STATISTICAL RETURNS OF THE LUNATIC ASYLUMS.                      5

11.  Act IV of 1912.—The introduction of the "Voluntary" system of
admission adds a new phase to the future development of our Asylums.
Captain Heffernan, I.M.S., in his report on the Madras Asylum for 1912,
remarks : " The year 1912 will be remembered for the introduction into
the region of practical therapeutics of Psycho-analysis and Psycho-
therapy .... The recognition of the fact that many forms of
mental disorder are of psychical origin, and can be treated successfully
by psychical means, is the greatest step psychiatrical science has made for
fifty years. Unfortunately, however, the cases for which such methods of
treatment are applicable do not come to the Lunatic Asylums until too
late. To treat such forms of mental disorder successfully the patient must
be caught early in the disease. The innovation in India of the ' Voluntary
Boarder ' by Act IV of 1912 will, it is hoped, help in ensuring that many
such cases may henceforth be treated before irreparable harm is done."

12.  Thirty-five " Voluntary Boarders" came under treatment at
Madras ; among them were 4 of the landed gentry, 2 merchants, and 7
of the liberal arts and professions. Three only of the " Unproductive "
population applied for admission at Vizagapatam, and none at Calicut.

13.  To induce the public to seek early treatment in mental disease,
and to secure investigation into its causes, it would, of course, be advisable

(1) that the centres of relief should be within easy reach of the sufferers ;

(2) that the accommodation and establishment provided should approxi-
mate as nearly as possible in comfort to those they are accustomed to at
home ; (3) that the Superintendents should be full-time specially qualified
officers who may win the confidence of those around them in dealing
with such cases. The north-west and south divisions are not provided
with separate facilities for dealing with mental disorders at present.

14.  Male insanes.—Four hundred and six civil and 156 criminal male
insanes remained in the asylums at the beginning of 1912. During the
triennium 526 and 140 were admitted ; the former figure includes 34
voluntary admissions ; the total exceeded that of the previous triennium
by 125. The daily average strength of the male population rose from
575.89 in 1912 to 600.75 in 1914 ; of these 161.20 and 177.24 were the averages
of the criminal section.

15.  Two-hundred and twenty left the Asylums after recovery, 92 after
some improvement in their condition, and 18 without appreciable improve-
ment ; 57 were discharged " otherwise "—a term, which sometimes means
merely transference from the criminal to the civil section, and sometimes
discharge so that the patient may die at home. Three escaped from the
Madras Asylum ; two of these were brought back, and subsequently left as
recovered cases; the third has not yet been traced. The deaths numbered
260 ; and 581 remained under treatment at the end of 1914.

16.  Forty-one cases (of whom 9 were " Voluntary ") came from outside
the Presidency. The West division contributed 178 cases; Madras City,
151, a fair proportion of these being criminals; from the North, Central
and South divisions, 84,83 and 88 cases respectively were brought; and
from the Deccan the Bellary district contributed 19 cases, and the rest of
the division, 22. The voluntary admissions from within the Presidency
included 12 residents of Madras, 3 of Tanjore, 2 of the Nilgiris and 8 of
other stations.

17.  Seven Europeans and Eurasians, 4 Indian Christians, 11 Hindus,
1 Muhammadan and 2 of other castes sought admission voluntarily.
Among those brought in under restraint the proportion of religions was,
Hindus, 63 per cent.; Muhammadans, 18.5 ; Indian Christians, 7 ; European
and Eurasian Christians, 5.5 ; and other castes, 6. Amongst males the
age limit most affected (71.92 per cent.) was between 20 and 40 years, of
age; the succeeding twenty-year periods accounted for 22.97 per cent. At
the census the return under these age periods was 45 and 28 per cent. of
the total afflicted male population.

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