ANNUAL REPORT ON LUNATIC ASYLUMS.                    15

                                                Caste.

Recoveries.—Forty-nine patients have been discharged recovered. Twenty-four

of these were cases of acute mania, giving a percentage of 58.53
to admissions and 33.53 to total treated. Nineteen were cases
of chronic mania, giving a percentage of 35.84 to admissions
and 10.81 to total treated, so that comparing the recoveries to
total treated in acute and chronic mania, they were in the proportion of 3 to 1.
There were 4 recoveries from melancholia out of 13 admissions and a total treated
of 37, giving a percentage of 30.76 to admissions and 10.81 to total treated. Two
cases of puerperal mania recovered out of 3 treated. One case has been in this
asylum for years, and might now be more properly classed under chronic mania.
There were no recoveries from acute or chronic dementia. Many of the patients
suffering from acute mania have been insane for months previous to their admission
into the asylum. The good results obtained from early treatment are well shown
in the cases of sepoys, for of 6 admissions no less than 5 have been discharged
recovered. The recoveries from all diseases to total treated is this year 13.31 as
compared with 14.04 last year.

Handed over.—Nineteen patients have been handed over to their relatives.
Inquiries are made for the friends of all chronic harmless insanes, but it is very
seldom that relatives can be found who are willing to take charge of them.

Sickness and Mortality.—The general health of the inmates has been good.
The death-rate is lower than in any year since 1872, and, but for two deaths from
violence, would have been lower than in any year on record.

The principal causes of admissions were fever, diarrhoea, dysentery, and general
debility, and the average daily sick was 27, or 10 per cent. of daily average strength.
As compared with previous years, the number treated in hospital was very high,
but the number of deaths to total treated was very low.

The explanation is this : Mr. Hardaker states that in former years only
serious cases were returned as sick in hospital. The ordinary cases of sickness
were not entered in the books. In a large body of insanes there will always be
a considerable number requiring treatment for general diseases. The early
detection of illness is of great importance, as insanes rapidly lose ground, and if
care and watchfulness are not shown, many disorders will be overlooked until the
most favorable time for treatment has passed. This is not to be wondered at when
it is remembered that lunacy masks many diseases. In cases of phthisis, for
instance, cough is usually entirely absent. The weighing-machine is of great
assistance in detecting disease, and for some time past I have had every patient
weighed once a month, and the weight entered in a book kept for the purpose, so
that a glance will show whether a patient is gaining or losing. By this means
I have detected cases of phthisis in an early stage, which might otherwise have
escaped notice.