8                  ANNUAL REPORT ON LUNATIC ASYLUMS.

criminal cottage is used for the purpose when required. Similarly in Calicut
there is no separate hospital accommodation for females and they are located
and treated in one of the cells in the female enclosure which accommodates 8;
there is hospital accommodation for 15 males.

In the Madras Asylum there is no real hospital accommodation for males
specially adapted for the proper treatment of the sick. In the old criminal
enclosure there are two ordinary barrack blocks and eight single cells capable of
holding a total of 32 patients. The two single blocks at present accommodate 12
sick each, with a superficial area of only 60 square feet per patient, which the
Superintendent considers too low for the sick. He says " considering the number
of insane patients who require treatment for mental and physical ailments in
hospital, the accommodation is utterly inadequate for men. The hospital blocks
themselves are but ill-adapted for their purpose being without separate accommo-
dation for isolating superior patients or others requiring individually special treat-
ment ; there are no baths, no hot water laid on or means of obtaining it except by
boiling it in a pot at the enclosure in the open, no ward at all for Europeans, and
the whole arrangements are a make-shift." The accommodation for females has
been increased during the year by the inclusion of the old male hospital which now
affords space for 14 in-patients, where formerly it was for five. The space has been
sufficient up to the present time, but the arrangements are faulty as on the male
side. Proposals are under consideration for the accommodation of 80 males and
20 females. Two separate isolation blocks of three single rooms each are used for
contagious diseases among the males, and two isolation blocks of three rooms each
for the females. Although these blocks were built evidently with an eye to the
security of the lunatic patients the accommodation does not appear to be suitable
for an epidemic,

8. SICKNESS AND ITS CAUSES—Vizagapatam Asylum.—The total treated was 85
against 91 in the previous year ; the average daily sick was 7.82 against 6.69.
The general health of the insanes has been good but one case of chronic pneumonic
phthisis and one of epilepsy, which were under treatment throughout the year, have
raised the daily average. Of the total treated (85), 73 were discharged cured, 1
relieved, 2 died and 9 remained at the end of the year.

The chief causes of admission were fevers 22, bowel-complaints 21, respi-
ratory and circulatory affections 10, nervous affections 5 and local injuries 7.

There were in all 25 admissions for 'symptoms,' namely, constipation, diar-
rhœa, dyspepsia, debility and anæmia. The Superintendent notes that "difficult as
it frequently is when dealing with sane persons to ascertain the probable cause of
such symptoms, this difficulty is necessarily increased in an asylum."

Calicut Asylum.—The general health of the insanes was, on the whole, good
during the year except during the monsoon. One hundred and twenty insanes were
treated in hospital, with an average daily sick of 15.07 against 87 in 1893 with an
average daily of 8.10. The increase is due to the weakly condition of many of
the insanes on admission and to the prompt removal of the sick to the hospital for
better care and treatment in the earlier stages of disease,

Madras Asylum. — In accordance with G.O., No. 1320, Judicial, dated 4th
July 1891, all members of the weakly gangs appear in the hospital returns as in
the other asylums. There have been nearly double the number of admissions into
hospital in 1894 as compared with the previous year, viz., 1,042 as against 539
The diseases which yielded the largest number of admissions are in order of fre-
quency as follows :—

Itch 114, surfeit 110, anæmia 72, constipation 65, catarrhal inflammation of
intestines 62, dysentery 60, ulcer 40, worms 35, simple continued fever 29, and
inflammation of external ear 17.

The Superintendent states that " the sum total of four of the principal
diseases, viz., 297 from surfeit, constipation, catarrhal inflammation of the intestines
and dysentery, adds force to his opinion that the food of the asylum is at all times
are of his greatest difficulties when conjoined with feeble health of many of the
patients and that a diet such as raggi is with such patients to be looked on with
suspicion. This opinion he says is further strengthened by the observation that