shows a tendency to
increase, and that their numbers grow faster than those of the
general asylum population. It naturally follows from the increased number of lunatics coming yearly under detention that the asylum accommodation is becoming too limited for the wants of the proThe asylums are, in fact, becoming vince. overcrowded notwithstanding appeal's from
a
frequent table in
additions
to their
capacity.
the report of 1873 that
It
while the
hold at 50 superficial feet per inmate are fit to 640 persons, the number in confinement on the 31st of December 1872 was 972, or 52 per cent, in excess of the existing ac-
asylums
The consequence of this is an increase of mortaespecially of mortality from chest diseases and bowel
commodation.
lity,
more
Drs. Payne and Wise, in their reports for 1873, forcibly upon the overcrowded state of the Dullundah and Dacca Asylums, and point to the unnecessarily large mortality as a positive and palpable effect of it. The necessity of providing additional accommodation for the rapidly increasing lunatics of Bengal has, in short, become so apparent within
complaints. dwell
recent years that Government lias been the Surgeon-General to build
repeatedly and strongly new asylums. Looking urged by to the relatively greater increase of criminal lunatics, the greater tendency of this class to accumulate in asylums and some peculiarities of discipline and treatment to which it is necessary to subject some of them, the Surgeon-General lias for some years advocated the erection of a separate asylum for them. Sir George Campbell did not approve of this measure, and thought that what was wanted was a special asylum for the unruly and dangerous insane classes. I he massing together of noisy and violent lunatics is, however, opposed to the most advanced views of asylum management, and we trust that this principle will We are glad to observe that Governnot be carried into effect. ment has acknowledged the need of increased asylum accommodation, but the steps hitherto taken are utterly insufficient to remedy the present difficulty. Hiere can be no manner of doubt that the overcrowding which now obtains causes a positive sacrifice of life, and justice and humanity alike demand that immediate measures be adopted to relieve existing institutions of their
We shall
return to this
issue.
surplus population. interesting report in our next
probably
Tolerance of Bee Stings.?The Philadelphia Reporter, oil the statement by an English journal devoted to that after one has received about twenty stings from bees, within about a month, a tolerance is established to such a decree that no subsequent swelling and hardly anv pain is caused by the sting, says that a similar inoculation unquestionably follows mosquito' bites.? Medical Press and Circular.
remarking apiculture
[April 1,
1875.
