8                      ANNUAL REPORT ON LUNATIC ASYLUMS.

14.   Sickness in Asylums.—The total hospital admissions in the three asylums
was 303, the numbers being somewhat in excess of those of the previous year.
The deaths were 45, and 19 cases remained in hospital at the end of the year.
The increase in number of sick treated is explained in great measure in Dr. Leap-
ingwell's report; he states that greater watchfulness has made it advisable to
bring men under observation in hospital, who formerly would have been treated
as ordinary insanes or as out-patients. Full particulars of sickness and mortality
will be found in Table VIII of the Appendix.

15.   Madras Asylum.—The report is drawn up by Dr. Leapingwell, who has been
in charge of the asylum for the whole year. There were 246 patients in the
beginning of the year, 122 new cases were admitted, 49 were discharged recovered,
19 were so far relieved that they were handed over to the charge of their relations,
6 were sent to England, 2 absconded and 2 were transferred to the police, 23 died,
and 267 remained in the asylum on 31st March 1881.

16.  Buildings.—  The asylum buildings are maintained in good order. During
the year an upper story was built to the quarters of the Superintendent, the roofs
of the cottages were repaired. The interiors of the separate cells in the criminal
enclosure were repainted, and the cooking stoves in the kitchen were substantially
repaired. The strong cottages alluded to in paragraph 8 of G.O., No. 2,077, of 24th
August 1880, have not been built. In my opinion the necessity for these very
expensive buildings had not been demonstrated, as in ten years' experience only one
really unmanageable European had been in the asylum. I accordingly recom-
mended modifications of the plans to provide more accommodation of a superior
description for European or East Indian patients, and the necessary works will be
shortly commenced.

The asylum grounds are kept in good order, and the fences are in better
condition than they have ever been before. The sanitary condition of the whole
establishment is most satisfactory.

17.   Dr. Leapingwell properly points out in his report the advantages of early
treatment in attacks of insanity, and instances the fact that of six sepoys admitted
for acute mania, no fewer than five made good recoveries. In the army, attacks of
mental disease are speedily recognised and measures taken for the treatment of the
patients, but unfortunately the same prompt action cannot be enforced in civil life,
and as a consequence the proportion of recoveries is not so great as it would be if
civil and criminal insanes could be subjected to treatment in earlier stages of
maniacal excitement.

Probably district officers and local authorities might be able to direct the
attention of friends and relatives of the insane to the advantages of early removal
to an asylum in cases coming under their observation.

18.   Two fatal accidents occurred within the year, regarding which something
must be said.

In the first case an imbecile youth wandered away and seems to have attempted
to bathe in a tank on the premises, where the water was deep, and was found
drowned. The warder in charge supposed that the patient had gone to the latrine
and never took any steps to watch him, as he should have done.

This tank has subsequently been filled in, but the accident was due to careless
supervision.

19.   The second case was that of a murderous assault by some men in the
asylum on a criminal lunatic in the criminal enclosure, from which the man suffered
such serious injuries that he died in a few hours from extensive fracture of the
skull and injury to the brain. The Coroner's Jury in the inquest on this case made
a presentment to Government of their opinion that the number of European warders
employed was insufficient for the safe custody of the patients. I thought it
advisable to ask Government to appoint a committee to inquire generally into the
sufficiency of the establishment, and to report on its discipline and management.
Accordingly a committee was appointed, and their recommendations submitted to
Government on the 18th June 1881.