10 ANNUAL REPORT ON LUNATIC ASYLUMS.
10. EPIDEMICS, CAUSES, AND HOW THEY WERE DEALT WITH.—There was no out-
break of epidemic disease during the year either at Vizagapatam or at Calicut.
In the Madras Asylum there was none until the very end of the year, when
cholera appeared.
As the epidemic was a very serious one I attach (appendix I) the report of the
Superintendent with my remarks. It will be noted that the epidemic continued
beyond the 1st January 1895 but I consider it is desirable to deal with it in this
report as it commenced in 1894.
11. INJURIES RECEIVED IN THE ASYLUMS. — In the Vizagapatam Asylum there
were seven admissions for local injuries, one male and three females, one female
being admitted four times for self-inflicted injuries ; none of these cases were severe
and all of them were unavoidable; only one was due to an assault by another insane
and none to attendants.
In the Calicut Asylum three cases were admitted into hospital, one for wound
of scalp, the result of an assault by another insane. The remaining two were due
to accidents, one a contusion of the upper extremity and the other a wound of the
lower extremity.
In the Madras Asylum—(1) On August 19th 'Nabi Sahib' received a slight
incised wound from a blow inflicted suddenly by patient ' Madura Coopu.'
(2) Ayah 'Allamaloo second' was bitten in the hand by patient Atcham-
mah,
(3) Patient 'Bukatiamah' was injured in the hand slightly by another
patient in pounding rice. This was thought to have been probably accidental.
(4) A patient 'Miss Schmidt' tried to strangle herself on August 27th by
means of a piece of clothing which she adjusted round her neck and twisted round
the bar of her door, no serious harm was done.
(5) A patient in the criminal enclosure 'Ganga Nagappah' committed
suicide by strangling himself with a rope made out of the cotton cloth made in the
weaving room. His case is noted under 'Mortality.'
12. HOSPITAL DIETS AND EXTRAS.—In the Vizagapatam Asylum the hospital diets
laid down in the Jail Code were in use; there were in all 350 hospital diets which
cost Rs. 50-9-11 ; the cost of extras was only Rs. 2-13-2.
In the Calicut Asylum no prescribed hospital diet was in use during the year,
special diets were given to suit the nature of the ailments and the condition of the
patients, the average daily sick being 5.25. Those who were continually losing
weight but had no appreciable disease were given extras with their ordinary diet.
The cost of the sick diets and extras amounted to Rs. 825-15-6.
In the Madras Asylum the diets were on a local hospital scale in customary
use at the asylum. The Superintendent remarks that the adoption of the Presi-
dency State Hospital scale of diets sanctioned by Government in G.O., No. 2472,
dated 11th October 1894, will doubtless prove beneficial, allowing greater range,
but will be more expensive. I am, however, doubtful whether it will be more
expensive, as it is the same scale as adopted in other Government hospitals and has
been found to work well in them ; and I am quite certain that the larger discretion
given to the Medical officers by these rules will conduce to the better treatment
of the patients in hospital and their more speedy recovery. These rules will
certainly give the Surgeon-General more opportunity of intelligently checking
the expenditure on hospital diets in comparison with the expenditure on patients
treated in other Government hospitals. The Superintendent reports that " the
expenditure on extras for the sick has been high but this is considered quite
necessary in view of the bad state of health which many of the insanes are in, on
admission, and the anæmic state of those who form a large group of the patients
often or nearly always included in those who are admitted nominally for dysentery,
or other ailments, that is they suffer from both conditions combined. For these
people, milk, broth, arrack and other extras are necessary, and many of these will
not eat the present 'full' and 'half' diets during convalescence. Their food is