54                                       BHOWANIPORE ASYLUM.

                                                        No. 54.

FROM THE SUPERINTENDENT OF ASYLUMS

                                                        AT THE PRESIDENCY,

To THE DEPY. INSPR.-GENL. OF HOSPITALS,

                                                        PRESIDENCY CIRCLE.

                                        FORT WILLIAM, Bhowanipore, the 6th February 1870.

SIR,

I HAVE the honor of submitting, for the information of the Inspector-General
of Hospitals and Government, the annual returns of the Bhowanipore Lunatic Asylum, and
of offering the following remarks on the facts they record.

Admissions.—There were 78 patients, male and female, admitted during the year, being
16 in excess of the admissions of the previous year. Two re-admissions occurred.

Causation.—It is observable that intemperance has been the imputed cause in an unusu-
ally small number of cases this year, in seven only of the total number. I have in former
years recommended that statements with reference to this cause should be received with
great caution, as intemperance as an early manifestation of insanity is so common, that it is
often mistaken for its precursor, and it will, I think, be generally found that the more care-
fully inquiry is made into the antecedents of insane persons, the less will be the proportion
of cases whose origin is ascribed to intemperance. Inheritance of insanity has been traced
or suspected on good grounds in 18 instances, a larger number than in former years, but
one which I cannot doubt is far short of the extent to which the condition really exists. Each
succeeding year appears to strengthen the conviction that many of the alleged causes of
mental disease are no more than the incidents or circumstances which have produced the
first outbreak in a constitution prepared for the change from birth. In thirteen cases the
affection was preceded by sun-stroke or climatic febrile disease. Domestic trouble caused or
preceded insanity in four women admitted; child-birth in two. Of the less productive causes,
cranial injury appears in three cases; epilepsy either as cause or accompanying complication
in the same number; excessive study and masturbation each in a single case. To the latter
cause I believe that the remarks which I have offered on intemperance have application.

It has been, as in former years, very difficult to obtain even an alleged cause in a large
number, and in several the opportunity of doing so has been accidental.

Varieties.—There have been forty-six cases of chronic mania, a number which points to
the prevalence of hereditary transmission. Including the maniacal delirium of alcohol and
the puerperal cases, there has been in only seven examples a condition which could be called
acute mania; but even this small number greatly exceeds those of former years. Melan-
cholia is represented by a single case, and there were nineteen of one or other form of
dementia, including the dementia of epilepsy. One case is entered as ephemeral mania.
It was that of a soldier sent to the asylum, as I suppose, by inadvertence. Several months
ago, in the hot weather, he had been visited by very transient excitement, during the existence
of which be threatened violence to a comrade. The attack lasted only a few hours. Being
a temperate, orderly man, his conduct was ascribed to insanity. Subsequently it would seem
that his period of service came to an end, and he was allowed to sign papers and transact
all the business connected with his discharge. Nevertheless on arriving at Chinsurah he
found himself under orders for the asylum. As soon as it became quite clear that there was
no reason for detaining him, he was sent back to the depôt, with a recommendation that he