LUNATIC ASYLUMS IN BENGAL.                                  13

Bowel complaints.

Lung diseases.

and phthisis, five other deaths were due to lung complaints—one to gangrene, three to
congestion, and one to œdema. Dysentery constituted 9.38 per cent. of all the cases treated in
hospital, and 17 per cent. of these died. " Only one case was in good health when admitted into
the asylum." Of the nine deaths from dysentery, five occurred within a year of admission, one
after a year, and three between two and four years. 12 per cent. of the sick were cases of
diarrhœa, but only one case was fatal. Fourteen cases of pneumonia were treated (twelve
males and two females) with seven deaths, of which six were males. Of the four fatal
cases of phthisis, all were males. Of the remaining deaths from lung diseases, three were males
and two females. So that of 16 deaths from pulmonary complaints, 13 were males and three
females. It has been noted above that the male wards are more overcrowded than the
female, and the disproportionately large number of deaths occurring in the former would lend
color to the idea that this class of casualties is in great measure due to the excessive aggre-
gation of human beings in a limited space.

Sickness.

46. The sickness in the Dacca asylum was not unusual. It appears excessive as
compared with Dullunda, but I suspect that this is due to a different system of registration;
slight cases not being registered in the latter institution. There was no epidemic disease in
the asylum during the year, and only four cases of cholera occurred, two of which were fatal.

Cases of recurrent
insanity.

47. Dr. Smith records the following cases, which have an interesting relation to the
question of discharging criminal lunatics:—

" Of three men who were returned in 1873 as not insane, one, Beshye, became excited after five years'
residence in the asylum, during the whole of which period he never showed the slightest sign of
insanity. On the 19th April he suddenly broke forth into most violent maniacal excitement; and a second
man, Sumbhoo Ram Dass, who had remained for two years perfectly rational, suddenly became noisy,
filthy, ungovernable, and dangerous. The third case was that of a man named Muktar Ali, who, after
more than four years' residence in the asylum, during which he never showed the slightest signs of insanity,
broke forth into the most violent maniacal excitement.

" Such cases are of extreme importance, as proving how necessary it is to be cautious in discharging
criminals, even although they seem to be well. The three cases above cited were all due to fever. In each
of the cases the lunatic could remember nothing of the crime with which he was charged. In all three
cases the patients remained quiet, harmless, obedient, and rational. They were all recommended for
discharge by the visitors, and yet they ultimately became very violent and dangerous. It is thus most
difficult to decide after what period of apparent rationality a criminal lunatic, who has once evinced
homicidal impulse, can be discharged with perfect safety to himself and to society. It is clear from the
above cases that years of apparently complete recovery do not afford sufficient guarantee of lasting sanity."

Causation.

48. The following observations are recorded on the important subject of the causation of
insanity:—

The assigned causes
of insanity.

" Table No. 7 shews the assigned causes of insanity amongst the majority of those treated. In 1872 no
cause was ascertained in 20.6 per cent. of the cases, for 1873 in 18.4 per cent., this year in 13.5 per cent.

Physical and moral
causes.

" Physical causes are responsible this year for 63.2 per cent. of the cases, and moral causes for 23.3
per cent. In 13.5 per cent. of all the cases, the causes could not be discovered.

Ganjah.

" The abuse of ganjah this year accounts for 37.6 per cent. of the total admissions, against 29.16 per
cent. in 1873. Of the total 106 males admitted and re-admitted, 45, or 42.45 per cent., were said to be
insane from ganjah. This is an unusually high rate. Of the females, five out of 27 (i.e. 18.5 per cent.,) had
become insane from this cause.

" Of the criminal lunatics, five males and one female were admitted whose insanity was referred to
ganjah.

"Of these, one was a fisherman, another a tailor, the third a bhat, the fourth a beggar, the fifth a
gomastha's servant, and the sixth a prostitute. Eighty-five per cent. of the males were Hindus, and only
15 per cent. were Muhammadans.

Ganjah licenses
and the
consumption of
the drug.

"Certain changes have recently occurred with regard to the granting of licenses for the sale of ganjah.
Last year 249 ganjah licenses, granted in the district of Dacca, produced a revenue of Rs. 10,793, while this
year the number has been reduced to 107, and these have let for Rs. 35,904.

" The following statement shews the number of ganjah-shops, the quantity sold, and the amount realized,
year by year, from 1869-70 up to date:—

" It is possible that the diminution in the number of ganjah-shops and the higher charge for licenses may
tend somewhat to reduce the consumption of the drug. The duty on ganjah was raised from the 1st April
1872 from Rs. 2 to Rs. 2-8 a seer.

Spirits.

" The abuse of spirits is responsible for 6.13 per cent. of the total treated. Of 23 persons whose
insanity was due to this cause, 18 were males and five females.

Hereditary
predisposition.

" Hereditary predisposition was assigned as the cause in 29 cases (23 males and six females).

Fever.

" Fever accounts for 3.2 per cent. of the total number treated. Of 12 cases, 10 were males and two
females.

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