6                         ANNUAL REPORT ON LUNATIC ASYLUMS.

11.   Causes of Mortality.—The asylums in the Madras Presidency have been
exempt from epidemic diseases during the year. The insane seems to be particularly
liable to phthisis, atrophy, and bowel-diseases.

Regarding the latter the remarks of Dr. Leapingwell show that the tendency
to bowel-diseases is probably much enhanced by the habits of the people of eating
or drinking from any dirty source. Dr. Leapingwell surmises that diarrhœa and
dysentery may be often induced by the patients drinking water from a foul source,
and the practical point to be borne in mind is that foul water, or dirty food, should
not be permitted within the range of lunatics.

Some years ago in the Native Asylum of Calcutta it was found that the
inmates suffered much from worms, and the disease was traced to the mode of
supplying water to the latrines. With a change in the washing arrangements, so
that the lunatics could not drink fouled water, the disease ceased.

In the Madras Asylum arrangements are being made to close the tanks contain-
ing surface water. The ordinary supply from wells is pure and good.

12.   There were in all 29 deaths in the Lunatic Asylums; the heaviest ratio of
mortality occurred at Waltair, where most of the cases are of a chronic nature.
The following table shows the causes of death:—

                        GENERAL RESULTS IN EACH ASYLUM.

13. The annexed table shows the more important results in each asylum in
one view. The ratio of recoveries to daily strength was highest in Vizagapatam,
and in this asylum also the mortality was the highest, but taking the admissions,
instead of daily strength, the percentage of recoveries was lowest in Vizagapatam.

The death-rate to daily strength was lowest in Madras, where only 8.82 per cent,
died. In Vizagapatam the mortality to daily strength was 39.2 and in Calicut 13.3.
The Madras death-rate was much below, and that of Vizagapatam above, the average.
In the latter asylum a nurse and patient were apparently both bitten at night by a
venomous snake in one of the rooms, and both were found dead next morning.