MADRAS LUNATIC ASYLUMS. three lunatic asylums in the Madras PreMadras, sidency?at Vizagapatam and Calicut?constructed to hold respectively 547, 60, and 96 patients. The report from which the following facts have been drawn is for the year 1877-78. It was compiled by Surgeon-General George Smith, M. D. "Why the There
are
rather than the calendar year has been it is not easy to conceive. The year ending adopted 31st of March is the most appropriate for vaccination reports, because the bulk of vaccine work in most parts
financial
within the six months October
of India is
compressed
to
and it would be inconvenient to divide the
March,
record of the season's work and impose on officers in the midst of it the duty of preparing a report. But no
similar
reason
exists in the
case
of
hospitals
and
THE INDIAN MEDICAL GAZETTE.
80
asylums, and as the calendar year has been adopted in every other presidency and country as the period embraced in annual reports, it is difficult to understand why
Madras
should be
There
is, moreover, deal, in reports
to
periods
same
an
of
exception to advantage similar institutions, an
obvious
the rule. in
having
with the
of time.
There is another defect in the report which ought also to be remedied, namely, that the statistics of mixed up together. European The causes, character and issue of insanity and the circumstances and cost of maintenance and treatment and native lunatics
differ
materially
in the two
are
and it would be
classes,
an
advantage if the statistics of each were separately shown. We have been unable to discover in what pro-
portion Europeans contribute to the population of It appears that Europeans and East these asylums. Indians formed 20 per cent, of the admissions, but what
resident, the rates of recovery and death of this class were is not indicated. In Bengal, as we have shown in a former article, Europeans and the numbers
habits of life
persons of
European separate asylum whose figures
general
summaries.
aslyum
exists.
these
patients
are
In Madras
Still,
even
in the
separately.
a
separate
European
expedient
to include
summaries and
the report ought to exhibit the facts Even in
confined in
not included in the
no
if it is
general
are
relating
Surgeon-Major
totals,
to
each
Nanney's lengthy
report of the Madras asylum no effort to made is separate the medical and financial facts two classes. The result is, that the the to relating and interesting
Madras statistics do
not indicate the
cost of treating either
circumstances
native
or
of the Government of India of
terially
affected
Madras asylums. tent. one.
January
the admissions
or
1876 have
discharges
They probably have
to
some
"With these preliminary remarks we shall briefly cite the main statistical facts of the year. The average number of residents in the asylums was 349-8?265-9 males and 83-9 females, or 76 and 24 per cent. ; the proportion of the latter being smaller than in Bengal. the 10 years 1867-77 the asylum population undergone an increase from 110-25 to 349-85,
During
figure
for 1877-8
being
below
that
the year amounted to 150
of the
(including
2
re-admissions;.
This number was below that of any of the five preceding years, and bore a ratio of 42*8 per cent, to strength? a
much
higher
rate than in
Bengal.
Non-criminal
lunatics were admitted in much larger relative numbers than criminal ?46'5 against 30-1. These figures do indicate that the famine caused any
not
increase of
lunacy as it undoubtedly did of crime ; but it is possible, as surmised by Dr. Nanney, that the diminished population and fewer admissions were owing "to the large number of poor creatures swept away by famine and disease, amongst whom those bereft of reason would be likely to succumb early." The per centage of females among admissions was 24. The number disamounted to 118 or 33'7 per cent, of strength.
charged
Of this number 97
27k7
or
were
returned
as
recoveries
considerably higher rate than in Bengal. The rate for the 10 years was 21*9, and that for females exceeded males, the proportions being 35*7 against 25*2.
?a
Non-criminal lunatics
portion acute
were
than criminals?34*1
of recoveries took
rity
mania,
proportion.
discharged
against
place
acute dementia
in
32-6.
larger The
among recent showing the next
Deaths amounted to 80
pro-
majo-
cases
of
highest
22 "8 per cent, The death rate
or
of strength. This is a very high rate. of the ten years 1867-87 was 15*7, and that of 1876, 19-9. Males died at the rate of 23"7 and females
criminal lunatics at 33*9 and non-criminal 19*7. Atrophy and diarrhoea account for 39 and 10 deaths
The
of
during the year under review, there' have been scarcity of food, prolonged drought and wide-spread disease, and these unfavorable influences, though less distinctly marked than in the preceding year, have left indications of their operation in the disease and mortality returns of asylums."
the
and
cent.,
ma-
ex-
Of these 349*8 luna-
361'68.
to the criminal class
respectively, dysentery each to the total. Only and none to small-pox.
The year 1877 was, however, an exceptional To quote from the Surgeon-General's report,
1879.
or 21-9 per 273'2 were non-criminal lunatics. The proportion of females among the former was 12-2 and among the latter 27'5 per cent. The admissions of
belonged
20*2,
"
has
namely
year,
tics 76'6
and
European lunatics, are not capable of being compared with reports in which the figures affecting these classes are separately recorded. It does not appear in this report whether the orders or
preceding
[March 1,
and diarrhoea one
death
was
contributing
5
due to cholera
lunatics admitted during the year belonged society. The district of
to the lower classes of
mostly Madras, including the town, furnished 64 of the 150 admitted. Very few were admitted from the Southern districts, where caste and religious prejudices are said
to be powerful: 66-6 per cent, of admissions were between the ages 20 and 40,20 per cent, between 40 and 60, 11*3 below 20 and 2-0 above 60. These
figures are shown to correspond closely with English statistics, the proportions of youthful and aged persons being higher in the latter case. As regards causation, recorded
41
cases are
as
due to narcotic
as
congenital
or
hereditary,
30
drugs, 17 to epilepsy, 13 to other intemperance, which is said to be on
diseases, 11 to increase, and 7 to puerperal causes. Of moral causes, grief, domestic trouble, misfortune and religion, fear, anger, desertion of husband or wife, love, the
jealousy,
and debt
are
the circumstances noted in 49
March 1,
cases.
BOMBAY LUNATIC ASYLUMS.
1879.]
Moral influences hold to
of 1 to 3
as
assigned
causes
of
physical insanity.
a
proportion parti-
The
cular "narcotic drugs" responsible for the 30 cases above noted are not stated. The average annual cost of each lunatic was about R,s. 265?a figure considerably higher than in Bengal (100), but it covers the cost of European as well as native lunatics, whereas the Bengal figure represents the cost of native lunatics only?that of Europeans being Us. 575. Us. 14,136, (15 per cent, of income) was received from paying patients (exclusive of hospital stop-
pages).
The estimated
Us. 726.
pulously
profit on manufactures was system is said to be scrutreatment of the lunatics, and
The non-restraint followed in the
order and
occupation
constitutes the main features of
moral management; recreation being also occasionally resorted to in the Madras and Calicut Asylums. The Gheel or boarding out system has not been as yet
tried,
and Dr. Nanney points out thatthere
are
peculiar
obstacles to its realization in India in consequence of the difficulty in securing suitable agents and arrangements.
81
are
rather than the calendar year has been it is not easy to conceive. The year ending adopted 31st of March is the most appropriate for vaccination reports, because the bulk of vaccine work in most parts
financial
within the six months October
of India is
compressed
to
and it would be inconvenient to divide the
March,
record of the season's work and impose on officers in the midst of it the duty of preparing a report. But no
similar
reason
exists in the
case
of
hospitals
and
THE INDIAN MEDICAL GAZETTE.
80
asylums, and as the calendar year has been adopted in every other presidency and country as the period embraced in annual reports, it is difficult to understand why
Madras
should be
There
is, moreover, deal, in reports
to
periods
same
an
of
exception to advantage similar institutions, an
obvious
the rule. in
having
with the
of time.
There is another defect in the report which ought also to be remedied, namely, that the statistics of mixed up together. European The causes, character and issue of insanity and the circumstances and cost of maintenance and treatment and native lunatics
differ
materially
in the two
are
and it would be
classes,
an
advantage if the statistics of each were separately shown. We have been unable to discover in what pro-
portion Europeans contribute to the population of It appears that Europeans and East these asylums. Indians formed 20 per cent, of the admissions, but what
resident, the rates of recovery and death of this class were is not indicated. In Bengal, as we have shown in a former article, Europeans and the numbers
habits of life
persons of
European separate asylum whose figures
general
summaries.
aslyum
exists.
these
patients
are
In Madras
Still,
even
in the
separately.
a
separate
European
expedient
to include
summaries and
the report ought to exhibit the facts Even in
confined in
not included in the
no
if it is
general
are
relating
Surgeon-Major
totals,
to
each
Nanney's lengthy
report of the Madras asylum no effort to made is separate the medical and financial facts two classes. The result is, that the the to relating and interesting
Madras statistics do
not indicate the
cost of treating either
circumstances
native
or
of the Government of India of
terially
affected
Madras asylums. tent. one.
January
the admissions
or
1876 have
discharges
They probably have
to
some
"With these preliminary remarks we shall briefly cite the main statistical facts of the year. The average number of residents in the asylums was 349-8?265-9 males and 83-9 females, or 76 and 24 per cent. ; the proportion of the latter being smaller than in Bengal. the 10 years 1867-77 the asylum population undergone an increase from 110-25 to 349-85,
During
figure
for 1877-8
being
below
that
the year amounted to 150
of the
(including
2
re-admissions;.
This number was below that of any of the five preceding years, and bore a ratio of 42*8 per cent, to strength? a
much
higher
rate than in
Bengal.
Non-criminal
lunatics were admitted in much larger relative numbers than criminal ?46'5 against 30-1. These figures do indicate that the famine caused any
not
increase of
lunacy as it undoubtedly did of crime ; but it is possible, as surmised by Dr. Nanney, that the diminished population and fewer admissions were owing "to the large number of poor creatures swept away by famine and disease, amongst whom those bereft of reason would be likely to succumb early." The per centage of females among admissions was 24. The number disamounted to 118 or 33'7 per cent, of strength.
charged
Of this number 97
27k7
or
were
returned
as
recoveries
considerably higher rate than in Bengal. The rate for the 10 years was 21*9, and that for females exceeded males, the proportions being 35*7 against 25*2.
?a
Non-criminal lunatics
portion acute
were
than criminals?34*1
of recoveries took
rity
mania,
proportion.
discharged
against
place
acute dementia
in
32-6.
larger The
among recent showing the next
Deaths amounted to 80
pro-
majo-
cases
of
highest
22 "8 per cent, The death rate
or
of strength. This is a very high rate. of the ten years 1867-87 was 15*7, and that of 1876, 19-9. Males died at the rate of 23"7 and females
criminal lunatics at 33*9 and non-criminal 19*7. Atrophy and diarrhoea account for 39 and 10 deaths
The
of
during the year under review, there' have been scarcity of food, prolonged drought and wide-spread disease, and these unfavorable influences, though less distinctly marked than in the preceding year, have left indications of their operation in the disease and mortality returns of asylums."
the
and
cent.,
ma-
ex-
Of these 349*8 luna-
361'68.
to the criminal class
respectively, dysentery each to the total. Only and none to small-pox.
The year 1877 was, however, an exceptional To quote from the Surgeon-General's report,
1879.
or 21-9 per 273'2 were non-criminal lunatics. The proportion of females among the former was 12-2 and among the latter 27'5 per cent. The admissions of
belonged
20*2,
"
has
namely
year,
tics 76'6
and
European lunatics, are not capable of being compared with reports in which the figures affecting these classes are separately recorded. It does not appear in this report whether the orders or
preceding
[March 1,
and diarrhoea one
death
was
contributing
5
due to cholera
lunatics admitted during the year belonged society. The district of
to the lower classes of
mostly Madras, including the town, furnished 64 of the 150 admitted. Very few were admitted from the Southern districts, where caste and religious prejudices are said
to be powerful: 66-6 per cent, of admissions were between the ages 20 and 40,20 per cent, between 40 and 60, 11*3 below 20 and 2-0 above 60. These
figures are shown to correspond closely with English statistics, the proportions of youthful and aged persons being higher in the latter case. As regards causation, recorded
41
cases are
as
due to narcotic
as
congenital
or
hereditary,
30
drugs, 17 to epilepsy, 13 to other intemperance, which is said to be on
diseases, 11 to increase, and 7 to puerperal causes. Of moral causes, grief, domestic trouble, misfortune and religion, fear, anger, desertion of husband or wife, love, the
jealousy,
and debt
are
the circumstances noted in 49
March 1,
cases.
BOMBAY LUNATIC ASYLUMS.
1879.]
Moral influences hold to
of 1 to 3
as
assigned
causes
of
physical insanity.
a
proportion parti-
The
cular "narcotic drugs" responsible for the 30 cases above noted are not stated. The average annual cost of each lunatic was about R,s. 265?a figure considerably higher than in Bengal (100), but it covers the cost of European as well as native lunatics, whereas the Bengal figure represents the cost of native lunatics only?that of Europeans being Us. 575. Us. 14,136, (15 per cent, of income) was received from paying patients (exclusive of hospital stop-
pages).
The estimated
Us. 726.
pulously
profit on manufactures was system is said to be scrutreatment of the lunatics, and
The non-restraint followed in the
order and
occupation
constitutes the main features of
moral management; recreation being also occasionally resorted to in the Madras and Calicut Asylums. The Gheel or boarding out system has not been as yet
tried,
and Dr. Nanney points out thatthere
are
peculiar
obstacles to its realization in India in consequence of the difficulty in securing suitable agents and arrangements.
81
