2                                    REPORT ON THE LUNATIC ASYLUMS IN BURMA FOR THE YEAR 1918.

it was not possible for the attendant to notice what was happening inside. These
have since been rectified and the keeper in charge was found to be at fault for
carelessness in allowing the secreting of the rope ; he was suitably punished.
The Superintendent reports that there were no less than half a dozen attempts at
suicide in the asylum during the year, but all were detected and prevented by
vigilance of keepers with the help of other staff of the asylum. All have been
trained in first aid with special reference to asylum conditions. There were no
cases of escape or of suicide in the asylum at Minbu.

         Statement I.

7.  Sickness and Mortality.—The percentage of mortality to daily average
strength whilst it showed a slight increase of 1.06 over the corresponding figure of
the year previous, was nevertheless much below that of the asylums in India
having been 7.84 as against 8.50 in Nagpore, 9.63 in Bengal, 10.63 in Patna,
13.57 in Madras, 14.4 in Bombay and 14.83 in Punjab. There were 64 deaths
during the year against 51 of 1917. To these, Rangoon alone contributed 61
deaths, most of which are attributable to Influenza and its sequelæ. Small-pox
and Plague, though present in Rangoon, fortunately did not gain access into the
asylum, probably owing to prompt adoption of precautionary measures. All the
new admissions were vaccinated against possible attacks of Small-pox. One or
two cases of Chicken-pox occurred in the female section, but its spread was
checked by early segregation of the cases. Influenza attacked 150 inmates in
Rangoon and 48 in Minbu, only one of the latter however died. Dr. Krishnasawmi
has taken keen interest in Laboratory work, for 1,394 cases of stools were
examined with the result that in 170 he detected Amœba, in 63 Ankylostomia, in
81 Round worms, in 34 Thread worms, in 44 Whip worms. He also examined 116
cases of urine and 99 cases of blood from two of which he was able to trace
malaria. Taking the two asylums together, the daily average sick was slightly
higher, being 174.23 as compared with 170.67 of the preceding year, and Influenza
was mainly responsible for this slight increase.

8.  Employment and Treatment.—The daily average number employed in the
Rangoon Asylum during the year was 337.79 against 282.08 in 1917. The number
employed in the Minbu Asylum was 101. These were employed in gardening,
cleaning and sweeping compounds and building, carpentry, in the making of
bamboo baskets, in the dairy, in kitchen, as sick attendants, dhobies, office orderly,
grass-cutters, etc. Inducements as stipends, tobacco, sweets, fruits, glass-bangles,
ear-rings, money, etc., were, as a rule, given to engender an interest in work and
their surroundings. Gramaphone entertainments, card-playing and other amuse-
ments were also permitted and special treats were given on Christmas, New Year,
and Easter and Victory Days. As regards treatment, no special drug was used
specifically for any type of insanity. Hyoscine injections were given in suitable
cases with great benefit. Paraldehyde and Sulphonal were the most reliable and
safe hypnotics used.

         Statement
VIII.

9. Finance.— The total amount expended for the up-keep of the Rangoon
Lunatic Asylum in 1918 was Rs. 1,72,887-12-6 as against Rs. 1,81,384-2-8 in
1917, resulting in a net decrease of Rs. 8,496-6-2. The charges on account of
work done by the Public Works Department came up to Rs. 23,062 in 1918 as
compared with Rs. 41,275 in the year previous. Excepting the decrease notice-
able under the charges on account of superintendence, bazaar medicines and
contingencies proper, there was a general increase under all other heads of expen-
diture. This, the Superintendent, Lunatic Asylum, Rangoon, ascribes to
"increased population, the increased staff and the increased number of cattle."
The amount of money remitted to Treasury, during the year on account of paying
patients, etc., was Rs. 42,662-2-2 as against Rs. 37,880-15-10 in 1917. The
increase of Rs. 4,781-2-4 was occasioned by a corresponding increase in the
numbers of paying patients. The total average cost per head during the year was
Rs. 164-3-10 against Rs. 170-9-0 in 1917. In Minbu, the total expenditure for
the maintenance of the asylum was Rs. 16,880-10-4 against Rs. 18,355-7-10
in 1917 and the average cost per head of the population fell from Rs. 118-4-9 in
1917 to Rs. 115-7-4 in the year under report.

         Statement
X.

10.  Manufacture Department.—This branch continued to work at a profit,
the gain in 1918 being Rs. 23,283-9-3 as against Rs. 24,206-12-10 in 1917.

11.  Staff.—Civil Assistant Surgeons C. S. Krishnasawmi Iyer and J, Banner-
jee continued to hold the charge of the Lunatic Asylums in Rangoon and Minbu,
respectively, throughout the year, while the post of Deputy Superintendent was
similarly held throughout the year by Senior Grade Sub-Assistant Surgeon
Shaik Kadir Bux in Rangoon and Sub-Assistant Surgeon N. Anand Rao in
Minbu. These officers carried out their duties with energy and zeal.

                           P. C. H. STRICKLAND, Col., I.M.S.,
                           Inspector-General of Civil Hospitals, Burma.