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marked among the female patients. In 1888 and 1889 also, the excessively high
death-rate among the women confined in the Madras Lunatic Asylum attracted atten-
tion, and the continuance of this abnormal mortality during the year under review
suggests some serious defect with regard to the management of this class of patients
which calls for early remedy. In paragraph 3 of his report for 1889, the Surgeon-
General alluded to two possible causes for unhealthiness in the Madras Asylum; of
these one was a contaminated water-supply and the other the defective drainage of
the female enclosure. The former defect has, the Surgeon-General reports, been
remedied, but it is not clear whether any steps have been taken to improve the
drainage. The matter should now receive immediate and careful attention. State-
ment I also shows that the proportion of inmates on the sick-list was, as in 1880,
far higher in the Madras Asylum than in the others. This is the more noticeable as
the Surgeon-General has recently reported that the hospital accommodation in this
asylum is insufficient—a circumstance which renders it extremely probable that, had
there been more room, the average number sick would have been still higher than it
was.

3. The following statement exhibits the diseases which proved most fatal during
the year:—

It will be seen from these figures that a considerable proportion of the deaths
which occurred was due to an epidemic of cholera and influenza in the Madras
Asylum and an outbreak of the former disease at Calicut. But even if deaths from
these two causes be excluded, the mortality still amounted to 10.9 per cent. of the
daily average strength, which is considerably above the death-rate in any of the four
preceding years. It is observed that two lepers are confined in the Lunatic Asylum,
Waltair ; it should be reported whether measures have been taken to segregate these
individuals.

4.  Out of 197 lunatics admitted during the year, 51, or 25.9 per cent, have been
registered as of unknown occupation; the results in this respect obtained in 1889 were
superior to those of the year under review, as the occupation of only 11.7 per cent.
of those admitted was unknown. It is doubtless in many cases difficult to ascertain
the previous livelihood of patients, and to this cause may perhaps be ascribed the
large fluctuations in the proportion classified as of unknown occupation from year to
year; the matter should, however, receive careful attention at the hands of Superin-
tendents, who should, where the papers sent with insanes do not furnish sufficient
Information, apply to the authorities forwarding the lunatics to supply, if possible,
what is wanting.

5.  A much more important matter is the investigation of the causes of insanity,
and it is to be regretted that in this respect the year under review showed a marked
deterioration as compared with 1889.

Statistics showing the progress made in the Classification of causes of insanity
during the last five years are given in the following statement:—