No. 44.
FROM

                    SURGEON MAJOR ARTHUR PAYNE, M. D.,

                              Superintendent of Asylums at the Presidency,

To

                    THE DEPY. INSPR. GENL. OF HOSPITALS,

                                                                      PRESIDENCY CIRCLE.

                                                                                          FORT WILLIAM,
                                                                             Dullunda, the 10th March 1869.

SIR,

I HAVE the honor of submitting herewith the several returns of
the Dullunda Lunatic Asylum, and of offering the following observations on
the facts which they set forth.

Admissions.—The aggregate of admissions and re-admissions does not differ
appreciably from that of last year; but the larger number remaining at the
close of 1867, and perhaps in some degree the method now employed of detain-
ing all recovered patients for discharge by the Visitors, have led to an increase
in the mean daily number of inmates, and affected the relation in which this
figure stands to the total number of individuals treated during the year.

From table 3 it will be seen that there has been a larger proportion of cases
of acute mania than in 1867. The distinction between this and the chronic
form has been, for the reason stated in my last report, based rather on the con-
dition of the person at the time of admission than on the duration of his symp-
toms, as throwing more light on the mortality of the year.

Of the causes of insanity information is, as usual, insufficient and unsatis-
factory ; smoking ganja predominates largely as before, and the proportion of
epileptics is high.

The proportion of the several creeds and sexes, as given in table 5, is very
uniform from year to year, and the same is true of the districts from which
the people come, Calcutta furnishing a number incomparably larger than any
other source.

Table 6, showing the previous occupation of the persons admitted in the
year, presents no feature of special interest.

The ratio per cent. of cures and transfers has risen on that of the previous
year from 25 to 29, a difference which may be traced to the increased proportion
of acute cases with their greater disposition to recovery.

There were 48 deaths during the year. The immediate cause in each case
is given in table No. 12. The several fatal conditions correspond with peculiar
closeness with those of the year 1867, the larger proportion of instances of
nervous exhaustion being due to the number of cases of acute mania, to which
form of insanity the risk of such exhaustion particularly belongs.