36                                                   REPORT ON THE

Results according
to duration of
insanity.

This table also shows that lunatics are cured and die in much larger proportion in the
first year than in any other.

* Vide General Statements Nos. 7 & 7a.

Table No. 9* shows the events of 1871 according to
duration of residence in asylums.

Events according
to duration of
residence.

The average residence of each inmate was 1,550 days, or over four years. This calcu-
lation establishes the fact that a very large proportion of the inmates are hopeless cases,
and that they may be considered permanent inmates.

Cures.

Of the cures, 21 out of 29 were discharged within a year of admission, and the average
residence was only 481 days.

Deaths.

Of the deaths, 11 occurred within six months of admission, and 20 within a year. The
average residence of all the fatal cases was 961 days.

General health on
admission and
discharge.

Table No. 10 shows the general health on admission and discharge of lunatics during 1871.
Of the 63 males, 18 were admitted in good, 23 in indifferent, and 22 in bad health.
Of the 17 females, 8 were in good, 1 in indifferent, and eight in bad health.

Of the total admitted 10 were discharged and 5 transferred to friends. Out of these 15,
10 were in good, 2 in indifferent, and 3 in bad health.

Deaths among ad-
missions of the
year.

Of the total admitted within the year the death-rate was high, 15 out of 80, or 18.75
per cent. dying.

Diseases causing
mortality.

† Vide General Statement No. 8.

Table No. 11† exhibits the diseases under which mortality occurred. As is the invariable
practice in this asylum, a careful post mortem examination
is made of each fatal case.

Debility.

The diseases which cause the chief mortality among lunatics are those dependent on
general physical debility, the consequence of mental disease, and exhaustion and coma have
to be specially guarded against in the treatment of all depressing complaints, such as fevers.

Remittent fever.

This year, four deaths from remittent fever occurred. Though the type was not so
severe as in the jail, yet in the course of the remissions exhaustion supervened and terminated
in death. Three were afflicted with chronic dementia, and one with acute mania. One
death took place in July and three in November, at the time when fever was perhaps more
general in Dacca than it has been for many years.

Cholera.

Cholera was unusually rare in Dacca during the year. There were four cases in the
asylum, and three deaths. No other epidemic disease appeared among the inmates.

Phthisis.

Tubercular diseases are much more common in this asylum than of old. This increase
may, however, be owing to the post mortem examinations, which are more frequently made
than formerly.

Of the six cases of phthisis, three were admitted into the asylum with the disease, one
died after eleven years' residence, one after seven years, and one after three years.

The cases of " tabes mesenterica" might with equal correctness have been returned
under the head of phthisis. The lungs in each case were far advanced in tubercular disease,
but the direct cause of death was the affection of the mesentery glands.

Softening of the
brain.

Two cases of circumscribed softening of the brain were examined after death. One
was a Brahmin who had been six years in the asylum as a criminal lunatic, and who had
been tried for cutting off his wife's head because she did not cook his dinner. While in
the asylum he was always irritable and quarrelsome, fond of exaggerating his sensations
in order that he might obtain extra indulgences.

Most common
lesions found after
death.

The second was a middle-aged man, who died suddenly three months after admission. In
the column of remarks of register, No. 4, details are given of the most important pathological
lesions found after death in those who died during the year. Anæmia, emaciation, chronic
brain disease, and ulceration of the intestines, characterise the whole series. Formerly the
term " cachexia" was applied to such cases, there being rarely one single disease, but a
concurrence of several.