4                                               ANNUAL REPORT ON LUNATIC ASYLUMS.

population is found to correspond with an increased number of lunatics. In this
country, however, the admissions into lunatic asylums afford no accurate index
of the amount of insanity prevailing amongst the civil population : the higher
caste Hindus are much averse to their relatives being confined in public institu-
tions, where they may have to associate with others of lower caste. There are
(it may reasonably be expected) doubtless a large number of insanes amongst
the native population, who are kept under restraint in private houses, and of
whom the Police authorities have no knowledge. Making all allowances for caste
prejudices, it is, however, a remarkable fact that the lunatic statistics in this Presi-
dency do not exhibit a more marked increase in the number of insanes amongst
the native population for the last ten years.

         Of the total number under treatment during the year 625 were males and
204 females, showing that there has been an increase in the number of lunatics of
both sexes as compared with 1889. The total number discharged was 118, of
whom 86 were males and 32 females. Of the total number discharged 64 are
returned as cured, 37 were transferred to the care of friends, and 17 discharged
otherwise. There were 114 deaths during the year.

         The following table shows the chief results in each of the three asylums for
the last three years :—

         4. SICKNESS AND MORTALITYA.—The general health of the inmates of the three
asylums was not at all satisfactory during the year under review; in Madras the
admissions to hospital rose from 245 in the previous year to 272 : this was not
a very large increase considering the excessive mortality in this institution. In
Waltair the number of admissions was 23 and in Calicut 84 against 11 and 67,
respectively, in 1889. In the Madras Asylum there was a large increase in the
percentage of deaths to daily average strength and admissions, and a fall in the
percentage of cures, while the daily average sick rose from 17.16 to 29.40.

         In Calicut the admissions to hospital were 84 and the number of deaths 27,
showing an increase of 17 and 19, respectively, as compared with the previous year.
In Waltair the admissions to hospital rose from 11 in 1889 to 23 in the year under
review, and the deaths to 6; there were no deaths in this asylum in 1889.

         The high mortality in the Madras and Calicut Asylums is partly accounted for
by an outbreak of cholera, which caused 15 deaths in the former, and 12 in the
latter; in Madras the insanes suffered severely from the influenza epidemic which
passed over India, and to it 19 of the deaths which occurred are ascribed; omitting,
however, the deaths due to these diseases from the total mortality in both institu-
tions, it will be seen that the death-rate was higher than it has been for the last
ten years, while there has been no material increase in the total population: and
the daily average strength as compared with 1889 shows a falling off.

         Excluding cholera and influenza the diseases which proved most fatal were
dysentery (13), diarrhœa (13), phthisis (6), apoplexy (5), epilepsy (5), and heart
disease (4). In addition to these there were 4 deaths in the Madras Asylum from
lung disease following influenza.

         The general death-rate for the year, calculated on the daily average strength,
was at the rate of 18.4 per cent., which compares unfavourably with previous
years and with the returns from other asylums in India.