8                    ANNUAL REPORT ON LUNATIC ASYLUMS.

13.  Sickness in the Asylums.—There were 250 patients treated in hospital
during the year, including nine remaining at the end of the previous year. Of
these 44 died, and 36 remained under treatment at the end of the year. The
principal causes of admission were fevers, debility, disease of the bowels, and
epileptic seizures. One case of small-pox occurred in the Madras Asylum. Full
particulars are given in Table VIII of Appendix.

14. Madras Asylum.—The annual report is drawn up by Surgeon Leapingwell
who was in charge of the asylum for the last five months of the year, having
relieved Surgeon-Major Nanney in November. The report, with Surgeon-Major
Nanney's observations for the period he was in charge, is appended. The year
opened with 227 patients, 136 were admitted, 51 cured, 21 relieved, 12 transferred
to England, and 1 absconded. Thirty-two patients died, one of these being a case of
suicide, the first that has occurred in the asylum for many years. There remained
246 patients at the end of the year.

15. The asylum buildings are on the whole in good repair, though the roofs of
some of the cottages will require attention. Dr. Leapingwell recommended the
demolition of the wall surrounding the idiot enclosure, but I am not prepared
to support this measure, as it may interfere with the safety of some of the idiots
who are mischievous and given to wandering.

16. Dr. Leapingwell points out that the death-rate amongst the criminal
lunatics is much higher than that of ordinary insanes. In the past year 26.8 per
cent. of the criminal lunatics died, while only 9.59 of the other patients died. As
regards diet and treatment in the asylum, the criminals are subjected to precisely
the same influences as other patients. The cause of undue mortality is no doubt
the bad state of health brought about by exposure and privation in these classes
before they came into the asylum. Of 13 criminal lunatics who died during the
year only one was in good health at the time of admission.

17. The suicidal death was the result of some carelessness on the part of the
female attendants. A well in the female enclosure, which is covered with a wooden
grating, having a movable opening for the passage of buckets, was unlocked for the
purpose of drawing water, and an insane female took advantage of its being
temporarily unguarded and threw herself into the opening. She was dead before
the body could be recovered.

18. As regards general employment and recreation of the insane, there has
been nothing new during the year. Cloth-making is carried on so as to meet all the
clothing requirements, and gardening to some extent. In the Native Asylum at
Calcutta I have myself seen the good results of stone-breaking as an employment,
but in Madras there are no stones at hand, nor could they be sold profitably to the
Municipality if we had the material available. Some suitable employment is wanted
for East Indian males.

In recreation the absence of Native Regiments from Madras has deprived the
asylum of the periodical attendance of a band. Probably this loss might be compen-
sated by the occasional hiring of native musicians and singers to amuse the insane
once a week or so.

19. Dr. Leapingwell does not give a good report of his European Warders, and
subsequent to the date of this report another accidental death from drowning has
occurred in the asylum, due in no small degree to lax and careless supervision.
The European and other Warders have been cautioned to exercise more vigilance
over their charges.

The grounds of the asylum are so extensive that accidents are sure to arise if
the Warders neglect their duty. The Subordinate Medical establishment and Matron
are spoken well of by Dr. Leapingwell,

20.  Financially the Madras Asylum shows a considerable reduction in expendi-
ture under nearly every head of charge. The total cost was Rupees 59,976-3-6
against Rupees 63,543-3-0 in the year preceding. The more important reductions
occur under the heads of " diets," " wines and spirits," and " perishable articles and
contingencies.''

21. Vizagapatam.—In this asylum there were 42 patients at the beginning of
the year ; 16 were admitted, 11 discharged (9 cured), 10 died, and there remained 37