DACCA LUNATIC ASYLUM.                                        37

Death-rate.

Causes of excessive
mortality.

The mortality as calculated on the daily average strength was 19.71, or 1.29 per cent.
more than in 1870, and 1.47 higher than the average of the last five years. In a special
report, dated 27th December last, to your address, I dwelt on the causes of the excessive
mortality during 1870. Not having been personally in charge, the proofs on which I based
my arguments were collected from the records in the asylum. I attributed the mortality
to four causes,—(1) the bad physical health of the lunatics on admission, (2) the long and
tiresome journey they were sent before arrival at the asylum, (3) the sudden alternations of
temperature they were exposed to during the cold season, and (4) the insufficient accommodation
provided for them in the asylum. I attribute the mortality of 1871 to the same causes.

Comparison with
Engish asylums ;
fallacious.

Comparison between the mortality of English and Bengal Asylums is often made; but
the class and condition of the lunatics sent to asylums in the two countries differ in many
material respects. In the metropolitan and borough asylums lunatics belonging to the middle
classes of society are admitted as well as paupers. The lunatics of the middle and lower
classes in England, with few expections, are inmates of these asylums, and it is penal to
keep a lunatic in a private house without legal sanction. In Bengal, on the other hand, a
very small proportion of the lunatic population is in asylums. The District Superintendent
lately furnished me with a list of 145 mad persons in this district alone who were in charge
of their relaties. Only those lunatics who are criminals, or are homeless, dangerous, or
incurable, find their way to asylums; their insanity has often lasted for years, and it is only
because the relatives are tired of looking after them, or because their means are exhausted,
that they forward them to the asylums.

Comparison          of
death-rates not
fair.

In the reports of the Commissioners on lunacy there is no table showing the duration
of insanity previous to admission, as it is not required. An individual in England, when-
ever he becomes insane, receives a certificate of insanity, and is admitted into one or other
of the numerous institutions existing throughout the country. For these reasons a com-
parison between the 10.31 per cent. of deaths to the daily average number resident
in English asylums is not a fair one. Before instituting any comparison of the
mortality of different asylums, it is necessary to know the class, age, previous history,
and duration of insanity of the lunatics admitted; the distances from which they come ; the
mode of conveyance by which they travel; the food given them en route, and the physical
state in which they arrive.

Cause of reduction
of mortality in
Dullundah.

In Dr. Payne's reports of the Dullunda Asylum for several years, the mortality is
found to be excessive; but in 1870 the death-rate suddenly falls to 12.62, the lowest perhaps
that had ever been recorded of a large Indian asylum. In 1866 the mortality was 32 19.
This surprising difference is referred by Dr. Payne to the order of Government prohibiting
the despatch to the Dullunda Asylum of mad people physically unfit to travel. I presume
the order alluded to is that forwarded to all Commissioners with letter No. 4382, dated
5th September 1868.

Hardships of travel -
ling in Eastern
Bengal.

Effect on health
of lunatics.

That this order has not effected a similar reduction in the mortality of the Dacca Asylum
is unintelligible, unless the routes by which lunatics are sent are considered. Travelling in
Eastern Bengal is done in boats or steamers. The lunatics are in the charge of constables.
When they are about to start from the zillah station, they are examined by the Civil Surgeon,
who testifies to their fitness to travel. From the date of this examination till the arrival
at the asylum weeks elapse During 1870 it took a lunatic 28 days to arrive at Dacca from
Assam, and 13 from Cooch Behar. In 1871 he accomplished the former journey in 20 ; the
latter in 13 days. The whole time the principal food provided is parched rice (chura),
worm-eaten, or new rice, and khisari dall. If demented or refractory, no care is taken that
the lunatic be properly covered at night. The consequence of this usage is that in
many instances on arrival the lunatic is found to be suffering from general debility, or,
worse still, from disease of the lungs or bowels.

                                                                                                                                    K