2                  8TH JUNE 1892, No. 1075, JUDICIAL.

by the Superintendent to the rapidity with which death or recovery supervened in
many instances. The explanation cannot be accepted. It is understood that the
hospital accommodation in the Madras Asylum is now sufficient for all needs, and
the coincidence of a low sick rate with high mortality raises a doubt whether the
medical supervision which should ensure that cases are brought sufficiently early under
treatment is adequate. The matter will be further considered in connection with
the special report of the Sanitary Board which is now with the Surgeon-General.
Dr. deFabeck will have seen from G.O., dated 27th April 1892, No. 807, Judicial, that
the Government is prepared to take into consideration proposals for strengthening
the staff of attendants in the Asylums.

3.  The great decline in the proportion of patients whose previous occupation was
declared on admission to be unknown is satisfactory, and it is still more gratifying to
observe the large advance in the percentage of admissions in respect of which the
cause of insanity was traced; this latter proportion was 79.34 per cent., being the
highest figure reached in the last five years. As remarked by the Surgeon-General, it
is interesting to observe how few cases of insanity are attributed to the use of opium.

4.  The outlay per head of daily average strength on account of establishment
was much the same in 1891 as in 1890. The charges per head of daily average
strength during the last four years under the other items of expenditure is shown
below :—

Under total cost there has been a continuous and considerable decrease at
Calicut during the last three years, but the outlay in Madras has increased largely
since 1889. The main item of expenditure is " Diet " and the Madras Asylum shows a
much higher figure under this head than do the other two Asylums. At Waltair
and Calicut, owing doubtless to economy, the cost of rations has been steadily
declining in the face of rising prices; but the results at the Madras Asylum show no
improvement. The report assigns various reasons for the high cost of diet at Madras.
The Surgeon-General points out that the average cost per head per diem amounts to
only As. 3-2 and expresses an opinion that it is impossible to reduce the rate to the
Bengal figure of A. 1-7. The Surgeon-General has, however, overlooked the fact
that the cost of dieting patients at Waltair was actually below the Bengal rate in
1891, and this Asylum, in marked contrast with Madras, shows an exceedingly small
death-rate. The fall by nearly Rs. 11 per head which has occurred in the cost of